PATIENT RESOURCES

Aldara Cream Instructions

Aldara (Imiquimod) is a cream that helps your immune system to fight against several types of

growths on your skin. It is used to treat warts, sun damaged skin (actinic keratosis), and some

skin cancers. Aldara causes local irritation and even ulceration when it works.

Duration of use:

Use Aldara as directed by your physician. It is typically prescribed 2-7 times per week 2-6 weeks but sometimes longer.

Application:

1.  Aldara cream comes in little packets. Perforate the packet with a needle and squeeze just enough onto your fingertip or a Q-tip to apply to the lesion and immediate surrounding areas. Only a small amount of cream is needed.

2.  Store the unfinished perforated packet in a zip-loc bag or cover with saran wrap so that it does not dry out.

3.  Apply at night. It will take 5 minutes to absorb into the skin after which time it will not rub off. Do not cover the treated area with a bandage after it was applied unless specifically discussed with your doctor.

4.  Wash hands after applying.

5.  Wash the treated area in the morning.

Expected Reactions:

1.  It is expected to have some degree of crusting, redness, itching and flaking. This is normal and desired. It is also normal to see areas that you have not directly applied the cream to react with redness and crusting.

2.  If a severe local reaction occurs, such as extensive crusting or blistering, stop the Aldara until the reaction resolves. This may take up to one week to heal.

     a.  Restart the cream and use it as tolerated. It is okay to restart the cream at a lower frequency than initially prescribed. For, example, instead of 5 days per week you may switch to 3 days per week and then increase back to 5 days per week as tolerated.

3.  Some patients may experience flu-like symptoms. If you are feeling ill, please call our office.

Biopsy Care Instructions

Nature of Procedure

You just had a procedure called a skin biopsy. There are two types of skin biopsy procedures, punch biopsy and shave biopsy. The punch biopsy tool is similar to a small circular cookie cutter that removes a circular piece of tissue. A suture is often required for proper wound healing. The shave biopsy blade goes flush with the surface of the skin and no suture is required. 

Care for Biopsy Site(s)

Supplies: 

Cotton-tipped applicator (Q-tip)

Band-Aid

Vaseline or Aquaphor ointment

Saline Solution or Soap & Water

1.  Leave the bandage on for 24 hours and keep the area covered and dry. 

2.  If you experience any discomfort, take Tylenol as directed every 4-6 hours. We recommend that you avoid aspirin, non-steroidal anti-inflammatory agents such as Motrin or Advil, and alcohol, for the first 24 hours as these may increase the likelihood that you will bleed. 

3.  Except when bathing, keep the area dry. If the dressing gets wet, change it. 

4.  Clean the biopsy site once a day: 

     a.  Wash hands before and after the dressing change. 

     b.  Use Saline Solution or soap & water to gently cleanse the area to remove any crusting or scabbing. 

     c.  Pat the area dry. 

     d.  Gently apply Vaseline or Aquaphor ointment with a Q-tip to keep the wound moist for better healing. 

     e.  Cover with a dry non-stick pad or Band-Aid. 

     f.  When the surface of the skin has healed (approximately 5 to 10 days), wound care may be discontinued. 

5.  It is normal for healing wounds to feel slightly tender to the touch, look pink around the edges and slightly yellow in the center of the wound. However, if after a few days it becomes increasingly red, swollen, painful, hot, or develops a discharge, please call our office. 

Potential Complications

Complications are rare but may include pain, loss of blood, infection, allergic reaction to anesthetic, scarring, and other complications. If you notice any of these or other concerns, please call the office immediately at 949-542-8500.

Biopsy Notification

We notify all patients of their results.

1.  Web Enabled Patients: You will receive an email notification or phone call. If you receive an email, please log on to your health portal at www.mypatientvisit.com/#/login to receive your results. If you do not receive a message in 3 weeks, please call our office. 

2.  Non-Web Enabled Patients: You should receive a letter or a phone call informing you of your results within 3 weeks. If you do not, please call the office.

RECOMMENDATIONS FOR DRY SKIN

1.  Use lukewarm water - avoid HOT or COLD water.

2.  Do not vigorously scrub with a washcloth, sponge, or brush.

3.  Use very little soap, and only in areas where needed. A mild soap such as Basis, Cetaphil unscented Dove or CeraVe is recommended.

4.  If your skin is very dry, Cetaphil or CeraVe lotions may be good alternatives to soap. They may be rinsed off or left on the skin.

5.  Reduce bathing time to 5-10 minutes, and always apply a moisturizer immediately after bathing.

6.  Do not use bubble bath, or use only a small amount and be sure to rinse off thoroughly.

7.  After bathing, PAT your skin with a towel to dry gently.

8.  Use moisturizers (such as Cetaphil, CeraVe, Vanicare lotion in summer, and Eucerin, CeraVe, Aveeno, Cetaphil cream, Aquaphor in winter) several times a day to the whole body, especially after bathing, to "lock-in" moisture.

9.  Do NOT use colognes, perfumes, sprays, powders etc. on your skin.

10.  Use a small amount of unscented laundry products such as Cheer-Free, All, or Dreft. If dry skin or inflammation persists with lubrication or prescription medication, you can also double rinse clothes after washing.

11.  Prescription creams and ointments should be applied to affected areas only. Moisturizers are best applied to the whole body at different times; if applied at the same time as prescription ointments or creams, always apply the prescription medication first.

12.  Do not wear tight or rough clothing. Wool clothes and new clothes can be irritating.

13.  Avoid saunas & steam baths - keep environmental temperatures on the cool side.

14.  For extreme dryness, a humidifier or vaporizer may help. Remember to keep it clean or molds may spread throughout the humidified area.

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What does liquid nitrogen do?

Liquid nitrogen therapy produces a freezing injury to the skin. It is also known as cryosurgery.

What can I expect?

You can anticipate a burning sensation for about 10-30 minutes following the treatment, then

perhaps some soreness.  Swelling and redness may occur within 24 hours.  It is normal for a clear

or blood blister to form.  Drying and crusting may persist for approximately one week and

pinkness may remain for up to one month.

How do I care for the area?

•  Keep the area clean with your normal daily cleansing.

•  Discomfort and pain are usually relieved with Tylenol or Extra Strength Tylenol.

•  Apply cool compresses if you experience swelling or soreness.

•  We do not recommend draining the blister if it forms.  However, if you develop a large,

painful blister, it can be drained with a sterile needle.

•  Apply an ointment, like Vaseline or Aquaphor, at night if you develop dry scale or a scab

begins to form.

•  You may apply makeup if your face was treated.

•  Continue to use your sunscreen daily.

•  Please do not hesitate to call the office if you have any problems after therapy.

The purpose of patch testing is to assess your skin’s reaction to a variety of potential allergens

that you may be exposed to at home, work or during recreational activities. Strips of tape will be placed on your back which contain a total of 80 allergens.  There are no needles or pricking

instruments used in this kind of allergy testing.

Three visits will be required.  At the first visit, the patches will be applied and marked with an indelible ink marker. The second visit will be 2 days later; the patches will be removed and the skin will be re-marked with ink.  The final read will be at the 3rd visit, usually 4-5 days after the first visit.  You will be advised of any allergies you have and how to minimize possible reoccurrence.

Patients should expect to spend 60 minutes in the office on the first visit, as the allergen patches must be prepared immediately prior to application.  The follow-up visits are typically shorter.

In order for the patch testing results to be valid, there are a few requirements:

1.  Medications: Avoid any topical cortisone creams on the back 2 weeks prior to patch testing. Avoid oral cortisone medications (prednisone) 1 week prior to testing.  Avoid intramuscular cortisone injections 1 month prior to patch testing.  Inform your doctor if you are taking any other medications that might alter the immune system.  Benadryl and other antihistamines are ok.

2.  Patch sites must remain dry.  Therefore, no showers are allowed.  The back is not to get wet until the final read at 4-5 days. Sponge baths are ok.

3.  Please avoid exercise in the first 48 hours as sweat may loosen the patches.

4.  The area can be uncomfortable and itchy; avoid scratching the area with the patches as it may alter the test results.

5.  Avoid any friction or rubbing as that can also loosen the patches. Wear a loose T-shirt at night to prevent bedding from loosening or peeling the patches.

6.  If you notice such a loosening have someone press the adhesive onto the skin. If necessary, you can also apply additional tape to the edges of the patches.

7.  Avoid direct sunlight or other UV exposure on the back for at least one week.

8.  Occasionally, some patients may experience a vigorous reaction to some of the substances. This may result in localized discomfort/itching. Please inform your provider if you are concerned.

Fees:

—  Insurance typically covers this procedure. If you have a high unmet deductible and have questions about cost, please contact our office at (949) 542-8500 to review your specific plan benefits.

—  Self Pay Fee: $890

If you have any questions, please do not hesitate to call our office.

For optimal healing, we have summarized some important instructions below.

One (1) week before your appointment:

Bleeding is often a concern after surgery. To minimize this risk, please follow the following instructions:

1.  Avoid taking aspirin or aspirin containing medications such as Ecotrin, Bufferin, Anacin, Alka Seltzer, and many others unless you have been instructed by a physician.

2.  Avoid non-steroidal anti-inflammatory medications such as ibuprofen (Advil, Motrin, Nuprin, others), naproxen (Aleve, Naprosyn), indomethacin, and others. If you experience significant pain, you may continue them at the lowest dose and frequency that keeps your pain at a tolerable level. Tylenol is an acceptable pain medication.

3.  Stop all herbal medications including but not limited to Garlic, Vitamin E, St. John’s Wort, Gingko, Ginseng, Feverfew, Airborne, Omega-3/Fish Oil, and diets rich in nuts as these do increase bleeding complications.

4.  You do NOT need to stop taking prescription blood thinners such as Plavix, Coumadin, Aggrenox, Effiant, Heparin, Pradaxa, and Persantine. Continue to take them as prescribed by your physician.

5.  If you have questions about your medications please call us at (949) 542-8500.

Three (3) days before your appointment:

1.  Stop alcohol-containing beverages.

2.  Stop smoking as this may affect your ability to heal. You may resume once the sutures are removed.

3.  Notify us if you are allergic to any prescriptions, including antibiotics, anesthetics and pain medications.

4.  Notify us if a doctor ever recommended you take antibiotics before surgery or teeth cleaning. 

5.  Notify us if your surgery site involves your lower leg or groin area. We do recommend all patients take antibiotics one hour prior to your surgery.

The day of the surgery:

1.  Eat a light meal before surgery. Please DO NOT FAST!

2.  Please arrive 10 minutes early for your appointment.

3.  You may drive yourself for most surgical procedures.

After the surgery:

1.  Go home and take it easy or return to work as long as it does not involve any physical labor.

2.  Minimize sun exposure to the surgical site for 2 weeks after surgery.

3.  Avoid strenuous activity including heavy lifting, exercise and water sports for 10-14 days after your surgery. Please contact us if you have questions.

4.  Follow the wound care sheet that will be given to you at the time of the surgery.

5.  Sutures are typically removed within 1 to 2 weeks.  If you must cancel, please notify us at least one week in advance, so patients that are waiting for an appointment may be scheduled in your place. Failure to give at least 24-hour notification of your cancellation may result in a late cancellation or no-show fee that is not covered by insurance. We appreciate the opportunity to serve you and will do all that we can to ensure that you have a positive experience. If you have any questions, please call us at (949) 542-8500.

The importance of your post-operative care to your surgical site cannot be overstressed. The care you take of yourself and your surgical wound is extremely important to the success of the procedure and to your recovery.

If No Steri-Strips were Applied: 

1. Keep the pressure dressing on and dry for 24 hours. Okay to remove after 24 hours.

2. Beneath the pressure dressing, there will be a waterproof (Tegaderm) dressing. Keep this in place for another 24 hours (48 hours total). It will protect your surgical site when you shower.

3. After 48 hours, remove the Tegaderm dressing.

a. Gently wash the area with soap & water or sterile saline to remove any crusting along the suture line.

b. Pat dry with a clean towel and apply Aquaphor or Vaseline ointment.

c. Cover with a clean, non-stick bandage.

d. Repeat daily until your suture removal appointment.

If Steri-Strips were Applied:

1. Keep the pressure dressing on and dry for 24 hours. Shower with this pressure dressing. At the end of the shower, remove the dressing. You will see the steri-strips over the wound.

2. You may shower with the steri-strips every day. Do not remove. After the shower, make sure to dry them well with a towel or hairdryer. Avoid direct contact of the shower stream with the wound.

3. No further wound care is necessary as long as the steri-strips stay in place and remain dry. If they fall off, follow the, “If No Steri-Strips were Applied” instructions.

If Instructed to Keep the Site Dry:

1. Keep the pressure dressing on and dry for 24 hours. Okay to remove after 24 hours.

2. Beneath the pressure dressing, there will be a waterproof dressing. Keep this in place for another 24 hours (48 hours total). It will protect your surgical site when you shower.

3. After 48 hours, remove the dressing and apply a new non-stick pad and Tegaderm dressing. Make sure your hands are clean. You do not need to clean the wound.

4. Change the dressing every 48 hours after showering unless the dressing gets wet, then change immediately.

a. You may purchase a Tegaderm Wound Care pack from our office for $25.

b. OR something waterproof like Nexcare Waterproof Bandages.

There are several things that can happen following surgery:

Bleeding: Bleeding can occur following surgery. To reduce this possibility, please follow these instructions.

1. Absolutely no exercise for 48 hours.

2. Avoid taking blood thinners, aspirin, or ibuprofen based products for 48 hours unless advised by your physician.

If there is discomfort, take only Tylenol or Extra- Strength Tylenol.

3. Avoid alcoholic beverages for 24 hours.

4. Should bleeding occur, apply firm, constant pressure on the area for 20 minutes. This should stop minor bleeding. If not, please call our office immediately.

Infection: 

The signs of infection are increased pain, swelling, redness, or a yellowish discharge from the surgery site.

1. Should any of these signs occur, please call the office.

Wound Opening: 

To reduce this possibility, please follow these instructions.

1. If steri-strips were applied, dry them well after shower.

2. Avoid water sports (ocean, lake, pool, and hot tub) entirely and limit physical activity until sutures are removed.

If you experience problems after hours or during the weekend, please contact the doctor on call at (949) 542-8500.

Botox and Filler Instructions

Before your appointment:

In order to minimize the chance of bruising, it is helpful (but not necessary) to stop the following medications:

7 days prior:

1.  Please avoid taking aspirin or aspirin containing medications.

2.  Please avoid non-steroidal anti-inflammatory medications such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and others.

3.  Other products that may increase bleeding include large amounts of garlic and garlic supplements, diets rich in nuts, Vitamin E, St. John’s Wort, Gingko, Omega 3/Fish Oils, Feverfew, Ginko, Ginseng, Airborne and other herbal supplements.

4.  Filler Patients Only:

     a.  Numbing – You will have a separate numbing appointment 30 minutes prior to your filler appointment.

     b.  Lip Area Treatments - Please notify us if you have a history of cold sores. We may prescribe a medication 1 day prior to your appointment.

3 days prior:

1.  Stop alcoholic beverages.

2.  Consider taking arnica and/or bromelain supplements.

After your appointment:

Botox Patients

1.  Do not rub or massage the treated area(s).

2.  Do not exercise or lay down for the first 4-6 hours.

3.  If you experience a headache, take either Tylenol or Advil. Headaches are considered a normal side effect.

Filler Patients

1.  You may experience swelling that will subside in 1-7 days. Ice may be applied immediately after the injection to help reduce the amount of swelling.

2.  You may notice bruising. Apply arnica gel to bruised area.

3.  You may apply makeup as soon as 1 hour after injections are complete.

4.  If you have extensive bruising, please call the office as some lasers can help reduce the duration and amount of bruising.

5.  Minimize exposure of the treated area to excessive sun or UV lamp exposure and extreme cold weather until any initial swelling or redness has gone away.

Sculptra Patients

1.  Massage face 5x/day for 5 days as instructed by your physician.

Kybella is a prescription medication approved for the reduction of moderate to severe fat below the chin (aka “double chin”).  After a sequence of treatments, patients can see a significant reduction of their neck fat without any cutting or sucking fat away.

Kybella is also being used as a treatment for the reduction of other small fat pooches or bulges, such as jowls, knees, bra, underarms, etc.  Ask your Dermatologist for details.

Before your appointment:

In order to minimize the chance of bruising, it is helpful (but not necessary) to stop the following medications one week prior to your appointment:

1.  Please avoid taking aspirin or aspirin containing medications such as Ecotrin, Bufferin, Anacin, Alka-Seltzer.

2.  Please avoid non-steroidal anti-inflammatory medications such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and others.

3.  Other products that may increase bleeding include large amounts of garlic and garlic supplements, diets rich in nuts, Vitamin E, St. John’s Wort, Gingko, Omega 3/Fish Oils, Feverfew, Ginko, Ginseng, Airborne and other herbal supplements.

4.  Numbing Cream – Please pick this up at our office. Apply 1 hour prior to your appointment time. It does increase the comfort of your treatment. Our office will order the cream for you from our compounding pharmacy.

Morning of the treatment:

1.  Men should shave their neck and the area beneath the chin the morning of their treatment.

2.  In order to reduce immediate swelling, bruising and discomfort after the treatment, please take the following 1 hour prior to your treatment.  These will not affect your risk of bruising.

     a.  Ibuprofen 400 mg (2 Advil Tablets) and

     b.  Extra-Strength Tylenol (500 mg acetaminophen)

After your appointment:

1.  You may apply ice immediately after the treatment for 10-15 minutes as needed to help reduce discomfort.

2.  Expected side effects are redness, swelling, bruising, tenderness to the touch, and occasionally numbness that may last several weeks after the treatment.

3.  You may apply makeup as soon as the next day after the treatment is completed.

4.  Treatments are spaced 6-8 weeks apart.  Typically, 4 sessions are required to achieve the desired results. Patients will need 4-6ml’s per treatment session.

5.  Please call us if you develop an asymmetric smile, facial muscle weakness, difficulty swallowing, or if existing symptoms worsen.

INSTRUCTIONS FOR LASER TREATMENTS

Before your treatment:

1.  No sun exposure or use of tanning products prior to treatment.

2.  Please inform us if you have taken isotretinoin (Accutane) in the past 6 months.

3.  Come with a clean face to the office.  If this is not possible, inform our staff that you are wearing makeup.

4.  Follow up treatments are monthly and average about 5 treatments to achieve 50% improvement.

After your treatment:

1.  Swelling is normal and expected.  It typically lasts 3 days.  You may take an antihistamine like Zyrtec to minimize any swelling that has occurred.

2.  Bruising can also occur.  It typically lasts for 5-7 days.

INSTRUCTIONS FOR IPL (PHOTOFACIAL) LASER TREATMENTS

Before your treatment:

1.  No sun exposure or use of tanning products 1 month prior to treatment and during the course of treatment.  If you are tan, please postpone your treatment.

2.  Please inform us if you are taking any tetracycline based medications including doxycycline and minocycline.  You must stop these medications 3 days prior to treatment.  If you have questions about other medications, please ask.

3.  For our male patients: this laser targets red and brown pigment.  It may target beard hair as well.  If you are concerned over losing hair in the beard area, please inform our nurse to avoid this area during your treatment session.

4.  Please inform us if you have taken isotretinoin (Accutane) in the past 6 months.

5.  Discontinue all retinoid based products and glycolic products 3 days prior to treatment.   Some common retinoic acid products include: Differin, Retin A, Renova, Tazorac, Veltin, Ziana, and Atralin.

6.  On the day of the treatment, please come with a clean face, wearing no makeup.

7.  Typically, you will need 3-5 treatments to achieve 50% improvement.  The treatments are spaced 1 month apart.

After your treatment:

1.  You will notice your brown spots are darker and your face will be a bit red immediately after your treatment.  Typically, the redness fades in 24-48 hours while the brown spots will continue to darken. After 7-10 days the brown spots with begin to peel and fade away.  This is normal.

2.  Wear sunscreen daily and reapply frequently. Avoid sun as much as possible. Wear a hat if you must be outside for extended periods.

3.  Avoid any irritating topical agents (retinoids, glycolics) for 1 week after your treatment.

4.  You may wear makeup immediately after the treatment.

Before your treatment:

1.  Sun Exposure: Avoid tanning and tanning products 1 month prior to your treatment.

2.  Medications: Please inform us if you have taken:

     a.  Isotretinoin in the past 6 months.

     b.  Topical retinoid products and glycolic products. You should discontinue 3 days prior to treatment.

3.  Medical Conditions: Please inform us if you have a history of:

     a.  Active Connective Tissue Diseases like Lupus

     b.  Cold Sore Breakouts (Herpes Simplex) - we will give you medication to help prevent this from occurring.

     c.  Active Infections and Current Chemotherapy or Radiation therapy

     d.  Pregnant or Breastfeeding

     e.  Allergy to Latex or Topical Anesthetic agents

     f.  Keloid Scarring or Darkening of pigment in the skin

4. Preparation for Laser

     a.  6 weeks prior - Do not pluck, wax, use a depilatory or undergo electrolysis in the areas you wish to have treated. Shaving is okay even the upper lip and chin area.

     b.  Shave the area to be treated the day prior to treatment.

     c.  Numbing Cream - Apply numbing cream to any sensitive areas like the lip, bikini and underarm.

         i. You may purchase LMX-4 (4% lidocaine) or LMX-5 (5% lidocaine) at your local pharmacy or online.

         ii.  Alternatively, you can purchase a compounded numbing cream (23% Lidocaine/7% Tetracaine) through us.  Our office will order the numbing cream for you from our compounding pharmacy.

        •  Please apply the numbing cream 60 minutes prior to your appointment.

        •  Cover with saran wrap

        •  Please do not exceed 15 grams per application

After your treatment:

1.  Redness and Swelling – This is normal. It should resolve within several hours to several days after treatment. If you get blisters, please call the office.

2.  Gently clean area twice daily.

3.  Avoid irritants (glycolics, retinoids etc.) for seven days after treatment.

4.  Apply sunscreen for 6 weeks over the treated area.

Micro-needling is an alternative to resurfacing aimed at stimulating the body’s own collagen production.  It can help reduce the appearance of fine lines and wrinkles, skin laxity, acne scarring, and minimize pore size.  It is ideal for patients who want rejuvenation but do not want laser treatments. It can be safer than lasers in darker skin types.  The process of micro-needling can also help to improve brown spots and melasma.  Treatment areas include: face, neck, chest, hands, stretch marks and scars.

Before your Micro-needling treatment:

1.  Sun Exposure: Avoid for 1 week prior to treatment.

2.  Medications:

     a.  Stop any ibuprofen-based medications such as Advil and Motrin 3 days prior as they may interfere with the natural healing process.

     b.  Bruising is common so it will be helpful to avoid aspirin, vitamin E, and fish oil supplements 1 week prior.

     c.  Avoid isotretinoin (Accutane) for 6 months prior to treatment

     d.  Discontinue topical retinoid products, glycolic acid agents, benzoyl peroxide and any other skin irritants for 7 days prior.

3.  Medical Conditions: Please inform us if you have a history of:

     a.  Cold Sore Breakouts (Herpes Simplex) - we prescribe you medication to help prevent this from occurring.

     b.  Active Infections, Immunosuppression, Lupus, or Vitiligo

     c.  Taking Blood Thinners

4.  Contraindications: Pregnancy, actively infected or inflamed skin, cystic acne in the area being treated, keloid scarring, sunburn, HIV and Hepatitis C.

5.  On the day of the treatment, please come with a clean face, wearing no makeup. You may wash your face in the office.

6.  Numbing: apply numbing cream 30-45 minutes prior to appointment. Available for advance pickup in office.

After your Micro-needling treatment:

1.  Day 1-3: Your skin will feel dry, tight and you may notice skin flaking. There may be bruising.  After treatment, gently cleanse and moisturize, using one of these two options:

     a.  Ladera Derm recommendation: Gently wash with LaderaDerm Elite Ultra Gentle Cleanser, and moisturize with Skin Medica HA5 Rejuvating Hydrator.

     b.  Over-the-Counter alternative: Gently wash with Cetaphil Gentle Cleanser, and moisturize with Neutrogena Hydro Boost gel-cream.

2.  You may resume your regular products, including Retin-A, after 5 days.

3.  Medications: Avoid Ibuprofen the day of the treatment. Tylenol is okay to take for soreness.

4.  Exercise and Swimming/Hot Tubs: It will take 24 hours for the micro-needling channels to close. It is important to avoid strenuous activity that can cause sweating and saunas/steam baths/hot tubs for 48 hours.

5.  Makeup: You can reapply your makeup after 48 hours.

6.  Sun Exposure: Continue your daily s sunscreen and avoid harsh sun exposure for 5 days. If you must be outside for an extended period, wear a hat.

Fractionated Non-Ablative Skin Resurfacing Laser Instructions

Used for the treatment of fine lines and wrinkles, melasma, acne scars, surgical scars and stretch marks.

Before your treatment:

1.  Sun Exposure: No sun exposure or use of tanning products 1 month prior to treatment.

2.  Medications: Please inform us if you have taken:

     a.  Tetracycline based medications including doxycycline and minocycline. You should discontinue 1 week prior to treatment.

     b.  Isotretinoin in the past 6 months to 1 year

     c.  Topical retinoid products and glycolic products. You should discontinue 1-2 weeks prior to treatment.

3. Medical Conditions: Please inform us if you have a history of:

     a.  Connective Tissue Diseases like Lupus

     b.  Cold Sore Breakouts (Herpes Simplex) - we will give you medication to help prevent this from occurring.

     c.  Light Induced Seizures or Reactions

     d.  Active Infections or Immunosuppression

     e.  Pregnant

     f.  Keloid formation

     g.  Prednisone therapy (current)

On the day of the treatment:

1.  Wash with soap and water the areas that will be treated.

2.  Apply the numbing cream 1 hour prior to your appointment time.  Please pick this up prior to your appointment.  Our office will order the numbing cream for you from our compounding pharmacy.

3.  Come to the office with the numbing cream on. We will remove it just prior to your treatment.

After your treatment:

1.  Burning and Stinging: Immediately post treatment you will have some burning and stinging for approximately 1 hour. Wrapped ice packs or cool gel packs can be helpful during this time.

2.  Redness and Swelling: This will typically last 2-3 days but can last up to 5 days.

3.  Bronzing: After 3-4 days some patients will experience bronzing (brown discoloration) of the skin and a sandpaper like feel to the skin.  To help remove this, you can soak a washcloth in water and gently soak the skin for 15 minutes.  Do not pick or scrub the skin.  This may last for a few weeks on areas other than the face.

4.  Cleansing: Gentle Cleansers should be used to wash your skin. If your treatment was more aggressive, you may want to use occlusive ointments like Aquaphor or Vanicare Ointment to help the healing process.

5.  Sun Exposure: As healing occurs, avoid sun exposure for 2 weeks after treatment, continue to wear sunscreen daily with SPF 30 or greater and reapply frequently.

6.  Topical Medications: Avoid any irritating topical agents (retinoids, glycolics) for 1-2 weeks after your treatment.

Follow Up:

1.  Typically, you will need 4 to 5 treatments spaced 4-6 weeks apart.

Fractionated Ablative Skin Resurfacing Laser Instructions

The CO2 laser is used for the treatment of fine lines and wrinkles, loose eyelid skin and wrinkles around the eyes, brown spots, uneven skin tone, acne scars, loose skin around the neck and jowls and enlarged pores.

Before your treatment:

1.  Sun Exposure: No sun exposure or use of tanning products 1 month prior to treatment.

2.  Medications: Please inform us if you have taken:

     a.  Isotretinoin in the past 6 months to 1 year

     b.  Topical retinoid products and glycolic products. You should discontinue 1-2 weeks prior to treatment.

3.  Medical Conditions: Please inform us if you have a history of:

     a.  Connective Tissue Diseases like Lupus

     b.  Cold Sore Breakouts (Herpes Simplex) - we will give you medication to help prevent this from occurring.

     c.  Light Induced Seizures or Reactions

     d.  Active Infections or Immunosuppression

     e.  Pregnant

     f.  Keloid formation

     g.  Prednisone therapy (current)

     h.  Melasma or Hyperpigmentation – we will start you on a lightening product 1 month prior.

One week before your treatment:

1.  Expect a phone call from our office to detail the procedure.

2.  Pick up numbing cream from our office & detailed aftercare instructions.  Our office will order the numbing cream for you from our compounding pharmacy.

3.  Make sure you have white vinegar on hand at home for the aftercare.

4.  Start on antiviral and antibiotics 1 day prior.

5.  Arrange for a driver on the day of the procedure.

6.  Plan on 5-7 days of downtime.

Day of the procedure:

1.  Plan on spending 4 hours in the office. Bring reading material as you will also be numbing here.

2.  Come with a clean face and do not wear your contact lenses.

3.  We will provide you with a post procedure kit which includes gauze for the white vinegar soaks.

4.  We will review your aftercare instructions in detail – please bring these with you.