Skin Care Regimens

Acne Skin Care Regimen

The basic tenants of skin care for acne patient is to keep the skin clean, prevent the follicles from being occluded, control surface oil and bacteria, and minimize inflammation. The minimum skin care regimen can be accomplished with over-the-counter products in some cases, but does require prescription products from a dermatologist or primary physician in many cases as well.
Acne skin care must start with a cleanser. The best agents tend to have 2% or more salicylic acid or 3-10% benzoyl peroxide. A suitable agent for acne prevention may also have glycolic acid in concentrations of 2-12% and be in combination with salicylic acid or benzoyl peroxide. Cleansers must be used 2-3 times daily to be optimally effective.

Astringents/Toners may also be used in patients with acne and oily skin. These agents are used after a cleanser and a more thorough cleansing agent. While they may be regularly used once or twice a day, care must be excised not to overuse astringents as they may remove an extra degree of skin surface oil and cause dryness.

For those with body acne on the chest and back, body washes in the shower are an effective way to help prevent further acne development. As stated above, ingredients such as salicylic acid and benzoyl peroxide are excellent for body acne as well as facial acne.

After application of these medicated cleansers, further care may be obtained through the use of prescription retinoids, topical/oral antibiotics, or other topical agents such as sodium sulfacetamide and azeleic acid.

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Post-Biopsy Wound Care Regimen

Shave biopsies:
A shave biopsy is one where a horizontal blade or razor is used to "shave" the specimen from the skin. Most commonly, these biopsies are superficial and resemble a deeper abrasion or erosion. They often have the look and feel of a deeper "rug burn".

While a small whitish or slightly dark scar is fully expected, the appearance of the scar can be minimalized with proper care of the wound. Place antibiotic ointment and a bandage three times a day for the first week or until the level of the wound is flush with the surrounding skin. Then, ointment may be applied 2-3 times a day for another 5-7 days without a bandage. The wound will begin to have a crust, and it is very important to allow the crust to remain on the wound as long as possible without trying to pick it off. Picking off the crust too early will result in a higher incidence of scarring where it might otherwise be avoided.

Showering and washing the area may be done 24-36 hours after the procedure. Use clean, warm, soapy water gently over the wound. Do not use hydrogen peroxide on the wound. Any signs of excess pain, redness, smell, drainage, pus, fever, chills, or swelling around the site should be interpreted as a possible infection - alert your dermatologist immediately should these signs occur.
Punch / Incisional biopsies:

A punch biopsy is done where a piece of tissue is cored-out with a biopsy instrument and the resulting wound is closed with a suture. The resulting wound is usually a small line less than half of a centimeter.

While a small whitish or slightly dark scar is fully expected, the appearance of the scar can be minimalized with proper care of the wound. These biopsies require less care than shave biopsies since the suture keeps the wound closed. Place antibiotic ointment on the wound for 2-3 days with a bandage. After 2-3 days, no ointment or bandage is needed. Showering and washing the area may be done 24-36 hours after the procedure. Use clean, warm, soapy water gently over the wound. Do not use hydrogen peroxide on the wound. Any signs of excess pain, redness, smell, drainage, pus, fever, chills, or swelling around the site should be interpreted as a possible infection - alert your dermatologist immediately should these signs occur.
The suture(s) should be removed in 4-7 days if the biopsy is done on the face, and in 7-14 days if done on the body. No wound care is needed after the suture(s) removal.
 

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Post-Laser / Post-Chemical Peel Regimen

While many of the most commonly used laser treatments and chemical peels do not often result in scarring, a good post-operative regimen may ensure optimal results from your procedure and minimalize side effects.

• Immediate post-operative comfort practices include ice-packs to decrease swelling and post-operative pain, if present.

• Gentle cleansing with a non-irritating cleanser and warm water (may be done by padding with a washcloth) is recommended 2-3 times a day, but be cautious not to induce over-drying of the treated skin. Immediate and copious application of a moisturizer 3-4 times daily should be done.
• A sunblock SPF 30 or higher should be used 3-4 times daily. Sunavoidance should be performed for at least 1-2 weeks after the procedure to decrease the risk of skin darkening.

Should you begin to experience excess pain, swelling, redness, fever, chills, or drainage from the treated area, please contact your dermatologist immediately.

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Post-Surgery Wound Care Regimen

Skin surgery usually results in the placement of multiple sutures in various arrays. An important point of post-surgery wound care is the avoidance of stress on the surgery site by heaving lifting, stretching, or physical exertion. Such wound stress will result in stretching of the incision leaving a wider and more noticeable scar. While avoidance of such physical stress on the wound should be practiced for 2-4 weeks after surgery, avoidance of such activity for 6-8 weeks will ensure the best possible appearance of the surgical scar. An exception is a back incision, since they may stretch for years after the surgical procedure.

While a whitish or slightly dark scar is fully expected, the appearance of the scar can be minimalized with proper care of the wound. These biopsies require less care than shave biopsies since the suture keeps the wound closed. Place antibiotic ointment on the wound for 2-3 days with a bandage. After 2-3 days, no ointment or bandage is needed. Showering and washing the area may be done 24-36 hours after the procedure. Use clean, warm, soapy water gently over the wound. Do not use hydrogen peroxide on the wound. Any signs of excess pain, redness, smell, drainage, pus, fever, chills, or swelling around the site should be interpreted as a possible infection - alert your dermatologist immediately should these signs occur.

The suture(s) should be removed in 4-7 days if the biopsy is done on the face, and in 7-14 days if done on the body. In certain cases such as subcuticular sutures, sutures may stay in place for over 3 weeks. No wound care is needed after the suture(s) removal.

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Wound Care Regimen

Superficial wounds and ulcers deserve special attention in order to heal with minimal scarring and discoloration. The best treatment for an acute wound is to thoroughly cleanse the wound with a clean gauze and distilled water / saline. If the wound was caused by an abrasion with a dirty surface, hydrogen peroxide is an excellent choice for disinfecting the wound.

After the wound has been cleansed, apply an ointment of your choice. Triple antibiotic ointment (Neosporin®) or even petrolatum jelly (Vaseline®) are ideal choices. Keep in mind that some people are allergic to the neomycin or bacitracin component of antibiotic ointments. The ointments should be applied 2-3 times daily and the wound should be covered with an occlusive bandage for at least the first 4-5 days to promote optimal wound healing. Once the wound has begun to develop a crust, the occlusive bandage is no longer necessary, but ointment application may be continually helpful in producing a better-looking scar.

Chronic ulcer treatment should be under the care of an experienced dermatologist or primary care physician because of the numerous causes and complications of these wounds. Compounds specific to chronic wound care may contain silver or papain for anti-infective and debridement purposes. Consult your physician regularly for the best management possible.

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