Ultrasound/RF (Level 2) | Epione

Ultrasound/RF (Level 2)

Laser Skin Resurfacing (Coolaser and CoolFrax)

Pre Treatment Instructions

  • In order to avoid skin discoloration avoid deep tanning (tanning beds, tanning creams) four to six weeks prior to the treatment. If you must go in the sun, use a sunscreen SPF 30 or greater.
  • Shave the area to be treated within 12 hours prior to the treatment if necessary.
  • Laser Skin Resurfacing is not recommended for you if you are breastfeeding or pregnant, or allergic to heat or cold. Consulting with a doctor is important before finalizing any major decisions.
  • Additionally, always tell your physician about any medical conditions that you may have so as to customize an ideal treatment plan for you.
  • Do not schedule important social activities, meetings, etc., immediately after the procedure.
  • Do your daily workout before your appointment for Laser Skin Resurfacing.
  • Do Not Use aspirin, alcohol, NSAID’s (ibuprofen, Naprosyn, etc.), vitamin E, Gingko and St. John’s Wart for 10 days prior to treatment. It is recommended that two Tylenol be taken one hour prior to the procedure.
  • If you have a history of perioral herpes (cold sores), and you are having your face treated, prophylactic antiviral therapy must be started before treatment commences and continued one week after treatment.

What to Expect

  • Discomfort
    You may experience discomfort, a burning sensation, or pain during the first few days. A topical anesthetic is usually used to block pain during the laser skin resurfacing treatment, but some degree of discomfort will occur after the anesthetic effects have worn off. This pain may persist for several days. You can take a Vicodin (if it has been prescribed to you). If pain persists, call our office.
  • Redness of Skin
    Erythema or redness of the skin may occur for a 2-6 month period and possibly longer. Using Epione Super-Healing ointment will reduce the redness.
  • Swelling
    Temporary edema (swelling) or ecchymosis (bruising) of the tissue of the face and neck and especially the eyes, usually will subside in 3–7 days. Keeping your head elevated when sleeping will reduce this. Using cool soaks also helps reduce this. If the swelling persists taking 25 mg Benadryl (if your doctor has recommended it) can be very helpful.
  • Wound Healing
    Oozing, weeping, crusting and flakiness of the treated area is rare but may persist for the first week. Gently wash your face with cool soaks and a mixture of hydrogen peroxide wash (mix two tablespoons of hydrogen peroxide with 6 oz of water and use in spray bottle) and continue with Epione Super-Healing Ointment.
  • Cysts or whiteheads
    Milia or cysts, especially in the eyelid skin region (if the eyelid skin is included in the area of treatment by the laser energy) may occur. This occurrence happens particularly if ointments are used in the post treatment phase for a prolonged period of time (stop using healing ointments after 5-10 days)
  • Skin Tightness
    Sensation of skin tightness may occur (peaks at 3–8 weeks post treatment).
  • Contact Dermatitis
    Contact dermatitis (irritation) may occur due to the post-treatment use of topical preparations ointments.
  • Herpes Simplex Dermatitis (Fever Blisters)
    Occurrence or recurrence of herpes simplex dermatitis is also a possible short-term effect, particularly if it is not pre-, intra-, and post- operatively treated with a systemic antiviral medication such as Valtrex. Please inform us of your history before we begin treatment.
  • Skin Itchiness
    Pruritus or itching in the early healing phase may occur. Using Epione Super-Healing ointment will help. Or you may take a 25 mg Benadryl (if your doctor has recommended it) at bedtime.
  • Skin Hyperpigmentation
    Transient hyperpigmentation (darkening of the skin) is another possibility, especially in darker-skinned people. This would typically occur at 3–8 weeks post-laser treatment. Avoiding sun exposure, heat, and even ultraviolet light and computer rays will help reduce this phenomenon. You must also adhere to the full post treatment regimen recommended for you to avoid occurrence of persistent hyperpigmentation.
  • Increased Susceptibility to Sun:
    Because of the temporary thinning of the epidermis and dermis and reduction in the number of melanocytes (pigment cells in the skin), you may be more susceptible to the photo-aging effects of sunlight and the carcinogenic (cancer-producing) effects of ultraviolet wavelengths inherent in sun exposure and tanning devices. You will also be much more susceptible to hyperpigmentation.
  • Scarring
    Risks of scarring are rare but exist in all cases. It is variable and is often related to an individual’s genetic makeup. Scarring can be reduced by carefully following appropriate aftercare instructions and notifying your physician if a problem develops.
  • Skin Pigment Changes
    Skin color and texture changes may occur. At the junction of the treated and untreated areas, there may be a difference in color, texture and/or thickness of the skin.
  • Infection
    Infection is a risk that occurs in any laser procedure. It is minimized by proper post-operative care. Mix two tablespoons of hydrogen peroxide with 6 oz of water and use in spray bottle.
  • Numbness & Change in Sensation
Treated areas may temporarily experience variable degrees of numbness and/or change in sensation because small nerve fibers may be disturbed during the procedure.
  • The risk of any side effect depends on the area(s) treated.

Post Treatment Care

Follow the chart at the bottom of the page
  • Do not smoke for at least 48 hours following your treatment, otherwise healing time may be prolonged.
  • Skin tightness and/or itching: Use Epione Super Healing Ointment immediately after and for the next 2 days until initial inflammation has subsided.
  • Discomfort and/or pain: You may use Tylenol or Nyquil or other over-the-counter pain medications. Avoid aspirin or aspirin-like medications for 2 weeks. You may apply cool compresses or cold water spray on the treated area to reduce swelling, tenderness, and bruising for a short period.
  • Redness, swelling, irritation: Most people describe the sensation as a sun burn. This usually lasts a few hours or longer, but it will subside shortly. The redness may last up to 10 days. Avoid rubbing, scratching or picking the area.
  • Washing: Wait at least 12 hours (next morning) to wash your face. Cleanse your face with a mild cleanser such as Cetaphil. Use the cleanser for the duration of the healing process. DO NOT use any scrubs or irritants such as Retin-A, Benzoyl Peroxide or any astringents. Skin always should be patted dry and NOT rubbed.
  • Hydrating: Apply Epione’s – Super Healing Ointment or Aquaphor on the treated area (avoid getting inside the eyes) a few times a day to keep the skin well moisturized. Leave the Super Healing Ointment or Aquaphor on while sleeping, and steam in the shower the following morning. Starting on Day 4 you can use a warm wash cloth in large, gentle circular motions to remove the ointment. Remember – DO NOT SCRUB. Avoid use of any other moisturizing products (lotions, serums, liquid sunscreens, etc.) for at least 5 days. Using these products will prevent your skin from peeling and may hinder the full benefits of the laser skin rejuvenation procedure.
  • Eating: There are no dietary restrictions following the procedure, although we do recommend avoiding spicy and physically hot foods for one week. Drink plenty of water.
  • Shower: You may shower the next morning after treatment. Do not use drying astringents, exfoliants, irritants, scrubs, or shavers on the treated area during the healing process as this may cause irritation or even worse, damage your sensitive skin. Use lukewarm water and mild soap (Cetaphil). Pat dry the skin and keep the treated area well moisturized after showering.
  • Exercise: Strenuous activity is restricted for 3 days. Slowly increase activity after this time.
  • Sun: Avoid any sun exposure to the treated area for the first week. After that, avoid prolonged sun exposure and protect yourself when you are near any windows (cars, etc.) if the treated area is exposed. Protect the area from excess sun for 2-6 months, wearing sun block (SPF 30 or higher) if you must be in the sun.
  • Medications (if prescribed)
    • Valtrex: 1000 mg: one tablet by mouth once a day for 7 days
    • Vicodin: I tablet by mouth once every 6 hours or as needed for pain
    • Valium: to help you sleep; one tablet by mouth at night.
Do not discontinue your other meds unless you have been instructed to do so by your physician.
  • For approximately 48 hours after treatment (or until redness is reduced):
    • Avoid extensive sun or heat exposure
    • Avoid wearing make up
    • Avoid strenuous exercises and sauna or getting a massage
    • Avoid hot showers, baths or hot tubs
    • Avoid alcoholic beverages. Alcohol has a tendency to worsen swelling and bruising
    • Make sure that you drink plenty of water.

Length of Benefits

  • The benefits of laser skin resurfacing can vary greatly depending on the area(s) treated. They can last from 4 weeks to semi-permanent after multiple treatments.
  • Every patient has a different body and factors such as age, sleep, medication, diet, stress, weight, and hormones can affect the resolution of veins. In most cases, additional treatments may be recommended for complete clearing.
  • The results will be temporary at first, and you will find that the first few treatments’ results initially last approximately 1 to 4 months. Maintaining a long-term plan with regular appointments will increase the longevity of the results of subsequent treatment sessions.

Your next visit

  • Return for your next treatment every 4-8 weeks to maintain results or as recommended by your physician.

When to Call

  • If you have increased swelling, scabbing or bruising, worsening after 48 hours
  • If swelling and redness persist after a few days.
  • If you have severe or increased pain.
  • If you have an oral temperature over 100.4 degrees.

For Medical Questions, Please Call

Post Treatment Instructions

Post Treatment Instructions Phase 1: Recovering (cool + wet) Time period: First 24 hours (or until skin is no longer warm to touch)
You may experience a burning sensation on the treated area that can last from 30 minutes to 72 hours, or possibly longer. Start the cooling process immediately after your treatment. You may use many methods to reduce the heat that is generated due to the laser treatment and to reduce inflammation.
  • Gently wash the face with a mild soap twice a day (do not rub or pick your skin)
  • Spray ice cold water on the skin 3–4 times an hour during waking hours
  • Fan the skin

Phase 2: Healing (hydrate + calm)

Time period: First 72 hours after the treatment or until skin is completely healed and is no longer irritated.
The laser treatment may result in an appearance similar to a darker tan or sunburn in a day or two. A fine scab may have formed over the skin within a couple of days. Begin process immediately after your treatment. This process prevents scarring, promotes healing, reduces itching and redness.
  • Gently wash the face with a mild soap twice a day (do not rub or pick your skin)
  • Follow this by applying a thin layer of Epione’s “Healing Ointment” or “Super Healing Ointment” to the entire area
  • Leave a thick layer of Healing Ointment or Super Healing Ointment on the skin overnight
  • You may use steam shower once a day to gently allow the skin to peel off. DO NOT SCRUB.

Phase 3: Restoration (week 3 +)

Time period: Once your skin is completely healed (no longer irritated or pink) you can gradually work up to using your therapeutic creams in the following fashion. Remember do not abruptly stop using your creams. If for any reason you choose to discontinue your creams you may do so in a gradual fashion.

Phase I: Immediately after treatment for the next 24 HOURS ONLY

Step 1 Epione Cleanser
Step 2 Epione Super Healing Ointment and Epione Calming Spray Apply a thin layer 1–2 times a day for 24hrs only.

Phase II: Day 2–7

Step 1 Epione Cleanser
Step 2 Epione Calming Cream Apply a thin layer 1–2 times a day (AM/PM).

Phase III: Day 7–21 (or when your skin is no longer red or irritated)

Step 1 Epione Cleanser
Step 2 Lift Twice a week in AM
Step 3 Hydration and Eye Creme Wait 15 mins after Step 3
Step 4 Sun block
Step 1 Epione Cleanser
Step 2 Firm and Fade/Restoration Twice a week in PM
Step 3 Flawless and Eye Creme Wait 15mins after step 3

Phase IV: Starting 3 Weeks after treatment

Step 1 Epione Cleanser
Step 2 Lift Every day or every other day in AM
Step 3 Hydration and Eye Creme
Step 4 Sun block
Step 1 Epione Cleanser
Step 2 Firm and Fade/Restoration Every day or every other day in PM
Step 3 Flawless and Eye Creme Wait 15mins after step 3


You have to get used to these creams. They are very strong so it does take time for your skin to get used to them. So as long as your skin is not overly irritated applying the creams every other night, you may begin using daily starting three weeks after treatment. The more you use the creams, the better.
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