I Have Herpes on my Cheeks. Will Laser Resurfacing Be Ok if I Take Valtrex Prior to Treat

active cold sores would prevent me from doing an ablative laser procedure but not necessarily a fractional nonablative laser if the patient is taking an antiviral and the laser does not treat the active site, although in this case I do offer to reschedule.  If the cold sore virus seeds the lasered areas it can cause many cold sores that in an ablative procedure would not look typical and their diagnosis could be delayed while the risk of scarring increases.

My protocol for my patients is to use Valtrex 1 gram by mouth daily starting the day before surgery and then continuing until the skin is healed, usually about one week.  I have never had anyone break through and have a serious herpes infection using this protocol.

Many people get facial cold sores.  That is why we always prescribe antiviral medications before doing resurfacing.  If a patient has an active cold sore the procedure must be rescheduled until complete healing has occurred.  It is not worth risking aggravating the viral infection.  The procedure can be done safely after the cold sore is gone.

Antiviral medications like Zovirax, Valtrex and Famvir, lessen the chances that there will be a breakout but do not guarantee it.  If a breakout does happen after laser resurfacing, it can involve the entire resurfaced area, so you must be very cautious about having such a resurfacing.

In addition, no cosmetic procedures or any procedures for that matter should be done in the area of an active herpes breakout.

Medication pre treatment does not preclude the occurrence of an outbreak. It only helps to statistically decrease one. 

Anyone with a history of herpetic lesions on the face is at greater risk for a pan-herpetic infection of the face anywhere up to two weeks following traditional laser resurfacing.  While anti-virals may help ameliorate the severity of the infection,  they in no way totally prevent an infection from taking place.  With a history of frequent outbreaks,  I would probably try to convince my patient to consider an alternative method of treatment other than skin resurfacing.

All patients who are going to have either chemical or laser skin resurfacing should be put on Valtrex prior to the procedures regardless of a history of past herpes sores.

I want to clarify your statement of "having herpes on (my) cheeks". If you have ACTIVE lesions, I would have you wait till they cleared before performing any treatments. If you do not have active lesions, then I would start a pre-treatment regimen with an anti-viral like Valtrex.