How to use your topical corticosteroid cream or ointment
Written by Helen Marshall, pharmacist
Topical corticosteroid creams and ointments are applied to the skin to reduce inflammation in conditions such as eczema, dermatitis and psoriasis. They include medicines such as hydrocortisone, betametasone and clobetasol.
Ointments are more greasy than creams. They are preferable if your skin is dry, whereas moist or weepy skin is best treated with a cream. Using a cream or ointment allows the medicine to be applied directly to the inflamed area of skin.
The most important thing to remember with topical corticosteroid creams and ointments is to apply them very thinly. This minimises the amount absorbed through the skin into the body.
How to use your topical corticosteroid cream or ointment
1.The first time you take the cap off the cream or ointment you may find the end of the tube is sealed. You can pierce this seal by inverting the cap of the tube and pushing it into the end of the tube.
2.Wash the affected area(s) of skin well and rinse away all traces of cleanser.
3.Pat the skin dry rather than rubbing it.
4.Apply the cream or ointment thinly and evenly to the affected area(s).
5.Gently massage the cream or ointment into the skin until it has all disappeared.
6.Replace the cap on the tube.
7.Wash your hands after applying the cream or ointment, unless the hands are the affected area.
8.Topical corticosteroids should not be applied more than twice a day and once a day may often be sufficient. Follow the instructions your doctor or pharmacist gives you.
9.If you have other creams, ointments or lotions to use on the same area of skin you should try and leave about half an hour between applying each one so that they don't mix on the skin.
How much should you use?
You can measure the amount required to "apply thinly" in terms of the length of cream or ointment squeezed out of the tube. This is measured in fingertip units. One fingertip unit is the distance from the tip of an adult index finger to the first crease of that finger.
The table below gives you a rough guide of how much cream or ointment to use for an adult. You should use less than this for smaller adults and children.
Affected body area Quantity of cream or ointment to use for adults
Both sides of one hand One fingertip unit
One foot Two fingertip units
One arm Three fingertip units
One leg Six fingertip units
Chest and abdomen Seven fingertip units
Back and buttocks Seven fingertip units
Don't worry if you have to use more or less than this - it is a rough guide based on average adult body size.
Other useful advice
Only use topical corticosteroids on the affected areas of skin. Never use them as moisturisers.
Do not use topical corticosteroids under nappies or dressings, unless your doctor tells you to. (Nappies and dressings make it easier for the medicine to pass through the skin and so could increase the risk of unwanted effects.)
Do not use topical corticosteroids on the face unless advised to do so by your doctor. If topical corticosteroids are to be used on the face, they should be used for no more than five to seven days. Ensure the product does not get in your eyes. Continued use of topical corticosteroid preparations may lead to a lightening of the skin.
There will be more medicine absorbed from raw skin, thin skin, the face and genitals, and areas of skin that rub together, such as beneath the breasts or between the buttocks, so take extra care to apply thinly if applying creams or ointments to these areas.
Over-use of any steroid cream or ointment, especially for long periods on large areas of skin, can result in too much medicine being absorbed into the body. This may lead to thinning or weakening of the skin or other side effects. Consult your doctor if you experience skin irritation or any other unusual effects.
Certain topical corticosteroid preparations can stain both the skin and clothes. To prevent the latter, a clean cloth or cotton bandage can be placed over the affected area. However, don't cover the area with airtight dressings unless directed by your doctor, as these can increase the absorption of the steroid into the body.
Creams and ointments are designed only for application to the skin. If they are accidentally taken by mouth, tell your doctor at once.
If you get the cream or ointment in your eye, rinse it out immediately with warm water and consult your doctor if there is any on-going irritation.
Always follow the advice on the printed label of the tube/box and/or as directed by your doctor or pharmacist.
If you forget to apply your cream or ointment, apply the correct dose when you remember, and then carry on as before.
Do not use your cream or ointment after the expiry date on the tube because it may be contaminated with germs.
Don't give your medicines to anyone else to use, even if they have the same symptoms as you. They may be harmful to other people.
Always keep medicines out of the reach of children.
Last updated 22.01.2009
http://www.netdoctor.co.uk/health_advice/facts/corticosteroidcream.htm
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