Aerolase Neo Elite

Two weeks before each session

• Stop all retinoids. Tretinoin, retinol, retinaldehyde, adapalene. Any vitamin A derivative increases photosensitivity and raises the risk of a reaction.
• Stop hydroquinone and kojic acid. Both are photosensitizing and can interfere with even treatment results.
• Stop exfoliating acids. AHAs such as glycolic and lactic, BHAs such as salicylic. These thin the skin barrier.

Four weeks before the first session, and throughout the course

• No tanning of any kind, including sun, beds and self-tanner. Uneven tone leads to uneven treatment, and for Fitzpatrick IV to VI a tan raises the risk of post-inflammatory hyperpigmentation considerably.
• No waxing or laser hair removal on the area being treated.

Start now if you have not already

• SPF 50 every morning, rain or shine. This is not negotiable before laser. It pre-conditions the skin and reduces the risk of pigmentation afterwards, particularly for Fitzpatrick III to VI.

Tell us before your appointment

• Any new medications, especially antibiotics. Doxycycline and minocycline are photosensitizing.
• Any cosmetic treatment in the last two weeks, including peels, microneedling or facials.
• If you are pregnant or breastfeeding. This treatment is not performed during pregnancy.
• Any history of cold sores. We may prescribe a preventive antiviral before facial treatment.

The day itself

• Arrive with clean skin and nothing on the treatment area. No moisturizer, SPF or makeup.
• Skip caffeine that morning if you flush easily.

• Expect mild to moderate redness, warmth and slight swelling. This usually peaks around four to six hours afterwards and then settles.
• Moisturize as soon as you get home, with something gentle and fragrance-free. Keep the skin hydrated.
• SPF 50 the next morning and every morning after. Sun exposure without protection is the single biggest cause of pigmentation after laser in Fitzpatrick III to VI.
• Avoid heat. Hot showers, saunas, steam rooms and hard exercise all increase inflammation and can worsen redness.
• No makeup on the treated area for 24 hours.
• No retinoids or acids for five days.

• Redness should be visibly improving by day two or three.
• Treated spots may darken before they fade. This is called peppering and it is a sign the treatment is working, not a problem.
• Those darkened spots shed on their own over 7 to 14 days. Do not pick, scratch or exfoliate them.
• Gentle moisturizer morning and evening. SPF 50 every morning without exception.
• By day seven the skin should look and feel close to normal, with pigmentation starting to fade.

• Resume retinoids and actives after day seven. Between sessions they improve the result rather than interfere with it.
• Continue SPF 50 daily throughout the course and afterwards. It is the most effective thing you can do to protect the result.
• Avoid sun exposure on the treated area. Even brief unprotected exposure during a course can undo progress on pigmentation.
• Avoid other lasers, peels or microneedling between sessions unless we have discussed it.

Skin of color responds well to this laser. It is designed for deeper tones, and the 650-microsecond pulse makes it meaningfully safer than other systems for Fitzpatrick III to VI. What matters more here than in any other patient group is the preparation. The work done before a session largely determines the outcome.

Four weeks before the first session

• Calm the barrier first. Inflamed or compromised skin going into laser treatment raises the risk of pigmentation afterwards. Switch to bland, fragrance-free moisturizers with ceramides, use a gentle non-stripping cleanser, and stop irritating acids and retinoids early. No scrubs, exfoliating devices or anything creating friction.
• Consider a tyrosinase inhibitor. Starting one two to four weeks before treatment primes pigment cells to resist overproducing in response to heat. This is among the highest-yield things a Fitzpatrick IV to VI patient can do. Options include hydroquinone, cysteamine, azelaic acid, tranexamic acid, kojic acid and arbutin. Which one depends on your skin and sensitivity, and it is a prescription decision made at consultation.
• SPF 50 starting now, not after. For deeper tones this is pre-conditioning rather than aftercare. Ultraviolet exposure in the weeks before treatment raises background pigment activity and increases risk during the course.
• Antiviral cover if you have any history of cold sores. In deeper skin an outbreak can trigger pigmentation out of proportion to the outbreak itself, and it is preventable.

How treatment is adapted

• Lower energy settings to begin with, adjusted as we see how your skin responds across the course.
• Conservative endpoints. The goal is the right amount of stimulation, not the maximum.
• Longer gaps between sessions, at least five to six weeks for Fitzpatrick V and VI, so inflammation resolves completely before retreating.

Afterwards

• SPF 50 every single morning. The most important instruction on this page.
• Do not pick at darkened spots. Removing them early breaks the barrier and raises pigmentation risk sharply.
• Resume your tyrosinase inhibitor at day seven to hold the gains and prevent rebound between sessions.
• Tell us if you see new darkening after day seven. It may mean adjusting the topical, lengthening the interval or lowering the energy. Caught early, this is very manageable.

Treating pigment from more than one direction

For deeper skin tones targeting hyperpigmentation, the laser is one layer rather than the whole plan. The second is topical: a tyrosinase inhibitor slowing new pigment production at skin level, preventing recurrence and protecting the result between sessions. Daily SPF 50 ties the layers together, because without it ultraviolet exposure continuously re-triggers pigment production and undermines everything else at once.

How the layers are timed and sequenced is decided at consultation, based on your imaging, your history and what you are already using.