Vitiligo Zone

Many of the known treatments for vitiligo rely on daily ointment applications. But do we know how to properly apply the ointment and in what quantity ? Here are some guidelines on how much ointment to apply to your vitiligo spots.

The amount of steroid the patient should apply to a particular area can be determined by using the fingertip unit method. A fingertip unit is defined as the amount that can be squeezed from the fingertip to the first crease of the finger. The table below describes the number of fingertip units needed to cover specific areas of the body. One hand-size area (i.e., the area of one side of the hand) of skin requires 0.5 fingertip units or 0.25 g of steroid. The amount dispensed and applied should be considered carefully because too little steroid can lead to a poor response, and too much can increase side effects.

These indications can be used both when treating vitiligo with topical immunomodulators (Protopic, Elidel) and corticosteroids.

Area of the body	Fingertip unit required for one application	Weight of ointment required for one application (g)	Weight of ointment required for an adult male to treat twice daily for one week (g)
Face and neck	2.5	1.125	17.5
Trunk (front or back)	7	3.5	49
One arm	3	1.5	21
One hand (one side)	0.5	0.25	3.5
One leg	6	3	42
One foot	2	1	14
·          One fingertip unit = approximately 0.5 g.

Please note that improper use of steroids can lead to skin atrophy, rosacea, erythema and infections so please consult your physician before starting a vitiligo treatment.

SOURCES:
Choosing Topical Corticosteroids JONATHAN D. FERENCE, PharmD, Nesbitt College of Pharmacy and Nursing, Wilkes University, Wilkes-Barre, Pennsylvania ALLEN R. LAST, MD, MPH,    Racine Family Medicine Residency Program, Medical College of Wisconsin, Racine, Wisconsin

 28.   Long CC, Finaly AY. The finger-tip unit—a new practical measure. Clin Exp Dermatol. 1991;16(6):444-447.