Triamcinolone Acetonide (TRIANEX) Risks, Warnings, and Complications

ADRENAL SUPPRESSION: Rarely, using topical triamcinolone acetonide can lead to a suppression of the adrenal glands (these glands make natural corticosteroids in the body). This is called HPA axis suppression. Adrenal suppression occurs because the body stops making natural steroids and becomes dependent on external steroids. If you suddenly stop using the medication, it can lead to serious symptoms. 

The risk of this happening is higher with the use of more potent corticosteroids compared to less potent steroids. Also, the risk of this deleterious effect is higher with chronic corticosteroid therapy (use of the medicine for prolonged periods), use of excessive amounts of the medicine, application of the medicine to large areas of skin, and covering the treated area with an occlusive dressing or bandage which can augment systemic absorption and produce systemic effects. 

Young children are also at greater risk of this complication. Studies evaluating HPA axis suppression in children have found that similar to systemically administered corticosteroids, topical corticosteroids can lead to poor growth and delayed weight gain. 

To lower your risk of adrenal suppression, your healthcare provider will tell you to use the lowest possible strength of triamcinolone for the shortest amount of time to achieve therapeutic efficacy. If you need to use more potent steroids or the medicine for prolonged periods, your provider may order laboratory tests such as an ACTH stimulation test and urinary free cortisol test to check your adrenal gland function. Do not stop using triamcinolone acetonide suddenly. Tell your doctor without delay if elevation in body temperature occurs or you develop low energy, joint pain, and muscle pain.

HIGH BLOOD GLUCOSE: Just like corticosteroids administered systemically can lead to high blood sugar, the same deleterious effect can occur with topical triamcinolone acetonide used for a long time or on large parts of the body. Tell your doctor immediately if you develop symptoms like sleepiness, unusual thirst or hunger, urinary frequency, flushing, fast breathing, fruity smelling breath, or confusion. If you have diabetes, your healthcare professional may ask you to check your blood sugar more frequently.

SKIN AND MOUTH INFECTIONS: If you apply triamcinolone acetonide ointment for more than 7 days, it can increase your risk of new or worsening dermatological infections (skin and mouth infections). Don't use triamcinolone acetonide if you have a skin infection as it can make the infection worse. Tell your provider if you develop signs of infection after using triamcinolone acetonide with symptoms like pain, redness, swelling, or pus. Also, tell your provider if your original symptoms do not improve after 7 days of using triamcinolone acetonide. 

SKIN REACTIONS: Using triamcinolone for prolonged periods can lead to skin problems like thinning skin, spider veins, stretch marks, changes in skin color, rash, burning, itching, dryness, irritation, and inflammation of the hair follicles. To lower your risk of severe skin reactions, your healthcare provider will prescribe a less potent steroid unless the potential benefit justifies using more potent corticosteroids. The goal is to use the lowest possible dose of triamcinolone acetonide for the shortest amount of time to treat your symptoms. Tell your doctor right away if you notice any new or worsening skin reactions.