Fraxel laser problems-January 16, 2006-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. Skin redness and irritation you describe can occur after a deep Fraxel treatment lor any laser skin rejuvenation procedure.
It is also common to have an acne type outbreak after any ablative laser skin rejuvenation procedure, which causes 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 is yeast infection after Fraxel® or any ablative laser skin treatment. 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 or photo facial is an excellent acne tretament when combined with photodynamic therapy.
For further information visit my Boston Plastic Surgery Practice, read Save Your Face or contact me.
Dr Seckel
Boston, Massachusetts,
Peabody, Massachusetts,
Concord, Massachusetts
January 17, 2006
Dear Dr. Seckel: Thank you so much for your prompt and thorough response. I did follow up today with a Board Certified Plastic Surgeon in my area who is the only other physician that uses the Fraxel Laser.
I think it’s important for others to know what he said to me regarding this treatment and the side effects I suffer. My previous Dr. told me yesterday that I was red, swollen and had a rash
around my mouth from acne or rosacea. He asked that I take the following medications (Nicomide, Tetrecycline and Metrolotion) and return on Wednesday, 8 days post Fraxel for a photo facial. He also advised me the blistering on my right temple was acne. I have always had perfect skin and no discoloration or problems with acne.
The doctor today told me that my skin was irritated and that I did not have acne or rosacea and that I also suffered a 2nd degree burn on my temple. He said that the medication prescribed for me for treatment was not necessary, that I only was required to use a steroid cream
as you had suggested.
Thank you so much for your advice, which was so helpful in my decision to get a 2nd opinion. He also said the Photo facial would only aggravate the area that was already irritated at this time.
He also said that I would have the same issues on future treatments and would not recommend that I continue with Fraxel® treatments. I think Fraxel websites only sugarcoat their product and that only a small percentage have a short down time. I am looking forward to recovery. Thank you so much Dr. Seckel.
January 18, 2006
Dr. Seckel,
Thank you again. The doctor who did my Fraxel® called today and told me that I must take the medication and come in for a photo facial.
I told him that we had to part ways…. I also asked for my medical records. They used a 22/125 on both my face and neck and a 15/220 on my chest and scar on my arm.
I also believe the TNX Recovery Body Cream they had me purchase for $90.00 and told me that I should put on my skin directly after treatment-helped cause the irritation.
Thank you again for everything. Keep up the great work!
I purchased your book and will advise my friends and family to purchase as
well.
Joanne
Always get a second opinion when you are in doubt, and always see a board certified doctor who is experienced in the technique you are considering.
Dr Seckel