Fludroxycortide

How it works

It binds cytoplasmic glucocorticoid receptors to exert anti-inflammatory, immunosuppressive and vasoconstrictive effects in the skin.

Prescribing in practice

• Prolonged or extensive use, occlusion, or application to the face and flexures increases the risk of skin atrophy, striae and systemic absorption; use the lowest effective potency for the shortest time.
• The impregnated tape provides occlusion that enhances potency and is suited to thickened or localised lesions but raises local and systemic absorption.
• Avoid use on untreated infected skin, and treat secondary bacterial, fungal or viral infection appropriately.

Monitoring

No routine laboratory monitoring is required; review for treatment response and local steroid side effects such as thinning, telangiectasia and perioral dermatitis.

Counselling the patient

• Apply a thin film to affected areas only and avoid the face unless specifically directed.
• Do not use on broken or infected skin without medical advice.
• Use only for the period advised and step down as the skin improves.

Evidence & guidelines

Topical corticosteroids are a mainstay of eczema flare management in NICE guidance, with potency matched to disease severity and body site.