ASDS Guidelines Task Force: Consensus Recommendations Regarding the Safety of Lasers, Dermabrasion, Chemical Peels, Energy Devices, and Skin Surgery During and After Isotretinoin Use

作者:Waldman Abigail; Bolotin Diana; Arndt Kenneth A; Dover Jeffrey S; Geronemus Roy G; Chapas Anne; Iyengar Sanjana; Kilmer Suzanne L; Krakowski Andrew C; Lawrence Naomi; Prather Heidi B; Rohrer Thomas E; Schlosser Bethanee J; Kim John Y S; Shumaker Peter R; Spring Leah K; Alam Murad*
来源:Dermatologic Surgery, 2017, 43(10): 1249-1262.
DOI:10.1097/DSS.0000000000001166

摘要

BACKGROUND Currently, the isotretinoin (13-cis-retinoic acid) package insert contains language advising the discontinuation of isotretinoin for 6 months before performing cosmetic procedures, including waxing, dermabrasion, chemical peels, laser procedures, or incisional and excisional cold-steel surgery. It is common practice to follow this standard because of concerns regarding reports of sporadic adverse events and increased risk of scarring. OBJECTIVE To develop expert consensus regarding the safety of skin procedures, including resurfacing, energy device treatments, and incisional and excisional procedures, in the setting of concurrent or recent isotretinoin use. MATERIALS AND METHODS The American Society for Dermatologic Surgery authorized a task force of content experts to review the evidence and provide guidance. First, data were extracted fromthe literature. This was followed by a clinical question review, a consensus Delphi process, and validation of the results by peer review. RESULTS The task force concluded that there is insufficient evidence to justify delaying treatment with superficial chemical peels and nonablative lasers, including hair removal lasers and lights, vascular lasers, and nonablative fractional devices for patients currently or recently exposed to isotretinoin. Superficial and focal dermabrasion may also be safe when performed by a well-trained clinician.