a. Acute Lesions. These lesions characteristically have appeared recently and
are red, burning, swollen, itching, blistering, or oozing. Treatment usually consists of
wet preparations such as soaks for lesions on the hands, arms, feet, or legs. Cool wet
dressings are used for lesions of the head, neck, or trunk. If the lesions are over
various parts of the body, baths can be used.
b. Subacute Lesions. Subacute lesions are not recent but do not go away and
come back. The acute stages of these lesions have subsided, and the area is slightly
swollen due to fluid retention. Treatment may be the wet preparations described in
acute lesions or lotions that are shaken, or both.
c. Chronic Lesions. These lesions have been on the skin for a long while.
They are inactive and are thickened, encrusted, cracked, and scaly. Such lesions can
be treated with the wet preparations just described or shake lotions or both. Also
effective are emulsions, hydrophilic ointments, pastes with a high powder content, and
creams such as cold cream and vanishing cream.
TYPES OF TOPICAL FORMULATIONS
A topical formulation is medicine that is applied directly to the skin as opposed to
a capsule that is swallowed or medication inserted directly into a vein. There are a
number of topical medications: wet preparations, powders, shake lotions, creams,
pastes, ointments, hydrocarbons, gels, and adherent dressings. The type selected
depends on several factors: the characteristics of the skin problem; the general
character of the patient's skin; previous medication; and drug allergies.
a. Wet Preparations.
(1) Baths, soaks, and wet dressings are referred to as wet preparations.
The preparation selected depends on the location and size of the affected skin area.
Each wet preparation can cleanse the skin and reduce itching.
(2) Wet dressings are wet compresses applied to skin areas. Wet dressings
are used mainly when skin lesions are highly inflamed or are draining. When medicine
is applied and then covered by a wet dressing, the lesion stays open and can drain
freely. Wet dressings are used in treating oozing dermatitis (skin problems) or swollen,
infected dermatitis (furunclitis, cellulitis). These dressings relieve the inflammation,
burning, itching, and have a cooling effect on the skin. Wet dressings are suitable for
even the most acute skin lesions.
(3) These solutions are commonly used in wet dressings to promote healing
and produce a soothing effect:
(a) Normal saline solution--nonmedicated and hypoallergenic; used
when treatment calls for drainage and heat.