Disclose everything, every session
Screening isn't a one-time intake question. Every session should start with a review of anything new since your last visit — prescriptions, over-the-counter drugs, supplements, topicals, hormonal changes. A settings adjustment based on your current state is the difference between a normal reaction and an unexpected one.
Bring the list, not the memory
Categories that matter
| Category | Example medications | Action |
|---|---|---|
| Photosensitizing antibiotics | Tetracyclines (doxycycline), sulfonamides, fluoroquinolones (ciprofloxacin) | Disclose. Settings adjusted; sometimes deferred. |
| Retinoids (topical) | Tretinoin, adapalene, retinol | Pause on treatment area 3–5 days before. |
| Isotretinoin (oral retinoid) | Accutane, Absorica, Claravis | 6-month gap after last dose required. |
| Certain antidepressants | Some SSRIs, tricyclics | Disclose. Usually just settings adjustment. |
| Hormone therapies | HRT, gender-affirming hormones, some contraceptives | Disclose. Can affect hair patterns; treatment continues. |
| Anti-inflammatories (chronic use) | High-dose NSAIDs | Disclose. Photosensitizing at sustained doses. |
| Certain diabetes medications | Sulfonylureas | Disclose. Photosensitizing potential. |
| Diuretics | Hydrochlorothiazide | Disclose. Can be photosensitizing. |
| Antifungals | Some oral antifungals | Disclose. Provider evaluates. |
Isotretinoin: the 6-month rule
Isotretinoin (branded Accutane, Absorica, Claravis) requires a minimum 6-month gap between the last dose and starting laser treatment. Isotretinoin makes skin more fragile, alters normal healing, and significantly raises the risk of scarring and pigment change from laser procedures.
This is a non-negotiable standard across reputable dermatology and aesthetics practices. If you're on isotretinoin now, plan for treatment 6+ months after your final dose.
See the full list of deferrals in Risks and Contraindications.
Supplements and herbs
- · St. John's wort — the classic photosensitizing herb. Disclose.
- · High-dose retinol supplements — treat like topical retinoids.
- · Gold-based supplements or medications — permanent contraindication (chrysiasis risk).
- · Excess vitamin A — can behave like a retinoid at high sustained doses.
Most supplements don't disqualify treatment. The point of disclosure is letting your provider make an informed settings decision.
Key takeaways
- · Disclose every medication and supplement, even if it seems unrelated.
- · Most photosensitizers just require a settings adjustment.
- · Isotretinoin (Accutane) requires a 6-month gap before treatment.
- · Topical retinoids need a short pause on the treatment area.
- · Herbal supplements can be photosensitizing too — St. John's wort is the classic example.