Application and quantity of topical corticosteroids

Topical corticosteroids should be applied liberally (not sparingly) to all areas of inflammation (not just to the worst areas).

Ensure an adequate quantity of topical corticosteroid is prescribed to treat the entire affected area for the appropriate duration—authority from the Pharmaceutical Benefits Scheme (PBS) may be required to prescribe a sufficient quantity of corticosteroids.

A ‘fingertip unit’ is a term used to explain to a patient how much topical corticosteroid should be applied. One fingertip unit describes the amount of product that is squeezed out of the tube from the tip of the index finger to the first crease of the index finger—see here for photo of a fingertip unit of cream. One average adult fingertip unit is usually enough to cover an area of skin the size of two flat adult hands with fingers together.

Figure 1. Fingertip unit

Note:

Photo sourced with permission from Ms Hannah Verhellen.

For an average-sized adult, a single application to cover the whole body requires approximately 20 g of ointment or 30 g of cream. This can be used as a guide for larger areas of application (eg atopic dermatitis affecting the whole body). For smaller areas of application, fingertip units can be used as a guide depending on the site of application—see here for a guide on number of fingertip units required depending on body area.
For children, adult fingertip units can be used as a guide for the amount of product to be applied. For the number of adult fingertip units required for different parts of the body in children, see here.
Figure 2. Guide on number of fingertip units to apply on different parts of a child and adult body.

Australian Medicines Handbook (AMH) Pty Ltd, Updated April 2017Bewley, 2008Long, 1998

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