How to build a skincare routine around your med spa treatments

Most patients either continue their full skincare routine unchanged around treatments or swing to the opposite extreme and stop everything. Neither is optimal. Here's how to coordinate your at-home skincare with professional procedures.

The foundational products that should never stop

These are the baseline regardless of what treatments you're getting:

SPF 30+ broad spectrum (daily):
Non-negotiable after any treatment that increases photosensitivity (lasers, peels, microneedling, retinoids)
The single most evidence-backed anti-aging intervention
Use it whether or not you're having treatments

Gentle cleanser:
No reason to stop; choose a non-stripping, non-active formulation around treatment time

Barrier-supporting moisturizer:
After any resurfacing treatment, a simple moisturizer (ceramides, petrolatum, glycerin) supports healing
More is not better — a plain moisturizer during healing is preferred over active-loaded serums

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Retinoids: the most important variable

Retinoids (tretinoin prescription, retinol OTC, retinaldehyde, adapalene) are the workhorse of at-home anti-aging — but they interact with many professional treatments.

Pause retinoids before:
Laser treatments: Stop 5–7 days before any laser procedure (makes skin more fragile; impairs wound healing if too recent)
Chemical peels: Stop 5–7 days before (retinoids and peels together can cause over-exfoliation and extended healing)
Microneedling: Some providers ask for 5–7 day pause; others don't — check with your provider
Waxing: Retinoids thin the skin; facial waxing on retinoid-active skin risks tearing (pause 3–5 days)

Resume retinoids after:
Post-laser: Resume when fully re-epithelialized (typically 2–4 weeks for ablative treatments; 1–2 weeks for non-ablative)
Post-peel: Resume when fully healed (2–4 weeks for medium peels; 1 week for superficial)
Post-microneedling: Usually resume at 5–7 days once peeling has resolved

Retinoids and Botox/filler: No significant interaction. No need to pause retinoids around injectable appointments.

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Vitamin C serums

Topical vitamin C (L-ascorbic acid, ascorbyl glucoside, sodium ascorbyl phosphate) is a useful antioxidant and pigmentation-brightening ingredient. How it interacts with treatments:

Before laser/peel: Some providers recommend pausing L-ascorbic acid (especially at low pH formulations) 3–5 days before treatment — it can increase skin sensitivity. Stable derivatives (ascorbyl glucoside) are gentler.

After laser/peel: Resume vitamin C once fully healed — it accelerates antioxidant recovery and helps with post-treatment skin protection. Some post-treatment serums include vitamin C alongside growth factors.

With injectables: No interaction; continue as normal.

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Exfoliating acids (AHAs, BHAs)

Glycolic acid, lactic acid, mandelic acid, salicylic acid — common in many serums and toners.

Pause before:
Laser treatments: 5–7 days
Chemical peels: 5–7 days (don't exfoliate before a peel — the peel is the exfoliation)
Microneedling: 5–7 days

During healing: Pause completely. Exfoliating agents on healing skin can disrupt the barrier and cause irritation or PIH.

After: Resume when fully healed. Gentle exfoliation (low-strength mandelic or lactic) can resume at 2–3 weeks post-peel; stronger acids (glycolic 10%+) at 4 weeks.

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The treatment "stack" concept

For patients actively doing regular treatments, a monthly or quarterly schedule helps coordinate:

Example: patient doing quarterly Botox + 2x/year medium peels + monthly HydraFacials

Continuous: Daily SPF, gentle cleanser, moisturizer
At home baseline (non-treatment weeks): Tretinoin 3–5x/week, vitamin C AM, AHA exfoliant 2–3x/week
Pause for peels: Stop tretinoin and actives 5–7 days before; resume at 4 weeks after
HydraFacial months: Continue all actives; HydraFacial has no interaction with routine skincare
Botox months: No changes to skincare needed

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Specific post-treatment protocols

After Botox or filler

No specific skincare restrictions. Normal routine the same day. Avoid vigorous facial massage for 4 hours.

After HydraFacial

Normal routine the same day. May feel slightly dry or tight on day 1 — add extra moisturizer. No actives needed for recovery.

After microneedling

Days 1–3: Gentle cleanser + plain moisturizer only. No actives, no acids, no vitamin C.
Days 3–5: May resume gentle moisturizer and SPF.
Day 5–7: Resume hyaluronic acid serums. Still no retinoids or acids.
Week 2: Resume full routine including vitamin C.
Days 5–7 or week 2: Resume retinoids (check with your provider).

After superficial chemical peel

Days 1–3: Plain moisturizer, avoid actives.
Day 3–5: Gentle skincare; add SPF.
Day 7+: Resume actives gradually, starting with vitamin C, then AHAs, then retinoids at 2 weeks.

After medium-depth TCA peel

Days 1–7: Petrolatum or gentle occlusive + SPF only.
Day 7–14: Once fully re-epithelialized: gentle cleanser + SPF + basic moisturizer.
Week 3–4: Add vitamin C.
Week 4–6: Resume retinoids and AHAs.

After laser resurfacing (non-ablative)

Days 1–5: Gentle routine only.
Day 5–7: Resume vitamin C and basic actives.
Week 2: Resume retinoids.

After ablative laser resurfacing

Weeks 1–2: Provider-directed wound care; typically petrolatum or similar occlusive.
Week 2–4: Gentle cleanser + plain moisturizer + SPF.
Week 4–6: Introduce vitamin C, then AHAs.
Week 6–8: Reintroduce retinoids (may be earlier depending on provider's protocol and healing).

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The hydroquinone question

Hydroquinone 4% is used for hyperpigmentation management — often as part of a pre-treatment protocol for darker skin tones.

Pre-treatment: 4 weeks before medium-depth peels or laser in patients with Fitzpatrick III–VI skin.
Post-treatment: May resume 4–6 weeks after, once healed, if pigment concerns are ongoing.
Long-term use: Hydroquinone is typically used in cycles (3 months on, break, 3 months on) — prolonged continuous use without supervision is not recommended.

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Questions to ask your provider

Given my current skincare routine (list actives), what should I pause before my treatment and when can I resume?
What moisturizer do you recommend during the healing phase specifically?
Is there any active or ingredient I should add post-treatment to improve my results?
How does my tretinoin routine interact with the sequence of treatments you're recommending?

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