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Figure 1.
Measuring fingertip units (FTUs).
TOP TIPS
i
Top tips on topical corticosteroid use
i
Topical corticosteroids come
in various strengths and
formulations. The
British
National Formulary
(BNF 70,
September 2015) categorises
the strength of topical
corticosteroids for the skin
as: mild, moderately potent,
potent and very potent.
Although some are suitable
for both adults and children,
being guided by the percentage
of the preparation — always
check the potency status.
i
Ointments: these may be the
most effective formulation. The
occlusive effects of ointments
make them ideal for dry,
thick, or hyperkeratotic skin,
however they may be too
greasy for hairy areas of skin.
Face
and neck
Arm
and hand
Leg
and foot
Front
Back
including
buttocks
Child’s age
Number of FTUs needed
3–6 months
1
1
1
1 /2
1
1
1 /2
1–2 years
1
1 /2
1
1 /2
2
2
3
3–5 years
1
1 /2
2
3
3
3
1 /2
6–10 years
2
2
1 /2
4
1 /2
3
1 /2
5
2.5 FTU
Face and neck
3 FTU
one arm
1 FTU
one hand
6 FTU
one leg
2 FTU
one foot
7 FTU
Trunk front
Trunk back
the potent and very potent
preparations should be used
with caution, especially if
selecting ‘off label’ use when
treating younger children.
i
Potency of a topical
corticosteroid preparation is
a result of the formulation as
well as the corticosteroid (BNF
70, September 2015). Avoid
Adult
Children —
numbers of fingertip units (FTUs)
Following comprehensive assessment and accurate diagnosis, topical corticosteroids are
WKH PRVW FRPPRQO\ XVHG PHGLFDWLRQV WR WUHDW LQÁDPPDWRU\ VNLQ FRQGLWLRQV VXFK DV HF]HPD
dermatitis, psoriasis, itching, etc. Here, Tanya Flavell, advanced nurse practitioner, South
Manchester University Hospitals NHS Foundation Trust, highlights some top tips around
topical corticosteroids to help clinicians both in their day-to-day practice and in educating
patients and carers around the correct application and use of these medications. It is
LPSRUWDQW WKDW FOLQLFLDQV DOZD\V WDNH WKH WLPH WR ÀQG RXW KRZ PXFK D SDWLHQW SDUHQW FDUHU
knows about the preparation in order to dispel any myths or misconceptions (such as skin
thinning, stretch marks), and to stress that if used correctly, the steroid is a safe and effective
treatment regimen. Having an understanding of the different potencies available and how
WKH\ IXQFWLRQ FDQ DOVR KHOS WR LQYROYH SDWLHQWV FDUHUV LQ D WUHDWPHQW UHJLPHQ ZKLFK FDQ EH
time-consuming and sometimes messy. Used appropriately, topical corticosteroids can help to
control symptoms and thereby improve patient quality of life and well-being.
SKIN CARE TODAY
2016,Vol 2, No 1
33