吃了異維A酸(泰爾絲)真的不能點陣激光了嗎?
這個說法是什麼原理?我在說明書上看到了一點:避免在陽光及紫外線下長時間照射。
可是我去中山三院的皮膚科時醫生讓我去照威伐光一次120的那種。泰爾絲也是中山三院開的。所以我很疑惑,到底吃異維A酸能不能照激光。
這個問題知乎上還沒有人回答過,我來答。
「避免在陽光及紫外線下長時間照射」,主要考慮的是泰爾絲的光敏性,一般來說國內外大部醫生建議都是停止服用藥物6個月以後在進行光電類的治療,因為以往有報道零星的不良反應和造成色素沉著,疤痕的事故發生。
但是今年2017年5月10號,美國ASDS發布了專家共識:即2017 ASDS共識建議:異維A酸應用期間及用後接受皮膚科手術的安全性。 ASDS是美國皮膚外科協會的簡稱。
原文:
ASDS Guidelines Task Force: Consensus Recommendations Regarding the Safety of Lasers, Dermabrasion, Chemical Peels, Energy Devices, and Skin Surgery During and After Isotretinoin Use
Currently, the isotretinoin (13-cis-retinoic acid) package insert contains language advising the discontinuation of isotretinoin for 6 months before performing cosmetic procedures, including waxing, dermabrasion, chemical peels, laser procedures, or incisional and excisional cold-steel surgery. It is common practice to follow this standard because of concerns regarding reports of sporadic adverse events and increased risk of scarring.To develop expert consensus regarding the safety of skin procedures, including resurfacing, energy device treatments, and incisional and excisional procedures, in the setting of concurrent or recent isotretinoin use.The American Society for Dermatologic Surgery authorized a task force of content experts to review the evidence and provide guidance. First, data were extracted from the literature. This was followed by a clinical question review, a consensus Delphi process, and validation of the results by peer review.The task force concluded that there is insufficient evidence to justify delaying treatment with superficial chemical peels and nonablative lasers, including hair removal lasers and lights, vascular lasers, and nonablative fractional devices for patients currently or recently exposed to isotretinoin. Superficial and focal dermabrasion may also be safe when performed by a well-trained clinician.
ASDA對口服異維A酸期間或者口服之後對使用激光器,磨皮術,化學換膚,能源設備等安全性方面發布了共識:
近期接觸異維A酸的患者進行表面化學換膚和非剝脫性激光治療不需要進行延期治療。
即不需要在停用6個月之後在進行化學換膚和光電治療了,一般口服泰爾絲期間,光子,紅藍光理論上都是可以的,可以考慮邊治療痘痘邊治療痘印。
注意一個關鍵詞:非剝脫性激光。聰明的你們,一定明白點陣激光能不能做了?
不過,海豚君還是建議,先治療痘痘再做激光,等痘痘炎症消退或者沒有大面積成片痘痘在皮膚穩定下來再考慮吧。
一般醫生也會問你治療後後有沒有嚴格防晒習慣,沒有的話,還是冬天再考慮一下吧,哈哈。
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因為光敏性的原因是一個,會有色沉,更重要的原因是服藥時候皮膚乾燥,不利於傷口恢復,而且停葯後會有複發的可能,導致二度傷痕,所以為了避免再發痤瘡,一般建議停葯穩定幾個月等到面部沒有紅色痘痘只有痘坑才能做。取得最大效益比例。
泰爾絲服用期間唯一可做的醫美項目是果酸換膚,我所了解的
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