The Dermatologist’s Medicine Cabinet

4 Apr

Ever wonder what creams, ointments, and moisturizers your dermatologist uses? Or which commonly used remedies your dermatologist wishes you’d pitch into the trash? That’s the focus of this article.

1. If it itches, put hydrocortisone on it.

I always keep a supply of hydrocortisone around. It’s almost always worth a try for itches. Feel free to apply it twice daily for a week. It’s safe for use on the face, safe for children, and in pregnancy. It’s pretty much the only over-the-counter medication that gets to the root cause of itch; inflammation.

2. Throw away your triple antibiotic cream, neosporin, and bacitracin.

People love these topical antibiotics but dermatologists do not. The problem is a very high frequency of contact allergic responses (10-15%). If you develop an allergy, the treated area grows red, itchy, tender, and possibly weepy. You can develop an allergy even if you’ve never had a problem with these medications before. Paradoxically, when an allergy develops, people believe the area is infected even though it’s the medication making the situation worse. Petrolatum (Vaseline) is a much better bet than topical antibiotics for minor cuts, scrapes and burns. We routinely recommend petrolatum instead of topical antibiotics for post-operative wound care.

3. Have a user-friendly lip balm (or put sunscreen on your lips).

Applying sunscreen to your lips is an essential component of sun safety. Preferred lip balms, Nivea and Blistex have easy-to-use, pocket-friendly formulations. These softer lip balms are nice and many prefer them to waxier chapstick-style lip balms. Choose one with sunscreen. Try to find SPF 45. If you don’t have lip balm, it’s safe to put the sunscreen you use on your skin on your lips.

4. A moisturizer ought to be thick and greasy.

If you have dry skin and your moisturizer isn’t cutting it, go thicker. Commonly recommended, thick moisturizers for use on the torso and extremities include petrolatum, Aquaphor, Eucerin, and Bag Balm. Good facial moisturizers include Cetaphil and CereVe creams (not lotions). The best time to apply moisturizer is immediately after showering. After a final rinse with warm water, towel dry and apply moisturizer.

5. You may need more than moisturizer for extremely dry skin.

If your skin is very dry (especially if you have eczema), you should take action to reduce skin moisture loss. The skin produces intrinsic moisturizers (some people more, others less). Hygiene routines, solvent exposure, and hot water exposure strip these natural protectants from the skin, leading to increased dryness. To reduce loss of natural moisturizers, try a less drying soap (Dove, unscented, for example), and use less of it. There is no need to work up a lather all over like they do in commercials. Use soap only on areas that need extra help to get clean. Arms, legs, back, chest and abdomen generally do fine with water alone. Water temperature is also an important consideration. Although a hot shower feels refreshing, hotter water strips more natural moisturizers from the skin than cold water.

6. Use alcohol-based hand sanitizers instead of soap for routine hand hygiene.

Many people mistakenly believe that alcohol-based hand sanitizers are more drying to the skin than soap and water. In fact, the opposite is true. Alcohol-based sanitizers remove no natural oils from the skin when used properly. Moreover, alcohol-based sanitizers are much more effective than soap and water at killing bacteria on the hands. These factors have driven a revolution in hand hygiene in the healthcare industry over the past decade. This is why you see widespread use of alcohol-based sanitizers among healthcare professionals.

7. In winter, take measures to increase indoor humidity to combat dry skin.

Drier air means drier skin. Consider using a cool mist humidifier and running it in your bedroom twenty-four hours a day. Keeping indoor temperatures lower in the winter helps improve air moisture content as well.