CO2 laser resurfacing works by removing microscopic channels of skin including some of the skin’s surface. Since it removes the surface of the skin, we consider it to be an “open wound” and take great measures to protect it while it is healing.
CO2 laser resurfacing takes about 7-10 days for the surface of the skin to heal. Once the surface is healed, bacteria are unlikely to be able to enter the skin and cause an infection. The deeper channels of the skin continue to heal over the next 3 months and the skin will continue to look pink during this healing process. If the skin is still pink, it means the skin is still healing and building collagen, which helps with skin firmness, texture, and wrinkle reduction!
Laser Resurfacing Post-Operative Instructions for the First Week
Vinegar soaks and Lubricating Ointment:
- Starting when you get home from surgery, do this treatment every two hours while you are awake.
- Mix 1 teaspoon of distilled white vinegar in 1 cup of distilled water (both these items can be purchased at the drug store or grocery store). Keeping the vinegar and distilled water cold in the refrigerator will make the treatment more soothing. Make a fresh solution every day to keep it clean.
- Dip a clean paper towel into the solution. Use the paper towel to gently wipe away the old ointment and debris from the skin. The goal is to remove all the old ointment and any bacteria that is on the resurfaced skin.
- Reapply the protective ointment. I recommend Vaseline. If you have an allergy to petrolatum products, ask your doctor for another recommendation.
- Apply gentle ice packs with a clean cover to the resurfaced skin for 30 minutes out of every hour for the first 72 hours while you are awake.
- Ice helps with pain, decreases swelling, and reduces bruising. Ice does not help as much after 72 hours.
- Do not put ice cubes directly on your skin. An easy and effective ice pack is a bag of frozen peas or corn wrapped in a thin clean dish towel or cloth. You can even remove some of the peas/corn if the bag feels too heavy.
For Full-Face Laser Resurfacing Treatment:
- Take Valtrex 1000mg once a day for 14 days starting 3 days before your procedure.
- If you feel a cold sore coming on, increase the dose to 1000mg twice a day and call your doctor.
- I prescribe Valtrex to all my full-face laser resurfacing patients because there is an increased risk of having a herpes outbreak (the virus that causes cold sores and chicken pox) after laser resurfacing. A herpes outbreak on resurfaced skin can lead to scarring. I have never had a patient get scarring from herpes after laser resurfacing treatment and I think this is because I believe prevention is the best medicine. The herpes virus is very common, and most people carry the virus even if they have never had a cold sore. That is why I recommend treating everyone even if they have not had a cold sore in the past.
Laser Resurfacing Post-Operative Instructions Starting Day 7 After Your Treatment
Decrease Vinegar Soaks to 4 times per day followed by a mineral-only sunscreen
- The skin surface is mostly healed now. You can decrease the frequency of the vinegar soaks to 4 times per day followed by a physical sunscreen (zinc oxide and titanium dioxide). You can stop using Vaseline.
- You can use any sunscreen that contains zinc oxide and titanium dioxide. My favorite physical sunscreen product is EltaMD UV Physical because it is formulated for post-procedure skin and it is very rare for it to cause an allergic reaction. Stay away from sunscreens with chemical active ingredients as these cause irritations to newly resurfaced skin.
- If you feel like the resurfaced skin is too dry with the sunscreen, go back to using the Aquaphor ointment.
- Do this routine for 4 days.
CE Ferulic Antioxidant Serum
- If you were using CE Ferulic antioxidant serum before your laser treatment, you can restart it now. It will likely burn on application. This is ok. If it makes your skin red and irritated, wait until 30 days after treatment to restart it.
- Do not start using this product now if you have not used it in the past!
Laser Resurfacing Post-Operative Instructions Starting Day 11 After Your Treatment
- You may stop using the Vinegar Soaks!
- You may wash your face with tap water and your regular facial cleanser. I recommend a gentle non-foaming facial cleanser.
- CONTINUE TO USE SUNSCREEN EVERY DAY!!!!!!!!!!!!!!!!!!! Resurfaced skin is very sensitive to the sun and is more likely to burn. Sun exposure also increases the risk of hyperpigmentation. Sunscreen is the very best beauty product on the market. Wearing sunscreen every day is the best way to prevent the signs of aging and prevent skin cancer!
- Wait a full 30 days before restarting your retinol (anti-aging) products. Start slowly (use only every other day), and stop or slow down if your skin becomes irritated.
Some skin types are prone to hyperpigmentation (Dark Spots) after CO2 laser treatment. If your scars tend to hyper-pigment after they heal, you may be prone to this.
- To prevent hyperpigmentation, carefully follow the instructions above.
- Sun exposure is a trigger for hyperpigmentation. It is crucial that you wear sunscreen every day (even if you are just running to the store) and avoid sun exposure.
- If you notice hyperpigmentation developing, please notify your doctor’s office, as there are topical creams that can help.
PLEASE CALL YOUR DOCTOR IF YOU EXPERIENCE:
- A decrease in vision or double vision.
- Pain or nausea that is not controlled with medication.
- Signs of infection including redness, pus-like discharge, tender nodules, warmth, and pain.
- Fever greater than 100F.
- Severe itching
- Any other concerns.
Post-operative instructions may vary for each individual patient. Please ask your doctor for your own personalized set of post-operative instructions. Do not hesitate to contact our office with any questions. We wish you a speedy recovery!