Accutane and Laser Hair Removal At the Same Time?
Accutane, otherwise known as isotretinoin is a drug that has been used extensively over the past few decades for treatment of acne. In this article, we take a look at a scientific study that attempts to answer the question of whether it is safe to combine laser hair removal with Accutane.
A Brief Overview of Accutane
Accutane has been hailed as a miracle drug because of its ability to clear up acne. It is essentially a vitamin A derivative that at doses over 30mg + over a period of months has been shown to reduce and clear even the harshest acne.
However, it doesn't come without its cost. There are numerous side effects associated with accutane, not least severely dry skin, chapped lips, joint pain and some studies have even linked the drug to depression.
One of the side effects that is relevant to this article is that patients on oral isotretinoin are reportedly at greater risk of developing scars and have a weakened ability to heal wounds after invasive procedures.
The Question: Given that accutane causes a weakened ability to heal wounds, is laser hair removal a suitable option for those that are currently taking it?
The Medline Plus Verdict - Don't Mix Accutane with Laser Hair Removal
Medline Plus is the National Institute of Health's web site for patients and their families. It's a respected site with high quality and trusted information.
On the accutane information page, the following quote can be found:-
"(you should) plan to avoid hair removal by waxing, laser skin treatments, and dermabrasion (surgical smoothing of the skin) while you are taking isotretinoin and for 6 months after your treatment.
Isotretinoin increases the risk that you will develop scars from these treatments. Ask your doctor when you can safely undergo these treatments."
Source: Medline Plus Web site
A lot of the trusted health publishers online include the same warning, that you should not user laser hair removal while taking isotretinoin.
However is there any scientific data to legitimise these warnings?
The Scientific Data Says...
We like to use the Scientific Method as much as possible when critically analysing evidence pertaining to a certain subject.
Study 1: Accutane and Laser Treatment for Acne Scars and Hair Removal (2014)
In one particular recent study (October, 2014), researchers investigated to see if Accutane interfered with the wound healing capabilities of 110 patients.
Half of these patients had either acne scars or hirsutism and underwent laser treatment for either acne scar removal or hair removal while taking oral isotretinoin.
The other half of the group received only topical medications - unfortunately I don't know which topical treatments were used because the entire study is behind a pay wall.
The results were quite surprising and fly in the face of common advice:
"Isotretinoin had not resulted in any untoward effects in patients who underwent the procedures. Atypical scarring, delayed wound healing, keloids, or hypertrophic scars were not observed in any patient."
Source: Chandrashekar BS1, Varsha DV, Vasanth V, Jagadish P, Madura C, Rajashekar ML.: Safety of performing invasive acne scar treatment and laser hair removal in patients on oral isotretinoin: a retrospective study of 110 patients. (2014)
The sample size of 55 for the Accutane group is small and doesn't represent a very conclusive argument. It could be that adverse affects are only seen in < 1% percent of patients.
It could also be that adverse effects are only seen in lasers of a certain type or strength (none of which are specified in public access to the study).
Nevertheless, it's encouraging to see a study that shows no adverse affects.
Study 2: Accutane and Diode Laser Hair Removal (2004)
A second study on the matter is 10 years old. Seven female patients who were going through isotretinoin therapy for acne received 2 treatments in the bikini area with a diode laser with a wavelength of 810nm.
Six of the seven females tested also went on to receive additional laser hair removal treatments on the chin area.
The results were as follows:-
"There was no erythema, pigmentary change, swelling, or scarring at any follow up visits. One volunteer presented with a bulla 1 week after second treatment, which was resolved at 1-month follow-up."
Source: Khatri KA. : Diode laser hair removal in patients undergoing isotretinoin therapy. (2004)
Again, the study showed no long term issues and the conclusion states that diode laser hair removal is safe in patients who are taking oral accutane.
Unfortunately, with a sample size of 7 that didn't include any male subjects, the test results are relatively meaningless in the world of science.
Study 3: Diode Laser Hair Removal and Isotretinoin Therapy (2005)
As a follow up to the 2004 study, a follow up article was written in "Dermatologic Surgery" in volume 31 (page 380-381) whereby the author also arrived at the same conclusion that the results suggest potential safety of diode laser hair removal in patients receiving isotretinoin.
What Should We Conclude from This?
Even though there is some degree of research to suggest that accutane and laser hair removal can be used at the same time without any ill effects, we still highly recommend not doing it at the same time.
The world of science is a messy one with many variables and the study profile that's been mentioned in this article is weak at best.
Participant numbers are far too low to conclude anything with any degree of certainty and even though it might be safe to perform the two treatments at the same time, the potential risk:reward ratio doesn't stack up.
Final Verdict: Your dermatologist will more than likely advise you not to do laser hair removal treatment while on accutane - we recommend that you follow this advice and wait at least 6 months after your final pill before starting any kind of laser treatment (whether that be for scar treatment or hair removal).
What about you? Do you have any experience in this? Perhaps you have undertaken laser hair removal at the same time as taking accutane?
Let us know your experiences in the comments box below and we can contribute to the discussion on this topic.