I Get Cold Sores Around my Mouth is That a Concern with Thermage

Cold sores may occur in response to a procedure.  "Outbreaks" of cold sores, caused by the herpes virus, may occur in response to stress, such as stress due to a procedure.  If there are any open wounds, including due to herpes lesions, I recommend postponing any procedure until they resolve.  There are both oral and topical medications which may be used to treat cold sores.  Even if no cold sore is present, sometimes it is advisable to use a lower dose of the medication (e.g., Valtrex) to minimize the risk of cold sores appearing shortly after a procedure is performed.

Any physical or emotional stress can trigger cold sores.  You should take Valtrex 1 gm twice a day starting the day before your treatment and continuing for 3 days to prevent an outbreak.  We recommend this regimen for procedures around the mouth, including peels, microdermabrasion, IPL, lasers and fillers, in patients who suffer from cold sores and do not treat if a cold sore is present.  We extend the treatment to one week in patients having fractional ablative laser resurfacing.

any stress can stimulate a herpes outbreak. This is very concerning when we perform skin resurfacing as we have open wounds and these outbreaks can travel outside of their normal boundaries. The stress of thermage may cause an outbreak but it shouldn't progress because there are no open wounds with radiofrquency

We recommend that if a patient has a history of cold sores they get  pre-treated with Valtrex (1gm) prior to any laser, radio frequency, peel, or injectables and sometimes even a second dose of Valtrex (1gm) 12hours later.  The HSV virus lays dormant in your nerve endings forever.  Any irritation, decrease immunity, excess sun exposure, etc. can cause an out break.  Valtrex is an anti-viral medication that can help prevent an outbreak from occurring.