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Patient Pre & Post Prodedure Care

Patient Pre and Post Procedure Instructions

Caring for your skin properly pre and post procedure helps ensure the most successful results. We have included the physician-directed care instructions for the following procedures. 

*Please find a link to a print-friendly version of each care instruction at the end of each treatment list.

During your Accutane Appointment

We will draw your bloodwork during your appointment. Please be fasting if possible (no food or drink after midnight the night before). We understand this isn’t always convenient. We will monitor your progress, discuss any side effects you are having, draw your labs and e-scribe your Accutane directly to a specialty pharmacy.

After Your Accutane Visit

(The FDA monitors the use of this medication through a program called IPledge because of the high potential for birth defects if you were to get pregnant while taking the medicine- we do not make the rules!)

Female patients: The day after your visit (or Monday if you are seen on a Friday), our nurses will log on to IPledge.com and change your status from “requires confirmation” to “confirmed.” We try to do this by 10am. After we mark you as confirmed, you need to sign in to IPledge.com and answer questions within 24 hours. Answering your questions is required before the pharmacy can fill the prescription. Remember to click the same contraceptive forms in the same order each time you log onto IPledge.

All Patients: MUST fill the prescription within 5 days of your appointment. If not, the prescription will expire and you will be locked out of the Ipledge system for an entire month. Please call your mail order pharmacy if you have not heard from them within 24 hours of your visit.

All patients: MUST come for your follow-up visits every 30-35 days. Your appointment day is Day 0. Book a follow up at day 30-35 before you leave. If you miss this window, we are not allowed to send your prescription for that month. Your insurance only allows a 30-day supply of medication, so you may be out of pills for a few days prior to your appointment.

BENEFITS

Accutane is a Vitamin A derivative mediation. Please don’t take Vitamin A while you are on Accutane. It’s different from any other acne medication because it is a possible cure for acne in about 70-80% of patients who complete a course of it. Every patient is clear of their acne after their course, but some patients (20-30%) may require more than one course.

SIDE EFFECTS

Dryness of: Lips—keep a good lip balm with you. Aquaphor Healing Ointment is our favorite. Nose—you may develop nosebleeds. You can prevent this by putting Aquaphor inside your nose. Eyes—dryness could be an issue if you wear contacts. Skin—you will need to apply a moisturizer to your skin twice daily.

Fragile skin: Waxing your skin for facial hair is not recommended. Wait until you have been off Accutane for one month. You will also be prone to ingrown toenails and skin infections while on Accutane. Using CLn BodyWash can be helpful when you are taking Accutane.

Elevated blood fats: You must be on a low fat diet. Avoid fried foods and dairy products that are high in fat. Your blood fats levels will be checked regularly.

Birth defects: Accutane causes birth defects in a developing fetus. A pregnancy test will be performed monthly in every female patient of childbearing potential. Accutane does NOT affect any future child bearing in males or females. You should wait at least one month after your treatment course before becoming pregnant.

OTHER:

  • Muscle pain- in about 20% of patients. Take Ibuprofen for relief.
  • Headache- if this gets severe, please let us know. Don’t take any doxycycline or minocycline while on accutane, as this can increase the risk of severe headaches.
  • Liver Injury- very rare, and we monitor this with your blood tests
  • Hair Loss- rare but if this happens it is not permanent
  • Depression- There was a large study of 20,000 patients that showed no increased risk of depression, although in those that have had a history of clinical depression, being on accutane may exacerbate it. Most patients have an improvement in their mental health when their acne clears!
  • Decreased night vision
  • Inflammatory Bowel Disease- there have been very large studies that disprove a cause and effect relationship between this, but rather that acne may have an increased association with IBD.
  • Premature epiphyseal closure of growth plates- rarely seen on the courses we give for acne, although it has been reported.

No cure exists for atopic dermatitis, but it can be controlled.
Caring for this condition requires paying attention to proper daily skin cleansing and moisturizing along with using the medicines prescribed by your doctor.

Skin Cleansing:

  • Use a fragrance free, mild soap or non-soap cleanser such as Aveeno, Cetaphil liquid cleanser, Dove, or Cerave cleanser. CLn is a cleanser we carry in the office that also treats eczema because of its ability to act like a bleach bath (see below)
  • Avoid aggressively scrubbing your skin with wash cloths, sponges or brushes.
  • Bathe in lukewarm water, once daily. Hot water worsens dry skin. Do not use bubble bath.
  • Soak rather than shower. Tub bathing for 10 minutes will allow for good rehydration of the skin. This is especially helpful during flares.
  • Bleach baths: ½ cup of bleach in the tub, soak for 20 minutes, then use fresh water for hair, face and final rinse. This will reduce skin bacteria that may worsen eczema

Skin Moisturizing:

  • Gently pat your skin partially dry immediately after getting wet. If a prescription medicine isprescribed, apply to the affected areas while your skin is damp and rub in well. Next layer/apply anon-irritating moisturizer (Aveeno lotion/cream, Cerave cream, Elta cream, Cetaphil cream,Aquaphor ointment) to lock in the moisture.
  • Try to apply the medicine/moisturizer to damp skin within 3 MINUTES after your bath.
  • Reapply the moisturizer as needed throughout the day.
  • Most prescription medicines should be applied twice a day on an as needed basis. More frequentapplication offers no additional benefit. If you look dry during the day, use your moisturizer.

Avoid Irritants:

  • Use a sensitive skin laundry detergent (Cheer Free, Dreft, All Free and Clear). Avoid using fabric softeners.
  • Run clothes through a second rinse cycle to remove any residual detergents.
  • Avoid wool clothing.
  • Avoid heavily scented or perfumed items.
  • Avoid becoming too hot and sweating (sweat is an irritant) or keeping the house too cool and dry with a/c. Use of heaters in the winter also increases dryness.

TREATMENT PLAN:

If it is RED, RAISED, SCALY or ITCHY, TREAT IT!
MEDICINE FIRST, THEN MOISTURIZE

Contact the office for flares and maintenance treatments.

Before your treatment:

Avoid direct, extended sun exposure for two weeks pre-treatment. For the safest and most effective treatment we want your skin at the lightest most natural color.

  • We cannot safely treat sunburned or sun sensitized skin
  • Avoid self tanning products for two weeks pre treatment
  • Avoid chemical peels and other pulsed light ot laser treatments for two weeks pre treatment
  • If you are using topical medications or products that irritate your skin or make your skin feel sensitive to the touch please stop use for 3-5 days pre treatment

After your treatment:

  • Post treatment your skin can feel warm and sensitive 
  • Please avoid direct and extended sun exposure for at least two weeks after treatment 
  • Sun spots will be slightly darker in color and/or inflamed immediately post treatment and can continue to get darker for appx 2 days before they begin to flake off
  • Do not attempt to scrub off the dark spots, they will flake off on their own within appx 7-10 days, if treating the body this process can take several weeks
  • If treating redness you will likely be more red immediately post treatment. Capillaries can appear darker red or become a purple color and bruising is also possible and should resolve within appx 10 days. It is also possible to have some swelling.
  • Please avoid hot tubs, saunas and strenuous exercise for appx 48 hours post treatment 

Most patients need appx 3 treatments at one month intervals for the best results.

*Click here for print-friendly: BBL Photofacial Care Instructions

Biopsy Post-Care Instructions

  • It is very important to take care of your biopsy site so that any scarring can be minimized.
  • Please keep the area clean with soap and water twice daily. If a scab forms, use hydrogen peroxide on a wet wash cloth to remove the scab.
  • Keep the area MOIST with vaseline or Aquaphor healing ointment and covered with a bandaid if possible. If you can’t cover it with a bandaid, make sure you are applying sunscreen.
  • If there is any increasing redness, pain, swelling or yellow discharge please call the office.
  • If you have not received your pathology report within 2 weeks after your biopsy please call the office.

Before your appointment:

It is recommended to schedule your appointment 1 month prior to a special event, as it take 2 full weeks for the effect to occur and to give yourself time for a tweak appointment if that becomes necessary. Remember that bruising can occur from the treatment. We use very small needles to inject the botox! Discontinue blood thinners such as aspirin, ibuprofen, St. Johns Wort, fish oil, Vitamin E, Ginger, Ginkgo Biloba or ginseng for 7 days unless you have been prescribed these by a physician. Take Arnica Montana and/or Bromelain (found naturally in pineapple or as a supplement) 1 day before and for 7 days after your injections to minimize bruising and swelling.

After your appointment:

  • DO make facial expressions (frown, smile, raise your forehead) for the hour after your treatment.
  • Do NOT lay down or bend over for at least 4 hours after your treatment.
  • Avoid alcohol, strenuous activities or excessive heat exposure for 24 hours.
  • Do not massage, manipulate the injection sites or have a facial or massage for 2 days.
  • Take Tylenol if you experience any discomfort or a headache after your treatment.
  • It will take 5-7 days for you to see improvement, and full effect occurs at 2 weeks.
  • After 2 weeks, DO call us if you are not completely satisfied with your results. We want you to have an outstanding result, and can perform a touch-up at this point if necessary. Your 2 week “touch-up” appointment is especially important if this is your first treatment here. This will help us determine the exact number of units necessary for your face so that future appointments will give you your best result.
  • Botox appointments are ideally scheduled 3 months apart. This is because our goal is not to completely freeze your facial expressions. Try to have your next treatment before the results return completely to baseline. If your results are not lasting, we may need to tweak the number of units used.

Before your chemical peel:

  • One week before your peel please avoid waxing, electrolysis, depilatory creams, and laser hair removal.
  • Three days before the peel discontinue using any prescription topicals such as AlphaRet, Retin-A, Differin, Epiduo Forte or Tazorac, as well as any products containing retinol, alpha hydroxy acids (AHA), beta hydroxy acids (BHA) or benzoyl peroxide.

After your chemical peel:

  • Depending on the chemical peel that was customized for you, you may begin experiencing peeling over the next 3-5 days.
  • Immediately after the peel, your skin will feel tight and may be red. Peeling usually lasts 5 days, depending on the actual peel treatment. Use of gentle cleanser, moisturizer and sunscreen is important, as it will enhance the healing process and results.
  • Normal activity may be resumed after the peel, however strenuous exercise and heavy sweating should be avoided for 2-3 days.
  • Sun exposure should be avoided while skin is peeling; exposure of treated skin to a lot of heat should also be avoided as it may induce swelling, redness and for deeper peels blisters under the skin.
  • Peeling skin should be allowed to slough off naturally; picking or peeling of flaking skin is prohibited, as it may lead to scarring.
  • Use of prescription topicals should be avoided for 3-5 days post peel.
  • Do not worry if you don’t experience any obvious peeling of skin after your peel. The success of the peel should not be judged by the amount of peeling, but by the end results that the peel will produce. The amount of peeling may vary depending on individual skin condition at the time of the peel or the depth of the peel. Regardless of the degree of peeling, the skin is still sloughing off at an accelerated rate, resulting in the improvement of skin tone and texture and an improvement of fine lines and uneven pigmentation.
  • It is recommended that you have a series of peels to achieve the best results.

ED & C Post Care Instructions

  • It is very important to take care of your now-treated skin cancer site so that any scarring can be minimized.
  • Please keep the area clean with soap and water twice daily. A man made scab has already been made over the area and care must be taken to not allow this scab to thicken. Use hydrogen peroxide on a wet wash cloth and dab the area gently twice daily.
  • Keep the area MOIST with vaseline or Aquaphor healing ointment and covered with a bandaid if possible. If you can’t cover it with a bandaid, make sure you are applying sunscreen.
  • If there is any increasing redness, pain, swelling or yellow discharge please call the office.
  • Ensure that you have already scheduled your 6 month skin check. If you have any concerns with how the lesion is healing prior to that appointment, please call the office.

Instructions before your Ellacor treatment:

These medications will be sent to your pharmacy, so please have them on hand the day before your appointment:

  • Valtrex 500mg, 1 tablet twice a day for 3 days starting on the day before the laser treatment. This will prevent any possible herpes outbreak, and is advised to take even if you don’t typically get cold sores.
  • Doxycycline 100mg twice daily starting on the day before your Ellacor treatment x 7 days.This will help reduce any acne breakouts or infection. Please take this WITH a meal. Do not take it on an empty stomach.

Two weeks before treatment:

  • Do not consume any blood thinning agents such as aspirin, ibuprofen, herbal medications, or supplements such as grapeseed extract, Vitamin E, fish oil, etc.
  • Avoid exposure to sun or tanning beds that could result in red, peeling, or swollen skin.
  • Avoid invasive and minimally invasive skin procedures in the procedure area.
  • If you are currently taking any type of blood thinners under the direction of a physician, please discuss this with your treating physician.

1 day before treatment:

  • Shave excessive facial hair; beard and/or mustache. When possible, use an electric powered shaver to minimize the potential for skin abrasions and cuts.
  • To minimize bruising, eat pineapple the day before your treatment and refrain from alcohol

Day of treatment:

  • The skin on your face, chin, and neck should be free of makeup, lotions, and other skincare products.
  • Wear comfortable clothes; avoid shirts with a high neck or collar.
  • Plan on 1 hour for the procedure. Your skin will be numbed with topical and injections of anesthetic to make the treatment comfortable. You will be able to drive home after the procedure.

Instructions after your Ellacor treatment:

Refrain from the following activities until your skin has fully healed and has no open wounds, and holes have closed:

Shaving, waxing, makeup and skin care products, using tanning beds and sunless tanning creams; scrubbing, scratching and/or picking at the treated area(s); contact sports or any activity that could cause injury to the treated site; submerging the treated area in water such as pools, whirlpools, oceans, etc.; and activities that result in overheating, such as long exposure to hot baths, spas, or excessive exercise, kisses from pets and wash hands thoroughly after contact.

Day of treatment:

  • Cleanse skin with water and CeraVe Hydrating Cleanser before bed
  • Pat dry with a clean towel and use Puracyn spray (sample provided)
  • Apply a thin layer of Vaseline, CeraVe Healing Ointment, or Cetaphil Healing Ointment
  • Use a clean pillowcase and avoid sleeping on your face

Day 1 (following treatment) – Day 3:

  • Twice daily (morning and evening) post-procedure care:
  • Cleanse skin with water and CeraVe Hydrating Cleanser
  • Pat dry with a clean towel and use Puracyn spray
  • Apply a thin layer of Vaseline, CeraVe Healing Ointment, or Cetaphil Healing Ointment
  • Use a clean towel each time to pat dry, or use a paper towel and discard. Do not share your towels.
  • Avoid scrubbing, scratching, or picking the treatment area. If itchy, use Puracyn spray (sample provided) or SkinSmart spray (available on Amazon)
  • Begin applying sunscreen (such as EltaMD UV Physical Broad Spectrum SPF 41) on Day 3 if skin is healed and the holes appear closed. Avoid prolonged sun exposure until healed and redness has resolved.

Erbium Laser Resurfacing MicroLaser Peel/Profractional/TRL Contour

Instructions before your Eribium Laser Treatment:

  • ABSOLUTELY avoid any type of sunburn or suntan for 4 weeks prior to laser treatments. Treatment of tanned skin can increase the risk of blistering and/or permanent skin discoloration.
  • PROLONGED SUN EXPOSURE IS TO BE AVOIDED FOR 4 WEEKS BEFORE AND AFTER TREATMENTS.
  • Do not use any self-tanning lotions in the month prior to treatment.oStop using retinoids (AlphaRet, Rx)for one week prior to treatment.
  • You may need to use Rx Hydroquinone Cream for 4 weeks prior to a treatment to reduce the possibility of hyperpigmentation if you have a skin type that hyperpigments easily.

These medications will be sent to your pharmacy, so please have them on hand the day before your appointment:

  • Valtrex 500mg, 1 tablet twice a day for 10 days starting on the day before the laser treatment
  • Mupirocin ointment—You will apply this to the treated area after each vinegar soak x 3 days
  • Doxycycline 100mg twice daily starting on the day before the laser treatment x 10 Days

Shopping List: You will need to use Aquaphor or Cerave Healing Ointment for up to 10 days following the procedure. You need to go to the store and get a large tube or jar before your appointment. You will also need distilled white vinegar and gauze for vinegar soaks. If you are wearing a mask during your healing stage, also buy nonadherent wound pads like telfa to protect your skin from the mask. Also buy a 1 Liter bottle of water for your vinegar soaks.

You need to arrive at our office 1 hour prior to the treatment in order for a topical anesthetic cream to be applied. You will be offered Pro-Nox during your appointment for increased comfort, and local numbing injections may also be done prior to your treatment. If you would like an anxiety medication prescribed to you (which will require you having a driver), please let us know a few days beforehand and you will take it when you arrive to the office.

Immediately after your laser treatment:

  • Intense burning, redness, warmth, and a sunburned sensation are normal responses following erbium laser resurfacing. This initial sunburn sensation generally lasts 2-8 hours after the procedure. Cool compresses with a damp, soft cloth or soft gel ice pack for 10-15 minutes at a time every 1-2 hours may help relieve the temporary discomfort. Tylenol can be taken as directed for pain. Use a towel or old t-shirt to cover your pillow on the first night. Sleeping with your head elevated can decrease swelling.
  • Perform vinegar soaks every 3-4 hours for the first 3 days. Put 1 teaspoon of distilled whitevinegar in the 1 Liter bottle of water you purchased. Keep this in the refrigerator between soaks.Apply a clean soaked gauze soaked in the vinegar solution to the treated area for 10-15 minutes,then pay dry and apply a thin layer of mupirocin ointment. KEEP IT MOIST!

First week of healing:

  • After the first 3 days, you may use a gentle cleanser followed by Aquaphor or Cerave Healing Ointment to be applied constantly during the wound healing phase. It is important for the treated area to remain soft and pliable during healing. The skin should not be allowed to dry out. KEEP IT MOIST!
  • When the skin has healed (7-10 days), you may use a gentle cleanser followed by Cerave cream and sunscreen.
  • The day after the procedure, your skin may feel tight, swollen, or itchy. Oozing can occur in isolated areas for a few days. Swelling can be significant and cause some discomfort. Some patients will wake up with facial swelling, particularly around the eyes for several days following the treatment. This is normal and usually resolves within 3-5 days.
  • Quick cool to warm showers are recommended for the first 3 days.
  • Aerobic exercise, saunas, and hot tubs should be avoided for 7 days.
  • Avoid use of topical skin care products containing retin-A, retinol, glycolic acid, or salicylic acid for 1 week.
  • Makeup can be used 2 weeks after the procedure.
  • DO NOT be alarmed if tiny grid patterns remain throughout the treated area (if you had profractional laser treatment). This should fade within 2-3 weeks. Skin should start sloughing off 5-7 days after the treatment. Most patients complete this process 7-10 days after treatment on the face, but if treated on the body it can take longer. Once sloughing is complete, you may notice some pink/redness for several weeks (up to 8 weeks). Makeup may be applied to minimize redness.
  • Some patients may also experience itching or temporary acne breakouts.
  • PROLONGED SUN EXPOSURE IS TO BE AVOIDED FOR 4 WEEKS BEFORE AND AFTER TREATMENT. A broad-spectrum SPF 30+ sunscreen containing zinc oxide or titanium dioxide such as EltaMD UV Elements or UV Restore should be applied daily. Wear hats and sunglasses. Diligent sun protection may lower the risk of laser-induced hyperpigmentation.
  • The Erbium laser stimulates collagen remodeling in the skin that occurs over a 6 month time period, so although you may notice improvement in the treated area in the first few weeks, the end results won’t be appreciated until 6 months after your treatment.

Halo Laser Post-Care Instructions

The Halo fractional treatment creates outcomes based on the aggressiveness of the treatment taking into account your skin concerns, the health of your skin and your individual healing ability. Due to this, patient response can vary after a Halo fractional treatment. Erythema (redness) and possibly edema (swelling) are the desired responses within a few minutes after the completion of the procedure. The degree of redness and length of healing time will increase with the depth and coverage of the procedure.

Post-Treatment

  • Redness is normal and expected. Redness generally increases in intensity the first few days after treatment with day 3 being most intense. Redness can persist for up to 7 days depending on the aggressiveness of the treatment.
  • Pinpoint bleeding may occur. This can last for a few hours – 12 hours depending on the treatment depth and may be isolated to certain treated areas.
  • Immediately after treatment, swelling is common and expected. Use of a cold compress or icepacks will help to relieve the swelling. To avoid further swelling, you may choose to sleep in an upright position the first night after the treatment. The first morning post treatment is when swelling is more prevalent, especially under the eyes. Swelling may last 2-4 days depending on the aggressiveness of the treatment.
  • The treated area may be extremely warm for 12-24 hours after the treatment. Cold compresses or ice packs may provide comfort during this time.
  • On the 2nd or 3rd day after treatment, you will increasingly notice tiny dark spots and bronzed appearance to the treated skin. These are called MENDS (microscopic epidermal necrotic debris). In individuals with heavily pigmented skin, or in areas where sun damage has produced pigmented lesions, the microscopic wounds, known as MENDS, contain large amounts of melanin. Because there are so many MENDS, they can make the skin look bronzed and small areas appear crusted (do not try to scratch them off). This is part of the healing process where treated tissue is working its way out of your body as new fresh skin is regenerated. During this time, your skin will be very dry and have a sandpaper texture and will begin to flake and peel. If the face is treated, it could take 5-7 days for the peeling process to be completed. If the neck, chest or anywhere on the body was treated, this process could take up to 2 weeks.
  • After the peeling process is complete, your skin will have a rosy, pink glow that will gradually resolve.
  • If an antiviral was prescribed for you, continue to take it as directed. If you have a history of coldsores and haven’t been prescribed an antiviral, please let us know.
  • Post treatment discomfort may be relieved by over the counter oral pain relievers; i.e. ExtraStrength Tylenol or prescribed pain medication if ordered by the doctor.
  • Itching may be experienced during the healing phase and is completely normal. Oral Benadrylmay help itching but can cause drowsiness. DO NOT scratch the treated area as scarring and pigmentation complications can occur.

Post-Treatment Care Instructions

  • Immediately after treatment, your clinician will apply Alastin Nectar to the treated area. If you wish to minimize your downtime and optimize your results from the laser treatment, it is recommended to apply this product twice daily.
  • Cleanse the skin two times a day with plain, lukewarm water and a gentle cleanser beginning the morning after the treatment. Use your hands to gently apply the cleanser and water and finish by patting dry with a soft cloth. DO NOT rub, scrub, use an exfoliant or a skin care brush e.g. Clarisonicin the treated area. Doing so could result in scarring and pigmentation complications.
  • Moisturizer should be applied generously over the treated area and reapplied whenever your skin feels dry. For severe dryness, add Aquaphor or Cerave Healing Ointment on top of your moisturizer.
  • Peeling and flaking generally occur within 24 hours post treatment and should be allowed to comeoff naturally. DO NOT PICK, RUB, OR FORCE OFF ANY SKIN DURING THE HEALING PROCESS, THISCOULD RESULT IN SCARRING, PIGMENTATION COMPLICATIONS AND INFECTION! Gently washingthe skin more frequently will help to promote the peeling process.
  • Sunscreen is a MUST and should be used daily beginning the day of treatment and used vigilantly for up to 3 months post procedure. Use recommended sunscreen with broadband protection (UVA and UVB) and a sun protection factor (SPF) of 30. Apply sunscreen 20 minutes before sun exposure. Reapply sunscreen every 2 hours. If direct sun exposure is necessary, wear a hat and clothing that covers the treated area. If treated area is exposed to sun (direct or indirect) blistering, scarring, hyperpigmentation or hypopigmentation can/will occur. Sun exposure should be avoided for 2months post treatment.oTypically, after the peeling process is complete, make up can be worn.
  • When showering in the next few days, be sure to avoid getting shampoo directly on the treated area. You may consider taking your shower with the back of your head to the water to avoiddirectly hitting your face with the full force stream of the water.
  • Avoid strenuous exercise and sweating until after skin has healed.

WARNING

There may be some degree of swelling after treatment; however, if you have excessive swelling or any of the following signs of infection, you should contact the office immediately at 214-675-3227 during business hours.

  • Drainage – looks like pus
  • Increased warmth at or around the treated area
  • Fever of 101.5 or greater
  • Extreme itching or tenderness

Hyaluronic Acid Filler/Sculptra/Radiesse

Before your appointment:

  • Do not schedule an injectable filler treatment if you have had dentalprocedures or a vaccination in the last 2 weeks.
  • Make sure you schedule your appointment at least 2 weeks in advance of aspecial event as you may bruise with the treatment.
  • Let us know if you have a history of cold sores if you are going to haveinjections around your mouth.
  • Discontinue blood thinners such as aspirin, ibuprofen, St. Johns Wort, fish oil,Vitamin E, Ginger, Ginkgo Biloba or ginseng for 7 days unless you have beenprescribed these by a physician.
  • Take Arnica Montana and/or Bromelain (found naturally in pineapple or as asupplement) 1 day before and for 7 days after your injections to minimizebruising and swelling.

After your appointment:

  • Avoid significant movement or massage of the treated area unless you have received Sculptra Aesthetic. After Sculptra, please massage the area treated for 5 minutes 5 times a day for 5 days.
  • Avoid alcohol, strenuous activities or excessive heat exposure for 24 hours.
  • Avoid any dental procedures or vaccinations for 2 weeks before and after your treatment.
  • You may apply a cool compress for 10 minutes every hour to reduce bruising and swelling.
  • Use Tylenol for discomfort.
  • Try to sleep face up and slightly elevated if you experience swelling.
  • You can take Arnica and drink pineapple juice to help with bruising and swelling.
  • With lip injections, some patients have swelling for up to a week and the lips can look uneven during this time. Keep your follow up appointment so we can assess symmetry.
  • With midface or tear trough injections, do not wear goggles, tight sunglasses or do anything that might put pressure on the area injected for the first 2 weeks.
  • Contact our office if you have any excessive pain, bruising, blisters or skin discoloration.

After your appointment:

  • Expect to be red, swollen and tender with potential bruising after the treatment for up to 1 week. Remember that the full effect of the treatment won’t be evident for a full 8-12 weeks and most patients require more than one treatment.
  • Ice the treated area for 10 minute intervals every hour for the first few hours.
  • Avoid blood thinners like aspirin, fish oil, NSAIDs, Vitamin E for 24 hours. You may take Tylenol for discomfort.
  • Avoid alcohol, smoking or nicotine for 24 hours.
  • Contact our office if you have any excessive pain, tenderness, swelling or concerns.

Before your hair removal:

Avoid direct sun exposure for four to one month prior to treatment. Do not apply self-tanners or spray tans for one month prior to treatment. Do not wax, tweeze, or use depilatory creams on the treatment area for one month prior to treatment. Do not use a retinoid on the skin for one week prior to your treatment. If you have a history of fever blisters, please let us know so that we may write you a prescription for prophylactic antiviral therapy to start on the day of treatment to prevent a flare-up. You must notify the technician if you have had any cosmetic tattooing on or near the area to be treated. Photosensitizing medications including doxycycline should be discontinued three days prior to treatment. Please shave the area to be treated on the day prior to your appointment.

After your hair removal:

  • BBL/Laser-treated hairs will still be visible after your treatment. However, they are now injured or destroyed at the level of the hair follicle (“root”) and will soon fall out (usually, within the next 2-5 days up to 2 weeks).
  • The treated area may redden and/or swell somewhat. A mild sunburn sensation may be noticed for up to several hours after treatment. This is caused by the BBL/laser energy, and represents inflammation, and not infection. It is normal and an expected part of the healing process.
  • While the BBL/laser usually leaves the overlying skin intact, avoid manipulating the treated area for the first week after treatment. No dressing is usually needed. However, if the treated area blisters, scales or scabs up, keep the healing area moist with Aquaphor or Cerave Healing Ointment twice daily.
  • You may see purpura (bruising or red-purple color) in some treated areas, which will last 7-10 days on average.
  • Please use a moisturizer and sunscreen over the treated area daily. Makeup is permitted, but be very gentle when applying or removing it, as rough removal of makeup can increase the incidence of post treatment complications. Do not rub, scratch, or pick the area(s).
  • No shaving of the treated area for 3 days post treatment. No waxing or plucking during the treatment course. Avoid tight elastic at the leg for several days after treatment of the bikini area to prevent rash or blistering from rubbing/irritation.
  • You may get the treated area wet, but be very gentle when drying it. Pat dry afterbathing/showering. Swimming is generally permitted after 2-3 days (if no crusts) or once all crusts have fallen off (usually, 5-10 days – if any crusts are present).
  • You may help relieve any swelling by applying an ice pack wrapped in a soft cloth.
  • Leave this on the treated area for 10-15 minutes per each hour for several or more hours.

PRECAUTIONS

If the treated area becomes increasingly tender, red, swollen and/or purulent,
contact our office immediately as this may represent an infection that may require treatment.

Cryosurgery (Liquid Nitrogen treatment)

  • You may treat the area like normal skin. Covering with a bandaid is fine. Tylenol or Ibuprofen can help with discomfort. You may continue your normal activities.
  • A blister may form within 1-2 days. Sometimes these can fill with blood. The blister will gradually dry up and separate from the healing skin below in 1-2 weeks. Sometimes the crusts will last as long as 1 month when deeper spots are treated. Rarely a permanent white mark or scar will be left after healing.
  • If the blister is uncomfortable, clean a small needle with rubbing alcohol and drain the blister. Do not remove the roof of the blister as this aids in healing.
  • Once the blister roof falls off or a scab/sore forms, clean the area with soap and water or hydrogen peroxide. Remember that crusts can lead to scar, so keep the area MOIST with vaseline or Aquaphor under a bandaid.
  • Some redness, itching and oozing is part of the normal healing process. Signs of infection include increasing redness, pain, swelling, heat, and yellow discharge.
    Please call the office if you are concerned about infection OR if the lesion is still present after 1 month.

Molluscum Contagiosum

Molluscum contagiosum are wart-like viral infection of the skin. They most commonly occur in young children, especially those with a tendency towards eczema or dry, sensitive skin. While they will eventually resolve with time, this can take weeks, months or sometimes even years. While generally leaving no mark after they clear, Molluscum can leave pox like scars. They can also be spread to other parts of the body, especially by scratching, or to other children if sharing a bath or while swimming. This virus grows best on a disrupted skin barrier, so there are certain cleansers and moisturizers that can help reduce the viral load. CLn BodyWash is recommended for cleansing Molluscum-infected skin and smothering the skin with a rich moisturizer like Cerave or Cetaphil cream twice daily is also recommended.

  • Dr Pruett has applied cantharadin, or “blister beetle juice” to your Molluscum. This medicine is generally non-irritating and does not cause scarring.
  • You will need to wash the medicine off in 1 hour.
  • Over the next 4-12 hours, you may experience mild discomfort and stinging. You may take Tylenol or Ibroprofen for this.
  • In the next 4-24 hours, a blister will occur around the Molluscum. This will peel off after 4 days and kills the virus. Sometimes only a crust may form without a blister. If the blisters are uncomfortable, clean a needle with rubbing alcohol, gently drain the blister and leave the roof in place. After the blister breaks, clean with soap and water daily. You may want to cover the area with a bandage.
  • In 4-7 days the area will be healed. There may be some residual redness that will clear over time. Often a dark spot will be left over the area treated. This is a normal reaction to healing and not a scar. It will resolve over 1-2 months.
  • Retreatment is often required every month until all Molluscum are cleared. Most lesions treated will clear with one treatment, although some require more than one treatment. What we cannot treat is Molluscum that is in the skin but hasn’t erupted yet. It often can take multiple monthly visits to slowly eliminate all of the virus.

Pre-Treatment Instructions:

  • Topical retinoid therapy should be discontinued a few days prior to treatment.
  • Avoid any prolonged exposure to the sun, if you must be in the sun use a zinc oxidesunscreen of at least SPF 30.
  • Avoid taking anticoagulants (aspirin, mobic, ibuprofen, naproxen) for one week prior unless prescribed by your doctor.
  • Arrive to your appointment with clean skin. You will be given the opportunity to remove your make-up in the event this was not possible.
  • Once you arrive in the office, we will apply numbing cream to your skin and allow that to sit for one hour while you wait in our numbing room. We will then bring you into your treatment room, clean your skin, allow you to start using Pro-Nox for maximum comfort, and Dr. Pruett will inject more numbing medication on your already topically-numbed skin.

After your Treatment:

  • Immediately after your treatment most patients will experience a clinical endpoint of erythema (redness) for 1-3 days, however for more aggressive treatments this may last longer. Slight to moderate edema (swelling) and mild to moderate sunburn sensation are also common post treatment and may last 1-3 days. Skin may crust and peel for 2-7 days depending on the treatment setting.
  • Skin may feel warm and tighter than usual
  • Skin may crust and peel for 3-7 days after treatment
  • Redness and swelling may last for 3-4 days

Post-Treatment Instructions:

  • Before discharge a topical ointment may be applied to the face. We will discuss what products to use post-treatment during your appointment.
  • Makeup may not be worn for 24 hours after the procedure. If there are no areas with active oozing and warm redness, makeup may be applied after this time. 
  • You may resume the use of your usual skin care products (usually 2-3 days). Retinoids may be used 5-7 days after treatment.
  • There are no restrictions on bathing except to treat the skin gently, avoid scrubbing or trauma to the treated areas, as if you had a sunburn.
  • Avoid sun exposure to reduce the chance of hyperpigmentation (darker pigmentation).
  • Please use a zinc oxide sunblock spf 30 at all times after your treatment.
  • Multiple treatments over a period of several months may be required to achieve the desired response. You will notice immediate as well as longer term improvements in your skin. The time for skin cell turnover is 28 days so most people will begin to see increased results after this time.

Instructions for Patch Testing

Patch testing is done by taping “allergens” under “patches” to your back and leaving them on for 48 hours. The patches are then removed, and under the areas examined for signs of a reaction. The back is then checked again two days later. We use an extensive patch test series called the North American Contact Dermatitis Group of allergens, which includes 80 of the most common ingredients that cause contact dermatitis.

Before your Appointment:

  • Two weeks before Day 1, stop all immunosuppressive oral medications (such asprednisone or corticosteroid pills) unless we have instructed you not to.
  • One week before Day 1, stop all of your medicated creams or ointments that you may be using on your back. Stop any sun exposure to your back.
  • Three days before Day 1, stop using all moisturizers, lotions, or creams on your back.

Day 1 (Monday): A series of allergen patches will be taped to your back. After the patches are applied, please avoid any sweating, exercise or strenuous activity until the patches are removed on Day 3. You can take a sponge bath only, but do not get your back wet. Showering, bathing or swimming is NOT allowed. Too much sweat or water will lift up the patches and make them lose contact with the skin, which will make the test useless.

Day 3 (Wednesday): You will return to have the patches removed and any reactions will be noted.

Days 3-5: Do not rub your back with a towel and avoid scratching the area. Do not wash off the markings on your back, as that will make the test useless.

Day 5 (Friday): You will return for a final reading. Once we have determined all of your allergens, we will enter your results into a database that will give us a SAFE list of products that you can use. This list will be emailed to you. We’d like to see how your rash is doing in about 1 month.

Pre-Treatment Instructions:

  • Avoid alcohol and ibuprofen for 48 hours before the treatment.
  • Avoid Aspirin, Ginko, Fish Oil, and products containing Aspirin for two weeks before your treatment. If these products were prescribed by your physician, stop using them only if your prescribing physician approves, then resume them 48 hours after your procedure.
  • Try to avoid shaving and moisturizers the day before, the day of, and the day after your procedure.
  • Bring a comfortable pair of shorts to wear during your treatment. Wear a loose skirt or pants to the office.
  • Bring support hose to wear after your procedure. We recommend medical grade hose that can be purchased at medical supply stores. Thigh high styles can be more comfortable than pantyhose.
  • Graduated compression is superior to department store brands like Hanes Alive.

Post-Treatment Instructions:

  • A pressure wrap and gauze are applied immediately after treatment. Your support hose will be worn over top. This wrap will be snug and should remain in place 24-48 hours.
  • Continue to go about your daily activities after your procedure. Avoid prolonged standing and sitting during the first 48 hours after your procedure.
  • After you remove the wrap, put on your support hose. You should wear the support hose for 3 days as directed by your doctor if red vessels were treated and for 7 days if larger blue vessels were treated. Do not remove the hose for 24 hours. For best results, leave the support hose on at night and even when you shower.
  • We do encourage mild exercise such as a 30 minute walk around your neighborhood the day of your sclerotherapy.
  • Leg rest and elevation are unnecessary, and in fact, may promote clot formation.
  • You may resume high impact exercise after 4-5 days as long as you wear your support hose as directed.

Follow the instructions in the post-care kit you have been given.

Post-treatment instructions:

  • Avoid sweating for 72 hours after the treatment.
  • Avoid direct sun exposure while your skin is healing. Use a broad brimmed hat or scarf to protect the facial skin. You may apply mineral sunscreen the day after your procedure.
  • Mineral makeup can be applied the day after your treatment.
  • Your skin will be red (like a sunburn) and may have pinpoint red spots(“petichiae”) due to where the microneedles punctured your skin. It is also possible, but not common, to have some bruising, especially around your lower eyelids. You may also be swollen.
  • For the first 3-5 days, your skin may feel hot and tight and be very dry. Flaking will become prevalent in a few days, and most people have very few signs of the procedure 1 week out.
  • You may resume your regular skin care routine after 48 hours.
  • SkinPen’s collagen induction therapy is a process–anywhere from 3-6 treatments spaced every month will produce the best results. Adding PRP to the treatment will not only enhance your results but it will decrease your downtime.

Post-Operative Care

  • The importance of post-op care to your surgical site cannot be stressed enough. The care you take of yourself and your wound is extremely important to the success of your procedure.
  • To reduce bleeding: Limit your activities for at least 24 hours and if possible until the sutures are removed. Keep the site elevated, and if the site is on your head or neck, avoid stooping or bending, straining to have a bowel movement and sleep with your head and shoulders elevated on extra pillows. Please avoid any activities that put stress on the wound.
  • SHOULD BLEEDING OCCUR, apply firm constant pressure on the bandage for 20 minutes. If it doesn’t stop, repeat. If the site is still bleeding, call us or go to the ER.
  • To reduce swelling, apply ice for 20 minutes each hour while you are awake.
  • Pain is generally slight and controlled with Extra Strength Tylenol.
  • Infection seldom occurs when the wound care instructions are carefully followed. Signs of infection include pain, swelling, redness or yellow drainage several days after surgery. If you think your wound is infected, please call the office.
  • There will be a scar and redness after surgery. This will decrease as healing progresses but redness should be expected for as long as 6 months.
  • If you are concerned with scarring, laser and light treatments can be performed to minimize the scarring and we can start these the day of your suture removal. Insurance will not cover the cost of scar treatments.

Wound care twice daily:

  • Wash hands with soap and water.
  • Apply hydrogen peroxide on a wet wash cloth or gauze and apply to suture line to remove crusts from the wound.
  • Dry the wound thoroughly with a clean soft cloth by blotting.o=
  • Apply a thin layer of ointment (vaseline, Aquaphor) to the scar with a q-tip. Avoid Neosporin as this is a common cause of dermatitis. Keep the area MOIST.
  • Cover with a clean, dry dressing.
  • If you have not received your pathology report by the time of your suture removal please let us know.