Treatment With Kenalog, Positivity in the Waiting Room, And More

TIP 1: INTRALESIONAL KENALOG PEARLS

I treat alopecia areata with monthly injections of kenalog 1 mg/cc which may seem low, but works almost 100% of the time and almost never causes atrophy.

I also inject acne lesions with same concentration. I have done this a million times over the years. Generally, it works overnight, and also almost never leaves a dent.

For the rare dents from steroid injections, I flush the injection site with normal saline. I am not sure of the optimal frequency, but every 2 weeks works. It will restore a dent in the face or buttocks within a month or two.

Intralesional kenalog 1 mg per cc works great in psoriatic plaques. If patients only have a few lesions, that’s all I do other than a topical steroid. I keep a drawer full of 3- and 1-cc syringes premixed. We add 3⁄4 cc of kenalog to a 30-cc vial of bacteriostatic saline. It works great on the scalp, especially those stubborn lesions on the back of the head. I think the recurrence rate for a lesion injected is lower than with any topical treatment. It can be used along with systemic therapy if someone has only a few lesions remaining.

Barry Ginsburg, MD
Birmingham, AL

TIP 2: CORKBOARD OF CARDS

When you receive kind thank you notes or cards for your care, consider posting them on a corkboard in your waiting room. Of course, do not post anything that’s too personal, and do ask for permission from your patient.

Patients are more likely to think positively of you and to question the “angry/crazy patient” ratings we all get online.

Benjamin Barankin, MD, FRCPC
Toronto, Ontario, Canada

TIP 3: BORROW YOUR PATIENT’S SMARTPHONE

When evaluating skin lesions, especially on the back where patients cannot see easily, I ask them to let me borrow their smartphone.

We use the camera feature from their phone to take pictures of their skin lesions, which we then measure.

They then have an easy resource to know if any of the moles or other skin lesions are changing.They can compare the pictures taken in the office to the future appearance of their lesion(s) and they can be more aware of any suspicious changes.

Scott Ross, MD
Manassas,VA