Topical corticosteroids (topical "steroids") like fluocinonide have been used to treat areas of hair loss in alopecia areata. Treatment, often applied once or twice a day, may be needed for 3 months or longer, but recurrence is common. Some people with this condition will respond to high dose topical corticosteroids applied to the areas with hair loss.

Fluocinonide is not specifically approved by the FDA to treat alopecia areata, but may still be prescribed by your doctor for this condition in an “off-label” fashion. Off-label drug use refers to prescribing a medication for a different purpose than those formally approved by the FDA and found in the package labeling of the drug.

Alopecia areata is thought to be an autoimmune skin condition that leads to patchy hair loss on the scalp. If you are experiencing worrisome hair loss, talk to your doctor for evaluation.

Is treatment always needed?

Alopecia areata can occur in adults and children, but treatment may not always be needed. Hair loss can spontaneously grow back within 12 months or less in roughly 50% of patients even without treatment. Topical corticosteroids may not be as beneficial for people with severe hair loss, and not all patients will have a good response.

Alopecia areata can lead to a reduced quality of life, lowered self esteem, and excessive worry in a patient’s life, although the condition is considered benign.

Studies of fluocinonide for alopecia areata

• In one small study of 13 patients, researchers compared 0.2% fluocinolone acetonide cream twice a day with the vehicle (the cream without any active drug).
• Patients applied the fluocinonide cream to one half of the head, and the vehicle to the other half. Fluocinonide was under occlusion (wrapped with plastic or cloth) at night.
• Results showed hair regrowth in 54% in the treatment arm compared with 0% in the vehicle group.

The most effective initial therapy for alopecia areata with few patches of bald spots is a course of corticosteroid intralesional injections (such as triamcinolone). Injections are made in the affected scalp areas every 4 to 8 weeks to suppress the immune response and allow for hair regrowth.

Injections may not be acceptable or possible for some patients, and other options may be needed, such as topical steroids or minoxidil 5% solution (Rogaine), as prescribed only by a doctor. Topical immunotherapy can also effective for more extensive disease. Anthralin has also been used, among other options.

Other topical steroids such as clobetasol, fluocinolone or betamethasone have been used.

Learn more:

• Does Clobex help hair growth?
• Does Clodan shampoo work for hair loss?

How does fluocinonide come at the pharmacy?

Fluocinonide comes as a brand name product (brand name: Vanos 0.1%) or as a generic option in a topical solution, cream, ointment, and gel. Solutions, gels and creams may be preferable over ointments in the scalp area. Generic options can save you money. Ask your doctor to prescribe generics if you prefer.

• Fluocinonide is a topical corticosteroid medicine used on the skin approved by the FDA to treat inflammation and itching caused by plaque psoriasis, eczema or other skin conditions.
• It can relieve symptoms such as redness, itching, dryness and scaling.
• Do not use topical steroids on your face, groin, or axillae (underarm area) or cover your affected area with an occlusive dressing or bandage unless told to do so by your doctor. Do not apply to inflamed, wounded or bleeding areas of the skin.

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.