I had co2 laser resurfacing done to my entire face yesterday, 75% ablative setting, what is best after skin regimen?

Question

I am using aquaphor after reading reviews on this site, I also read comments about vinegar soaks, are Nsaids OK! I was told to avoid them so my body could experience the inflammatory response for healing...I am very swollen, red and oozing today....Advice would be helpful! Thanks ❣

Hooman Khorasani, MD · Answer

Thank you for your excellent question.  Your doctor should provide detailed aftercare instructions for you and I suggest you contact your doctor for detailed instructions.  
Our office specializes in fractional CO2 laser resurfacing - an excellent treatment for photoageing, fine lines and wrinkles, dark spots and a rejuvenating glow.  As a guide, the open wound phase starts after treatment and continues until full re-epithelialization occurs.  This is usually 3-5 days.  On the first postprocedural day the treatment area is an open wound which will be red, oozing, crusting.  There may be pinpoint bleeding.  By day 3-5 after the procedure the area is should be re-epithelializing, with mild redness.  Open wound care involves gentle rinsing of the treatment area with special post-laser soaks and washes several times per day.  Some practitioners use dilute acetic acid (vinegar) soaks.  There will be brown crusted tissue which will eventually be removed in the wash and which will reveal healthy pink skin.  Sometimes pinpoint bleeding occurs during the washing process.  After washing the skin, an occlusive ointment such as Aquaphor is applied liberally to ensure moist wound healing.  During the open wound phase, no sunscreen or makeup is worn and strict sun avoidance is essential to reduce the risk of pigmentation issues.
Once the open wound phase has completed, the skin is epithelialized and fully intact.  This normally lasts for several weeks.  The skin is mildly pink and more sensitive.  A regular moisturiser is used as well as sunscreen with a physical blocker.  Makeup may be worn during this phase.
Regular follow up with the treating doctor is necessary during the healing phase.
I hope this is useful information for your post-laser aftercare.

Jason Emer, MD · Answer

I recommend following up with your Doctor about appropriate after care. Laser results take 6-12 weeks to settle. Photodynamic therapy can help healing. Lasers like Co2 work best in combination with other treatments in order to improve the skin's texture and collagen. After Co2, I recommend adding fraxel lasers, microneedling/prp and radiofrequency treatments. See an expert. Best, Dr. Emer.

Alex Eshaghian, MD, PhD · Answer

Thank you for your question Cynder. Fractional CO2 laser resurfacing is an
outstanding treatment that can address multiple aspects of aging in a single
treatment. Aquaphor, Vaseline, and the Elta MD Intense moisturizer are great products to use to speed up the healing. They go on best on a wet skin surface. I recommend that my patients use the Avene Thermal Spray water prior to application of such an emollient. Dilute white vinegar soaks can be used to prevent infection; I prescribe antibiotics instead. Anti-inflammatory medications can decrease swelling when severe, but may interfere with the healing process and decrease the collagen stimulation. 
Please consult with a doctor for specific
recommendations. Good luck!

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