Co2 laser resurfacing is by far the most powerful skin rejuvenation technique available for facial skin.
It is performed in order to:
- Completely renew facial skin
- Tighten the skin to help reduce the consequences of laxity
- Remove wrinkles
- Improve elasticity and skin thickness
- Removing precancerous cells that may lead to skin cancer formation – Significant reduction in skin cancer risk
- Removal of Sundamage
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This is a facial laser surgical procedure performed under a special type of local anaesthetic. Treatment of skin laxity and wrinkles around the eyes can also be incorporated into the treatment.
Not all CO2 and Erbium YAG laser are the same. This is a fully ablative CO2 laser or fully ablative Erbium YAG procedure that is only performed by a handful of experienced laser surgeons worldwide. It needs to be performed using a surgical-grade CO2 and Erbium YAG laser (not an aesthetic grade CO2/Erbium YAG laser which lacks the power and the ultra-short pulse width required to perform this procedure safely). Dr Hussein is one of the few laser surgeons worldwide who have the knowledge and the experience to offer this procedure and has performed numerous cases. He uses the Lumenis Ultrapulse Alpha CO2 and Sciton Joule X Erbium YAG laser. These are the world’s most powerful and state-of-the-art skin resurfacing lasers
As you will see from the photos below Dr Hussein is capable of performing what few others worldwide are capable of. The level of skin rejuvenation is simply outstanding.
This degree of improvement will, however, require minimum 14 days at home. At this point you are safe to resume normal chores and activities and medically fit for work. However there will be ongoing redness, inflammation, grainy (orange peel) skin texture and possible hyperpigmentation. It takes 3 months for this to settle completely. So even though you are technically fit for work at 2 weeks it will take 3 months for everything to settle completely and full healing and benefits to be seen.
Dr Hussein can perform a full-face treatment including eyes OR periorbital treatment (around the eyes only). Eyelid tightening treatment with fully ablative CO2 technique is the second most effective technique to reduce eyelid laxity after a surgical blepharoplasty. For clients who are not keen on surgical blepharoplasty, fully ablative CO2 eyelid treatment will give a considerable improvement for eyelid skin laxity and wrinkles. It actually improves lower lid wrinkles and skin surface texture over and above surgical blepharoplasty.
The greatest benefit of this procedure is that the results are permanent. Once healing is complete the skin you are left with is your new skin. The procedure doesn’t have to be repeated like other cosmetic treatments such as dermal fillers. As long as the client takes good care of their skin results will last for many years before they need to consider doing anything further.
New type 3 collagen continues to be synthesized for up to 6 months post-procedure meaning that there is further improvement after the immediate healing phase. Dr Hussein is capable of performing laser resurfacing with fully ablative CO2 and Erbium YAG laser on all skin types. In general, darker skin types may encounter a higher chance of hyperpigmentation but this will eventually settle.
Perioral Lines /Smoker’s Lines/ Lip Lines / Barcode Lines – Difinitive treatment
This is one of the most bothersome issues that affects women as their skin ages. It causes the face to look prematurely aged. The only treatment that can naturally resolve this issue is deep full ablation. This requires aggressive resurfacing around the mouth. Very often significant amounts of skin tissue have to be removed in order to completely smooth this area.
The intraoperative photos below give an indication of the resurfacing depth. There are few laser surgeons around the world who have the expertise and skills to perform this kind of level of full ablation resurfacing. Healing has to be closely monitored and aftercare instructions must be strictly adhered to in order to minimise the risk of infection, excessive inflammation delayed healing and scarring.
The result of deep perioral full ablation is restoration of normal skin around the mouth, The result therefore looks entirely natural as it is natural. This type of rejuvenation is intrinsic and permanent. Doctors often struggle with alternatives such as fractional laser as this type of laser does not remove the abnormal elastotic tissue. Dermal fillers give very poor results and yet are often used in poor attempts to correct this issue.
PERIORAL / LIP LINE / BARCODE LINE GALLERY
DR HUSSEIN’S CASE GALLERY – BEFORE & AFTER
DR HUSSEIN’S CASE GALLERY VIDEOS
PROCEDURE DETAILS
Once the patient has seen Dr Hussein for a consultation and treatment has been deemed appropriate the client will be listed for the procedure. During the consultation, a prescription for prophylaxis will be discussed, once the procedure is scheduled a online prescription for the laser pack including the medications will be organised and purchased prior to procedure. These medications are to be used as instructed by Dr Hussein during the immediate few days recovery period following the procedure. Taking these medications minimises the risk of harmful side effects such as infection following this type of more aggressive skin laser surgery.
It is important that the patient has somebody available to drive them home after the procedure is performed. Clients must not expect to drive back home themselves.
Dr Hussein will see the patient before the procedure in order to prepare and clarify things. A consent form will be signed giving Dr Hussein permission to carry out the procedure. Antiviral tablets will be then administered as well as an optional sedative. Pre-procedure photos will be taken at the initial consultation, if pre procedure photos have not been taken they will be at this point, the face will be cleansed and prepared with a special type of topical local anaesthetic gel. Dr Hussein will also use additional anaesthetic techniques such as tumescent anaesthesia or nerve blocks. These involve injections of a special type of local anaesthetic under the skin.
Anaesthetic preparation will last for about 45 minutes. Following this, the patient will be moved into the procedure room and prepared for the fully ablative CO2 or Erbium YAG laser procedure. If treatment around the eye area is to be performed then the patient will have had anaesthetic eyedrops applied and metal contact lens style eye-shields will be inserted. If the facial treatment only is performed then adhesive eye-shields that stick over the eyes will be applied. In most cases, clients who opt for full-face treatment usually will want to incorporate the benefits of eyelid treatment as well. It is therefore commonplace for patients to have both treatments performed in the same session.
Once Dr Hussein has commenced the procedure it will usually take around 45 minutes to complete. The level of discomfort experienced during the procedure is typically a prickly burning sensation that usually can reach up to a 5 out of 10 subjective severity. Dr Hussein has never encountered anyone who has been unable to cope with the procedure from a pain or discomfort point of view. Pain or discomfort from this type of laser surgery is best described as moderate at the most.
Following the completion of the procedure, the patients face will feel very hot. It is best described as a sunburn sensation. This burning sensation will last for up to 24 hours before settling. Following removal of protective eye-wear, a barrier cream called CU3 cream or Eucerin Aquaphor cream is applied to the freshly treated skin. This cream acts as an impermeable barrier to protect the denuded skin from dehydration and infection.
Detailed aftercare instructions will be discussed and issued to the patient. These instructions must be adhered to strictly. Strict sun avoidance will need to be maintained in the immediate recovery phase and up to a month at least post-procedure. Sunscreen can only be used from at least a month after procedure (see details below in aftercare instructions)
Patients are at risk of infection during the first few days following the procedure. It is important to keep the face clean and strictly adhere to the aftercare instructions to minimise this risk. Dr Hussein usually gives a once a day antibiotic dose to minimise bacterial infection risk. There will also be a twice a day antiviral tablet as well. These tablets are to be continued for 14 days after the procedure. There will also be a pack containing medications for use ONLY if instructed to do so by Dr Hussein.
Dr Hussein will typically monitor day by day healing via the VIRTUAL WARD ROUND. This is through the use of ‘selfie’ photos taken by the client and sent to the contact details issued by Dr Hussein. Dr Hussein can then provide real-time advice during the first 14 days of the recovery period. Any patient having this procedure will have a direct line of communication with Dr Hussein at all times throughout recovery. Close monitoring of this nature allows any potential complications to be dealt with quickly and risks minimised.
After 14 days patients can return to work. There will still be some ongoing redness that will take a 12 weeks to settle.
Aftercare instructions must not be ignored by patients otherwise they may develop permanent scarring and textural change of the skin. A brown pigmentation on the treated areas of the face (post-inflammatory hyperpigmentation) can occur but this will spontaneously resolve. Hyperpigmentation can be minimised through sun avoidance.
POTENTIAL COMPLICATIONS
Fully ablative CO2 resurfacing is the most aggressive type of skin resurfacing procedure undertaken by Dr Hussein. As Dr Hussein is an expert in cutaneous laser surgery the incidence of side effects is low. In Dr Hussein’s hands fully ablative CO2 laser is a safe procedure.
However with any laser resurfacing treatment complications are possible. In fully ablative CO2 laser these include the following:
Post Inflammatory Hyperpigmentation (skin darkening)
This is the most common side effect. It is more common on darker skin types. Thankfully it usually spontaneously improves. Improvement can be speeded up by the addition of topical treatment. Duration usually depends on the severity of the inflammation that created it in the first place. Complete resolution can take anything from a few weeks to 6 months depending on severity. Sun exposure is the most common aggravating factor and this is why strict sun avoidance is important in the first few weeks following treatment. If the aftercare instructions are strictly adhered to one is much more likely to avoid this type of complication.
True Hypopigmentation and Pseudo-hypopigmentation (skin lightening)
Hypopigmentation is the medical term for lightening of the skin. After fully ablative CO2 resurfacing it is normal for the skin to be slightly lighter. This is due to the way that the organised collagen in the new skin reflects more light. This gives an impression of a slightly lighter colour. This effect is called pseudo-hypopigmentation. True hypopigmentation is lack of melanin production due to damage caused to melanin producing cells by thermal injury from the laser. This is rare with fully ablative CO2 resurfacing as the new skin is repopulated with new melanin producing cells from the deeper adnexal structures which are a reasonable distance away from the treated surface of the skin. If true hypopigmentation occurs, it can take many months to recover and can indeed be permanent.
Demarcation lines
This is usually only an issue if a face is partly treated (eg. Treatment limited to around the mouth for smokers lines). The new skin may be subtly different in shade to the surrounding skin leading to a visible line of demarcation between treated and untreated areas. This is less likely in lighter skin types. Dr Hussein usually prefers to avoid part treatment for this reason and will treat the whole face albeit with a variable strength depending on what needs to be achieved. This allows for a more blended result. It is important to note that if lighter freckled skin is part treated there will also be a demarcation between untreated freckled skin and treated freckle free skin.
Infection (bacterial / viral / fungal)
This can happen in any kind of laser resurfacing. HSV infection (cold sore virus) is the most common kind but is usually prevented by taking an acyclovir tablet three times daily for 7 days during the recovery period. Bacterial infection prophylaxis is also issued by Dr Hussein in the form of a once daily antibiotic tablet taken for 7 days after the procedure. Fungal infection is also a possibility and as a result Dr Hussein will include medications in the aftercare pack to treat this should it occur. It is however only necessary to start these if Dr Hussein instructs. Uncontrolled infection can then go on to result in hypertrophic (raised bumps) scarring. Thankfully if caught and treated early any problems can be prevented. This is why Dr Hussein monitors the healing closely with the use of ‘selfie’ photos daily for the first week.
Scarring
This is a possibility but exceptionally rare. The most likely cause of scarring would be uncontrolled infection. This is highly unlikely due to insistence by Dr Hussein on direct photo monitoring in the first two weeks post treatment. The second reason is due to a thermal injury directly created from the laser (burn). This is extremely unlikely due to Dr Hussein’s level of experience and expertise as well as the state of the art equipment that he uses. Some procedures carry a naturally greater risk of scarring. These are procedures where the CO2 and Erbium YAG laser are used in combination for really deep resurfacing. These procedures are mentioned below:
Peri-oral combined deep resurfacing
Resurfacing for deep wrinkles around the mouth. To efface these wrinkles required deep combined laser resurfacing that naturally carries a higher risk of hypertrophic scarring.
Combined deep resurfacing for acne scars
Where there are deeper acne scars in the skin, resurfacing depth needs to be pushed. This is commonly on the cheeks. Here there is a naturally greater risk of delayed healing, atrophic or hypertrophic scaring and hypopigmentation.
Cribiform / cicatricial scarring
This is a textured raised scarring that forms a web like pattern on the skin. It occurs very rarely in cases of delayed healing and prolonged inflammation post laser resurfacing. It is slightly more common on the forehead. It has been noted during COVID that mask wearing increases the incidence of this type of scarring. This is why DrH strictly forbids the use of any masks for 3 months after laser resurfacing.
Ectropion (Applies only to eyelid treatments)
This is a treatment in which the eyelid skin is over-tightened. It can lead to eversion of the eyelid margins and an inability to completely close the eye. Mild cases may improve with non- surgical management but more severe cases may require corrective oculoplastic surgery.
Prolonged redness (erythema)
This is not really a complication. After fully ablative CO2 laser every client will experience this to some degree. It tends to progressively settle and generally tends to takes up to 3-4 months to completely settle. It is important to understand that whilst redness remains the likelihood of developing post inflammatory hyperpigmentation (browning/tanning of the skin) still exists. It is therefore important to take sun avoidance precautions and uses SPF 50 sun block until the redness has completely settle.
Post-resurfacing contact dermatitis
This complication of laser surgery is more likely in aggressive forms of laser resurfacing such as fully ablative CO2 resurfacing. This is a form of increased sensitivity of the skin that is encountered by a proportion of individuals post laser resurfacing. In some cases it can be quite severe. Mild irritants can trigger a disproportionately large irritation of the skin (burning and itching) that then can result in prolonged redness and darkening of the skin. It is usually treated by topical steroid ointment if it occurs and eventually spontaneously settles. Triggering can be minimised by the use of mild perfume free cleansers and skin products post treatment. Dr Hussein can advise on suitable products.
Erosive pustular dermatosis
This is an extremely rare dermatological condition that can be triggered by any type of skin injury including laser. There are only a few case reports worldwide following laser sugery. It is an exceptionally rare consequence but effectively amounts to the failure of the skin to completely heal after treatment. Management would be undertaken in a specialist dermatology unit if this was to occur but the consequence of this could be permanent scarring.
Capsules as a treatment for severe acne
Severe acne treatments capsules are often cited as a potential danger with regards to laser procedures. The risk of hypertrophic scarring increases when it comes to laser resurfacing when on this medication. The difficult question is how long after cessation of the medication, is laser resurfacing safe to proceed with. Historically there has been a consensus that 6 months is the safe margin. However a growing body of evidence shows that this is far greater than necessary. In his clinical experience Dr H deems it safe to perform full ablation following a 3 month period after cessation. It is also to be noted that if the medication needs to be commenced post resurfacing it should be done no earlier than 3 months post resurfacing and in a low dose longterm course.
AFTERCARE
This treatment is designed to renew, tighten and improve the texture of the facial skin. It is an aggressive procedure and requires strict adherence to these aftercare instructions. Immediate and very visible benefits can be seen in the form of reduction in laxity (tightening), reduction in wrinkles, removal of sun damage, increase in elasticity and improvement in collagen density and thickness.
It is a procedure that is also used to improve acne scarring by causing contraction of the skin, a degree of direct physical vaporization of the acne scars and remodelling of the collagen within the deeper layer of skin (dermis). Fractional CO2 laser may also be used for acne scar remodelling but it is a considerably less powerful technique.
What you will experience following the treatment:
- You will experience a burning sensation following treatment and swelling of the face will develop over the next 24 hours. The burning sensation takes 24-48 hours to resolve.
- Over the next three to four days the face will feel tight and swollen. There can be weeping of yellowish serous fluid for up to 5 days after the procedure.
- Crusts may develop over the first few days post procedure and must not be removed. They will come away leaving fresh new skin underneath as healing continues.
- It is not unusual to experience some degree of itching between 4-6 days following the treatment. Dr Hussein will advise on how to manage this.
- At the end of 10 days the skin will have largely healed. There should be no further crusted areas. The skin will remain pink and this will settle progressively over the following weeks.
Never pick or remove skin flakes or crusts. Allow them to shed naturally. Picking will increase the likelihood of scarring.
Please note the time periods above may vary according to the strength of treatment. For example the duration of crusting may be longer in more aggressive treatments.
You will be issued with a skincare pack containing dermol facewash and Aquaphor cream. These are the only two things that should be used to maintain the healing skin over the next 4 weeks. There are also medications in the pack and you will be instructed on how to use these.
Full Ablation – Stage 1 face care (Day 1 to Day 28 post surgery)
- Products – Dermol and Aquapor/Vaseline
- Face wash after full ablation – General
After fully ablative laser the face should be washed twice a day. The first wash should be on the morning after surgery. From then the face should be washed in the morning on waking and before going to bed at night.
Twice daily face wash should be performed (morning and evening). The purpose of washing the face twice a day is to remove the residue that builds on the face as it slowly oozes serous fluid. This serous fluid tends to drip from the chin and crystallizes into a yellow crust/residue. Facewash removes this residue and the antiseptic agent in the facewash (benzylkonium chloride) reduces any microbial build up on the face. Face washing is important to minimise the risk of infection after fully ablative laser.
Face washing must not be performed more than twice a day. It is tempting to do this when the residue builds up throughout the day. However washing more than twice a day results in unnecessary trauma and irritation of the skin. This then increases inflammation and slows the healing process. By reducing the speed of healing we increase the probability of infection.
It is imperative that you wash your face twice a day. No more and no less.
How do I wash my face?
Facewash should be performed in the shower under running lukewarm water. The water must not be hot. Test it on the back of your hand as you would test temperature for a baby. Washing your face in the sink is not adequate as it is difficult to remove residue by throwing water up at your face. Check that the shower water pressure is reasonable and that the temperature is lukewarm. Rinse the face using copious amounts of shower water. Then apply about a tablespoon of dermol facewash and massage all over the face. Leave on the face for a minute to a minute and a half. It will sting and this is normal. After this period rinse off the dermol wash with plenty of warm shower water. Pressure of face massage should be enough to remove the crystalline residue.
Drying the face
It is possible to dry the face with a disposable paper towel or disposable kitchen roll. You must not use a regular towel as this is not clean enough. If you wish you can allow the face to air dry.
Hairwashing
Many patients naturally feel that washing hair should be avoided. Failure to wash hair allows build up of potentially infective debris along the hairline. This will increase the risk of infection after the procedure. Hair can be washed while standing in the shower. With your back to the shower tilt your head backwards and rinse the hair with copious amounts of lukewarm shower water. Then apply shampoo taking care to minimise shampoo foam application to the face but to also ensure that the hairline adjacent to the face is cleaned appropriately. Rinse shampoo backwards. This can be done by tilting the head backwards as if you were having your hair washed at a hairdresser.
Application of Aquaphor or Plain Vaseline (Petroleum Jelly)
The only substance that should be applied to your skin after full ablation for the first month after surgery is Aquaphor OR Vaseline. These two products are safe and the risk of irritation, inflammation and delayed healing is minimal with these products. They create an occlusive barrier over the face that stops it from drying out. This moist occlusive environment favours regeneration and healing of the skin. Aquaphor is less greasy than Vaseline and this will be contained in your laser pack. In around one percent of cases patients may suffer with contact allergy to Aquaphor. The patient usually notices this when there is persistent stinging, burning and discomfort after application. Normally Aquaphor should soothe the skin. In this case Dr Hussein will recommend switching to Vaseline. Remember Aquaphor and Vaseline are to be used for a whole month following surgery. Application of any other moisturisers or healing balms is strictly forbidden. Enough Vaseline or Aquaphor should be applied to the face to ensure good coverage of all lasered areas including the eyelids. It is unnecessary to apply overly thick layers. As it is normal for your face to ooze and be greasy as a result of Vaseline or Aquaphor you should use a clean towel over your pillow when you sleep. Change this towel daily for the first 10 days post surgery.
Sun cream / SPF
Laser procedures and application of sun cream following the procedure usually go hand in hand. Fully ablative laser is an exception to this. This is because the outer barrier layer (epidermis) has been entirely removed. Sun cream is only designed to be applied to healthy intact skin with an epidermal layer. As are most over the counter creams. Having lost this natural barrier temporarily after full ablation your skin will react adversely if suncream is applied too early. It will cause contact irritant dermatitis (a harmful inflammatory reaction to the skin). If this occurs your healing will be delayed. In darker skin patients early application of sun cream is more likely to cause inflammation and hyperpigmentation. It should therefore be avoided for at least one month post full ablation. Once sufficient settling has occurred Dr Hussein will advise sun cream to be started. This will never be earlier than one month. Excessive sun should be avoided. If you are going to develop hyperpigmentation after laser it will occur irrespective of sun cream application. You cannot prevent this from happening. However sticking rigidly to your aftercare instructions will ensure a quicker recovery. Remember sun avoidance NOT sun cream.
Common misconceptions
Patients often ask about special healing creams such as Cicalfate, Bio oil, Sudocrem, Bepanthen, Biafine, Flammazine or Silicone based gels. These are all strictly to be avoided for a total of three months after surgery. Full ablation is a very specific type of laser surgical procedure. Use of these products before three month will increase the chances of developing permanent scarring. It is imperative that you adhere closely to instructions without experimentation. Silicone based dressings such as kelocote or Stratacel will cause scarring if applied in the first three months.
Mask Wear (Covid masks)
Masks for protection against Covid transmission are strictly NOT to be worn for 3 months after the procedure. It may seem like a good idea as it hides the embarrassing redness after surgery. Use of masks in this 3 month period will lead to a inflammation, folliculitis and a fine web like scarring on the face (cicatricial scarring). This type of scarring is permanent if untreated. DO NOT WEAR A MASK FOR THREE MONTHS. DrHConsult will provide you with a mask exemption letter if necessary. Please note it is now not a legal requirement to wear a mask in the United Kingdom.
Shaving
Shaving with a razor should be strictly avoided within the first month post full ablation. Electric shavers that rub against the skin with rotary or oscillating heads should also be avoided. From day 14 post surgery a beard trimmer may be used lightly every few days if necessary. Razor shaving may be tentatively commenced 6 weeks after your procedure.
Full Ablation – Stage 2 face care (week 5 to week 12 post surgery)
Facewash
Face can now be washed normally in sink or shower with a facewash such as Avene Cleanance or Cetaphil Gentle Cleanser. Warm water (not hot) should be used otherwise you will increase redness after washing.
Moisturiser
If you are disciplined enough use of Aquaphor or Vaseline should continue for as long as possible throughout this period. It is common however to begin to become tired of the excessive greasy appearance caused by these barrier ointments. You may therefore attempt to switch to CeraVe Facial Moisturiser Cream in the morning after facewash. It is important to hydrate the skin even though you may not have used a moisturiser prior to the procedure. Failure to do this will increase inflammation and redness. Skin sensitivity is still high during this period and it is entirely possible to develop sensitivity/allergy/contact irritant dermatitis to moisturisers and sun cream. You will be able to tell if this is the case as your skin will become red, itchy, bumpy and a burning or stinging sensation will be felt. Despite the offending moisturiser or sun cream you will feel dry and tight rapidly. If this issue develops be prepared to switch back to Vaseline.
In the evening before bed and after washing it is still advisable to use Aquaphor, Vaseline or Neova CU3 copper peptide healing cream.
Products: Aquaphor, Vaseline Petroleum Jelly, Neova CU3 copper peptide cream
Sun Cream
You may tentatively start to use sun cream at week 5. Be prepared to stop using it if you develop irritation or allergy. There is no gain from protecting against the sun by invoking an allergic reaction. If you are a darker skin type hyperpigmentation is in fact more likely in this case. If sun cream irritates the face stop applying it. Continue with a default basic routine of Aquaphor or Vaseline only. If you manage to tolerate sun cream well then it is fine to apply it morning time after moisturiser.
Sun creams – La roche posay antihelios 50
Foundation/Tinted moisturiser/Anti-redness creams
It is usual at this stage to become fatigued by redness or in darker skin types, to feel self-conscious because of post inflammatory hyperpigmentation. It is normal for patients to wish to camouflage this. The risk and benefit of any product must be assessed. If that product irritates the skin redness and post inflammatory hyperpigmentation will be prolonged by its use. So the short term gain that is won through camouflage is lost by prolonging the pigmentation or redness issue. You will still be under close supervision and only a message away from the DrHConsult team at this stage. So make sure to alert the team if you believe you are experiencing a problem when commencing these types of products.
- Foundation – Lycogel Camouflage Foundation (requires colour matching) Contains SPF 50
- Tinted SPF – Skinceuticals UV protection 50 tinted / Heliocare tinted SPF
- Anti-redness – Lycogel green tint foundation for redness / Eucerin anti-redness green tint
Full Ablation – Stage 3 face care (Week 12 onwards post surgery)
In over 85% of cases patients will be able to re-instate their normal face care routine at this point. Actives can be cautiously re-introduced. Glycolic or salicylic acid exfoliators can be re-introduced. Niacinamide and anti-oxidants such as Vitamin C can also be re-introduced. After photos will usually be requested at this stage as now is the time where healing should be complete enough to make accurate before and after assessment.
Morning
Wash face with Avene Cleanance soapless gel cleanser. Apply Avene Hydrance Optimal Light moisturizer. Optional – Lycogel foundation is a specially formulated foundation that can be colour matched to your skin and safely applied post laser treatment to help mask any redness whilst things continue to settle. Apply Heliocare 360 oil free sunscreen. Occasionally this preparation can result in tightness in which case it can be substituted for the Heliocare SPF 50 UVA & UVB protection.
Evening
Wash face with Avene Cleanance face wash Apply Avene Cicalfate cream.
GOOGLE REVIEWS
1 CO2 laser in which I was supported the whole way through sending daily pictures and advice and feedback daily. Being sent home with every drug that may be needed depending on the how my skin would react after the procedure. If your thinking of CO2 let me tell you it literally knocked 10 years of me I felt totally cared for and in safe hands knowing he was always there no matter what time of day
2. Vascular laser to sort out my rosacea I don’t think I can remember a time in all my life I’ve had such beautiful flawless skin. I’ve always had high colour that’s completely disappeared now, just a beautiful pale complexion
3. Scar maintenance. After having a brow lift I was left ( which is the normal now ) 2 small scar’s just above my brow. Day 10 after surgery he wizzed over the scars with a laser to soften them up so I could get to work on massaging them, and week 12 after surgery he went over with another laser. If I told you 3 months after surgery that they have nearly disappeared I’m not exaggerating. I was advised 6-9-12 months before they would fade. Anything I ever need to have done to my skin, he is my go to. You definitely won’t be disappointed, especially if you’re looking for an outcome that you might think it’s unachievable. Thank you Dr H for always doing what I never thought was possible
Sarah age 58
Only after I found Dr H and had my scars treated by him I got results that I still can’t get used to every time I look in the mirror.
Dr H is truly passionate about what he does and I’m so happy I trusted him as I know some of these procedures may look a bit scary.
I felt extremely well looked after by dr H and his team. After having fully ablative laser done I would send a selfie to drH every day so that he could monitor the healing process and he has always been just a message away which put me at ease throughout the whole process.
I am Fitzpatrick 2 skin type with tethered rolling acne scarring. My scars haven’t completely disappeared but a degree of improvement we have achieved is over 70% which I’m so so happy with.
I can honestly 100% recommend Dr H and his amazing team if you’re struggling with acne scarring. I wish I’d found him sooner as not only I got improvement in my skin but it also has had a positive impact on my mental well-being. I highly recommend dr H and his clinic.
The results have been amazing and exactly what he predicted. From the beginning, he thoroughly explained all options, potential outcomes and ensured I was comfortable with the plan. Unlike others in London, he is not there to just take your money for no results.
He has been absolutely amazing to work with and I cannot recommend Dr H highly enough. He’s very knowledgable and has all the lasers you can imagine - and I’d trust his advice with every single one of them!
Debbie his receptionist is also amazing - she is very kind and accommodating!
I am absolutely satisfied with the result!
I already had a standard subcision in Germany but unfortunately I haven’t recognised any progress.
I am sure that people who suffer from acne scars understand my feelings of a “suddenly whole new attitude to life”.
In winter I will travel again to Dr. H for a full ablative laser treatment and I am really looking forward to meet Dr. H and his amazing team again! Thanks a lot again for that great experience!
I would not hesitate to return, Thank you so much Dr H x
I can honestly say the treatment was completely painless, most of the swelling has subsided this morning, now looking forward to seeing the results in the coming weeks and to have the co2 laser at the end of the year.
A huge thank you Dr H and his team, the service provided from start to finish was amazing.
In terms of the procedures themselves - I had Taylor Liberator Subcision in Nov 2021 & CO2 laser in Jan 2022; I really liked how upfront & direct Dr H was - no hidden costs or additional procedures required - you will be told how it is from day one. The recovery for the laser can be tough, however it’s just a few days downtime for a lifetime of feeling confident & having beautiful skin! So it’s 1000% worth it. Dr H’s aftercare is also second to none - you can contact him directly for any aftercare concerns/questions & you are monitored daily for 2weeks post laser, which really put my mind at ease. Dr H’s assistants who work at the clinic are also really lovely - they both put my mind at rest when I was nervously waiting, pre-procedures.
Overall, I am so so happy that I found Dr H - I only wish I’d discovered him sooner. I will say this; Coming from experience - do not waste your time & money on expensive procedures that will give you a mere 5% improvement (if that) - just see Dr H & get the issue sorted, once & for all! He’s truly the best.
I had taylor liberator subcision and then two treatments of CO2 laser and the results have been amazing, I would say I have seen around an 80-90% reduction in my scarring.
Dr H is extremely thorough and knowledgeable in this field, you instantly feel at ease and assured that he will gain the results he promises.
Although it is more expensive in comparison to other treatments, the results make it so worthwhile.
In terms of the procedure, it looks more scary than it feels! It just felt like a pinch when getting injected and you can’t feel the rest. The recovery time is quick.
I loved the time he dedicated to talk things through with me and the preventative measures he used, as well as his very personal approach before, during and after the procedure. It was extremely re-assuring to have easy access, particularly in the days and weeks following the procedure. I have just had my 4 month post procedure review abs and very happy with the results
Dr H has been available daily with encouragement and advice, I am so happy that I trusted in him, for me it’s the best thing I could have done and I will never be able to thank him enough for the difference he has made giving me confidence in my appearance and now I know longer need to avoid looking at myself.
Save your precious time, money and protect yourself. I really hope people are careful with him because he promises results and fails to deliver. He claims he’s the best in the UK and is very arrogant but yet can’t deliver results. He also claims that he is the only one in UK who does fully ablative laser on his website but there are many dermatologists who does the same treatment so he's not telling the truth. Stay safe everyone!
Before Dr H's amazing procedure I viewed skincare products as a method to camouflage my flaws, not as tool to enhance my appearance. A month has gone by and already my skin feels " baby smooth"!
Still have some redness and dryness to contend with at this stage, but Dr H's WhatsApp facility available to you post procedure, any concerns or queries can be dealt with - it has been an invaluable asset.
I so thankful for the care and attention I have received.
Very unprofessional
I had a fully ablative CO2 laser 3 months ago and it has changed my skin dramatically. I used to have a lot of acne scars and large pores, which at this point are significantly improved (about 50-60%) and the overall appearance of my skin is much healthier than before. The procedure itself is a bit painful but it’s totally worth it. First 3 days of the recovery were the worst part for me personally as I was very exhausted and my face was very swollen. From day 4 onwards I was gradually getting better and by day 8 I had my face fully peeled off, tough it may take a bit longer for some people. From week 2 till week 5 I’ve had hyperpigmentation which was very annoying but it has settled down at week 6. Currently, I still have a bit of pigmentation on my cheeks but it’s easy to camouflage it with a medical grade foundation. For those of you who are still unsure weather or not to go ahead with that procedure I would strongly recommend you to get in touch with doctor Hussein, you won’t regret it!
ETA: It has been a long time since this procedure now and if anything the destruction that he caused has only gotten worse as time goes by.
I had a fully ablative laser with him and my scars almost disappeared specially those on cheeks, some left (beside eyes) but are definitely better.
I tried 3 different dermatologist over a period of THREE years but did NOT got even 10% of what I've got with Dr H, taking my money and time into consideration
In my opinion, DO NOT waste you money and time if you suffer from such a problems just go there and got it sorted.
Good luck
Waited for over a year for my appointment and was cancelled without any notice or even an apology.
Staff are disgustingly rude and have no manners whatsoever.
Used to admire Dr Asifs work but it looks like the success has got to his head which is a real shame.
Money and precious time will be taken from you so please do not fall for this scam.
Stay safe lovely people.
Just wish I was referred to him earlier in my journey.
I am lost for words to say how grateful I am for the incredibly precise work he has done. Last time I saw my skin looking like this I was 13 years old!
He is very friendly and an absolute professional and perfectionist! He supervised the healing process day by day and was very responsive to messages, which made me feel very secure.
Every time I see my face in the mirror I am bursting with joy and I am only 2 weeks post treatment! Dr Hussein gave me back my confidence and I will never be able to thank him enough for the way he's changed my life!
Recently, he has done my CO2 laser resurfacing and I am extremely happy with the outcome. Skin feels a lot smoother to the touch, some old acne scars are gone completely and those that haven't have been significantly reduced, eyelids are less droopy and small under eye wrinkles are gone.
The level of professionalism and customer service that Dr H provides is second to none and I would like to extend that compliment to all the staff there that meet and greet you and make you feel welcomed as soon as you walk in. An all round excellent service that cannot be faulted or recommended highly enough. Thank you, Daniel.
Staff were very welcoming on arrival I was numbed with cream and then injections. The procedure lasted around 40 minutes mostly pain free some areas around my jaw were a bit sore but manageable as Dr H was very reassuring throughout. Most painful part I would say immediately after for around 45mins, I would say your almost in shock but that does go then it’s a very sunburnt feeling and very swollen.
Recovery is lengthy but for results we are after i would say it will be worth it in the end. Im still in recovery atm but it gets better every day. My recovery had been complicated by pseudomonas but managed quickly and effectively by Dr H, he always available through WhatsApp and prescribed what I needed straight away and got it under control.
I do have texture issues and indentation marks and probably massage Him everyday checking that it’s normal, But it is very early days and Dr H has assured me this will all go. I’m very excited to see the end result over next few months.
I will happily come back for 6 months photos Too, thanks Dr Hassien.
But was finally diagnosed correctly by dr h, he prescribed medication which has finally stopped the acne. I have scaring however rather than suggesting expensive treatment which does not work he reassured me it would clear in time. I have not given him 5 stars because I’m too scared too just in case the acne returns however he really does deserve 5⭐️
Day of the procedure
The staff at skin were as welcoming and wonderful as the first time I met them, the lovely lady who works alongside Dr h came and applied my numbing cream and put me at ease, after about a 40 minute numbing wait the lady brought me into the room where I was to have my treatment, Dr h was extremely reassuring the whole time, asking if I was comfortable, explaining everything he was doing and was even kind enough after my treatment to explain everything to my partner, since I was drowsy and tired ( please have someone to escort you home) he gave me his contact number to monitor me throughout my recovery.
Following days after treatment
Next day
My face swole as expected eyes super tight and puffy the following day, it was a little scary due to the fact I couldn't see too well, (this is completely normal and to be expected though)
Am and pm routine for 10 days
Wash with dermol apply Vaseline or aquaphor
Meds
Update Dr h with selfies
By day 2 yellow oozing and crusts were on my face (which is a good sign) and this continued for a couple of days, Dr h assured me everyday that things were going well I was healing as I should be
By day 3 all major swelling was gone and eyes looked all youthful and bright - outstanding! Skin was still peeling and gross though
Day 4-7 still around the clock aftercare and support from Dr h via calls and Watts app, things were vastly improving, any questions I had were answered promptly, Dr H was extremely supportive!
(Overall mood from day of treatment to day 4 was eat sleep and repeat lol. Plenty of high calorie snacks and fluid)
Day 7-10 fucibet cream was to be applied for 3 days am and pm followed by my Vaseline
Day 10 - today using gentle face wash and moisturising cream by a brand called ceraVe and spf 50+, skin looks brand new, little bit of rough texture on cheeks which is common after resurfacing and will always settle in a few weeks, I am looking forward to seeing my full results in 3-6 months, I don't want to speak too soon but I don't have a visible imperfection on my face! Dr h is the only person who will be performing any future treatments I may ever need later down the line in regards to laser. I have passed on his information to my sister and mother who will no doubt be in touch with him soon! Many thanks Dr H and team!
I will start by saying that I'm probably not the most obvious candidate for it as I'm only 30 and have been fortunate enough not to suffer acne scarring however I am a skin obsessive and perfectionist so I see a thousand flaws and I had it done as I wanted to get rid of some of the fine lines that had taken up residence over the last 5 years or so as well as other imperfections.
The procedure itself wasn't painful (at least not most of the time) and Dr H was very reassuring however it does leave you feeling rather in shock afterwards I found, so if you can, have someone waiting for you after. I was prepared for pain in the immediate recovery days what I wasn't prepared for was how little I would be able to see due to the swelling up around my eyes (audio books are your friend at this point people! Also plenty of painkillers and food that you can eat without having to open your mouth too wide because that will hurt too.)
I had a week off from work and then I had to go back and well looking at me was definitely pretty shocking - no longer hideous like I had been (there is a definite hideous monster stage of recover, no point sugar coating it) but pretty darn shocking. I had a lot of odd looks and as a teacher I gave my poor kids a bit of a shock but thankfully kids are super accepting. Every time I caught a glance of myself in the mirror though I'd be like "wow the kids are amazing!" they treated me just like normal after the initial morning of shock wore off and honestly I looked pretty awful for a while. Kids are way better at that stuff than adults.
You just have to roll with it and concentrate on making sure you're doing everything right to help your skin recover. I didn't rush to put make-up back on or anything because honestly why potentially mess something so major up by not just waiting a little while longer. I did unfortunately get an infection around my eyes which meant they took longer to heal overall but Dr H soon got the infection itself cleared up and he checked the selfies daily. The recovery can be hard, I expect some people heal a lot more quickly than I do but I'm not a fast healer and it isn't easy to constantly have to put yourself out there not looking like yourself. It was at least month before I started feeling like my outside reflected my inside again and it can make various aspects of life difficult.
Shortly before lockdown happened in the last week of schools being open I was wearing very light make-up again and looking passably normal but although probably not noticeable to most people I was pinker in overall tone and that takes a long time to fade. I was finally feeling attractive again though - yay! I think my skin appreciated lockdown and having more time of zero commute/pollution/little make-up as it gave it more recovery time and I now look totally normal.
Well I say normal...I look better! The little lines around my eyes - gone! My cheeks - plumper! Gotta love that collagen. My mum says my cheeks remind her more of 19 year old me. It has also slightly softened the frown between my eyebrows (that thing is a curse) It hasn't totally perfected my skin but it has done a darn good job of all but the most problematic area of it. My friends say I look really good and I did not look bad before! It is quite fascinating because it is basically impossible for someone to put their finger on exactly what is different but something subtle is.
I think if you had more skin irregularities or older skin you would probably see more dramatic results but it would still be very natural looking. I would have it or something similar done again in another 10 years or when I felt it needed doing but I urge you do plan enough down time! Was it worth it? Yes..but I'm not rushing to go through that recovery again 😉
I hope this has been helpful 🙂 Thanks Dr Hussein 🙂
I had very large pores and sun damage on my skin, I had halo laser but it was a light laser for the size of my pores so we attempted a mild Co2 laser, today is day 11 and I can't be happier with the results, the large pores have reduced a lot! My skin looks younger, healthier, still a bit red but that will settle soon.
I have definitely achieve what I wanted I am not going to wear make up foundation for a while ????.
Dr H has been there for me every time I had a question, daily since the first day giving me advice and looking after me.
It was the best money investment I've done on my skin.
Also mention Iulia, she has been incredible taking care of me while I had the treatment as I had to go on my own to the clinic, reassuring me and making sure I was fine.
I know how important is this as I am a nurse myself, they both made me feel like at home.
Thank you all! ????????
He definitely knows what he does!
I can already see big improvement on my skin texture even though I know my skin still needs loads of time to fully settle so the improvement will continue.
Thank you
