Is this reaction normal after first Enlighten Pico laser treatment? (Photos)

Question

I had my first facial laser treatment done yesterday. Long story short: Aladdin Peel; 9 days after, acne care/extraction; 6 days after, Enlighten Pico. My skin: thick, sensitive, oily, big pores, lots of redness, some dark pigmentation. Used hands to squeeze black/whiteheads & acne for a long time. Laser did hurt even after numbing cream. Smelled burnt skin during process. Aftercare HELPED (cooling/soothing). Now: still red, forehead is itchy & has lots of whiteheads, nose/front cheeks feel like sandpaper. Help!

Christopher Dannaker, DO, MPH, FAAD · Answer

Although I don't currently have a pico laser, the same issues come up with the q switched lasers and fraxel restore. Firstly whenever there are fairly large areas of peeling skin, the laser needs to be turned down. Perhaps though the dryness began with your post laser peel? After laser best not to peel for at least two weeks for this reason. 
It appears you’ve had a pustular, acneform response to the laser- not unusual. Some hypothesize its the sudden removal of p acnes or the  laser heat temporarily stimulating oil glands that triggers this. My experience is that it tends to recur with every treatment and as such suggest patients pretreat with a low dose antibiotic before each treatment. Any board certified dermatologist will be familiar with the drill. Non core specialists and paramedical personnel should not, in my opinion, be relied upon for such treatments.

Is this reaction normal after first Enlighten Pico laser treatment? (Photos)

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