Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Mar;82(3):700-708.
doi: 10.1016/j.jaad.2019.09.080. Epub 2019 Nov 12.

An expert panel consensus on opioid-prescribing guidelines for dermatologic procedures

Affiliations

An expert panel consensus on opioid-prescribing guidelines for dermatologic procedures

Justin M McLawhorn et al. J Am Acad Dermatol. 2020 Mar.

Abstract

Background: Opioid overprescribing is a major contributor to the opioid crisis. The lack of procedure-specific guidelines contributes to the vast differences in prescribing practices.

Objective: To create opioid-prescribing consensus guidelines for common dermatologic procedures.

Methods: We used a 4-step modified Delphi method to conduct a systematic discussion among a panel of dermatologists in the fields of general dermatology, dermatologic surgery, and cosmetics/phlebology to develop opioid prescribing guidelines for some of the most common dermatologic procedural scenarios. Guidelines were developed for opioid-naive patients undergoing routine procedures. Opioid tablets were defined as oxycodone 5-mg oral equivalents.

Results: Postoperative pain after most uncomplicated procedures (76%) can be adequately managed with acetaminophen and/or ibuprofen. Group consensus identified no specific dermatologic scenario that routinely requires more than 15 oxycodone 5-mg oral equivalents to manage postoperative pain. Group consensus found that 23% of the procedural scenarios routinely require 1 to 10 opioid tablets, and only 1 routinely requires 1 to 15 opioid tablets.

Limitations: These recommendations are based on expert consensus in lieu of quality evidence-based outcomes research. These recommendations must be individualized to accommodate patients' comorbidities.

Conclusions: Procedure-specific opioid prescribing guidelines may serve as a foundation to produce effective and responsible postoperative pain management strategies after dermatologic interventions.

Keywords: Mohs micrographic surgery; cosmetic dermatology; dermatologic surgery; opioid guidelines; opioid overuse; pain management; postoperative pain; public health.

PubMed Disclaimer

Publication types

Substances

LinkOut - more resources