13.1 Management of skin conditions

General notes

  • Creams are more cosmetically acceptable than ointments. Gels are particularly suitable for application on the face and scalp while lotions are used for moist conditions and hairy areas. Ointments are much less likely to sensitise and are suitable for chronic dry lesions. Pastes are less occlusive than ointments and can be used to protect inflamed, lichenified, or excoriated skin.
  • Unlicensed ‘specials’ may be required when a suitable licensed product isn’t available. These products can be very expensive. Please adhere to the British Association of Dermatologists (BAD) list of preferred specials – available here.
  • Multi-ingredient skin preparations should be prescribed by BRAND name as generic prescribing may not be practical or may lead to confusion due to multiple ingredients.
  • It is important that skin preparations are prescribed in appropriate quantities.

The table below lists quantities suitable for an adult for twice daily application of a non-steroid cream/ointment for 4 weeks:

Body areaNon–corticosteroid cream/ointmentLotions
Face 60 to 120g400mls
Both hands100 to 200g800mls
Scalp 200 to 400g800mls
Both arms400 to 800g800mls
Both legs400 to 800g800mls
Trunk1600g2000mls
Groins and genitalia60 to 100g400mls

The table below lists quantities suitable for an adult for single daily application for two weeks for steroid cream/ ointment.  The table below lists quantities suitable for an adult for single daily application for two weeks for steroid cream/ointment:

Body areaCorticosteroid cream/ointment
Face and neck15 to 30g
Both hands15 to 30g
Scalp 15 to 30g
Both arms30 to 60g
Both legs100g
Trunk100g
Groins and genitalia15 to 30g

The fingertip unit may also be helpful to guide the amount of topical steroid to apply.