Fluocinolone Acetonide Shampoo: Uses, Benefits and Side Effects
Fluocinolone acetonide shampoo is a topical corticosteroid medication used to treat certain scalp conditions. It works by reducing inflammation, itching, and other symptoms associated with these conditions. This article provides a detailed overview of fluocinolone acetonide shampoo, including its uses, how it works, available brands and forms, storage instructions, potential side effects, warnings, precautions, and drug interactions.
Overview of Fluocinolone Acetonide
Topical fluocinolone is a corticosteroid used to treat skin conditions involving inflammation and itchiness, including scalp psoriasis and atopic dermatitis. It is available in various forms, including creams, ointments, oils, solutions, and shampoos.
What is Fluocinolone Acetonide Shampoo Used For?
Fluocinolone acetonide shampoo is primarily used to treat seborrheic dermatitis of the scalp, a common skin condition that causes dry, flaky, and itchy skin. Seborrheic dermatitis, also known as dandruff, is a skin disorder that results from neither too much moisture nor too much oil. The shampoo works by decreasing inflammation of the skin.
Topical fluocinolone, in general, 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 a healthcare provider.
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How Does Fluocinolone Acetonide Work?
Fluocinolone acetonide belongs to a group of medicines called topical corticosteroids. These medications may help reduce inflammation in the 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. Additionally, these medicines may narrow blood vessels where they are applied, which may help to reduce swelling.
Brands and Dosage Forms
Fluocinolone acetonide is available under various brand names and in different dosage forms:
- Brands: Capex, Derma-Smoothe/FS, Synalar, Fluoderm Mild Cream, Fluoderm Mild Ointment, Fluoderm Regular Cream, Fluoderm Regular Ointment, Fluolar Mild, Fluolar Regular, Fluonide Mild-Cream, Synalar Mild, Synalar Regular, Synamol.
- Dosage Forms: Topical cream (0.025%, 0.01%), topical oil (0.01%), topical ointment (0.025%), topical solution (0.01%), and shampoo.
Fluocinolone is also available as an ear drop (Fluocinolone otic).
How to Use Fluocinolone Acetonide Shampoo
This medication is for external use only. Do not take by mouth. Wash hands before and after use. Use this medication as directed on the prescription label at the same time every day. Shake well before using.
- Wet hair and scalp thoroughly.
- Shake the container well and apply about one ounce of the shampoo to the scalp area.
- Work the shampoo into a lather and leave on the scalp for 5 minutes.
- Wash hair and scalp thoroughly with water, rinsing two times. Also, rinse any other body parts (e.g., hands, face, neck, shoulders) that may have come in contact with the shampoo.
Do not bandage, wrap, or cover the affected area (e.g., avoid using shower caps or bathing caps) unless directed by your doctor.
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This shampoo should be used only on the scalp. Do not apply this medication to your face, neck, groin, or underarms. After applying the medication, wash your hands. Avoid getting this medication in the eyes, nose, or mouth. If you get the medication in these areas, rinse with plenty of water.
Do not use this medication more often or for a longer period than prescribed because the risk of side effects may be increased. Inform your doctor if your condition persists or worsens after 2 weeks.
Generally, the scalp oil is used daily as needed.
Storage Instructions
Proper storage of fluocinolone acetonide is essential to maintain its effectiveness and safety:
- Topical Ointment, Cream, and Solution: Store 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: Store 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.
- Keep the bottle tightly closed. Throw away any remaining shampoo after 2 months. Discard after 3 months.
Keep all medicines away from children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed.
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Potential Side Effects
Like all medications, fluocinolone acetonide shampoo can cause side effects. It is important to be aware of these potential effects and to contact a healthcare provider if they occur or worsen.
Common Side Effects
The most common side effects of topical fluocinolone are skin reactions, such as redness, pain, and inflammation. Other common side effects include:
- Common cold symptoms, including coughing, runny nose, fever, and sore throat (topical oil)
- Burning, stinging, irritation, dryness, or redness when first applied to the scalp
- Mild skin irritation, redness, or dryness
- Unexpected hair growth at the application site
If any of these effects persist or worsen, notify your doctor or pharmacist promptly.
Serious Side Effects
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)
- Acne, excessive hair growth, "hair bumps" (folliculitis), skin thinning/discoloration, or stretch marks may also occur.
- Rarely, it is possible this medication will be absorbed from the skin into the bloodstream. This can lead to side effects of too much corticosteroid. These side effects are more likely in children, and in people who use this medication for a long time or over large areas of the skin. Tell your doctor right away if any of the following side effects occur: unusual/extreme tiredness, weight loss, headache, swelling ankles/feet, increased thirst/urination, vision problems.
Reporting Side Effects
Contact your health care provider if you think you are having a side effect of a medicine. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345. In the US, call your doctor for medical advice about side effects.
Warnings and Precautions
Before using fluocinolone acetonide shampoo, it is important to be aware of certain warnings and precautions:
- Allergies: People who are allergic to fluocinolone, corticosteroids, or any of the ingredients in the specific product should not use topical fluocinolone. Your pharmacist can tell you all of the ingredients in the specific topical fluocinolone products they stock.
- General Precautions:
- 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.
- Medical History: Before using this medication, tell your doctor or pharmacist your medical history, especially of: other skin/scalp conditions (e.g., rosacea, perioral dermatitis).
- Skin Infections: Do not use if there is an infection or sore in the area to be treated. Skin infections can become worse when using this medication. Notify your doctor if redness, swelling, or irritation does not improve.
- Adrenal Gland Problems: Topical fluocinolone can cause reduced adrenal function. Tell your health care provider if you have any adrenal gland problems.
- Diabetes: Topical fluocinolone can increase your blood sugar. 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.
- 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. During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.
- 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. It is not known whether this drug passes into breast milk when applied to the skin. Similar medications pass into breast milk when taken by mouth. Consult your doctor before breast-feeding.
- Geriatric: No information is available on the relationship of age to the effects of fluocinolone topical in geriatric patients.
- Pediatric: Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of fluocinolone topical in the pediatric population. However, because of this medicine's toxicity, it should be used with caution. Children may absorb large amounts through the skin, which can cause serious side effects. If your child is using this medicine, follow your doctor's instructions very carefully. For the body oil form, safety and efficacy in children 3 months of age and younger have not been established.
Drug Interactions
Before using fluocinolone acetonide shampoo, it is important to inform your healthcare provider about all medications, supplements, and herbal products you are currently taking.
- 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.
- Corticosteroids: 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.
Other Interactions
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Dosage Information
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
- For redness, itching, and swelling of the skin:
- For topical dosage form (cream, ointment, and solution):
- Adults-Apply to the affected areas of the skin three to four times a day.
- Children-Use and dose must be determined by your doctor.
- For topical dosage form (body oil):
- Adults-Apply to the affected areas of the skin three times a day for up to 2 weeks.
- Children 3 months of age and older-Apply to the affected areas two times a day for up to 4 weeks.
- For seborrheic dermatitis:
- For topical dosage form (shampoo):
- Adults-Use on the scalp area once a day.
- Children-Use and dose must be determined by your doctor.
- For scalp psoriasis:
- For topical dosage form (scalp oil):
- Adults-Apply to the affected areas of the scalp and leave overnight.
- Children 2 years of age and older-Apply to the affected areas 2 times a day for up to 4 weeks.
If you miss a dose of this medicine, apply it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.
Additional Information
- This medication has been prescribed for your current condition only. Do not use it later for other skin problems unless told to do so by your doctor. A different medication may be necessary in those cases.
- Laboratory and/or medical tests (such as adrenal gland function tests) may be performed periodically to monitor your progress or check for side effects, especially if you use this drug for an extended period of time or apply it over large areas of the body. Consult your doctor for more details.
- Inform all your doctors you use or have used this medication.
- This drug should be used on the outside of your body only. Avoid contact with your eyes. Don’t use this medication on your face, genitals, rectal area, skin creases, or armpits. When applying the cream to hairy sites, part the hair to allow direct contact with the affected area.
- Your doctor may ask you to cover the affected area with a bandage or a wrap after applying the medication. Only do this if your doctor tells you to do so. If they don’t, avoid bandaging, covering, or wrapping the treated skin.
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