Monday 26 February, 2007

The “fingertip unit” of topical steroids

Posted in Dermatology, Emergency Dept., General Practice, Michael Tam at 21:16 by Michael Tam

Original article by: Michael Tam :: Printer friendly

The fingertip unit

This article was inspired by a comment from Dr Ewen McPhee (a rural GP) who mentioned the use of the “fingertip unit” in the article on topical corticosteroids.

The “fingertip unit” was original described by Long and Finlay in 1991 and is a handy guide for both doctors and patients to describe quantities of corticosteroid cream (1).

In essence, one “fingertip unit” is equivalent to 20-25 mm of cream or ointment squeezed onto the “fingertip”. One “fingertip unit” is approximately 0.5 g of cream or ointment is is enough to cover the front and back of a single hand.

One fingertip unit = 0.5 g of cream or ointment = two hand (palm) surfaces

Fingertip units for body surfaces

The following diagram was liberated from a dosing handout by Schering-Plough Pty Ltd for mometasone furoate 0.1% cream (Elocon):

Note: “hand” refers to the entire hand (i.e., palmar and dorsal surfaces)

For example:

An adult patient has atopic dermatitis over the trunk and back with an area equivalent in size to approximately 4 hand (palm) surfaces. The is equivalent to 2 fingertip units or 1 g of cream

If the cream is applied once a day and the tube contains 30 g of corticosteroid cream, then we would expect that the tube should last approximately 30 days.

Reference article

(1) Long C., Finlay A. The finger tip unit… a new practical measure. Clin Exp Dermatol 1991;16:444-7. [Link]

Please read the disclaimer

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5 Comments »

  1. Lisa said,

    I have black discoloration skin which suddenly presents all over my neck and my underarms,and I need to know if this cream can cure my problems please I need your help Im being living with this problem since I was 14 yrs old now i’M 20 and still have it.

  2. Michael Tam said,

    To be perfectly honest, I have absolutely no idea what skin condition you have but blind use of topical corticosteroids is a bad idea. The only advice that I can give is that you see your regular general practitioner and consider a referral to see a dermatologist.

  3. Don Skelley said,

    I have plaque psoriasis only on the palms of my hands. At least thats what I’m told. Its interesting to see that neither my doctor or the pharmacist offer “any” direction on the dose size of each steroid ointment application. The label simply reads “apply” to affected area twice a day.
    I think the words “Doctor” and “Pharmacist” are handed out willy nilly sometimes!!!!!

  4. Michael Tam said,

    To be perfectly frank, if you weren’t sure of how to apply the cream, why did you not ask your doctor or the pharmacist? There is nothing to it really. You put enough of the cream on your affected area so that it covers the rash.

    This article is for practitioners so that they can estimate how much cream they need to prescribe.

  5. Marie said,

    This article is useful for my becose I have an investigation for my job.


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