Who cannot have laser treatment? Contraindications for laser and light
Not every skin and not every health situation tolerates treatment with laser, light or radiofrequency. This page explains the most important contraindications: pregnancy and breastfeeding, photosensitising medication, isotretinoin, blood thinners, skin diseases, herpes, moles, epilepsy, pacemakers, metal implants, tattoos, a tendency to keloids, a recent tan and minimum age.
You will find out when treatment is merely postponed, when a medical assessment is needed and how lasers such as the DEWEON 4LD or the FRACO CO2 XL, light systems such as the DERMAFORCE BBL PRO and RF microneedling with the EUPHEUS M8 differ. The answers do not replace a pre-treatment consultation. They show which questions must be asked there.
What health questions does a studio have to ask before the first laser treatment?
Before the first session, the client is asked about pregnancy, medication, skin conditions, herpes, a tendency to scarring, implants, epilepsy, sun exposure in recent weeks and any previous reactions to laser or light. There are two groups: with absolute contraindications no treatment is carried out at all, while with relative contraindications treatment is postponed, the area is left out, or treatment goes ahead only after medical consultation. The questionnaire is signed and briefly updated before every further session, because medication and tan change during a course of treatment.
In the client management system of the DEWEON 4LD you record client data and treated areas. The Skin Analyzer Pro additionally documents pigment, redness and pores in images. It does not replace a medical assessment.
Laser, BBL or RF microneedling during pregnancy and breastfeeding: what is off limits and what has to wait?
During pregnancy, neither laser nor broadband light nor RF microneedling is carried out, and while breastfeeding most providers likewise wait or treat only after medical consultation. Harm to the child has not been demonstrated, but studies are lacking, and nobody takes an unclear risk for an elective treatment. In addition, hormones alter hair growth and pigment formation, the skin develops pigment spots more easily, and the result is harder to predict. Numbing creams, as commonly used before needles and ablative lasers, are a matter for the doctor or midwife during this time.
This applies to hair removal with the DEWEON 4LD just as it does to skin treatments with the FRACO CO2 XL or the EUPHEUS M8. A course that has already begun is paused and resumed later, and the sessions completed so far are not lost.
Which medicines make the skin photosensitive and are a reason not to have laser treatment?
Substances that can cause photosensitivity include certain antibiotics, St John's wort, some diuretics, retinoids and some painkillers and anti-rheumatic medicines. Under the influence of such active substances the skin reacts to light more strongly than expected: with redness, blisters or pigment spots. Whether your medication is one of them is stated in the patient information leaflet, and how long to wait after stopping it is determined by the doctor. Never stop taking a medication on your own initiative for the sake of a laser appointment.
This is particularly important with systems using visible light, such as the DERMAFORCE BBL PRO with 400 to 800 nm, but it also applies to hair removal lasers such as the DEWEON 4LD. At the consultation, mention all preparations, including herbal remedies and creams containing retinoic acid.
How long do you have to wait after isotretinoin before you can have laser treatment?
A cautious guide value is around 6 months after the end of the course of medication, and the decision rests with the treating doctor. Isotretinoin for acne makes the skin thinner, drier and more sensitive, and wound healing may be altered. The critical procedures are therefore above all those that injure the skin: the ablative fractional CO2 laser FRACO CO2 XL and RF microneedling with the EUPHEUS M8. For superficial treatments and hair removal, shorter intervals are sometimes discussed, and this too is a medical decision made case by case.
For acne scars this means: first complete the acne treatment, then wait, then tackle the scars. The waiting period can be used for consultation, skin analysis and the treatment plan.
Can you have laser treatment or RF microneedling while taking blood thinners?
With treatments that do not injure the skin this is often possible, whereas needles and ablative lasers require medical clearance beforehand. Blood-thinning medication prolongs bleeding and promotes bruising. During hair removal with the DEWEON 4LD the skin surface remains intact, and anything more than occasional small bruises is rare. In RF microneedling with the EUPHEUS M8 the needles penetrate up to 7 mm deep depending on the setting, and the FRACO CO2 XL ablates tissue: here bleeding, bruising and a longer healing time may follow.
You never stop the medication yourself for a cosmetic treatment. Whether it may be paused is decided solely by the doctor who prescribed it.
Can you have laser treatment if you have atopic eczema, psoriasis or vitiligo?
Acutely affected areas are not treated, but on calm, healthy skin treatment is often possible after medical assessment. In atopic eczema the skin barrier is impaired, and heat can aggravate a flare-up. Psoriasis and vitiligo can newly appear in previously unaffected areas as a result of skin irritation, which specialists call the Koebner phenomenon. That is why the decision belongs with the dermatologist who knows your history.
If treatment is carried out, then in a stable phase, with a test patch and a cautious energy setting. During hair removal with the DEWEON 4LD the sapphire cooling protects the epidermis, but affected areas are still left out. Procedures that injure the skin, such as the FRACO CO2 XL, are more irritating and can be considered in these conditions only with particular restraint.
Can you have laser treatment if you have herpes, and when is prophylaxis advisable?
With active herpes in the treatment area no laser treatment is carried out, and the appointment is postponed until everything has healed. Heat and skin irritation can reactivate the virus, and on freshly treated skin an outbreak can spread over a wide area. Anyone who regularly gets cold sores should say so at the consultation, even if nothing is visible at the time. Before intensive treatments around the mouth, the doctor may prescribe an antiviral medicine as a preventive measure.
This concerns above all resurfacing with the FRACO CO2 XL, but also RF microneedling with the EUPHEUS M8 and hair removal on the upper lip with the DEWEON 4LD. In the intimate area, the same applies to genital herpes.
Why can moles and suspicious skin lesions not simply be lasered along with the rest?
Moles are left out because their dense pigment absorbs the energy strongly and because a laser can change their appearance. The first leads to burns, the second later makes it harder to judge whether a lesion is harmless. During hair removal with the DEWEON 4LD or the AlexDUAL UFO, moles are therefore covered or worked around. A dark lesion that is new, growing, irregular in appearance, itching or bleeding should be seen by a dermatologist before any treatment.
This applies particularly to pigment treatments with the PICOLO XL: only what has previously been classified as benign by a doctor is removed. A studio does not make a diagnosis and, if in doubt, does not treat.
Can you have laser or light treatment if you have epilepsy?
Epilepsy does not rule out treatment as a matter of principle, but it should be discussed beforehand with the treating neurologist. Only a small proportion of those affected react to light stimuli, and what matters is how well controlled the condition is. During treatment the eyes are covered by light-tight goggles, yet bright flashes, tension and pain can still be a strain. Some anti-epileptic medicines additionally make the skin photosensitive.
The flashes are most pronounced with visible broadband light, as with the DERMAFORCE BBL PRO. RF microneedling with the EUPHEUS M8 works without light, and here too the doctor decides. Once clearance has been given, the team should know what to do in the event of a seizure.
Is RF microneedling possible with a pacemaker or an implanted defibrillator?
No, RF microneedling is not carried out on anyone with a pacemaker, an implanted defibrillator or other electronic implants. Radiofrequency is high-frequency alternating current that generates heat in the tissue, and electromagnetic fields can interfere with the electronics of an implant. This applies even if only the face is treated. The EUPHEUS M8 works in bipolar mode at 4 MHz, so the current flows only between the needles, yet a pacemaker remains an exclusion criterion. The same applies to the EUPHEUS V.
Laser devices such as the TULIX work with light and do not conduct current through the tissue. Whether such a treatment is an option for you is something to clarify with your cardiologist.
Can radiofrequency be used over metal implants, dental implants or piercings?
As a rule, radiofrequency is not used directly over metal in the treatment area. Metal conducts current and heat differently from tissue, and around plates, screws or joint replacements the energy can spread uncontrollably. Piercings are removed beforehand. Dental implants, crowns and fixed braces are a point for the consultation: over the jaw, work is carried out more superficially and more cautiously, or the area is left out. With a copper coil, medical advice is sought before treatments on the lower abdomen.
With the EUPHEUS M8 the energy flows in bipolar mode between the needles, and with the EUPHEUS V the needles are additionally insulated. The rule nevertheless stands. Laser light, as with the TULIX, does not reach deep-lying implants.
Tattoo or permanent make-up in the treatment area: which laser and light treatments are ruled out there?
Over tattoos and permanent make-up, all treatments that use light to target pigment are ruled out: laser hair removal, broadband light and pigment lasers, unless the design is to be removed deliberately. The ink pigments absorb the energy far more strongly than hair or skin pigment. The consequences can be burns, blisters and scars, and the design may fade, become patchy or change colour. This also applies to light colours and to permanent make-up on the eyebrows, eyelids and lips. A margin of about 2 to 3 cm around the design is usual, and the design is additionally covered in a light colour.
During hair removal with the DEWEON 4LD or the AlexDUAL UFO, the large spots are therefore deliberately placed at a distance. During light treatment of the face with the DERMAFORCE BBL PRO, pigmented brows and lip contours are left out.
Can you have laser treatment if you are prone to keloids or raised scars?
With a known tendency to keloids, all procedures that injure the skin are possible only after medical assessment and are often avoided altogether. A keloid forms when the skin produces too much scar tissue after an injury. Ablative lasers such as the FRACO CO2 XL and the needles in RF microneedling with the EUPHEUS M8 deliberately create small injuries and can trigger precisely this reaction. Tattoo removal is also among the treatments with increased risk.
During hair removal the skin surface remains intact, and the risk is considerably lower. Even so, treatment starts with a test patch and the reaction is awaited. At the consultation, ask about previous scars on the earlobes, chest and shoulders, as this is where keloids appear most often.
Sunburn or a fresh tan: when is the skin ready again for laser, light or radiofrequency?
After sunbathing or a sunbed you usually wait 2 to 4 weeks, before light treatments more like 4 weeks, and after sunburn until the skin has healed completely. A fresh tan means active melanin in the epidermis. Lasers and light that target pigment then hit not only the hair or the pigment spot but also the skin above it: burns and pigmentary changes become more likely. Self-tanner stains the stratum corneum and interferes in just the same way.
This applies to hair removal with the DEWEON 4LD and especially to light treatments with the DERMAFORCE BBL PRO. RF microneedling with the EUPHEUS M8 works independently of pigment, but here too sunburn is a reason to postpone the appointment.
From what age can you have laser treatment, and what applies to minors?
Most studios and practices treat from the age of 18, and minors only with written parental consent and often only after medical consultation. There is no fixed medical age limit, and the rules differ from country to country. From a professional point of view, there is a good case for patience during puberty: hair growth is not yet hormonally complete, new hairs keep coming through, and an early course often has to be topped up later. Tattoo removal and ablative treatments in adolescents are a medical decision.
If heavy hair growth causes adolescents great distress, it is worth looking first at possible hormonal causes. After that, hair removal with the DEWEON 4LD can make sense, started at low energy and closely supervised.
