9 responses to “Using topical corticosteroids safely and effectively”

  1. Dear Dr. Murray
    this is a BRILLIANT resource
    I would like to seek your permission to reference / provide these materials as appendices in undergrad med
    grateful if you would let me know your thoughts on this
    thank you very much !

  2. Great article, thank you

  3. Can you provide some examples of the typical amounts/volumes you prescribe for standard areas of the body?

  4. I generally advise dermatitis patients that, if told by a pharmacist to use the med “sparingly”, follow MY advice, not to be stingy.

  5. “How much topical medication do you need to prescribe for your patient?” is a very good question.
    The medication should be rubbed gently onto the affected area until it is absorbed by the skin. A small amount goes a long way.

    About 30grams of an ointment or cream will cover the total body surface.

    To help you decide you can follow the “finger tip unit” rule.
    One FTU is the amount of topical medication spanning the ventral tip of the index finger to the distal skin crease from a tube with a 5mm nozzle.
    That amount is about 1/2 gram and will cover the equivalent area of two adult hands lying flat on the skin.
    That amount applied twice a day for two weeks would require a 15 gram tube.

  6. One of the dermatologists who did some resident teaching for us (Dr. Lewis in Kamloops) had a good, easily explained way of describing to patients how much cream should cover how much skin: the rice-to-toonie ratio. An amount of cream the size of a grain of rice should cover an area of skin the size of a toonie.

  7. Excellent review of use of topical steroids. Thank you.

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  9. Why does the TABLE 2 say to use more than once a day for ranks 1-4?

    Earlier in the arrticle you say, “Instruct patients to apply super potent to moderately potent (ranks 1-4) preparations once daily…….Many of the new corticosteroid molecules, such as prednicarbate and mometasone propionate, accumulate in the skin producing a reservoir so that they need only be applied once a day.”

    Thank you for your paper.

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