A guide for patient satisfaction

Recommending the proper skincare and supplement regimens both before and after a surgical or cosmetic procedure can greatly improve outcomes and patient satisfaction. Research has shown that patient education is a vital part of compliance with their prescribed skincare regimen. To educate your patients prior to a procedure, provide them with a detailed list of written instructions for what to do — and not do — before and after a procedure so they know exactly what to expect. Use this as a guide to help educate your patients about how to care for their skin pre- and post-procedure.

Pre-Procedure Topical and Oral Recommendations

Proper use of topical and oral products and supplements can help to minimize the risk of infection, scarring, hyperpigmentation, and other adverse effects after a procedure. For two to four weeks before cosmetic surgery or skin treatments, recommend topical retinoids such as tretinoin and retinol. These ingredients have been shown to accelerate wound healing by increasing collagen production. Adapalene should be started five to six weeks before treatment, since it has a longer half-life than tretinoin and therefore requires an earlier initiation period.

Topical ascorbic acid and hydroxy acids used before a procedure may also aid in collagen synthesis and wound repair. However, more research is needed in this area to make any definitive claims.

It is also imperative to educate patients about what not to use on their skin prior to injectable treatments. Nonsteroidal anti-inflammatory drugs including aspirin, ibuprofen, and naproxen should be avoided for at least ten days prior to treatment to avoid bruising. Other medications and supplements that can also worsen bruising include St. John’s wort, vitamin E, omega-3 fatty acid supplements, flaxseed oil, ginseng, salmon, and alcohol.

Smoking and other tobacco use should be avoided for at least four weeks before and after a surgical procedure.

Post-Procedure Topical and Oral Recommendations

If taken immediately post-procedure, oral vitamin C and zinc supplements may accelerate wound healing. To reduce bruising and inflammation, oral arnica tablets and tinctures may be used, although there is limited clinical evidence in this area. Topical Arnica montana and Rhododendron tomentosum, however, have been shown to reduce bruising and swelling following oculofacial surgery.

Other topical products that may speed wound healing after a procedure include curcumin seeds; an occlusive ointment that contains antioxidants; and defensin, an important protein involved in wound repair.

Sun protection is a must after cosmetic surgery or any skin treatment. Instruct patients to keep wounds covered and avoid sun exposure until epithelialization is complete. Then, patients should use a physical sunscreen that contains zinc oxide. Chemical sunscreens can be absorbed into the skin and may cause an allergic reaction, so it is prudent to avoid them during the healing process.

Acidic skincare ingredients such as benzoic acid, hydroxy acids and ascorbic acid should be avoided after a procedure because they can cause stinging if applied to wounded skin. Other ingredients to avoid that may irritate post-procedure skin include essential oils, botanical ingredients, and oral vitamin E supplements. After skin cancer surgery, patients should not use topical retinoids until re-epithelialization is complete.

Summary

Providing your patients with specific pre- and post-procedure guidelines is one of the best ways to educate them about how to care for their skin before and after a procedure. Many patients do not remember oral instructions, so be sure to offer an easy-to-read print-out that they can take home with them and easily refer to at any time. Encourage them to ask questions and voice concerns during their initial consultation, and always provide the best method(s) of contacting your office, should they have any additional questions or concerns after they leave.