Potent topical corticosteroid Pregnancy: There is inadequate evidence of safety in human pregnancy; topical steroids given to pregnant animals can cause abnormalities of foetal development including cleft palate and intrauterine growth retardation, so there may be a very small risk of such effects on the human foetus. Lactation: do not apply to the breasts prior to nursing; elsewhere minimise both the amount applied and the length of treatment.

Fluocinonide

Brand names: Metosyn

Fluocinonide is a potent topical corticosteroid used for steroid-responsive inflammatory dermatoses such as eczema and psoriasis.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Fluocinonide 0.05% w/w cream (Metosyn FAPG) — apply a small quantity to the affected area and massage well in

Route: Topical

Frequency: Three to four times daily; once improvement is apparent usage may be reduced to twice or even once daily

Use undiluted. The label will state strong steroid. Treatment on the face should not normally be extended beyond 5 days, and occlusion in such cases should not be used. Where there is bacterial infection associated with an inflammatory skin condition, only administer if adequate antibacterial cover is also given. Elderly: as adult dose. Paediatric (SPC section 4.2, no numeric dose given): not advised in children under one year of age; over one year, as adult dose, but treatment should not normally be extended beyond five days and occlusion should not be used.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Rosacea, acne and peri-oral dermatitis
Tuberculous, syphilitic, fungal and viral infections of the skin
Should not be used for napkin eruption or anogenital pruritus

Side effects

Hypersensitivity (extremely rare)
Irritation at the site of application (infrequent)
Local atrophic changes with extensive treatment, occlusive dressings or in skin folds — striae, skin thinning, telangiectasia
Systemic effects such as adrenal suppression (features of hypercorticalism), especially in infants and children
Contact dermatitis, perioral dermatitis, acne or worsening of acne or acne rosacea, mild (possibly reversible) depigmentation, hypertrichosis
Withdrawal reactions — redness extending beyond the initial affected area, burning or stinging, itch, skin peeling, oozing pustules
Spread of opportunist infection if used on infected lesions without appropriate anti-infective therapy

Interactions

None known (SPC section 4.5)

Clinical monograph

How it works

It binds glucocorticoid receptors in skin cells to produce anti-inflammatory, immunosuppressive and vasoconstrictive effects.

Prescribing in practice

Because it is potent, prolonged use, large surface areas, occlusion, or use on the face and flexures increases the risk of skin atrophy and systemic absorption; use the lowest effective potency for the shortest time.
Reserve potent steroids for thicker or more resistant lesions and step down as the condition improves.
Avoid application to untreated infected skin.

Monitoring

No routine laboratory monitoring is required; review for treatment response and signs of local steroid-induced skin changes.

Counselling the patient

Apply a thin layer to affected skin only and avoid the face unless specifically advised.
Do not use on infected or broken skin without medical advice.
Keep using emollients alongside the steroid.

Evidence & guidelines

Potent topical corticosteroids are an established option for resistant inflammatory dermatoses, consistent with NICE potency-matched prescribing.

Reference: Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

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