What is the gram amount of a fingertip unit (FTU) of cream for topical application?

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Fingertip Unit Measurement for Topical Cream Application

One fingertip unit (FTU) equals approximately 0.5 grams of cream or ointment. 1

Definition and Measurement

  • An FTU is defined as the amount of ointment expressed from a tube with a 5mm diameter nozzle, applied from the distal skin crease to the tip of the index finger. 2

  • This standardized measurement covers approximately 2% body surface area (BSA) in adults, equivalent to roughly two adult palm areas. 1, 3

  • The actual weight varies slightly by sex: males average 0.45g per FTU, while females average 0.38g per FTU. 4

Coverage Area

  • One FTU covers approximately 286 cm² of skin surface in adults (312 cm² in males, 257 cm² in females). 2

  • This measurement provides a practical, reproducible method for both patients and clinicians to estimate appropriate topical medication quantities. 2, 5

Clinical Application by Body Region

The American Academy of Dermatology provides specific FTU recommendations for different anatomical areas 6, 1:

  • Face and neck: 2.5 FTU (approximately 1.25 grams)
  • One hand (front and back): 1 FTU (approximately 0.5 grams)
  • One entire arm: 4 FTU (approximately 2 grams)
  • One entire leg: 8 FTU (approximately 4 grams)
  • Trunk (anterior or posterior): 8 FTU each (approximately 4 grams each)
  • Scalp: 3 FTU (approximately 1.5 grams)
  • Genitalia: 0.5 FTU (approximately 0.25 grams)
  • Buttocks: 4 FTU (approximately 2 grams)

Important Clinical Considerations

  • The FTU method is the most frequently used and validated measurement for accurate topical medication application. 5, 3

  • Many pharmacists and patients inadequately apply topical medications, often instructed to use "a thin layer," which typically results in underdosing and treatment failure. 7

  • For maintenance therapy requiring twice-weekly application, prescribe adequate quantities: 15-30g per 2 weeks for face/neck, 30-60g for both arms, and 100g for both legs or trunk. 8

  • Proper patient education using the FTU method significantly improves treatment adherence and outcomes compared to vague instructions. 5, 7

References

1
Guideline

Guidelines for Topical Cream and Ointment Application Amounts

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

2
Research

The finger-tip unit--a new practical measure.

Clinical and experimental dermatology, 1991

3
Research

Topical Corticosteroids: Choice and Application.

American family physician, 2021

5
Research

[Adequate prescription and application of topicals : How to calculate the right volume for the prescription of ointment needed?].

Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete, 2018

6
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

8
Guideline

Topical Treatments for Eczema

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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