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How to use your topical corticosteroid cream or ointment
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Written by Helen Marshall, pharmacist
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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
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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.
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Wash the affected area(s) of skin well and rinse away all
traces of cleanser.
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Pat the skin dry rather than rubbing it.
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Apply the cream or ointment thinly and evenly to the affected
area(s).
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Gently massage the cream or ointment into the skin until it has
all disappeared.
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Replace the cap on the tube.
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Wash your hands after applying the cream or ointment, unless
the hands are the affected area.
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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.
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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
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Only use topical corticosteroids on the affected areas of skin.
Never use them as moisturisers.
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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.)
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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.
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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.
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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.
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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.
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Creams and ointments are designed only for application to the
skin. If they are accidentally taken by mouth, tell your doctor at once.
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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.
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Always follow the advice on the printed label of the tube/box
and/or as directed by your doctor or pharmacist.
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If you forget to apply your cream or ointment, apply the
correct dose when you remember, and then carry on as before.
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Do not use your cream or ointment after the expiry date on the
tube because it may be contaminated with germs.
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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.
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Always keep medicines out of the reach of children.
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Last updated 08.12.2010
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