Contraindications to FotoFacial RF Pro®
Although the FotoFacial RF Pro® approach is a very safe
procedure, with a high index of therapeutic safety, there are
certain patients upon whom the procedure should not be offered.
Like any medical procedure, there are absolute and relative
contraindications to the FotoFacial RF Pro® procedure.
(i) History of abnormal response to sunlight: This would include
conditions such as Polymorphous Light Eruption, Solar
Urticaria or some of the porphyrias.
(ii) Photo-sensitizing medications or drugs (see Table I):
DO NOT TREAT! Always ask about current or recent drug use.
Patients on known photosensitizing medications should be
offered a test patch in an inconspicuous region prior to
offering a FotoFacial RF Pro® program. The risk of treating
patients on known photosensitizing medications include
excessive swelling, pain, purpura, pigmentation
abnormalities and possible scarring.
(iii) Patient on Accutane: (Treatments can begin 6 months after
stopping.) Accutane does photosensitize and, in the unlikely
event that a cutaneous, epidermal eruption were to result
from treatment, re-epithelialization and wound healing
(iv) Pregnancy: Although no known medical link to tertagenicity
or miscarriage is associated with FotoFacial RF Pro®, one
should avoid aesthetic therapies of any kind during
pregnancy. Pregnancy is a temporary state and aesthetic
therapy can be initiated post-partum.
(v) Suspicious moles or skin lesions: Should not be treated over
under any circumstances, until a biopsy conﬁrmed diagnosis
(vi) Persistent unrealistic expectations: Following consultation,
this is the most important of all contraindications to the
FotoFacial RF Pro® procedure. The secret to the success of
any cosmetic medical practice is the appropriate and effective
management of the patient’s expectations. In questioning
your patient’s goals and expectations from the FotoFacial RF
Pro® procedure, always search for inappropriate expectations
and goals. Ensure that the goals and expectations always
match what the FotoFacial RF Pro® can deliver before
The relative contraindications include many of the psychological
factors in patient selection (next section) as well as medical
Table I. Drugs that may cause FotoFacial RF Pro® photosensitivity.* Anticancer Drugs Antidepressants Antihypertensives Antihistamines Antiparasitic Antimicrobials Diuretics Antipsychotic
* Note: This list contains some of the more common medications that may lead to
photosensitivity but it is not a complete or exhaustive list of potentially harmful drugs. Relative Contraindications
(i) Medical Conditions That May Affect Wound Healing: Patients
suffering from severe and uncontrolled medical conditions
that have known deleterious wound healing effects should be
carefully evaluated, and most likely avoided prior to
instituting FotoFacial RF Pro® therapy. Uncontrolled Systemic
Lupus, Scleroderma, Rheumatoid Arthritis, Phorpheria,
Uncontrolled Diabetes, Buerger’s Disease, Arteriosclerosis
and active Vitilago may be severe enough to contraindicate
therapy. In the rare event that FotoFacial RF Pro® treatments
result in a minor epidermal injury, these conditions may
result in a diminished ability to heal effectively and may lead
to scarring or pigmentation abnormalities. Darkly pigmented
individuals (skin types 4 and 5) can undergo treatment with
the special settings and technique described.
(ii) Coumadin, Aspirin and Other Blood Thinners: These may
result in purpura, especially in rosacea patients. A test spot
(iii) Accutane Discontinued: Theoretically Accutane should not
effect the outcome of an uncomplicated FotoFacial RF Pro®
treatment, as we are not relying upon re-epithelialization.
However, Accutane can result in photosensitization in some
individuals. When the occasional epidermal disruption
occurs and then the blunted re-epithelialization by dermal
appendage, effects of Accutane may compromise uneventful
epidermal healing. It is controversial how long one should be
off Accutane prior to initiating FotoFacial RF Pro® therapy,
but 3-6 months would likely be safe.
(iv) Non-Medical Reasons: Individuals with unrealistic expecta-
tions, psychological disturbances and inability to follow
through with the treatment process, should not be offered
FotoFacial RF Pro®. Unrealistic expectations are probably the
single greatest cause of denying clients treatment.
(v) Currently Tanned: Individuals who present for treatment
and are acutely tanned should not be offered immediate
treatment. If acutely tanned individuals are treated there is
a high incidence of epidermal reaction, blistering and
pigmentation abnormalities. A safe approach is to provide
total block, hydroquinone and even kojic acid for the face/
body for 3-4 weeks to facilitate fading of the tan. Weekly
microdermabrasions are also effective. The client can use
self-tanning lotions that are then discontinued 2 weeks prior
to treatment. Following treatment, the self-tanning lotion
can be immediately applied again 2 weeks after treatment.
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