Immediately after treatment, erythema and edema are common, and may persist for two to three days, or slightly longer with ablative treatments, and when more aggressive settings are used. Edema is typically most prominent in the periorbital area and usually lasts less than 1 week in most patients [18]. With ablative fractional resurfacing, punctate bleeding and serous oozing are also commonly present, but typically resolve within 24 hours. Petechiae and/or purpura are also seen in a minority of patients. To help minimize these effects, patients are encouraged to use ice packs and sleep with their head elevated for one to two days after treatment.
Patients may apply moisturizer, sunscreen, and makeup after nonablative fractional treatments since the stratum corneum remains intact, but these products should be avoided for several days after ablative fractional treatments. A few days later, their skin may have a tanned or bronzed appearance once the erythema resolves. This improves as the skin exfoliates over the next several weeks. Xerosis, and occasionally some associated pruritis are also commonly experienced for several days afterward, usually resolving around the same time that the erythema and edema dissipate [38].
A limited number of patients may experience an acneiform eruption that often occurs in the perioral area. This may be treated with topical acne medications or oral antibiotics if persistent or bothersome. Finally, patients should be strongly encouraged to avoid direct sun exposure for one to two months after treatment, to help minimize any abnormal pigmentation and ensure long-standing clinical improvement.