Not All Skin Procedures and Treatments Will Do You Good

285 SkinJanAmong the countless options in skin health treatments and procedures, it appears that several may not do us much (or any) good. According to the American Academy of Dermatology (AAD,, you might want to save your resources and skip the following options:

  • Oral antifungal therapy for suspected nail fungus when your dermatologist has not confirmed a fungal infection— The AAD states that approximately half of all patients with “suspected” nail fungus do not in fact have a fungal infection. So unless your doctor has tested a sample of the affected nail or skin beneath it and found evidence of fungus, you probably won’t benefit from oral antifungal therapy (Lamisil® [terbinafine] or Diflucan® [fluconazole], for example).
  • Sentinel lymph node biopsy or other diagnostic tests for the evaluation of early, thin melanoma— According to the AAD, diagnostic testing for early, thin melanoma isn’t likely to improve survival. There is a low risk of these types of melanomas spreading to other parts of the body, and the five-year survival rate is 97 percent. So it’s unlikely that biopsy or other testing may improve outcomes (in other words, the associated risks and costs of testing may outweigh the benefit).
  • Don’t treat uncomplicated smaller nonmelanoma skin cancer on the trunk, hands, and feet with Mohs micrographic surgery (a procedure where layers of skin cancer are removed and examined under a microscope)— The AAD advises that for nonmelanoma skin cancer less than one centimeter in size on certain parts of the body, the risks of Mohs micrographic surgery may outweigh the benefits.
  • Don’t use oral antibiotics for treatment of eczema (also called atopic dermatitis) unless there is clinical evidence of infection—Antibiotic therapy has not been shown to reduce the signs, symptoms, or severity of eczema (an itchy inflammation of the skin) that’s not infected. Your doctor can determine if your eczema is infected.
  • Don’t routinely use topical antibiotics (such as Neosporin®) on a surgical wound—According to the AAD, using topical antibiotics on a clean surgical wound has not been shown to reduce the rate of infection. Other (nonsurgical) wounds, however—such as common cuts and scrapes—may benefit from topical antibiotics.


What These Guidelines Mean for You

It’s possible that your dermatologist may recommend one of these treatments or procedures, even for a condition for which the AAD says it may not be effective. Keep n mind that every condition and patient is unique and your doctor may have a good reason for a certain recommendation. But make sure to ask questions and discuss your concerns. And, if you think it’s appropriate, get a second opinion.