You only need to use a small amount of cream or ointment. Apply it thinly just to the areas affected, and then massage it gently into the skin. It must not be applied more than twice a day, and once a day is often sufficient.
Topical corticosteroids should not be used for long periods of time or on large areas of the body, especially in children.
Fluocinolone (unless combined with an antibacterial agent) should not be used on infected areas of skin.
|Type of medicine||A topical corticosteroid|
|Used for||Inflammatory skin conditions such as eczema and dermatitis|
|Available as||Cream, gel, ointment|
Fluocinolone is classed as a topical corticosteroid. Topical corticosteroids are also referred to as topical steroids. Topical steroids are used in addition to moisturisers (emollients) for treating inflammatory skin conditions such as eczema and dermatitis. A topical steroid is used when patches of eczema or dermatitis flare up. Fluocinolone relieves the symptoms of a flare-up by reducing inflammation, itching and redness. It is not a cure for the condition, but it will help to relieve the symptoms. Short courses of fluocinolone may also be prescribed for the treatment of small areas of psoriasis.
It is likely you will be prescribed a cream if the affected areas of your skin are moist or weeping, or an ointment if your skin is dry, or a gel for hairy areas of skin such as the scalp.
There are three strengths of fluocinolone. Preparations which contain 0.025% fluocinolone (Synalar®) are classed as potent topical steroids. Preparations containing 0.00625% fluocinolone (Synalar 1 in 4 Dilution®) are classed as moderately potent and, the lowest-strength cream which contains 0.0025% fluocinolone (Synalar 1 in 10 Dilution®) is classed as a mild topical steroid. The higher strengths may be prescribed initially to control your symptoms if they are severe, and then as soon as your symptoms improve, the strength will be reduced. Fluocinolone may be prescribed for a child but the less potent strengths are usually preferred.
There are also fluocinolone preparations available which contain antibacterial agents. These are Synalar C® (fluocinolone with clioquinol) and Synalar N® (fluocinolone with neomycin). You may be prescribed one of these preparations for short-term use if your skin has become infected. They are typically used twice a day for one week only.
Before using fluocinolone
To make sure this is the right treatment for you, before you start using fluocinolone it is important that your doctor or pharmacist knows:
- If you have any areas of infected skin.
- If you have rosacea or acne.
- If you are pregnant or breast-feeding.
- If you have ever had an allergic reaction to a skin preparation.
How to use fluocinolone
- Before you start using this preparation, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about topical steroids and will provide you with a full list of side-effects that you may experience from using them.
- Your doctor will tell you how often to apply fluocinolone. It must not be applied more than twice a day, and once a day is often sufficient.
- Do not use fluocinolone on any areas of infected skin unless you have a preparation which also contains an antibacterial (Synalar C® or Synalar N®). If you are using one of these preparations, use it regularly twice daily for one week only, unless you have been directed otherwise by your doctor.
- The amount of topical steroid that you should apply is commonly measured by fingertip units (FTUs). One FTU is the amount of cream or ointment that is squeezed out along an adult's fingertip (that is, from the very end of the finger to the first crease in the finger). As a guide, one FTU is enough to cover an area twice the size of an adult hand. Your doctor will give you an idea of how many FTUs you will need to cover the area of your skin which is affected.
- If you are using more than one topical corticosteroid, make sure you know how and where to use each one. If you are unsure, check with your doctor or ask your pharmacist for further advice.
- After you have applied fluocinolone, wash your hands (unless your hands are the treated area).
- If you are using fluocinolone for psoriasis, make sure you follow your doctor's instructions carefully. It should not be used for large areas of psoriasis or for long periods of time, as this can cause your symptoms to flare up afterwards.
Getting the most from your treatment
- If you are using a moisturiser along with this preparation, apply the moisturiser first. Then wait 10-15 minutes before applying fluocinolone. This allows time for the moisturiser to be absorbed before the topical corticosteroid is applied. Your skin should be moist but not slippery when you apply fluocinolone.
- Do not use fluocinolone on your face unless your doctor has said you should. If you have been told to use it on your face, be careful not to get any preparation near your eyes and do not use it for longer periods of time than you have been advised.
- Unless advised to do so by your doctor, do not apply a bandage or dressing to the area being treated, as this will increase absorption of the steroid and increase the risk of side-effects.
- It is generally recommended that you continue to use fluocinolone until the flare-up is controlled, and then stop it. A course of treatment for 7-14 days is usually sufficient. Your doctor may prescribe one of the lower-strength preparations for you to use after this time. If your symptoms do not improve (or if they get worse), speak again with your doctor for further advice. Topical corticosteroids like fluocinolone should not be used for long periods of time or on large areas of the body, especially in children.
- If you are using the brand called Synalar C®, be careful not to let the preparation come into contact with your clothing, as it may stain.
- After you finish using fluocinolone, continue to use your moisturiser every day. This will help to prevent a further flare-up.
Can fluocinolone cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. You can reduce the risk of side-effects from fluocinolone, by applying the preparation thinly, no more than twice a day, and to the affected areas only.
|Side-effects of fluocinolone||What can I do if I experience this?|
|A burning sensation, or smarting||These may occur in the first few days but usually get better after this|
|Thinning of the skin, permanent stretchmarks, allergic contact dermatitis, acne, rosacea, and hair growth at the site of application||These would normally only affect you if you use fluocinolone for long periods of time|
|The steroid may get through your skin and into your bloodstream||This usually causes no problem unless you use fluocinolone regularly for long periods of time on large areas of your skin|
Speak with your doctor or pharmacist for further advice if you experience these or any other side-effects which you think may be due to using fluocinolone.
How to store fluocinolone
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Make sure that the person supplying this medicine knows about any other medicines that you are taking or using. This includes medicines you buy and herbal and homeopathic medicines.
Before using this medicine tell your doctor if you have ever had an allergic reaction after taking or using any medicine.
Never use more than the prescribed dose. If you suspect that someone has swallowed some of the medicine by accident, contact the accident and emergency department of your local hospital for advice.
If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking or using.
If you buy any medicines check with a pharmacist that they are safe to take with your other medicines.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading & references
- British National Formulary; 68th Edition (Sep 2014) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr Adrian Bonsall