Herpetic complications of various types of peeling. Allergy after peeling – what to do? Herpes after peeling what to do

Peeling has become very popular: this procedure helps to get rid of many skin imperfections for a long time.

But at the same time, such an aggressive effect on the epidermis can lead to harmful consequences if you approach it incorrectly and without preparation.

What consequences are possible after peeling, how to prevent them, how to eliminate them? Let's figure it out.

Types of procedures, their action, purpose

Much during cleaning depends on the characteristics of the skin, the cleaning option, and the level of exposure.

Among the purifications are:

– it does not reach the deep layers of the dermis, acting only on the surface. Reduces pigmentation, evens out tone, slightly reduces fine wrinkles.
– reaches the stratum corneum and part of the epidermis. Levels out age spots, reduces the accumulation of wrinkles, and significantly improves complexion.
– reaches deep skin layers. Significantly reduces the number of wrinkles, age spots, whitens well, has a rejuvenating effect.

First type of procedure Suitable for sensitive, dry (with caution), combination skin that does not show serious age-related changes.

Median good for oily skin with active pigmentation and wrinkles.

Deep view Suitable for getting rid of significant imperfections - deep wrinkles, an abundance of age spots, and other changes.

Adverse Results

All consequences are divided into 2 types: expected and unexpected.

The first group includes problems that arise in patients, occur without any special consequences and pass quickly. This is a predictable reaction to the manifestation of stimuli.

These include:

Erythema– redness of the area of the epidermis that has undergone cleansing. Depends on the type of exposure, its duration, skin sensitivity. Red spots on the face after the procedure can last from 3 hours to several days. During laser resurfacing skin may remain red for two months.

Peeling usually goes almost unnoticed, especially when using fruit acids. After trichloroacetic acid, peeling becomes widespread, lasting a week. If your face peels off after the procedure, you should not help your epidermis renew itself - the process must take place naturally. You need to take care of good hydration during the recovery period.
Increased sensitivity– after cleansing, the dermis can react in a unique way to any irritants - light, exposure to temperature or mechanical stimulation. With a special course of the process, sensitivity can persist for up to a year, but usually goes away in a couple of weeks.
Swelling is an inflammatory reaction. By increasing the permeability of the capillaries located in the epidermis, cleaning causes fluid to leave them and accumulate in the tissues. Swelling occurs. There is usually no such reaction after using light acids, but retinoids can cause swelling. It can last for several days, but does not appear immediately, on the 2nd or 3rd day after the procedure.
Darkening of the skin– treated areas may “oxidize” - acquire dark shade. But as you exfoliate, the old scales of the epidermis will be removed, and renewed, lighter ones will appear in their place.

Here's what your facial skin looks like in the photo before, immediately after, and some time after peeling:

The second group includes those consequences that are illegal are selective.

They may have a negative impact on the aesthetics of the result, are unsafe, and require treatment.

Among them:

Allergic reactions– they arise not in response to substances affecting the skin during peeling, but in response to subsequent irritants, when the skin is renewed, thin and irritated.
Herpetic infection– occurs after medium and deep cleaning, laser resurfacing. It may occur due to relapse of herpes, but sometimes infection occurs during the procedure if the patient’s immunity is reduced.
Other infections may arise due to the doctor’s negligence towards the standards of the procedure or the patient himself towards the post-peeling period.
Pallor or marbling– due to the leveling of a large number of melanocytes, reverse pigmentation may occur – lightening of areas of the dermis, especially if its owner was dark-skinned. Such a reaction cannot be completely cured, but with light peelings you can try to reduce it a little and even out the tone.

Persistent erythema– if the patient has dilated superficial vessels, the problem may appear after deep peeling. This reaction can last up to a year, but usually goes away on its own.
Hyperpigmentation– occurs after deep and laser peelings performed incorrectly. Inflamed skin cells actively produce melanin, which leads to darkening.
Appearance or worsening of acne. Acne after peeling appeared because the provoked inflammatory reaction causes the cells that produce sebum to work actively. Pores become clogged and acne appears. At risk are people with oily skin, a predisposition to acne, and those who decide to undergo deep or medium peels.
Scarring– facial skin disorders after exposure to deep chemical peels. They may appear after an incorrect cleaning procedure.
Burns– a slight burn on the surface is not considered a deviation from the norm. But if the procedure was performed incorrectly or the patient has sensitive facial skin, the burn after peeling may become more serious.

What consequences are possible after peeling:

Treatment of complications

If the cleaning procedure does lead to negative consequences, they need to be leveled out, especially if there are serious underlying causes.

Treatment may be as follows:

Appearing itching It usually goes away with time, but you can help your skin recover faster.
After peeling, apply a cold compress and take an antihistamine. Keep the dermis moisturized and use hypoallergenic products.
If after peeling your face is very itchy and red, you can resort to sedatives. Use all medications only after consulting a doctor.

Erythema easily treated with corticosteroids in combination with moisturizers and sedatives. Need to use sunscreens. If redness does not go away after a week of such manipulations, consult a doctor to rule out an infectious lesion.
Resulting scars treated with corticosteroid injections. Occlusive dressings can be added; in more severe cases, laser treatment and surgery are indicated.
Hyperpigmentation usually goes away on its own. To prevent its growth, use Sanskrins. This manifestation is treated with a laser method (in severe cases).
Infections of bacterial or viral origin are leveled by antiviral and antibacterial agents - ointments, creams.
The occurrence of acne can be treated with antibiotics, azelaic acid, small doses of steroids or isotretinoin.

Any negative impact can be easily prevented if know about the characteristics of the patient’s skin, his predispositions, while observing all the rules of hygiene and cleaning procedures.

Precautionary measures:

to prevent allergies It is advisable to conduct a test for active drugs;
Herpes infections can be avoided, having previously resorted to antiherpetic drugs;
other infections can be prevented by taking antibiotics;
persistent erythema is prevented by avoiding saunas, drinking alcohol, spicy and spicy foods, and active physical work;
Hyperpigmentation can be avoided, having carried out a thorough examination for the presence of a predisposition to the formation of age spots. It is important to cure ongoing inflammatory processes in advance;
acne is prevented By taking the Aevit multivitamin complex, antibiotics may be prescribed. A competent cosmetologist and doctor will immediately after the procedure make a soothing and healing mask, apply the necessary protective creams or ointments;
to prevent crust formation After peeling, it is advisable to immediately conduct a session of nourishing masks immediately after the cleansing procedure.

If you follow all the rules of preparation and proper skin care measures, you can prevent the occurrence of all negative consequences and achieve good results when cleansing your skin.

Peeling is a cosmetic method of improving the appearance and condition of the skin. Peeling has remained a popular procedure for a long time and is not losing ground in the near future. The essence of the method is that to renew the skin and get rid of cosmetic defects, you need to damage the superficial or even deep structural layers of the skin. Any intervention in the body is dangerous due to complications and side effects. The risk of their occurrence after peeling is relatively small, but they can seriously affect the result and expectations from the procedure.

Why do complications occur after peeling?

Experts divide complications into expected(predicted) and unexpected(unpredictable), uncharacteristic for this procedure. Expected complications naturally arise soon after the procedure; they are a natural reaction of the body to damaging effects (chemical, mechanical, etc.).

When peeling, the upper layer of the epithelium, which performs protective functions, is removed, and the upper layers of the skin are dehydrated. In this state, the dermis is hypersensitive to ultraviolet and thermal radiation, changes occur in metabolic processes and vascular reactions. These processes are influenced individual characteristics and the level of sensitivity of the body. The deeper layers of skin the peeling affects, the stronger the body reacts, i.e. With deep peeling, complications will be more significant.

The type of complications and the severity of their severity depend on many factors. The cosmetologist must correctly assess the initial state of the dermis, thickness, sensitivity and phototype of the skin, take into account the patient’s age and individual regenerative capabilities, the severity of dermatological changes, the presence of chronic diseases, etc.

Dangers of Acid Peels

The choice of peeling type is of great importance. Certain types of peeling have specific types of complications. For example, if a patient suffers from a chronic disease of the cardiovascular system, liver or kidneys, some complications after a chemical peel may be dangerous for him. The explanation for this phenomenon is that chemical reagents are easily and quickly absorbed from the damaged surface and have a toxic effect on internal organs.

Also, a competent cosmetologist always takes into account the sensitivity of the skin and strictly follows the procedure protocol when performing acid peeling, because with it there is a very high risk of skin burns, hyperpigmentation, the formation of a “borderline” line and persistent erythema.

Risks of laser peeling

Complications of chemical peeling are associated with the aggressive chemical effects of drugs; complications of laser peeling have their own specifics. The list of common complications is supplemented by consequences specific only to the laser procedure:

the appearance of blisters with a serous or bloody mass (typical of sun or thermal burns), after their opening, erosions are formed, which subsequently become scarred and pigmented;
minor hemorrhages and subsequent hematomas due to damage to small vessels (on the surface of the skin it looks like bloody dew);
if a specialist incorrectly assesses the thickness of the skin and sets incorrect parameters for the procedure, the risk of a “gauze” effect increases, when multiple small atrophic scars form on the skin;the appearance of this complication may also be associated with an individual tendency to form keloid scars.

Complications after peeling

Peelings differ in depth and mechanism of action, but they all have one the goal is to remove the surface layers of the skin, therefore the main possible consequences peeling procedures are similar.

Expected complications

Erythema or persistent pronounced redness in the treatment area. The more aggressive the peeling technique, the more persistent and pronounced the redness will be. This complication often occurs after deep peeling in patients with dilated vascular networks on the face.

Swelling on the face and eyelids. They arise due to the fact that the liquid part of the blood comes out into the tissue, because. small vessels become more permeable. This occurs within 1-3 days after the procedure and persists for several days. This type of complications is most typical for retinoid and mechanical peels and laser procedures.

Peeling– in fact, this is why the peeling procedure was carried out, its usual and expected consequence, which takes place within 1-3 days. After using trichloroacetic acid or resorcinol, the keratinized skin comes off in large scales within a week; to facilitate this process, cosmetologists recommend using a moisturizer.

Darkening of the skin, usually uniform and passing after exfoliation within 1-2 weeks.

Increased skin sensitivity to mechanical, temperature, pain effects, sunlight. This reaction usually goes away within 1-2 weeks, but in rare cases it can persist for up to a year after the procedure.

Hyperpigmentation– a reaction in which dark areas form on the skin due to an inadequate cellular response and excess melanin production; characteristic of laser peeling and peeling with trichloroacetic acid.

Unpredictable complications

The occurrence of these complications is possible, but not natural. This group includes complications that negatively affect the aesthetic result of the procedure or threaten the patient’s health.

Persistent erythema– intense persistent redness of the skin, which lasts up to 1 year and goes away on its own. It is more often observed in patients who have rosacea after laser resurfacing or deep peeling. In this case, cosmetologists recommend avoiding actions that provoke a rush of blood to the face: do not visit the bathhouse or sauna, exclude hot and spicy foods and alcohol from the diet.

In this case, this complication can be alleviated with the help of drugs that strengthen the walls of blood vessels and increase their elasticity. Omega-3 fatty acids have this effect. Microcirculation in skin cells helps to improve heparin and hepatothrombin ointments, as well as remas with arnica extract. Microcurrent therapy, which improves lymphatic drainage, cellular regeneration and blood microcirculation, significantly improves the condition of the skin in this complication.

Allergic reaction can be expressed in various rashes on the body, itching, angioedema and other forms, the most serious of which are respiratory failure and anaphylactic shock. Allergic reactions occur mainly to the auxiliary components of the peeling preparations used - ascorbic and kojic acids. In mild cases, antihistamines may be sufficient; in severe cases, emergency intensive care may be required.

Exacerbation of herpes– rashes on the wound surface, healing with the formation of atrophic or (less often) hypertrophic scars. If a patient experiences exacerbations of a herpetic infection, he is prescribed preventive treatment with Acyclovir once every six months. In case of relapse after the procedure, oral antiherpetic drugs and external use of similar ointments are also prescribed.

Tissue inflammation with hyperemia(redness) soreness and swelling, with symptoms lasting more than 3 days. This complication is treated with local application of non-steroidal anti-inflammatory drugs (for example, indomethacin ointment).

Skin marbling– a complication that occurs due to excessively deep exposure to the peeling drug or gross violations during the procedure, resulting in the destruction of a large number of melanocytes in the skin. This complication is dangerous because it cannot be completely corrected, only slightly adjusting the overall uniformity of skin tone.

Demarcation line– formation of a pronounced border of the treated area. It is more common in dark, porous skin after deep types of peeling. This complication is not dangerous; it can be smoothed out with additional peeling procedures.

Exacerbation of acne. Peeling can both help get rid of acne and post-acne, and provoke an aggravation due to irritation and activation of the function of the sebaceous glands. To treat this complication, antibiotics and vitamin complexes are prescribed.

Formation of keloid and hypertrophic scars, which can only be eliminated using a comprehensive method - using laser resurfacing, cryotherapy, steroid drugs or even surgical methods.

To minimize the risk of complications, you must strictly follow the rules of preparation for peeling and care after it.

Some tips for those who decide to undergo a chemical peel

Cosmetologists say that patients agree to peeling with such readiness that they do not agree to any other procedures. For most, peeling opened the door to a world of more serious cosmetic procedures And plastic surgery, because its motivational power is very great: with minimal effort you can get such a pronounced result.

In order for all expectations from the procedure to be met, you need to responsibly prepare for it.

Choose a licensed esthetician.

Only an experienced specialist can correctly diagnose the condition and problems of the skin, identify the characteristics of the patient’s lifestyle and determine the skin phototype, and then determine the feasibility of the procedure. For example, if a patient spends a lot of time in the sun throughout the year, chemical peeling can only worsen skin problems; an experienced cosmetologist will definitely talk about this and choose the most suitable therapy scenario.

In addition, only a certified specialist understands the smallest nuances of the peeling procedure and knows how to reduce the risk of unpleasant complications. The success of the procedure largely depends on the master’s ability to sense when to interrupt the procedure or, conversely, to make it deeper in certain places.

You need to consider a skin care system before, during and after the procedure.

All inflammations on the skin must be cured before the procedure, hair removal should not be done at least a week before peeling, avoid medications containing vitamin A in advance, choose powerful sunscreen and moisturizers - the cosmetologist should inform the patient about all this. You need to return to your usual care system gradually and very carefully, after complete exfoliation and restoration of the dermis.

You can plan a vacation to hot/cold countries or a trip to the bathhouse/sauna no earlier than 6 weeks after the procedure. Temperature changes cause hyperpigmentation.
For 2 days after the procedure, you should refrain from intense physical activity and sports training; ideally, this is a time of bed rest.
For the first few days, it is better not to wash your face with tap water; chlorinated water will dry out your already damaged skin.
Under no circumstances should you touch your face during the period of peeling of the skin; after peeling off the exfoliating scales, scars remain.

You can help your skin renew itself more quickly by washing your face with soft water, then patting your face with a soft towel and applying a generous amount of moisturizer.

It is better not to plan anything for a few days after the procedure. important meetings. Even after superficial peeling, the skin does not look in the best possible way until the scales peel off.
If the result is not noticeable, this does not mean that the peeling is ineffective.

Even if the promised abundant peeling does not occur, peeling “works” at the cellular level and triggers renewal processes, and changes occur differently for everyone.

It is useful to alternate peelings of different intensity and composition, but you need to know when to stop.

Our salon cosmetologists develop optimal treatment schedules for clients that prevent the skin from becoming “accustomed” when it gradually stops responding to the same type of repeated procedure, while at the same time taking care not to thin the dermis and reduce resistance to infections and bacteria.

Predictable complications after peeling

This includes complications after the procedure, which in one way or another manifest themselves in most people who have undergone a salon peeling session. Such complications should be expected within the first two weeks after the procedure, and they resolve on their own and in a short time. For this reason, they should not be classified as complications or side effects; they are just a skin reaction to this cosmetic procedure.

Erythema is the redness of the skin area treated with peeling, and the duration and severity of the manifestation depends on how “aggressive” the peeling was chosen for use in each individual case. For example, if the procedure was performed on the basis of alpha hydroxy acids, then redness can last about three hours. After a Jessner peel, erythema may persist slightly longer - about a couple of days. If a medium acid-based TCA peel was used, the erythema can last up to five days, and after deep peels, dermabrasion and laser resurfacing, the erythema lasts about 60 days.

Peeling skin

Many people are familiar with this manifestation in everyday life, and peeling usually occurs due to excessive dryness of the skin. However, the peeling of the skin that occurs after peeling goes away within a few days. When using soft peelings, peeling is almost unnoticeable, but if strong chemical solutions were used, then within a week the skin will peel off on its own with large flakes of dead and treated cells. At this time, you cannot promote this process, otherwise you can seriously damage the skin. The process must proceed naturally and complete on its own, especially if you moisturize and nourish your skin in a timely manner.

Swelling

Edema is a local inflammatory skin reaction to external influences. After a peeling session, capillary permeability increases, so liquid comes out of them, which then accumulates in the tissues, thereby causing swelling. This problem is especially expected for the skin in the neck and around the eyes, because there it is most delicate, thin and vulnerable. Peeling based on fruit acids is practically incapable of causing this skin reaction, but any stronger peeling can lead to swelling. They appear in a few days or less, while remaining on the skin for some time. Your specialist can minimize the skin's reaction to peeling if he can choose the right composition for your specific skin type.

This manifestation can occur on the skin, but there is no need to worry about it. The darkening goes away on its own after skin exfoliation.

Increased skin sensitivity

After peeling, the skin exposed to the peeling may react more strongly than usual to any external irritants. The problem goes away on its own after a couple of weeks, but it can become a complication, and then increased sensitivity may last a year.

Unpredictable side effects and complications of peeling

These problems can appear either after a few hours or after long time after peeling. They should not be classified as expected complications and skin reactions to the procedure. It is such manifestations that can not only spoil the entire aesthetic effect created by peeling, but in many cases threaten human health and require treatment.

Herpes virus infection

This complication in most cases is caused by deep and median chemical peels, as well as dermabrasion and laser resurfacing. Patients with recurrent herpes are especially at risk in this case, but it also happens that strong peelings cause primary infection due to a decrease in immunity caused by the procedure. Your doctor may prescribe medications to eliminate the herpes virus, but sometimes more complex treatment may be required.

Other infectious complications

In this situation, the activation of the problem may be associated with a violation of hygiene standards by medical personnel during the procedure, or by the patient during the recovery process after peeling. The main manifestation is streptostaphyloderma, which can be cured by taking appropriate antibiotics appropriate to the severity of the process.

Allergic reactions

The skin after a peel remains unprotected for some time, so something that has not caused an allergy in the past or caused mild itching can cause significant swelling and hives in the skin damaged by the peel. To prevent this from happening, take a sensitivity test to the peeling components and eliminate the influence of allergens during the rehabilitation period. This complication can be eliminated with steroids and antihistamines.

Skin marbling

This problem is a consequence of the death of a huge number of melanocytes caused by deep chemical peeling or aggressive skin resurfacing. Patients with dark skin are especially at risk. This situation is considered almost irreparable, but with the help of secondary sessions of superficial peeling, you can slightly even out the tone of damaged skin.

Persistent erythema

This complication often occurs in patients who have dilated superficial skin vessels and decide to undergo deep peeling. This skin reaction can last up to a year, but after that it often goes away on its own. To speed up rehabilitation, avoid alcoholic beverages, spicy foods, saunas, baths, beaches and gyms.

Skin hyperpigmentation

This complication often occurs after TCA peeling or after this procedure performed with a laser. Hyperpigmentation occurs due to poor diagnostics before the procedure. The work of improperly processed skin cells that actively produce melanin leads to the formation of dark skin areas.

If you want to avoid this problem, it is recommended to undergo a full medical examination. If the problem already exists, then mesotherapy based on ascorbic acid or phenol and retinoic peels can help.

Exacerbation of seborrhea and acne

This complication is provoked by inflammation, which encourages the cells responsible for the formation of sebum to actively work. Patients with chronic seborrhea or oily skin, after deep and medium peeling or laser resurfacing.

A preventative measure is to take a vitamin complex, and if inflammation has already occurred, then antibiotic therapy is carried out.

Appearance of the demarcation line

The demarcation line is a noticeable boundary between the untouched and peeled areas of the skin. This problem occurs in patients with porous or dark skin, especially after laser, deep or medium peeling. Smoothing of the boundaries of the demarcation line is carried out using Jessner peeling sessions.

Coarse scarring

Coarse scars can occur after deep chemical peels, or when the technique of TCA peeling is broken.

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Complications after peeling can occur due to many reasons. Side effects appear after surgery in the form of symptoms. As a result, a trip to a cosmetologist becomes a real tragedy. Complications can be predicted, then, by following all the instructions of the cosmetologist, all diseases will go away. But there are cases when even a doctor is unable to fix something. Therefore, additional treatment is prescribed for the skin.

What can go wrong with peeling?

Different types of cleansing have different effects on the skin. For example, complications after a TCA peel are usually a response to irritating chemical components. Laser peeling has its own peculiarities. That is, some symptoms are characteristic of this type of operation.

Ulcers may appear on the skin, which are filled with either blood or serous contents. If they are pierced, scars will form in place and the skin will change its color. The occurrence of microhematomas, vascular damage. Blood, in this case, comes to the surface. Outwardly, it resembles bloody droplets, like after light rain.

Another type of complication is the “gauze” effect. This can be a side effect of the skin layers being incorrectly identified, an error in calculations, or the body being susceptible to scarring.

If the patient follows all the instructions, then the problem lies in a medical error. For example, incorrect laser settings can cause redness to persist for up to a year. And if the drugs used in the clinic are expired, then acne may form throughout the body.

Who is to blame for complications after peeling?

Any operation is a very responsible matter. It is simply unacceptable for an amateur to undertake such work. But errors can occur not only on the part of the doctor. Patients often do not follow the instructions that they are required to read. For example, with some complications it is prohibited to drink alcohol. But some patients think that nothing will happen with one glass of cognac or a can of beer. Then in the morning, after one serving, problems begin. And the money spent on the operation simply goes down the drain.

While some types of procedures can be performed by a novice, other types of surgery should only be performed by an experienced cosmetologist. For example, calculate the acid concentration that is harmless to the skin.

Predicted side effects

The peeling process occurs by exposing the skin to a laser. As a result, the body experiences very severe stress. Old cells are removed, and the skin is renewed thanks to natural processes. Because dead cells accumulate in the pores and prevent the skin from breathing normally. Thus, by removing problem layers, the skin is again saturated with nutrients and oxygen.

The skin may experience consequences after facial peeling, and the laser treatment area will begin to peel off. This is a natural process. But for each predicted side effect there is a separate treatment method. Don't panic, it's better to follow your doctor's orders.

Erythema

Redness of the area of skin that was treated with the laser. And the stronger the impact of the beam, the more clearly the symptoms will appear. It is also necessary to take into account the sensitivity of the patient’s skin. People with this diagnosis are susceptible to this complication.

If the clinic uses a superficial technique, where fruit acids, then the redness lasts for several hours. But after a deep Jessner cleanse, these symptoms do not go away for two to three days.

Erythema after using medium acid exfoliations can last from 3 to 5 days. But there are methods after which redness of the skin can be observed from a week to a month. For example, deep cleansing or dermabrasion.

Edema

They appear due to the structural features of blood vessels. If they have increased permeability, then after laser treatment, fluid begins to release and accumulate from the vessels, which forms edema. Most often, symptoms are observed on the face, where there are sensitive areas.

However, the swelling itself does not appear immediately. The patient begins to notice complications the next day. Sometimes symptoms appear after 3 days.

To avoid this effect, the cosmetologist must calculate the harmless concentration of the acidic product. But for this you need to have a lot of experience.

Peeling

This is a necessary side effect. After treating an area of skin with a laser, cells begin to divide and renew themselves. Therefore, the more intense the peeling, the better for the skin. As a result, the upper layers of the epidermis begin to peel off and become very itchy. But at the same time, it is forbidden to touch it or rip off the sagging areas.

Darkening of the skin

As the chemical peeling was carried out, the skin begins to darken in some areas. But this is a natural process and there is no reason to worry. These are formations of old cells that will disappear after exfoliation.

Skin hypersensitivity

The effects of peeling can cause severe pain when touched. The skin becomes very sensitive and the patient feels this even when washing with warm water or while putting on makeup.

This complication manifests itself individually. Sometimes it ends in a week, and sometimes the symptoms last up to a year. This occurs because after exfoliation soft fabrics lose their protection. Sensitivity increases and the UV barrier decreases.

Unpredictable side effects

Complications can arise when no one expects them. That is, after the operation the patient begins to notice changes that are unusual for the body. Typically, these negative side effects have a very negative impact on the patient and can cause various health problems. Therefore, if such symptoms appear after surgery, you should immediately consult your doctor.

Allergy

This symptom may occur if an allergy test was not performed before surgery. As a result, the entire face and body are covered with malignant spots that constantly itch. In severe cases, swelling and difficulty breathing are added to the spots.

If the allergic reaction is mild, then the patient is prescribed antihistamines. But in other cases the patient is hospitalized.

An allergy test is carried out: Before surgery, a laser is applied to an open area of skin (for example, the arm), then the reaction is monitored.

Herpes

It can occur if a viral infection gets into the wound. As a result, the face becomes covered with purulent rashes. Typically, the immune system is weakened after exfoliation. Therefore, after medium and deep cleansing, doctors recommend taking a course of antiviral drugs.

Persistent erythema

If the patient has a tendency to rosacea. That is, a violation of blood circulation, as a result of which redness in the form of stars will begin to appear on the skin. Then the symptoms of erythema intensify, and the redness does not go away for a very long time. This usually occurs after deep laser exposure.

The complication may not go away for up to a year. During this period, doctors categorically prohibit visiting saunas, steam baths, and solariums. This year we will have to change the menu. Any spicy dishes and alcohol. Physical activity is also contraindicated. In particular, visiting gyms, fitness centers and other types of sports hobbies.

Marble shade

This problem occurs if patients initially had dark skin color. But after deep peeling or dermabrasion, melanocytes begin to die in the body. This causes dullness of the skin.

To fix the problem, you will have to try very hard. To do this, you need to go through a surface cleaning course more than once.

Scarring

If the cosmetologist does not set the laser correctly or does not calculate the effect of chemicals, scars may remain on the surface. This defect cannot always be corrected, for example, complications after a Jessner peel. A burn may form on the skin. But laser resurfacing can partially correct this problem. Cryotherapy or invasive methods can be used.

The emergence of a line of demarcation

This line separates the part of the face where exfoliation was performed and where the operation was not performed. The line contrast will depend on the laser penetration depth. This complication occurs most often in people with dark skin. To correct the defect, you must undergo a course of Jessner peeling.

Acne

There are many reasons for the problem:

Firstly, a side effect may occur if the infection occurs on a healthy area of skin;
Secondly, the patient may have wide sebaceous glands that constantly clog the pores;
Thirdly, the use of expired funds during the operation.

In order for acne to go away, the patient is prescribed a course of medication (antibiotics to eliminate the infection and a vitamin complex to strengthen the immune system).

How to prevent complications from occurring

Side effects can occur both due to the fault of the cosmetologist and the fault of the patient. You must adhere to the following recommendations:

Rehabilitation period

This period depends on the depth of the peeling. All instructions must be followed strictly as prescribed by the cosmetologist. Superficial peeling does not cause any particular harm to the skin. Can be used classic way skin care, but use hypoallergenic cosmetics and regular sunscreens.

Medium peeling. If after the operation the patient does not have some defects (in particular the basement membrane), then the use of sunscreens with maximum protection is allowed (see point 9).

Deep peeling (damage to the basement membrane due to medium peeling). To do this, a rehabilitation course is prescribed using antibacterial and anti-inflammatory drugs. Usually after the course the patient takes a vitamin course to restore immunity.

Problems after skin surgery are common. This may be the incompetence of the doctor or the carelessness of the patient. But any defect must be corrected. True, not all side effects can be eliminated. Therefore, you need to carefully prepare for the operation and know what consequences may arise after peeling.

About the author: Larisa Vladimirovna Lukina

Dermatovenerology (Internship in the specialty of dermatovenerology (2003-2004), Certificate of the Department of Dermatovenerology of St. Petersburg State Medical University named after academician I.P. Pavlov dated June 29, 2004); Confirmation of the certificate in the Federal State Institution "SSC Rosmedtekhnologii" (144 hours, 2009) Confirmation of the certificate in the Rost State Medical University of the Ministry of Health of Russia (144 hours, 2014); Professional competencies: management of dermatovenerological patients according to the procedures of care medical care, standards of medical care and approved clinical protocols. Read more about me in the Doctors-Authors section.

The term “disease” has many synonyms, including illness, disease, disorder, pathology, and others. They all describe any external or internal change which interferes with the normal functioning of the human body. There are many mandatory factors that are necessary for a person to remain healthy. Among them are clean air and water, proper diet nutrition, personal hygiene, adequate physical activity, etc.

The relevance of herpes simplex (HS) is beyond doubt among most cosmetologists. And yet, quite often one has to deal with ignoring measures for the prevention and treatment of this very common infection. When cosmetologists undergo training in peelings, dermatopigmentation, contouring, mesotherapy, etc. teachers always talk about the possibility of exacerbation of PG during procedures; therapeutic and prophylactic doses of synthetic nucleosides are indicated. But..how many cosmetologists use these recommendations in their routine activities? How many people bother themselves before carrying out superficial peelings or mesotherapy to collect anamnesis for relapses of PG? Very few. IN best case scenario, the patient will independently indicate the presence of relapses and ask whether this matters. At worst, herpes simplex will manifest itself in full and regress unrecognized. The problem lies not only in preventing the occurrence of PG, but also in its diagnosis and treatment when a relapse occurs. This article is devoted to these three questions.

The relevance of herpes simplex in cosmetology.

The relevance of the problem of herpes simplex (HS) in cosmetology is due to the fact that many procedures are based on disruption of the epidermal barrier (mechanical or chemical effects). Any damage to the skin, including those carried out for therapeutic purposes, is potentially an “entry gate” for any infection and a triggering factor for the exacerbation of a chronic infection: herpes simplex, facial pyoderma, candidiasis, etc. At the same time, herpes simplex is one of the most common infections localized in the facial area. Why should you prevent PG? Why do they always talk about the risk of relapse in training? Are exacerbations of PG dangerous due to cosmetic procedures? Maybe, if it has already arisen, you should use some local antiseptic or a local form of acyclic nucleosides, and the problem will be solved? But it's not that simple. Firstly, if the epidermal barrier is disrupted, PG can spread to the entire face, similar to Kaposi's herpetic eczema. Dermatologists observe similar phenomena against the background of rosacea, atopic dermatitis and other skin diseases. Secondly, herpes simplex, like any infection, disrupts the healing process, which is accompanied by the formation of scars and post-inflammatory hyperpigmentation. It is impossible to quickly stop an exacerbation by taking nucleosides or local remedies (if treatment is started later than 12 hours from the onset of a relapse), you can only shorten its duration and smooth out the severity of symptoms, reduce the number of vesicles, and prevent possible complications. Thirdly, and this is least known to a wide range of cosmetologists, type 1 PG localized on the face can be the initiating factor of various systemic diseases. For example, exudative erythema multiforme (5)

Criteria for prescribing medications.

One of the most important questions is: how to predict whether a relapse will occur? What are the specific criteria for prescribing certain medications?

The decision depends on 2 factors, which are assessed in each case individually:

1) the presence of relapses of PG in the patient’s history

2) the degree of skin damage by the procedure

If the patient has never had herpes, but the procedure creates an extensive wound surface, the prophylactic use of antiviral agents is necessarily prescribed. This applies, for example, to deep chemical peeling or laser peeling face (CO2 laser, etc.) Even with all the factors indicating the advisability of preventing or treating exacerbation of PG, many cosmetologists are reluctant to prescribe systemic nucleosides. The reasons for this are underestimation possible complications, which can cause exacerbation of PG, as well as considerations about the harmfulness of “extra” for the patient’s body and economic inexpediency. It should be noted that the latest generation of acyclic nucleosides selectively interact with the cell affected by the virus, since they have maximum affinity for viral proteins (2,4). If the procedure is superficial, but relapses of PG are frequent, treatment should also be prescribed. What is considered frequent relapse? If a patient has symptoms of herpes simplex more than 3-4 times a year, it is better to prescribe prophylactic treatment with acyclic nucleosides (4). Below we will discuss the features of preventing PG during basic cosmetic procedures: peelings, mesotherapy, etc. In general, it can be noted that there are three ways to prevent exacerbation of PG:

1) Taking synthetic nucleosides: valacyclovir, famciclovir, acyclovir

2) Use of dosage forms for local application: Acyclovir ointment, Viru Merz Serol gel

3) Compliance with the rules of asepsis and antisepsis during the procedure and subsequent home care.

Doses of use of synthetic nucleosides for the prevention of exacerbation of PG:

Acyclovir 400 mg twice daily Valacyclovir – 500 mg once daily Famciclovir – 250 mg twice daily

Of course, for superficial interventions and/or rare relapses, it is not necessary to prescribe systemic nucleosides; in this case, local antiviral agents are the optimal choice. Products for topical use are mainly presented in the following forms.

1) Ointments based on synthetic nucleosides (acyclovir and famciclovir) with various trade names, affecting the viral replication protein thymidine kinase

2) Drugs that enhance the local, in particular, immune response to HSV, mainly interferon inducers or phagocytosis stimulators. Alpha-interferon-based agents are most often used.

3) Agents with antiviral properties that do not belong to the group of synthetic nucleosides. This group includes tromantadi n, a substance that suppresses the processes of integration of the virus with skin cells, which is important specifically for the prevention of exacerbation. On our market, the tromantadine-containing drug is represented by the trade form Viru Merz Serol. The base of the product for prevention is also important; it is better to use a gel form that is transparent and does not create a greasy white film. From this point of view, for example, tromantadine gel (Viru Merz Serol) is convenient.

Diagnosis of PG.

One of the problems associated with PG is its diagnosis. Difficulties arise when PH occurs in an erased form, like a “burn”, or when primary herpes develops. The typical appearance of grouped herpetic vesicles and erosions on an edematous-hyperemic background most often does not cause diagnostic difficulties. However, with procedures that violate the epidermal barrier, PG can occur as a wound or “burn”; there is swelling and redness, slight discomfort or a slight burning sensation, vesicles are single or absent, but the process is persistent and can spread to the entire face (Fig. 1). It is difficult to immediately diagnose this form of PG. Doing a polymerase chain reaction (PCR) analysis from a lesion is problematic, since the dermatocosmetologist usually does not have established connections with PCR laboratories, and in addition, this takes time. It is not practical to detect specific antibodies in the blood, since they are present in most people and do not correlate with the “culpability” of the virus in causing the skin problem.

How to understand that it is herpes? It retains the following symptoms: a burning sensation of varying degrees of severity and slight swelling revealed by palpation. And in most cases, at least single vesicles can be detected when examined under a magnifying lamp. Primary herpes can also be problematic. This is a more extensive lesion that can involve large areas of the gums, mucous membranes of the lips, nose or other areas of the face. Primary herpes occurs at the first contact of the herpes simplex virus with the body, and may be accompanied by pain and symptoms of general intoxication. Often, patients with primary herpes leave dermatologists with diagnoses of allergic dermatitis, stomatitis, etc., and with treatment corresponding to these diagnoses. In general, the focus of primary herpes is similar to the usual “cold on the lips”, but more extensive, with a large number of vesicles and erosions, with a swollen, brightly hyperemic base and, often, pronounced subjective sensations. Treatment of primary herpes requires higher doses of acyclic nucleosides.

Stopping a relapse.

What to do if preventive measures were not taken, or there were no prerequisites for them, but PG still developed? In this case use:

1) Taking systemic synthetic nucleosides for 5-7 days.

2) If damage to the epidermal barrier persists, for example, if a relapse occurs 3-4 days after the mid-peel, the entire face is treated with an antiseptic without local irritation, preferably an aqueous rather than an alcohol solution (for example, an aqueous solution of chlorhexidine)

3) If there is one large lesion, for example, on the lips after contouring, the intake of nucleosides is supplemented with a local antiviral agent to combine systemic and local action

4) In the event of the appearance of “harbingers” of PG (a burning sensation in the skin area typical of the localization of PG) or the first vesicles, it is necessary to start regular intake of nucleosides in the first 24 hours of exacerbation, and preferably in the first 12 hours, this improves the prognosis of treatment. The earlier it is started, the better the result. The course of such therapy is at least 5 days. It is better to prescribe systemic nucleosides of the latest generation, which have a high affinity for viral thymidine kinase (virus reproduction protein), have a convenient dosing regimen and are well tolerated, for example, valacyclovir or famciclovir. Dosages of acyclic nucleosides in the treatment of relapse of PG:

Acyclovir 200 mg – 5 times a day
Valaciclovir 500 mg – 2 times a day
Famciclovir 250 mg – 2 times a day

Topical products are mainly represented by acyclovir-based ointments with various trade names; drugs that enhance local immunity; patented agents with antiviral and/or wound-healing properties. The most commonly used are alpha-interferon gels, acyclovir ointments, and Viru Merz Serol. These drugs have the following mechanisms of action. Acyclovir interacts with viral reproduction proteins, alpha-interferon is one of the natural components of antiviral resistance, that is, they suppress the vital activity of the virus. Viru Merz Serol is a local remedy containing tromantadine, a substance that inhibits the formation of syncytia at the site of virus replication and suppresses the processes of virus integration with skin cells, which is important not only for treatment, but also for the prevention of exacerbation. The main requirements when choosing a local drug are the presence of controlled studies of effectiveness and safety, as well as the absence of local irritation and allergenic effects. Herpes simplex and peeling The intake of synthetic nucleosides is recommended during medium and deep peeling (in the latter case it is mandatory).

In our opinion, the possibility of recurrence of PG during medium and mid-deep peels depends on the presence of relapses of PG not only in the patient, but also in the doctor, since the HSV virus is transmitted by airborne droplets. During the procedure, the doctor bends over the patient’s face, which by the end of the procedure often has a wound surface. Therefore, if the doctor suffers from relapses of labial PG, he needs to carry out the procedure wearing a mask. It should be remembered that the virus can be released asymptomatically, in the absence of visible rashes, so a mask is advisable in any case, even if the procedure involves minimal damage to the skin. The duration of prophylactic administration of nucleosides depends on the depth of peeling. For medium peeling, it is better to start taking it the day before the procedure and continue until the bulk of the crusts have come off. The deeper the peeling, the longer the course of taking nucleosides. With medium peeling, herpes often worsens on the 3-4th day of rehabilitation, when crusts have already formed and the patient can rip them off, or accidentally break their integrity during facial movements, which leads to exposure of the wound surface. Recurrences of PG can also occur with superficial peeling; this depends on its acidity and the severity of the local irritant effect; the greater it is, the higher the likelihood of exacerbation of PG if there is a history of frequent relapses. When carrying out a course of superficial peelings, it is not advisable to use systemic synthetic nucleosides.

However, if there is a history of relapses and the peeling has a locally irritating effect, the pre-peel preparation can include lubrication of the areas where PG is usually localized with an antiherpetic agent for topical use. To do this, it is better to use products that do not have an allergenic, irritating, exfoliating or any other effect that could increase acid penetration during peeling ( good choice is Viru Merz serol, the basis of this medicine does not change skin characteristics that affect the penetration of glycolic and other acids).

Herpes simplex and contouring with injection implants

In this case, the factor of disruption of the epidermal barrier is not as important as the presence of relapses. Firstly, with frequent relapses of PG, foci of fibrosis form on the lips, which makes it difficult to insert an injection implant. Secondly, in most cases, the formation of abscesses and granulomas during contouring is associated with chronic infection, inflammation occurs at the implant/tissue border. Abscesses and granulomas are rare with the introduction of biodegradable implants; more often there is an episodic appearance of swelling and redness over the implant, which is also associated with chronic infection. Therefore, in case of frequent relapses, it is better to postpone the procedure until the process stabilizes and use biodegradable implants, since the complications associated with them correspond to the short “life” of the implant in the tissues. In case of rare relapses, you can limit yourself to preventive (within 5 days before and after the procedure) lubricating the lips with a topical preparation, for example, acyclovir ointment, gel with interferon alpha or Viru Merz Serol. Thus, it is possible to exclude exacerbation of PG due to injection, but this does not guarantee against the absence of recurrence of PG in the future, as well as from its negative impact on the implant. We observed the development of PG twice after contour plastic surgery. In one case, labial herpes developed in a patient 5 days after the lip contouring procedure; she had not previously had relapses of PG (Fig. 4). In another case, 3 days after contouring of lips and nasolabial wrinkles, the lesion was localized on the lower lip (the last exacerbation of PG in this patient was 2 years ago). After contouring, the doctor should give the patient recommendations in case of exacerbation of PG, which consists of taking acyclic nucleosides and using local agents.

Herpes simplex and dermatopigmentation

Recurrences of PG disrupt the contour of the lip tattoo. The degree of circuit disruption can vary and depends on the severity of the exacerbation. Sometimes after tattooing, patients experience more frequent relapses of PG. If relapses occur more than 4 times a year or there is a tendency for the frequency of relapses to increase, then better procedure postpone until the process stabilizes. This is due to the type of immune response to the herpes simplex virus; at the specified frequency of relapses, the normal cellular type of response to the virus is lost and the functional one deepens. If relapses are less frequent, then 1–2 days before the procedure a 5–7 day course of systemic acyclic nucleosides should be prescribed. Dermatopigmentation is one of the most common reasons exacerbation of PG, therefore, even in the absence of a history of PG relapses, it is advisable to prescribe preventive treatment of the lip area. For example, 3 days before the procedure, start lubricating the red border of the lips with Viru Merz Serol, 3-4 times a day, or acyclovir ointment.

Herpes simplex and botulinum toxin

Problems with the use of botulinum toxin are usually associated with the effect of the drug when administered incorrectly. We present a case from practice where a recurrence of PG may have occurred as a result of impaired neurotrophism and microcirculation. A 41-year-old patient who suffered from frequent relapses of herpes (8–9 times a year), shortly after the injection of botulinum toxin (the injection was made during remission of PG), a diffuse burning sensation appeared in the projections of the drug administration and a relapse of PG developed (there was swelling under the eye, on the lips - rashes typical for PG). PCR from the lesions showed a positive result, and 2 days later herpes-associated erythema multiforme developed. Taking nucleosides for 10 days and administering 2 ml of diprospan stopped the manifestation of erythema multiforme, but subsequently relapses of erythema multiforme recurred. After 2 months, the patient developed a persistent lymphocytic infiltration in the place where there was edematous herpes (Fig. 2). In case of frequent relapses, botulinum toxin should not be administered until the process has stabilized.

Herpes simplex and mesotherapy

The effect of mesotherapy treatment on PG can be characterized as positive; traditionally administered drugs are hyaluronic acid, vitamin C, organic silicon, vitamin complexes, etc. have the property of increasing the regenerative and immunocompetent properties of the skin. However, after mesotherapy procedures, exacerbation of PG is still possible. The likelihood of exacerbation depends on the local irritating properties of the administered drug and pain during the procedure. We performed mesotherapy on two patients who had a history of exacerbation of PG after the mesotherapy procedure. In the first case, the patient noted extremely painful sensations during the procedure, but the doctor insistently recommended not to perform anesthesia, citing the lack of proper anesthesia effect from mesotherapy treatment. Two procedures were performed with an interval of 14 days, after both there was an exacerbation of PG after 1-2 days (history of relapses of PG 3-4 times a year), after which the patient stopped visits. Our procedures were carried out after topical anesthesia with Emla; no exacerbation of PG was noted during the entire course of procedures. Another patient had a strong burning sensation when the drug was administered, which is often observed with the papular administration of a number of mesotherapy agents. She had a recurrence of PG after the procedure (Fig. 3), as a result of which she did not continue the course. Thus, it can be assumed that during mesotherapy the trigger for exacerbation of PG is pain and the local irritating effect of the drug rather than a violation of the integrity of the skin with a needle.

Herpes simplex and skin diseases

Against the background of skin diseases that weaken the epidermal barrier (atopic dermatitis, rosacea, etc.), lesions of PG can spread throughout the face. This condition, called Kaposi's eczema herpetiformis minor, is also characteristic of atopic dermatitis and some other dermatoses. If disseminated blisters that tend to cluster appear on the face, PG should be excluded. For this purpose, PCR for the AI virus from vesicles or erosions is used. Treatment requires mandatory intake of systemic nucleosides for 10 days. Foci of PG during relapse can be detected on the scalp, which occurs against the background of seborrheic dermatitis or other diseases of this localization, but this is rare, in this case diagnosis requires verification using polymerase chain reaction.

Conclusion

Herpes simplex is quite common in cosmetologist practice. Timely clarification of herpetic history and taking preventive measures significantly reduces the likelihood of relapse. For prophylaxis, either the use of systemic acyclic nucleosides (acyclovir, valacyclovir, famciclovir) or the use of local agents without a local irritant effect (Viru Merz Serol) is used, depending on the frequency of exacerbations of PG in history and the type of procedure. When diagnosing PH, one should take into account the features of PH against the background of a number of cosmetic procedures (“wound” herpes: often disseminated lesions, but with erased clinical manifestations and single vesicles. When an exacerbation occurs, local antiseptics, systemic acyclic nucleosides and local antiherpetic agents are used in combination.