Skin Types?

Today, I have been asked about “skin types” and whether a particular “skin type” is better or worse for surgery.

Many commercially oriented sites will tell you that there is a “normal skin,” or “dry skin,” etc. This might be relevant for your choice of makeup. However, it has little or no bearing on how we perform a particular surgical procedure. Dermatology was one of my specializations at Columbia. Let me preface, for your benefit: the skin is a most miraculous organ, and we cannot do it justice in a brief answer or posting. I believe what my concerned patient, Mrs. T, had in mind was whether a particular kind of skin may cause particular problems. Indeed, it may, but it has very little to do with a “skin type.”

What is most relevant is the age of the patient, genetic factors, and overall exposure to the sun. Natural aging causes wrinkles and sagging, the skin is less flexible, if you will, and heals longer. Sun exposure causes a different type of wrinkles (somewhat deeper) and destroys a specific type of collagen in the dermis. Generally, aging of the skin can be decreased, if not averted, by topical application of creams containing estradiol, and collagen. It is therefore a sound choice to avoid exposure to the sun and use such creams. These should be accompanied with vitamins, mainly of the B-group, vitamin A and E, and oral collagen.

Exposure to the sun causes irreversible changes in the dermis and the skin stops reacting to artificially supplied collagen and estradiol. Studies have shown that this cuts across skin colors, types, and even sexes (men benefit from the topical use of the same creams). Pre-operation, we have to clean and dry your skin. Post-operation, it has to remain dry until the sutures are stabilized and firm (usually 7-10 days, but, depending on your age and quality, rather than “type” of the skin, it can be 2-3 weeks). That is why is it absolutely essential not to take a shower or be in any contact with moisture in the affected area. I could not emphasize this more.

After the stabilizing period, when the sutures are sufficiently firm (following my post-op examination) you should apply the above-stated topical crèmes to facilitate healing and minimize scarring. Again, vitamin and mineral supplements are also beneficial.

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