Greater Washington Plastic Surgery Associates What to Expect After Fractionated Laser Skin Resurfacing Treatment Fraxel® Laser Treatment produces some side-effects. The intensity and duration of your side effects depends on the treatment aggressiveness your individual healing characteristics. Generally, patients who are treated more aggressively experience more intense side-effects that last longer. However, some patients have greater than “expected” reactions to less aggressive treatments and others have fewer side-effects to aggressive treatments than would ordinarily be expected. Notify your physician if the severity of your side-effects becomes a problem for you.  Swelling. You will notice most of the swelling on the first morning after treatment, particularly under the eyes. Swelling usually lasts two to three days. To minimize swelling do the following:  Apply cold compresses to the treatment area for 10 minutes of every hour on the day of treatment, until you go to bed.  Sleep elevated the first night. Use as many pillows as you can tolerate.  Redness. Most redness resolves during the first week after treatment, but a rosy “glow” can remain for several weeks. If you wish, you can apply makeup immediately after treatment to minimize the redness.  Dry skin. Your skin may feel dry, peel, or flake. You may notice a “sandpaper” texture a few days after treatment. This is the treated tissue working its way out of your body as new fresh skin is regenerated.  Bronzing, Crusting and Small Dark Dots. Fraxel Laser Treatment causes destruction to microscopic cylinders of skin which then exfoliates during the healing process. In individuals with heavily pigmented skin, or in areas where sun damage has produced pigmented lesions, these microscopic wounds, known as MENDs, contain large amounts of melanin. Because there are so many MENDs, they can make the skin look bronzed, or small areas appear crusted (do not try to scratch them off). When high energies are used to produce deep and wide lesions, the MENDs can sometimes be seen as individual dark dots. On the face, the MENDs will shed within 7-10 days. Off the face, it may take as long as 3 weeks for the MENDs to shed.  Raw Skin. If you develop areas of raw skin post treatment, keep them moist with something like Aquaphor® or Bacitracin®. You do not need to apply band-aids, but keep the areas moist and do not pick at them. They will heal very rapidly on their own and without problems. Greater Washington Plastic Surgery Associates 2826 Old Lee Hwy, Ste 330, Merrifield, VA 22031 • Phone: 703-544-8971 • Fax: 703-562-6994 www.gwpsa.com Greater Washington Plastic Surgery Associates How to Care for Your Skin After Treatment Congratulations! You have taken the first step toward more healthy and radiant looking skin by having a Fraxel re:store™ laser treatment. Now it is important to help your skin heal quickly and protect your skin investment. We strongly suggest you meet with our aesthetician to additionally maximize your result.  Skin Care Products. All of your skin care products should be non-irritating and non-clogging for the first week or so after Fraxel Laser Treatment.  Sunscreen. According to the American Academy of Dermatology, proper and frequent application of sunscreen is very important. The sunscreen should offer broadband protection (UVA and UVB) and have a sun protection factor (SPF) of 60 or more. You should first apply sunscreen 20 minutes before going outside, and again, immediately before. After that, reapply your sunscreen every 2 hours. If direct sun exposure is necessary, wear a hat and clothing that covers the treated area. Use this regimen during the healing period and always. You will probably find that you use about 1 bottle of sunscreen per month, rather than the 1 bottle per year that most people use.  Moisturizer. Remember that peeling and/or flaking is normal during the healing process. Therefore, the product should be non-irritating and non-clogging, else you could develop breakouts. During the healing period your normal moisturizer may be too occlusive, so consider products from the brands listed above. Instead of using 2 separate products, use moisturizers that contain SPF30+. Reapply whenever your skin feels dry.  Scrubs, Toners, Glycolic Acid, and Retin A. Your skin will be sensitive for the first week or so after treatment, so do not use products that will cause irritation during this time. Do not use abrasive scrubs, toners, or products that contain glycolyic acids or Retin A. Read the product labels. NO RETIN A TWO WEEKS BEFORE ANY TREATMENT.  Bleaching Creams. Discontinue use of your bleaching cream while your skin is tender. Restart your bleaching cream 2 DAYS AFTER TREATMENT  Resume your normal skin care regimen when your skin has fully healed.  Cold Sores. If you have a history of cold sores, ask your doctor about care! You will need a prescription for valtrex.  Other Instructions: Greater Washington Plastic Surgery Associates 2826 Old Lee Hwy, Ste 330, Merrifield, VA 22031 • Phone: 703-544-8971 • Fax: 703-562-6994 www.gwpsa.com Greater Washington Plastic Surgery Associates HYDROQUINONE (BLEACHING CREAM) HYDROQUINONE is applied to the skin to lighten areas that have darkened (hyperpigmented). Hydroquinone will work best if you avoid excessive exposure to sunlight and wear sunscreens and protective clothing; some hydroquinone products contain sunscreens and other cosmetic ingredients. The products required after fraxel laser treatment are available only with a prescription. Generic hydroquinone skin cream, gel, or solution is available. How should I use this medicine? Hydroquinone is for external use only, do not take by mouth. Follow the directions on the prescription label. Make sure the skin is clean and dry. Apply just enough to cover the affected area. Rub in gently but completely. Do not apply near the eyes, mouth, and other mucous membranes. Wash your hands after applying. If you are using other topical medications, apply them at different times of the day. Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed. What drug(s) may interact with hydroquinone? • benzoyl peroxide Check with your prescriber if you are using other medications which are applied to the skin. Non-medicated cosmetics, sunscreens, and moisturizing lotions may be worn over the hydroquinone preparation. However, wait several minutes after application of hydroquinone before applying them. Tell your prescriber or health care professional about all other medicines you are taking, including nonprescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check before stopping or starting any of your medicines. Do not get hydroquinone in the eyes, inside the nose, on wounds, or any other sensitive areas of skin. If accidental contact occurs, large amounts of water should be used to was the affected area. If the eyes are involved and eye irritation persists after thoroughly washing, contact your prescriber. Do not apply to sunburned areas or if you have a skin abrasion in the area of application. To increase the chance that hydroquinone will be effective, keep out of the sun, or wear protective clothing outdoors and use a sunscreen (SPF 60 or higher). Do not use sun lamps or sun tanning beds or booths. Greater Washington Plastic Surgery Associates 2826 Old Lee Hwy, Ste 330, Merrifield, VA 22031 • Phone: 703-544-8971 • Fax: 703-562-6994 www.gwpsa.com