๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
POSTPROCEDURE CARE
POSTPROCEDURE CARE
After laser treatment, patients should apply noncomedogenic moisturizers to mitigate the risk of acneiform eruptions and milia. In patients with anticipated severe acne flares, oral tetracycline may be provided.44 If the patient was treated with a non-AFL, erythema should be expected for up to 4 days.45 If the laser was ablative, erythema may last 4 weeks. Postinflammatory hyperpigmentation is most commonly observed in those with Fitzpatrick skin types III to VI.44,46 The risks of treatment of a patient with skin types III to VI with a nonfractional ablative laser typically outweigh the benefits.10,46,47
Additional recommendations are to minimize sun exposure 2 weeks before and after treatment and be religious with sunscreen use. Development of HSV reactivation occurs in up to 2% of those treated with non-AFLs.48 Among those treated with nonfractionated ablative lasers, the incidence may be as high as 7%.49 To reduce the risk of an HSV eruption, oral antivirals may be given for 5 to 7 days, beginning the day of, or the day prior to, the procedure.
Patients treated with fractional lasers may rarely experience delayed purpura 3 days after treatment. For this reason, anticoagulants such as aspirin and other nonsteroidal anti- inflammatory agents are not recommended.50 Rarely reported recall phenomena have been described with patients treated with fractional lasers. A transient, benign, erythematous patch may appear after a hot shower or sunlight exposure in the previously treated areas.51 In those treated with RF devices, erythema and scabs may develop, in addition to pain that is experienced by up to 88% of patients.37 A reported side effect of monopolar RF treatment is loss of adipose tissue due to heating, which may lead to contour irregularities.52,53
CONCLUSIONS
There have been significant advances in energy-based resurfacing devices over the past three decades. Five major classes of resurfacing devices are available, including ablative fractionated, ablative nonfractionated, nonablative fractionated, nonablative nonfractionated, and RF devices. Combination devices have been studied, and demonstrated efficacy in facial skin resurfacing.54 Choice of device depends on a patientโs skin type, acceptance of postoperative downtime, and desired outcome. Technological advancements continue to be made on energy-based resurfacing with a focus on maximizing cosmetic efficacy while minimizing subsequent postoperative pain, dyspigmentation, desquamation, and erythema.