Medical lasers set on stun

LASERS are powerful, high-tech medical tools which can be seriously dangerous if left in untrained hands. Unfortunately, most of them are.

Lasers and intense pulsed light (IPL) machines are surprisingly easy to get. Since they’re largely used for hair removal and beauty touch-ups, the Therapeutic Goods Administration does not require them to be registered, classified or even checked for malfunctions. User manuals may be poorly translated and difficult to understand. Not exactly clinical.

The use of these devices remains unregulated in Australia’s two most populous states, New South Wales and Victoria. The process of national standardising and regulation has been an on-and-off process over the last 10 years, and shows little momentum for a breakthrough anytime soon. So until the powers that be get it right, we’re on our own and must be aware of the hazards.

Beauty salons with the medical-sounding name “beauty therapist” employ lasers all the time for hair removal and cosmetic skin treatments, like erasing freckles. You don’t need to be a doctor to pull the trigger, but you do need a doctor to judge if the treatment and device settings are appropriate.

Dr Mary Dingley is a spokesperson for the Cosmetic Physicians Society of Australasia. She says this lack of responsible and knowledgeable authority at the beautician is the root of the problem.

“Even if they say they know about all the different skin types and that they’ll use the right settings, these machines do have the ability to treat more than hair,” Dingley said. “So what is to stop these people from saying, ‘oh, that looks like a sun spot on your face. Let’s zap that as well’? 

“They used to send people off to the doctor to have these things checked, but now they’re using intense pulsed light for everything. ‘Let’s see what happens. Let’s just give it a zap’,” she said. “That can be dangerous.”

Camouflaging cancerous lesions out-of-sight, out-of-mind is certainly the scariest aspect of laser misuse, especially in a country which happens to lead the world in skin cancer cases. But even the common burns, blisters and blunders caused by non-medical laser operators can have lifelong effects.  

“Burns and the changing of skin colour is what happens the most frequently,” Dingley said. “Blistering can lead to scarring and it can take the colour out of skin, or in the short-term, it can increase the colour in skin.

“It could take all of the pigmentation completely out of the skin so the patient is left with these white stripes on their face which can be permanent.”

Laser use can also cause vision problems or even blindness by damaging the retina. Many beauticians with laser and IPL machines don’t realise this threat and conduct treatments without any eye protection for themselves or their patients.

This is a difficult problem because, in a way, the genie has already been released from the lamp. It’s not easy for administrative authorities to tell thousands of beauty salons across the country that they have to give back their favourite toys.

In many cases, victims of botched treatments do not come forward to health authorities, or the situation is treated as a consumer affairs issue rather than a health issue. The complaints that are made tend to be marginalised to fair trading regulators where disputes are treated as business problems that can be solved by reimbursement. Passing legislation on this issue will require the coalescing of public outcry.

“Just about every week there’s a story on Today Tonight or A Current Affair about people getting burnt by beauty therapists with IPLs and things like that,” Dingley said, “but it just doesn’t seem to go anywhere. ARPANSA says they don’t have the volume of complaints but it’s really just that they haven’t all been collated by one body.”

The Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) monitors and regulates radiation risks.
 
“People do complain and seek remediation for their problems,” Dingley continued, “and there are authorities that people can go to if they have a medical concern. But those authorities don’t look after things that happen in beauty therapy clinics. Often if people do complain to their state complaints commission, they’ll be told it’s not a health problem.”