Topical steroids are used for various skin conditions. The amount of topical steroid that you should apply is commonly measured by 'fingertip units'.
What are topical steroids and how do they work?
Topical steroids are creams, ointments and lotions which contain steroid drugs. Topical steroids work by reducing inflammation in the skin. They are used for various skin conditions. Unlike many other creams and ointments, it is important to get the dose right when using topical steroids. This is why a standard measure is often used - the fingertip unit.
Fingertip units
One fingertip unit (FTU) is the amount of topical steroid that is squeezed out from a standard tube along an adults fingertip. (This assumes the tube has a standard 5 mm nozzle.) A finger tip is from the very end of the finger to the first crease in the finger.
One FTU is enough to treat an area of skin twice the size of the flat of an adult's hand with the fingers together.
Two FTUs are about the same as 1 g of topical steroid. Therefore, for example, say you treat an area of skin the size of eight adult hands. You will need four FTUs for each dose. (This is 2 g per dose. If the dose is once a day, then a 30 g tube should last about 15 days of treatment.)
The following are further examples:
| Area of skin to be treated (adults) | Size is roughly: | FTUs each dose (adults) |
A hand and fingers (front and back) | About 2 adult hands | 1 FTU |
A foot (all over) | About 4 adult hands | 2 FTUs |
Front of chest and abdomen | About 14 adult hands | 7 FTUs |
Back and buttocks | About 14 adult hands | 7 FTUs |
Face and neck | About 5 adult hands | 2.5 FTUs |
An entire arm and hand | About 8 adult hands | 4 FTUs |
An entire leg and foot | About 16 adult hands | 8 FTUs |
Fingertip units and children
An FTU of cream or ointment is measured on an adult index finger before being rubbed onto a child. Again, one FTU is used to treat an area of skin on a child equivalent to twice the size of the flat of an adult's hand with the fingers together. You can gauge the amount of topical steroid to use by using your (adult) hand to measure the amount of skin affected on the child. From this you can work out the amount of topical steroid to use.
The following gives a rough guide:
- For a 3-6 month old child
- Entire face and neck - 1 FTU
- An entire arm and hand - 1 FTU
- An entire leg and foot - 1.5 FTUs
- The entire front of chest and abdomen - 1 FTU
- The entire back including buttocks - 1.5 FTUs
- For a 1-2 year old child
- Entire face and neck - 1.5 FTUs
- An entire arm and hand - 1.5 FTUs
- An entire leg and foot - 2 FTUs
- The entire front of chest and abdomen - 2 FTUs
- The entire back including buttocks - 3 FTUs
- For a 3-5 year old child
- Entire face and neck - 1.5 FTUs
- An entire arm and hand - 2 FTUs
- An entire leg and foot - 3 FTUs
- The entire front of chest and abdomen - 3 FTUs
- The entire back including buttocks - 3.5 FTUs
- For a 6-10 year old child
- Entire face and neck - 2 FTUs
- An entire arm and hand - 2.5 FTUs
- An entire leg and foot - 4.5 FTUs
- The entire front of chest and abdomen - 3.5 FTUs
- The entire back including buttocks - 5 FTUs
©EMIS and PIP 2004
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