Fluocinolone Acetonide is a corticosteroid with anti-inflammatory, antipruritic and vasoconstrictor properties. It is used in the treatment of various skin disorders (e.g. eczema, dermatitis, allergies, rashes) and is used to reduce skin inflammation. It is also used to treat acute otitis externa (AOE), retinopathy and melasma.

Acute Otitis Externa (AOE)

The combination of ciprofloxacin, 0.3%, plus fluocinolone acetonide, 0.025%, has already shown superiority vs ciprofloxacin alone for the treatment of diffuse otitis externa and vs ciprofloxacin or fluocinolone acetonide alone for children with acute otitis media with tympanostomy tubes (AOMTs). This combination is currently approved to treat AOE and AOMTs in more than 50 countries outside the US and for AOMTs in the US and Canada. In addition, studies have shown the benefits of using a combination of the antibiotic ciprofloxacin and the corticosteroid fluocinolone acetate prednisone for better control of bacterial infections as well as typical signs and symptoms of illness in patients with AOE.

Intravitreal Fluocinolone Acetonide implants

A study of the visual outcome of intravitreal fluocinolone acetonide implants for the treatment of chronic postoperative macular oedema. We analyzed 16 consecutive eyes of 16 patients with chronic, post-surgical CME treated with fluocinolone acetonide intravitreal implant. Surgical indications included cataract surgery, vitrectomy plus membrane peeling and combined phaco-vitrectomy. Baseline mean BRVA of 0.8?±?0.65 logMAR improved to 0.60?±?0.4 logMAR (p?=?0.02) at 12 months and to 0.7?±?0.5 logMAR (p?=?0.32) at 24 months. At month 12, BRVA improved in 11 eyes, stabilized in 4 eyes, and decreased in 1 eye. At month 24, VA remained improved in 5 eyes, remained stabilized in 5 eyes, and decreased in 1 eye. Mean CRT decreased from 524?±?132?μm at baseline to 389?μm at month 3, 347?μm at month 6, 355?±?106?μm (p?=?0.0003) at month 12, and 313?±?83?μm (p?=?0.0001) at month 24. At 12 months, CRT improved in 13 eyes and remained unchanged in 2 eyes. At 24 months, CRT improved further in 8 eyes, and stabilized in 3 eyes. Increased IOP (≥21?mmHg) was observed only in 4 eyes, all successfully managed with topical medication. No further side effects were observed in any patient. These results suggest that a single fluocinolone acetate lactone implantation in CME eyes with a long history of prior treatment and severe disease can improve vision and anatomy within 24 months with fewer side effects.

Melasma

Studies have shown that topical fluocinolone 3-in-1 cream (hydroquinone 4%, tretinoin 0.05%, fluocinolone acetate 0.01%) can be used for the treatment of melasma. However, the product can cause side effects such as erythema, hirsutism, hyperpigmentation, and acne-like lesions.

Side Effects

Fluocinolone Acetonide can cause common side effects like stinging, burning, itching, dryness, and redness at the application site, which usually subside as your body adjusts. More serious side effects include stretch marks, skin thinning or discoloration, acne, unwanted hair growth, and folliculitis. Skin infections may worsen with use, and failure to improve is a signal to consult a doctor. Rare system absorption can lead to corticosteroid excess symptoms such as extreme tiredness, weight loss, headache, swelling, increased thirst or urination, and vision issues, especially in children or with prolonged use. Allergic reactions like rash, severe itching, swelling, dizziness, and breathing issues are rare but require immediate medical attention. Consult a healthcare professional for any other effects not listed.

References:

[1] LAURENCE CHU. Efficacy and Safety of Ciprofloxacin Plus Fluocinolone Acetonide Among Patients With Acute Otitis Externa: A Randomized Clinical Trial.[J]. JAMA Network Open, 2022. DOI:10.1001/jamanetworkopen.2022.21699.

[2] ARGYRIOS CHRONOPOULOS. Intravitreal fluocinolone acetonide implant for chronic postoperative cystoid macular edema - two years results.[J]. European Journal of Ophthalmology, 2022. DOI:10.1177/11206721221124688.

[3] M. K. SHAHZAD. Comparing Efficacy of Intradermal Tranexamic Acid (TA) Verses Fluocinolone-Based Triple Combination (Hydroquinone 4%, Tretinoin 0.05%, Fluocinolone Acetonide 0.01%) Therapy in the Treatment of Melasma[J]. Pakistan Journal of Medical and Health Sciences, 2021. DOI:10.53350/pjmhs211551714.