hands applying topical cream

8 Tips for Sticking to Your Topical Treatment Plan

By Kerry Weiss
Reviewed by Allison Truong, M.D.
January 05, 2024

If your doctor prescribes topical treatment—medication that’s applied directly to the skin—it’s important to follow their directions closely. However, as many as 65 percent of people who are prescribed topicals do not follow all the recommendations their doctor has given them. Yet, in order to get your skin condition and symptoms under control, it’s crucial to stay on top of your treatment.

“I can suggest over-the-counter medications or prescribe medications, but they don’t work if they’re not used,” says Laura Ferris, M.D., Ph.D., associate professor of dermatology at the University of Pittsburgh School of Medicine and director of clinical trials for the UPMC Department of Dermatology.

That includes topicals, which some people may think of differently compared to taking pills or getting shots. However, topicals are extremely effective when used appropriately; and, they have few side effects, which is a major benefit.

“I tell patients that topical treatments are similar to any other medications they may take if they’re diagnosed with other medical conditions like diabetes or hypertension,” says Isha Tiernan, M.D., a dermatologist at Tufts Medical Center in Boston. “You’re not going to notice any improvement unless you actually use the medication with the frequency that’s prescribed.”

Common Reasons People Skip Their Topical

With topical treatment, several issues come up that can prevent people from staying on top of their treatment regimen. These include:

  • Forgetfulness. “With medication adherence in dermatology, the number one factor is forgetfulness—just forgetting to take the medication,” explains Tiernan.
  • Misinformation. Unclear instructions from your physician, or even misinformation about side effects, can also be barriers. Many prescription medications are prescribed for longer than what is on the prescription patient insert (which usually tells patients to stop medications at two weeks). If the instructions you’re given aren’t clear, or if there is any confusion, you should ask your doctor or pharmacist for clarification.
  • Formulation. If something is too greasy, or if it’s too drying, it may make you want to stop using it. But know that there are other formulas that you may prefer better.
  • Cost. “If cost is an issue, reach out,” says Tiernan. "We have alternatives. We can help facilitate with insurance companies to try to get things approved and covered.” Your doctor also may know of other ways to getting the medications through coupons or samples.
  • Short appointment slots. Tiernan admits that dermatologists and patients often don’t have enough time to talk over how to properly take medication during a typical visit. “I think it’s an area where both patients and providers can do a better job of making sure they discuss medication adherence,” she says.

Tips for Properly Applying a Topical Treatment

While many people feel that applying topical treatment regularly and as directed isn’t as easy as taking a pill, there are a few tips that can help you stay on top of your regimen:

1. Ask questions. During your appointment, ask your doctor to clarify how to use your medication, the frequency with which to use it, any potential side effects you may experience, and any expectations for how long it should take to see results, explains Tiernan.

2. Pay attention to location. People often forget where they should apply their medications if they have more than one of them. “There are certain topical steroids that are safe for the face and certain that are safe the body,” explains Tiernan. “When people forget, they get worried and they may not use the medication. Bring it in and have your doctor write on each tube which one is for the face, and which one is for the body.”

3. Time it right. Certain topicals, such as acne medications, may be affected by sunlight, so they’re recommended for use at night, for example. If you know the best time of day to apply your medication, you can better work it into a routine. So ask.

4. Apply liberally. Ferris says that with topicals, it’s more common for a patient to not use enough than to use too much. “Make sure you’re covering the area of the body that’s affected with a thin layer,” adds Tiernan.

5. Apply after bathing. “Most topicals work best when they’re applied to freshly cleaned skin, so I recommend applying right after a shower or bath,” says Ferris. Keeping your tube or bottle next to the tub can make it handy to grab post-soak.

6. Apply it first. “Some people also use other skincare products, like moisturizers,” says Tiernan. “In general, the topical should go on the body first, then other things like moisturizers can go on top of it.”

7. Use visual cues. “To address forgetfulness, put the medication near something you always use—for example, next to your toothbrush—so you have a visual reminder every day to apply your topical treatment [when you brush your teeth],” says Tiernan.

8. Set reminders. “Another thing you can do is set reminders for yourself—use your smartphone to set an alarm, or put a sticky note on your bathroom mirror,” adds Tiernan.

Discuss Any Obstacles with Your Doctor

If you’re having trouble staying on top of your treatment regimen, talk it over with your doctor. Perhaps they can prescribe something you’re more likely to use as directed.

“Patients need to be advocates for their disease and work with their dermatologist to find the best medication—one that they will use,” says Ferris. “It’s important for patients to be realistic in conversations with their doctor about their expectations and to be realistic about their ability to adhere to a therapy.”

Your desires and preferences play a big role. “I talk a lot about the vehicle: a cream vs. a lotion vs. an ointment. Each has different benefits and challenges,” says Ferris. “I ask patients if they prefer one over another because it has to be something that they believe is working for them and that they will be comfortable using.”

Your reason for not using your topical could be something as simple as the fact that it’s greasy and you don’t want to put pants on over it. Even if it seems minor, if it’s interfering with your treatment plan, you should speak up.

“We can adjust,” says Tiernan. “We can modify the strength, or we can try other types, as some might work better for you than others.”

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