Can You Have Laser, Peels or Waxing while Taking Isotretinoin?

Why do you hear two different recommendations?

For many years, it was taught that skin procedures should be postponed in people taking isotretinoin and in the months after they stopped the medicine. The 2017 systematic review showed that this teaching was based on three small case series published in the mid-1980s. This history and the general approach for people taking medicines are described in our article “Medical Aesthetics for People on Medication or with Chronic Conditions”; here we go into detail procedure by procedure.

Today, two separate groups of sources say different things. On one side are expert consensus reports and later reviews; these report that waiting is not supported by evidence for some procedures. On the other side is the product information for the medicine: the current product information in the USA recommends avoiding waxing and skin resurfacing procedures such as dermabrasion and laser during treatment and for at least 6 months after it ends, and consulting a physician about timing. The patient page of the United Kingdom’s official health service (NHS) also advises not to have waxing, laser hair removal, or procedures such as microdermabrasion and chemical peels while taking the medicine.

These two views do not completely contradict each other. The consensus reports do not say 'every procedure is safe'; they say 'there is not enough evidence to make postponement mandatory for these procedures'. The product information, on the other hand, is a cautious general rule written for everyone. Which applies to you is decided by your physician, taking into account how deep the procedure is, your skin and the state of your acne.

Procedure by procedure: what does the evidence say?

The table below summarises the published evidence for procedures carried out while taking the medicine or shortly after stopping it. The phrase 'insufficient evidence for postponing' does not mean that the procedure is suitable for you; it only shows that there are no strong data making waiting mandatory.

The terms in the table, briefly: ablative laser removes the upper layer of the skin by vaporising it; non-ablative laser heats the skin but does not open the surface. In fractional treatment, energy is delivered not to the whole skin but to many small points with intact skin left between them; this is why healing is faster. Dermabrasion is the abrading of the upper layer of the skin by sanding; it can be done by hand or with a motorised device with a rotating head. The deeper a procedure goes, the longer healing takes and the greater the caution.

The 'later studies' column in the table is based on the abstracts of reviews published after 2017. These reviews mostly bring together small, retrospective studies carried out with different methods; they do not provide definitive evidence of safety.

What does 'insufficient evidence' mean, and what does it not mean?

The 2017 systematic review examined about 1,500 procedures reported in 32 publications and graded the evidence. The task force of the American Society for Dermatologic Surgery reached a similar conclusion through expert consensus. A review published in 2025 examined 34 studies and more than 1,500 patients and stated that problems such as scars and keloids (raised, growing scars) were reported in only a small number of cases. Another review published in 2026 also reported that wound healing was normal in most current studies and that routinely postponing procedures solely because of isotretinoin may not be necessary for many people.

However, these findings have limits:

• Most studies are small and retrospective; the procedures, devices and durations of medicine use differ from one another.
• There are few data for people with darker skin and for those prone to scars or keloids; the 2026 review emphasises that prospective studies are needed in these groups.
• Another systematic review published in 2017 reported that, because of inconsistencies in the data, no firm conclusion could be reached either confirming or refuting postponement, and recommended that each patient be assessed individually.
• Negative results are not always published; a small number of reported problems does not mean that the problem never occurs.

In short, the view that 'waiting is mandatory' is not based on strong evidence; the view that 'there is no risk at all' has not been proven either. Your physician fills the gap between them according to your situation.

Do you have to wait until the medicine is finished for acne scar treatment?

This question is important especially for young people with severe acne that leaves scars. Under the old rule, scar treatment could only be started months after the medicine was finished; this could delay treatment by close to a year. The authors of the 2017 systematic review stated that, for some patients and in some situations, an informed decision may allow earlier and possibly more effective intervention.

In later reviews, improvements in acne and acne scars have been reported in small studies in which isotretinoin was used together with procedures such as non-ablative lasers, vascular lasers or radiofrequency microneedling. These studies were carried out with small numbers of people, and the results cannot be generalised to everyone. In addition, the timing of scar treatment is not determined by the medicine alone: whether the acne is still active, the type of scar and the current condition of the skin also matter. So 'starting early' does not always mean 'starting now'; assess the options together with your physician.

Why is waxing a separate issue?

Isotretinoin makes the skin markedly dry and sensitive. During this period, when a hot or cold wax strip is pulled off, the upper layer of the skin can come away together with the hair; what remains is a pink, wet-looking, sore area. This kind of skin peeling has been described in case reports and can leave scarring or discolouration. The risk is not limited to the face; the same can happen with waxing on body areas such as the legs, arms, armpits and bikini area.

The consensus reports did not assess waxing separately. The product information and the NHS patient page, however, recommend avoiding waxing. So being cautious about waxing is not an approach that contradicts the evidence. Ask the physician who prescribed the medicine which hair removal method is suitable for you while taking it and when you can go back to waxing after stopping it.

Can I have filler or botulinum toxin?

The consensus reports and the reviews we examined did not assess filler and botulinum toxin treatments separately; we did not find research specific to this subject. This does not mean that the procedure is prohibited; but there are also no data showing that it is safe. These procedures do not abrade the skin surface; still, they involve needle entry, and isotretinoin can make the lips and skin markedly dry. If there are cracks, sores or irritation in the treatment area, the procedure is usually postponed until the skin has recovered. We did not come across a known drug interaction between botulinum toxin and isotretinoin in the sources for this article; even so, you need to mention all your medicines.

If you are considering filler or botulinum toxin during this period, be sure to tell the physician who will perform the procedure that you are taking the medicine. You can find which symptoms after filler are an emergency in our article “After Fillers: When Is It an Emergency? Vascular Occlusion and Other Warning Signs”.

Who makes the decision, and how?

Two physicians’ views matter in this decision: the physician who prescribed isotretinoin and the physician who will perform the procedure. They may be the same physician; if not, both need to know that you are taking the medicine and about the planned procedure. The authors of the 2017 systematic review stated that physician and patient can discuss the known risks on the basis of the evidence and that, in some situations, an informed decision may allow earlier and more effective treatment.

1. Tell the physician who will perform the procedure that you are taking the medicine or when you stopped it; if you do not know how long the medicine has been used, ask the physician who prescribed it.
2. Ask which group in the table the planned procedure belongs to: is it superficial or deep, does it abrade the skin surface?
3. Discuss your own risks: darker skin, skin that easily develops dark spots, a history of scars or keloids, a history of cold sores, currently active acne.
4. If necessary, ask whether a small test area or a gentler option could be tried first.
5. Is waiting or going ahead now more suitable? Weigh the benefits and risks of both together.

For procedures carried out without treating the acne itself, see our article “Medical Aesthetics for Active Acne”, and for the general plan for scar treatment, see our article “Acne Scars”.

Do not forget contraception

Isotretinoin can cause serious birth defects in pregnancy. People who could become pregnant need to use effective contraception while taking the medicine and for the period stated by the prescribing physician. These rules do not change when planning an aesthetic procedure. For details, see our article “Medical Aesthetics in Pregnancy and Breastfeeding”.

After the procedure: is this normal?

While taking isotretinoin, the skin’s reaction to a procedure may be somewhat more pronounced. In an emergency, call 112 (or your local emergency number). The table below shows which symptoms you can keep an eye on, which require consulting your physician and which are an emergency.

What can be done to reduce the risk?

• Before the procedure, mention all the medicines you take and any you have stopped in the past year.
• Do not have a procedure while your skin is very dry, cracked or irritated; replan the timing with your physician.
• Protect yourself strictly from the sun; care with sunlight is recommended while taking isotretinoin. Our article “Medicines That Cause Sensitivity to Light” can be a useful guide on this.
• Do not use acid, abrasive or retinoid-containing products that your physician has not recommended before and after the procedure.
• Follow the aftercare instructions after the procedure and do not pick off scabs; if there is a problem, contact the physician who performed the procedure immediately.

Limits of the evidence: much of the evidence on this subject is based on small, retrospective studies, case reports and expert consensus. There is a difference between the consensus reports and the product information for the medicine; the current Turkish text of the product information was not examined separately for this article. No data specific to filler and botulinum toxin were found. This page is for general information; it does not give you a personal waiting period and does not replace an examination.