CONTRAINDICATIONS FOR IPL/LASER TREATMENTS

Transcription

1 CONTRAINDICATIONS FOR IPL/LASER TREATMENTS Permanent Contraindications: You will unfortunately not be able to HAVE the treatment if any of the below apply: Vitiligo Diabetes Porphyria Dark - Black Skin (Fitzpatrick VI) Haemophilia Lupus Disease Gold Injections Keloid Scarring Herpes simplex Xeroderma (XP) Use of anti-coagulants Liver or kidney disease Photosensitive epilepsy Heart diseases or pacemakers Cancer of any form at any time Autoimmune diseases, HIV or AIDS Thyroid problems (hormone imbalance) Severe high blood pressure or circulation problems Deep vein thrombosis, varicose veins, inflammation of the veins CONTRAINDICATIONS FOR IPL/LASER TREATMENTS Temporal Contraindications Unfortunately the START of your course will be DELAYED if any of the below apply:

2 1. Pregnant, breastfeeding or lactating 2. Recently tanned skin: Sun (UVA/UVB) exposure (4 weeks after last exposure) Tan bed (4 weeks after last use) Fake tan (4 weeks after last use) Bleaching agents (4 weeks after last use) 3. Cosmetic Chemical Peeling: Light chemical peeling (4 weeks after last treatment for light peeling, medical peeling with TCA is longer required doctor approval) Microdermabrasion ( 3-4 weeks after last treatment) 4. Treatment with: Anti-inflammatories (2 weeks after last use) Oral Antibiotics (2 weeks after last use) Hydrocortisone (3 weeks after last use) Medical strength retinoid ( 4 week after last use) Acutane - Roaccutane (6 months to 1 year after last use) Electrolysis (6 weeks after last use) Wax, tweezing, plucking, threading (4 weeks after last use) Contraindicated Areas Do not go over any areas where there are tattoos, permanent makeup, or contraindicated implants. Filler, Do not go over any areas with recently cosmetic filler injection. Do not treat area with botox recently injected. Do not treat open wound. Sunburned or tanned area. Keep away from the eyes and mucous zone. Over keloids. Areas with piercings.

3 Contraindicated Implants: A birth control method often referred to as "the stick"; Lap Bands. In the case of implanted birth control, this only applies to treatments near the implant, ex: Underarms or Upper Arms. In case of doubt about any implant contraindication contact the manufacturers or doctor, and ask for a written confirmation or authorization. A client with the stick may receive a treatment anywhere but in the upper arm, breast, or underarm region. For all other areas, they must be informed of the potential risk of falling pregnant, and the therapist must record fully in their notes the details of the discussion. Non-contraindicated Implants: Breast implants Photo-Sensitising Topical Creams, Natural Supplements, or Oral Medication IPL Contraindications - Citrus Essential Oils: Oils taken from the rind of Orange, Lemon, Mandarin, Lime, and Bergamot are highly photo-sensitising and if used in pure form, will cause skin to burn if exposed too long to light. The client needs to wash off the oil and leave the skin 24 hours to return to normal; - St John's Wort, Prescribed Retin-A: If the client has used any of these medications for up to 1 month, they need to cease use and come back in a month. If the client has used any of these for over a month, then they need to cease use and leave any Pulsed Light or Laser treatments for 3 (three) months. In the case of Retin-A (also called Retinol or Concentrated Vitamin A) or St John's Wort, we are only concerned with creams that have been prescribed by a GP, Naturopath, or Dermatologist. Over the counter products are very low dose and largely ineffective, and are not considered a contraindication to treatment but client must cease of use a week before treatment.

4 - Doxycycline, Tetracycline, and Minomycin: These compounds (not an extensive list) are most common in powerful antibiotics, and their use causes the skin to become photo-sensitive. Drugs containing these compounds are usually prescribed when normal antibiotics don't do the trick, or to fight an ongoing condition, or even in conjunction with skin creams where a bacterial infection is present. Black Garments - IPL Contraindications Light attracts to areas of darkness, and particularly in the case of nylon or polyester underwear and bras, pulsed light can melt the fabric onto the skin if accidental contact occurs. If working near these areas, have the client remove the garment and cover themselves with a towel instead. Depilatory Creams & Sprays - IPL Contraindications Minimal use of depilatory creams is enough to permanently damage the skin, and therefore their use is a definite contraindication to treatment for fear of the risk of scarring. Clients who have used these products must wait six weeks from use before receiving a Pulsed Light or Laser treatment. Suntan or Fake Tan IPL Contraindications Clients should not use spray tans or tanning moisturizers for two weeks prior to next treatment, and any remnants should be completely exfoliated. Clients must not get real suntans or use solariums (tanning bed) for the entire duration of their course of treatments and for one month after their final treatment. Natural Pigmentation - IPL Contraindications Where a client has a naturally darker complexion, e.g.: if they are of Mediterranean, Asian, Arab, or Indian complexion, they usually fall into a skin-type category of 4 or 5. Natural pigmentation in the 4 to lighter 5 scale should not be a contraindication to treatment. Where a client who falls into this category has

5 a tan in addition to their natural pigment, then they must lose their tan first so their skin returns to its normal state. The same applies to treating genital skin on Caucasian clients, i.e. the labia, scrotum, and anal areas, which are invariably darker than surrounding skin on white-skinned people. If a client is a skin type 5 or above, a small patch test must be carried out on an inconspicuous part of the body, then left for two weeks. If lightening or darkening of the skin is apparent, that person is not suitable for treatment. Recent Waxing, Plucking, or Sugaring IPL Hair Removal Contraindications Light-based hair removal requires a hair root to target. During waxing, plucking, or sugaring, the hair root is pulled out of the shaft. If a client has recently had hair removal using one of these methods, they need to wait a minimum of two weeks for the hair root to regrow. Contagious Skin Diseases or Disorders - Some skin diseases are not easily detectable, and a therapist can only rely on client honesty. If a client discloses that they have a skin disease, and it is one that the therapist does not consider a contraindication to treatment, the following precautions must be taken: Extra care must be taken to clean the IPL handpiece with 70 degree alcohol or cavicide wipe during and after treatment; Gloves must be worn at all time; All surfaces must be wiped down thoroughly with alcohol 70 afterwards; Shaving must be performed by the client 24 hours before to prevent bleeding or skin reaction during treatment. Herpes 1 & 2 - IPLContraindications The concerns for Herpes is the same as other contagious skin diseases, however due to the heat caused during a treatment, it is your Duty of Care to inform the client that the treatment may cause an outbreak.

6 Visible Skin Trauma IPL Contraindications If someone presents with visible skin trauma, the area is to be avoided. In cases of oral medication, check for photosensibility. Lesions, Sores, and Open Wounds IPL Contraindications If someone presents with lesions, sores or open wounds, the area is to be avoided. In cases of oral medication, check for photosensibility. Post-Surgical Scarring - IPL Contraindications Pulsed Light or Laser treatments of any kind will have a softening effect on scarring, however scars must be fully healed and closed. If any moisture or trauma is present, do not perform a treatment over the area. Keloid or Hypertrophic Scarring - IPL Contraindications Clients who are genuinely prone to keloid or hypertrophic scarring must be thoroughly informed that there is a risk of skin trauma resultant from Pulsed Light or Laser, and that it is their decision if they go ahead with the treatment. Thorough notes should be kept on the details of the discussion between therapist and client. Moles, Freckles, Skin Marks - IPL Contraindications Pulsed Light and laser do not operate in the UV part of the light spectrum, and there is no evidence to suggest that such treatments can cause skin cancer or change the properties of a skin mark to make it cancerous. The primary concern with skin marks is ethical. It is not a therapist's place to diagnose any of the above skin conditions. It is however, a therapist's Duty of Care to tell the client if they notice a condition that may be suspicious. It is a therapist's Duty of Care to inform the client that any marks in the treated area may fade, and thus make it more difficult for a GP to diagnose. When clients go to their GP for skin checkups, they should state that they have undergone a light-based treatment so that the doctor looks a little harder.

7 - Raised Moles (black or red): Work around the mole. Do not go over it; - Sunspots and freckles: Not contraindicated, however they may darken for a few weeks then lighten; - Skin Tags: Not contraindicated, however be careful when shaving the area. Sunburn IPL Contraindications Skin showing signs of redness from sun or solarium (Tanning bed) exposure must not be treated with until the skin calms down again. Usually this will take three to four week at the minimum, and up to several months where the skin has tanned significantly. (See sun tanned) If the client has a residual tan, this will affect their skin typing, and must be taken into account before performing a Pulsed Light or Laser treatment. Epilepsy or Seizures Caused by Flashing Light - Hair Removal Contraindications Epilepsy and other types of seizures caused by flashing light are a contraindication for Pulsed Light or Laser, unless the client's GP provides a letter of authorization. When treating a client with epilepsy or seizures induced by flashing light, they must wear fully opaque 'swimming goggle' eye protection to block out 100% of light, preferably with a cotton pad or tissue beneath each lens to ensure client comfort and for added protection. Pregnancy and Breastfeeding IPL Hair Removal Contraindications While there is no medical evidence to suggest that a Pulsed Light or Laser treatment can harm an unborn child, there is abundant evidence that the massive fluctuations in hormone levels during pregnancy and breastfeeding make any attempts to remove hair fruitless. For ethical and client safety reasons, a therapist should not perform a light-based treatment until breastfeeding has ended and hormone levels have begun to settle again. Polycystic Ovarian Syndrome (PCOS) - Hair Removal Contraindications The best course of action for PCOS-related hair growth or hyperpigmentation is medical. The client needs to be on the right medical

8 treatment to bring their body's hormone levels under control, and once that's achieved, chances are that problems such as excessive hair growth and odd pigment marks will begin to reduce naturally. Therapists should not treat a client with PCOS for hair removal if that client's condition is unmanaged. Therapists should remain vigilant. Clients do lie, and some will say that their PCOS is managed, believing that they know better than we do. If they have male hair growth patterns - eg excessive hair on their face, chest, lower back, or buttocks, and no history of hereditary hirsutism, there is a very good chance that they are lying. For their own good, do not treat them and tell them to go back to their GP to recheck their medication. Simply informing them that people with unmanaged PCOS can experience increased hair growth instead of reduction, is usually enough for them to begin taking it seriously. Once the client has achieved that balance, we can help tidy up what's left, assuming that there are no other contraindications to treatment. Hormone Supplementing Medications - Hair Removal Contraindications Predominantly women, but also people undergoing gender reassignment, take hormone supplements such as HRT and thyroid medications to moderate their levels of various sex hormones. This has a direct effect on hair growth. If the client's medication is regulating their hormones satisfactorily, then Pulsed Light or Laser should prove beneficial. If the medication is not regulating their hormones satisfactorily, the client needs to speak to their GP about adjusting their dose before we can do a treatment. Hirsutism - Hair Removal Contraindications Hirsutism occurs in women who present with male hair growth patterns. There are two types of hirsutism: genetic and hormonal, and they are easy to differentiate.

9 A simple question - Does your mom, grandmother, or any or your aunts have facial hair? If yes, then the hirsutism is genetic. If there is no family history of hirsutism, then the condition is most likely hormonal. Genetic Hirsutism is not a contraindication, but it should be treated as male hair. Hormonal Hirsutism will generally have an underlying cause that may be remedied with medical intervention. If Hirsutism is present, therapists have a Duty of Care to inform clients that results will in all probability take longer. Xeroderma pigmentosum, or XP, is an autosomal recessive genetic disorder of DNA repair in which the ability to repair damage caused by ultraviolet (UV) light is deficient. [2]:574 In extreme cases, all exposure to sunlight must be forbidden, no matter how small; as such, individuals with the disease are often colloquially referred to as Children of the Night