At our clinic we carry out a full assessment, check the medical history and then proceed to examination. This involves visually (with magnification) and physically assessing the lesions, as well as checking for any other relevant clinical signs like arcus senilis.
A discussion follows confirming the diagnosis and then a consideration of treatment options. We always like to make it clear that a legitimate option is no treatment. This is to ensure our patients have the option to make a truly informed choice.
Treatment may be offered on the day of assessment or at a later date. The patient will decide if they wish to have the procedure, as well as when. We always stress that time to reflect and plan can be useful where there is any doubt about how to proceed.
Following skin preparation, local anaesthetic is carefully injected into the relevant areas. We deliberately make the area quite swollen with anaesthesia as this provides enhanced safety and clarity during the procedure. Occasionally a small bruise can result following the injection. Anaesthesia is allowed to develop for at least 10 minutes prior to continuing.
Next anaesthetic eye-drops are instilled so as to numb the surface of the eye. They sting a little but allow the intra-ocular shields (required eye protection for when undergoing laser treatment to the eye region) to be placed with ease and total comfort.
Now lasering can commence and should be completely painless. The erbium laser makes some noise (the absorption of light by the chromophore water is so intense that there is a photo-acoustic reaction) and there is also an additional noise from the plume evacuator and the cold air machine.
Laser treatment may take as little as 10 minutes
Recovery / Aftercare
Removal of XP results in a wound which we liken to falling and grazing your knee. The area is ‘raw’ for a few days and must be managed with gentle cleansing (avoidance of any harsh cleansers or ‘active skincare’) and application of a greasy ointment. We typically give the patient chloramphenicol ointment away to apply (unless they have an allergy to it in which case we recommend vaseline).
Some swelling is normal and this may take a few days to settle.
New skin starts to form within a few days and this process occurs more quickly due to the application of the ointment. Typically by day 9 the new skin has formed and any scab will have come off.
It is normal to have some redness in the surrounding area and this is part of the normal healing response. Increasing redness and associated pain would raise the possibility of infection and should lead to communication with the clinic. That said, infection is very uncommon in this area.