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Survival Guide: Fractional CO2 Resurfacing (Active FX)

by Hadley, Skin Care Specialist at Zimmet Vein & Dermatology

I recently took the plunge into Fractional CO2 laser resurfacing (Active FX) and survived! As an aesthetician, I’ve experienced a variety of skin treatments but this was by far the most challenging and rewarding. Active FX requires dedicated post-procedure care and maintenance by the patient at home. This process is imperative for proper healing. This guide is based on my personal ActiveFX experience and intended to help patients prepare for and manage the healing phase of Active, Deep or TotalFX.

Active FX Fractional CO2 Laser Resurfacing Video – Part I

Medications

As soon as possible pick up the two prescription medications, Valtrex and Vicodin, we called into your pharmacy. Valtrex is an anti-viral medication and is used to prevent viral outbreaks on your skin.  Take as prescribed, starting the day before treatment and continue taking until all the medication is finished. Vicodin is a painkiller. Bring the Vicodin with you the day of the procedure.

Schedule a driver

The medications we administer can cause drowsiness. Please arrange transportation home from our office.

Supply List

We supply 4 travel size cleansers, Aquaphor, Epidermal Repair, and Physical UV Defense. The following additional supplies can help during the recovery phase. Make sure to gather lots of towels (all sizes), old sheets and pillowcases, paper towels, tissues, box of disposable gloves, hair ties, headbands, bobby pins, dry shampoo (can be purchased at The Beauty Store or People’s pharmacy), large hat and sunglasses.  Remember to stock up on groceries.

If treated, do not cover the neck or chest with clothing. Sleeveless tops, low cut tank tops with thin straps, or camisoles are the most comfortable and easiest to take on and off.

Larger pump bottles of Cerave or Cetaphil cleansers and moisturizers are available at most drug and grocery stores and are good products to use in the weeks following the procedure.

Procedure Day

On the day of the procedure please arrive with no make-up. If you wish to shower please do so before the procedure. After the procedure we ask you to wait 24 hours to shower.  We give you a disposable headband upon arrival but if you have long hair or bangs you may want to pull your hair back from your face. Remove contact lenses and wear glasses if necessary. After the consent form and photos, a strong topical numbing cream is applied to the treatment area. It is normal to feel numb lips and numb inside your mouth.

Next, we administer Xanax, a medication to promote relaxation, and instruct you to take your Vicodin. You can sit or lie down and relax during this time. After about 30 minutes, Dr. Zimmet performs nerve block injections to the face above your eyebrows, mid-face and around your mouth. The injections may sting a bit but are over quickly. Acetone wipes are used to remove the numbing cream and get your skin clean. If the eyelids are treated, Dr. Zimmet places numbing drops in the eyes and inserts eye shields. These shields may feel awkward going in the eye but do not hurt.

During the procedure, very cold air is blown onto your skin. Dr. Zimmet covers every inch of the treatment area with the laser and checks in with you periodically. The laser sounds like a bee buzzing around your head. Most patients report minimal discomfort during the procedure. DeepFX, which may be used in localized areas, goes deeper into the skin so you may feel more discomfort during this treatment.

When the treatment is finished Aquaphor is applied and you can be driven home to rest. It is common to experience a heat or sunburn sensation in the treated areas. This heat will dissipate over the next few hours. Cold compresses, such as ice packs, may help soothe the heat and can be gently applied to the skin.

The Healing Process

Healing times vary depending on the individual but generally you can expect the following: Face 5-6 days, Neck 7-10 days, Chest 10-14 days

Oozing is common and generally looks like yellowish drips on the skin. Blot these areas gently with a soft tissue and reapply the Aquaphor as needed. Swelling of the face and/or eyes is common, and typically begins to reduce by the third day after treatment. Sleeping with your head elevated can help decrease swelling.   Almost everyone experiences itching, which can range from mild to intense. Benadryl, an oral antihistamine, can be helpful. Do not drive as this medication may cause drowsiness. Gently pressing a clean Q-tip onto the skin also helps to relieve itchiness.  Itching usually lasts a few days.

Proper cleansing and reapplication of the Aquaphor on the treatment area is imperative. Cleanse the skin about 4 times a day (morning, afternoon, evening, bedtime). The process of cleansing may be slightly uncomfortable for the first two days after the procedure.  The skin may feel tender to the touch, so be gentle and careful. Gloves help to keep cleansing less sticky and messy. Pour a quarter size amount onto your fingertips. Gently apply the cleanser to your face a using small circles. Splash the face with tepid water and pat dry with a paper towel or soft washcloth. Reapply the Aquaphor.

As the skin heals it is common to see dots all over the skin. Around the fourth day you may notice skin starting to peel off usually starting at the middle. Do not pull, peel, or scrap the skin off. Just let the skin come off in the cleansing process.

Aquaphor is sticky and messy. Use old pillowcases or cover pillows with towels. Dish liquids are designed to cut grease and can help to clean your hands. Dry shampoo is the best option for getting the Aquaphor off of the hairline. Cover your face, spray the shampoo onto the hair, and massage into the scalp.

Follow-up

A follow-up appointment will be scheduled generally 3-4 days post-procedure. Make sure to wear a large hat and sunglasses on your way to the office. Dr. Zimmet will check your skin and give you an estimation of when you can transition from Aquaphor (very greasy) to Epidermal Repair (not greasy) and UV Physical Defense 30.  The skincare routine after this transition is Cerave or Cetaphil cleanser, Epidermal Repair, fragrance free moisturizer, and UV Physical Defense.  Do not use exfoliating products on the skin for 4 weeks.

If you would like to learn more about the procedures and treatments by Austin TX Cosmetic Dermatologist, Dr. Steven Zimmet, please contact us at 512-402-6694.

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