Laser in Pregnancy

Utilization of Laser Therapy During Pregnancy

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• Using various cases, clinical trials, cohort studies, and retrospective reviews, these authors reviewed the safety of laser treatments of various wavelengths in 380 pregnant women during all trimesters. No cases of maternal or fetal morbidity or mortality, premature labor, or identifiable fetal stress were observed. There was only 1 case of premature rupture of membranes reported, which could not be confirmed as related to the laser treatment.

• While laser physics and optics indicate that there should be no theoretical risk to the fetus from cutaneous laser treatment, laser treatment during pregnancy has traditionally been limited due to concerns of safety. These findings suggest that laser therapy in pregnant women may not impose significant fetal risks during any trimester.

– InYoung Kim, MD, PhD

Historically, elective laser treatments during pregnancy have not been recommended. In fact, manufacturers, for FDA labeling purposes, commonly list pregnancy as a contraindication to patient selection for cosmetic laser treatments. Yet, there has never been any evidence to support such guidelines. A literature review of multiple medical and legal databases revealed a total of 380 women were treated with a variety of laser wavelengths during pregnancy. Reported ages ranged from 14 to 41 years and the data was taken from worldwide literature. Among virtually every study, there was no definitive evidence of laser-induced spontaneous abortion, fetal malformations, or preterm labor occurring secondary to laser therapy during pregnancy.

In fact, the use of laser treatments in the pregnant woman has shown no significant risk to the fetus during any trimester of pregnancy. Although only laser wavelengths were studied and intense pulsed lights (the most commonly used energy-based device worldwide) were not evaluated, the physics of such devices are identical.

Given the cumulative evidence in the literature worldwide, the guidelines for use of lasers, and intense pulsed lights in the gravid patient should be changed to reflect the recently reported, long-term safety profile of such technologies. To date, there has been no reported significant harm to mother or fetus, due to laser therapy, during any stage of pregnancy.

Abstract

BACKGROUND

Due to concerns regarding maternal and fetal safety and the absence of evidence to the contrary, laser treatment during pregnancy has traditionally been limited to situations of absolute necessity.

OBJECTIVE

This review seeks to examine the available evidence to determine the safety of laser therapy during pregnancy.

METHODS

Medical databases were searched for relevant reports from all specialties regarding the use of lasers during pregnancy from 1960 to 2017. A legal case review was also performed.

RESULTS

Twenty-two publications in the literature reported the use of various laser wavelengths in 380 pregnant women during all trimesters. Other than 1 case of premature rupture of membranes questionably related to the laser treatment, there were no cases of maternal or fetal morbidity or mortality, premature labor, or identifiable fetal stress.

CONCLUSION

The available evidence, limited to low evidence level case reports and series, indicates cutaneous laser treatment during pregnancy is safe for both mother and fetus. Furthermore, laser physics and optics dictate there should theoretically be no risk of fetal laser exposure from commonly used cutaneous lasers.

Dermatologic Surgery

Utilization of Laser Therapy During Pregnancy: A Systematic Review of the Maternal and Fetal Effects Reported From 1960 to 2017

Dermatol Surg 2019 Apr 16;[EPub Ahead of Print], EC Wilkerson, MM Van Acker, BS Bloom, DJ Goldberg

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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