Varicella-zoster virus expression following fractional Thulium laser treatment for skin rejuvenation: the first case report

The use of high-power lasers for facial rejuvenation has been growing every year. In particular, the Thulium laser in non-ablative mode has gained prominence due to its safety, postoperative comfort, and wide clinical indication. This report details the first documented case of a varicella-zoster virus expression following the use of a non-ablative fractional 1927 nm Thulium laser for facial skin aging and pigmentated lesions. The treatment proposed involved a combination of phototherapies as an adjunctive local strategy, alongside systemic acyclovir therapy. In nine days, herpetic lesions and skin areas with altered sensory function were no longer present. Varicella-zoster virus expression should be considered following aesthetic skin treatments with fractional Thulium laser, and the need for prophylaxis with antiviral agents may be appropriate for certain cases. Moreover, the combination of phototherapies proposed herein seemed to be beneficial for accelerating the resolution of such a condition.