Five Recommendations About Skin Tests and Treatments

American Academy of Dermatology releases skin health treatments and test recommendations

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) For people with skin, hair or nail concerns, how do you know when your treatment is the right thing for you?

The American Academy of Dermatology recently released a list of five recommendations that doctors and patients should consider when prescribing and seeking treatments.

According to the report, the recommendations can help patients talk with their doctors about medical tests and treatments that may or may not be needed for their conditions.

"Ask your doctor to explain your treatments."

Through the Choosing Wisely initiative by the ABIM Foundation, national medical organizations are aiming to help patients choose care that is truly necessary, free from harm and supported by evidence.

As part of Choosing Wisely, the American Academy of Dermatology (AAD) made the following five recommendations that patients and doctors should consider:

  1. Only prescribe oral antifungal therapy for nail fungus after a confirmed fungal infection diagnosis — about half of all patients with suspected nail fungus do not actually have an infection.
  2. Do not perform sentinel lymph node biopsy or other diagnostic tests for evaluating early, thin melanoma, a type of skin cancer. A biopsy is a procedure that involves cutting into the skin for a sample which is tested.
  3. Do not treat uncomplicated, non-melanoma skin cancer that is less than 1 centimeter in size on the trunk, arms and legs using Mohs micrographic surgery. According to the dermatologists, the risks associated with this type of surgery, a specialized surgical procedure, outweighs the benefits. Mohs surgery can be considered for skin cancers on the hands, feet, genitals, ankles and shins.
  4. Only use oral antibiotics to treat atopic dermatitis if there is clinical evidence of an infection. It has not yet been proven whether antibiotic therapy can reduce the signs, severity and symptoms of atopic dermatitis that is not infected. Routine use of oral antibiotic medicines could lead to allergic reactions or the development of resistance to the antibiotics.
  5. Avoid routinely using topical antibiotics on surgical wounds. The report states that using topical antibiotics on clean surgical wounds has not been shown to reduce infections compared to using non-antibiotic ointments or no ointment.

Further, topical antibiotics can make open wounds worse and hinder the normal healing process. The chances of developing contact dermatitis, in which the skin becomes sore, red or inflamed, goes up when topical antibiotics are used.

“It is important for patients with skin, hair or nails concerns to talk with and ask questions of their dermatologist about medical care they may not need,” said Brett Coldiron, MD, FAAD, incoming president of the AAD, in a press release. “This Choosing Wisely® list can help patients save time and money by avoiding medical treatments and tests their condition may not require.”

The AAD released its list of skin care treatments and procedures on October 29.

Review Date: 
October 31, 2013
Last Updated:
February 17, 2014