I had fractional CO2 treatment on my face/neck. I started antiviral Valacyclovir (twice a day) 2 days post & antibiotic Cephalexin 500mg one day post. Cetaphil cleanser and Aquaphor three times daily. Noticed small pustules forming around my mouth, nose, cheeks, and neck. Many more are forming. How do various doctors address 2-4 post treatment?
Treating Acne Flare 2-4 Days Post Fractional Co2?
Doctor Answers (4)
Pustules after fractional laser treatment
There are two primary reasons why you might have a pustular eruption after a fractional laser treatment:
- Most likely it's from the occlusion ointments, like Aquaphor, that are used to help heal the skin after the treatment. We do need and use occlusive ointments to help repair the intentional wounding the laser treatment does to the skin. It's the repair process after the wounding that gives the results of diminishing wrinkles, sun damage and acne scars as well as skin tightening with fractional laser resurfacing. If these are pustules due to the occlusive effect of the Aquaphor, discontinuing the ointment and a few days of treatment with an antibiotic topical like clindamycin or aczone should resolve the eruption.
- The other possibility is a bacterial infection (folliculitis) that may not be covered by the cephalexin you are taking. Usually a viral infection presents as blisters or erosions, so it is much less likely that this is viral in etiology.
Please see your doctor as soon as possible for a more complete evaluation and possible bacterial cultures of the eruption.
Also, I recommend anti-viral prophylaxis to be started three days prior to the procedure and to be continued until three days after the procedure.
Acne can happen after Fraxel
Acne can occur after the Fraxel laser usually as a result of using aquaphor or other occlusive ointments on the skin after the Laser. The milia or acne is easily treatable and fill not interfere with anticipated excellent results. I put all of my Fraxel patients prophylactically on Valtrex to prevent cold sores. It is best to find a board certified dermatologist to consult with who has a lot of experience with Fraxel.
Acne outbreak after CO2 fractional laser
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Acne outbreaks after Fractional Laser
Acne flare-ups may be seen after fractional laser resurfacing as the oil glands in the skin recover from the laser damage. While I put all of my patients on anti-viral medicines, such as acyclovir or valacyclovir, in order to decrease the risk of cold sores, I typically do not prescribe antiobiotics for acne. If my patients look like they may be developing an outbreak, then I like to use Doxycyline 100mg once a day until it resolves. One thing that you should look at is if you may be putting too much Aquaphor on your skin. There are some patients whose skin reacts to the excessive occlusion and can produce whiteheads or pimples. I would definitely talk to your physician to address your concerns.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.