Skin Resurfacing: Preparation

Preparation for the chemical peel begins several weeks before the actual procedure. To promote turnover of skin cells, patients use a mild glycolic acid lotion or cream in the morning, and the acne cream tretinoin in the evening. They also use hydroquinone cream, a bleaching product that helps prevent later discoloration. To prevent reappearance of a herpes simplex virus infection, antiviral medicine is started a few days before the procedure and continues until the skin has healed.

Patients arrive for the procedure wearing no makeup. The physician "degreases" the patient's face using alcohol or another cleanser. Some degree of pain accompanies all types of peels. For a superficial peel, use of a hand held fan to cool the face during the procedure is often sufficient. For medium-depth peels, the patient may take a sedative or aspirin. During the procedure, cold compresses and a hand-held fan can also reduce pain. Deep peels can be extremely painful. Some physicians prefer general anesthesia, but local anesthetics combined with intravenous sedatives are frequently sufficient to control pain.

Dermabrasion does not require much preparation. It is usually performed under local anesthesia, although some physicians use intravenous sedation or general anesthesia. The physician begins by marking the areas to be treated and then chilling them with ice packs. In order to stiffen the skin, a spray refrigerant is applied to the area, which also helps control pain. Some physicians prefer to inject the area with a solution of saline and local anesthetic, which also leaves the skin's surface more solid. Since dermabrasion can cause quite a bit of bleeding, physicians and their assistants will wear gloves, gowns, and masks to protect themselves from possible blood-transmitted infection.

Antiviral medications should be started several days before the procedure. Laser resurfacing is performed under local anesthesia. An oral sedative may also be taken. The patient's eyes must be shielded, and the area surrounding the face should be shielded with wet drapes or crumpled foil to catch stray beams of laser light. The physician will mark the areas to be treated before beginning the procedure.

— Richard H. Camer