CO2 Laser Skin Resurfacing
Maximize Non-surgical Tighter Skin, Smoother Texture, Less Discoloration
Informed Consent and
Before and After Care Instructions
Congratulations on scheduling your cosmetic procedure at Spa 35 Medical Spa.
Use the Information below to learn how to prepare for your treatment and how to maximize your experience after your procedure.
The informed consent form for each procedure also provides important information. Please be sure to read it before signing. Ask a Spa 35 team member to answer your questions before scheduling your procedure.
Call Spa 35 with any questions or concerns regarding your treatment at 208-367-0700. After business hours select option 4 for urgent after-hours assistance. If you have an emergency call 911.
CO2 Laser Skin Resurfacing - Treatment Purpose
CO2RE Laser Skin Resurfacing is a powerful CO2 cosmetic laser procedure that tightens skin, diminishes ages spots, improves texture, improves wrinkles, improves acne scars and improves other skin imperfections. Skin tissue is removed with laser energy, stimulating the body to create new skin. The CO2RE procedure is typically used in a manner that leaves untreated skin within the treated area to speed the rebuilding process (fractional/fractionated), but it can also be used in a fully ablative method for more aggressive spot treatments. Healing from the treatment usually takes 6 to 10 days. Improvements in skin appearance can be immediately seen with the maximum results taking as long as one year as skin tissue regenerates. Clinical results vary, depending on individual factors. These include, but not limited to, medical history, amount of sun damage or textural problems, skin type, patient compliance with pre/post treatment instructions, and individual response to treatment.
CO2 laser skin resurfacing demonstrates improvement in the smoothness of the skin; however, a complete elimination of wrinkles or scarring is not a realistic expectation.
Platelet Rich Plasma (PRP) is usually recommended to speed the healing process after your CO2 Laser Resurfacing procedure. Please review the informed consent for PRP if you choose to include it with your procedure.
CO2 Laser Skin Resurfacing - Consent for Treatment
Informed consent documents are used to communicate information about the proposed cosmetic treatment along with disclosure of risks and alternative forms of treatment(s). Despite C02RE Fractional Resurfacing high level of efficacy and safety, it is not free of side effects.
As a patient you have the right to be informed about your treatment so that you may make the decision whether to proceed with the C02RE treatment or decline after knowing the risks involved. This disclosure is to inform you about the risks, side effects and possible complications related to the C02RE prior to your treatment. This disclosure should not be considered all-inclusive in defining other methods of care and risks encountered. Spa 35 may provide you with additional or different information which is based on all the facts in your particular case and the state of medical knowledge.
CO2 Laser Skin Resurfacing - Risks and Treatment Experience
There are both risks, and complications associated with the CO2 Laser Resurfacing procedure. Although the majority of patients do not experience these complications, you should understand the risks and potential complications of laser skin treatment.
Potential risks and experiences include, but are not limited to:
Erythema and edema- Redness and swelling of the treated area can be expected and usually subside within a ten days but can take longer. Expect irritation, itching, and/or a mild burning sensation, similar to a moderate or severe sunburn. Blistering, scabbing and temporary bruising are also possible.
Hyperpigmentation (darkening) and hypopigmentation (lightening)- CO2 Laser treatments may potentially change the natural color of your skin. Skin redness usually lasts 2 weeks 3 months and occasionally up to 6 months following laser skin treatment. Darkening and lightening of the skin in the treated areas can occasionally occur. Mostly it is transient, lasting up to six months, but in rare cases it can be permanent. Occasionally these pigmentary changes occur despite appropriate protection from the sun. A line of demarcation between normal skin and skin treated with lasers can occur.
Pinpoint bleeding and pattern- Bleeding and/or grid marks may occur during your CO2 Laser Resurfacing treatment. Laser treatment procedures may produce visible patterns within the skin. They typically resolve within 30 days. The occurrence of this is not predictable.
Burns - Laser energy can produce burns. Adjacent structures including the eyes may be injured or permanently damaged by the laser beam. Burns are rare yet represent the effect of heat produced within the tissues by laser energy. Additional treatment may be necessary to treat laser bums.
Eye damage- There is a risk of accidental eye injury by the laser energy or beam, which could cause blindness or burns of the eyeball.
Accutane (Isotretinoin) Accutane is a prescription medication used to treat certain skin diseases. This drug may impair the ability of skin to heal following treatments for a variable amount of time even after the patient has ceased taking it. Individuals who have taken the drug are advised to allow their skin adequate time to recover from Accutane before undergoing laser skin treatment procedures.
Scarring- Although normal healing after the procedure is expected, abnormal scars may occur both in the skin and deeper tissues. In rare cases, keloid scars may result. Scars may be unattractive and of different color than the surrounding skin. Additional treatments may be needed to treat scarring. Strict adherence to all advised post-operative instructions will reduce the possibility of scarring.
Infections- Although infection following laser skin treatment is unusual, bacterial, fungal, and viral infections can occur. Herpetic outbreaks can be triggered by CO2 Laser Resurfacing treatments. An outbreak increases the risk of scarring. This applies to both individuals with a past history of Herpes simplex virus infections and individuals with no known history of Herpes simplex virus infections. Specific medications may be prescribed and taken both prior to and following the laser treatment procedure in order to suppress an infection from this virus. Should any type of skin infection occur, additional treatment including antibiotics may be necessary.
Numbing agent reactions- Your skin will be numbed using an analgesic agent(s) as part of your CO2 Laser Resurfacing procedure. Analgesics typically include but are not limited to benzocaine, lidocaine and tetracaine (BLT). BLT is a central nervous system depressant and has risks including, but not limited to: numbness, tingling, vertigo, restlessness, seizures, tremors, convulsions, tachycardia, and even death.
Prescribed medications- Systemic reactions may result from drugs used during the procedure and prescription medicines.
Damaged Skin Skin that has been previously treated with chemical peels or dermabrasion, or damaged by bums, electrolysis (hair removal treatments), or radiation therapy may heal abnormally or slowly following treatment by lasers or other cosmetic techniques. The occurrence of this is not predictable. Additional treatment may be necessary.
Distortion of Anatomic Features Laser skin treatments can produce distortion of the appearance of the eyelids, mouth and other visible anatomic landmarks. The occurrence of this is not predictable. Should this occur corrective medical treatments may be necessary.
Pain Very infrequently chronic pain may occur after laser skin treatment procedures.
Injection site reactions – Your skin may be injected with numbing agents as part of your treatment. And you may have blood drawn for PRP. Injection sites may be red, painful, injure nerves or muscles, or may cause bruising.
Skin lesions- Laser energy directed at skin lesions may potentially vaporize the lesion. Laboratory examination of the tissue specimen may not be possible.
Ectropion- In rare instances, a downward pull of the eyelids can result after peri-orbital laser resurfacing.
Increased susceptibility to sun – With reduced skin pigmentation CO2 laser skin resurfaced areas can be more susceptible to the photo-aging effects of sunlight and the potential carcinogenic (cancer-producing) effects of ultraviolet wavelengths. Limiting direct sun exposure and using high quality sunscreen will decrease photo-aging after your procedure.
Fire Inflammable agents, drapes and tubing, hair, and clothing may be ignited by laser energy. Laser energy used in the presence of supplemental oxygen increases the potential hazard of fire.
Laser Smoke (plume) Laser smoke is noxious to those who come in contact with it. This smoke may represent a possible bio hazard.
CO2 Laser Skin Resurfacing - Pre Treatment Instructions
It is prudent to follow some simple guidelines before your treatment. These guidelines can reduce possible side effects associated with the procedure and make all the difference between a fair result and a great result.
Hydrate- We recommend that for seven days pre-treatment you moisturize skin in the morning and evening, drink at least 8 glasses of water per day to completely hydrate your skin and optimize treatment results.
Self-Tanner- Stop self-tanner for four weeks prior to treatment.
Skin Care- Stop exfoliating skin care products, such as retinols and glycolic acid, for one week before your treatment. This includes Retin-A.
Prescription Medications- We will provide you with an antiviral to take before your appointment to decrease the risk of a herpetic outbreak. Take your first tablet 24 hours before your treatment and follow instructions on the bottle. Take other medications that may be prescribed for anxiety or pain management as instructed on the bottle. Stop taking prescription medications that may increase the risk of bruising as instructed and in coordination with your physician.
Over the Counter Medications- Avoid aspirin, naproxen and Ibuprofen for one week prior to your treatment. Inform your provider if you are taking blood thinners or regularly take aspirin or Ibuprofen.
Supplements- Avoid fish oil, Gingko Biloba, Garlic, Flax Oil, Cod Liver Oil, Vitamin A, Vitamin E, or any other supplements one week before treatment.
Alcohol- Avoid alcohol for two days prior to treatment.
Accutane- Inform your provider if you have taken Accutane (oral acne medication) in the past year.
Ice Packs- Store ice packs in your freezer for use after you get home from procedure.
Special Events- Schedule your treatment at least four weeks prior to a special event i.e., wedding, vacation, speaking engagement, to allow time for the healing process.
Secure a ride for after treatment- You must secure a ride home fir you choose to use the pain and/or anxiety medication.
Photographs- Take at home photos to monitor your skin improvement.
CO2 Laser Skin Resurfacing - Treatment Day Instructions
Discomfort- The sharp, burning sensation of each laser pulse may produce a moderate to severe amount of discomfort. Topical anesthetics and anesthetic injections are used to block the pain during the procedure.
Take prescription medications- Take prescribed medications as directed.
Plan for social downtime- Expect to stay home/stay "under the radar" for 5 to 10 days (potentially longer for a more aggressive treatment).
Swelling- Plan on swelling after your treatment. Sleep with head elevated with pillows or in a recliner the first 1-2 nights to reduce swelling. Areas most likely to swell are around the eyes and neck. If extreme swelling occurs around the eyes, a corticosteroid prescription can be called into your pharmacy.
Oozing- A clear fluid may be present in the treated areas and may create a crust or scab if the areas are not kept moist. Within about 2 days, you may appear to have an exaggerated tan with slight crusting that may last as l long as two weeks. A healing emollient, such as
Make-up- Please arrive for your appointment without make-up.
Clothing- Wear comfortable clothing with an open collar.
Transportation arrangements – Some medications may restrict your ability to drive home after your procedure. Please coordinate transportation home after your procedure if you chose to take such medications.
CO2 Laser Skin Resurfacing - Post Treatment Instruction
Immediately after your CO2RE Laser Resurfacing your skin will feel warm and sensitive to the touch. It is important to keep the skin covered with a protective gel (such as Aquaphor) at all times immediately after your treatment. Plan on an immediate recovery period of 5 to 10 days. After the initial recovery your skin maybe continue to be red and sensitive for weeks as it fully heals.
Expect the treated area to be red, swollen, scabby and irritated, similar to a severe sunburn. It is important to keep the treated skin covered with an emollient cream, such as Aquaphor. Similar to a severe sunburn, the treated skin will become darker and will gradually slough off over time.
Redness and swelling- Immediately after your CO2 treatment expect to experiennce significant redness and scabbing for 1 to 10 days. For more aggressive treatments, this may last longer. Slight to moderate swelling is typically experienced for 2 to 3 days after your CO2 procedure, but can last longer. It is important to keep the treated skin covered with an emollient cream, such as Aquaphor. The dark skin will "flake" off during the vinegar/cleansing process (see below).
Ice Packs for Inflammation- To minimize post-procedural inflammation and to give comfort, apply ice packs (with cloth barrier) to the treatment area for up to 10 minutes per hour, several times a day for 24-48 hours.
Contact Dermatitis –You may experience contact dermatitis due to topical preparations (ointments) used post-operatively.
Skin Itchiness – Your skin may feel itchy in the early healing phase.
Sleep with head elevated- Sleep with head elevated with pillows or in a recliner for the first night to reduce swelling. If swelling persists into day 2, again, sleep with head elevated (above the heart).
Sun Exposure- Start using sunscreen with zinc oxide after skin is fully epithelialized (5-10 days post treatment) and continue for at least two weeks after your procedure. Avoid direct sun exposure for at least one month after procedure. Lifetime daily sunblock use is recommended to prolong your results and protect your skin from photo-aging.
Post Treatment Skin Cleaning Process - xUse a diluted vinegar solution and gauze pads to gently cleanse the skin 4 times a day beginning the night of, or morning after your CO2 procedure (your provider will provide more direction on timing). Clean the skin by gently removing the emollient cream with a gauze pad soaked in the diluted vinegar solution. Do not scrub or pick off the dead skin, allow it to exfoliate as part of the natural healing process. It will take multiple passes of the gauze over the skin to remove all the emollient cream. After removing the emollient cream reapply fresh emollient cream. Combine hydrocortisone and Aquaphor for the first 48 hours after treatment. This cleaning process should be repeated for 5 to 10 days. Until no tightness or discomfort is experienced without emollient cream on the skin. Keep emollient cream on treated areas AT ALL TIMES for 5 to 10 days. If in doubt continue use of the emollient cream. Avoid dryness and dry scab formation.
Gentle cleanser may be used starting 6 days after your treatment if it does not cause irritation. Post treatment recovery kit and skincare kit will be provided for you. Details below. There are no restrictions on bathing except to treat the skin gently. Avoid scrubbing or trauma to the treated area. Avoid harsh products, exfoliants and Retin-A for 30 days post treatment. Avoid makeup for 7-10 days, and then use only on intact skin.
Post Treatment Recovery Kit
(start evening after procedure)
Gauze
Diluted Vinegar Solution (1 teaspoon vinegar to 1 cup water)
Paper Pillowcases
Acquaphor
Hydrocortisone Emollient Cream
Post Treatment Maintenance Skincare – Beginning fourteen days after your CO2 Laser Resurfacing procedure you can start the skin maintenance program. The skincare products will help maintain the results from your CO2 procedure. You can purchase these products at your follow-up appointment.
Post Treatment Skincare Kit
Obagi Gentle Cleanser
Obagi Hydrate
Obagi Sunscreen
Obagi Blender
Obagi Tretinoin/ Retin A (start at thirty days post procedure)
Bathing- There are no restrictions on bathing except to treat the skin gently.
Acne or Milia formation- Flare-up acne or formation of milia can occur in the post-operative period. Please contact Spa 35 if you experience acne or milia.
Prescription medications – Continue any prescription medications as directed.
Bathing- There are no restrictions on bathing except to treat the skin gently.
Acne or Milia formation- Flare-up acne or formation of milia can occur in the post-operative period. Please contact Spa 35 if you experience acne or milia.
Prescription medications – Continue any prescription medications as directed.
CO2 Laser Skin Resurfacing - Treatment schedule
We recommend CO2 Laser Resurfacing procedures are separated by at least 6 months’ time. For some people a CO2 Laser Skin Resurfacing treatment is a once in a lifetime procedure. Others prefer to repeat the procedure as the aging process continues.
CO2 Laser Skin Resurfacing - Alternative Treatments
No treatment is an alternative, accepting my present skin condition. Other alternatives to CO2 Laser Skin Resurfacing include dermabrasion, chemical peels, other energy-based cosmetic procedures (e.g. Intense Pulsed Light, Picoway Resolve) and cosmetic surgery. Risks and potential complications are associated with alternative forms of treatment that involve skin treatments or cosmetic procedures.
CO2 Laser Skin Resurfacing - Synergistic Treatments
In general people considering CO2 Laser Skin Resurfacing are also candidates for other treatments, such as: Botox for wrinkle relaxation, dermal filler (e.g. Juvederm) injections for youthful face proportions, Intense Pulsed Light treatments for skin discoloration and Picoway Resolve laser treatments for collagen remodeling.
CO2 Laser Skin Resurfacing - Acknowledgement
I have read and understand the Informed Consent documentation and been informed about what I must do and "not do" before, during and after my treatment. I agree to follow the pre and post care instructions carefully. I understand that compliance with recommended pre and post procedure guidelines are crucial for healing, prevention of scarring, and other side effects and complications.
I completed an accurate medical history document. If there are any issues that are not covered by the medical history form which I think are relevant to my treatment, I will inform Spa 35 prior to my treatment. I will also notify Spa 35 of any changes in my health or medical care as they occur during my treatment program.
I confirm that I am not pregnant or breastfeeding at this time.
Photographs: I give permission for my photographs to be used to help document my treatment course. Complete confidentiality will be maintained.
No guarantee, warranty, or assurance has been made to me as to the results that may be obtained. I am aware that follow-up treatments may be necessary for desired results. Clinical results will vary per patient. I agree to adhere to all safety precautions and regulations during the treatment. Some people are unable to complete the treatment due to discomfort. No refunds will be given for treatments received.
I recognize that during the course of the treatment, medical treatment or anesthesia, unforeseen conditions may necessitate different procedures than those above. I therefore authorize Spa 35 providers to perform such other procedures that are in the exercise of his or her professional judgment necessary and desirable. The authority granted under this paragraph shall include all conditions that require treatment and are not known to the provider at the time the procedure is begun.
I understand and agree that all services rendered to me are charged directly to me and that I am personally responsible for payment.
The nature and purpose of the treatment have been explained to me. I have read and understand this agreement. All of my questions have been answered to my satisfaction and I consent to the terms of this agreement. Alternative methods of treatment and their risks and benefits have been explained to me and I understand that I have the right to refuse treatment.
If I experience any major or life-threatening symptoms, I will call 911 immediately. For non-emergency questions I will call Spa 35 at 208-367-0700, (for after-hours concerns selection option #4).
I release Spa 35, medical staff, and specific technicians from liability associated with this procedure. I certify that I am a competent adult of at least 18 years of age. This Consent Form is freely and voluntarily executed and shall be binding upon my spouse, relatives, legal representatives, heirs, administrators, successors, and assigns.
Please contact the Spa 35 team if you have questions about CO2 Laser Skin Resurfacing and/or information on this webpage.
Why Chose Spa 35 Med Spa for Your Cosmetic Treatments?
The medical providers at Spa 35 Med Spa have been delivering cosmetic services for thirteen years. Our staff includes Nurse Practitioners, Registered Nurses and Aestheticians.
Experience - Spa 35 Med Spa has been helping clients Look and Feel their Best for twelve years.
Medical Staff - The team is led by Nurse Practitioners and composed of Registered Nurses and aesthetic skin care professionals. Botox and filler injections are performed by medically trained injectors, not estheticians.
Industry Leadership - Warren Danforth, the Spa 35 owner, is a Key Opinion Leader for Candela Medicals's Medical Spa Program. Candela Medical is a global non-surgical aesthetic device company and the maker of Profound RF Skin Tightening, CO2RE CO2 Laser Resurfacing, Sublative RF Resurfacing and Picoway Tattoo removal devices.
Broad Scope of Expertise - From Botox to CoolSculpting Fat Reduction and Vaginal Rejuvenation, Spa 35® Med Spa has an extensive set of experience to help you reach your goals. This means you get the expertise to help you select the service(s) are right for you and your budget.
Photographs on this website are used to illustrate how services are used and their potential impact on your appearance. Your results will not completely match any photographs. Genetics, sun exposure, diet and exercise all influence your results. The Spa 35 Med Spa team strongly encourages all of our clients to maximize their lifestyle choices.