Cosmetic Lasers and Regulation - Is there blame when complications occur?

Posted on the 04 January 2012 at 10:48

The dangers surrounding the plethora of Cosmetic Lasers currently available in the UK marketplace are numerous and can have serious effects. There are unfortunately, many untrained, unlicensed, unqualified medical professionals operating lasers around the UK as well as many clinics seeking cheap, unregulated foreign lasers from the Far East, as a way to stay afloat during the current economic downturn.

It will therefore, probably come as no surprise that the number of accidents resulting from cosmetic lasers are steadily increasing year in year out. Perhaps the most famous example depicting this is Charlotte Cripps, a UK journalist who after undergoing IPL (Intense Pulsed Light) treatment in 2008 has been left with disfiguring burns. 

Charlotte Cripps - IPL Burns
At 37, Charlotte began to notice her skin had become grey, dull and lifeless so sought rejuvenation treatment. IPL is a light source that when directed over the skin, passes through the epidermis and penetrates deeper to stimulate fibroblast cells which produce fresh collagen, leaving your skin looking fresher and rejuvenated. 

On the recommendation of the clinic’s beauty therapist Charlotte’s IPL headpiece was switched to a stronger setting. The first indication to Charlotte that the treatment has been anything but successful was when, after several days she had severe red marks that she likens to being “branded with an iron”, and sought the expert help of Dr. Nick Lowe. 

It was through discussions with Dr. Lowe that Charlotte found that several key procedural steps had been overlooked by the clinic.

1. The treatment was performed on the décolletage and chest area which at the time had a tan and therefore was not eligible for IPL treatment
2. The clinic had failed to do a patch test which would have highlighted any initial reactions to the IPL

That was 2008 and now three years later in 2011, Charlotte has once again been speaking out about the lack of regulation in the cosmetic industry to protect the unassuming consumer.

Despite being initially rebuffed by the clinic as she was told she had no legal rebuke due to her signing a consent form acknowledging that adverse effects may occur and that the clinic could not be held negligible; after a lengthy legal battle Charlotte received compensation from the clinic but is speaking out against the current lack of regulation in the industry. 

As the debate over the controversial issue of whether non-medical people (i.e. beauty therapists) versus those who are medically led (nurse practitioners and doctors) and their eligibility to administer Botox continues, Charlotte is now campaigning for regulation prohibiting non-medics from administering injectables or performing IPL treatments unless under the supervision of a doctor. 

She is not alone in her criticism of cosmetic regulation, members of the aesthetic industry are split as to whether the recent Government deregulation of the IPL and Laser market have been detrimental to the industry or not.

Leading champions of cosmetic regulation have spoken out against industry regulation. Sally Taber of TreatmentsYouCanTrust, a Department of Health backed registry that provides a directory of regulated doctors, dentists and nurses for cosmetic injectables, has praised Charlotte for her message urging consumers to “shop responsibly.” 

Consumers need to be aware that beauty therapists are not appropriately qualified to safely administer cosmetic treatments, including Botox® and dermal fillers. Only Doctors, Dentists and Registered Nurses have the clinical background and knowledge of the facial anatomy to administer cosmetic injectable treatments safely. Instances of vial sharing, the storage of Botox® in a domestic fridge and the lack of waste collection for used needles are all problems commonly associated with beauty salons and can lead to significant problems and infection. Beauty therapists are not in the position to conduct the necessary medical consultation to ensure the desired treatment is appropriate and shockingly can be unaware that a patient may have a reaction to the injectable cosmetic treatment making it is essential that the injector is a clinical professional who knows how to manage any medical emergencies.” 

Here at The Consulting Room™ we regularly receive enquiries about Lasers and we’ve noticed that there seems to be a bit of confusion over the regulation of these increasing popular machines. One question we are constantly being asked is whether lasers for use in aesthetic treatments should be regulated by the Care Quality Commission?

Providers of lasers and lights used for non-surgical cosmetic aesthetic purposes, such as hair removal by a healthcare or non-healthcare professional (a beautician for example) were registered under the CSA 2000, but not required to register under the Health and Social Care Act 2008. They are, therefore, no longer subject to regulation by the Care Quality Commission as of 1st October 2010.

The laws currently pertain that only treatments for procedures involving disease, disorder or injury are regulated. Therefore treatments for use against wrinkles and hair removal procedures do not fall under these categories and are left unregulated. 

The CQC only license and regulate cosmetic treatments that could potentially fall under the above definition, or that involve surgical procedures and therefore there are currently a number of cosmetic treatments which are not regulated or licensed by the CQC in England. Lasers (along with muscle relaxing injections and remodelling techniques using cells, tissue or synthetic products and chemical peels) are therefore not regulated and as such providers of these services are not inspected to ensure they meet standards of quality or safety.  (Laser and IPL clinics in Wales continue to be subject to registration by Healthcare Inspectorate Wales.) 

It appears that foreign exporters are selling lasers to anyone willing to buy direct and without investigating the intended use of the device and adherence to appropriate regulation required and training background of the purchaser. The ethical notion of non-medically trained personnel buying potentially harmful laser machines does not even enter into the equation and is a diminishing factor as the availability of imported machines rises. 

What about the question of safety? Any practitioner knows that if treatments involving lasers are not carried out correctly then both the practitioner and patient is at risk of harm, yet many of these machines do not come with warnings about the right laser goggles or sometimes even the right settings for the machine itself.

Clinics who are not registered, not medically led and do not have evidence of training or machine servicing are, because of the lack of effective regulation, practicing cosmetic treatments using lasers - endangering the patients who put their safety in the hands of these practitioners. 

For more information on laser regulation read Dr Philip Dobson’s Blog.

Whilst thousands of treatments involving cosmetic lasers are carried out per year in the UK alone, the potential for adverse side effects is always present. We believe that education is the first step to reducing the likelihood of this occurrence. Clinics should be researching their laser and suppliers and the patient should educate themselves as much as possible on all areas involving their treatment.

Whilst the question of industry regulation remains a hotly debated and much ambiguous topic we must stress the importance of consumer education. Before setting foot into a clinic for any procedure research is vital. Educate yourself as to the treatment options and product brands that are available. Visit our Treatment FAQ pages to help educate yourself. It is also important to research your clinic, your doctor, their qualifications and make sure you are in a position to understand what the procedure involves before you enter into a contract with the clinic. (For more information on choosing the right clinic and procedure that’s right for you read Antonia Mariconda blog on her decision to undergo VASER Liposuction).

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Blog Comment(s) [1]

Cosmetic lasers are in trend and works great on skin. Sometimes because of poor consultation, these skin complications occur. I think we should not blame on these laser equipments. If you are going into the laser cosmetic medication process first you should consult with a good surgeon. If treatment has been taken under the guidance of a good cosmetic surgeon then chances of these skin infections are very negligible.

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