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Patient Information Use of Steroid creams - How much to apply Topical corticosteroid creams and ointments are applied to the skin to reduce inflammation in conditions such as eczema and psoriasis. Used correctly, topical steroids are safe and effective. Topical steroids vary in potencies (strengths): • Mild- e.g. Hydrocortisone 1%- Use for babies and children and delicate areas of skin such as the face and neck. Psoriasis under breasts, behind elbows and knees. • Moderate- e.g. Clobetasone butyrate 0.05%- Use for older children or adults • Potent- e.g. Betamethasone valerate 0.1%- Use for eczema that has not responded to less potent steroids and psoriasis of scalp, hands and feet • Very potent- e.g. Clobetasol propionate 0.05% - Use for severe eczema or psoriasis not responding to other steroids. You may need to step up to a more potent (stronger) steroid if there is no response but in general, use the lowest strength, which works. Your doctor or pharmacist can explain the differences between the preparations available. Dosage The amount of ointment you should use can be measured as an Adult Fingertip Unit (FTU). Use your index finger (first finger, next to your thumb) as a measure. Squeeze the ointment from the tube along your index finger from the tip to the first joint - this is a fingertip measure. Number of Adult Fingertip Units 1. An adult -Face and neck- 2.5; Arm and hand- 4; Leg and foot8; Trunk (front)-7; Trunk (back) including buttocks-7 2. Child (3-6 months) Face and neck- 1; Arm and hand- 1; Leg and foot-1.5; Trunk (front1; Trunk (back) including buttocks-1.5 3. Child (1-2 years)- Face and neck- 1.5; Arm and hand- 1.5; Leg and foot-2; Trunk (front)-2; Trunk (back) including buttocks-3 4. Child (3-5 years)- Face and neck- 1.5; Arm and hand- 2; Leg and foot-3; Trunk (front)-3; Trunk (back) including buttocks-3.5 5. Child (6-10 years)- Face and neck- 2; Arm and hand- 2.5; Leg and foot-4.5; Trunk (front)-3.5; Trunk (back) including buttocks-5 As a rough guide: • 15g tube is equivalent to 30 ftu • 30g tube is equivalent to 60 ftu • 100g tube is equivalent to 200 ftu Therefore an adult requires about 40ftu for 1 total body treatment i.e. about 35 to 40g per day • • • Apply the topical steroid once or twice a day, depending on the preparation. Always try to leave a gap of at least 10-15 minutes after applying emollient before applying the steroid otherwise you may dilute the effect of the steroid. If you are using a moderate potency or higher, step down to a less potent steroid to maintain the condition until completely controlled and then continue with emollient. This reduces the chance of a rebound flare-up reaction. For further information please contact the Dermatology department on Tel: 01246 512140 We would like to thank NHS Direct for allowing us to reproduce the information in this leaflet. If you would like any further information please visit their website at http://cks.library.nhs.uk/patient_information_leaflet/corticosteroids