Basic Principle to treat Skin Disorder

Treatment on the skin is an art, why? Because many unique condition of patient’s skin need specific regiment, not only basic chemical substance but also topical substances. Below we describe the principle to treat the skin disorder. Treatment of most of the common skin conditions is simpler to understand when the physician is aware of three basic principles:

First, The type of skin lesion, more than the cause, influences the kind of local medication used. The old adage, “If it's wet, use a wet dressing, and if it's dry, use an ointment,” is important in most cases. For example, the physician should prescribe wet soaks, to treat a patient with an acute oozing, crusting dermatitis of the dorsum of the hand, whether due to poison ivy or soap,. An ointment is indicated for a chronic-looking, dry, scaly patch of psoriasis on the elbow, because an aqueous lotion or a wet dressing would only be more drying. Bear in mind, however, that the type of skin lesion can change rapidly under treatment. The patient must be followed closely after beginning therapy. An acute oozing dermatitis treated with soaks can change, in 2 or 3 days, to a dry, scaly lesion that requires a cream or an ointment. Conversely, a chronic dry patch may become irritated with too strong therapy and begin to ooze.

The second basic principle in treatment is never do any harm and never overtreat. It is important for the physician to know which of the chemicals prescribed for local use on the skin are the greatest irritants and sensitizers. It is no exaggeration to say that the most commonly seen dermatitis is the overtreatment contact dermatitis. The overtreatment is often performed by the patient, who has gone to the neighborhood drugstore, or to a friend, and used any, and many, of the medications available for the treatment of skin diseases. It is certainly not unusual to hear the patient tell of using a strong athlete's foot salve for the treatment of the lesions of pityriasis rosea.

The third principle is to instruct the patient adequately regarding the application of the medicine prescribed. The patient does not have to be told how to swallow a pill but does have to be told how to put on a wet dressing. Most patients with skin disorders are ambulatory, so there is no nurse to help them. They are their own nurses. The success or the failure of therapy rests on adequate instruction of the patient or person responsible for the care. Even in hospitals, particularly when wet dressings or aqueous lotions are prescribed, it is wise for the physician to instruct the nurse regarding the procedure.

With these principles of management in mind, let us now turn to the medicine used. It is important to stress that we are endeavoring to present here only the most basic material necessary to treat most skin diseases. For instance, there are many solutions for wet dressings, but Burow's solution is good choice. Other physicians have preferences different from the drugs listed, and their choices are respected.