General Dermatology Instructions

DermAssociates Rockville wants to make sure that you are well informed before and after receiving general dermatology care. Please review the following instructions if you have received a biopsy or are a woman of childbearing potential interested in Accutane.

Wound Care Instructions

Accutane Guidelines


Shave Biopsy Wound Care (without stitches)

INSTRUCTIONS FOR CARING FOR YOUR SHAVE BIOPSY SITE

WOUND CARE

  • Your biopsy site will be covered with a pressure dressing. This should be left in place and kept dry for 24 hours.
  • After 24 hours remove the bandage and begin once-daily wound care as follows:
    • Clean the wound with warm soapy water (use a gentle soap like Dove) with a Q tip or gauze pad
    • Rinse thoroughly
    • Dry wound with a Q tip or gauze pad
    • Apply a layer of Vaseline petroleum jelly or Aquaphor to wound
    • Cover wound with a non-stick gauze pad and paper tape or with a bandaid
  • Clean the wound and replace the dressing once a day until the wound is healed completely. This should take 7-10 days.
  • Shower normally. It is perfectly fine for the wound to get wet in the shower, however, if you do this, after your shower, clean the wound as above and replace the dressing.
  • Do not submerge the wound or participate in water activities like swimming until the wound is healed.
  • You should NOT leave the wound open to the air and you should NOT allow a scab to form. Contrary to popular belief, this actually impairs wound healing and increases scar formation.

BLEEDING

  • If significant bleeding occurs that soaks the dressing or leaks from the dressing, remove the dressing and apply direct pressure to the bleeding site with rolled up clean gauze or clean cloth. Keep constant pressure on the site for 20 minutes without removing the new dressing (this means no peeking to look at the wound for 20 full minutes).
  • Applying an ice pack over the entire area, over the gauze while holding pressure can also help stop the bleeding.
  • If bleeding continues after two 20-minute cycles of applied pressure, call the numbers below or go to the nearest emergency room.

PAIN

  • Your biopsy site should not be particularly painful. You can apply ice to the area or take Tylenol for discomfort. Don’t take Motrin, Ibuprofen, Aspirin or any other blood thinning medications.
  • A significant increase in pain may indicate a problem. Call the office if this occurs.

In case of emergency, or with questions about your wound, call the DermAssociates Rockville office at 301-681-7000 during regular business hours.

Punch Biopsy Wound Care (with stitches)

Studies have proven that wounds heal faster when scabs are not allowed to form. Follow these instructions to prevent scabs from forming. This will result in better wound healing.

  1. Leave the original dressing in place for 24 hours
  2. Clean the wound once a day. Allow water, shampoo and soap from the shower to wash over the wound.
  3. Cover the wound with Aquaphor or Vaseline and then apply a bandage for 1-2 weeks. Change the bandage daily.

We recommend that you apply Aquaphor or Vaseline to a Band-Aid or Telfa pad (non-stick gauze) with tape. If you prefer not to use a band-aid, apply a thick coat of Vaseline or Aquaphor twice daily. Keep the wound covered with Aquaphor or Vaseline at all times until for 2 weeks.

ADDITIONAL INFORMATION

  • If a crust forms on the biopsy site, mix a solution of ½ tap water and ½ Hydrogen peroxide. Dip a Q-tip into the mixture and gently clean around the wound to remove the crust.
  • Take Acetaminophen (Tylenol) if you have discomfort. If you are not able to take Tylenol, ask your doctor what medicine you can take for the pain.
  • If a dissolvable stitch has been placed it will dissolve within 3-4 weeks. If the stitch is blue or black the stitch is likely non-dissolvable and will require removal. Typically non-dissolvable stitches are removed 7-14 days after the procedure.

REPORT ANY OF THESE SYMPTOMS TO YOUR PHYSICIAN

  • Increase in redness more than ¼ inch on each side of the biopsy site
  • Swelling
  • Increasing or severe pain
  • Drainage of pus
  • Fever over 100.5 degrees
  • If bleeding occurs which you cannot stop with firm pressure for 20 minutes

WHO TO CALL

  • DermAssociates, PC at 301-681-7000 for problems, Monday through Friday from 8am to 4pm. Ask for your physician and inform the staff if you have a problem with your biopsy site.
  • For urgent problems in the evenings or after hours, call 301.681.7000. After the prompt, press 1 to contact the physician on call.
  • If you have not received a report of your skin biopsy either by mail or by phone within 2 weeks after your biopsy, please call our office.

Accutane Guidelines For Women of Childbearing Potential

Now that you’ve decided to take Accutane, here are your next steps:

  1. Before starting Accutane, you will need two negative pregnancy tests one month apart. Your doctor will provide two blood work forms for you, one to be done now and one to be done 2-3 days before your next appointment.
  2. Make sure you review the I-pledge booklet and that you know where to locate your I-pledge number.
  3. After you have done your first blood test, your doctor’s office will register you in the I-pledge system. After you have been registered in I-pledge, you should receive information (either by US Mail or e-mail) with step-by-step instructions on how to log into the system. They will also provide you with a temporary I-pledge password.
  4. 2-3 days before your next doctor’s appointment, go to the lab with your second blood work form. The day you get your blood work done starts the “7-day window” which is when you are eligible to receive your Accutane prescription.

What is my 7-day window?

The “7-day window” signals the time you are eligible to receive your Accutane prescription. In the 7-day window, four steps must be completed:

  1. Get your blood work done.
  2. Have your appointment with your doctor.
  3. Complete your questions in the I-pledge system. You must enter the two forms of birth control you are using. You can only answer your questions after your doctor has entered your test results into the I-pledge system.
  4. Pick-up your prescription from the pharmacy. Bring your I-pledge card with you to the pharmacy so the pharmacy staff can complete their questions on I-pledge.

Why do I have to get bloodwork done 2-3 days before my appointment?

We ask that you complete the blood work 2-3 days before your appointment so that the doctor can review the results with you during the time of your appointment. Our office cannot update you in the I-pledge system until we have received a negative pregnancy test result from the lab.