Dr. Steven Jepson - Laser Safety Issues

From an Article published in the Draper Paper

When I bought my first cosmetic laser several years ago, the general public wasn't really aware of all the wonderful things these laser could do for their skin. Consequently, I found myself focusing a lot of my laser pateint education on procedure awareness. Over the last two years, the number of laser centers seems to have grown exponentially, while at the same time naturally, the number of cosmetic laser procedures done in Utah has grown expontentially as well. Light-based therapies are probably the #1 cosmetic procedure now done in this country. And it seems everyone now has a pretty good idea about what comsetic laser can do, including sun damage reduction, hair removal, spider vein removal, skin tightening, wrinkle reduction, etc.

But as the number of laser centers have grown, so have the number of concerns regarding the use of these lasers. I believe that anyone shopping for laser procedures needs to be an educated savvy consumer. These are medical procedures and you need to shop for them as carefully as though you were choosing a cosmetic surgeon. The purpose fo this article is to hopefully educate you about what to look for when shopping for cosmetic laser procedures and what follows are three essential points to consider:

1. An IPL is not a laser -- Most laser procedures in the valley are not done by lasers at all. They are done using an "Intense Pulse Light" or IPL. This technology uses a diffuse light over many wavelengths to affect a change (fading of abnormal pigment, destruction of a hair follicle). Laser, instead, uses a very focused, one wavelength frequency to affect a change. Because laser light energy is more focused and more specific, the end result with laser is better with fewer potential side effects (such as burns and skin pigment changes). IPLs are more common because they are less expensive for a physician to purchase and require less technical expertise to operate. IPLs do an OK job - otherwise there wouldn't be so many of them. But lasers do a better job with fewer potential complications and generally cost the consumer no more money than an IPL treatment. So when shopping for laser procedures, always know what kind of equipment will be used.

2. Who is running your laser? -- Lasers and IPLs are considered by the FDA to be medical prescriptive devices. This means that only a Medical Doctor can purchase this type of equipment. But in many laser centers, the purchasing MD does not operate the laser. Different states have differing laws about who can actually operate this type of equipment. New Jersey only allows doctors to operate this equipment. California will allow and RN to run the equipment, but only under direct MD supervision (the MD must be on site).

Utah's laws are less clear and right now pretty much anyone can operate a laser or IPL in Utah. Consequently, odds are that when you have a laser procedure done here in the valley, it will not be done by a doctor, sometimes it will be done by a nurse practitioner or RN, but most often it will be done by a "laser tech" - someone with very little medical training who was given a few hours of training on the laser before being given the keys. Theoretically the doctor still needs to be directly involoved with each laser procedure and be in the facility at the time the procedure is taking place. But in lots of laser clnics and med spas around the valley, the doctor leaves the laser part of the practice completely in the hands of the laser techs or nurse (and often is not even on site all the time).

There have been many reports in the media lately about serious cosmetic laser burns. In every report that I have seen, the patient was burned by a technician who had used the wrong settings or the wrong laser (!!), So my advice when shopping for laser procedures is to ask who will be running the laser and find out how much experience they have. In my clinic, I am the only one who runs the lasers. No one else even knows how to turn them on.

3. How much does the doctor understand about lasers? -- This point is even more important than Point 2. There are a lot of laser companies now trying to place a laser in just about every doctor's office, no matter the specialty. They will convince the doctor that the laser can be put in a back room, that a low-paid "tech" can be hired to run it, and that the cash will flow into the doctor's pocket. The company will then come in and give the office (doctor included) a half day training session, and then set the office loose on the public. Often, in this scenario, the doctor then goes about his/her normal practice, and leaves the laser part of the practice up to his/her staff. The doctor never really learns much about the science or operation specifics of the laser, and even more concerning is that if there is a complication, the doctor doesn't know the most effective ways to fix it. Doctors who are directly involved in the day-to-day operation of their laser will always understand their laser best, and you as the consumer are ensured your best and safest possible results!

Cosmetic Lasers are a great new way to reverse the tell-tale signs of aging and improve the quality of your skin. But like any medical procedure, research carefully and make sure that you are getting the kind of care you deserve.

By Dr. Steven Jepson