title: Triamcinolone spray: no-rub application as effective as rub application.
abstract: BACKGROUND
  Adherence to therapy is important to achieve successful treatment outcomes. Although effective, topical treatments in dermatology may result in sticky skin or may be too time-consuming to apply, thereby creating adherence issues. Spray formulations have excellent products aesthetics, but may require a 2-step application process.
  
  
  OBJECTIVE
  This study was conducted to determine whether the spray formulation of triamcinolone acetonide (TAC) 0.2% works equally well in a no-rub and rub application process.
  
  
  METHODS
  Fifty patients 18 years of age and older with mild symmetrical arm or leg eczema or atopic dermatitis were enrolled in a 2-week investigator-blinded study. One limb was randomized to be treated with TAC spray and no rubbing, and the other was to be treated with TAC spray and rubbing. Patients applied the spray three times daily for 2 weeks. The use of moisturizers was not permitted.
  
  
  RESULTS
  After 2 weeks, there was a highly clinical and statistical (P < 0.001) improvement in all investigator and patient parameters evaluated with both the no-rub and rub techniques. There was no difference in final assessment scores between the no-rub and rub applications (P > 0.7), and no study product tolerability issues were identified. Transepidermal water loss and corneometry measures revealed no issues in skin barrier impairment even though patients were not permitted to use moisturizers.
  
  
  CONCLUSIONS
  This study demonstrates the application parity between a no-rub and rub application of TAC spray in the absence of a moisturizer. Both techniques resulted in clinical and significant improvement in eczema and atopic dermatitis and neither resulted in skin barrier issues.
authors.affiliation: Dermatology Consulting Services, High Point, NC, USA.
authors.forename: Zoe Diana
authors.initials: ZD
authors.lastname: Draelos
mesh_terms: D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D003876:Dermatitis, Atopic / Q000188:drug therapy* / Q000378:metabolism; D004485:Eczema / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D016037:Single-Blind Method; D016896:Treatment Outcome; D014221:Triamcinolone / Q000008:administration & dosage*; D014870:Water Loss, Insensible; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D014221:Triamcinolone
keywords: application technique; corticosteroid spray; percutaneous penetration