Caring For Skin After Chemical Peel/Laser Treatment

Your procedure effectively exfoliates the uppermost damaged skin layers, leaving your skin fresh. While your procedure was formulated to be gentle, you will most likely experience peeling and redness on your journey to new skin. In fact, you should see noticeable results after just the first treatment. Follow these important steps to keep your skin protected.

1. Use sunscreen with an SPF of at least 30 with UVA & UVB protection at all times for at least the first three weeks.

2. Avoid direct sun exposure. Too much sun may cause improper healing and even reverse the benefits of the peel.

3. Treat the skin gently. Do not exfoliate. Do not pick at peeling skin. Dead skin will naturally slough off. Do not use ice to the face. Cool moist towel is acceptable.

4. Avoid alpha- and beta-hydroxy acid products, retinols, and facial products containing fragrance.

5. Please consult with your physician prior to returning to your normal skin care regimen.

6. Bromelain and/or arnica supplements can help with bruising and swelling.

The resurfacing procedure designed to rejuvenate the facial and/or neck skin. Patient compliance and the ability to follow directions are paramount for the success. Failure to obey your doctor's orders can lead to serious complications such as herpes or bacterial infection or permanent scarring.

The day of your procedure, you will present to the office without any makeup. We will degrease your face before. Your face may feel sunburned but you should not be in extreme pain. We will coat your face with either Vaseline, Triple Paste, Eucerin, or Cerave and you will continue to apply this until you see the doctor again.

Most patients do not experience significant pain after the procedure. If your face hurts, the best treatment is to apply cool wet moist compresses to the treated areas of the face. However, try not to use ice.

We recommend that you take a salad bowl and wash it well. Fill it with water and ice cubes and soak several wash cloths (or gauze) in the bowl and keep the bowl in the refrigerator. Apply the cold moist cloth to the face and this will ease the discomfort and assist the swelling. When the cloth becomes warm, replace it with a new cold soak cloth. You can do this as much as you wish, but doing this will wash off the moisturizer, so remember to place a good coat over the treated areas when needed.

Make sure you have your Obagi kits, moisturizers, and/or other prescriptions ready. In addition, you will may need five to seven days’ worth of antibiotics to take during your healing process.

Use the Foaming Gel or a gentle cleanser (Neutrogena, Dove, Purpose, Cerave; fragrance free) to wash your face gently for 20 to 30 seconds twice daily. Lather the cleanser in your hands and gently pat onto your face, then splash lukewarm water onto your face to rinse. Dry your face by patting gently and then cleaning with a towel.

If you have been instructed to use 3% hydrogen peroxide (which reduces the chance of infection), use it diluted (mixed half/half with clean water) after washing your face twice per day. Gently dab onto your face with cotton balls or gauze. It will bubble and may often turn white. If hydrogen peroxide is too irritating and stings, you can dilute even more with clean water. After washing and patting your face dry, apply the moisturizers and/or prescription conditioning ointments as directed, both morning and night. Apply your ointment or moisturizer gently and do not rub this in hard. You should use the ointment/moisturizers as often as necessary to keep your skin from becoming dry and crackled. I would rather you be too greasy than not greasy enough.

Do not let your skin dry out, it will pull on the new tissue underneath and may cause red, irritated areas. You can apply your ointment or moisturizer five times per day, if you so desire. This will reduce the tightness and make you more comfortable, and do not worry if all the ointment does not come off, when you wash your face; it will not harm you to leave some on.

You may develop occasional whiteheads because of all the ointment on your skin, and this is normal, and do not be alarmed since they will resolve over time. Also, be aware that some mild itching and burning is normal at this time.

Be sure and minimize facial expressions during your healing. Excessive facial movements will cause the skin to crack prematurely and this is not a good time to see a funny movie, visit your dentist, or eat a large burger or sandwich.

Do not pick or rub your skin at all! If you must wash your hair, wash it with your head tilted backward in the shower or in the sink. Do not wet your face in the shower, too much water will cause you to peel prematurely and it will leave you with red, sore areas that may lead to scarring or need to be treated again.

If large pieces of skin are hanging from your face, they may be cut off carefully with a blunt-nose scissors. Do not sit in a sauna or jacuzzi or do strenuous exercise at this time. Sweating will make your face sting and it will cause you to peel too soon.

Do not expose your face to sunlight at all during healing (for the first two weeks). If you have to do some exercise, you may go out for a walk in the early morning or late evening, when the sun is barely out and wear a hat.

During peeling, think of your dark old skin (which is peeling off) as a bandage protecting the fresh skin underneath. The longer you can keep this bandage in place, the better the results of your peel.

You may have some swelling during the first two to three days after your peel, particularly if it is a medium or deep peel. In extreme cases, your eyes may swell almost closed during the first two mornings. This is a normal response and will resolve on its own, but sleeping with an extra pillow to elevate your head may help decrease the swelling in the meantime. Do not apply ice packs or cold compresses to your face to decrease the swelling. The moisture from these may cause the skin to peel prematurely.

It is important you try to sleep on your back so as to not rub your peeling against the pillow. This could create an area of prematurely peeled skin.

After the peel, sunscreen must be used to protect your skin from the rays of the sun. Sunscreen keeping sun off the face is very important and important for proper healing. All patients should avoid direct sunlight for 4-6 weeks after surgery. It is also very important to avoid sunlight or sun exposure for the first month after peel. Failure to do so can cause hyperpigmentation and will reduce the effects of you peel. In addition, sunlight will prompt a quicker return of brown spots. After the tenth day, you should be wearing daily sunscreen (you should be anyhow!). In addition, our office can provide you with medically based skin care products that will protect the longevity of your facial improvement. Using sunscreen and sunglasses, and a wide brimmed hat are necessary. It is also important to protect your healing skin from sunlight that comes through car or office windows. Using a high quality sunscreen with at least SPF 30 and both UVA and UVB protection is recommended. This should be applied several times per day during the healing period. You need to use sunscreen even if wearing a hat, since the reflected rays may also cause damage, and you should have a prescription for sunscreen in your Obagi Kit, if you bought one.

Makeup may be used after one to two days after peeling is complete (usually after a week), but your doctor will advise as to when you may where it.

If you have unexpected irritation or possible infection, call the office immediately! Do not wait until your next appointment. This is especially important, if you think you may be developing a cold sore on your lip.

If you are experiencing a lot of itching, be sure to use plenty of 1% hydrocortisone ointment. If you do not have a prescription, call the office. You may also try using a daily lotion four to five times per day. (Refrigerating your lotion will make it feel more soothing).

PRESCRIPTIONS

Your procedure is meant to be a safe and predictable procedure, but is reliant on multiple medications to prevent viral and bacterial infection, reduce swelling, control discomfort and assist in sleeping. You will be given prescriptions for some of the following medications. The prescriptions that you have been given should be taken as prescribed. It is imperative that you understand the prescription regimen and take the medicines as directed by your doctor. If any questions, do not hesitate to call.

SUMMARY

1. Continue to wash your face twice daily with cleanser and lukewarm water; do not wash off every bit of remaining ointment.

2. Use may your daily lotion throughout the peeling, in the morning and evening.

3. Keep your face very moist. Use Action and Tolereen or 1% hydrocortisone ointment, if recommended.

4. Do not pick or rub your skin.

5. Do not go into the sun at all while peeling, even for five minutes!

6. Do not use the cleaning or moisturizing routines as an excuse to speed up the peeling of your skin through excessive rubbing; it will only increase your risk of complications.

7. Do not be alarmed, if you feel flush or warm, when you bend over, as this is a temporary condition that resolves after the peel has completely healed.

8. Avoid exercise and sweating.

9. Minimize facial expressions.

10. Sleep on your back.

If you have prolonged or severe pain, swelling, bleeding, fever, nausea, vomiting, chest pain, shortness of breath, or other concerning symptoms, please go to the nearest Emergency Room. Otherwise, please feel free to call the office at 301-982-4555 with any questions. After-hours, a surgeon can be reached at 301-665-7775. Leave a message and the doctor will get back to you as soon as they can.