LHR for Arms and Face with NDYag Laser: Do I Listen to a Dermatologist or a Medspa Aesthetician Under Care of Plastic Surgeon?

I'm Mid-Eastern with hair on my face & arms and breakout when I wax. My derm rx Hydroquinone 8% & Finacea for face; LHR for both; never said to shave before LHR, 1st time burned arms only and said cooling spray was set too high. Rx Hq for arms. Later txts went well. Facial skin improved. I moved-went to a Medspa for LHR. Aesthetician did my arms but refused to do my face while under txt of Hq & Finacea and told me to stop use; claimed Hq was a carcinogen; says I must shave prior & derm is wrong.

Doctor Answers 1

Laser hair removal safe while using finacea and HQ

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Prior to any laser hair removal session, you will want to shave the area to be treated because you want the target of the laser - the hair - to be below the skin surface. If the hair is long and on the surface the laser energy will be absorbed there rather than down in the follicle where you want the hair destruction to occur. We usually recommend just enough stubble or regrowth so that we know where to treat.

Regarding use of topical finacea and hydroquinone (HQ), these agents might help prevent post inflammatory hyperpigmentation, or skin darkening, after any laser treatment and are certainly fine to use while undergoing laser hair removal treatments. 

Regarding the concern about HQ as a carcinogen below is an exert from my patient handout about melasma and bleaching agents:

One of the concerns regarding hydroquinone is the potential for risks from the production of benzene derivatives after hepatic metabolism; however, topically applied hydroquinone is not metabolized by the liver and is water soluble and excreted thorough the kidneys. Kidney tumors are therefore a concern but no renal toxicity or tumors have ever been reported with topical hydroquinone use.
Hydroquinone is a compound that is commonly found in many foods and beverages, including berries, tea, coffee, red wine, wheat, and the skin of pears. Workers involved in the manufacture of hydroquinone and who are exposed to large quantities of this agent have not been found to have any significantly increased risk of premature death or increased prevalence of cancer, and there has been no malignancy reported in animal testing. An extensive scientific review of hydroquinone safety issues, found no risk real of malignancy and an exceedingly low risk of developing ochronosis or other side effects in patients using available prescription topical preparations of hydroquinone under the supervision of a physician.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.