Can I have laser hair removal while taking isotretinoin (13-cis-retinoic acid)?

From the Guidelines

It is recommended to exercise caution and consider delaying laser hair removal procedures until at least 6 to 12 months after discontinuing isotretinoin, due to the potential risks of delayed wound healing or keloid formation 1. When considering laser hair removal while taking isotretinoin, it's essential to weigh the potential benefits against the risks. Isotretinoin can make the skin more sensitive and prone to damage, which may increase the risk of severe burns, scarring, hyperpigmentation, and poor wound healing if combined with laser treatments. Some key points to consider:

• The current recommendation is to delay procedures such as dermabrasion or laser resurfacing until 6 to 12 months after discontinuing isotretinoin 1.
• However, there are also retrospective studies and case reports demonstrating safety with laser hair removal, pulsed dye laser, and CO2 laser in patients taking isotretinoin 1.
• Elective procedures should be delayed for 6 to 12 months when possible, but careful consideration may be given on a case-by-case basis 1. It's crucial to inform your dermatologist and laser technician about your isotretinoin history, as they may recommend specific skin tests before proceeding with full treatment. During the waiting period, temporary hair removal methods like shaving or depilatory creams can be used. Ultimately, the decision to undergo laser hair removal while taking isotretinoin should be made in consultation with a healthcare professional, taking into account individual circumstances and the potential risks and benefits 1.

From the FDA Drug Label

Wax epilation and skin resurfacing procedures (such as dermabrasion, laser) should be avoided during isotretinoin capsules therapy and for at least 6 months thereafter due to the possibility of scarring

Laser hair removal should be avoided while taking isotretinoin and for at least 6 months after stopping the medication, due to the risk of scarring. 2

From the Research

Laser Hair Removal and Isotretinoin

• The use of laser hair removal in patients taking isotretinoin (13-cis-retinoic acid) has been a topic of discussion due to concerns about potential side effects and scarring 3, 4, 5, 6, 7.
• Studies have shown that laser hair removal can be safe for patients undergoing isotretinoin therapy, with minimal risk of adverse effects such as erythema, pigmentary change, swelling, or scarring 4, 5.
• A study published in 2017 found that there is insufficient evidence to support the current protocol of avoiding and delaying treatments in patients with concurrent or recent isotretinoin administration, and recommends that the current practice should be discontinued 3.
• Another study published in 2021 found that laser hair removal with alexandrite, diode, and Nd:YAG lasers is safe in patients receiving systemic isotretinoin treatment, with no significant difference in side effects compared to a control group 5.
• The American Society for Dermatologic Surgery has also concluded that there is insufficient evidence to justify delaying treatment with superficial chemical peels and nonablative lasers, including hair removal lasers and lights, for patients currently or recently exposed to isotretinoin 6.
• A systematic review published in 2020 found that the risk associated with concomitant isotretinoin and laser use is small to absent, and suggests that current contraindications may be overly cautious 7.

Key Findings

• Laser hair removal can be safe for patients taking isotretinoin, with minimal risk of adverse effects 4, 5.
• There is insufficient evidence to support the current protocol of avoiding and delaying treatments in patients with concurrent or recent isotretinoin administration 3, 6.
• The risk associated with concomitant isotretinoin and laser use is small to absent 7.