Topical Corticosteroid Cream or Ointment

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 and reduces the risk of side effects. The most important thing to remember with topical corticosteroid creams and ointments is to apply them very thinly. This minimises the amount absorbed into the body.

How to use your topical corticosteroid cream or ointment
1. 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.
2. Wash the affected area(s) of skin well and rinse away all traces of cleanser.
3. Pat the skin dry rather than rubbing it.
4. Apply the cream or ointment thinly and evenly to the affected area(s).
5. Gently massage the cream or ointment into the skin until it has all disappeared.
6. Replace the cap on the tube.
7. Wash your hands after applying the cream or ointment, unless the hands are the affected area.
8. Topical corticosteroids should generally not be applied more than twice a day or for longer than one week, but follow the instructions your doctor or pharmacist gives you.

How much should you use?
You can measure the amount required 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.

Other useful advice :
• 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.)
• 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 limited to no more than five days. Ensure the product does not get in your eyes. Continued use of topical corticosteroid preparations may lead to a lightening of the skin.
• 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.
• There will be more medicine absorbed from the face, genitals and areas of skin that rub together, such as beneath the breasts or between the buttocks, so take care if applying creams or ointments to these areas.
• 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.
• Always follow the advice on the printed label of the tube/box and/or as directed by your doctor or pharmacist.
• 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.
• Always keep medicines out of the reach of children.
• Creams and ointments are designed only for application to the skin. If they are accidentally taken by mouth, tell your doctor at once.
• 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.
• Do not use your cream or ointment after the expiry date on the tube.
• If you forget to apply your cream or ointment, apply the correct dose when you remember, and then carry on as before.

Written by Helen Davis, Pharmacist