Fingertip units for topical steroids
Granskad av Dr Colin Tidy, MRCGPSenast uppdaterad av Dr Doug McKechnie, MRCGPLast updated 19 Jan 2023
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Topical steroids are used for various skin conditions. The amount of topical steroid that you should apply is commonly measured by fingertip units.
At a glance
Topical steroids are creams, ointments, and lotions containing steroid drugs.
They reduce inflammation and are used for various skin conditions like eczema.
A fingertip unit (FTU) is a standard measure for applying topical steroids.
One FTU is the amount of cream from the end of a finger to the first crease.
One FTU covers an area of skin twice the size of an adult's hand.
The article provides guidance on the number of FTUs needed for different body parts and ages.
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What are topical steroids?
Topical steroids are creams, ointments and lotions which contain steroid drugs. Topical steroids work by reducing inflammation in the skin. They are used for various skin conditions, such as atopic eczema. Unlike many other creams and ointments, it is important to get the dose right when using topical steroids, to avoid giving too much, or too little. This is why a standard measure is often used - the fingertip unit (FTU).
See the separate leaflet called Topical Steroids for Eczema for more information.
Fingertip units
Tillbaka till innehållPicture of a fingertip unit of a topical steroid
One FTU is the amount of topical steroid that is squeezed out from a standard tube along an adult's fingertip. (This assumes the tube has a standard 5 mm nozzle.) A fingertip is from the very end of the finger to the first crease in the finger. One FTU is enough to treat an area of skin twice the size of the flat of an adult's hand with the fingers together (ie a 'handprint').
Two FTUs are about the same as 1 g of topical steroid. Therefore, for example, say you treat an area of skin the size of eight adult hands. You will need four FTUs for each dose. (This is 2 g per dose. If the dose is once a day, then a 30 g tube should last for about 15 days of treatment.)
The following are further examples:
Area of skin to be treated (adults) | Size is roughly | FTUs each dose (adults) |
A hand and fingers (front and back) | About 2 adult hands | 1 FTU |
Front of chest and abdomen | About 14 adult hands | 7 FTUs |
Back and buttocks | About 14 adult hands | 7 FTUs |
Face and neck | About 5 adult hands | 2.5 FTUs |
An entire arm and hand | About 8 adult hands | 4 FTUs |
An entire leg and foot | About 16 adult hands | 8 FTUs |
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Fingertip units and children
Tillbaka till innehållAn FTU of cream or ointment is measured on an adult index finger before being rubbed on to a child. Again, one FTU is used to treat an area of skin on a child, equivalent to twice the size of the flat of an adult's hand with the fingers together. You can gauge the amount of topical steroid to use by using your (adult) hand to measure the amount of skin affected on the child. From this you can work out the amount of topical steroid to use.
The following gives a rough guide:
For a child aged 3-6 months
Entire face and neck - 1 FTU.
An entire arm and hand - 1 FTU.
An entire leg and foot - 1.5 FTUs.
The entire front of chest and tummy (abdomen) - 1 FTU.
The entire back including buttocks - 1.5 FTUs.
For a child aged 1-2 years
Entire face and neck - 1.5 FTUs.
An entire arm and hand - 1.5 FTUs.
An entire leg and foot - 2 FTUs.
The entire front of chest and abdomen - 2 FTUs.
The entire back including buttocks - 3 FTUs.
For a child aged 3-5 years
Entire face and neck - 1.5 FTUs.
An entire arm and hand - 2 FTUs.
An entire leg and foot - 3 FTUs.
The entire front of chest and abdomen - 3 FTUs.
The entire back including buttocks - 3.5 FTUs.
For a child aged 6-10 years
Entire face and neck - 2 FTUs.
An entire arm and hand - 2.5 FTUs.
An entire leg and foot - 4.5 FTUs.
The entire front of chest and abdomen - 3.5 FTUs.
The entire back including buttocks - 5 FTUs.
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Topical steroids for eczema
Topical steroids are medicated steroid creams that are put on the skin. They are used in addition to moisturisers (also called emollients) for treating eczema. Topical steroids reduce skin inflammation. A short course will usually clear a flare-up of eczema. Side-effects are unlikely to occur with short courses.
av Dr Toni Hazell, MRCGP
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Vanliga frågor
What is the primary purpose of using topical steroids?
Topical steroids are used to reduce inflammation in the skin. They are beneficial for various skin conditions, such as atopic eczema, by calming down the skin's reaction.
How big an area can one fingertip unit (FTU) cover?
One fingertip unit (FTU) is enough topical steroid to treat an area of skin that is twice the size of an adult's flat hand with the fingers together. This is equivalent to one 'handprint'.
How much does one fingertip unit (FTU) weigh in grams?
Two fingertip units (FTUs) are approximately equal to 1 gram of topical steroid. Therefore, one FTU is roughly 0.5 grams.
If I need to treat a large area, like my entire back and buttocks, how many FTUs would I need as an adult?
For an adult, treating the entire back and buttocks, which is roughly 14 adult hands in size, would require 7 FTUs for each dose.
When measuring an FTU for a child, whose fingertip should be used?
When measuring an FTU for a child, the cream or ointment should be squeezed onto an adult's index finger. The amount measured on the adult's finger is then applied to the child's skin.
How can I estimate the amount of topical steroid needed for a child's affected skin area?
You can estimate the amount by using your own adult hand to measure the size of the skin area affected on the child. One FTU should cover an area equivalent to two of your adult handprints on the child's skin.
Vidare läsning och referenser
- Long CC, Finlay AY; The finger-tip unit - a new practical measure. Clin Exp Dermatol. 1991 Nov;16(6):444-7.
- Bewley A; Expert consensus: time for a change in the way we advise our patients to use topical corticosteroids. Br J Dermatol. 2008 May;158(5):917-20. Epub 2008 Feb 22.
- British National Formulary (BNF); NICE Evidence Services (UK access only)
- Corticosteroids - topical (skin), nose, and eyes; NICE CKS, June 2022 (UK access only)
- Eczema - atopic; NICE CKS, April 2022 (UK access only)
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About the authorView full bio
Dr Doug McKechnie, MRCGP
Medical Writer
MA, MBBS, MSc, DRCOG, MRCP(UK), MRCGP(2021), FHEA
Dr Doug McKechnie is an NHS GP working in London. He works full-time clinically and is also the Deputy Lead for the Clinical and Professional Practice module at University College London Medical School.
About the reviewerView full bio
Dr Colin Tidy, MRCGP
General Practitioner, Medical Author
MBBS, MRCGP, MRCP (Paediatrics), DCH
Dr Colin Tidy is an NHS Doctor, based in Oxfordshire.
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Informationen på denna sida är skriven och granskad av kvalificerade kliniker.
Next review due: 18 Jan 2028
19 Jan 2023 | Senaste versionen
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