SmartSkin CO2 Laser Skin Resurfacing Pre/Post Instructions

Pre-Treatment Instructions

• The following should be obtained prior to treatment day: 
  • The following should be obtained prior to treatment day: 
  • Aquaphor or plain Vaseline 
  • Gentle moisturizer  
  • Gentle cleanser 
  • Sunscreen with SPF 30 or greater (mineral sunscreens preferred) 
  • 4×4 inch gauze pads (available at local pharmacy) 
  • White vinegar 
  • Tylenol (optional) 
  • Antihistamine (optional) 
    • Diphenhydramine/Benadryl or cetirizine/Zyrtec can be taken as needed for itching, but may cause drowsiness 
• Begin the recommended Pre-Treatment Skin Care routine listed at the bottom of this sheet 2 weeks prior to treatment.  
• For patients pre-treating with hydroquinone, stop 2 days before your scheduled treatment  
• Avoid direct sun exposure for 4 weeks prior to your treatment.  Absolutely no tanning, either in a tanning bed or outdoors prior to treatment. You cannot be treated if you have a sunburn, recently tanned, or have sunless tanner on your skin. 
  • Apply a daily sunscreen with SPF 30 or greater and reapply as needed. 
• If you have had other skin rejuvenation procedures in the past month, please discuss with your provider to ensure adequate spacing of treatments.
• Avoid the following active ingredients in treatment areas 7 days prior to treatment:  
  • topical retinoids (e.g. Retin-A, tretinoin, adapalene) 
  • Vitamin C,  
  • Glycolic acid and salicylic acid.  
  • If you are concerned about any of the products you are using, please ask your provider.  
• Treatment area(s) should be shaved within 1-2 days of treatment if hair is present. CO2 laser may cause unwanted hair loss in the treatment area.   
• Avoid filler for 1 month prior to treatment, effects on filler are unknown.  
• Botox can be performed 2 weeks before or 2 weeks after CO2 laser treatment.  
• Avoid unnecessary blood-thinning medications (e.g. NSAIDs like ibuprofen), but please take all medications that are prescribed by your primary physician as you normally would.  
• Come with clean, product-free skin and loose-fitting clothes over all treatment areas.   
• If you have a history of herpes simplex virus (HSV) in any treatment areas, notify your provider, as pre-treatment with an anti-viral medication will be required. Your provider will give specific instructions. 
• Notify your provider of all medications you are taking as some medications can be photosensitizing.  
• We recommend you wait at least 6 months after isotretinoin (Accutane) treatment before having CO2 laser. 

Post-Treatment Instructions

FOR THE NEXT 72 HOURS:

• Treated areas may feel hot, tight, and/or itchy. Mild/moderate pinpoint bleeding, swelling, and redness is normal and expected. The following medications are recommendations for treating post treatment concerns. They can be purchased at your local pharmacy. 
  • Antihistamines can be taken for swelling and itching.  
    • Benadryl/Diphenhyramine 25 mg tablets. Take 1-2 tablets every 4-6 hours as needed 
      • Zyrtec/Cetirizine 10 mg. Take 1 tablet daily as needed 
  • Pain relievers can be taken for discomfort.  
    • Tylenol 500 mg x 2 tablets every 4-6 hours as needed 
  • Contact your provider at 800-429-1151 if pain is still present after 3 days. 
    • You will start a 7-day course of antibiotics on the day of treatment, as instructed by your provider. Always take the antibiotic on a full stomach. 
• Headaches and nausea are not uncommon in the first days after CO2 laser. If excessive, please contact your provider for guidance. 
• Swelling tends to be greatest in the morning. Keep your head elevated by using pillows while lying down to help minimize swelling.  
• Apply cool compresses using a solution made of dilute white vinegar (see below) at least 4 times a day for 20 minutes at a time to help with swelling and discomfort. 
• Preparation: 1 tsp white vinegar per pint of water 
  • Keep the solution cool in the refrigerator  
  • 4×4 inch gauze pads are recommended for applying solution to the skin 
  • After soaking, gently dab the skin with clean gauze pad  
  • If irritation or sensitivity occurs with the solution, please discontinue, and contact your treatment provider for further instructions. 
  • After each vinegar soak, cover any treated areas with Alastin Skin Nectar (if using) followed by a thin layer of Aquaphor or Vaseline. Continue to apply Aquaphor or Vaseline every 2 hours to help lock in moisture and protect the skin barrier.  
• Direct sun exposure should be strictly avoided for 4-6 weeks post-treatment. Sunscreen should not be worn for the first 72 hours while the skin heals. Refer to the post-treatment skin care regimen below for step-by-step instructions. 

FOR THE NEXT 4-14 DAYS:

• Gently clean the skin using hands, cool water, and the recommended cleanser both morning and night. Do not pick, scrub, use exfoliants, or any other cleansing tools. Dilute vinegar soaks are also permitted during this this up to 3x a day, particularly if swelling, itching, or pinpoint bleeding continues to be present. Soaks may also help speed healing. 
• After washing, apply Alastin Skin Nectar (if using), followed by a thin layer of Aquaphor, Vaseline, or another recommended gentle moisturizer, both morning and night.  
• Continue to practice strict sun avoidance. To protect against passive sun exposure when leaving home, sunscreen with SPF 30 or greater should be applied daily and reapplied as needed.  
• Avoid increased body temperatures that may result from hot tub or sauna use, or intense exercise. 
• Avoid wearing makeup until skin is completely healed.

FOR THE NEXT 4 WEEKS:

• Please continue to avoid direct sun exposure, as outlined above. Sunscreen with SPF 30 or greater should be worn daily and reapplied as needed to protect against passive sun exposure.   
• Resume normal activities as tolerated. 
• Avoid swimming, saunas, and hot tubs if redness is still present. These activities may be resumed once any redness has resolved.  
• A normal skin care routine, including shaving and use of products with active ingredients can be resumed once redness is resolved.