I routinely give my patients a Vicodin and Prednisone (an oral steroid to help swelling) immediately before their procedure and send them home with a prescription for 5 more of the Vicodin and 4 days worth of Prednisone. We use a highly effective combination of topical high dose Lidocaine and Tetracaine along with local nerve blocks and forced cold air for anesthesia during the procedure. The skin may feel hot and uncomfortable for about 2-4 hours after the procedure. For this reason, I also send my patients home with two gel ice packs, which almost completely alleviates this discomfort.
Although swelling can be significant (especially with more aggressive treatments), there is only minor discomfort during the days following the procedure. Patient routinely tell me that they took a single Vicodin to sleep the night after their procedure and have not required anything stronger than ibuprofen after that. Depending on the amount of swelling, oral steroids such a Prednisone are usually offered to the patients. Patients who have a history of cold sores should also be placed on antiviral medication such as Acyclovir or Valtrex.