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Guide Health: A little dab will do you

A little can go a long way when it comes to topical medications

Creams and ointments are an ideal way to deliver medication to skin conditions.

The saying “a little dab will do you” really is true when it comes to applying creams and ointments to your skin. These creams are termed topical agents because they are applied directly to your skin where they act. At any one time, it is estimated that 75 per cent of Canadians are using a cream or ointment, and most people have used a topical product at least once.

Creams and ointments are ideal to deliver medication to skin lesions and conditions, or alternatively to moisturize and protect your skin. They are the mainstay of treating acne, minor skin infections, eczema, psoriasis, rosacea, and even contact dermatitis like dish-pan-hands or poison ivy.

Creams contain more water than ointments and they feel less greasy. However, ointments like petroleum jelly remain on the skin and are less likely to be washed off. Thus, ointments have the ability to act longer and are considered more potent.

Where you are going to apply the cream or ointment can affect your choice, however. For example, you probably want a cream for rosacea on your face, but an ointment for psoriasis on your elbow.

Gels are also topical agents, but have an alcohol base. They are suited to skin conditions that benefit from the drying action of the alcohol, such as acne. Also available are lotions that are liquid preparations either in an alcohol or water base. Lotions are best for areas of skin that are hairy, such as your scalp.

Choosing the right size of tube of a cream or ointment can be difficult because your aim should be to use the complete tube without any waste. Historically, a fingertip unit was the measure that was used, and in some parts of the world still is.

A fingertip unit is approximately 0.5 grams and is the amount of cream or ointment that you can squeeze from a tube and will extend from your fingertip to the finger crease next to it. This amount will cover both the front and back of your hand, including your fingers.

An arm will need about three times as much, a leg about six times as much, and a foot about twice as much. Then, you can use your math skills to calculate whether you need a 15- or 30-gram tube.

Most medicated creams and ointments are only recommended to be applied once or twice daily. Moisturizers are usually applied more often in order to treat dry skin, and some products such as sunscreen lotions need to be reapplied after sweating.

Mild corticosteroid creams and ointments are available without a prescription to be used for minor skin inflammation, such as a mild case of poison ivy. However, if no improvement occurs after about two weeks, you need to have your skin condition checked because it may need a more potent prescription medication.

Non-prescription antibiotic creams and ointments are useful for minor cuts and scrapes, but should not be used in place of appropriate cleansing of the wound.

To obtain the most benefit from your cream or ointment, correct application is important. Wash your hands before application and after as well (unless, of course you are applying the cream or ointment to your hands). Apply a thin layer to clean, dry skin, and in the direction of hair growth if there is hair. Avoid application to broken or damaged skin because this can result in systemic absorption of the medication into your body.

Also avoid scented products; the additives can worsen skin irritation. As well, some types of creams and ointments are best avoided because they can cause skin sensitization, for example topical antihistamines. Remember to check for expiry dates, and that once opened creams and ointments can be contaminated. And don’t save your old, rolled-up tube!

Skin creams and ointments are not replacements for common sense measures to keep your skin healthy. If a skin rash or lesion happens, check for any activities or environmental factors that may have caused it; and if you know you are at risk for a skin problem, take steps to avoid it, for example wear gloves when washing the dishes, and know what poison ivy looks like and keep away. Common sense may save your skin!

About the author


Marie Berry is a lawyer/pharmacist interested in health and education.



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