Synalar, a Symbol of Progress in Dermatology

The discovery and development of halogenated corticosteroids in the second half of the 20th century revolutionized the treatment of inflammatory and allergic skin conditions. Among these advancements, Synalar, a topical corticosteroid based on fluocinolone acetonide, emerged as a milestone in dermatology. First synthesized in 1957 by the pharmaceutical laboratory Syntex, based in Palo Alto, California, and developed at its research center in Mexico City, Synalar marked a turning point in the management of skin disorders. This article reviews the history of Synalar, its impact on medicine, and its enduring relevance in the pharmaceutical market.
 
Origins: Syntex and Innovation in Corticosteroids
 
In the 1950s, corticosteroid research was in full swing, driven by the discovery of cortisone and its therapeutic applications. However, early corticosteroids had limitations, such as low potency and significant systemic side effects when applied topically. Syntex, a pioneering company in steroid chemistry, set out to overcome these barriers. Founded in 1944 in Mexico and later established in Palo Alto, Syntex had already gained recognition for its advances in synthesizing steroid hormones, including progesterone.
 
In 1957, Syntex scientists, working in their research department in Mexico City, successfully synthesized fluocinolone acetonide, a synthetic derivative of hydrocortisone. The key to their innovation was the incorporation of a fluorine atom at position 9 of the steroid nucleus, significantly enhancing the compound’s potency. This chemical modification not only boosted the corticosteroid’s anti-inflammatory, antipruritic, and vasoconstrictive activity but also minimized systemic absorption, making it ideal for topical use. The resulting compound was named fluocinolone acetonide, and Syntex marketed it under the brand name Synalar in 1959, becoming one of the first halogenated corticosteroids available on the market.
 
Synalar: A Breakthrough in Dermatological Treatment
 
Synalar was initially introduced in concentrations ranging from 0.01% to 0.025%, designed to treat a wide variety of inflammatory, allergic, and pruritic skin conditions. Its ability to relieve symptoms such as redness, itching, inflammation, scaling, and crusting quickly made it a drug of choice for disorders like atopic dermatitis, psoriasis, eczema, contact dermatitis, lichen planus, and discoid lupus erythematosus.
 
Fluocinolone acetonide, classified as a potent grade III corticosteroid, offered superior efficacy compared to earlier corticosteroids like hydrocortisone, thanks to its greater affinity for glucocorticoid receptors and localized action. Additionally, its formulation in cream, ointment, solution, shampoo, and oil allowed it to meet diverse clinical needs, from scalp applications to the treatment of extensive lesions. Synalar’s versatility, combined with its efficacy, positioned it as a leader in the dermatological market.
 
Synalar also stood out for its use in combinations with other active ingredients, such as neomycin (Synalar-Neo), an antibiotic that addresses secondary bacterial infections in dermatoses, or with agents like ciprofloxacin in otic preparations. These formulations expanded its therapeutic scope, including conditions like external otitis and inflamed hemorrhoids.
 
Impact and Evolution in Dermatology
 
The launch of Synalar marked a paradigm shift in dermatology. Before its arrival, treatments for inflammatory skin conditions were limited and often required systemic therapies with higher risks of adverse effects. Synalar provided a safe and effective alternative, enabling physicians to treat localized conditions with minimal systemic absorption. Its success inspired the development of other halogenated topical corticosteroids, solidifying Syntex’s position as a leader in the pharmaceutical industry.
 
Over the decades, Synalar remained relevant due to its proven efficacy and safety profile when used as directed. Clinical studies and reviews have supported its utility in managing recalcitrant dermatoses, although clear precautions have been established, such as avoiding prolonged use in children, on large areas, or under occlusive dressings, due to risks of skin atrophy, hypopigmentation, or suppression of the hypothalamic-pituitary-adrenal axis.
 
The drug has also undergone commercial adaptations. In addition to its classic presentations, Synalar has been marketed under names like Fluocid Forte, Gelidina, and Synalar Gamma, and in combinations such as Synalar Rectal for hemorrhoids. Its availability in various concentrations and formats has allowed for personalized treatment based on the severity of the condition and the patient’s sensitivity.
 
Current Relevance and Legacy
 
More than six decades after its launch, Synalar remains a cornerstone in dermatology. Despite the emergence of new topical corticosteroids and biologic treatments, Synalar’s cost-effectiveness, versatility, and efficacy keep it a preferred choice for physicians and patients. In many countries, it is available both in generic form and under commercial brands, ensuring its accessibility.
 
Synalar’s legacy extends beyond its clinical impact. It represents Syntex’s success as a pioneer in steroid research and serves as an example of how chemical innovation can transform medical practice.
 
Synalar is, therefore, much more than a medication: it is a symbol of progress in dermatology. From its synthesis in 1957 to its continued use in the 21st century, it has alleviated the suffering of millions of patients with inflammatory and allergic skin conditions. Despite the challenges associated with topical corticosteroids, its efficacy, versatility, and safety, when used correctly, have cemented its status as a leader in its field.
 
Synalar’s impact endures, not only in pharmacies and clinics but also in the history of pharmaceutical innovation, proving that a well-executed discovery can withstand the test of time.
 

A journey through the history of the pharmaceutical industry and one of its great laboratories that had its origins in Alfred Nobel...
“From Alfred Nobel to AstraZeneca”: https://a.co/d/9svRTuI