Topical triamcinolone can be absorbed in sufficient amounts to produce systemic effects. Systemic absorption of topical triamcinolone has produced reversible HPA axis suppression, Cushing's syndrome, hyperglycemia and glycosuria. Periodically evaluate patients for evidence of HPA axis suppression by using morning plasma cortisol, urinary free cortisol and ACTH stimulation tests. If HPA axis suppression is noted, attempt to withdraw the drug, reduce the frequency of applications, substitute a less potent steroid or use a sequential approach with the occlusive technique. Also test for impairment of thermal homeostasis. Recovery of HPA axis function and thermal homeostasis are generally prompt and complete upon discontinuation of the drug. Infrequently, signs and symptoms of steroid withdrawal may occur, requiring supplemental systemic corticosteroids.