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      Triamcinolone

      What is triamcinolone?

      Triamcinolone belongs to a class of medications called corticosteroids, a class of prescription and over-the-counter drugs used for conditions where the immune system is overactive. Steroids decrease the release of several pro-inflammatory mediators, such as prostaglandin and leukotrienes.   


      Why is triamcinolone part of my treatment plan?

      Topical corticosteroids are first-line therapy for the patchy limited hair loss seen with alopecia areata. Your genetic profile indicated that your GR-alpha gene is normal. This gene encodes for the corticosteroid receptor, and abnormalities in the gene make steroid therapy less effective. Alternative medications are recommended for changes in the GR-alpha gene that make steroids less effective.


      Are topical corticosteroids effective for alopecia areata (AA)?

      Topical therapy with corticosteroids has shown efficacy in clinical trials for alopecia areata. In a trial of 70 patients with desoximetasone, 58% regrow their hair entirely after 12 weeks.1  Another 12-week trial compared betamethasone vs. triamcinolone injections vs. tacrolimus and found that more than 75% of people using betamethasone (the steroid) regrow their hair.2


      Are there any adverse effects to using topical corticosteroids?

      Adverse reactions can occur when using steroids and are more likely with longer durations and higher potency formulations. Adverse effects include local skin atrophy, hypo or hyperpigmentation, acne, redness, burning, stretch marks, telangiectasias, swelling, itching, pain, skin infections, and rarely adrenal suppression.3


      How long is the treatment course for AA

      Treatment for AA needs to be individualized based on the response to therapy. Therapy is generally tapered within three to six months. If there is no response to treatment within three months, another agent should be initiated. 

      Drug Summary: Triamcinolone


      References

      1. Charuwichitratana S, Wattanakrai P, Tanrattanakorn S. Randomized double-blind placebo-controlled trial in the treatment of alopecia areata with 0.25% desoximetasone cream. Arch Dermatol. 2000;136(10):1276-1277. doi:10.1001/archderm.136.10.1276
      2. Kuldeep C, Singhal H, Khare AK, Mittal A, Gupta LK, Garg A. Randomized comparison of topical betamethasone valerate foam, intralesional triamcinolone acetonide and tacrolimus ointment in management of localized alopecia areata. Int J Trichology. 2011;3(1):20-24. doi:10.4103/0974-7753.82123
      3. Hengge UR, Ruzicka T, Schwartz RA, Cork MJ. Adverse effects of topical glucocorticosteroids. J Am Acad Dermatol. 2006;54(1):1-18. doi:10.1016/j.jaad.2005.01.010