No, fluocinonide is not an antifungal cream. It is a potent topical corticosteroid (“steroid”) treatment used to treat skin inflammation (redness and swelling) and itching of conditions such as plaque psoriasis, atopic dermatitis (eczema) or other steroid-responsive skin conditions.

Can you combine fluocinonide cream with an antifungal?

Topical steroids are combined with antifungal medicines in some products, for example Lotrisone cream (betamethasone 0.05% / clotrimazole 1%) but are only used in patients 17 years of age and older for 2 to 4 weeks. These products are used short-term to treat athlete’s foot, jock itch and ringworm.

However, concerns do exist with the combined use of these agents. Combining topical steroids with antifungals may also result in a high rate of recurrence of the fungal infection and treatment failure. Many clinicians do not recommend the combined use of topical steroids and antifungals for this reason.

Children are more likely to absorb the steroid cream from Lotrisone through the skin. Patients younger than 17 years of age may have side effects such as HPA axis suppression (decreased production of the natural steroid hormone cortisol), skin atrophy (thinning), Cushing syndrome, high blood sugar, abnormal hair growth, and delayed growth.

How does fluocinonide work?

Corticosteroids (steroids) used on the skin such as fluocinonide work by decreasing the activity of natural chemicals in your body that lead to inflammation (swelling and pain). It inhibits the release of arachidonic acid and suppresses release of inflammatory chemicals such as kinins, histamine, or prostaglandins.

Fluocinonide is considered a high potency corticosteroid.

What are the side effects of fluocinonide?

Even though these products are used topically, they can still be absorbed through the skin and associated with important side effects. Local side effects are more likely to occur if the area is covered with an occlusive dressing (wrap) or with extensive or prolonged use of high strength medicines.

Higher strengths products, such as the 0.1% agents, should not be used on the face, groin, or axillae (armpit).

Side effects due to fluocinonide include:

• Localized skin effects such as: irritation, itching burning, contact dermatitis, skin atrophy or striae, folliculitis, or skin pigment changes.
• Endocrine and metabolic disorders such as: Cushing's syndrome, sugar in the urine (glycosuria), growth decline, HPA-axis suppression, adrenal crisis, high blood sugar (hyperglycemia).
• Skin infections

If you experience any irritation or side effect with the use of fluocinonide, contact your doctor immediately. This is not a complete list of side effects or warnings. Review the full fluocinonide monograph to see all reported side effects.

Bottom Line

• Fluocinonide is not an antifungal cream. It is a high potency topical corticosteroid (“steroid”) cream used to decrease inflammation and itching of conditions such as plaque psoriasis and atopic dermatitis (eczema).
• Antifungals are combined with steroid creams for use in conditions such as jock itch, ringworm or athlete’s foot (for example: Lotrisone cream) in patients 17 years of age and older. Many clinicians do not prescribe topical steroids with topical antifungal agents due to risk of side effects and treatment failure.
• Corticosteroids creams can be absorbed through the skin and cause side effects like skin thinning, pigment changes, and blood sugar changes. Follow your doctor’s instructions exactly and contact them if any side effects should occur.

This is not all the information you need to know about fluocinonide for safe and effective use. Review the full fluocinonide information here, and discuss this information with your doctor or other health care provider.