Before you book

Can I have this if something else is going on?

Pregnancy, a flare, a cold sore, a course of medication, skin that reacts to everything. These are the questions people ring and ask, and the answer is often no — which is why almost nobody publishes them. Here they are, answered as they would be on the phone.

Answered, not sold · Registered nurse–led · Springvale, Victoria

Why this page

A page of nos.

Most of what follows is a reason you cannot have something today. That is an unusual thing for a clinic to publish, and the reason it is rare is straightforward — a clinic that answers these honestly loses the booking, and a clinic that answers them vaguely keeps it.

We would rather you read it now than find out in the chair. Nobody should drive across Melbourne, pay, get changed and then be told the treatment is not happening.

One thing worth understanding before the list, because it explains nearly every entry on it. Most of what a skin clinic does works by disrupting the skin's surface in a controlled way — peels, needling, dermaplaning, microdermabrasion. On settled skin, that controlled disruption is the entire point. On skin that is already inflamed, broken, burnt or busy healing, the same disruption lands somewhere that cannot absorb it, and it goes badly.

So the question is rarely is this treatment any good. It is is your skin in a position to receive it this week.

The circumstances

What is available, and what isn't.

General positions, not personal advice. The decision is always made by the nurse looking at your skin on the day — this is what to expect her to say.

Pregnant: Needling is not available, and most peels are not. Not because harm has been demonstrated, but because it has not been studied in pregnancy and the honest position is that we do not experiment on people who are pregnant. Hydrating and cleansing facials without abrasion are generally available. Tell us when you book rather than on arrival, and expect a smaller plan than you might have had otherwise — that is the correct plan, not a lesser one. [TALIHA: confirm which specific facials remain available, and whether any peel does]
Breastfeeding: More is available than in pregnancy, but not everything, and it depends on what is being used rather than on the treatment name. Worth a conversation rather than an assumption in either direction. [TALIHA: confirm the position]
A cold sore, right now: Nothing on the face while one is active. This one is firm and it is not negotiable on the day. Facial treatments can spread it and can trigger a larger outbreak. If you get them often, say so at the consultation — it changes how treatments are planned rather than ruling them out. [TALIHA: confirm whether prophylaxis is ever arranged before treatment, or always a GP matter]
Sunburnt, or freshly very tanned: Not while skin is burnt. Sunburn is an injury and the skin is already dealing with one. Peels, needling and abrasion all go badly on it. The answer is time, and moving the appointment costs nothing. [TALIHA: how long after sunburn]
Actively breaking out, inflamed: Depends heavily on what kind. Congestion and blackheads are often exactly what a treatment is for. Angry, inflamed, painful lesions usually are not — needling through active inflammation tends to spread it and can leave marks that outlast the breakout. Frequently the better answer is to settle things first, which may be a skincare change or may be a GP.
A diagnosed skin condition, flaring: Eczema, psoriasis, dermatitis or rosacea in flare: treatment is generally deferred, and unaffected areas may still be workable. We do not treat these conditions — a doctor does — but we do plan around them.
A diagnosed skin condition, controlled: Often yes. This is the row people expect to say no and it usually does not. A condition that is identified and managed is far easier to plan around than an undiagnosed one, because we know what we are working with. Bring the name of it and what you use.
Prone to keloid or raised scarring: Needling is not available, and this is one of the firmest limits here. Skin that scars this way can respond to controlled injury by doing more of it. If you have had a raised scar from a piercing, a cut or surgery, say so before anything is planned.
A scar you want improved: Depends on its age and type. Indented scars that have fully matured are what needling suits best. Fresh scars, raised scars and anything still healing are not treated here. Where a scar is surgical, we want the surgeon's or GP's clearance first, not as a formality — they know what is under it. Nothing removes a scar; the honest word is improved. [TALIHA: minimum time post-surgery before assessment]
On oral acne medication: The strong prescription oral treatments for acne change how skin heals, and peels, needling and dermaplaning are generally not done during a course or for a period afterwards. Your prescriber sets that period. Tell us what you are on and when you started — we will not ask you to stop anything.
Using strong actives at home: Retinoids and acids thin the surface in a way that changes how a treatment lands. Usually the answer is a pause of a few days beforehand rather than a no. This is the most common reason a treatment gets adjusted on the day, and the easiest to avoid — tell us what you actually use, including what you use occasionally.
Skin that reacts to everything: Available, but the plan looks different and it should. Reactive skin is the category where doing less is most often right and where an enthusiastic treatment plan does the most harm. Expect fewer treatments, spaced further apart, and a longer conversation about what you are putting on it.
A mole or a spot that has changed: That goes to a doctor before it goes anywhere near us, and it is not a delay we will negotiate. Anything that has changed in size, shape, colour or behaviour needs someone qualified to identify it. We do not, and we would rather lose the appointment than be the reason it was looked at late.
Diabetes, an immune condition, or blood thinners: Not automatically a no, and not automatically a yes. These affect healing and bleeding, which affects which treatments make sense and how they are spaced. It is a conversation at the consultation, and sometimes a conversation with your GP. [TALIHA: which of these require GP clearance rather than disclosure]
A treatment somewhere else, recently: Spacing matters, and it matters more than people expect. Tell us what you had and when. Stacking treatments too closely is one of the more common ways skin gets worse while somebody is actively trying to improve it. [TALIHA: standard spacing]

Every line here is a general position. None of it is advice about you, and none of it replaces being looked at.

If it is no

Being told no is not being turned away.

When a nurse here declines to treat something, she is not saying she does not know what it is. She is saying she can see the skin is not in a position to take it, and that her instruments would make it worse. That is a judgement about the tools in the room, and it is one she can make without naming anything.

What happens next is that you keep the consultation, you keep the written plan for everything unaffected, you get a reason in plain words, a referral if you want one, and a point at which to come back.

One treatment, on one day, is deferred. Nothing else is. The order changes; the plan does not disappear.

Questions

Asked before booking.

Answered the way they would be answered on the phone.

Can you get skin needling when pregnant?

Not here. Microneedling is generally avoided in pregnancy — not because harm has been shown, but because it has not been studied in pregnancy, and the honest position is that we do not run experiments on people who are pregnant. Hydrating facials without abrasion are usually still available. Tell us when you book rather than when you arrive.

Can you get a facial while pregnant?

Usually yes, in a narrower form. Cleansing and hydrating facials without abrasion are generally available; peels and needling are not. Some ingredients are set aside for the duration. Expect a smaller plan than you would otherwise be offered — for most people that is nine months of maintaining skin rather than changing it, which is the correct answer rather than a lesser one.

Does microneedling help rosacea?

It is not a treatment for rosacea, and rosacea is a medical condition managed by a doctor. Microneedling works by creating controlled injury, which skin prone to flushing and inflammation often does not tolerate, so it is frequently not appropriate. Someone with well-controlled rosacea may have it for a separate reason such as texture or scarring, but that is an individual assessment and for many the honest answer is no.

Can you have microneedling with active acne?

Generally not through areas that are actively inflamed. Needling across angry, painful lesions tends to spread bacteria and can leave marks that outlast the breakout itself. Microneedling is well suited to the scarring left behind once things have settled, which is a different appointment at a different time. Congestion without inflammation is a separate question and often treatable.

Can you get a facial with sunburn?

No. Sunburn is an injury and the skin is already repairing one. Peels, abrasion and needling on burnt skin extend the damage rather than treating it. Move the appointment — there is no charge for doing so — and in the meantime the answer is cool, bland, unscented moisture and no actives at all.

Do chemical peels work for melasma?

Melasma is a diagnosis and identifying it belongs to a doctor. Speaking generally about pigment: peels can reduce how visible surface pigment is, but the kind of pigment that sits deeper is far less responsive, it recurs readily with sun and hormonal change, and in some skin an aggressive approach makes it worse rather than better. Anyone promising to clear it is describing something that does not happen reliably.

How many microneedling sessions for acne scars?

Usually a course rather than one appointment, spaced several weeks apart, and the honest answer is that it depends on the type of scarring more than on the number. Indented scars that have fully matured respond best. Raised scarring generally does not, and skin prone to keloid is not treated this way at all. We would rather tell you at the assessment that a scar is unlikely to respond than sell you a course.

Which facial suits sensitive skin?

Generally the ones without abrasion or acid — hydrating and barrier-focused treatments rather than peels, needling or microdermabrasion. But sensitive skin is a description rather than a category, and skin that reacts to everything often reacts because of what is being used on it at home. That is usually where the conversation starts.

What should I tell the clinic before I book?

Any diagnosed skin condition and whether it is flaring, pregnancy or breastfeeding, prescription medication for skin, a history of cold sores or raised scarring, recent sun exposure, any treatment you have had elsewhere in the last few weeks, and everything you currently put on your face — including what you only use occasionally. None of it is used to talk you out of anything. It is used to avoid the appointment where you arrive and we cannot proceed.

Where this leads

If none of these are you.

Most people read a page like this, find nothing that applies, and book. That is the usual outcome — the list is long because it is complete, not because it is common.

The consultation · $150

Ninety minutes and a written plan. Every question above gets asked properly here, once, and then it is on the record.

Flaking and scaling

Seborrhoeic dermatitis, psoriasis, eczema and rosacea look alike and get confused constantly. What differs, and why the name matters here.

What we don't do

The treatments, claims and offers this clinic declines, and the reasons.

What costs what

Every price published, and which treatments need seeing first.