Onoue S, Seto Y, Ochi M, Inoue R, Ito H, Hatano T Yamada S (2011) In vitro photochemical and phototoxicological characterization of major constituents in St. John’s wort (Hypericum perforatum) extracts. It is advisable to check with the prescribing physician if laser treatment can proceed safely. Dtsch Arztebl Int 108(9):135–141Lugović L, Situm M, Ozanić-Bulić S, Sjerobabski-Masnec I (2007) Phototoxic and photoallergic skin reactions. This patient had received biweekly treatments with the excimer laser for years prior without any history of adverse reactions. A PubMed review of published article titles and abstracts was performed using the search term Laser with each of the following terms individually: photosensitive, photosensitiser, photosensitizer, phototoxicity, photoallergy, complications, case-report, tetracycline, minocycline, amiodarone, nitrofurantoin and medication. If you continue to use this site we will assume that you are happy with it. Drugs administered for topical PDT5, e.g. Dermatol Surg 10:1201-410. Four publications were identified, none of which reported any complication in the use of laser in patients taking photosensitising medication. Springer, BerlinMoore DE (1998) Mechanisms of photosensitization by phototoxic drugs. Guidance provided by the British Medical Laser Association.This advice relates to non-essential aesthetic laser applications and reflects the best data available at the time of this report. As there are no published accounts of adverse effects of laser in patients with photosensitive medication, we performed a review of the mechanism of photosensitivity by compiling a list of photosensitive medication and the peak wavelength of radiation required to activate the drug. Wait 1 week prior to treatment and avoid use immediately following laser therapy. Subscription will auto renew annually.Over 10 million scientific documents at your fingertips Dwyer CM, Cuddihy AM, Kerr REI, Chapman RR, Allam BF (1993) Skin pigmentation due to minocycline treatment of facial dermatoses. Lancet Oncol Dec;1:212-9.5. We recommend a national database of drugs and the wavelengths causing photosensitive reactions of each which a laser department can access prior to treatment.Immediate online access to all issues from 2019. Br J Dermatol 129(2):158-629. LASER QUESTIONNAIRE FORM!! For laser/IPL (intense pulsed light) devices emitting wavelengths above 500nm there is very little likelihood of such a reaction for the vast majority of drugs. If taking other medications or herbal remedies of any sort then careful initial test patch, wait 4-7 days in the case of hair removal and 4-6 weeks in the case of vascular/pigmented treatments.e. Kerstein RL, Lister T, Cole R (2014) Laser therapy and photosensitive medication: a review of the evidence. This is not at all in accord with the original BMLA guidelines nor with the current revision which sets out the evidence on which the guidance is based.Other drugs may have an effect on the skin’s healing ability without causing photosensitivity.Information regarding all drugs a patient/client is taking should be recorded including:a. Clin Pharm 12(8):580–587Lim J, Goh C (1994) Lasers used in dermatology. Morton CA et al (2008) Photodynamic Therapy (PDT) Guidelines for topical photodynamic therapy: update. Photodynamic therapy (PDT) as promising alternative to conventional cancer treatments works by irradiation of a photosensitizer (PS) with light, which creates reactive oxygen species and singlet oxygen (1 O 2), that damage the tumor.However, a routine use is hindered by the PS’s poor water solubility and extended cutaneous photosensitivity of patients after treatment. Following this and anecdotal advice, many laser centres refuse to treat patients who are on known photosensitive medication. A test treatment will be performed in any situation when the outcome is questionable. Drugs administered for systemic Photodynamic Therapy (PDT)4, e.g. Mutat Res Fundam Mol Mech Mutagen 422(1):165–173Wu Q, Christensen LA, Legerski RJ, Vasquez KM (2005) Mismatch repair participates in error-free processing of DNA interstrand crosslinks in human cells.
Oral Retinoids – There is some controversy around this. Despite this, some centres continue to deny treatment to a patient/client who is on any medication with a known photosensitivity3. Ann Acad Med Singap 23(1):52–59The authors have no conflict of interest to declare.Salisbury District Hospital, Odstock Road, Salisbury, SP2 8BQ, UKYou can also search for this author in Ferguson J (2002) Photosensitivity due to drugs. Minocycline (Minocin) – risk of hyperpigmentationd. This guidance has often, in the opinion of the authors, been largely based on an inappropriately rigid interpretation of what data exists.Reports of photosensitivity reactions as a result of drug administration do occur, but we believe that these reactions have been reported to regulatory bodies with no indication of the wavelength of light that has been responsible. Br J Dermatol 159:1245-666. Test and assess results carefully and treat small areas initially. Photofrin, Foscan.b. Lasers Med Sci 30(8):2223-44. Recommence use once treated area is healed.Examples: Betamethasone, cortisone, deflazacort, dexamethasone, hydrocortisone, methyl prednisolone, prednisolone, triamcinoloned.