What's the probability of having herpes, cold sores, after Fraxel laser? When I have cold & on the hot sun always I have it.

Herpes simplex type I is a common viral condition which many if not most people carry.  This is manifest as occasional herpetic viral outbreaks around the mouth;  commonly known as "cold sores."  Ablative laser resurfacing removes skin from around the mouth making a patient who carries the virus susceptible to a severe herpetic outbreak.  For ABLATIVE resurfacing procedures (Fraxel Re:Pair, Erbium laser, or CO2 laser), antiviral prophylaxis with an antiviral agent such as acyclovir is always recommended.  For nonablative laser procedures such as Fraxel Re:Store, IPL/photofacial, or Clear and Brilliant antiviral prophylaxis is reserved only for those who have a known history of herpetic infection.  These procedures do not remove the protective skin barrier and are low risk for herpetic outbreak. 

Thank you for your question. It would be best to pre treat with Valtrex or Lysine to prevent any breakout. Sometimes heat or stress can trigger cold sore breakout. I hope this helps!

If you are at high risk for herpes, you will likely need prophylactic treatment with a prescription before your laser treatment. Best, Dr. Karamanoukian Los Angeles

Risk of herpes reactivation is high after any trauma to the area of skin that you tend to get it.  Sun, laser (including Fraxel Laser), peels and needle sticks can all stimulate it.  We recommend to our patients that they take Valcyclovir the night before and day of their treatment.

It is possible to get herpes after fraxel, I have all my patients take valtrex prior to their treatment.  Best, Dr. Emer.

The risk is that you get herpetic outbreak over your face. This is a painful and harder problem to fix after the fact. Much easier to treat before with Vatrex.  A few doses is what I use. One just before, and 2 doses after. 

Honestly, I would say the likelihood of cold sores or a herpes outbreak is high if you have any laser and are prone to getting them. Just like it is if you go to the dentist. I always have people pre-medicate the day of and then take Valtrex or Acyclovir for a few days post too. I have yet to have people have issues if they do it this way. "This answer has been solicited without seeing this patient and
cannot be held as true medical advice, but only opinion. Seek in-person
treatment with a trained medical professional for appropriate care."