Post Treatment Progression

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1 Post Treatment Progression Please see Pearl Fractional Post Care Instructions for detailed instructions on how to properly care for treated area Below is a list of what you may or may not experience after your Pearl Fractional treatment Please note that not all patients see every reaction listed below If you are concerned about any phase of the healing process please contact your provider at First Hours Skin will feel sunburn hot for up to one hour post treatment Pinpoint oozing is likely to occur within minutes of treatment o Most intense for first hours post treatment o Should resolve within hours Possible swelling varies by treatment or patient Edema swelling peaks at days post treatment o Sleeping with head elevated may reduce swelling Edema swelling will begin to subside o Can persist longer for patients with prior facial surgery Face begins to peel o Some patients report itchiness during this period

2 o Frequent vinegar soaks beginning at day one help to relieve itching and soothe skin Mild erythema redness may persist for a few weeks varies by patient Peeling should subside by days Okay to wear makeup When to call your provider Reoccurring Erythema Redness o If redness decreases and then increases Persistent Edema Swelling o Longer than hours or not reducing Fever Intense itching o It is normal to feel itching after skin peels Please contact provider if skin continues to feel tight and very itchy Rash or pustules pimples Cold sores herpes break out anywhere on the face Laser Post Treatment Instructions Ways to Speed Healing: Apply a thin layer of Aquaphor Healing Ointment or plain Vaseline to treated area. o Always thoroughly wash hands before touching treated area. o Re-apply frequently as needed to maintain a continuous layer on your skin. Soak the treated skin with a plain white vinegar solution at least 4 to 8 times each day. o You can t soak too much. Soaking reduces redness and speeds healing! Do not pick, rub, scrub or irritate your skin while it is healing. How to Soak: Dip a clean, soft, cloth into vinegar solution and place the wet cloth against your skin, gently pressing to ensure the vinegar solution wets the skin. Rinse and repeat for 10 to 15 minutes. Most of the ointment should come off during the soak (do NOT rub).

3 o Solution: 1 teaspoon of plain white vinegar to 2 cups of water. Solution may be mixed up ahead of time and kept in the refrigerator. o Apply a thin layer of ointment to the treated area immediately after soaking. If the skin gets dry or scabs appear, you need to soak more often and apply more ointment. + Soak 2 Cups of Water 1 Teaspoon of White Vinegar DO NOT: Do not put ANY other creams, ointments or products of any kind on the treated area until your care provider indicates it is ok to do so. Do not let your skin come in contact with detergents, fabric softeners or dryer sheets. Fabrics that have been treated with these products may irritate your skin. Do not pick, rub, scrub or irritate your skin in any way while it is healing. Do not expose the treated area to the sun (even on cloudy days). Remember, UVA passes through house and car windows. UVA exposure can cause skin to darken.

4 What to Expect: Oozing may occur for the first 24 hours. You may notice small red/brown spots on your skin which may turn darker, but will disappear as the skin begins to heal. o You may wish to protect your pillow the first night following treatment with an old, clean pillow case. Swelling may occur and usually resolves in 2-4 days. o Sleeping on 2 pillows with your head elevated is helpful. Redness is a normal and expected reaction and will resolve with time. It is normal for skin to feel sunburned and/or tight. General Instructions: Avoid touching the treated area unless necessary (vinegar soaks). Do not pick the treated area but allow skin to heal on its own. You may shower, but keep soaps and hair products from coming in contact with the treated area. o Do a vinegar soak after the shower, followed by ointment. If you experience itching, an over the counter antihistamine such as Benadryl (diphenhydramine) may be helpful. Ibuprofen or acetaminophen may be used if needed. After stopping the ointment, use ONLY a clinician recommended moisturizer (can be purchased at a pharmacy) for at least one week. Examples are: o Vanicream o Cetaphil Moisturizing Cream (this is more gentle than Cetaphil lotion) Make-up may be worn after the majority of treated skin has healed, usually within 4 to 7 days. It is very important to use sunscreen with a SPF of 20 or greater when your clinician says your skin is ready. o This helps prevent post inflammatory hyperpigmentation (darker areas). Please call the office (If after normal business hours please call Amy Powers cellphone ) if you experience intense pain, drainage, severe redness or fever, increased itching, the appearance of a cold sore, blister or a tingling sensation, or if at any time you feel that you are not healing normally.

5 Pearl Post Treatment Instructions (Vinegar Soak Info) Day One Treatment Day Wait 3-4 hours post treatment to do first vinegar and water soak followed by ointment. This will remove most of the dried blood and serous drainage. Continue to do vinegar and water soak followed by Skinmedica Restorative Ointment at least every 3-4 hours. Day Two Vinegar and water soaks followed by Restorative Ointment at least every 3-4 hours. When oozing has completely stopped you may use the Skinmedica Sensitive Skin Cleanser prior to vinegar and water washes. Continue to use Skinmedica Restorative Ointment to keep skin moist and protected. Day Three Use Skinmedica Sensitive Skin Cleanser. Vinegar, water and Skinmedica Restorative Ointment 4-8 times or at least every 3-4 hours. Day Four Continue regimen. Return to Rejuvenations Medical Spa for follow up appointment. When okayed by practitioner and when skin has re-epithelialized you may begin Skinmedica s TNS Ceramide Lotion in place of Restorative Ointment. You may also wear makeup at this point. You may continue vinegar, water and Restorative Ointment as desired. VERY IMPORTANT! BE SURE TO USE SUNSCREEN DAILY ONCE SKIN HAS HEALED AND YOUR SKIN IS EXPOSED TO SUNLIGHT.

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