Fractionated Carbon Dioxide Laser

Fractionated Carbon Dioxide laser: Pre-operative Instructions

1. Before we start, please review the consent form thoroughly and make sure all your questions are answered.

2. You will be here for approximately 3 hours. Please arrange for someone to pick you up at the end of the treatment. You will not be comfortable on public transport.

3. If prescribed please start taking the oral antibiotics the evening before your procedure and continue to take regularly until the course is finished.

4. If prescribed please start taking Aciclovir 400mg at bedtime the evening before. Take 400mg tablets, twice a day until you finish all the tablets supplied.

5. Start using Dermovate cream on the morning of the day before the procedure, applying morning and evening. You will have applied this cream a total of three times before the treatment.

6. Take one 10mg Zirtek the night before the procedure. You will also be asked to continue this for several nights.

7. You need to stop taking Aspirin or other pain medication such as Ibuprofen, 5 days before the procedure. You may take Paracetamol for pain.

8. Supra-therapeutic dose of Vitamin E and other herbal supplements have been associated with increased bleeding risk. Please let us know if you are on any herbal or non-prescription supplements.

9. Please have following items ready before your treatment day:

  • Hair bands and ties to keep hair off your face and neck: make sure they are soft and not too tight, as you may need to keep them on for 48 hours.

  • Bags of frozen peas as ice packs.

  • Home environment: make sure that you have a room which is free from direct sunlight. Blinds and curtains are sufficient. Vacuum the room and laundry linens to cut down risk of infection.

  • Sunblock with SPF 30 or above: once the skin is healed, you will be instructed to apply sunscreen liberally for 3 months.

  • Arrange for backup help during the week after the procedure in case you need help.

  • Wound Care regime.

10. On the day of treatment, please come to the Clinic a good hour prior to your scheduled treatment time with no make up and a buttoned shirt i.e. wearing garments that don’t need to be removed over your head. Do not wear contact lenses for that day.

Fractionated Carbon Dioxide laser: Post-operative skin care

What you might experience after the procedure:

1. Redness and swelling are common. While swelling may resolve within 1-2 weeks, prolonged redness may last up to 3 months.

2. Exudates/bleeding/crusting. Because the laser beam penetrates into the deep dermal layer, clear fluid (exudate) or blood may ooze onto the skin. Crusting or scabs may form if exudate or blood dries. Keeping treated areas moist helps prevent crusting and subsequent scarring.

3. Pain may linger after the procedure is completed.

4. Risk of infection from bacterial, viral or fungal agents exists despite our best preventative efforts.

5. Scarring may occur from crusting, infection, or simply being exposed to laser.

6. Pigmentary changes: After treatment, skin may appear darker (hyper-pigmentation) or lighter (hypopigmentation) than before. Although most are transient, it could be permanent.

7. Itching may occur as part of infection, poor wound healing, contact dermatitis, or normal wound healing process.

8. Ectropion: Rarely, a downward pull of the eyelids can result after treating the around-the-eye area.

9. Acne or milia formation: Flare-up of acne or formation of milia due to use of semi-occlusive dressings.

10. Non-responsiveness to laser treatment: You skin condition may not improve or may worsen.

What to do:

1. You may shower normally the day after the procedure and then proceed with the wound care.

2. Limit movement of the face and neck as far as is possible. This facilitates healing.

3. Hand-washing is the most important thing you can do to prevent infection. Wash your hands every time before you touch treated areas.

4. To reduce swelling and for pain relief, you may place ice packs, bags or frozen peas on the treated area for first 2 – 3 days. You may also take paracetamol 500 mg, two tablets, every 6 hours.

5. Keep your head elevated while resting, and for the first few nights. This helps reduce swelling and promote healing.

6. Remember to finish all of your oral medication as prescribed.

7. Follow wound care instruction below.

8. Call us if you experience any one of the following:

  • Pain that is not relieved by paracetamol.

  • Excessive redness, swelling, bleeding, and/or scab formation.

  • Excessive itching, especially when accompanied by sign of infection.

  • Signs of infection: whitish to yellowish film on treated area, with or without foul odour.

  • If you develop a fever of 100.4F or above.

  • or, if you are just not sure. If you cannot reach us and it is an emergency, call 999.

Fractionated Carbon Dioxide Laser: Wound Care Regime

What you need:

  • Dermol 200 Shower Emollient
  • Cotton Wood Balls and Buds

  • A clean container

  • 50:50 (Vaseline and Liquid Paraffin)

What to do:

1. Wash hands thoroughly with soap, rinse and dry before each wound care session

2. Half fill a clean 1pt (500ml) container with warm water and add a tablespoon of Dermol 200.

3. Using a fresh cotton wool ball each time, gently wipe the areas with the diluted lotion. Soak any crusted areas and use cotton buds gently to remove any crusts. Pat dry. Apply 50:50 generously over entire treated area after each cleansing.

4. Wash every 2 – 3 hours during the first 24 hours. Set alarm to wake up at least once during first night for cleansing. You may gradually increase to every 3 – 4 hours after 24 hours. Continue to wash twice a day for one week. You may change to a bland unperfumed moisturiser after 2 – 3 days.

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