Medicines and Health Conditions That Matter Before Laser Treatment

Why your provider asks about your health

The health questions at a laser consultation can feel like paperwork, but they shape your plan. Laser treatment works by sending energy into the skin, and your skin then has to heal. Medicines and conditions that affect light sensitivity, healing or the immune system can change both parts.

The American Academy of Dermatology (AAD), in its advice on preparing for laser hair removal, says to tell your dermatologist about any medicine you take, including ones you buy without a prescription, such as aspirin. The same habit makes sense before any laser. Laser Eraser's site says a physician screens for certain medications before treatment, and the candidacy quiz asks whether you have a condition you would want to discuss.

One rule comes first: do not stop or change a prescribed medicine on your own to qualify for laser treatment. Tell your laser provider what you take, then let them and the doctor who prescribed it decide together whether anything should change.

Isotretinoin: how the advice has changed

Isotretinoin is a prescription pill for severe acne. For years, it was widely taught that taking it within 6 to 12 months of skin surgery could lead to abnormal scarring or slow healing. The AAD still lists having taken isotretinoin among things to tell your dermatologist before laser hair removal. A 2017 report from an American Society for Dermatologic Surgery (ASDS) task force noted that the drug's package insert advised stopping it 6 months before cosmetic procedures, including laser procedures.

Two consensus reviews published in 2017 looked at the evidence. One, in JAMA Dermatology, found the waiting rule was based on 3 small case series from the mid-1980s. Its panel reviewed 32 publications reporting 1,485 procedures. It found insufficient evidence to support delaying laser hair removal or fractional ablative and nonablative laser procedures, and it did not recommend fully ablative laser or mechanical dermabrasion during isotretinoin treatment.

The ASDS task force reached a similar view. It found insufficient evidence to justify delaying nonablative lasers, including hair removal, vascular and nonablative fractional lasers, for people currently or recently taking isotretinoin.

These conclusions have limits. They rest mostly on small studies and panel agreement, and the procedures their summaries name do not include tattoo-removal lasers. The JAMA Dermatology panel framed it as an informed discussion between doctor and patient. Some providers still prefer to wait, so tell your provider if you have taken isotretinoin and when you stopped.

Gold therapy and a rare blue-gray reaction

Injected gold has been used to treat arthritis. A small number of case reports describe a reaction called laser-induced chrysiasis: blue-gray patches that appeared right away at spots treated with a Q-switched laser in people who had received gold therapy.

A 2015 review found five reported patients, most of whom had received large amounts of gold over several years. In some, gold therapy had ended as long as 26 years before the laser treatment. This is rare and known only from case reports, but it is a reason to mention any past gold injections, however long ago.

Light sensitivity, healing and bleeding

The AAD notes that some medicines can make the skin more sensitive to laser light. If a medicine label warns about sun sensitivity, or you have ever burned unusually easily while taking something, tell your provider.

Healing and bleeding matter too. The AAD's guidance on laser scar treatment says some medicines and supplements, such as vitamin E and aspirin, can delay healing, and that you may need to pause something for a while. That decision belongs to your doctors. If you take a blood thinner or daily aspirin for your heart, do not stop it for a cosmetic visit; ask the prescriber first and let your laser provider plan around the answer.

Skin care products count as well. The AAD notes you may need to stop certain products, like topical retinoids, before laser treatment, and its scar guidance says to stop retinoid or glycolic acid products for 2 to 4 weeks first. Ask your provider what they want before tattoo removal. If the retinoid cream was prescribed, check with the prescriber too.

Skin conditions that can react to treatment

Laser treatment injures the skin in a controlled way, and some conditions respond to any skin injury. Mention these even if they are quiet right now:

• Psoriasis. The AAD says any skin injury, including a tattoo, can trigger a psoriasis flare near the spot, about 10 to 14 days later.
• Vitiligo. The AAD says a wound can trigger new vitiligo patches on injured skin (the Koebner phenomenon), appearing about 10 to 14 days after the injury.
• Keloids. The AAD lists a history of keloids, or a tendency to scar, among things to tell your dermatologist before laser hair removal. Laser Eraser treats keloids with injections into the scar, not laser, and our keloid glossary entry explains why they behave differently.
• Cold sores. If a lip tattoo or lip blush is being treated and you get cold sores, the AAD notes that people prone to them may need medicine to prevent an outbreak. That comes from your doctor.
• Conditions that affect healing or immunity. Any condition or medicine that affects your immune system or how you heal is worth raising, so your provider can judge timing.

When to see your own doctor first

Sometimes the laser office is not the right first stop. If a condition is flaring, newly diagnosed or still being adjusted, talk with the doctor who treats it before you book. The same goes for any new or changing mole or spot near the tattoo, which should be examined by a dermatologist first.

Pregnancy and breastfeeding have their own guide: read laser treatment during pregnancy and breastfeeding. For short-term reasons to hold off, like a tan or a healing tattoo, see when to wait before tattoo removal. When you are ready, bring a written list of your medicines, supplements and conditions to your free consultation.