CO2 Laser Ablation of Xanthelasma Lesions Aftercare

What to Expect After Treatment

Xanthelasma lesions around your eyes have been removed using precise CO2 laser ablation. The treated areas will appear as small wounds that will heal over 2-4 weeks. Because the periorbital (around the eye) area is delicate and vascular, some swelling and bruising are normal and expected.

Timeline of Healing

Days 0-2: Redness, swelling, possible mild bruising or “black eye”
Days 3-7: Scab formation begins; swelling reduces
Days 7-14: Scabs fall off naturally; pink skin underneath
Weeks 2-6: Pink colour gradually fades
Months 3-6: Final colour match and texture normalisation

Immediate Post-Treatment (Day 0)

First Hours

Mild discomfort, swelling, and redness are normal
Eyes may feel puffy—this typically peaks on Day 1-2
Apply cold compresses gently around (not directly on) the treated areas for 10-15 minutes every 1-2 hours
Use clean gauze or soft washcloths with ice water
Sleep with head elevated on 2-3 pillows to minimise swelling

Initial Dressing

A light non-adherent dressing and antibiotic ointment will be applied before you leave the clinic
Keep this dressing in place for 24 hours
Do not get the area wet during the first 24 hours

Days 1-10: Active Healing Phase

Wound Care

After 24 hours, gently remove the dressing
Begin applying chloramphenicol ointment to the treated areas 3-4 times daily
Use a clean cotton bud or freshly washed fingertip
Apply a thin layer directly to the wound
Continue until scabs have formed and fallen off naturally (typically 7-10 days)

Cleansing

Keep the area clean and dry
You may gently cleanse around (not directly on) the wounds with lukewarm water and mild soap from Day 2
Pat dry very gently with a clean towel
Avoid rubbing or scrubbing

Scab Management

Scabs will form between Days 3-7—this is normal and protective
Do not pick, scratch, or remove scabs prematurely
Premature removal can cause scarring, infection, or pigmentation changes
Allow scabs to fall off naturally, which usually occurs between Days 7-14
If scabs soften during cleansing and gently lift away, this is acceptable

Days 10-28: Recovery Phase

As Scabs Fall Off

New pink skin will be revealed underneath
Once scabs have completely shed, discontinue chloramphenicol ointment
Switch to a gentle, fragrance-free moisturiser or healing ointment (Aquaphor)
Apply 2-3 times daily to keep the area supple

Sun Protection (Critical)

The new skin is highly susceptible to UV damage and hyperpigmentation
Apply high-SPF sunscreen (minimum SPF 50) to the area daily once scabs have fallen off
Wear sunglasses when outdoors
Avoid direct sun exposure for at least 6 weeks
Use a wide-brimmed hat for additional protection

Important Restrictions

Avoid for 2 Weeks Minimum:

Rubbing or touching the treated areas
Eye makeup or cosmetics near the treated sites
Swimming pools, hot tubs, saunas
Excessive sweating from strenuous exercise
Hair sprays or facial products near the eyes
Dusty or dirty environments

Avoid for 6 Weeks:

Direct sun exposure (essential to prevent hyperpigmentation)
Tanning beds
Other laser or energy treatments near the area
Facial waxing or threading near the eyes

Managing Swelling and Bruising

Swelling

Mild puffiness or swelling is normal, especially in the mornings
Typically worst on Days 1-2, then gradually improves
Sleep elevated
Cold compresses help reduce swelling
Usually resolves within 3-5 days

Bruising

Some patients may develop bruising or a “black eye” appearance
This is more common with deeper or larger lesions
Arnica cream may help speed bruising resolution (apply to surrounding skin, not directly on wounds)
Bruising typically resolves within 7-14 days

Skincare and Cosmetics

Eye Care

You may use artificial tears if eyes feel dry or irritated
Apply Vaseline to lips if needed
Be gentle when removing any eye discharge

When to Resume Makeup

Wait until all scabs have fallen off and wounds are fully closed (typically 10-14 days)
Use only fresh, clean makeup products
Apply gently and avoid rubbing

Medications

Chloramphenicol 1% Eye Ointment

Your primary wound care treatment
Apply 3-4 times daily to the wound sites
Provides antimicrobial protection and keeps wounds moist
Continue until scabs form and fall off
Wash hands before and after application

Pain Relief

Discomfort is typically mild
Paracetamol 500mg-1g every 4-6 hours as needed
Avoid aspirin and NSAIDs for first 48 hours if bruising is present

Warning Signs

Seek medical attention immediately if you experience:

Increasing redness, warmth, swelling, or pain after Day 3
Yellow or green discharge, or pus
Spreading redness or inflammation
Fever or feeling unwell
Vision changes or eye pain
Signs of infection

Potential Complications

Post-Inflammatory Hyperpigmentation

Temporary darkening of the treated area may occur, especially with sun exposure
This is why sun protection is critical
Usually resolves over 3-6 months with proper care
More common in darker skin types (Fitzpatrick III-VI)

Hypopigmentation

Treated areas may be slightly lighter than surrounding skin
Usually minimal with proper technique
Typically improves over 6-12 months

Recurrence

Xanthelasma can recur, especially if associated with high cholesterol
Consider cholesterol screening and management with your GP if recurrence occurs

Expected Results

Most patients achieve excellent cosmetic results with smooth, clear skin in the treated areas. The pink colour typically fades to match surrounding skin over 3-6 months. Single treatment is usually sufficient, though occasionally a touch-up may be needed for deeper or larger lesions.

General Advice for All CO2 Laser Treatments

Lifestyle Factors That Support Healing

Nutrition

Eat a balanced diet rich in protein, vitamins A, C, and E, and zinc
Stay well hydrated (2 litres water daily)
Avoid alcohol for at least 7-14 days post-treatment (impairs healing)

Smoking

Do not smoke during the healing period
Smoking dramatically impairs wound healing and collagen formation
Increases risk of infection and poor scarring

Sleep

Aim for 7-9 hours of quality sleep nightly
Sleep with head elevated if facial treatment
Clean pillowcases daily during healing

Stress

Minimise stress—stress hormones can impair healing
Rest and relax during the recovery period

Sun Protection Cannot Be Overstated

Why Sun Protection is Critical:

UV exposure on healing or recently healed skin can cause permanent hyperpigmentation (dark marks)
This is especially important for patients with darker skin types (Fitzpatrick III-VI)
Post-inflammatory hyperpigmentation can take months to years to fade if it occurs

How to Protect:

Use SPF 50 broad-spectrum mineral sunscreen daily
Reapply every 2 hours outdoors
Wear protective clothing, hats, and sunglasses
Seek shade
Avoid sun exposure between 10am-4pm
Use sun protection even on cloudy days and indoors near windows

Contact Information

For any concerns, questions, or complications, please contact us.

In Case of Emergency:
If you experience severe symptoms outside of clinic hours (severe pain, signs of serious infection, allergic reaction, breathing difficulties), seek immediate medical attention at your nearest Emergency Department or call 999.

Final Notes

These aftercare instructions are based on current best practice and are designed to optimise your healing and results. Every patient heals differently, and you may experience variations from the timelines described. The most important principles are:

Keep the treated area moist (for resurfacing) or clean and protected (for lesion removal)
Do not pick, scratch, or interfere with scabs or peeling skin
Protect from sun exposure rigorously
Watch for signs of infection and seek help promptly
Follow the instructions exactly as provided

Your commitment to proper aftercare will directly impact your results. If you have any questions or concerns at any point during your recovery, please do not hesitate to contact Dr Brad's clinic.

We are here to support you through your healing journey and help you achieve the best possible outcomes.