How Long Until Whiteheads Clear After Fraxel?

I received my 2nd Fraxel laser treatment on Monday for pigementation and light acne scarring. My 1st treatment recovery process was normal; dry, peeling and voila done in about 4 days. The 2nd treatment recovery is much different - on day 2, tiny whiteheads started sprouting all over my chin/upper lip area and I'm now quite worried that these will cause additional scarring. What can I do to eliminate these? I have not used any heavy emollients (ie, Aquafor), simply pure aloe gel.

Doctor Answers 2

We use oral doxycycline for this.

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Assuming there are not contraindications for the use of this medication, oral doxycycline seems to work well to help eradicate this problem. I think this condition occurs because of a process called "apoptosis", which is essentially where the body pushed out entrapped cellular debris and oils that have accumlulated over time. Generally, the medication is prescribed for a ten day period, primarily as an anti-inflammatory agent rather than an antibacterial agent, generally at 100 mg, but that is dependent on your personal medical history which you and your doctor know best. You will need to speak with your doctor to make sure that there are no contraindications for the use of this drug. Incidentally, do not use minocycline (hyperpigmentation may occur).

Alpharetta Dermatologic Surgeon

Fraxel and whiteheads

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It is possible that your Fraxel treatment was more aggressive this time and the inflammation has caused the pustules.  Contact your physician who may culture the pustules to see if they are sterile or perhaps contain bacteria or yeast.  You can then be treated accordingly.  These pustules usually clear within a week or so with treatment.

Martie Gidon, MD, FRCPC
Toronto Dermatologist

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.