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Concerns Grow Over Unregulated Laser Clinics That Cause Injuries

extract from Daily Mail 24 October 2010.

In the right hands, medical lasers can have almost miraculous effects. They can erase unsightly thread veins and birthmarks, and treat the redness of the skin disease rosacea.

Laser treatment: these powerful beams of light can reduce scarring and stretch marks as well as unwanted body hair.

Considering their versatility, it is little surprise that laser therapy has become one of the most common non-surgical medical procedures.

A survey by Which? in 2008 revealed that an estimated six million British women were considering the treatment and 700,000 had had it.

Yet proliferation comes at a cost. Last month, regulatory body the British Association of Aesthetic Plastic Surgeons (BAAPS) announced concerns over an increase in patients needing corrective treatment for injury and burns after botched laser therapy.

And, despite pleas from within the industry, this month the Government went ahead with planned deregulation of laser equipment.

Before this, practitioners had to register with the governing body the Care Quality Commission (CQC) and follow strict guidelines, but now anyone can buy a laser for cosmetic use.

‘This is great news if you’re a beauty salon looking to make a good profit,’ says dermatologist Dr Mervyn Patterson, ‘but not so great for the thousands who have suffered injuries at the hands of untrained or inexperienced practitioners.’

This is something mother-of two Elizabeth Miller, 38, from Buckinghamshire, discovered the hard way. Two years ago she went for a course of laser-hair removal and ended up with scarring to her stomach. ‘On my third visit I moaned about post-baby stretch marks on my tummy and the therapist said she could treat those with the laser,’ she said.

Elizabeth realised almost immediately that something was wrong. ‘It stung, which I assumed was normal, but that night the pain got worse and I could see blistering on the skin. The next morning I went to A&E.

They told me that I had third degree burns. The doctors said the therapist used the wrong laser setting.’

BAAPS estimate that there are 1,000 unlicensed practitioners operating in the UK. There are nearly 4,000 reports of laser ‘adverse events’ each year.

‘There is no question that we are going to see an increase,’ says consultant dermatologist and Professor Nick Lowe.

Alongside burns there can be permanent pigmentation changes and eye problems. Consultant plastic surgeon David Gault explains: ‘If safety goggles aren’t worn they can cause retinal damage and blindness.’

To understand just how dangerous these medical devices can be in the wrong hands, it is important to explain how they work. A laser is a single-wavelength (one colour of light) source of energy which can be focused to transmit light and heat on to a precise area. This heat can be used to selectively destroy body tissue.

Different laser wavelengths target different skin issues, and administering the right laser type is a highly specialised process.

‘The wavelength determines exactly what’s being heated up,’ says Dr Patterson. ‘A short-wavelength laser will target the red of thread veins.

A higher wavelength will be used for hair removal. Even higher will help leg veins, and the highest wavelengths turn the top layers of skin to vapour.

You simply cannot swap one for the other or you will cause untold damage.’

Stories of disastrous outcomes come as no surprise to the highly trained doctors who treat laser injuries. ‘I saw 17 injured people last year,’ says Mr Gault. ‘This year I’ve already seen 32.’

Prof Lowe recommends that patients ask key questions – such as are the laser operators medically trained and qualified in their use. Cosmetic dermatologists are the best trained in the use of lasers.

Dr Patterson agrees. ‘I’d recommend practitioners who have a wide range of lasers and also clinics with good examples to show of patients before and after therapy so that you can see their work.’

A wide range of drugs can affect the response of the skin to laser treatments. ‘These include St John’s Wort, which makes skin more sensitive to lasers,’ says Dr Patterson. ‘Anti-platelet drugs and blood thinning drugs such as aspirin may cause excessive bruising. Some diabetic drugs also increase sensitivity.’

A cynical point of view is that the deregulation is financially inspired. ‘It costs the Government to enforce legislation and it has been worked out that despite the cost resulting from rising numbers of patients with burns from poor use of lasers needing treatment, the NHS would still save money through deregulation,’ says Gault.

The Department of Health insists that non-surgical cosmetic lasers carry low levels of risk. And yet, less than a year ago, the CQC prosecuted the owner of a salon chain, Skin Health Spa, for operating hair-removal lasers without registration.

The comment from their senior enforcement manager last November was a stern warning: ‘Lasers can cause harm if they are not used properly. That’s why we register services.’

He went on to urge people considering laser treatment to do their research and check that the service is regulated. Sadly, of course, that is no longer an option, and for women like Elizabeth Miller it is too late.

So make sure you ensure that the clinic you use is Registered with Care Quality Commission. If it says on its website or uses the CQC logo gives some reassurance however you can search on to be certain.