Fluocinolone, hydroquinone, and tretinoin Topical application

Fluocinolone, hydroquinone, and tretinoin topical is a combination of medicines used to treat moderate to severe melasma (skin discoloration) of the face. Melasma usually happens with hormone changes in women.

Fluocinolone is a corticosteroid (steroid medicine), hydroquinone is a bleaching agent, and tretinoin is a retinoid (related to vitamin A).

fluocinolone, hydroquinone, and tretinoin is available only with your doctor's prescription.

It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to use it.

Make sure your doctor knows if you are pregnant or planning to become pregnant. If you become pregnant while using fluocinolone, hydroquinone, and tretinoin, tell your doctor right away.

fluocinolone, hydroquinone, and tretinoin may cause a skin condition called exogenous ochronosis, which is a blue-black discoloration of the skin. Check with your doctor right away if you have a gradual darkening of the skin.

fluocinolone, hydroquinone, and tretinoin may make your skin more sensitive to sunlight, wind, and cold weather. Avoid sunlamps and tanning beds.

Skin reactions such as dryness, redness, peeling, burning, or itching can occur when you use fluocinolone, hydroquinone, and tretinoin. Use a moisturizer as needed to lessen these skin problems.

Using too much of fluocinolone, hydroquinone, and tretinoin or using it for a long time may increase your risk of having adrenal gland problems. Talk to your doctor right away if you have more than one of these symptoms while you are using fluocinolone, hydroquinone, and tretinoin: blurred vision, dizziness or fainting, a fast, irregular, or pounding heartbeat, increased thirst or urination, irritability, or unusual tiredness or weakness.

If you have a sunburn, stop using fluocinolone, hydroquinone, and tretinoin until your skin is healed.

Do not use any other medicines on the treated skin areas without talking to your doctor. Avoid using any skin care products that can dry or irritate your skin. These include rough skin cleansers, wart removal products, soaps or cosmetics that cause dryness, or products that contain alcohol, astringents, spices, or lime.

Commonly reported side effects of fluocinolone/hydroquinone/tretinoin topical include: burning sensation, desquamation, pruritus, erythema, and xeroderma. See below for a comprehensive list of adverse effects.

Data not available

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Administration advice:
-This drug is to be used topically, and should not be given orally, ophthalmically, or intravaginally.
-Moisturizers and cosmetics may be used on the affected area(s) during the day.

Storage requirements:
-When not in use, this drug should be kept in a refrigerator (2 to 8C).

General:
-Patients should avoid sunlight exposure, and should be instructed to use an SPF 30 sunscreen and wear protective clothing during the day.
-Long-term/maintenance treatment should be avoided. Once patients achieve control of melasma, they may be switched over to other treatments; however, melasma usually recurs after discontinuation of this drug.
-Safety and efficacy of this drug have not been established in patients with Fitzpatrick Skin Types V and VI; these patients may develop excessive skin bleaching.

Monitoring:
-Hypersensitivity and cutaneous reactions
-Hypothalamus-pituitary-adrenal axis suppression, especially in patients receiving long-term therapy

Patient advice:
-Patients should be advised to avoid concomitant photosensitizing drugs.
-Patients should told to avoid concomitant use of medicated/abrasive soaps/cleansers, drying soaps/cosmetics, products with high concentrations of alcohol/astringents, and other irritant/keratolytic drugs.
-Patients should be instructed to contact their healthcare provider if hypersensitivity reactions or exogenous ochronosis occurs.