Q: Dr. Eppley, I lost a chunk of my nose — right on the bridge. It was not a cut — a chunk of skin is missing – down past epidermis and dermis into subQ. It has a nice granular base. I know it will have to scar — is there any way to help it heal while keeping scarring minimal?A certain wound gel or something? I usually fill in missing skin with redder tissue that is hyperpigmented. Thanks for any advice.
A: As to your nose, I don;t think there is really any magic about what makes skin heal. Given that you have a full-thickness skin loss that is now granulated, what you need is something that will help in re-epithelize faster. The topical agent that i recommend to my patients in this situation, believe it or not, is A & D ointment. (as in Vitamin A and D) While it is most commonly know for use in diaper rash ( a very superficial de-epithelization problem), vitamins A and D are well known agents that skin cells need to grow. I have found this very simple and inexpensive topical cream very helpful in such cases. It has a bit of an unusual odor because the vitamins are derived from cod liver oil which is also why the cream is a little dark or brown-colored. Just keeping the area a little moist with it should help it heal quickly over the next 7 to 10 days.
Dr. Barry Eppley