SUPPLEMENT: Algorithm for Pre-/Post-Procedure Measures for Facial Laser and Energy Devices Treatment

January 2021 | Volume 20 | Issue 1 | Department | s3 | Copyright © January 2021


Published online December 24, 2020

Michael Gold MD FAADa, Anneke Andriessen PhDb, David J Goldberg MD JD FAADc, Komel V Grover MBAd, Shasa Hu MD FAADe, Z Paul Lorenc MD FACSf, Stephen H Mandy MD FAADg, Janelle M Vega MD FAADh

aGold Skin Care Center, Nashville,TN;Vanderbilt University School of Medicine and Nursing, Nashville,TN
bRadboud UMC Nijmegen,Andriessen Consultants, Malden, Netherlands
cSkin Laser & Surgery Specialists of NY and NJ, Hackensack, NJ; Icahn School of Medicine at Mt. Sinai, New York, NY
dStrategic Development, Swiss American CDMO, Dallas,TX
eDr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL
fLorenc Aesthetic Plastic Surgery Center, New York, NY; Department of Plastic Surgery, Lenox Hill Hospital, New York, NY
gDr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami FL
hMayoral Dermatology, Miami, FL
cDallas Center for Dermatology and Aesthetics, Dallas,TX
dGeorge Washington University,Washington, DC

Abstract
Background: Laser and energy devices may be used for the treatment of facial aging signs. While previous investigators have evaluated methods of reducing risks of adverse events due to the treatment procedure itself, no algorithm exists on peri-procedure measures for laser and energy device treatment.
Methods: A panel of dermatologists and plastic surgeons was convened for a meeting to develop an algorithm for peri-procedure measures for facial laser and energy devices treatment. A modified Delphi technique was used to develop the algorithm, which was based on the best available evidence, the outcome of a previous survey on the subject coupled with the panelists’ experience and opinion.
Results: The four sections of the algorithm address prevention, pre-procedure, during the procedure, and post-procedure measures. Prevention includes the avoidance of excessive sun exposure before and the use of a broad-spectrum sunscreen with an SPF 30 or higher. The panel recommends the use of oral antiviral prophylaxis for patients undergoing ablative laser treatments. Products for pre- and post-procedure management that combine bacterial, antiviral, and antifungal activity while stimulating wound healing offer benefits. When used after resurfacing, the use of such products is to be followed by the application of an emollient.
Conclusions: The algorithm was designed as a tool to support an optimal treatment outcome providing physicians with guidance to choose the best pre-/post-procedure measures for their patients.

J Drugs Dermatol. 2021;20:1(Suppl):s3-11

BACKGROUND

Both internal and external factors such as solar radiation, air pollution, tobacco smoke, and poor nutrition may1,2 trigger facial aging. Various processes are involved in skin aging, including elevated production of reactive oxygen species (ROS), thereby inducing cellular inflammatory infiltrates, and damaging the dermal extracellular matrix (ECM) and protein structures.1,2

Laser and energy devices are frequently used for facial rejuvenation. The choice of treatment depends on individual patient characteristics and expectations and physician expertise.3-5 For optimal treatment outcomes, patients should be appropriately selected, screened, followed by a physical exam of the face before treatment.6