The treated area will be red, swollen and tender. The swelling and pain usually lasts for one to four days. The skin will ooze for approximately three to seven days. Redness may last for weeks. As the treated area is very delicate, proper wound care is essential for the best possible result. Please read and follow these directions:
The basic principle is to keep the skin as moist as possible at all times to ensure proper healing. Any crusting you develop should not be "picked off." Crusts should be thoroughly soaked and gently rubbed off with a moist gauze pad as detailed below.
Step 1 (Days 1-10: Open technique with ointments)
It is very important to keep the skin covered with a generous layer of Vaseline Jelly at all times during this phase of healing. It is also important to gently remove any crusts that form through the cold compresses detailed below.
How to do cold compresses
- Soaking with cool water is among the most important aspects of your postoperative care in this part of the healing process.
- Cool water soaks should be performed frequently while you are awake starting when back at home. Please soak every one to two hours as tolerated the first two days then every two to four hours as long as you have oozing or bleeding.
- Fill a large clean bowl with cold tap water and a few ice cubes. Add one tablespoon white vinegar for every cup of water. Place a large stack of 4x4 cm gauze pads nearby.
- Take a few damp, almost dripping wet, gauze pads and apply them over the treated areas, replacing them before they dry (change every five minutes or so). An alternative is to leave the gauze pads in place and dripping cold water repeatedly over them.
- After the compress is over, pat yourself dry with a clean soft towel and reapply Vaseline gently.
Scheduled regimen of care
Immediately upon waking in the morning, you should apply the cold soaks (detailed above) for at least 30 minutes. This will help loosen any crusting that may have formed overnight. After this you should shower, letting lukewarm water stream over your face (do not let the water hit directly in the face). Do not use any soap on your face. After letting the water stream over your face, shower and wash the rest of the body with warm water. The stream of water and steam should help loosen or remove any crusting. You may wash your hair with a gentle shampoo such as baby shampoo.
After the shower, perform a second cold soak for 30 minutes. Then take a warm wet 4x4 gauze pad and gently rub off any loose crusting. Do not pick any crust off with your fingernail.
After each cold soak, gently pat your skin dry and then apply Vaseline Jelly liberally. It is critical to keep your skin covered with Vaseline Jelly at all times (the skin heals better in a moist environment). Apply with your fingertips (after washing your hands) or Q-tips. There is no need to remove the ointments prior to the next cold soak.
After one to four hours perform the next cold soak/ointment regimen as detailed under the "How to do cold soaks section."
In between cold soaks, you may gently pat your face dry with a clean, soft towel and apply Vaseline Jelly.
At bedtime, apply Vaseline Jelly liberally after your last soak. Make sure that the entire treated area is covered with ointment. Place an old towel over your pillow to prevent the ointment from getting on the pillow.
To protect the face and decrease swelling it is best to sleep on your back with your head elevated. Some people roll two small towels and place on either side of their face to prevent them from rolling over at night.
Step 2 (Day 10 and onward: Lighter moisturizer and sun protection)
Once daily in the morning apply Neutrogena Sensitive Skin Sunblock with Purescreen. You may also switch to a lighter moisturizer such as Cetaphil or Cerave Cream. The first two weeks they should be applied at least three to four times a day. Afterward, daily use for at least three months is required. They should not contain anything with the potential to irritate such as Glycolic acid, etc. If you have any questions please ask us. At this point the skin is still very sensitive and may not tolerate certain skin care products.
At this point the skin is still healing and you may notice the following side effects. A pink or red appearance is normal and reflects the healing process. It may take a few weeks or months for it to resolve. Some people notice new visible blood vessels that may appear. Meanwhile the skin may itch, feel tight and more prone to developing a rash. Because of the intense wound care in steps 1 and 2, you may temporarily be more prone to developing acne or small cysts. Some patients may develop lighter or darker skin color in the treated area. Depending on how you heal, you may be prescribed certain medications to help minimize redness or darkening of the skin.
After approval of your physician, you may start wearing make-up two weeks after the laser surgery. It is important to remove the make-up very gently with a mild cleansing lotion (Cetaphil Cleansing Lotion – over the counter). Please avoid scrubbing your skin.
Though the above regimen is repetitive and time consuming, the first week or so is critically important to a great result. Close follow-up helps us catch and correct potential complications early. Please keep your follow-up appointments.
Should you experience any pain, discomfort, or stinging within the first three days take Tylenol (acetaminophen). Avoid aspirin and ibuprofen. Stronger pain medication can be prescribed. Pain should gradually improve a few days after laser resurfacing. If pain persists or worsens please let us know.
If prescribed, take the full course of any antiviral or antibiotic medications. Please call us if you have any side effects.
Significant swelling is expected during the first 24 to 48 hours, especially around the eyes. It is very important to keep the head upright or elevated with two to three pillows when resting. Also please avoid bending over or lifting for the first two weeks.
If there are any unusual symptoms or signs suggesting infection (fever, increased swelling, blistering or increased redness in an area) please contact our office.
It is very important to avoid all contact with anyone who has a herpes cold sore, impetigo or anything that can infect the skin. Avoid swimming, hot tubs and strenuous exercise until you have physician approval.
Use only the products we recommend during the healing phase. When washing your face, use only water. Do not use any facial cleansers, toners or soap unless instructed to do so.
Avoid direct exposure to the sun for three months following laser resurfacing. During the immediate postoperative period (steps 1 and 2), we recommend staying indoors during the day. Afterward a daily sunscreen should be used to intact skin for at least three months. Staying indoors during peak daylight hours (10 a.m. to 3 p.m.) and wearing a hat can be very helpful.
Because the Vaseline Jelly may clog your pores, you may notice a temporary outbreak of pimples and/or tiny superficial cysts.
Itching frequently occurs in first three weeks after treatment. Most people have very good temporary relief with cool compresses (small towel soaked in cold water placed on the skin for 15 minutes as needed). If itching persists, over the counter Benadryl (25mg) taken at bedtime can be helpful. In some instances your physician may give you a prescription anti-itch cream.
A pink or red appearance is normal and reflects the healing process. It may take a few weeks or months for it to resolve.
Depending on how you heal, you may be prescribed certain medications to help minimize redness or darkening of the skin.