Practice patterns regarding combination treatments and laser and energy based devices: A survey of American Society for Laser Medicine and Surgery Members.

OBJECTIVE: The use of laser and energy-based devices (LEBD) has grown exponentially in recent years, and variations in common practices exist. Our study sought to evaluate the current practice paradigms of leaders in the field of LEBD with regard to antimicrobial prophylaxis, adjuvant topical treatments, use of laser procedures in pregnancy, and combination of procedures.

METHODS: Anonymous surveys were distributed to leading dermatologists in American Society for Laser Medicine & Surgery (ASLMS) via email.

RESULTS: Surveys were distributed to 65 ASLMS members; 37 submitted responses. Routine antiviral prophylaxis is used by 76% for fractional ablative procedures of the face, but only 27% for fractional non-ablative procedures. Routine antifungal prophylaxis was used by a minority (16%) for ablative procedures, whereas antibacterial prophylaxis was used by 68%, with varying antibiotics. Wide variations exist in skin preparation and topicals used post-laser treatment. Most respondents feel comfortable combining same-day LEBD and botulinum toxin injections, specifically vascular or Q-switched/picosecond lasers. Most respondents avoid performing LEBD during pregnancy.

CONCLUSIONS: Expert consensus in a rapidly growing field sheds light on common, reliable practices. However, even at the expert level, variations exist. Further high-quality research is needed to standardize and update guidelines.