Care Instructions


Warts are caused by a virus, and consistent treatment is required to fully eliminate them. Expect to have multiple in-office treatments, with home treatments in between.


Warts may spread to other areas of the body or to other people with direct contact. Covering warts with a bandage may reduce the risk of contagion.

Treatment Methods

Cantharone (Blister Beetle)

  • This treatment is applied in the office and then removed 4-6 hours later at home
  • Cantharone is poisonous. Ensure treated areas remain covered by bandage until it has been washed off completely.
  • Soak off bandages and wash completely with soap and water 4-6 hours after application, sooner upon noticing redness, significant irritation, or pain.



Mediplast Home Treatment

  • Mediplast is an over the counter treatment for warts. It contains 40% salicylic acid in a sticky plaster that can be applied directly to the wart. Although it treats the wart slowly, it is often very effective if used consistently.
  • You may apply Mediplast or other topical treatment approximately one week after in-office treatment after warts have healed from treatment.
  • Mediplast comes in large sheets. Using a pair of scissors, cut a piece to the approximate size of each wart. Peel the backing off and stick the Mediplast directly to the wart.
  • For warts on the hands and feet, you may use athletic tape to hold the Mediplast in place. You may shower, exercise, and do all of your normal activities with it in place. You may leave in place for up to a week, or replace daily. Mediplast should not be used on the face or ears and should not be used to treat genital warts.
  • When you remove a piece of Mediplast, the wart will appear white and soft. Use a pumice stone or a washcloth to remove any loose skin, then apply a new piece of Mediplast as above. Once the wart appears to be completely gone, continue treatment for one week further to try to ensure its destruction.
  • Mediplast is available at our office for $1.50 per sheet or may be special ordered online.

What to Expect

  • Some visibility of spider veins will be reduced, but every patient (and every vein) responds uniquely to treatment, so results cannot be guaranteed and it is common for multiple treatments to be needed.
  • Some veins may disappear initially after treatment, then recur, especially if compression instructions are not followed diligently.
  • Redness, itching, and irritation may develop as a reaction to tape, bandages, or compression stockings.
  • Bruising or tenderness may occur, but it is generally mild and temporary.
  • Treatments may leave residual brownish pigmentation. This is not uncommon, usually temporary, and generally resolves over weeks to months.


  • Stay active and walk (avoid prolonged standing and sitting) for several days. On a long plane or car trip, get up and move around, or at least flex your ankles periodically to activate the venous pump in the calf muscles.
  • Wear compression stockings daily for at least 1-2 weeks. They should be removed only to shower.
  • Avoid weightlifting, running, and high-impact aerobics for one week.
  • Avoid heat on your legs, such as hot baths and sunbathing, for at least a week. Heat causes blood vessels to dilate.
  • Avoid salty food and drink plenty of water for 2-3 days.
  • For discomfort take over-the-counter Tylenol (acetaminophen), if you are able to take Tylenol. Ibuprofen may increase the risk of bleeding.

When to Call the Doctor

  • Superficial inflammation (phlebitis) may occur, with tenderness and firmness. This typically resolves with treatment, but in some cases can be long-lasting.
  • If any bleeding is not controlled with 20 minutes of firm, constant pressure, contact our office.

Next Steps

  • Schedule a follow-up treatment in 4-6 weeks after your procedure, as it is difficult to achieve 100% clearance of spider veins in one treatment session.
  • Most people need 2-3 sessions, and more may be required if veins are very extensive.

What is Mohs Surgery?

Mohs surgery has the highest cure rates for all non-melanoma skin cancers. For certain cases of the most common types of skin cancer — squamous cell carcinoma and basal cell carcinoma — the cure rate can be as high as 99 percent.

How is Mohs Surgery Performed?

Your Diagnosis

Non-melanoma skin cancers can grow large and even be disfiguring. Some can even metastasize if left untreated.

Your Treatment: Mohs Surgery

If present on the face or other critical site, Mohs surgery ( is a common and highly effective treatment. Mohs is also recommended for non-melanoma skin cancers that have recurred after initial treatment. Benefits are:

  • Surgery is done by a dermatologist with special training in skin cancer removal, skin pathology (microscope assessments of the tissue removed), and cosmetic closure techniques.
  • It is performed under local anesthesia in a physician’s office.
  • Mohs has the highest cure rate since the tissue is examined for cancer cells during the surgery. Surgery continues until the examination shows all clear.
  • The least amount of tissue will be removed since only small amounts of skin are taken at a time, so scar length is minimized compared to standard excision surgeries. (Remember, however, that the visible portion of the skin cancer may be only the “tip of the iceberg”, so lesions are possibly much larger than they initially appeared.

Next Steps

  • If you have been specifically referred to a Mohs surgeon, your medical records have been faxed. (Advise if you elect a different surgeon.) Contact them directly for a surgery consultation within the next few weeks.

Follow Up

  • After surgery (typically in 3-6 months, as directed by your doctor), return to our clinic for a full-body skin cancer screening. Call sooner for any growing or changing lesions.
  • Use careful and consistent sun protection to minimize additional skin cancer.

Care of Wound Site

  • Keep wound dry for 24 hours, then remove bandage and shower normally.
  • Cleanse wound gently, allowing soap and water to run overwound, but do not scrub.
  • Keep wound moist with Polysporin ointment or Vaseline, and cover daily with a clean non-stick bandage.

If You Have Bleeding

  • Hold firm pressure for 20 minutes, without lifting pressure to look at the wound. Repeat as needed.
  • If the wound continues to bleed, call our office or report to the nearest emergency room.

If You Have Pain

  • Elevate the affected limb on the date of the procedure and the following day; this will minimize throbbing pain, swelling, and bleeding.
  • If toenail was removed, wear open-toe shoes as much as possible.
  • For any wound discomfort, you may take Tylenol (or acetaminophen), for adults 500-1000 mg every six hours (if you are able to take Tylenol) and/or use cold compresses for up to 20 minutes hourly as needed.

Activity to Avoid

  • Avoid contaminated water (lake, river, or ocean); use waterproof bandage in a chlorinated pool.
  • Minimize activity that produces stress to the avulsion site, such as running, until well healed.

Watch for Infection

  • Call the office if you have signs of infection, such as increased tenderness, warmth, spreading redness, swelling, or thick white-to-yellow discharge.
  • Severe infection may also include fever, chills, nausea, or pain radiating from the wound to surrounding tissue; seek urgent medical attention.
  • Slight redness, initial tenderness, and clear yellow discharge are normal.

What is an Abscess?

  • An abscess is an area under the skin where pus collects. This is most commonly caused by a bacterial infection and can occur anywhere on the body.
  • Incision and drainage (I and D) is a procedure to drain the pus from an abscess, which aids healing.
  • Sometimes culture is performed to determine the type of bacteria and which antibiotics will work best.


  • Pain medicine: Adults may alternate Advil/ibuprofen (400 mg with food) every three hours with Tylenol/acetaminophen (500-1000 mg) for maximum pain relief. Do not take more than 3000 mg of Tylenol daily, and do not take either Tylenol or Advil if you have been advised by another physician not to take these medications.
  • Take oral antibiotics (if any) as directed. Advise if you are allergic to any medicine. Take the full course of antibiotics, even if you are improving. Call your healthcare provider if you think your medicine is not helping or if you have side effects.

Wound Care

  • Bandage: Leave the bandage in place for 24 hours. Then remove your bandage and cleanse the wound with soap and water 1-2 times daily. A small amount of bloody discharge on the dressing is normal. Replace Polysporin antibiotic and dressing over wound daily for 1-2 weeks, or until your wound is well healed. Wash hands before and after dressing wound.
  • Elevate: If your wound is on the arm or leg, elevate when possible to reduce pain and swelling. Raise above the level of your heart as often as you can. Prop arm or leg on two pillows when at rest.

Follow Up

  • Call for worsening symptoms: If you have increasing pain, warmth, redness, streaking, or swelling, contact the office immediately or proceed to an emergency room for evaluation. Monitor for systemic symptoms, such as fever, shaking chills, vomiting, or severe fatigue; this could indicate a serious infection that needs immediate attention.
  • Recheck: Call for a follow-up appointment if the wound is not noticeably improving in 3-5 days, or if symptoms recur in the future.
  • Results: If a culture was performed, results will be given by phone within 3-4 days. Contact our office if you have not been contacted in 3-4 days, or sooner if symptoms are worsening.

Cryotherapy, using liquid nitrogen, creates a superficial chemical burn. This is used to destroy multiple types of benign and even precancerous lesions on the skin.

What to Expect

  • Anticipate redness, with itching or burning pain initially. Tylenol (if you are able to take Tylenol) or cold compresses can help with any significant discomfort.
  • Blisters may occur at the treated area(s) over the next few days. The blister may be clear or bloody and may begin to weep or drain.
  • After lesion heals, your skin may be slightly darker or lighter at the treatment site; this typically fades in a few weeks.

Care of Treated Area(s)

  • Wash gently each day, but do not scrub.
  • Apply Vaseline frequently to minimize irritation and reduce scab formation.
  • If the blister is tense and uncomfortable, you may clean with alcohol and puncture with a sterile (cleansed in alcohol) needle. Wear gloves, or wash hands immediately before and after this procedure.
  • If open or draining, you may apply Polysporin antibiotic ointment or Vaseline and a bandage, if needed.
  • Do not pick at or pull off your scab. Allow to completely heal.

Return to Clinic

  • If the lesion is persistent 3 to 4 weeks after treatment, please return to the clinic for additional treatment.

Daily Skin Care

Critical to prevent or minimize eczema (atopic dermatitis) flare-ups

Gentle Bathing

  • Bathe skin as little as possible, to prevent stripping the skin of natural oils that protect it.
  • Take short, warm (but not hot or cold) showers or baths.
  • Use a gentle cleanser to wash the skin, such as DoveEltaCetaphil Gentle CleanserCerave cleanser, or Purpose cleanserDO NOT use Ivory, Zest, Irish Spring, or Dial.
  • Be gentle when drying the skin. Pat the skin with a soft towel to dry.

Aggressive Moisturizing

  • Moisturize the skin as much as possible, especially right after a bath or shower.
  • Good choices for moisturizers are plain VaselineElta moisturizer (available at the front desk), Cetaphil cream, or CeraVe cream (available at the front desk). Do not use scented moisturizers.
  • For especially dry hands or feet, apply Elta moisturizer at bedtime and cover it with cotton gloves or socks to wear while sleeping.

Other Tips

  • Launder clothing with a scent-free detergent such as Dreft, All Free, or Cheer Free. Use the extra rinse cycle when possible.
  • Cut fingernails short to help minimize scratching.

What to Do When Flaring

Topical Medications

  • Prescription treatment may be necessary when eczema flares up, as there is usually more itching, redness, cracking of the skin, and sometimes infection.
  • Apply treatment creams provided by your doctor, a small amount on each itchy or red area.
  • Steroid creams should not be applied to the face, underarms, or groin area without consulting with your doctor first. If you are unsure where to put the cream or which one to use, call the office.
  • For severe outbreaks, your doctor may recommend “wet dressings” (see below).

Oral Medications

  • Medicines (such as Atarax/hydroxyzine, doxepin, or Benadryl/diphenhydramine) taken at bedtime can help with itching and sleep. These medicines often cause drowsiness, so it is important not to drive or operate machinery after taking them. If you still feel sleepy in the morning, call your doctor to discuss a different dose or medication.
  • Other antihistamines that cause less sleepiness (such as Zyrtec, Allegra, or Claritin) are available over the counter for daytime use if needed.
  • Not all of these medications can be used for children. If you have questions about over-the-counter medications for your child, please call our office.


  • If you are concerned that the skin is infected (fever, warm and tender skin, yellow or white weeping drainage), then call your doctor immediately.
  • If antibiotics (such as Keflex/cephalexin, amoxicillin or doxycycline) are prescribed, make sure to take the full course of treatment as directed by your doctor, even if the infection seems to be getting better.
  • If your doctor recommends, use bleach baths to control infection recurrence (see below).

Bleach Baths

Bleach baths are an inexpensive and easy way of reducing the number of bacteria, including Staph Aureus, on the skin. If the skin gets too dry from these baths, rinse off more thoroughly after bathing or reduce the amount of bleach added to the tub.

  • Fill bathtub to a water level of 1-1/2 feet.
  • Add 1 capful Clorox (bleach) to the bathwater.
  • Soak for 10-20 minutes.
  • Rinse skin well in the shower afterward. You may use regular soaps or shampoos, as desired.
  • Blot skin dry with a towel, using a fresh towel after each bath. WARNING: Use a white towel or old towel, as the bleach may cause it to lose color.
  • Repeat 2-3 times weekly, as directed.

Instructions for Wet Dressings

Wet dressings are an intensive regiment to control severe skin dryness and irritation. This is a short-term solution, and aims to make the patient more comfortable and calm down inflammation to that more traditional, less time-intensive treatments can be used instead. This technique will greatly increase the strength of the topical medication and should only be used as prescribed.

Getting Ready

  • Patients may get cold as the dressings evaporate, so treat it in a warm environment.
  • Materials: 100% cotton recommended for wet wraps (cotton pajamas, T-shirt, socks, gloves) followed by dry warm materials (towels, sweat suits, blanket).
  • Solution:   Soak dressings in warm water or diluted vinegar (1/8-½ cup vinegar to 4 cups water)

Apply the Dressing

  • Apply the prescription medication to the affected areas in a thin, even film. Be careful to use steroids only on the recommended areas, stronger steroids on the trunk, arms, and legs and mild steroids on the face, groin, and underarms (avoid near eyes).
  • Remove dressings from the solution, and gently squeeze out excess fluid. The material should feel wet, but not dripping.
  • Cover the dressing with dry towels, dry clothing, or blanket. Leave in place for at least 20-30 minutes.
  • Remove the dressings, and reapply a thin coat of steroid cream to all of the affected areas as prescribed.

What to Expect

  • Redness or bruising in treated areas, with some vascular lesions still visible.
  • Itching or mild discomfort, occasionally with slight blistering, followed by scabbing.

Care of Treated Area(s)

  • Wash as usual, with a gentle cleanser, but do not scrub.
  • Apply Vaseline to minimize crusting.
  • If a blister opens or drains, you may apply Polysporin antibiotic ointment and a bandage, if needed.
  • Use sunscreen consistently to minimize burning, irritation, and pigment changes in treated areas.

Activity to Avoid

  • Do not pick or pull off your scab. Allow to completely heal.
  • Avoid excess sun exposure.

Return to Clinic

  • For any signs or symptoms of infection.
  • If the lesion is persistent 3 to 4 weeks after treatment, may return to the clinic for additional treatment.
  • Contact the office for a quote for the cost of further treatments.

What to Expect

  • Any mild swelling, pinprick bleeding, or bruising should resolve in a few days, although it is possible to last up to two weeks.
  • Expect some small but firm ridges that you can feel under the skin. Do not massage these unless instructed by the physician. These typically lessen during the week following treatment. 

Post-Treatment Care

  • Gently apply ice packs to treated areas every few hours, for 10-20 minutes. Continue as needed until swelling resolves.
  • Tylenol, if you are able to take it, can be helpful for any discomfort.
  • Arnica sublingual (under the tongue) tablets may be taken daily until bruising and swelling resolve. Arnica is available for sale in our office or at the pharmacy.
  • May resume cosmetics or other skin products the day following treatment.

Next Steps

  • Contact our office for any concerns, and return to the clinic as needed.
  • Retreatment is common at 6-8 months, depending on the type and sites of injections. It may be helpful to have an appointment for additional injections before the benefits of the filler have fully faded.
  • To earn points and savings toward your next dermal filler (or Botox procedure), register online at Brilliant Distinctions ( This applies to Allergan products only (Botox, Juvederm, Voluma, Latisse).

What to Expect

  • Microscopic (not always visible) peeling is a normal reaction to chemical peels. Some patients experience more significant peeling for several days.
  • Mild redness or irritation is possible and usually resolves in a few days, depending on the type of peel.
  • FOR TCA PEELS ONLY: Dramatic redness (or a purplish burned look) and peeling are possible for 1-2 weeks.
  • FOR VITALIZE PEELS ONLY: A yellow tinge may persist on the treated areas of skin until the peel is washed off.

Care of Treated Areas

  • Wash with a gentle cleanser daily, such as Cetaphil, however:
  • FOR VITALIZE PEEL: Wait 4-6 hours before washing your skin
  • FOR MANDELIC OR MELANOSTOP PEELS: Wait 12 hours before washing skin
  • Apply moisturizing cream, such as Cetaphil or Cerave cream, or even Vaseline, 4-5 times daily.
  • Apply sunscreen with a minimum SPF 30 each morning, and reapply every two hours when outdoors.
  • Drink 8 glasses of water daily.

Activity to Avoid

  • Avoid sun exposure while healing. Wear a hat and use SPF 30 sunscreen. Very consistent sunscreen use following chemical peels will help maintain the benefit of the peel.
  • Avoid drying or irritating agents, such as benzoyl peroxide or Retin-A, while healing.
  • Do not peel, pull, pick, or scratch the treated skin. This can lead to permanent scarring.
  • Hold off on cardio exercise for 24 hours, to prevent further skin irritation due to heat and exertion.

Next Steps

  • You may resume any topical retinoids (Retin-A, Tazorac, etc.) or topical acne medications in 5-7 days after the peel, if your skin is well healed.
  • Repeat chemical peel in 3-4 weeks for optimal results, as directed by your dermatologist.

Normal Response to Injections

  • Mild pinprick bleeding, mild swelling, or bruising.
  • Some movement in the treated muscles for 1-2 weeks.
  • Persistent “at rest” lines in the face, as Botox only softens the “movement lines.”
  • Some patients find that once wrinkles have been diminished in one area, the wrinkles in other areas of the face may become more bothersome. If you would like to consider treatment in another area, you may call our office for an appointment to discuss with your doctor.

Post-Treatment Care

  • Do not lie flat or rub/scrub the area for four hours after injection.
  • Exercise facial muscles with repeated movement of treated muscles.

Call the Office at (512) 280-3939

  • If you have a severe headache, fever, weakness, or other significant changes in your health, seek emergency care, and notify our office.
  • For any drooping of the eyelids (ptosis) or other unexpected side effects of treatment.

Next Steps

  • Allow 2 weeks to see the full benefit, although many patients note some changes within a few days.
  • Return to the clinic for a no-charge touch-up, if movement at two weeks is greater than desired.
  • Consider retreating the area with Botox in 3-6 months, or as movement returns in the treated area.

Wound Site Care

  • Keep the wound dry today and remove the bandage in 24 hours.
  • Shower normally, allowing soap and water to run across the wound, but do not scrub. Antibacterial soaps such as Dial may be used daily.
  • Keep the wound moist with an application of Polysporin ointment or Vaseline 1-2 times daily. (If you have itching or irritation from topical antibiotics like Polysporin, then switch to plain Vaseline.) Keeping the wound moist reduces infection, minimizes scarring, and prevents crust formation over the wound.
  • Cover the wound with a clean bandage daily. If you have steri-strips (small white bandages) across the wound, leave intact. These typically fall off within a few days.
  • Avoid picking at the wound site, which increases the risk of infection and scarring.
  • If the wound is near your eyes, cold compresses may be used for 20 minutes each hour to minimize pain, swelling, and bruising. Puffiness under the eyes is possible for a few days after the procedure.
  • For any wound discomfort, you may take Tylenol (or acetaminophen). Adults may take 500-1000 mg every six hours (if you are able to take Tylenol). Or use cold compresses for up to 20 minutes hourly as needed.
  • Allow several weeks for the wound to fully heal. Temporary discoloration at the wound site is normal and may take several months to fade.

If You Have Bleeding

  • Hold firm pressure for 20 minutes, without lifting the pressure to look at the wound. Repeat as needed.
  • If bleeding does not stop, apply ice compresses and call our office (or report to the nearest emergency room).

Activities to Avoid

If your wound is large or has sutures, then until sutures are removed you should:

  • Avoid contaminated water (lake, river, or ocean); use waterproof bandage in a chlorinated pool.
  • If sutures are present, minimize activity that produces stress to excision site (heavy lifting or exercise that pulls at the wound, such as lunges for thigh wounds or golf for upper back wounds).

Watch for Infection

  • Slight redness, initial tenderness, and clear yellow discharge are normal.
  • Call the office if you have signs of infection, such as increased tenderness, warmth, spreading redness, swelling, or thick white-to-yellow discharge.
  • Seek urgent medical attention for severe infection, with fever, chills, nausea, or pain radiating from the wound to surrounding tissue.

Next Steps

  • If you have sutures, return for suture removal in 5-14 days, as directed by your physician, but call sooner if you are concerned about your wound.
  • Pathology results will be given by telephone in 7-10 days. Sometimes results may take longer depending on if special stains or testing is needed. If you have not received results after 14 days it is important that you call our office and let us know.
  • Return to the clinic if you notice any new or changing moles, or if your physician recommended regular skin exams.

Patch Testing Process

  • You are being patch tested to determine if your rash is caused by an allergic reaction to specific substances (allergens, such as chemicals, minerals, or medications) that may have come into contact with your skin.
  • We have tested the most common allergens in North America; but since the test cannot be comprehensive, not everyone will get conclusive results.
  • The test process will involve at least two visits to the clinic after the test is applied, to look for various degrees of redness, swelling, or even blistering at the test sites.

What to Expect

  • We have applied strips of tape with small amounts of suspect substances onto your back. This may occasionally feel uncomfortable, and you may develop itching under one or more of the chambers.
  • Try to avoid scratching, as itching is normally an indication of a positive reaction and scratching might alter the test results. If pain occurs call us.
  • Keep the area dry until the patches are removed in 2-3 days. You may take a sponge bath, but DO NOT get your back wet.
  • Avoid heavy and physical exercises that could cause excessive perspiration and detachment of the test unit.
  • If you notice patches peeling or loosening from the skin, have someone apply pressure to the adhesive portion of the strips. If necessary, you can also apply additional tape to the edges of the chamber units.
  • Abstain from taking oral or injected steroid medications; these may invalidate the test.
  • Avoid prolonged sun exposure to the test area.

Next Steps

  • The chamber units will be removed after about 2 days for the initial reading, to assess for early reactions at the test sites and mark them with ink.
  • A second reading will be scheduled in about 2 additional days to assess final test results.
  • Continue to watch the test area over the next week, in the event there is a delayed reaction on the skin.


  • Upon completion of this procedure, you will be provided with written results and advised of any skin allergies you may have.
  • We will provide you with the various names of the positive allergens and where to find them in your environment.
  • Isolating your skin allergens and avoiding exposure to them can help reduce the risk of future allergic reactions.
  • Return to see us if your skin condition is persistent or recurrent, and your doctor will provide treatment options, as needed.

What is Accutane?

  • Accutane is dispensed only under the rules of iPledge, a government-regulated prescription program. The rules of iPledge are very inflexible, so it’s important to follow the detailed instructions so that you are able to get your medication. Due to the risks associated with pregnancy, the rules for females are particularly strict.
  • This page contains some useful hints and tips for Accutane. However, for complete information about this medication, please reference the iPledge booklet and instructions that you were provided at your appointment.

Registration in iPledge Program

  • Females – Registration occurs at your office visit, at the time of signing consent forms, taking a pregnancy test, and receiving a contraceptive counseling. A prescription is issued during your second office visit which occurs after a 30-day waiting period, with documentation of two pregnancy tests (no less than 30 days apart) and lab results (liver testing, baseline cholesterol, general health panel).
  • Males – Registration and prescription offered after lab results; no waiting period required.

Monthly Lab Tests

  • Obtain fasting labs (nothing by mouth except water for 8 hours prior to test) 1-2 days prior to monthly visits.
  • If labs are not reviewed in the office, you will be contacted in 2-3 days with your results and prescription information.
  • Females – Pregnancy tests are required for registration, each prescription, at the end of the treatment course, and 30 days after treatment. They must be repeated whenever prescriptions are not picked up in a timely manner.

Filling Your Prescription

  • After notification of normal test results (including two pregnancy tests over 30 days for females), the first prescription is sent to your pharmacy. Insurance authorization may be required prior to filling your prescription.
  • Females – You must go online to to complete a questionnaire, using your iPledge ID number (from wallet cards or iPledge book) and password (sent to you in the mail).
  • Females – CRITICAL: Your prescription will expire 6 days from the pregnancy test date, so pick up your medicine at the pharmacy immediately. Delays in filling the prescription (regardless of reason) may cause a 19-day lockout in iPledge. This will require additional pregnancy tests and a delay in filling your prescription.
  • For cash pay patients (or patients with high out-of-pocket costs), consider discount pharmacies, such as Costco, Sam’s Club, or Walmart. (There is an additional 40% discount for Sam’s Business Club members.)

What to Expect

  • Monthly labs and medical visits for an approximately six- month course Accutane treatment.
  • Most common side effects: Dry lips, dry skin, and dry eyes are typical.
  • Possible side effects: Muscle aches after exercising may be more pronounced.
  • Acne below the surface may erupt faster initially, then decrease in amount and severity over 2-6 months.
  • Most patients see improvement over the course of treatment, but about 1/3 will have some recurrence of acne at some point in the future.

Tips for Improving Effectiveness and Minimizing Side Effects

  • Discontinue all other acne medications, including over-the-counter creams and washes.
  • Take your medication as directed and with a fatty meal.
  • Maintain a healthy diet (avoiding fatty sweets, for instance) to minimize lipid increases.
  • Avoid alcohol and Tylenol (acetaminophen) to reduce liver irritation; ibuprofen is acceptable.
  • Use caution with nighttime driving, initially, due to possible night vision changes.
  • Do not share medication with others or donate blood for 30 days after the course of treatment due to birth defect risks.
  • Gentle cleansers, moisturizers, and lip balm (such as Dr. Dan’s, available in the office) help dry, itchy skin and chapped lips.
  • Use sunscreen consistently due to photosensitivity, and reapply every two hours with sun exposure.
  • Females – Maintain two forms of birth control throughout treatment, and for 30 additional days after completing treatment, in order to prevent severe birth defects.

When to Call Your Doctor

  • If you think you may be pregnant.
  • If you experience a severe headache, vision changes, yellowing of the eyes or skin, or muscle aches that inhibit normal activity.
  • If you experience bloody diarrhea or other significant gastrointestinal issues, or any significant new symptom or change in your health.
  • Any concerns about changes in mood, signs of depression, or suicidal thoughts. Concerns about suicide should be considered a medical emergency.