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dr. jennifer palmer
ACETIC ACID SOAKS
1. Mix 3 tablespoons of plain white vinegar per quart of cool tap water.
2. Dip cloth in solution and apply to the affected area as many times as your physician perscribed
3. Leave soaks on for 15 to 20 minutes.

WART TREATMENT
We suggest that you try this at home treatment before making an appointment. If you do have any questions, we invite you to call us.
1. Soak wart in warm water for 10 to 15 minutes. Take out and pat dry.

2. Pare down softened skin gently with either emery board or pumice stone until all softened tissue is removed.

3. Apply wart medication (Occulusal-HP, Occlusal, Duofilm, Duoplant) to wart.

4. Allow medication to dry completely. It will usually turn a white, chalky color when completely dry.

5. Cover wart with a piece of Blenderm tape, to be left on until the next time the wart is treated.

6. Continue this treatment nightly. More than likely, you will come to a point in time when the skin surrounding the wart is irritated. When this occurs, wart treatment should be discontinued for several days, until the surrounding skin has recovered. Then reinstitute wart treatment, as given above. You may find that you are only able to tolerate this several nights on, several nights off, or on an every other night basis.

7. You will find the wart will gradually decrease in size. If small enough at the time of your next appointment, a decision will be made to either continue this form of wart treatment or to institute additional treatment modalities.

SIMPLE GUIDELINES TO HELP PROTECT YOU FROM THE DAMAGING RAYS OF THE SUN
Brought to you by The Skin Cancer Foundation
1. Minimize sun exposure during the hours of 10 a.m. to 4 p.m. when the sun is strongest. Try to plan your outdoor activities for the early morning or late afternoon.
2. Wear a hat, long-sleeved shirts and long pants when out in the sun. Choose tightly-woven materials for greater protection from the sun's rays.
3. Apply a sunscreen before every exposure to the sun, and reapply frequently and liberally, at least every two hours, as long as you stay in the sun. The sunscreen should always be reapplied after swimming or perspiring heavily, since products differ in their degrees of water resistance. We recommend sunscreens with an SPF (sun protection factor) of 15 or more printed on the label.*
4. Use a sunscreen during high altitude activities such as mountain climbing and skiing. At high altitudes, where there is less atmosphere to absorb the sun's rays, your risk of burning is greater. The sun also is stronger near the equator where the sun's rays earth most directly.
5. Don't forget to use your sunscreen on overcast days. The sun's rays are as damaging to your skin on cloudy, hazy days as they are on sunny days.
6. Individuals at high risk for skin cancer (outdoor workers, fair-skinned individuals, and persons who have already had skin cancer) should apply sunscreens daily.
7. Photosensitivity - an increased sensitivity to sun exposure - is a possible side effect of certain medications, drugs and cosmetics, and of birth control pills. Consult your physician or pharmacist before going out in the sun if you're using any such products need to take extra precautions.
8. If you develop an allergic reaction to your sunscreen, change sunscreens. One of the many products on the market today should be right for you.
9. Beware of reflective surfaces! Sand, snow, concrete and water can reflect more half the sun's rays onto your skin. Sitting in the shade does not guarantee protection burn.
10. Avoid tanning parlors. The UV light emitted by tanning booths causes sunburn and premature aging, and increases your risk of developing skin cancer.
11. Keep young infants out of the sun. Begin using sunscreens on children at six months of age, and then allow sun exposure with moderation.
12. Teach children sun protection early. Sun damage occurs with each unprotected sun exposure and accumulates over the course of a lifetime.

RETIN-A
WHAT YOU CAN EXPECT WITH RETIN-A (TRETINOIN) TREATMENT
* During the first few days of therapy some patients may experience a heightened skin sensitivity, peeling or notice a "blush". If this happens to you, it is only your skin adjusting to Retin-A, and it will probably subside in two to four weeks.

* After three to six weeks, you may notice the appearance of "new" blemishes. These are not new blemishes, but previously unseen, deep-rooted lesions or microcomedones that have been brought to the skin surface. These uprooted blemishes are part of the healing process and a sign that Retin-A is working. When you have reached this stage, it is very important to continue the therapy.

* Do not be discouraged if you see no immediate improvement. Gradual improvement should be noticed after six to twelve weeks.

WHILE YOU ARE ON RETIN-A THERAPY
* Do not use products with a high concentration of alcohol, spices, lime or any that have a drying effect.
* Use cosmetics that are listed as non-comedogenic (non-acne producing).
* Do not use abrasive soaps or cleansers.
* Do not pick, squeeze or "pop" blemishes.
* Do not go to tanning booths.
* Do not become pregnant while on Retin-A. If this should occur, discontinue Retin-A and contact your dermatologist.

AND REMEMBER THESE SPECIAL CONSIDERATIONS:
* Minimize exposure to the sun and use a sunscreen.
* Avoid excessive exposure to the wind and cold. If exposed, use protective clothing, such as a scarf or high-neck coat collar.
* Do not use other medications with Retin-A unless your doctor recommends them.
* Keep medication from the nose, eyes and mouth. * For facial dryness, you may use a non-comedogenic facial moisturizer, such as Neutrogena Facial Moisturizer

SENSITIVE SKIN
We suggest that you try these at home treatments and care before making an appointment. If you do have any questions, we invite you to call us.
1. Avoid Fragrances and Dyes

2. Bathe in warm, but not hot water using Dove unscented or Cetaphil bar soap.

3. After bath or shower, pat dry then apply moisturizer - Cetaphil Cream
4. Datergent - All-Free (Frangrance and Preservative Free)
5. Fabric Softeners that er used in the rinse cycle of the washers are fine. No dryer sheets or bleach.

HAND PROTECTION
You must protect your skin from soaps, detergents, iffitants and alergens as much as possible. Therefore; your routine activities should always include the following:
1. Use mild soap such as Cetaphil or Dove unscented to minimize irritation and don't over wash your hands. Dry thoroughly.
2. Regularly use Cetaphil crea,. Most helpful when applies to damp skin.
3. Protect ands with gloves when using irritants, cleaning supplies, washing dishes, cutting fruits and vegtables.
4. The best rubber gloves to use are Playtex cotton lined rubber gloves or you may obtain white cotton gloves liners at the pharmacy and wear these inside of protective gloves to help absorb perspiration (moisture).
5. Apply perscriptions as directed by physicians, use these directly on skin and you may apply a moisturizer over the top of the perscription medication once it has dried.


PREVENTION OF FUNGAL REINFECTION
After treatment with pills, all four of the fungus should be gone from the skin of your feet. The fungus in your nails should also be killed, although the nails may remain thickened and discolored until they completely grow out.

It is possible for fungus to re-infect the skin of your feet or your nail, even after taking pills. Here are some helpful hints to prevent re-infection.

1. Keep feet and nails clean by washing your feet everyday with soap.
2. Trim nails to about 2-3 mm beyond the attachment of the nail. DO not cut too short - "into the quick."
3. Don't share nail clippers or any other nail care equipment. If your toenails are infected with fungus, don't use toenail clippers on fingernails.
4. Avoid going barefoot in public facilities, especially locker rooms.
5. Avoid going barefoot in hotels, as fungal particles may be living in the carpeting and on the bathroom floor.
6. Never wear someone else's shoes or socks.
7. Older tennis shoes and well-worn shoes should be thrown away, as they may be heavily contaminated with fungal particles.
8. Always wear gloves when working in the garden.
9. Always wear shoes when outside.
10. Give toes breathing room - wear loose-fitting, well-ventilated shoes.
11. Keep feet, socks and shoes as dry as possible.
12. Wear socks made of natural, absorbent materials such as cotton and wool (not synthetics such as rayon and polyester).
13. Use bleach when washing socks.
14. Have other family members evaluated to see if others may be infected.
15. Use antifungal powder or cream on your feet an shoes once a week.

The Skin Cancer Foundation grants its Seal of Recommendation to sunscreen products of SPF 15 or greater and sun protection devices which meet the Foundation's criteria as "aids in the prevention of sun-induced damage to the skin." For a complete list of products, please send a stamped, self-addressed, business size envelope to:
The Skin Cancer Foundation, Box 561, Dept. SR, New York, NY 10156

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