What is a substitute for fluocinonide cream?

Fluocinonide cream 0.1% (brand name: Vanos) is a highly potent corticosteroid (“steroid”) cream used to treat redness and itching due to plaque psoriasis, atopic dermatitis (eczema) or other skin conditions. Fluocinonide can relieve symptoms such as inflammation and pain, itching, crusting, and scaling.

Examples of substitutes that could be used in place of fluocinonide cream include: clobetasol, halobetasol or betamethasone cream, depending upon which strength of fluocinonide you are using. You will need to see your doctor, as all of these creams require a prescription.

Prescription corticosteroid creams come in various potencies and are often classified by their strengths.

• For example, fluocinonide is considered to be a super-highly potent (0.1%) to highly potent topical corticosteroid (0.05%) and is among the strongest of corticosteroids.
• Your doctor will be able to assess your skin condition and determine the best type and potency of medication for you to use.

Cream formulations are usually stronger than lotions but less potent than ointments, which will have greater skin penetration. Creams have a high percentage of water in the vehicle and can be easily washed off. Patients often find creams preferable over ointments or solutions, which may be messy. Creams are often used on smooth non-hair areas, areas with thickened skin, the palms of the hands or the soles of the feet, and in skin fold areas.

Which other steroid creams are like fluocinonide?

Fluocinonide 0.1% cream (Vanos), a “super-high potency” corticosteroid, is found in the Group 1 US classification of corticosteroids, the most potent classification. Other topical corticosteroids creams in this super-high potency (Group 1) that may be appropriate substitutes include:

• clobetasol propionate 0.05% cream
• halobetasol propionate 0.05% cream (Ultravate)

Fluocinonide 0.05% cream (only available as generics) is grouped in the high potency (Group 2 and 3) classification of corticosteroids, the second and third most potent group of topical steroids. Some other topical corticosteroids in high potency group 2 and 3 that may be appropriate substitutes include:

• amcinonide 0.1% cream
• betamethasone dipropionate 0.05% cream (Diprolene AF)
• clobetasol propionate 0.025% cream (Impoyz)
• desoximetasone 0.25% or 0.05% cream (Topicort)
• diflorasone diacetate 0.05% cream (ApexiCon E)
• fluticasone propionate 0.005% cream (Cutivate)
• halcinonide 0.1% cream (Halog)
• triamcinolone acetonide 0.5% cream (Triderm)

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What factors affect the selection of a steroid cream?

Beside strength and potency classification, other important factors to consider when selecting a topical corticosteroid include:

• dosage form (i.e., lotion, solution cream, ointment, etc)
• total area of application
• type of lesion (i.e., moist vs. dry or scaly)
• place to be applied (i.e., hairy vs. non-hairy area, skin-fold area)
• cost or insurance coverage

Is there an OTC substitute for fluocinonide cream?

Because of the potency classification of fluocinonide, there are not any over-the-counter (OTC) options available as a substitute. You will need to contact your doctor about getting a substitution for this cream, as it will require a prescription.

Hydrocortisone (brand example: Cortiosone) is a topical corticosteroid available OTC, but it is very weak (least potent, group 7) when compared to fluocinonide and is not an appropriate substitute. OTC hydrocortisone is considered the weakest of topical corticosteroids, but it is safer to use than the more potent agents, and that's why it does not require a prescription.

Bottom Line

• Fluocinonide cream 0.1% (Vanos) is a highly potent corticosteroid (“steroid”) cream used to treat redness and itching due to plaque psoriasis, atopic dermatitis (eczema) or other skin conditions.
• Examples of substitutes that could be used in place of fluocinonide cream include: clobetasol, halobetasol or betamethasone cream, depending upon which strength of fluocinonide you are using. Other options are available, too.
• You will need to see your doctor, as all of these creams require a prescription.

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.