Diflucortolone for severe inflammatory skin conditions

About diflucortolone

Diflucortolone is classed as a potent topical corticosteroid. Topical corticosteroids are also referred to as topical steroids. Topical steroids are used in addition to moisturisers (emollients) for treating inflammatory skin conditions such as eczema and dermatitis. A topical steroid is used when patches of eczema or dermatitis flare up. Diflucortolone relieves the symptoms of a flare-up by reducing inflammation, itching and redness. It is not a cure for the condition, but it will help to relieve the symptoms.

Specialist skin doctors may on occasion prescribe a short course of diflucortolone for the treatment of psoriasis, although it is not generally recommended for this skin condition. Diflucortolone is not recommended for use in children, although again, it may be prescribed for a child by a specialist doctor under certain circumstances.

Diflucortolone is available as a number of different preparations. It is likely you will be prescribed a cream if the affected areas of your skin are moist or weeping, or an ointment if your skin is dry.

There are two strengths of diflucortolone. Preparations containing 0.1% diflucortolone (Nerisone®) are potent topical steroids, and the higher strength which contains 0.3% diflucortolone (Nerisone Forte®) is classed as a very potent topical steroid. You will have been given the higher strength to use if your flare-up has not responded to a lower-strength steroid cream. As soon as your symptoms improve, the strength of your steroid cream/ointment will be reduced.

Before using diflucortolone

To make sure this is the right treatment for you, before you start using diflucortolone it is important that your doctor knows:

• If you have any areas of infected skin.

• If you have rosacea or acne.

• If you are pregnant or breastfeeding.

• If you have ever had an allergic reaction to a skin preparation.

How to use diflucortolone

• Before you start using the preparation, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about topical steroids and will provide you with a full list of the side-effects that you may experience from using them.

• Apply a small amount to the areas of skin which are inflamed. Then gently rub it into the skin until it has disappeared. Do not use diflucortolone on any open sores or areas of infected skin.

• The amount of topical steroid that you should apply is commonly measured by fingertip units (FTUs). One FTU is the amount of cream or ointment that is squeezed out along an adult's fingertip (that is, from the very end of the finger to the first crease in the finger). As a guide, one FTU is enough to cover an area twice the size of an adult hand. Your doctor will give you an idea of how many FTUs you will need to cover the area of your skin which is affected.

• Your doctor will tell you how often to apply diflucortolone. It must not be applied more than twice a day, and once a day is often sufficient.

• If you are using more than one topical corticosteroid, make sure you know when and where to use each one. If you are unsure, check with your doctor or ask your pharmacist for further advice.

• After you have applied diflucortolone, remember to wash your hands (unless your hands are the treated area).

• If you are using diflucortolone for psoriasis, make sure you follow your doctor's instructions carefully. It should not be used for large areas of psoriasis or for long periods of time, as these can cause your symptoms to flare up again afterwards.

• Diflucortolone is not suitable for use in children unless it is has been advised by a skin specialist. This is because children are particularly susceptible to side-effects from strong topical steroids. The main concern is for children who need frequent courses, as it can have an effect on their growth and this will need to be monitored. If your child has been prescribed diflucortolone, follow the directions you have been given very carefully, and do not use it for longer than you have been told to. As a general rule, it should not be used for more than five days in children.

Getting the most from your treatment

• If you are using a moisturiser along with this preparation, apply the moisturiser first. Then wait 10-15 minutes before applying diflucortolone. This allows time for the moisturiser to be absorbed before the topical corticosteroid is applied. Your skin should be moist but not slippery when you apply diflucortolone.

• Do not use diflucortolone on your face unless a skin specialist doctor has said you should. If you have been told to use it on your face, be careful not to get any preparation near your eyes and do not use it for longer periods of time than you have been advised.

• Unless advised to do so by your doctor, do not apply a bandage or dressing to the area being treated, as this will increase absorption of the preparation and increase the risk of side-effects.

• Continue to use diflucortolone until the flare-up is controlled, and then stop it. A course of treatment for 7-14 days is usually sufficient. Do not use Nerisone Forte® for more than two weeks, and do not use Nerisone® for more than four weeks. If your symptoms have not improved after this time (or if they get worse), speak again with your doctor for further advice.

• After you finish using diflucortolone, continue to use your moisturiser every day. This will help to prevent a further flare-up. Your doctor may also prescribe a less potent steroid cream for you to use when needed.

Can diflucortolone cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. You can reduce the risk of side-effects from diflucortolone by applying the preparation thinly, no more than twice a day, and to the affected areas only.

If you experience any other symptoms which you think may be due to diflucortolone, speak with your doctor or pharmacist for further advice.

How to store diflucortolone

• Keep all medicines out of the reach and sight of children.

• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines