Pico Laser Before & After Care

Physician-led instructions from Kathryn Schaefer, MD
Botox Oahu · Aina Haina · (808) 261-1121

 

From Dr. Schaefer: Pico laser uses ultra-short pulses to break up pigment and refresh skin with little downtime. In Hawaii the sun is strong every month of the year. How you protect your skin before and after treatment matters as much as the treatment itself.

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Before treatment

 

Two weeks before

 

Avoid sunburns, tanning beds, and self-tanner on the treatment area. A fresh tan raises the risk of burns and dark marks. Tell us if you have taken isotretinoin (Accutane) in the past year, if you get cold sores, and every medication or supplement you use. Some antibiotics and photosensitizing drugs change how skin handles laser energy. If you have melasma or a history of dark marks after procedures, say so — we may start a pigment-calming cream first.

 

Seven days before

 

Stop retinoids (tretinoin, retinol, Differin), AHAs/BHAs, glycolic and salicylic acids, strong vitamin C, benzoyl peroxide, and scrubs on the area. No waxing, threading, or depilatory cream. Wear a broad-spectrum mineral sunscreen, SPF 50 or higher, every day. Neurotoxin is best at least 2 weeks before laser; filler at least 4 weeks before — or we schedule them after you have healed.

 

Day of your appointment

 

Arrive with clean, bare skin. No makeup, moisturizer, sunscreen, perfume, or lotion on the treatment area. Do not come in with a sunburn, open sores, or an active cold sore. Eat, hydrate, and bring a wide-brim hat for the ride home.

 

What to expect

The skin often feels warm or sunburned for a few hours. Redness and mild swelling usually settle in 24–48 hours. Treated spots may look darker for several days (a “coffee-ground” or frosting look) before they flake — that is expected, not a burn. Stronger settings or tattoo work can cause pinpoint petechiae, small blisters, or light scabbing. Let crusts fall off on their own. Itching is common because the laser dries the surface. Moisturize with ointment, Neosporin works well. Do not scratch.

 

Aftercare — first 24–48 hours

Cleanse once or twice daily with lukewarm water and a mild, fragrance-free cleanser. Pat dry. Do not rub. A wrapped cold pack eases heat; never put ice directly on skin. Acetaminophen or an anti-inflammatory is fine if you tolerate it. Avoid aspirin-based pain relief if bruising is a concern. Apply Biafine, CeraVe, Aquaphor, or another bland moisturizer twice daily. Skip sauna, steam, hot yoga, very hot showers, and hard workouts for 24–48 hours. Stay out of the ocean, pools, and hot tubs until the surface is intact. No makeup, fragrance, or new products on healing skin. Light mineral makeup is often fine after 24 hours if there is no open skin — ask if you are unsure.

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Aftercare — days 3 through healing

Do not pick flakes or scabs. Do not shave the area until it is fully healed. Hold retinoids, acids, scrubs, and strong vitamin C until we clear you — usually 5–7 days after a light session, longer if the skin is still pink. Everyday movement is fine once heat and sweat no longer sting. Wait 4–6 weeks between Pico sessions on the same area.

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Sun — the most important rule in Hawaii

Treated skin is extra sensitive to UV. Unprotected sun is the main reason pigment returns or darkens. Wear broad-spectrum sunscreen, minimum SPF 50, over the area for at least 3 months after every session. Mineral (zinc/titanium) formulas are preferred on healing skin. Reapply every 2 hours outdoors, after swimming, and after sweating. A wide-brim hat and shade from 10 a.m. to 4 p.m. are not optional here. No tanning beds. No “base tan.”

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When to call

Call or text (808) 261-1121 for spreading redness, pus, fever, unusual bleeding, worsening pain, or a cold-sore outbreak. Questions about a product, a beach day, or when to restart your retinoid — ask. For an extreme reaction (trouble breathing, rapidly spreading swelling, severe blistering), seek emergency care first, then notify us.

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Kathryn Schaefer, MD
Physician-Led Aesthetics · Botox Oahu
850 W Hind Drive, Suite 109, Honolulu, HI 96821
Mon · Tue · Thu · Fri, 8am–5pm