Peri-procedural dermocosmetic protocol combined with EBD (energy-based devices) treatment: literature review

Energy-based devices (fractional lasers, IPL, radiofrequency, HIFU, plasma) induce a controlled tissue inflammatory response that temporarily compromises the skin barrier function. Peri-procedural dermocosmetic management is not an optional add-on, but a therapeutic component with a direct impact on downtime, post-inflammatory hyperpigmentation (PIH) and long-term outcomes.

Pre-procedural phase (2-6 weeks before) Skin preparation reduces the risk of complications and homogenises tissue response. Evidence-based actives include retinol/tretinoin (to be discontinued 5-14 days before), vitamin C ≥10% (PIH prophylaxis in higher phototypes), low-concentration AHAs (to be discontinued 72-96h before ablative EBD) and niacinamide 4-5% (may be maintained until the procedure). SPF ≥50 photoprotection is mandatory throughout the protocol.

Immediate post-procedural phase (first 72h) TEWL can increase up to 10-fold from baseline values. Formulations must be free of fragrances, SLS and keratolytics. Priority actives include ceramides (barrier restoration), low molecular weight hyaluronic acid, panthenol, Centella asiatica and bisabolol. Mineral-based photoprotection (zinc oxide/titanium dioxide) is preferred for its anti-inflammatory profile.

Home follow-up (weeks 1-4) The reintroduction of functional actives must be stepwise: first barrier consolidation (days 1-7), then hydration and inflammatory control (days 7-14), finally antioxidants and depigmenting agents (weeks 2-4). Photoprotection should be maintained for at least 4-6 weeks after ablative EBD.

The main limitation of the current literature is the absence of standardised protocols for specific device-dermocosmetic combinations: most studies evaluate single actives in isolation, making direct translation into clinical practice challenging.

Conclusions

This work presents a systematic literature review on the use of home dermocosmetic protocols in combination with outpatient energy-based device (EBD) treatments. The aim is to analyse the most effective pre- and post-procedural strategies to reduce downtime, adverse effects and complications, with particular focus on post-inflammatory hyperpigmentation in medium-to-high phototypes.

The available evidence supports a structured three-phase approach — pre-procedural preparation, immediate post-treatment management and stepwise home follow-up — in which the selection of dermocosmetic actives must be tailored to the type of EBD, the patient's phototype and individual clinical profile. The integration of this protocol into daily clinical practice represents a qualifying element in the management of energy-based aesthetic treatments, with a measurable impact on patient safety and satisfaction.