Topical triamcinolone acetonide

What is topical triamcinolone acetonide?

Triamcinolone acetonide — a topical drug used to treat various inflammation-related skin conditions — is an anti-inflammatory medication that belongs to a group of drugs known as corticosteroids.¹

It is considered a medium- to high-potency topical steroid.²

The medication works by regulating the production of natural substances that cause swelling and inflammation and calming an overactive immune system. This helps relieve the itching, pain, and redness that result from these conditions.³

What is triamcinolone acetonide used to treat?

Triamcinolone acetonide is prescribed to treat several inflammatory and allergic skin conditions, including psoriasis, contact dermatitis, and eczema. The medication helps improve the symptoms of these conditions, such as redness, itching, dryness, crusting, scaling, pain, and inflammation.⁴

What You Need To Know About Eczema

The dental paste formulation is used to relieve symptoms of inflammatory sores and ulcerative sores caused by trauma. This formulation is not indicated for use in children.⁵

Dosage forms and strengths

The available topical dosage forms are as follows:

• Cream (generic, Triderm): 0.025%, 0.1%, 0.5%⁶ ⁷

• Ointment:

  • Generic: 0.025%. 0.05%, 0.1%, 0.5% ⁸ ⁹ ¹⁰

  • Trianex: 0.05%¹¹

• Lotion: 0.025%, 0.1%¹²

• Spray (generic): 0.147mg/g¹³

• Dental paste: 0.1%¹⁴

How do you use topical triamcinolone acetonide?

Cream/ointment/lotion

Your dosage schedule will depend on the severity of your condition. Follow your doctor’s or pharmacist’s usage instructions carefully.

Apply a thin layer of the cream/lotion/ointment to the affected area. Rub it in gently.¹⁵

Take care not to get the medicine in your eyes. Wash your hands well with soap immediately after applying the medication.

Using an occlusive dressing

Your doctor may recommend using an occlusive dressing to manage psoriasis or if you have another condition with symptoms that don’t improve with treatment.¹⁶

Do not use occlusive dressings if:

1. The area is infected

2. Your doctor has not recommended this method

Spray

Shake the aerosol can well and spray it onto the affected area, holding the can 3–6 inches away from your skin.¹⁷

Be careful not to inhale the spray or get it in your eyes.

Triamcinolone acetonide spray is flammable. Do not apply the spray around heat or flames. Avoid smoking when using this formulation.

Dental paste

Apply a small amount of dental paste onto the sore until a smooth, slippery film develops. Don’t rub it in. A larger amount of paste may be needed for some sores.¹⁸

If your symptoms have not improved within seven days, consult with your doctor.

Seeing results

There can be some improvement in the inflammatory symptoms even after the first use of the topical formulation. Regular application of the drug as prescribed, along with emollients, can help keep itching and redness at bay.

A study of people using the spray formulation found that just over half of the participants experienced improvement within three days, and nearly 85% experienced improvement within seven days.¹⁹

Many factors affect absorption, including the formulation used, skin integrity, whether you use occlusive dressings, and any disease or inflammation you have that’s affecting your skin.²⁰

Who should not use topical triamcinolone acetonide?

The drug should not be used in people with the following conditions:²¹

• A history of hypersensitivity to triamcinolone acetonide or any of its ingredients

• A bacterial, fungal, or viral infection of the skin

The drug should be used with caution in children and people who are pregnant, breastfeeding, or planning to become pregnant.

Potential side effects of topical triamcinolone acetonide

The common side effects experienced when using topical triamcinolone acetonide include the following:²² ²³

• Burning, itching, irritation

• Inflamed hair follicles (folliculitis)

• Acne

• Lighter patches of skin (hypopigmentation)

• Unwanted hair growth

• Tiny red bumps or a rash around the mouth (perioral dermatitis)

• Skin that looks white or “pruned”

• Secondary infection

• Thinning skin

• Heat rash (miliaria)

• Stretch marks (striae)

Talk to your doctor if you experience any persistent side effects when using topical triamcinolone acetonide.

Adverse effects in children

Topical corticosteroids have been reported to cause hypothalamic-pituitary-adrenal (HPA) axis suppression, Cushing’s syndrome, and intracranial hypertension in some children. Because of their smaller size relative to the amount of product that can be absorbed into the skin, they are more likely to experience the drug’s toxic effects.²⁴

Chronic corticosteroid use may affect a child’s growth and development.

Triamcinolone acetonide should only be used in children at the lowest effective dose and for the least amount of time necessary.

Overdose

Overdoses are uncommon with topical corticosteroids as they are generally not absorbed in large amounts.²⁵

If you or someone else accidentally ingests the drug, call 911 or the National Poison Control Center helpline at 1-800-222-1222.

Allergy information

Topical triamcinolone can induce allergic reactions in some people. Symptoms of an allergic reaction may include:²⁶

• Skin rash, hives, and itching

• Redness, peeling, or swelling over the area the medication has been applied to

• Rapid heart rate

• Wheezing, difficulty breathing

• Vomiting

• Swelling of the mouth, tongue, or throat

• Loss of consciousness

Seek medical attention if you experience any of these symptoms. Call 911 if your symptoms are severe.

It’s also possible to have an allergic reaction to the material or adhesive used for an occlusive dressing. In this case, you will need to use a different material.²⁷

Long-term use of topical triamcinolone acetonide

Triamcinolone acetonide, like other topical corticosteroids, is not intended for long-term regular use.

Using these medications for longer periods than your doctor recommends may lead to the development of side effects related to steroid overuse, such as thinning, fragile skin, easy bruising, hypopigmentation, and secondary infections.²⁸

Systemic absorption can also occur with prolonged use on large areas of skin. This is where large amounts of the drug are absorbed and enter the bloodstream, causing harmful effects and adrenal suppression.

Pregnancy category

Triamcinolone acetonide is listed as a pregnancy category C medication by the FDA. This means the risk of using it during pregnancy cannot be ruled out. While human research has been insufficient for assessing negative effects, animal studies have demonstrated a risk to the fetus.²⁹

Topical triamcinolone and pregnancy

As seen in animal studies, low doses of systemically administered corticosteroids (such as those taken orally or intravenously) are known to interfere with normal fetal growth. High-strength topical corticosteroids have also been seen to have harmful effects in studies of pregnant animals.

Using corticosteroids for prolonged periods or in large amounts when pregnant is not recommended. Your doctor will determine whether the benefits of using the medicine outweigh its potential risks in your case.³⁰

Topical triamcinolone acetonide and breastfeeding

It is not known whether corticosteroids pass into breast milk when applied topically. However, systemically administered corticosteroids are known to be present in breast milk.

Topical corticosteroids have only been seen to cause systemic effects in adults when used extensively in high strengths, so it’s unlikely that the drug will harm a nursing infant when used over a short period.³¹

It is recommended to use the least potent formulation possible on the smallest area of skin. Ensure your infant’s skin does not come into contact with the areas on which you have applied the medication. If you need to treat the breast or nipple area, ensure you clean the skin thoroughly before breastfeeding.

Missed doses

If you miss a dose, apply the cream, ointment, lotion, or paste as soon as you remember. If it’s almost time for your next dose, don’t apply it. Instead, wait for your next dose and resume your dosing schedule as usual. Never apply an additional dose to make up for one you missed.³²

Drug interactions

Triamcinolone acetonide is unlikely to interact with other drugs because you apply it directly onto the skin. Despite this, using the drug excessively or for prolonged periods can increase the risk of systemic absorption, which may cause interactions with other drugs you are taking, including the following:

• Diabetes drugs, such as insulin, semaglutide (Ozempic), rosiglitazone, pioglitazone (Actos), metformin (Glumetza, Riomet), miglitol (Glyset), and others

• Drugs for treating HIV, including cobicistat (Tybost) and darunavir (Prezista)

Before using triamcinolone acetonide, tell your doctor about all other drugs you are taking, including prescription and over-the-counter medications, vitamins, supplements, and herbal products.

Can I drink alcohol while using topical triamcinolone acetonide?

Drinking alcohol when using topical corticosteroids is not thought to be harmful. Review your alcohol use with your doctor to determine if there are any risks in your case.

What to discuss with your doctor before using topical triamcinolone acetonide?

To help you use topical triamcinolone acetonide formulations safely and effectively, here’s what you should discuss with your doctor before getting a prescription:

• Your medical history, including history of your skin condition, any underlying bacterial, fungal, or viral infections, diabetes, liver disease, or any problems with your adrenal gland

• Current medications, including prescribed and over-the-counter drugs, supplements, and herbal medicines

• History of reactions to medication, particularly steroids and other topically applied drugs

• Pregnancy or plans to become pregnant

• Breastfeeding or plans to breastfeed

• The potential side effects of topical triamcinolone acetonide

• Exactly how and when to apply the medication, when to discontinue it, and any necessary precautions

• What to do if you miss a dose or use too much of the drug

Stopping triamcinolone acetonide

Topical steroid withdrawal has been seen in cases of prolonged use of mid- to high-strength topical corticosteroids. Symptoms may include erythema (reddening of the skin, rash), skin sensitivity, flaking, and a painful burning sensation.³³

Triamcinolone acetonide is not intended for long-term use. Don’t keep using your medication after your prescription has ended, and don’t share your medication with others.

Drug approval history

1958: Topical triamcinolone acetonide was first approved by the FDA as a cream formulation.³⁴

1960: The FDA approved Kenalog in Orabase, the first dental paste formulation. While the brand has been discontinued, this formulation is still available as a generic medication.³⁵

1974: The FDA approved the topical spray formulation of triamcinolone acetonide to be marketed as Kenalog. The brand-name product has since been discontinued, but a generic version is still available.³⁶

1984: The FDA approved the brand-name medication Triderm, a cream formulation.³⁷

1995: Trianex was approved by the FDA, a branded 0.05% ointment formulation.³⁸

Tips for using topical triamcinolone acetonide

• Wash your hands before and after applying triamcinolone acetonide.

• Clean and dry the affected area before applying.

• Always wash your hands after applying your topical steroid product.

• Avoid getting the medication in your eyes.

• Follow up with your doctor if you don’t notice any improvements in your symptoms. Don’t keep using the medication for longer than your prescription states.

• Avoid covering the treated area with a cloth or bandage unless this is what your doctor recommends.

• Store the cream, ointment, lotion, and spray formulations at 20–25°C (68–77°F).³⁹

• Store the spray formulation away from sources of fire and intense heat. Do not puncture or incinerate the aerosol can.⁴⁰