The following article, written by Cindy Steele, was published in Specialty Skin Care, the official publication of the Society of Plastic Surgical Skin Care Specialists. Cindy is a clinical aesthetician and laser specialist at Advanced Aesthetics, a division of Arkansas Plastic Surgery.
PRE AND POST-TREATMENT INFORMATION FOR IPL, LASER AND LIGHT BASED TREATMENTS
Staying up to date on the ever changing precautions to protect your patient and yourself from complications can be a challenge and therefore a constant battle. We have all had that non compliant patient that has to be fired!
Acids: So many OTC products now contain a variety of acids, so be aware pre-treatments. Such as citric acids, AHA, BHA, lactic, glycolic and Retina-A, etc. It is recommended for the patient to be off these products two weeks prior to a treatment.
Fever Blisters: One month before treatments, patient should be without fever blisters, always be informed of the last date of the lesion. Pre treatment medications might be needed.
Sun: Three weeks before a treatment-no extended sun exposure including tanning beds. Must wear at least a SPF 30 and a hat daily. In the summer, I often bump the SPF factor up to 50. Now available are visors and hats that include a UPF of 50 plus. At our New York meeting, Dr. Mariwalla, a MOH’s plastic surgeon, explained the “TWO RULE”. If you are in direct sun reapply SPF every TWO hours. If you are at work under florescent lighting, in front of a computer or just running errands to and from your car SPF should be applied TWO times daily.
Medications: If the patient has been ill and was put on antibiotics they must finish last dose, then wait 2 weeks prior to treatment, because it can stay in the system, causing photosensitivity. Three days before treatments-No asprin,Ibuprofin, Advil, Aleve, NSIDS, Benadryl, Tylenol PM or herbal supplements such as Ginko Biloba, St.Johns Wort etc. There is now an OTC multi vitamin for ages 50+ which contains Ginko Biloba, so always be informed of all oral ingestions. This is not intended to be a full and complete list. It is the patient’s responsibility to call their pharmacist regarding any medications, including over the counter mediations that they are currently taking. The patient should tell the pharmacist that they are having a light based treatment and need to check the medications for photosensitivity.
Post treatment: We need to strongly encourage no heat, steam or exercise for 24 hours. Including activities such as standing over a hot grill, stirring a pot of boiling water or standing over the dishwasher as it completes the cycle. Keep in mind even exercise can stimulate heat and therefore cause unnecessary hyper-pigmentation issues. Even consider if a patient is having a hair treatment where heat or light is being used. Discourage radio-frequency home devices or manual exfoliation 3 days prior and 3 days post treatment of a laser or light device.
To honor Dr. Panell, recently deceased, I’d like to discuss his discovery of the use of topical L-ascorbic acid and the benefits of it’s use for the skin. After laser treatments, inflammation in the skin can occur, therefore, using an antioxidant 5 to 7 days prior is a good prep. Skin rapidly is depleted of Vitamin C at a time when it needs it the most. There are many clinical studies out that suggest the use of L-ascorbic acid when used in an appropriate vehicle and when initiated at an appropriate post operative period, may decrease the degree and duration of erythema after cutaneous CO 2 laser resurfacing. It is presumed that the effect of Vitamin C is responsible for an anti-inflammatory effect.
Cindy Steele, Little Rock, Ar., has been an active member of SPSSCS since 2005, serving on the Board of Directors, has led round table discussions at the meetings, worked on several committees such as scholarship awards and planning of the annual meetings for several years. She’s works as a clinical aesthetician and laser specialist at Advanced Aesthetics, which is a division of Arkansas Plastic Surgery. She is a nationally certified aesthetician, NCEA. She has written articles for SPSSCS and has been published in magazine articles for pre and post skincare regime for surgery patients in Med Aesthetics.