It’s about responsible patient outcomes …

Sometimes you just need to stand up for what’s right

A beauty therapist, it was the person you visited to have your nails done, a relaxing massage, even a facial. What it was not, was a person you visited using a Class 4 laser device with the potential to cause permanent disfigurement, second-degree burns, or maybe just change the colour of your skin, forever.

Perhaps you think it is strange that we are sending a shot, clear across the bow of the beauty industry, when we are members of that very industry. Call us mavericks, not team players, yet, there is a method to our strafing fire.

A recent study, Hammes et al., in Germany looked into 50 cases of patients that had complications after laser and light treatments.

This is what they found;

• 81.4% had undesired pigmentation changes
• 25.6% were left scarred
• 14% had unwanted textural changes to the epidermis.

The sources of error (multiple answers possible) were the following:

• 62.8% excessively high energy
• 39.5% wrong device for the indication
• 20.9% treatment of patients with darker skin or marked tanning
• 7% no cooling
• 4.6% incorrect information

A trainer I know of says; “If you are not putting ice packs on the skin during IPL treatment then you are just not using enough Joules”. That is exactly the kind of gap in education and maybe even experience, breeding and feeding the problems our sector faces.

“I just saw a young girl — it was a very sad case — who developed a very prominent scar on her right upper lip from laser hair removal. She’s under 20 years old; It’s heart-wrenching to deal with these cases because … they’re going in to look better, and come out looking worse.” Dermatologist Dr Vince Bertucci, consultant dermatologist at Women’s College Hospital and former codirector of undergraduate dermatology at the University of Toronto in Ontario. (Galt V)

In the previous introductory article ‘The industry needs more effective laser and light training courses‘ Dr Callaghan Condon, a consultant at the Blackrock Clinic, said tattoo removal poses a biohazard. In Western Australia, the only people that can use 3B and Class 4 Lasers are medical practitioners, and other states are looking at more regulation.

Currently, there is a group of Doctors, including Dr Condon that are lobbying the EU to implement more regulations here in Ireland, and who could blame them?

Worldwide, Doctors, Dermatologists, and associated professionals are pressuring governance bodies for more regulation. Let us also not be nieve; it is not just about outcomes for patients that has the medical sector a little rattled, it is also hitting the hip pocket nerve. Compound a loss in revenue, with undesirable results in treatment for the general public, and you have a platform that is, easily leveraged. Furthermore, the beauty sector is terrible for not recognising the problems and doing something about it. That is clearly evident with the top down approach across many countries, resulting in some cases with the beauty sector being locked out.

On a salon website, I came across recently; they say to come in for Tattoo removal with an IPL. They go on to explain the treatment and how the IPL burns off the skin containing the tattoo and may require several sessions.

The tattoo will absorb the IPL energy, but not effectively enough to remove the tattoo, and there is a high risk of a burning. An IPL is not designed to break down the tattoo ink, and neither are hair removal laser machines. People have had to have skin grafts after visiting salons, and the incorrect laser device has been used for tattoo removal.

We have to reach the same conclusions, as the cited articles. Malpractice suggests insufficient training, inadequate diagnostic abilities and the promising of unrealistic results. It is of our opinion this is addressed with elevating the training requirements to include hours spent in the clinical environment under direct supervision. Occupational health and safety and professional competency compliance following a quality assured model, is not only required, but it is ethically the right thing to do.

Come back for Part 3, when we look further at how we can address the problems the industry faces and the need for a more robust training model.

Hammes, S., & Karsai, S. (2013). Treatment Errors Resulting From Use of Lasers and IPL By Medical Laypersons: Results of a nationwide survey. Journal of the German Society of Dermatology, 149-156.

Galt V. Laser hair removal a risky business in need of regulation, experts say. CMAJ : Canadian Medical Association Journal. 2010;182(8):755-756. doi:10.1503/cmaj.109-3230.

Alam, M, Waldman, A, Nouri, K, Council, ML & Cartee, TV 2016, ‘Practice and Educational Gaps in Light, Laser, and Energy Treatments’ Dermatologic Clinics, vol 34, no. 3, pp. 347-352. DOI: 10.1016/j.det.2016.03.002