Medications
Post Procedure Care
Recommended Gentle Skincare Products
Medications
5-Fluorouracil (5FU)
5-Fluorouracil is a topical, chemotherapeutic cream typically applied twice daily for 2 weeks to treat precancerous and mild cancerous lesions. The effects of the medication may not be apparent for up to 1 week.
Expected effects of 5-Fluorouracil include, but are not limited to:
- erythema
- scaling
- itching
- weeping
- crusting
- pain
A 2 week follow-up appointment is typically made for the provider to assess your response to the medication. During that visit, a medication can be prescribed to help calm down any irritation associated with the Fluorouracil treatment.
Doxycycline
Doxycycline will cause photosensitivity and increased risk for sunburn. Avoid sunlight, if possible. When exposed to sunlight, patients should wear protective clothing, sunglasses, and sunscreen.
Other common side effects include stomach upset and heartburn, so be sure to take medication with food and a large glass of water.
Minocycline
Minocycline is generally very well tolerated. Common side effects include stomach upset, headache and dizziness. Very rare side effects include photosensitivity, autoimmune diseases, and discoloration of the teeth and skin. The side effects can be minimized by limiting the duration of treatment and exposure to sunlight.
Avoid pregnancy while on therapy due to potential birth defects.
Call the office immediately if any of the following severe adverse effects occur:
- hearing changes
- easy bruising/bleeding
- severe headache
- vision changes
Isotretinoin/Accutane
Patients should follow the guidance below:
- do not become pregnant
- be on two forms of birth control
- get monthly blood tests
- do not donate blood
- do not drive at night if vision is affected
- do not share medication
- do not undergo elective surgery for at least 6 months after treatment is completed
If any of the guidance above is not followed, please contact the office immediately.
Protopic
Patients may experience a mild burning sensation during topical application. Protopic is not approved in children less than 2 years of age. There have been case reports of hematologic and skin malignancies in patients using topical calcineurin inhibitors although causality is questionable.
Taltz (Ixekizumab)
Risks of Taltz (Ixekizumab) include, but are not limited to:
- Immunosuppression
- Serious infections
- Worsening, or new onset, of inflammatory bowel disease
- Allergic reaction
Testing for Tuberculosis is required prior to initiation of medication and the patient must alert the office if symptoms of infection or other concerning signs are noted.
Cosentix
Risks of Cosentyx include, but are not limited to:
Testing for Tuberculosis is required prior to initiation of medication and the patient must alert the office if symptoms of infection or other concerning signs are noted.
Dupixent (Dupilumab)
Risks of Dupixent include, but are not limited to:
- eye infection and irritation
- cold sores
- injection site reactions
- worsening of asthma
- allergic reactions
- increased risk of parasitic infection
Dupixent will also interact with certain medications such as Warfarin and Cyclosporine.
Methotrexate
Possible adverse effects of Methotrexate include, but are not limited to:
- nausea
- vomiting
- abnormalities in liver function tests
- development of mouth sores
- rash
- diarrhea
- abnormalities in blood counts
Monitoring is required including Liver Function Tests (LFTs) and blood counts. There is a rare possibility of scarring of the liver and lung dysfunction that can occur when taking Methotrexate. Persistent nausea, loss of appetite, pale stools, dark urine, cough, and shortness of breath should be reported immediately.
Discontinue Methotrexate treatment at least three months before attempting to become pregnant. Males should also not conceive while taking Methotrexate.
Otezla
Possible adverse effects of Otezla include, but are not limited to: worsening or new depression weight loss diarrhea Nausea upper respiratory tract infection headache.
Patients should call the office if any adverse effects occur.
Cellcept/Mycophenolate
Risks of Mycophenolate Mofetil include, but are not limited to:
- infection/immunosuppression
- GI upset
- Hypokalemia
- Hypercholesterolemia
- bone marrow suppression
- lymphoproliferative disorders
- malignancy
- GI ulceration/bleed/perforation
- colitis
- interstitial lung disease
- kidney failure
- progressive multifocal leukoencephalopathy
- birth defects
Monitoring is required including a baseline creatinine and regular Complete Blood Count (CBC) testing. Patients must alert us immediately if symptoms of infection, or other concerning signs, are noted.
Topical Steroids
Prolonged use of topical steroids can result in the increased appearance of superficial blood vessels (telangiectasias), lightening (hypopigmentation) and thinning of the skin (atrophy). Avoid using high potency steroids in skin folds, the groin or the face.
Tretionin
Apply a pea-sized amount on your face only at bedtime (to avoid inactivation caused by sunlight) 30 minutes after washing. Start with an application every other night. If it is too drying, you may add a non-comedogenic moisturizer (ex: CeraVe).
Keflex
To be taken by mouth as directed by the provider. May cause an upset stomach so take with food. Take exactly as directed and for the duration intended. Do not finish the course earlier than prescribed. seek medical advice if chronic diarrhea develops during or following a course of Keflex. Contact your doctor if you develop symptoms such as abdominal pain, excessive bruising or bleeding, or a rash.
Aldara (Imiquimod)
Imiquimod is an immune stimulating topical medication used for the treatment of warts, precancerous and some non-aggressive cancerous lesions. The cream is generally applied twice daily for 2 weeks to the affected area, unless otherwise specified by the provider. The effects of the medication may not be apparent for up to 1 week.
Expected effects of Imiquimod, but are not limited to:
- erythema
- scaling
- itching
- weeping
- crusting
- pain
A 2 week follow-up appointment is typically made for the provider to assess your response to the medication. During that visit, a medication can be prescribed to help calm down any irritation associated with the Imiquimod treatment.
Inflammatory response to Imiquimod is variable from person to person. If flu-like symptoms develop, discontinue the medication and contact us immediately.
Post Procedure Care
Caring For Your Biopsy Site(s)
Cryotherapy
Cryotherapy involves using liquid nitrogen (approximately -320 degrees F) to freeze and destroy abnormal skin tissue include, but are not limited to:
warts skin tags seborrheic keratoses actinic keratoses other benign or precancerous growths
The area that was treated will become red, swollen, and may develop a blister. It will then form a scab after a few days. The scab will crust over and fall off on its own within 1-2 weeks. A second scab may form as well, and it too will shed on its own.
Healing takes about 2 weeks, after which the skin may look perfectly normal, or slightly discolored for a period of time. If you begin to experience signs of an infection such as fever, swelling, tenderness, purulence (pus), or oozing from the site; contact our office.
Punch Biopsy
After a punch biopsy, a bandage will be put on to prevent bleeding. This can be removed at any time. Occasionally, the biopsy site bleeds after you leave the doctor's office. This is more likely in people taking blood-thinning (anti-coagulant) medications. If this occurs, apply continuous, direct pressure to the wound for 20 minutes, then look at it. Wash and dry as you normally would. You may apply vaseline to help keep the area moist and act as a barrier. You can cover with a bandaid, but it is not necessary.
Shave Biopsy (Scoop Biopsy)
The bandaid can come off later that same day No activity restrictions (e.g. exercise, bathing, etc.). Vaseline can be applied if the scab becomes thick or uncomfortable.
Please contact the office if you are noticing signs of infection:
We contact patients regarding their biopsies. We always leave a voicemail unless we are unable to do so. Please call us if you have not received your results and it has been more than 2 weeks since the procedure was performed.
Intertrigo Care and Recommend Products
Recommended Skincare Products
Recommended Gentle Skincare Products
Soaps: Dove unscented bar soap
Facial Cleansers: Neutrogena or Cetaphil Gentle Foaming Cleanser
Moisturizers: CeraVe moisturizing cream or Vanicream
Sunscreens: Neutrogena 30+ sport spray sunscreen.