Is It Normal To Breakout In Painful Acne After Laser Resurfacing?

Question

I had Laser resurfacing 2 weeks ago and am experiencing what I can only call as painful acne (I have never had any acne issues before) around my mouth and eye areas that do not seem to be getting any better. I also have swelling of lower part of my face and wanted to find out if this in normal or anything I should be concerned with?

Sonia Badreshia-Bansal, MD · Answer

Thank you for your question. Swelling can occur for about a week after laser resurfacing and at times, people can breakout especially acne prone skin or from products used in the post operative period. I would recommend a follow up with your provider. Be certain to be under the supervision of a Board Certified Dermatologist or Plastic Surgeon for best results and safest treatment options. I hope this helps!

Sanusi Umar, MD · Answer

Without seeing your condition first hand, it would be difficult to form any solid conclusions about your post laser acne condition. However, what may have happened is that the laser may have affected the hair follicles or sebaceous glands in your skin. As you may know, sebaceous glands produce oil. And in acne patients, these glands are usually quite enlarged and active. Painful acne is quite possible after laser resurfacing, particularly in patients with dark hair. Dark hair has melanin which absorbs laser light and brings it into the hair follicles.

	However, you should certainly consult with your dermatologist if you are not seeing improvements in the situation.

Adam Tattelbaum, MD · Answer

I agree with the other posters that you should check in with your doctor. Acne is possible but usually not painful. Herpes reactivation is possible and treatment may help. The rash you describe is also possible with topical bacitracin allergy-- if you are using it.

Ron Shelton, MD · Answer

Painful lesions developing after laser resurfacing could be serioius within the first few weeks. Laser resurfacing is not to be taken lightly. Please contact your doctor. Herpes can break out and cause scarring so can Staph bacterial hair follicle infections. Sometimes it is just acne and some prescribed medication can make it feel better, resolve more quickly and limit the chance for it to scar if you have a tendency to have scarring cystic acne.

William Franckle, MD, FACS · Answer

Generally in my practice after laser resurfacing, patients need to be placed on a post peel regime to guard against the development of post procedure acne and discoloration (dyschromia). I encourage all of my patients to closely follow up with me during the critical period of healing after any procedure. You may want to visit your doctor again to be sure everything is OK.

Richard O. Gregory, MD · Answer

This is very common.  There is no negligence.  I believe there are two causes (or more) for the breakouts. First the oil glands are temporarily stimulated and there are more secretions and secondly the pores are tighter due to swelling and shrinkage of the skin and drain poorly.  Many patients who have resurfacing are acne-prone anyway.We routinely give antibiotics and antiviral medications to our patients for a very short course including pre op prophylacticly .  Treatment of the breakouts is important and may consist of cleansing and antibiotics.  Dilute vinegar solution soaks can be helpful as is the ultrasonic cleansing brush (not the rotating model).  Be sure to wash your hands while treating your lasered area and DO NOT scratch because it will itch and it will cause scars if you scratch (wear gloves at night).

Daniel Shapiro, MD · Answer

Healing afterwards is generally uneventful, consisting of what looks like a deep sunburn that is treated with topical lubricants for 7 to 10 days, at which time the skin is healed. Skin pinkness can persist for weeks, and is minimized by topical steroid crèmes. However, acne could be a common side effect as well. I would suggest speaking with the doctor who performed the treatment, so that he or she can recommend a treatment plan to clear up the breakout. Best of luck.

Kris M. Reddy, MD, FACS · Answer

While acne is possible, herpes reactivation is more likely. Consult with your physician at as soon as possible.

Lesley Clark-Loeser, MD · Answer

Acne breakouts, especially on the lower 1/2 of the face, can be seen a week or two following both ablative and non-ablative laser resurfacing. This tends to occur more often in individuals who have a past history of inflammatory (or painful) acne. Nonetheless, this can happen to anyone. Treatment for these post- treatment painful acne breakouts can be alleviated with oral antibiotics. However, it is extremely important to be evaluated by your doctor to ensure that what you have is indeed an acne flare and not a viral or different bacterial infection.

Todd C. Case, MD · Answer

The appearance of milia or whiteheads is not uncommon after laser resurfacing, likely associated with the topical ointments or medications used for wound healing.  However, painful outbreaks are unusual and should be evaluated by your surgeon.  This may be a herpes outbreak which can spread over the resurfaced areas.

Is It Normal To Breakout In Painful Acne After Laser Resurfacing?

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