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« Dermatologist Bernard Ackerman likes a tan. | Main | Fraxel: Pain Control when doing Fractional Treatments »

Fraxel: Rashes, Reactions & Treatment Protocols

I just had my third fraxel treatment. I gotten a rash after each but this is much worse then the others. I am afraid to go out of the house. I have been given an antibiotic and I do not feel I my rash is improving. It itches and when I scratch it feel soooo sore. Why does this happen? I am not going to do this again unless I can figure out why

Posted by Jeff E

My first assumption is they are using something topically for after care that is causing a contact dermatitis. This is why I hate to use the topical antibiotics. I only use vaseline for after care. It could be something in the topical from the compounding as well. Just my first impressions.


I agree, it may be the topical. Even Aquaphor caused problems with some folks.
I have done hundreds of the fractional treatments, and have gone to a very "ingredient free" occlusive ointment from Elta. Have not had a problem since!


What is a good moisturizer which has minimal irritating "stuff" in it?

Jeff E

Maybe this can help...

I have seen rashes like this occuring after thedoctor (chiropractor) at my office performs a fraxel treatment. He is known to not wipe the numbing cream off thoroughly and then puts the gliding gel on directly after. After performing the treatment he does not thoroughly clean the skin and immediately puts aloe on the skin. Clients usually come in days later complaining of a rash and itchiness, especially on the cheeks and chin. Im guessing the rash is from a combination of the heat and multiple substances still being on the skin. It is very important to make sure that the skin is very clean before, during and after the treatment. The topical we use is a 7/7 lidocaine/tetracaine combo and most clients that I've treated come out pretty good without any complications after aside from the swelling.

After the treatment I let the client sit with cold aloe vera along with the simmer chiller blasting cold air onthe face for about 15 mins. Then I have them rinse the skin and I immediately apply the Neocutis BioRestorative Gel that is very light in texture and great for post op care. The Neocutis line is great for burns, scars, rashes, irritations and is best for after fraxel treatments for the first week. It helps the skin get back to a normal state. i usually sell these products along with the Fraxel package so that the client can use the products at home and continue caring for the skin properly. Using anything thick like a vaseline base, bacitracin, heavy creams immediately after the treatment and during the first week post op will irritate and clog the skin and cause more complications.


For post laser sunblock, consider Elta MD 45 physical block-never seen acne break out or contact dermatitis with it. It is extremely cosmetically elegant, just not waterproof.


We put a cream on similiar to Cetaphilday 1.We are experimenting with a post balm ointment....that we sell. I will let you know how this works out.


My first choice is vaseline but I have some of the Elta and i am giving it a try.


I agree, it may be the topical. Even Aquaphor caused problems with some folks.
I have done hundreds of the fractional treatments, and have gone to a very "ingredient free" occlusive ointment from Elta. Have not had a problem since!


Reader Comments (3)

i am concerned after reading about our contributors' complications in the form of "rashes" after laser-related treatments. although even aquaphor can cause sensitivity reactions, please make sure all of our clinicians consider herpes breakouts. they are relatively common after light or laser treatments and unless treated prophylactically can cause scarring and chronic pain. please consider valtrex 500 mg daily for 7-10 days, starting a day or so before laser or pulsed light treatment.

02.1 | Unregistered CommenterBeth

thanks, beth.
Great point.
Also, I think they might look "different" than usual after ablative treatments so you can be fooled.

02.1 | Unregistered CommenterJEE

Many skin care products that are used after a Fractional Ablative Treatment can cause redness and irritation and even rashes (small bumps and acne). Many moisturizers and many sunscreens have chemicals that are harmful to the skin. After a Fractional Laser treatment, the skin has thousands of 140 micron holes in it, so products (and the harmful chemicals they contain) are absorbed much more robustly. The laser companies do not have this worked out so you have to find this information on your own. Many acne medications have chemicals that make acne worse!!!! Even Aquaphor has some chemicals that can be harmful! Read the labels on all products you recommend. For a full list of harmful chemicals (including those that can make acne worse) see, Acne Rx by James E. Fulton Jr, MD, PhD. Read Chapter 9 page 117 - 145. You might even learn a thing or two about Acne! You can get this on

02.1 | Unregistered CommenterJEE

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