Question about triamcinolone acetonide cream usp 0.1%?

Question

can this topical medication interfere with the your natural production of cortisol in any way? i mean even a little bit? what about if used for a 3year period 2x a day?

Answer 1

Prolonged use of this medication may develop systemic effects especially when spread on a large area of the skin. It may affect the hypothalamus, pituitary glands, and adrenals. since Cortisol is produced by the adrenals and stimulated by the pituitary and hypothalamus, then it may be affected and result in Cushing's syndrome.

Answer 2

Wow - thank you for asking me to look at this question.

Well, there is no clinical data to demonstrate either way that it does or that it does not interfere with your natural production of cortisol.

This stuff is marketed in Australia under the name "Aristocort" and is a strong steroid cream for the treatment of eczema, dermatitis and a variety of skin ailments. (Although we actually only use a 0.02% preparation)

The side effect profile listed does not include Cushing's disease (which is the usual result of oral or injected steroids over a long period of time) but it is known to be absorbed systemically into the blood stream - known to have half life of 2-5hrs and to be metabolised mostly in the liver to biologically inactive compounds which are excreted in the urine.

It is quite possible to theorize that a 0.1% preparation used regularly on a large area of damaged skin (which is why you'd be given the stuff in the first place) for a long period of time could have an effect on the adrenal glands and DECREASE your normal production of cortisol (iatrogenic Cushing's disease).

Proving it would be a different (and more difficult) matter.

Incidentally, I am not an expert in this area. You would do better to consult a pharmacologist or dermatologist.

Interestingly, drugs.com lists bony fractures and mood changes (side effects of systemic corticosteroids) among the side effects ... although Cushing's disease is not listed here either.

I hope this answer has been helpful.

Regards.

Answer 3

This is an excellent question.  

Kenalog (triamcinolone acetonide cream usp 0.1%) applied bid, like many topical corticosteroid preparations, can be absorbed from normal intact skin. Inflammation and/or other disease processes in the skin increase percutaneous absorption as does the use of occlusive dressings, as these substantially increase the percutaneous absorption of topical corticosteroid as does usage over a large surface area, usage for a prolonged time period and, invariably, underlying skin inflammation and/or disease.

The concentration of the preparation varies directly with the degree of absorption and thus serum levels.  With the topical use of this cream over a prolonged period of time, there is evidence for the production reversible HPA (hypothalamic-pituiatry adrenal) axis suppression, manifestations of Cushing's syndrome, hyperglycemia, and glucosuria and thus it is recommended that patients applying Kenalog 0.1% for a prolonged period of time (at the discretion of the treating physician) be evaluated periodically for evidence of HPA axis suppression by using the urinary free cortisol and ACTH stimulation tests.

Answer 4

Topical triamcenalone can be used without side effects on skin for Acne vulgaris and some other conditions.Recurrence can occur but that is not a side effect.