Patient After-Visit Instructions (Dermatology)

Patient Name: [Patient full name]

Date of Birth: [DOB]

Visit Date: [Visit date]

Clinic/Location: [Clinic or location]

Provider: [Provider name and credentials]

Clinic Phone: [Clinic phone number] | After-hours: [After-hours number if available]

If this is a life-threatening emergency, call 911.

Today's Visit

[One-sentence summary of what was addressed today, using direct "you" language]

• [Diagnosis name] — [Plain-language explanation]. [Body location and severity/phase if relevant].

  [2–3 sentences explaining what the condition is and its typical course/prognosis.] (Avoid unexplained jargon and abbreviations.)

  (If the diagnosis is not yet confirmed, label it as a working diagnosis and state what is pending.)

• [Additional diagnosis name] — [Plain-language explanation]. [Body location and severity/phase if relevant].

  [2–3 sentence explanation of the condition and typical course/prognosis.]

(Repeat for each diagnosis addressed today.)

Procedure performed: [Biopsy / excision / cryotherapy / other] at [anatomic site]. [Number of lesions/sites if applicable]. (Include only if a procedure was performed.)

Your Action Plan

(List the 3–5 most important actions to take. Prioritize new medication starts and time-sensitive tasks.)

• [ ] [Top priority action #1, using time anchors like morning/evening/bedtime]
• [ ] [Top priority action #2]
• [ ] [Top priority action #3]
• [ ] [Additional action if needed]
• [ ] [Additional action if needed]

Medications (If any details are incomplete, write "Detailed medication instructions will be sent separately" and list only the medication name.)

• [Medication name: generic (Brand)] — [Purpose in plain language].

  • How to use: [Dose], [Route/site], [Frequency with time anchors], [Duration].
  • Technique tips: [Application instructions, e.g., thin layer, wash hands after, avoid eyes/mouth, whether okay for face or skin folds]. (Include for topicals only.)
  • Cautions: [Photosensitivity, pregnancy warnings, or other specific cautions]. (Include only if applicable.)
  • Side effects: [Common, mild effects to expect]. Stop and call if: [Severe reaction or concerning symptoms].
(Repeat for each medication prescribed or directed.)

Wound care after your procedure (Include only if a procedure was performed. If procedure type or care steps are not fully specified, omit and note instructions will be provided separately.)

1. Remove the initial dressing [when to remove, e.g., after 24 hours].
2. Wash your hands before touching the area.
3. Clean the site with [gentle soap and water / saline], [frequency]. Pat dry.
4. Apply [thin layer of petroleum jelly or prescribed ointment] (if directed).
5. Cover with [type of dressing] and change [frequency].
6. Bathing: [Guidance, e.g., okay to shower after 24 hours; avoid soaking until healed].
7. Pain control: [Recommended pain reliever and dosing] (if applicable).
8. Healing: Expect [timeline and normal appearance during healing].
9. Bleeding: If bleeding occurs, apply firm, direct pressure with clean gauze for 10–15 minutes without lifting. If it does not stop, call the clinic or seek urgent care.

Daily skin care routine (Include only if discussed.)

• Morning: [Gentle cleanser] → [Moisturizer] → [Broad-spectrum sunscreen SPF 30+].
• Evening: [Gentle cleanser] → [Moisturizer] → [Nighttime treatment if prescribed].
• Sun protection: Use broad-spectrum SPF 30 or higher, apply 15 minutes before sun exposure, reapply every 2 hours and after swimming or sweating, wear protective clothing and a wide-brim hat, seek shade especially 10 a.m.–4 p.m. (Emphasize strongly if photosensitizing medications were prescribed or a procedure was performed.)

Follow-Up & When to Call

Follow-up plan: [Scheduled date/time] or [Recommended timeframe to return]. Purpose: [Review results / check healing / adjust treatment]. [How to schedule if not yet scheduled].

Test or pathology results: Expect results in [timeframe]. You will be notified by [phone / patient portal]. Call if you have not heard back by [date]. (Include only if results are pending.)

Call 911:

• Trouble breathing
• Swelling of lips, tongue, or face
• Fainting or passing out
• Severe, rapidly spreading rash

Call us right away at [Clinic Phone]:

• Signs of wound infection: increasing redness, warmth, swelling, pus, or fever
• Worsening pain not controlled with the plan above
• Bleeding that does not stop after 15 minutes of firm pressure
• Severe medication reaction (blistering, intense burning, or hives)

Call or message us:

• Non-urgent medication side effects
• No improvement by expected timeframe
• Questions about treatment or how to use your medicines
• Refill needs

(Omit any section where no relevant information was discussed.)