Contraindications, Adverse Reactions, and Complication Management
Absolute versus relative
An absolute contraindication means do not perform the service: active infection, open or weeping lesions, recent isotretinoin, known allergy to a planned ingredient, compromised immunity in the treatment area, or an undiagnosed lesion. A relative contraindication means modify, delay, or get medical clearance: pregnancy, photosensitizing medications, recent waxing or laser, anticoagulants, keloid history, and active tanning.
Common medication categories to know: retinoids, isotretinoin (typically wait six months after the last dose - confirm with the prescribing physician), antibiotics such as tetracyclines and fluoroquinolones (photosensitivity), anticoagulants and antiplatelets (bruising and bleeding), and immunosuppressants.
Recognizing reactions
Irritant contact dermatitis is dose-related, burning and stinging, and appears quickly with a sharp border where product sat. Allergic contact dermatitis is immune-mediated, often delayed 24 to 72 hours, itchy, and may spread beyond the contact area. Urticaria is immediate. Infection usually appears days later with warmth, pus, or increasing pain. PIH appears over weeks. Herpes reactivation appears as clustered vesicles, often within 48 hours.
Response protocol
Stop the service, remove product, cool and soothe, document objectively with photos and consent, provide aftercare, and refer to a physician when there is blistering, spreading rash, pus, systemic symptoms, or eye involvement. Report per your employer's policy and stay inside your scope - you assess and refer, you do not diagnose or prescribe.
Traps
- Labeling every reaction an allergy.
- Continuing a peel because the client says it is fine.
- Failing to document what you actually applied.
Rule of thumb
Stop, document, refer. Timing tells the story: immediate equals irritation or urticaria, one to three days equals allergy, three to fourteen days equals infection.