What steps should you take if a patient has edema or blistering during the session?

• A. Pause treatment, cool the area, reassess, and adjust settings or stop.
• B. Increase energy to overcome barriers.
• C. Continue with the current settings.
• D. Ignore and proceed at risk.

Answer: (A)

When edema or blistering shows up during a session, it means the skin has been overheated and is being damaged. The safest course is to pause the treatment, cool the area, reassess the reaction, and adjust the plan or stop for that area.

Pause the treatment immediately to prevent additional energy from being delivered to inflamed skin. Gently cool the area with a cool, damp cloth or a standard cold compress to reduce heat and swelling—never apply extreme cold directly to the skin. Reassess the skin: note the extent of edema or blistering, the patient’s comfort, and any signs of deeper injury. Based on what you find, adjust the treatment plan: lower the energy (fluence), shorten the pulse duration, use a smaller or differently shaped spot, or increase the spacing between treated areas, or stop treatment for that area altogether until healing occurs.

If a blister forms, protect it and manage as a minor burn: keep it clean, avoid popping, and seek further guidance if it enlarges or shows signs of infection. Document the reaction and plan for follow-up treatment after healing. Avoid increasing energy, continuing with the same settings, or ignoring the issue, as these can worsen injury and delay healing.