ARTICLE: Pre- and Post-Procedural Care Best Practices to Enhance Energy-Based Treatment Outcomes

August 2019 | Volume 18 | Issue 8 | Supplement Individual Articles | 187 | Copyright © August 2019

Suzanne L. Kilmer MD,a Roy G. Geronemus MD,b Nazanin Saedi MD,c Elizabeth Tanzi MD,d Kian Karimi MD,e A. Jay Burns MDf

aLaser & Skin Surgery Center of Northern California, Sacramento, CA bLaser & Skin Surgery Center of New York, New York, NY cJefferson Laser Surgery and Cosmetic Dermatology Center, Philadelphia, PA dCapital Laser & Skin Care, Chevy Chase, MD eRejuva Medical Aesthetics, Los Angeles, CA fDr. A Jay Burns Cosmetic Surgery, Dallas, TX

Consumer demand for skin tightening and resurfacing procedures has accelerated during the last several years. Numerous energy-based treatment options have emerged for facial rejuvenation together with new complementary skincare products that are specifically formulated for pre- and post-treatment care. Currently, no widely accepted “best practices” guideline exists for combining the safe and effective use of these devices and products for improving clinical outcomes, reducing recovery time, and enhancing overall patient satisfaction. A group of experienced aesthetic dermatologists and plastic surgeons convened for a roundtable discussion of the pre- and post-treatment skincare protocols they currently use with various energy-based facial rejuvenation devices. The objective of this discussion was to generate a Best Practices Guideline. Overall, participants agreed that rejuvenation procedures represent a significant investment in time and money for their patients. Any adjunctive treatment that improves outcomes of a rejuvenation procedure, shortens downtime, and increases patient convenience is desirable and will provide benefits to both the patient and the practice. Participants also agreed that the concept of pre-treatment skin preparation is a recent change in their overall treatment protocol. Depending on the procedure, a variety of pre-treatments being used include hydroquinones for patients prone to post-inflammatory hyperpigmentation, retinoids, moisturizers, ceramides, sunscreens, and exfoliants, along with products specifically formulated for pre-procedure use. Similarly, there is a range of post-procedural treatments including ice packs, vinegar soaks, hydroquinones, oral antibiotics, and antivirals, along with products specifically formulated for post-procedure recovery. Although the use of these treatments varied widely across practices, all authors use the Alastin® Skincare line of products, particularly Regenerating Skin Nectar, for both pre- and post-procedural skincare.

J Drugs Dermatol. 2019;18(8 Suppl 1):s187-195.


In recent years, numerous energy-based treatments have emerged for facial rejuvenation. Similarly, new complementary skincare options have become available to enhance the outcomes of these procedures. There are currently no widely accepted “best practices” for combining the use of skincare products with these devices to improve clinical outcomes, maximize patient safety, reduce recovery time, and enhance overall patient satisfaction.

A group of experienced aesthetic dermatologists and plastic surgeons convened for a roundtable discussion of their experiences with device-based non-ablative and ablative procedures. Specifically, they shared pre- and post-treatment regimen protocols used with various energy-based devices for facial rejuvenation. The objective of this discussion was to generate a Best Practices Guideline in order to share these experiences with other aesthetic clinicians.


Prior to the meeting, a survey was sent to roundtable participants to establish the value of generating a Best Practice Guideline, confirm their experience with energy-based rejuvenation procedures, inquire about the current pre- and post-procedure practices used for the various procedures they perform, and form the basis for subsequent discussion.

Based on the results of this survey, it was determined that the primary value of a Best Practices Guideline is to ensure practitioner confidence and help establish and reinforce safe treatment practices (Table 1). Specifically, the most important factors practitioners consider when choosing products and protocols for pre and post-procedure use are the need for scientific evidence that supports product effectiveness and products that improve treatment outcomes. The most important factors for patients when choosing to undergo an energy-based procedure are results and downtime (Table 2). Based on the number of en