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Done with Accutane. Treatment with IPL laser for redness and pigmentation. Breaking out on chest, stomach and thighs. Help?

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Practicing since : 2006
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hello,
so iv done 5 months of Accutane and finished around may of this year, so its been 5 months, and I went for one treatment of ipl laser for my scarring and redness and pigmentation. After this one treatment iv been breaking out everyday, some days it would clear up and then break out again and ect, is this because of the ipl because this has been happening for a month now, I feel like I hould go back on Accutane again, also breaking out on my chest,stomch, and thighs, don't know why?
Help , thanks.
Posted Sun, 10 Nov 2013 in Skin Hair and Nails
 
 
Answered by Dr. Kalpana Pathak 2 hours later
Brief Answer:
the frequent break out is not due to ipl

Detailed Answer:
Hi
Thanks for writing to us.
Acne recurrence can occur even after course of isotretinoin. Usually isotretinoin in dose of 1 mg per kg body weight given for 4 months not only treats acne but also decreases incidences of recurrence.
Your frequent break out is not related to laser session
If somebody is having recurrence, it has to be seen what is the severity of acne breakout according to which topical medicines, oral medicines like doxycycline or azithromycin and if required isotretinoin can be given.
But with isotretinoin lasers can't be done. Infact if somebody has taken isotretinoin we avoid procedures after stopping isotretinoin for 3 to 6 months as it can lead to untoward side effects lije erythema or scarring etc.
You are getting lasers done over face and having break outs at other body areas, so I hope you understand its not related. Please XXXXXXX your dermatologist to get a prescription after proper assessment.
Take care
Above answer was peer-reviewed by
 
Follow-up: Done with Accutane. Treatment with IPL laser for redness and pigmentation. Breaking out on chest, stomach and thighs. Help? 6 hours later
So should I continue on with my laser treatments?
 
 
Answered by Dr. Kalpana Pathak 19 hours later
Brief Answer:
lasers can be continued

Detailed Answer:
Hi,
Thanks for writing back.
Even if having break outs over other body areas or very few acne lesions over face,laser over face can be continued.
If having severe break out, your doctor may put you on oral antibiotics like doxycycline or azithromycin. Even with oral antibiotics lasers can be continued. However, if in case to control breakout isotretionin is required then lasers will have to be dicontinued.
As I mentioned previously oral medicines are required for severe acne, if having few lesions only it can be managed with topical anti acne medicines alone.

So in your case, if at all lasers need to be discontinued it would only be if lesions are too severe and a course of isotretinoin is required or if there is persistent redness over face.

Please XXXXXXX your dermatologist, to get your skin analysed so that further treatment can be planned.
Take care
Above answer was peer-reviewed by
 
Follow-up: Done with Accutane. Treatment with IPL laser for redness and pigmentation. Breaking out on chest, stomach and thighs. Help? 18 hours later
So today my face was much reder than usual, I think because I was in the car for a while and it was XXXXXXX But usualy my face is still red and my derm said we can do ipl laser until your scarring is gone and then we can take care of the redness, she didn't say how, but I kind of want to take care of the redness now, because its the most worst thing to have, like how many treatments of ipl will I need till my scarring is gone you think? They have faded quite abit though to me, just asking you?
thanks.
 
 
Answered by Dr. Kalpana Pathak 26 hours later
Brief Answer:
redness and scarring both should be tackled

Detailed Answer:
Hi,
Thanks for writing to us.
Personally I believe that if redness persists after a laser session, it should be tackled too. we can't leave it as such to be treated later on. Persistent erythema may later on leave pigmentation over face. Some degree of erythema is acceptable over face after lasers but it should nt be too prominent.
Usually use of sunscreen, steroid cream, calamine lotion helps. Post lasers skin is sensitive to sun. So adequate sun protection should be maintained. for the same use a water based sunscreen like Clinique or neutrogena.. Apply a mild steroid cream like hydrocortisone two times in a day. Also use calamine lotion over face. These steps should reduce redness over face.

atleast four to six sessions of lasers are required to see reduction in scars. So remain in touch with your dermatologist for same.

Hope this helped.
Take care
Above answer was peer-reviewed by
 
Follow-up: Done with Accutane. Treatment with IPL laser for redness and pigmentation. Breaking out on chest, stomach and thighs. Help? 21 hours later
Thanks!

So I see my derm this Friday, my scarring is pretty faded and less visible I would say, but redness and red marks are unreal . Wow. So im wondering instead of using creams for the redness and marks if I could just get laser done? What about pulse XXXXXXX laser? How does that work, and would that work for my face according to my pictures? /And how many treatments would I need?
 
 
Answered by Dr. Kalpana Pathak 38 hours later
Brief Answer:
Lasers should be used only when creams do not work

Detailed Answer:
Hi,
Thanks for writing back.
You are not willing to use sunscreens and steroid creams. Let me tell you these two will be required even if using pulsed XXXXXXX laser to reduce marks and redness. IPL works well to reduce acne induced pigmentation.

So personally I feel you should continue with IPL and use sun screen and steroid cream to reduce redness. Laser can be used to treat persistent redness while what you are having is transient and it is primarily due to reluctance from your side in using topical medication and following sun protection. So I would not suggest Pulsed XXXXXXX laser in your case.It is not at all recommended in your case.

If sun protection is not proper, redness can accentuate after any laser session. Not only ultraviolet rays but visible light too can induce pigmentation and hence sunscreen should be used even when staying indoors.

Hope this answered your query.
Take care
Above answer was peer-reviewed by
 
Follow-up: Done with Accutane. Treatment with IPL laser for redness and pigmentation. Breaking out on chest, stomach and thighs. Help? 7 hours later
I think I will continue to do ipl treatments. But I'm still breaking out alittle on my face every other day so it sucks. So this leads to more redness and red marks. I guess I'll see what I'll be doing next on Friday.

The scarring has really improved though. Ill show you what my face looks like tonight, scars are fading, but still have red marks and some redness, I just want to get that under control first. What do you think I should do next according to my pictures?
Follow-up: Done with Accutane. Treatment with IPL laser for redness and pigmentation. Breaking out on chest, stomach and thighs. Help? 54 minutes later
The scarring has really improved though. Ill show you what my face looks like tonight, scars are fading, but still have red marks and some redness, I just want to get that under control first. What do you think I should do next according to my pictures?
 
 
Answered by Dr. Kalpana Pathak 30 hours later
Brief Answer:
Use sunscreen and mild steroid

Detailed Answer:
Hi,
Thanks for writing back.
To help settle your break outs, use a face wash meant for oily skin like cetaphil OS cleanser. Use clindamycin adapalene combination gel only over your break outs in night. This would treat it. As I said earlier also(in my first post), please consult your dermatologist to see whether you need oral antiacne drugs or not.

As far as redness is concerned, use of sunscreen and a mild steroid like hydrocortisone for few days should settle it.

Yes,you may continue with IPL sessions if having good response.

Take care
Above answer was peer-reviewed by
 
Follow-up: Done with Accutane. Treatment with IPL laser for redness and pigmentation. Breaking out on chest, stomach and thighs. Help? 8 hours later
Well today my face is really clear, no breakouts, scarring is really faded so kind of happy. Still have abit of scarring left and I have redness and red marks still . But they are getting less visible which is good. Today I see my derm to see what to do next, what do you think should be done? Continue laser ?
 
 
Answered by Dr. Kalpana Pathak 36 hours later
Brief Answer:
continue laser

Detailed Answer:
Hi

Thanks for writing back.
as you are having good result with laser in terms of scar reduction, continue with same.
Redness as you mentioned has reduced but still follow strict sun protection and use sunscreen . For break outs use anti acne creams as nentioned in previous post
Hope this helped
Take care
Above answer was peer-reviewed by
 
Follow-up: Done with Accutane. Treatment with IPL laser for redness and pigmentation. Breaking out on chest, stomach and thighs. Help? 18 hours later
Yes I will continue with the laser treatments, today I broke out today on my areas that were treated as well. But they should be gone soon. Also she gave me a sample of this green stuff for redness, not sure what it is, and she also gave me a sample of this liquid glycolic acid. Not sure if I want to use these samples yet, should I ? She didn't really explain them in detail so. What will they do for me? And also she sked if I clean my face and I said I just splash with water every morning. She says I need to get a cleanser. What are good cleansers, my skin is really sensitive so.

Thanks.
 
 
Answered by Dr. Kalpana Pathak 30 hours later
Brief Answer:
use cetaphil cleanser for washing face

Detailed Answer:
Hi,
Thanks for writing to us.
Immediately after lasers and atleast for a week i wouldnt advise any medicine applicayion over face. Icing over face and sunscreen useis indicated immediately after lasers to reduce redness.
After a week you may use medicines given by yoyr doctor. I have no idea what that green atuff could be. Glycolic acid is a peeling agent. its regular use reduces marks,scars and acne. So you may use it.
Like I have stressed earluer also, use a sunscreen post laser and avoid persistent redness over face which can be controlled by sun protection, icing, calamine lotion use and mild steroids.

Hope this helped.
Take care
Above answer was peer-reviewed by
 
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