Fingertip Units for Topical Steroids

Authored by Dr Roger Henderson, Reviewed by Dr Helen Huins on | Certified by The Information Standard

Topical steroids are used for various skin conditions. The amount of topical steroid that you should apply is commonly measured by fingertip units.

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. This is why a standard measure is often used - the fingertip unit (FTU).

See separate leaflet called Topical Steroids for Eczema for more information.

Picture 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.

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 roughlyFTUs each
dose (adults)
A hand and fingers (front and back)About 2 adult hands1 FTU
Front of chest and abdomenAbout 14 adult hands7 FTUs
Back and buttocksAbout 14 adult hands7 FTUs
Face and neckAbout 5 adult hands2.5 FTUs
An entire arm and handAbout 8 adult hands4 FTUs
An entire leg and footAbout 16 adult hands8 FTUs

An 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.

Further reading and references

  • ; The finger-tip unit - a new practical measure. Clin Exp Dermatol. 1991 Nov16(6):444-7.

  • ; Expert consensus: time for a change in the way we advise our patients to use topical corticosteroids. Br J Dermatol. 2008 May158(5):917-20. Epub 2008 Feb 22.

  • ; NICE CKS, September 2015 (UK access only)

  • ; NICE CKS, March 2017 (UK access only)

  • ; NICE Evidence Services (UK access only)

Started at about 15 mgs of Prednisone 3 years ago for PMR. Was just reduced from 4 mgs to 3 in the last week. I feel awful! I periodically get severe acid reflux, belly pain, and pretty much have...

Bert5560
Health Tools

Feeling unwell?

Assess your symptoms online with our free symptom checker.

Start symptom checker