Skin Care Before and After Fractionated Carbon Dioxide Laser Treatment

 This information will help you care for your skin before and after your fractionated carbon dioxide (CO₂) laser treatment.

Some people need many treatments to get the best results. Ask your healthcare provider how many treatments you will need. 

Skin care before CO2 laser treatment 

It’s important that you avoid tanning or heavy sun exposure. Use a broad-spectrum sunscreen (mineral titanium dioxide or zinc oxide) every day for 4 weeks before your treatment. SPF30 or above.

Do not use medications that cause sun sensitivity (such as doxycycline or minocycline) for at least 3 days before treatment. Tell your care team if you are currently taking any antibiotics.

If you have a history of herpes (such as oral cold sores or genital) or shingles in your treatment area, let your healthcare provider know.  Your healthcare provider may want you to start an antiviral medication (such as valacyclovir or acyclovir) as directed. This is usually 2 days before treatment and continues after your laser treatment for the days prescribed.

Tell your care team if you have micro bladed eyebrows or a lip liner tattoo.

It’s also important to eat and drink before your procedure to prevent dehydration.

Skin care after CO2 laser treatment

After CO₂ laser treatment, it usually takes about 1 to 2 weeks for your skin to heal. Your skin will be very sensitive during this time. Follow the guidelines below to help your skin heal and prevent infection.

Once your CO₂ laser treatment is done, your nurse will give you an ice pack to cover the treated area. Hold the ice pack on the treated area for 15 minutes. This will help reduce swelling and make you more comfortable.

Before you leave, your nurse will cover the treated area with petroleum jelly (Vaseline^®) or an antibacterial cream such as mupirocin (Bactroban^®). Your treated area will also be covered with a bandage. You will change this dressing multiple times a day according to the directions we give you. 

At home

You can shower right away after your treatment. Do not take a bath until the treated area has healed.

For the first 2 to 3 days after your treatment:

• Apply an ice pack wrapped in a soft cloth to the treated area. Hold the ice pack on the treated area for 15 to 20 minutes. Put the ice pack on the treated area every few hours, or 1 to 5 times each day. After the first 2 to 3 days, use the ice pack as needed

For __________ days after your treatment:

• Gently wash the treated area by switching between washing with diluted white vinegar
• and water and liquid soap and water. For example, you can wash with vinegar and water in the morning, and soap and water at night.  
• Make a vinegar solution by mixing 1 (8 ounce) cup of water and 1 tablespoon of white vinegar. Store covered in the refrigerator for up to 5 days. 
• Do not use groundwater (well water) or tap water to clean your treated site directly. You’ll need to buy distilled water to clean your site if you live in a place that only has well water. If you’re taking a shower with well or groundwater, keep your site covered.
• Do not apply any ointment to your skin including over the counter or natural products.  These products may stop the healing process. Only apply what your provider tells you to.
• Keep the treated area covered with a bandage (Band-Aid®). Change the bandage 2 times each day, after washing the area.

For 1 to 2 weeks after your treatment:

• Do not use saunas, swimming pools, baths, or hot tubs (such as a Jacuzzi®).
• Do not shave over the treated area.

General tips

• Do not wear makeup on the treated area until it’s completely healed.
• Avoid exposing the treated area to the sun until it’s completely healed. If you need to be in the sun, use a mineral sunscreen of at least SPF 30 or wear clothing or a hat that protects the treated area from the sun.
• If you have a history of facial herpes (cold sores), you should take an antiviral medication before and during your treatment. Talk with your healthcare provider that treats this condition about prescribing medication for you. Tell your healthcare team if you develop any new blisters or sores before, during, and after your treatment.

It usually takes many weeks for people to notice that the treated area is healing. During this time, the area may turn a red or blackish color, and a crust may form. The crust should slowly go away 1 to 2 weeks after treatment. Don’t pick at or remove the crust. It will fall off on its own.

Medications after CO2 laser treatment

If you have pain or discomfort, taking acetaminophen (Tylenol^®) or NSAIDs (such as Motrin^® or Advil^®) may help. Ask your healthcare provider how much acetaminophen or NSAIDs you should take.

Don’t take acetaminophen if you have liver problems. Don’t take NSAIDs if you have kidney problems. If you’re having pain but have a history of liver problems or kidney problems, call your healthcare provider’s office.

Call your healthcare provider if you have:

• A fever of 101° F (38.3° C) or higher
• Chills (shaking)
• Green or yellowish drainage from the treated area
• Increased pain or discomfort
• Increased redness or swelling around the treated area
• Bleeding that doesn’t stop when after applying pressure
• Pain or discomfort that isn’t helped by pain medication 

If you have any questions, call the MSK Basking Ridge dermatology office at 908-542-3395.