Dermatology Book

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Topical Medication Quantity

Aka: Topical Medication Quantity, Fingertip Estimate of Topical Medication Quantity, Finger Tip unit, FTU, Rule of Hand
  1. Definitions
    1. Rule of Hand
      1. One adult hand print (palmar surface of hand and fingers) is 0.8% (~1%) of body surface area
      2. One adult hand print requires 0.25 grams of topical medication per application
      3. Two adult hand prints require 0.5 grams of topical medication per application (1 Finger Tip unit)
      4. Four adult hand prints require 1 gram of topical medication (2 Finger Tip units)
    2. Finger Tip unit (FTU)
      1. Line expressed from a 5mm nozzle starting at adult index finger DIP joint and extending to finger tip
      2. One FTU is equivalent to 0.5 grams of topical medication and covers 2 hand prints (1.6% of body surface area)
      3. Two FTU is equivalent to 1 gram of topical medication and covers 4 hand prints (3.2% of body surface area)
  2. Protocol: Fingertip Unit Estimate for Ointment Quantity
    1. Background
      1. One fingertip unit (FTU) is equivalent to 0.5 grams of ointment
      2. One Finger Tip unit covers two adult hand prints (2% of body surface area)
      3. Topical medications are often most cost effective in standard tube sizes (15g, 30g, 45g, 60g)
        1. Prescribed amounts are rounded up to available tube sizes
        2. One 15 gram tube is equivalent to a travel size toothpaste
    2. Face and Neck: 5 adult hand prints
      1. Fingertip unit needed for one application: 2.5 units
      2. Ointment weight needed per application: 1.25 grams for an adult
      3. Ointment weight needed for two weeks (twice daily): 35 grams
      4. Prescribe
        1. Adult: 30 grams
        2. Older child: 30 grams
        3. Younger child: 15 grams
        4. Infant: 15 grams
    3. One side of Trunk (chest and Abdomen or thoracic and lumbar back): 7 adult hand prints
      1. Fingertip unit needed for one application: 3.5 units
      2. Ointment weight needed per application: 1.75 grams for an adult
      3. Ointment weight needed for two week (twice daily): 49 grams
      4. Prescribe
        1. Adult: 60 grams
        2. Older child: 45 grams
        3. Younger child: 30 grams
        4. Infant: 15 grams
    4. Entire Trunk (back and front): 14 adult hand prints
      1. Fingertip unit needed for one application: 7 units
      2. Ointment weight needed per application: 3.5 grams for an adult
      3. Ointment weight needed for two week (twice daily): 98 grams
      4. Prescribe
        1. Adult: 120 grams
        2. Older child: 90 grams
        3. Younger child: 60 grams
        4. Infant: 30 grams
    5. One arm: 6 adult hand prints
      1. Fingertip unit needed for one application: 3 units
      2. Ointment weight needed per application: 1.5 grams for an adult
      3. Ointment weight needed for two weeks (twice daily): 42 grams
      4. Prescribe
        1. Adult: 45 grams
        2. Older child: 45 grams
        3. Younger child: 30 grams
        4. Infant: 15 grams
    6. One hand and fingers (both sides): 2 adult hand prints
      1. Fingertip unit needed for one application: 1 unit
      2. Ointment weight needed per application: 0.5 grams for an adult
      3. Ointment weight needed for two weeks (twice daily): 14 grams
      4. Prescribe
        1. Adult: 15 grams
        2. Older child: 15 grams
        3. Younger child: 7.5 grams (15 gram may be smallest tube size available)
        4. Infant: 7.5 grams (15 gram may be smallest tube size available)
    7. One leg: 12 adult hand prints
      1. Fingertip unit needed for one application: 6 units
      2. Ointment weight needed per application: 3 grams for an adult
      3. Ointment weight needed for two weeks (twice daily): 84 grams
      4. Prescribe
        1. Adult: 90 grams
        2. Older child: 60 grams
        3. Younger child: 30 grams
        4. Infant: 15 grams
    8. One foot: 4 adult hand prints
      1. Fingertip unit needed for one application: 2 units
      2. Ointment weight needed per application: 1 gram for an adult
      3. Ointment weight needed for two weeks (twice daily): 28 grams
      4. Prescribe
        1. Adult: 30 grams
        2. Older child: 30 grams
        3. Younger child: 15 grams
        4. Infant: 15 grams
  3. References
    1. Habif (2004) Clinical Dermatology, 4th ed, Mosby, New York, p. 27
    2. Long (1991) Clin Exp Dermatol 16(6): 444-7 [PubMed]

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