CLS CLS Contraindications & Adverse Events Management 2 — Questions and Answers
Question 1: Post-inflammatory hyperpigmentation (PIH) after laser treatment is most common in which Fitzpatrick skin types?
- Fitzpatrick Types I and II
- Fitzpatrick Types IV, V, and VI (Correct answer)
- Fitzpatrick Type III only
- Equally common in all skin types
Correct answer: Fitzpatrick Types IV, V, and VI
PIH is significantly more common in darker Fitzpatrick skin types (IV–VI) because higher baseline melanin content makes melanocytes more reactive to laser-induced inflammation.
Question 2: Which of the following is a relative contraindication (not absolute) for laser treatment?
- Active cancer in the treatment area
- Open wound at the treatment site
- Pregnancy (Correct answer)
- Tattoo ink of unknown composition in a removal candidate
Correct answer: Pregnancy
Pregnancy is a relative contraindication because while risks are not fully established, treatment is generally deferred until after delivery; absolute contraindications carry known definitive risks.
Question 3: How should a CLS manage a client who develops hypopigmentation (loss of skin color) following laser treatment?
- Immediately retreat the area at higher energy
- Document the finding, reassure the client, and refer to a physician for evaluation (Correct answer)
- Apply a tanning accelerator to restore pigment
- Schedule the client for another session within one week
Correct answer: Document the finding, reassure the client, and refer to a physician for evaluation
Hypopigmentation should be documented and the client referred to a physician for evaluation, as it may indicate permanent melanocyte damage requiring specialist management.
Question 4: Which eye hazard is the primary safety concern when using Nd:YAG lasers near the periorbital area?
- Surface corneal burns only
- Retinal damage from penetrating 1064 nm radiation (Correct answer)
- Eyelash singeing
- Temporary vision blurring only
Correct answer: Retinal damage from penetrating 1064 nm radiation
Nd:YAG 1064 nm radiation is transmitted through the cornea and lens to reach the retina, where it can cause permanent retinal damage if proper eye protection is not used.
Question 5: A client reports intense itching and urticaria (hives) that developed within minutes of beginning laser treatment. What should the CLS do first?
- Apply a topical cortisone cream and continue treatment
- Stop treatment and assess for signs of allergic reaction or anaphylaxis (Correct answer)
- Increase the cooling system and finish the session
- Photograph the reaction and complete the treatment
Correct answer: Stop treatment and assess for signs of allergic reaction or anaphylaxis
Rapid-onset urticaria can be a sign of systemic allergic reaction or anaphylaxis; treatment must stop immediately and the client must be assessed for emergency intervention.
Question 6: What does the term 'frosting' indicate when observed during laser tattoo removal treatment?
- The cooling system is working correctly
- Immediate whitening of the skin caused by rapid gas formation from ink fragmentation (Correct answer)
- Excessive ice pack application before treatment
- Normal skin melanin response to laser energy
Correct answer: Immediate whitening of the skin caused by rapid gas formation from ink fragmentation
Frosting is the immediate white discoloration seen during Q-switched laser tattoo removal, caused by rapid formation of CO2 gas bubbles from laser-ink interaction.
CLS CLS Contraindications & Adverse Events Management 2
Post-inflammatory hyperpigmentation (PIH) after laser treatment is most common in which Fitzpatrick skin types?