– Discuss the procedure, what to expect during and after.
– Develop a treatment plan that emphasizes the importance of maintenance. BBL should be done in series and requires 3-4 procedures per year to maintain results.
– Stress the importance of sun protection before and after treatments.
– Go over the patient’s Fitzpatrick Skin Type test and discuss what this result means for their treatment, including discussing risks for hyperpigmentation.
– Contraindications: metal plates in the treatment area, Skin Type VI, active infections
– If needed, write prescriptions for antivirals:Valtrex 500 MG PO BID x 5 days to start day of procedure or if possible 1 day before
– Go over a comprehensive plan for home skin care for maintenance and discuss products.
– Hyperpigmentation: many patients who are being treated with BBL for hyperpigmentation would get an added benefit from a lightening cream such as Advanced Pigment Corrector
– Melasma: Melasma is very challenging and should be treated with both topical bleaching creams and laser settings must be very gentle. Discuss the challenge of treating melasma with patients to set realistic expectations.
– Acne: Acne treatments require up to 11 passes per session. It is best to use BBL in combination with topical and/or oral acne treatments at the same time. Sessions should be 1-2 a week for a minimum of 6 sessions. Destruction of P. acnes continues for a few weeks following the last BBL treatment and the effects of the treatment will be maintained until bacterial populations rebuild to their initial concentrations. Some patients may require a maintenance treatment within 3-6 months of the initial series of treatments.
– If Botox is being done on the same day, do BBL first, then Botox. Filler should ideally not be done on the same day.
Instructions Prior to BBL Treatment
– ABSOLUTELY avoid any type of sunburn or suntan for 4 weeks prior to BBL treatments. Treatment of tanned skin can increase the risk of blistering and/or permanent skin discoloration. Prolonged sun exposure should be avoided for 4-weeks before and after treatments.
– Do not use any self-tanning lotions at least one month prior to treatment.
– Discontinue the use of Retin-A, Renova, and Differin at least one week prior to treatment, as they may cause photosensitivity.
– Please notify us if you have a history of “herpes,” “cold sores,” or “fever blisters”. Like sunlight, the laser light may cause an outbreak leading to more serious complications. We recommend taking Valacyclovir 500mg, 1 tablet twice a day for 5 days starting one day prior to the treatment.
Instructions Following BBL Treatment
– Intense burning, redness, warmth, and sunburned sensation are normal reactions following a BBL treatment. The discomfort and redness generally lasts 2-4 hours after the treatment. Cool compresses may help relieve the temporary discomfort.
– Brown patches or spots will become darker and frequently feel scaly like coffee grounds on your skin within the first few days. Within 1-2 weeks these areas will fall off and leave new, healthy skin behind. Do not pick or scrub these spots, no matter how tempting!
– Avoid the use of skin care products that contain Retin-A, Retinol, glycolic acid, or salicylic acid for 1 week.
– Makeup can be used if there is no blistering. When applying and removing makeup treat the area with care, as it is still delicate and sensitive.
– If the skin is broken or blisters appear, notify our office.
– Prolonged sun exposure should be avoided for 4-weeks before and after treatments.. A total sunblock, like EltaMD or SkinCeuticals, containing zinc oxide should be applied daily if you are going to be in the sun. Unprotected exposure to the sun may cause complications such as permanent skin discoloration and severe blistering.