CO2 Instructions

Village Dermatology offers CO2 at our Memorial and Katy locations. 

Pre-Treatment:

  • Moisturize the skin at least 2 times a day (AM/PM). 

  • Increase water intake to 8 glasses (8oz) or more per day.

  • Avoid direct and prolonged exposure to the sun. 

    • If exposure is unavoidable, use a zinc or titanium-oxide (mineral) based sunscreen of SPF 30+ daily, and reapply every 2 hours. 

    • Wear a hat and seek the shade

  • Special products (2-4 weeks prior to treatment)

    • Apply 1-2 pumps of Alastin Skin Regenerating Nectar morning and night to the treatment areas.

  • STOP using topical retinoids or glycolic acid 1 week prior to the procedure.

  • PURCHASE (over-the-counter):

    • Benadryl 25 mg - take 1 tab the night before your procedure. You may continue this for 2-3 nights post procedure as needed for itching. 

  • If you suffer from cold sores, please let us know. We will call in an antiviral medication to the pharmacy: Valtrex 500 mg - take 1 tab two times per day starting 1 day prior to the procedure for a total of 7 days.

  • Use clean and ideally unimportant pillowcases and sheets on your bed as the balm may ruin them. You must keep all pets out of the bed until you are healed.

  • PREPARE TO:

    • Spend about 2 hours for preparation and treatment at Village Dermatology

    • Eat prior to your appointment

    • Wear a button up shirt that can be easily removed

    • Bring a hair tie to keep the hair away from your face

    • Please note that our clinic does not prescribe anti-anxiety medications for CO2 laser treatments. If you feel that you need medication, you must wait to take it until after the consent form has been signed. Additionally, you must have someone to drive you home after taking any medication. If you do not have an accompanying driver, we will be unable to proceed with the procedure.

    ARRIVAL:

    • Please arrive 10 minutes early with clean skin—no lotions, oils, makeup, sunscreens, deodorant, powders, or perfumes

    • We will take pre-treatment photos, have you complete a consent form, and answer any of your questions/concerns

    • The topical numbing ointment must be applied for at least 1 hour on the treatment area(s). 

      • If you arrive late, this does not allow an adequate amount of time for all the above protocols. 

    PROCEDURE:

    • Take Advil or Tylenol 30 minutes prior to starting the procedure

    • Protective eyewear will be used during the treatment

    • A smoke evacuator (which sounds like a vacuum) will be running to remove smoke/debris from the air

    • You will feel a prickly sensation from the laser. 

    • Immediately after the treatment, you may experience some discomfort similar to intense sunburn.  

  • POST-TREATMENT PRODUCTS:

    1. Alastin Regenerating Skin Nectar (purchase when scheduling)

    2. Alastin Soothe and Protect Recovery Balm

    3. Square gauze pads for vinegar soaks 

    4. 16 oz Vinegar solution (provided). 

      1. If you need more: Combine 1 tbsp white distilled vinegar in 16 ounces filtered water, OR 3 tbsp vinegar in 1 quart of water

    5. Alastin Ultra Calm Cleansing Cream

    6. Alastin HA Immerse

    7. Alastin Hydratint Pro Mineral Sunscreen 

    8. Skinceuticals Biocellulose Mask

  • Post-procedure discomfort is typically minimal.  You can take over-the-counter Tylenol (after the first 24 hours if needed). Benadryl can help with any itching or swelling. Continue on any prescribed antiviral medications. 

    Swelling and a mild-moderate sunburn sensation are common after the treatment and may last 1-3 days. Sleep with the treatment area(s) elevated for at least 4 days to reduce potential swelling. You may use cold compresses or ice packs to alleviate this. Swelling may increase the next morning, especially around the eyes and mouth.

    Many patients experience redness for multiple days after CO2. Redness is a sign of new collagen formation, and is expected to last longer with stronger treatments. (Face and Neck: 5-7 days / Chest: 7-10 days / Hands: 10-14+ days)

    No exercise or other strenuous activity for 1-2 weeks. Avoid the sun for 1-2 months. 

    Initial 48 Hours:

    Repeat every 2-3 hours during the day and at least once during the first night. 

    Vinegar soak 

    1. Wash your hands thoroughly

    2. Place 2-3 pieces of gauze or towelettes in a container and pour the vinegar solution (see above) over the gauze to soak it. 

    Tip: The vinegar solution can be cold by making this ahead and keeping in the refrigerator. 

    1. Wring out the wipes and using gentle pressure, apply it to the treated areas. Allow this to soak for at least 5 minutes; longer if crusting is present. 

    2. Remove the wipes gently and pat dry. 

    3. After 5-10 minutes, apply a thin layer of the Alastin Nectar followed by the Recovery Balm. 

    4. Reapply Alastin Recovery Balm as needed to avoid the area becoming dry. 

    5. Use the Skinceuticals Biocellulose Mask to relieve itching and/or stinging. 

    48-72 hours: 

    1. After 48 hours (day 3), switch to washing with the Alastin Ultra Calm Cleansing Cream three times daily

    2. Continue vinegar soaks at least twice a day 

    3. Each time you cleanse the skin, pat dry gently, then apply a thin layer of Alastin Nectar followed by Recovery Balm. 

    4. Reapply Recovery Balm throughout the day to keep the treated areas moist. 

    Days 3-7:

    AM:

    1. Wash with Alastin Cleansing Cream. If you still have crusted areas, perform a vinegar soak. 

    2. Apply Alastin Nectar

    3. Wait ~ 10 minutes, then apply Alastin Hydratint Sunscreen. 

    4. Wait ~ 5 minutes, apply a very thin layer (dime sized or thinner) of Recovery Balm to any areas that are still red/crusted. Reapply throughout the day to keep treated areas moist.

    PM:

    1. Wash with Alastin Gentle Cleanser. If you still have crusted areas, perform a vinegar soak. 

    2. Apply Alastin Nectar, followed by Alastin HA Immerse

    3. Wait ~ 10 minutes, then apply a thin layer of Recovery Balm Avoid to any areas that are still red or crusted.

    After 7 days:

    You may resume a normal skincare regimen, including makeup at this time:

    AM: 

    1. Gentle cleanser

    2. C radical defense serum

    3. Moisturizer

    4. Mineral sunscreen

    5. Makeup (mineral is best)

    PM:

    1. Gentle cleanser

    2. Moisturizer

    Continue Recovery Balm on any areas that are still sensitive and healing.

    After 14 days you can resume retinols, glycolics and other exfoliating treatments.

Results:

Immediate and progressive improvement may include a reduction of fine lines and texture, evening of skin tone, removal of brown or red pigment, and overall brightening of your complexion. 

**Plan to follow-up in 3 and 6 months for progress photos. Thank you**

Reminders:

  • Avoid scrubbing the treated area. Use cool compresses, ice packs, or Benadryl as needed to reduce itching. 

  • We recommend changing your pillowcase regularly the first 1-2 weeks.

  • Avoid sun exposure for 1-2 months post-procedure. Always wear your mineral sunscreen, sunglasses and a hat when exposed to the sun. Reapply sunscreen every 2 hours.

  • It is best to avoid strenuous exercise or any excessive heat for 2 weeks 

  • Be careful with hair products (shampoo, hair spray, etc.) and perfumes, so they do not touch the treated area 

  • Avoid waxing the treated areas for 3 months. 

If you experience any of the following, you may contact our clinic:

  • Excessive pain, itching, swelling, bleeding, scab formation

  • Signs of infection

  • Any further questions