What is the best Fraxel Repair aftercare regimen?

Question

What sort of aftercare regimen do you recommend after Fraxel repair treatment? Are there any particular skin care products I should or shouldn't be using?

Michael A. Persky, MD · Answer

Hi,
Both before and after your Fraxel repair treatment it is important to avoid skin care products that are harsh on the skin.  Avoid mechanical exfoliants as well.  You should use only very mild cleansers, moisturizers, and sun blocks for 7 to 10 days before your treatment.
Immediate aftercare is standard mild acetic acid washes (dilute vinegar-water) followed by Aquaphor for the first few days.  The remainder of the aftercare varies among physicians.  You should be given clear instructions of your aftercare before your treatment.
Good luck and be well.
Dr. P

Hooman Khorasani, MD · Answer

Thank you for the question.  
Your doctor should have provided you with detailed verbal and written instructions on Fraxel aftercare.
It is really important to help you skin heal quickly and protect your skin investment.  On the night following treatment, I recommend patients wash the treated area gently with lukewarm water and avoid hot water in these areas.  I ask my patients to use a 4x4 gauze pad soaked with tepid water diluted with white vinegar (1 teaspoon per cup) to gently go over the resurfaced area 3-5 times a day until the skin has stopped exfoliating. The goal is to lightly remove the exfoliating skin and crusting that develops after the laser.  This should be a gentle process with no scrubbing or abrading.  Frequent cleaning is important in order to prevent bacterial, viral or fungal infection.  After each cleaning I ask my patients to apply a thick coat fo a prescribed topical moisturizer with Q tips.  My patients continue this for 7-10 days at which point the skin is completely resurfaced.  My patients are then advised to continue to moisturize and photoprotect from the sun.  All of your skin care products should be non-irritating and non-clogging for a few weeks after laser treatment.  I schedule close follow up to check on my Fraxel patients and ensure we achieve the best possible results.
For patients who are prone to cold sores / herpes, Valtrex is used before and after the procedure.
If you would like to learn more about the procedure I recommend an in person consultation with a board certified dermatologist with cosmetic training.

Raffy Karamanoukian, MD, FACS · Answer

Fraxel lasers and chemical peels can cause unwanted discloration and pigmentation if not performed conservatively. 
After melasma laser or chemical peels; the following protocol is advised:
Elevase Moisture Booster: Twice daily application of Elevase Moisture Booster to help hydrate chapped, sensitized, and dry skin after treatment. Apply liberally on the treated area and reapply if you are experiencing persistent dryness.Melarase AM + Melarase PM: Once the skin has healed over and the peeled, apply Melarase AM in the morning and Melarase PM in the evening to help reduce abnormal pigmentation or PIH. Melarase creams can help maintain a smooth complexion and should be used for at least several months (Note: one bottle contains one month supply).Best, 
Dr. Karamanoukian
Realself100 Surgeon

Nissan Pilest, MD · Answer

The after care for Fraxel Repair is very important.

	We advice our patients to start soaking with water and vinegar as soon as they arrive home followed by application of Aquaphor every 2-3 hours for the first 3 days.

	They are also to take the antibiotics, antivirals and anti fungals two times a day for one week.

	We also bring the patients everyday or every other day for treatments with the Omnilus Red 633 nm for faster healing.

	We dont start any other topicals for one week after the procedure to eliminate any risk of contact dermatitis.

Kari L. Colen, MD · Answer

For the first 72 hours after Fraxel repair, you should follow a strict protocol of vinegar soaks and aquaphor ointment. You should also be take Valtrex (or another anti-herpetic medication).
After that, you should use a gentle moisturizer and skin cleanser. Different doctors have their own products that they prefer, so you should get detailed directions and after care instructions from the physician doing your treatment.

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