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Day 1 : Treatment Day I had PSR 2, single and double pass to the whole face. This is my second treatment for mild acne scarring. The first treatment I had was PSR 1.5 double pass to the whole face, 1 month ago.
Dr Chan and Dr. Moscato discuss the treatment process, complications and post-treatment care with you prior to treatment and any health concerns you may have that will possibly effect the healing phase of the treatment.
A topical anaesthetic is applied twice, to the whole face, at thirty-minute intervals. On each application, gladwrap is applied to the face.
Wet gauze was applied to the eyebrow area so that no hairs were singed and I had a cloth headband on to protect my hairline! They do grow back but I have a function in a few weeks so I need them intact. Once again Dr Chan was very diligent in making sure no hair was singed.
The actual treatment process was about 40 minutes. Pain was minimal. I could feel the treatment a lot more than the PSR 1.5 though. I had been quite sick before treatment though, so my pain threshold was not as good as1 it usually is. The more sensitive areas for me were the forehead, upper lip and under the eyes.
After the treatment my skin felt very hot and I started to swell a lot under the eyes.
Dr Chan told me to spray a glow minerals hydrating mist on my face when it was feeling hot. I used it every 15 mins for the first couple of hours until the heat of my face started to subside. Dr Chan also gave me a vinegar spray to use for itching and tightness.
Prior to my first treatment, I had purchased from Dr Chan, the Cosmedix rescue balm and sea buckthorn quad active serum to apply to my face after the first 24 hours of treatment. The Cosmedix products are the best range of products you will ever use, I have used them for two years and they helped my skin immensely. If you can afford them, the products are worth purchasing!
When I got home I sprayed my face with the Cosmedix mystic spray every half hour till I went to sleep.
I slept with gloves on so I didn't knock or touch my face, propped up pillows to minimise swelling and tried to sleep on my back!
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Day 2
I didn't sleep very well because I usually sleep on my side or stomach. I didn't have much discomfort on my face just minimal soreness to touch and my face and eye area is very swollen. My face is starting to look more red and bronzed.
I definitely know that spraying my face every half hour with the mystic spray helped with tightness and discomfort (c.f. PSR 1.5 treatment, I didn't apply anything to my skin for the first 24 hours and then the next day I couldn't even move my face due to the tightness).
I washed my face for the first time at 1:30pm 24 hours post treatment. I used the Cosmedix benefit cleanser (for sensitive skin). I gently splashed my face with tepid water, then used a small amount of the cleanser and emulsified it before dabbing it on my skin. It stung a little. I rinsed my skin by splashing water on my face. Then I sprayed on the vinegar mix and left it on for a few minutes to soothe the skin.
I splashed more water on my face to remove the vinegar mix and then dabbed my skin dry with a soft towel. I then applied the mystic spray, the serum and the rescue balm by dabbing them all over the face. I then sprayed some of the Cosmedix reflect SPF 30 on my face to protect from any ultraviolet rays. Even though I am inside the sun still comes through the blinds.
After having my first PSR treatment I learned that from the minute your treatment is complete you must treat your skin like an egg shell (i.e., since the skins surface acts as a biological dressing, you must assure it remains intact until it is ready to shed on its own with absolutely no help from you!) If you don't you will increase risks of serious complications.
This whole process will now be my daily washing, bathing and product application ritual until my face has completely healed!
The vinegar spray really helped the tightness and itching. I am so glad I used it this treatment.
I had no real discomfort all day except the swelling around my eyes.
I will sleep with gloves on again, pillows propped up and on my back until my skin has fully healed.
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Day 3
My face was really swollen again. My face feels really tight and it looks really red and bronzed. I have almost no striping on my face (zebra effect), only a really small area on my forehead.
Dr Chan is always really thorough to cover the whole face. I have read some stories via the internet where people have had a lot of areas of the face missed because the doctor is not thorough enough! Lucky Dr Chan is a perfectionist.
I washed my face this morning and it stung a little more today than yesterday but the vinegar helped again. After I applied all my products my face was stinging a bit but subsided after about 15 minutes.
By mid afternoon my eyes were aching quite a lot, light sensitive and I found it hard to focus, due to the swelling. I think I will take some Panadol. Today would be the most uncomfortable day since I have had my treatment done.
My face stung when I washed it before bed but the vinegar helped a little. It feels really tight and sore at present. Hopefully I will get some sleep! |
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Day 4
I had about 2 hours sleep because my face felt too tight and sore to move. When I awoke this morning I had an ulcer on the left side of my chin (this also happened to me with the PSR 1.5 treatment) and some blisters on my left cheek also. I took silver colloid (natural antibiotic) as I did with my last treatment. I also took some Panadol for the discomfort.
Washing my face was quite uncomfortable again and it didn't matter how much cream, serum and spray I applied to my face it is still unbearably tight and sore. I know it will pass, as it did with my last treatment, but this time I can't wait for that time to come. It is not so much painful as it is irritating because I also feel like I can't eat or my face will crack.
I sent Dr Chan an email with a photo of my face to see if I had to go on pharmaceutical grade antibiotics. He said it looks fine for now and to let him know if anything changes.
After washing my face and applying creams before bed my face was stinging and really tight and quite painful. Hopefully I will get some sleep tonight.
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Day 5
I didn't sleep at all again I was in too much pain. My face was unbearably tight and stinging like crazy. I took some Panadol and aspirin but neither did any good.
When I washed my face today some skin came off around the nose area and the chin. I was hoping that this would make some of the tightness subside but it didn't and then when I applied the creams it was stinging again because the skin is still very red underneath with some white areas also (all which is normal). The ulcer is starting to heel. One positive at least!
I ceased using the vinegar wash now because my skin is starting to peel.
Poor Dr Chan, I had to write to him again to ask him what pain medication I can take because I am not coping very well. I was sick the day before I got the procedure done, so I am wondering if that is why I am not coping so well with this whole process. Dr Chan said that it is not normal to be in this much pain and suggested voltaren and some paracetamol. It is 36 degrees today, so I am sure that is making the swelling and tightness worse.
I called my partner and he got me some nurofen and soov. I took some nurofen and then cleansed my face and then applied the soov. Finally relief for now! Because it is an antiseptic cream and numbs the skin, I might actually get some sleep!
I have read a lot about the portrait on forums on the internet and most individuals experiences are not like mine but on one website (Dr Garcia) I did read that healing time can be delayed for those with thin/delicate/sensitive skin types.
On the shore laser website under Other considerations and complications of PSR it says: all skin resurfacing procedures carry some risk, and the variations in patients response to even a mild and controlled injury deserve mention. So I guess I am one of those patients! Sometimes it is a good thing to read about an experience that is not strictly textbook in terms of the suggested time frame for the post-healing phase, because then you don't overreact when things don't go according to that plan.
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Day 6
I didn't sleep again, my face was too itchy, swollen, tight and I had these sharp pains in my face, now and then, like little pinpricks. I had to get up every couple of hours and reapply the soov.
After cleansing today I applied the rescue as a heeling balm and then put lots of petroleum jelly on my face. This seemed to make some of the tightness go away and then I took some nurofen plus for the discomfort. In hindsight I should have been lathering my face with petroleum from the first day I had my procedure done.
Although the cosmedix rescue is a great healing balm I feel that you need something thicker and more moisturising to prevent tightness and crusting to the degree that I had. I would suggest use of both products from day one: the rescue heals whilst the petroleum jelly draws moisture to the surface of the skin.
Each product brings with it different benefits of which your skin needs both. Then I would have used the seabuckthorn serum after my skin had peeled completely. Hindsight would have been good but I guess you live and learn?
I have been drinking plenty of water, eating lots of fruit and veges and taking my vitamins.
When I washed my face in the late afternoon more than three-quarters of my face sloughed off. I think it is too early for my skin to be coming off because it is still so sore. Where I had the blisters and the ulcer the skin remained intact because I was gentle washing my face. When I put the serum and rescue on my face it stung like crazy for hours. It feels extremely raw and sensitive. I wish the skin could have stayed on longer even though with the crust on my face it did pull the skin tighter and made it itchier in places.
I put more numbing cream on before bed and took more nurofen plus. Hopefully this is the last night I need to use the numbing cream as I find that it is not very moisturising.
My skin was so sensitive that when my partner had the fan on I couldn't handle it because the slight breeze I felt on my skin made it unbearable itchy and uncomfortable. At this point I knew how raw and fragile my skin was.
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Day 7
I had a couple of hours sleep, finally. I need lots of sleep or my skin will not heal properly.
After cleansing my skin this morning I noticed that where the blisters were there were a few tiny ulcers present again. I know lack of sleep and having been sick previously will definitely be contributing to the formation of ulcers. I only used the rescue today and put some cosmedix sunscreen on: reflect SPF 30. I haven't been able to use sunscreen for a few days because my skin had been too irritated. Dr Chan said to me not to put too many products on my skin so as to not irritate the skin.
My skin was really raw all day today: tingling and itchy. It is really red raw in some places and really white in others. Before bed I put lots of rescue on and some Vit E from the capsule on the areas that have had ulcers. Hopefully it will heal ok.
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Day 8
I had a couple of hours sleep, finally. I need lots of sleep or my skin will not heal properly.
After cleansing my skin this morning I noticed that where the blisters were there were a few tiny ulcers present again. I know lack of sleep and having been sick previously will definitely be contributing to the formation of ulcers.
I only used the rescue today and put some cosmedix sunscreen on: reflect SPF 30. I haven't been able to use sunscreen for a few days because my skin had been too irritated. Dr Chan said to me not to put too many products on my skin so as to not irritate the skin.
My skin was really raw all day today: tingling and itchy. It is really red raw in some places and really white in others. Before bed I put lots of rescue on and some Vit E from the capsule on the areas that have had ulcers. Hopefully it will heal ok. |
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Day 9
Christmas day today! My face was really itchy all night again so I didn't get much sleep.
I washed my face as soon as I awoke and applied the cosmedix emulsion and rescue. It felt good to put one of my normal moisturisers back on. The emulsion is a great post resurfacing moisturiser as it has shea butter and other great ingredients. My skin is really red today again and scabby.
I went to my sister's house for dinner and because it was so cold she had the central heating on and my face was burning and itching like crazy. It dried my skin out badly.
I kept getting up all night to put the rescue balm on because of the heating drying out my skin and making it so itchy.
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Day 10
My skin is blotchy and itchy again today but the redness has toned down a little bit since yesterday.
I washed my face and applied some emulsion, rescue and cosmedix reflect SPF 30. This sunscreen is the best as it calms down the skin a lot and doesn't irritate as it is made for post resurfacing procedures, peels etc.
All day it was itchy again but I know the central heating makes it so much worse.
After cleansing, some of the scabs came off but the skin is very raw red underneath. I think I will take a while to heal and for the redness to fade.
Day 11
Finally, I slept right through the night, without waking up once to apply more cream.
My skin is not as tight or itchy but the redness is still very apparent. The few fine lines I had around my eyes appear to be gone but I know that this is temporary because of the minor swelling still evident but apparently remodelling has already begun.
After cleansing, I noticed that my nose was starting to get a little congested from all the creams that I have had to apply over the past eleven days. I have read that breakouts are a normal occurrence after a high-energy treatment such as PSR2/3 and less likely after PSR1.
I applied the emulsion, rescue and reflect SPF 30 again today and will continue to do so until the skin has completely healed.
Day 12
When I awoke today I had quite a few breakouts on my chin and nose. A lot of the scabs have come off now but the skin on my cheeks and chin area is still quite red and my skin still feels like sand paper.
I wish I could use my retinol products for the breakouts but apparently you are not suppose to use any AHAs or retinoids for at least 6 months after a high energy treatment because they can burn the skin.
Day 13
I decided today that I need a really strong sunscreen in case I need to go outside, so I purchased a new sunscreen: the Cosmedix Serious Protection, it is suppose to be the best sunblock on the market because it has the highest content of zinc oxide, which blocks UVA, UVB and UVC rays.
After cleansing I used rescue and then the serious protection.
By the end of the day my skin was much calmer and less itchy. The redness had also toned down a little too. My pores appeared less congested also.
Awesome products. I can't wait to see what my skin looks like when it heals. Apart from the pigment having disappeared for the mean time, it is a little hard to see much improvement because my skin is still red and blotchy.
Day 14
Each day my skin becomes a little less red but it is still raw and sensitive and at times itchy. My skin is not quite as oily today and congestion is starting to disappear. I still have this rash/blotchiness on my face, especially where the blisters and ulcers were. It looks like it won't go away until the skin is fully healed!
I am just going to use the serum during the day with the sunblock and use the serum and the rescue at night. |
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Day 15
Its New Years Eve and I don't think I will be going anywhere by the looks of my skin! It is still too red and blotchy to go anywhere and it feels like sandpaper. It has improved day by day but not enough to go anywhere yet.
I can see some improvement with my skin in terms of less pigmentation, refinement in scars and increased firmness of the skin but in terms of texture it is difficult to assess at this point in time.
Day 16
My skin is very blotchy today but I think it is hormonal this time. Certain areas are still very sensitive to touch and my skin has been very itchy which is exacerbated by the fact that it is extremely hot and humid today. My skin always calms down once I have applied my creams.
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Day 17
After waking up my skin always looks calm and less red but after I wash it, it flares up again. I think I may have dermatitis on my face because it is getting worse day by day.
I used the emulsion and the rescue at night to heel the dermatitis.
Day 18
My skin is less irritated this morning so using the richer creams at night seems to help.
I have decided to use the serum during the day with the sunscreen and the emulsion and rescue at night. I will see how this goes. It is annoying having skin that is surface dry but still breaks out as one thing seems to flare up the other!
In terms of texture my skin feels a little less rough today than previous days but still has a way to go.
Day 19
Now that a lot of the redness is healing I can see how the scars are looking. Some scars seem to be a little more refined but I can also see some indentations that were not apparent before the treatment. Hopefully they will disappear once the collagen remodelling is completed.
Due to the fact that aggressive sunscreen use is mandatory at this point, I did some research today on sunscreen application and effectiveness. Apparently, I haven't been applying my sunscreen correctly! Often referred to as the teaspoon rule it is a guide to the correct application of sunscreen.
According to the rule, people should apply more than half a teaspoon (about 3mls) of sunscreen to the face/neck and each arm, and just over one teaspoon (about 6mls) to the chest/abdomen, back, and each leg. This means that close to 35mls is needed to cover the average adult body with a coating thick enough to reach the full sun protection factor (SPF) rating. Using half the required thickness of an SPF 25 would only give protection equivalent to an SPF 7. I also learnt that the difference between a SPF 15 and 30 is only about 4% (i.e., SPF 15 has UV protection of 93% and SPF 30 has 97% UV protection).
Day 20
My skin is calming down day by day in terms of redness and blotchiness. It still feels rough but I think the blond hairs growing back on my face don't help either. I applied lots of sunscreen to my face today after applying the serum. But apparently you have to wait at least 15 minutes to apply an inorganic sunscreen after applying a moisturiser, so that the moisturiser doesn't dilute the sunscreens effectiveness.
Day 21
My skin today has broken out again because I put Vit E oil on last night where I had the more severe burns. The dermatitis has still settled though. My skin feels a little softer today than yesterday.
I have a few dots around one cheek and near my left eye, but I can't work out whether it is pigment or just redness. Hopefully it is just redness! I think it will be some time until I can assess what improvements I have exactly.
UPDATE: ALMOST 3 MONTHS LATER
At this point my skin has almost healed. It is still a little more red where I had the blisters and ulcers than the rest of my face but barely noticeable. My skin is still fairly sensitive, so I have only just started to re-introduce some of my more active Cosmedix products such as the retinols and lightening serums a few times a week.
Almost all my pigment is gone and my scars at this point have improved by 60%. Immediate improvement was evident with respect to texture and tone. My skin is much softer and complexion more even. In terms of wrinkles, I didn't really have many to begin with but the few I did have are much more refined.
At this point I am very happy with the results and have no regrets. Had my skin not been so sensitive and thin I would have had the PSR 3 treatment because with getting such good results from the lower level treatment I could only imagine what results one could get from the higher-level treatment.
My treatment program is suppose to consist of three lower level treatments and so far I have only had two but I am going to wait six months to assess if I need another treatment!
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