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Overview: Topical fluocinolone is used to treat skin conditions that involve inflammation and itchiness, including scalp psoriasis and atopic dermatitis. Common side effects from topical fluocinolone are skin reactions, such as redness, pain, and inflammation. Do not bandage, wrap, or otherwise seal the area where topical fluocinolone is used unless your health care provider instructed you to do so. Doing this could increase the amount of fluocinolone in your blood and possibly increase side effects.

Uses

What is topical fluocinolone used for?

Topical fluocinolone is commonly used to treat the following skin conditions.

  • Skin conditions that cause inflammation and itchiness
  • Scalp psoriasis, a skin condition that can cause itchy, painful raised patches, scales, or crust
  • Atopic dermatitis, a skin condition that can cause inflammation and irritation of your skin

Topical fluocinolone may also be used for other conditions as determined by your health care provider.

How does topical fluocinolone work (mechanism of action)?

Topical fluocinolone belongs to a group of medicines called corticosteroids. Topical corticosteroids may help reduce inflammation in your skin by calming down the immune system's defense cells (white blood cells). They may also stop these cells from releasing substances that cause inflammation. These medicines may also narrow blood vessels where they are applied, which may help to reduce swelling.

How is topical fluocinolone supplied (dosage forms)?

Brands and other names

  • Capex
  • Derma-Smoothe/FS
  • Synalar

Dosage forms and strengths

  • 0.025% topical cream
  • 0.01% topical cream
  • 0.01% topical oil
  • 0.025% topical ointment
  • 0.01% topical solution

Fluocinolone is also available as an ear drop. See Fluocinolone otic for more information. 

How should I store topical fluocinolone?

Topical Ointment, Cream, and Solution. Topical fluocinolone ointment, cream, and solution should be stored at room temperature, between 59 F and 77 F (15 C and 25 C). Do not freeze. Do not expose it to temperatures above 104 F (40 C).

Topical Oil. Topical fluocinolone oil should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Side Effects

What are the most common side effects of topical fluocinolone?

The most common side effects of topical fluocinolone are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Skin reactions (see below)
  • Common cold symptoms, including coughing, runny nose, fever, and sore throat (topical oil)

There may be other side effects of topical fluocinolone that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of topical fluocinolone?

While less common, the most serious side effects of topical fluocinolone are described below, along with what to do if they happen.

Severe Allergic Reactions. Topical fluocinolone may cause allergic reactions, which can be serious. Stop using topical fluocinolone and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Reduced Adrenal Function. Topical fluocinolone can pass through your skin and cause your body’s adrenal glands to stop making as much cortisol (the stress hormone). This is known as adrenal insufficiency. This is especially a concern if you use it over large skin areas or for a long period of time, wrap or cover the skin after applying it, use it on damaged skin, or use it with other corticosteroids. Adrenal insufficiency can get worse if your body is under stress because of fever, surgery, or trauma. Tell your health care provider if you have any of the following symptoms of adrenal insufficiency.

  • Nausea and vomiting
  • Weakness, tiredness, or lack of energy
  • Low blood pressure

Cushing’s Syndrome. Topical fluocinolone can cause Cushing’s syndrome, a condition that happens when your body is exposed to too much cortisol (the stress hormone). This is especially a concern if you use it over large skin areas or for a long period of time, wrap or cover the skin after applying it, use it on damaged skin, or use it with other corticosteroids. Tell your health care provider if you notice any of the following symptoms.

  • Rounded, rosy face
  • Weight gain, especially in the upper body
  • Thinning of skin
  • Acne
  • Unusual tiredness or weakness
  • Depressed mood or anxiety
  • Kidney stones
  • Sleep problems
  • Unusual hair growth

High Blood Sugar. Topical fluocinolone may increase your blood sugar levels, especially if you use it over large skin areas or for a long period of time, wrap or cover the skin after applying it, use it on damaged skin, or use it with other corticosteroids. It may also cause your body to leak sugar into your urine (pee). Keep all appointments with your health care provider to check your blood work. Talk to your health care provider about how to maintain healthy blood sugar levels. Call your health care provider if you have the following symptoms of high blood sugar.

  • Thirsty more than usual
  • Peeing more than usual
  • Increase in hunger
  • Tiredness
  • Feeling sick to your stomach
  • Confusion
  • Your breath smelling fruity

Skin Reactions. Topical fluocinolone may cause skin-related side effects. Tell your health care provider if you have any of the following side effects.

  • Inflamed hair follicles or skin swelling or burning
  • Bumps or blisters on the skin that may look like acne
  • Rash around your mouth
  • Lightening of skin color
  • Skin infections at the site of use
  • Skin thinning
  • Skin itching, dryness, cracking, or scaly skin
  • Stretch marks
  • Heat rash or sweat rash caused by blocked sweat glands

Vision Problems. Topical fluocinolone oil may cause cataracts and glaucoma, which can lead to blindness. Tell your health care provider right away if you have any of the following symptoms.

  • Cloudy or foggy vision
  • Nearsightedness
  • Changes in how you see colors
  • Problems with glare (such as traffic lights when driving at night)
  • Loss of vision
  • Eye pain or redness
  • Severe headache or vomiting
  • Seeing bright, colorful circles around lights (vision halos)

Warnings & Precautions

Who should not use topical fluocinolone?

Allergies to Ingredients. People who are allergic to any of the following should not use topical fluocinolone.

  • Capex
  • Derma-Smoothe/FS
  • Fluocinolone
  • Synalar
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific topical fluocinolone products they stock.

What should I know about topical fluocinolone before using it?

Do not use topical fluocinolone unless it has been prescribed to you by a health care provider. Use it as prescribed.

Do not share topical fluocinolone with other people, even if they have the same condition as you. It may harm them.

Keep topical fluocinolone out of the reach of children.

Topical fluocinolone is for use on the skin only. Keep topical fluocinolone ointment, cream, and solution away from your eyes. Keep topical fluocinolone oil away from areas such as your eyes, mouth, and vagina. 

Avoid using topical fluocinolone oil on your face, groin, or armpits unless your health care provider instructed you to do so. Topical fluocinolone oil should also be avoided on other areas where your skin can rub together.

Do not bandage, wrap, or otherwise seal the area where topical fluocinolone is applied unless your health care provider instructed you to do so. This includes applying topical fluocinolone to the diaper area (diapers or plastic pants may seal the area). The shower cap supplied with the scalp oil is an exception. The scalp should be covered with the supplied cap after applying it, as instructed.

After applying the scalp oil on your scalp, leave it on overnight or for at least 4 hours before washing it off.

Stop using topical fluocinolone oil once the skin condition is under control. Tell your health care provider if your condition does not improve after two weeks of using topical fluocinolone oil.

Topical fluocinolone, when used on children, may slow the height and weight growth. The risk may be higher in those who use it for an extended period of time. Tell your child’s health care provider if you have concerns about their growth.

What should I tell my health care provider before using topical fluocinolone?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if topical fluocinolone is right for you.

In particular, make sure that you discuss any of the following.

Other Medicines and Supplements. Topical fluocinolone may interact with other medicines and supplements. Before using topical fluocinolone, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Adrenal Gland Problems. Topical fluocinolone can cause reduced adrenal function. See the Side Effects section for more details. Tell your health care provider if you have any adrenal gland problems.

Diabetes. Topical fluocinolone can increase your blood sugar. See the Side Effects section for more details. Tell your health care provider if you have diabetes.

Liver Problems. Liver problems can increase your risk of developing serious side effects. Tell your health care provider if you have any known or suspected liver problems. 

Skin Infections. Tell your health care provider if you currently have a skin infection. The infection may need to be treated first before you can use topical fluocinolone.

Peanut Sensitivity. Topical fluocinolone oil contains peanut oil. Tell your health care provider if you are sensitive to peanuts or other products that contain peanuts.

Pregnancy. It is not known if or how topical fluocinolone could affect pregnancy or harm an unborn baby. Tell your health care provider if you are or plan to become pregnant.

Breastfeeding. It is not known if topical fluocinolone passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will advise you if you should use topical fluocinolone while breastfeeding. If you use topical fluocinolone while breastfeeding, avoid getting it on your nipple or areola.

Interactions

Does topical fluocinolone interact with foods or drinks?

There are no known interactions between topical fluocinolone and foods or drinks.

It is unknown if drinking alcohol will affect topical fluocinolone.

Does topical fluocinolone interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, skin products, and other supplements you are using.

In particular, make sure that you discuss if you are using or taking any other corticosteroid, including medicines you take by mouth as well as other medicines you apply to the skin. Examples include dexamethasone, methylprednisolone, or prednisone, which are medicines for certain inflammatory conditions.

This may not be a complete list of medicines that can interact with topical fluocinolone. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much topical fluocinolone?

If you or someone else has used too much topical fluocinolone, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of topical fluocinolone?

If you miss your scheduled dose of topical fluocinolone, apply it as soon as you remember. If it is almost time for your next scheduled dose, skip the missed dose and follow the original schedule. Generally, the scalp oil is used daily as needed. Do not apply topical fluocinolone more often than prescribed.