Medications in the intake form: ask and document, but do not prescribe or discontinue

“Are you taking any medication?” sounds straightforward but often produces an incomplete answer. A client may omit a topical treatment, supplement, painkiller or long-term prescription because they do not think of it as medication. The opposite error occurs when a practitioner recognises a drug name and tells the client to stop it. The professional boundary is clear: ask, document and follow the referral pathway, but do not prescribe, discontinue or alter treatment.

Collect a complete list without judging the prescription

I ask for the names of prescription drugs, over-the-counter products, dietary supplements and active skin-care products applied to the intended area. It is important to note what started, ended or changed since the last visit. If the name is forgotten, it is safer to ask for a photo of the packaging and postpone the decision than to guess by the colour of the tablet or the general purpose.

Record the exact product name, formulation, route of administration and, where known, relevant dates. Record the reason for taking a medicine only when it is needed to refer the question to the responsible clinician. The practitioner does not judge prescribed treatment or ask the client to choose between their medication and a paid procedure.

• Prescription drugs and recent dosage changes.
• Over-the-counter pain relievers, supplements, and herbal remedies.
• Topical medications and active skin-care products in the area.
• Start date, stop date and most recent change.
• Previous unusual reaction to sun, light, or healing.

Do not rely on a universal internet list

Photosensitivity and healing depend on the active substance, route of administration, dose, skin condition and individual response. A drug-class name alone may not give the practitioner enough information for a safe treatment decision. The device manufacturer may also specify restrictions for medicines that increase photosensitivity or alter skin metabolism.

A table that says “this drug is acceptable after three days, that one after a week” therefore creates false confidence. Instead, document the product, check the current IFU and clinical protocol and, where necessary, obtain a decision from an appropriately qualified clinician. Defer treatment until enough information is available.

Discuss isotretinoin using current evidence

The old rule of a mandatory six-month wait after isotretinoin was repeated for a long time for all procedures. The ASDS consensus and systematic reviews did not find sufficient evidence to automatically delay every non-ablative laser, including hair removal lasers, for this length of time. But this does not mean that the drug can be omitted or that the procedure is guaranteed to be safe for any skin condition.

The practitioner records the drug and timing, assesses the visible state of the treatment area and follows the established clinical decision pathway. The current device-specific IFU and local medical protocol remain mandatory. If there is dryness, irritation, damage or another risk factor, the skin itself may be a reason to pause, regardless of any debate about a fixed calendar interval.

Separate data collection from medical decision-making

The phrase “I’ll check according to the protocol and come back with an answer” is more professional than an instant yes or no. The clinic must have a clear pathway: who checks the medicine, where the current IFU is stored, how the conclusion is recorded, and who communicates the decision to the client. Verbal permission without a name, date and context is difficult to verify at the next visit.

If the treating doctor's opinion is required, make the request specific and do not ask them to stop the prescribed treatment. The doctor must understand which procedure, treatment area and device are being planned. Any approval received does not replace examining the skin before the session or carrying out a test patch where required.

Update the medication history at every visit

The initial signature does not make the list of medications eternal. Before each visit, I ask about new medications, dose changes, topical treatments, and unusual reactions from the last session. The negative answer is also dated. Such a short review takes minutes and protects better than a long questionnaire that no one re-reads.

Tone matters. If a client expects a penalty or judgement for disclosing a new medicine, they are more likely to remain silent. The possibility of straightforward rescheduling must be discussed in advance. Disclosing medication then becomes part of shared safety rather than an admission that the client has broken a rule.