Fluocinolone, Hydroquinone, and Tretinoin (topical)

Overview

Fluocinolone, Hydroquinone and Tretinoin is used as a combination to help treat patients suffering from severe skin discoloration (melasma) of the face. The problem of melasma normally arises as hormone changes take place in women.

The Fluocinolone is known as a corticosteroid, which is a steroid medicine. The Hydroquinone is a type of bleaching agent. Finally, the Tretinoin is known as a retinoid, which is related to vitamin A. You should not attempt to access Fluocinolone, Hydroquinone and Tretinoin combination on your own as it is only available via a doctor's prescription.

It is known to interact with a wide variety of other drugs and substances and can cause a range of adverse side effects. Your doctor is best placed to decide whether it is indeed suitable for you, and can then advise on ways to minimise any unwanted side effects.

Condition(s) treated

  • Melasma of the face

Type of medicine

  • Cream

Side effects

As well as providing benefits, there is the possibility that Fluocinolone, Hydroquinone and Tretinoin will cause a range of different side effects in those using it. Some of these side effects are not very serious, and will simply pass as your body adapts to the medicine. However, in other cases, the side effects are more troubling and can require immediate medical assistance. Directly below is a list of these more serious side effects. If you experience any of these whilst using Fluocinolone, Hydroquinone and Tretinoin combination, contact your doctor straight away.

More common

  • Itching, burning, redness, drying, or peeling skin

Less common effects

  • Rash

Incidence unknown

  • Scaling and redness around the mouth

As mentioned, you could also encounter a range of other side effects which are less serious. Below is a list of such side effects. You may find that they pass gradually over time, in which case they won't need to be reported to your doctor. However, if they are persistent and causing you unwanted distress, then you can still contact your doctor. They may be able to advise on certain ways to limit the unwanted effects you are experiencing.

Less common

  • Dark red, raised, wart-like spots on the skin

Beyond this, there is the possibility that you may experience other side effects not listed. If this is the case, and the effects you are experiencing are troubling you, then you can contact your doctor and discuss these with them.

Dosage

Below you can find the typical dosages given to people suffering from melasma. However, do be aware that the exact prescription given to you by your doctor may differ from the one below. This is because the requirements of every patient may be different. You should not alter the dosage given to you by your doctor unless it is first discussed with them.

  • Adults. At least 30 minutes prior to bedtime, apply a thin layer of Fluocinolone, Hydroquinone and Tretinoin to the affected areas of the skin.

It is important that you apply the cream at all scheduled times each day. If you miss a dose, then you should take the missed dose straight away. However, if it is almost time for your next dose, then simply skip the missed dose and go back to the regular schedule.

It is imperative that you follow your doctor's prescription as closely as possible. You should not use Fluocinolone, Hydroquinone and Tretinoin for longer than required, more often, and shouldn't use more of it. Doing this will likely lead to unwanted skin irritation and side effects. Be aware that this medicine is not suitable for long-term use.

You will find a patient information insert given with this medicine. You should read this carefully before using and then address any questions to your doctor.

It is important that you only use this medicine on your skin, and do not get it in your mouth, eyes, or nose. Similarly, do not apply it to areas with burns, scrapes, or cuts. If you do apply it to any of these areas by accident, then you should rinse it off immediately with water.

If you have other skin conditions then you should not use this medicine for that unless authorized to do so by your doctor.

Here is a standard guide to using the Fluocinolone, Hydroquinone and Tretinoin combination.

  • You should thoroughly wash your hands with both water and soap prior to and after using this medicine.

When out during the day, apply a sunscreen that has a factor of at least SPF 30. You should also wear protective clothing.

During the daytime, you may also still use other cosmetics and moisturizers.

Interactions

There is the possibility that the Fluocinolone, Hydroquinone and Tretinoin combination will interact with other drugs you are currently taking. In many cases, these interactions can be quite severe, so must be avoided where possible. Prior to prescribing you this cream, your doctor will, therefore, require you to disclose any and all drugs you are currently using. This will include prescription and non-prescription drugs, as well as any herbal vitamins or supplements. Directly below is a list of drugs which are known to react more severely with the Fluocinolone, Hydroquinone and Tretinoin combination and so it is usually recommended you do not use the two at the same time. However, if it is necessary that you continue to take both, our doctor may need to limit the dosage of one or both.

  • Lymecycline

Furthermore, if you use the Fluocinolone, Hydroquinone and Tretinoin combination with any of the following drugs, there could be an increased risk of certain side effects occurring. Nonetheless, taking both may still be the best course of treatment. Again, your doctor may need to limit the dosages of each medicine.

  • Ketoconazole

As well as interacting with drugs, it could be that the Fluocinolone, Hydroquinone and Tretinoin combination will interact with other areas of your dietary intake. This could include what you eat, drink and smoke. Your doctor may require you to limit the intake of certain things, such as tobacco or alcohol, so as to limit the chance of unwanted interactions.

Finally, other medical problems you are currently suffering from could interact with the medicine. You should be honest with your doctor about your full medical history. In particular, be careful in highlighting any of the following if they apply to you.

  • Sulfite allergy. Use the medicine with caution as it contains sodium metabisulfite.

Warnings

As a part of your consultation prior to prescribing this medicine, your doctor will need to understand the extent of your medical condition. This includes any allergies you have to animals, foods, preservatives, dyes or other drugs. You should be honest in helping them understand any allergies you have, as these could be aggravated by the medicine.

As of writing, no safety and efficacy have been established for the use of Fluocinolone, Hydroquinone and Tretinoin combination on the pediatric population. This is because a lack of appropriate studies have been conducted into the effects it has on younger patients.

With regards to geriatric patients, any studies performed have not highlighted any problems that would limit the usefulness of this medicine. However, be aware that older patients do tend to be more susceptible to having liver, kidney or heart problems. This may, in turn, require adjustments to be made to the doses prescribed to elderly patients.

As of writing, it is not clear as to whether appropriate studies have been conducted into the usefulness of this drug on pregnant women. Our doctor is best placed to understand any increased risks and weigh them against the benefits. If you become pregnant at any time whilst using the Fluocinolone, Hydroquinone and Tretinoin combination, you should inform your doctor immediately.

Similarly, no adequate studies have been performed on women who are breastfeeding and using the medicine. Instead, you will need to weigh the risks and benefits with your doctor prior to prescription.

Yoru doctor will schedule regular appointments to check the condition of your melasma and the effect this drug is having. It is important you attend these as your doctor may need to make adjustments to your prescription.

If you are planning to become pregnant or are pregnant whilst using this medicine, you should let your doctor know. Similarly, if you become pregnant whilst using it, be sure to tell your doctor.

Using this medicine can potentially cause a skin condition known as exogenous ochronosis. This will appear as a blue-black discoloration of your skin. If you notice any gradual darkening of your skin, inform your doctor right away.

You should try and avoid direct sunlight and any tanning beds whilst using this cream, as it can make your skin more sensitive to light, cold weather and wind.

If you experience any burning, redness, itching, dryness or peeling when using this medicine, you can use a moisturizer to help lessen the problems.

This medicine is only for short-term use, as using it for too long, or using too much of it, can lead to adrenal gland problems. If you notice more than one of the following symptoms whilst using this medicine, contact your doctor immediately.

  • Irritability

If you get sunburn then you should stop using this medicine until the affected area has fully healed.

You shouldn't use any other medicines on the areas you are treating unless they have been first approved by your doctor. Avoid using any medicine or creams that will irritate or dry your skin. This includes products such as soaps or cosmetics that cause dryness, products that contain alcohol, astringents, spices, or lime, rough skin cleansers or wart removal products.

Storage

You should store your Fluocinolone, Hydroquinone and Tretinoin combination in a refrigerator and keep it away from children. Do not allow it to freeze at any time. Once you are done with the medicine, or if it goes out of date at all, then you should dispose of it in a safe and sensible manner. Yoru doctor can advise on how is best to do so.

Summary

If you are suffering from melasma on your face, then the Fluocinolone, Hydroquinone and Tretinoin combination could be a very useful medicine to help treat the affected areas. However, using this cream does have the potential to cause a range of side effects, and is not suitable for certain patients. You should only use it if prescribed by your doctor. You should then follow their exact guidance as closely as possible to help limit any unwanted side effects.

Above you can find more information on the sorts of side effects that can occur, and what to do if you experience them. Be careful in how you store the medicine, and keep it safely away from any pets of children as it can be harmful to them. To help get the most out of this medicine, you should avoid getting sunburn and take any necessary preventative measures. If you have any other questions regarding the use of this medicine, you should address them to your healthcare professional.