Dear Dr. Seckel, I recently had Fraxel on my face, neck and chest and found it rather painful even though I have a very high pain tolerance. I was told my face would have a sunburned appearance and minimal swelling for 1-3 days. I was swollen for 6 days and I still have redness on my right temple. I went to the doctors today and he said that I have acne or small case of rosacea. I have never had a pimple in my life and I am very worried that my skin will never be the same. I have looked at a zillion websites and cannot find any reaction similar to mine. Most show no side effects. I am on medication and he wants to do a photo facial on me this Wednesday. Is this ok? Have you heard of anything like this? Help… I am only 40 years old, and looked like a young 32 yr old - I so wish that I never done this. Joey, Austin, Texas.
Dear Joey,
Please don’t worry; I am sure your skin will improve in time.
It is common to have an acne type outbreak after any ablative laser skin rejuvenation procedure which causes skin exfoliation on the face. The Fraxel® does ablate (remove) tissue. Because the Fraxel® does micro ablation (unlike laser resurfacing which removes all of the skin surface) small amounts of dead skin and debris from the Fraxel® procedure can still be embedded in the skin and block the skin pores. Skin oil can back up in the oil glands that normally drain out of the pore and become infected causing a pimple or acne lesion. If small areas of tissue which were injured by the Fraxel® are embedded in the skin they also may become infected.
Gentle cleansing and a topical antibiotic like Cleocyn T can help the acne lesions if that is what they are-your doctor should be able to tell.
Another problem which can happen after Fraxel® laser skin rejuvenation or any ablative laser procedure is Yeast Infection. This usually happens at about 10 days to two weeks after the procedure and is a very itchy sensation and many red bumps usually around the mouth. I doubt if this is the problem but ask your doctor. If he thinks yeast is the problem then a pill called Diflucan can be very helpful.
I think this will pass with gentle care and time. If your doctor is sure that there is no yeast and there are no white heads or pustules, and only red bumps then sometimes a steroid cream like 1% Hydrocortisone can help relieve the irritation-but don’t use the Hydrocortisone longer than 3 weeks and only with your doctors approval.
IPL or Photo facial can help remove blood vessels and pigment. It may be helpful in preventing Hypertrophic scars. Ask your doctor if he thinks the red areas are Hypertrophic scars. If he does then a stronger steroid like Temovate for 10 days and light therapy such as photo facial may help. If however he is only treating blood vessels and Rosacea and does not think he is treating scars or is treating acne-then I would wait for the skin to calm down with the gentle treatments mentioned earlier. IPL with photodynamic therapy can help control acne.
I hope this helps. For further information visit my Boston Plastic Surgery Practice, read Save Your Face or contact me.
Boston, Massachusetts
Peabody, Massachusetts