The CO2 laser and the fractionated CO2 laser are used to create microscopic channels in the skin and remove the very superficial sections of the skin. It is important to treat the skin with clean hands until healed (about 7–10 days).

The deeper channels of the treatment continue to heal over several months. It is normal for the skin pinkness to fade gradually: the pinkness indicates the building of new collagen, helping create firm skin with an improved texture and reduction of wrinkles, pores, skin irregularities, and pigment spots.

We also combine the use of nano fat grafts together with stem cells derived from fat and/or blood with the laser in all our patients, as we get the most superb improvement in the skin. In fact, our facelifts and hammock lifts are known for improvement in the skin as much as for the amazing changes we create in the facial and neck structures.

How to Look After the Skin Following Face CO2 Laser

1. Icing the Area

Ice for ten to fifteen minutes every hour for the first 5 – 6 hours to reduce swelling.  Use a bag of frozen peas covered with a thin clean cloth/towel. Many patients find the cool air from a fan also helps sooth the skin.

2. Vinegar Solution

HOW TO MIX THE VINEGAR SOLUTION AND HOW TO SOAK:

• Mix a tablespoon of plain white kitchen vinegar in 2 cups of water.
• This solution can be mixed up ahead of time and kept in the refrigerator.  Keeping the solution cool makes it soothing on the skin.
• Dip a clean, soft, washcloth into this vinegar solution and dab the whole face applying gentle pressure to ensure the vinegar solution wets the skin. Repeat this 3 to 4 times to the whole face. The whole procedure takes only a couple of minutes but is vital to keep the skin clean and to allow it to heal efficiently.
• Soak the whole face 4 or 5 times a day for the first week and twice a day for the second week.

THE PURPOSE OF THE SOAKS

Soaking and dabbing with the mixture helps remove the peeling skin. It also cleans up the area nicely. Most of my patients find this very useful for the first week and up to 2 weeks. Use a clean face-cloth rather than cotton wool (the wool will stick to the face!).

WHAT TYPE OF WATER?

You can use tap water, although some patients mix the vinegar in cold distilled water (distilled water and white vinegar can be purchased in any grocery store or drug store).

AFTER EACH SOAK

Apply a layer of the special moisturizing solution we give you. When that runs out, switch to Aquaphor or plain Vaseline ointment.

VINEGAR SOAK TIPS

• Make a fresh solution every day.
• Avoid scratching or rubbing the treated skin – do not put adhesive dressings over treated areas.

3. Shaving

Men may shave 1-2 days post-treatment but be gentle. Best to use an electric razor for the first few days!

4. Things to Avoid

• Avoid all saunas and hot tubs. Showers can be taken, but avoid hot water and direct shower spray to treatment area for 3 days following treatment. You may, however, shower and get the face and treated areas wet the day after the treatment.
• Avoid strenuous exercise for 48-72 hours (this includes all yoga, especially the upside down, inside out Bridge-Lion pose).
• Avoid alcoholic beverages for 24-48 hours.

• DO NOT expose your skin to direct sunlight for the first 4 weeks, and wear a sun block (see below).  If actively outdoors, you should reapply your sunscreen every 2–4 hours and wear a wide-brimmed hat. You can start using a physical sunscreen like zinc oxide and titanium dioxide on your skin after 2 weeks. A good sunscreen is EltaMD UV Physical Tinted Face Sunscreen with an SPF protection of more than 40. If you Google it, you can find many places that se
• DO NOT use any retinoid, Retin-A or glycolic products for 4 weeks following the procedure.  Do not use any non-prescription creams without checking with us first.

• DO NOT apply any other creams, ointments or products, including detergents and fabric softeners to your face as it heals for the first 2 weeks.
• Refrain from any chemical peel treatments or microdermabrasion (or deep facials!) for 4 weeks post-procedure.

5. Sleep Tips

Sleep with 1-2 extra pillows at night to keep head raised for the 2 nights.

6. Medications

Take the prescribed pain medication (or ibuprofen or acetaminophen) as and if needed and please take the prescribed anti-viral medication to prevent cold sores or a breakout of herpes simplex. After 1 week, most patients find that using the water-and-vinegar soaks 2 to 3 times a day for another week makes the skin feel better.

What to Expect After Your CO2 Laser Treatment

Initial Period

• The skin will usually start sloughing on day 3 or 4. Do not pick at the skin, but allow the skin to slough off on its own.
• The skin may be red for the first 3 – 7 days. Then it turns darker as the skin sloughs (peels).
• Swelling of the face will get worse for 3 days, and then it starts to settle.
• Your skin will feel tight, similar to a sunburn.
• Most patients will experience a sensation of itching: over-the-counter Benadryl (diphenhydramine) is useful, as are the water-and-vinegar soaks.

Note: The degree of pinkness varies from person-to-person because of the different levels of treatment and because of the different skin types. Occasionally, we will prescribe a weak steroid after 3 to 4 weeks, which helps reduce the pinkness. We may also occasionally use a specific laser that helps to reduce the pinkness. But we should not rush the production of new collagen!

After Your Skin Peels (3–5 Days)

• Make-up may be worn by day 5 to day 7 once the majority of the peeling is complete. However, depending upon the degree to which we treat you, it may take a little longer before make-up may be used.
• Sunscreen use is important to prevent hyperpigmentation of the skin as it heals.
• After the first week, you can reduce the use of the moisturizer to 2 to 3 times a day.
• We will guide you through the process and ensure you get a beautiful result

BCK Patel MD, FRCS