13.1 Management of skin conditions
- 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 area||Non–corticosteroid cream/ointment||Lotions|
|Face||60 to 120g||400mls|
|Both hands||100 to 200g||800mls|
|Scalp||200 to 400g||800mls|
|Both arms||400 to 800g||800mls|
|Both legs||400 to 800g||800mls|
|Groins and genitalia||60 to 100g||400mls|
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 area||Corticosteroid cream/ointment|
|Face and neck||15 to 30g|
|Both hands||15 to 30g|
|Scalp||15 to 30g|
|Both arms||30 to 60g|
|Groins and genitalia||15 to 30g|
The fingertip unit may also be helpful to guide the amount of topical steroid to apply.