QWhat is your post-treatment protocol after an ablative resurfacing laser?
I put every patient on doxycycline 100mg twice daily for 7 days and valacyclovir 1g once daily for 7 days starting on the day of the procedure. Some sources recommend fluconazole 150 mg once, but I only do this for very extensive treatment areas. I have the patients bring their prescriptions with them to the clinic on the procedure day along with a brand-new jar of Aquaphor. After the laser treatment I personally apply a heavy layer of Aquaphor on the patients’s face and show them with a mirror, so they know how much to apply. Patients typically tend to do less at home, so I purposefully go extra heavy on the ointment to emphasize the importance of keeping their skin well protected.
Post procedure care includes Aquaphor multiple times daily, along with dilute plain white vinegar soaks to the entire treatment area 2-3 times daily for the first four days. On the 5th day patients can cut down to vinegar soaks once daily. Starting on day 7 they can apply mineral sunscreen and regular moisturizer during the day, Aquaphor at night. Depending on how the patient is healing and how aggressive the treatment the patient may return to use serums and retinoids on week 3 or 4. If there is any concern for post inflammatory hyperpigmentation I pre-treat the area with hydroquinone starting one month prior to procedure day, and resume that on post treatment week 2. I also schedule a quick telehealth visit 2 days after the procedure and see the patients back in clinic 1 week after the treatment. Patients do really well and appreciate the extra attention.