Devices using light, including lasers and IPL, have become popularly used by specialists in the field of aesthetics. According to Statistics MRC1, the global market for Aesthetic Lasers will reach USD 1 293.7 million by 2022, increasing by 14.3% in the period from 2016 to 2022.
The ageing society, technological progress, growing awareness of the use of treatments and the increasingly common use of non-invasive procedures, as well as the changing lifestyle and increasing income of patients are factors that increase market growth regarding laser therapy in aesthetics.
Popular Treatments Using Laser Therapy in Aesthetics
The most popular treatments are photorejuvenation treatments, including pigmentation, redness and wrinkle where IPL devices and lasers can be used.
The next treatments that should be mentioned are undoubtedly photoed epilation treatments commonly referred to as laser hair reduction. Here the most popular are diode lasers – which are the gold standard, but also Alexandrite and Nd:Yag lasers as well as IPL devices
The demand for treatments to remove the unwanted tattoo or permanent make-up is still growing – here we use lasers in Q-switch technology, e.g., Nd:Yag with a pulse length expressed in nano or pico-seconds.
What is worth noticing about the world markets are strict regulations and regulations regarding the safety of lasers, including the qualifications of specialists. Such limitations eliminate people unauthorised to perform therapy with lasers and IPL and minimise the risk which, apart from undeniable benefits, carries the use of lasers, IPL and LED devices.
Classification Of Lasers
Light emitting devices are classified in eight basic security classes, and those that we use as a treatment, both lasers, and IPL devices are placed in class 4 as posing a high risk for eyes and skin.
The equipment available on the market must meet precisely defined standards and standards – and at the same time be approved by the FDA. Here, our role is to choose the right equipment depending on the quality of the treatments we want to provide to our patients. For a layperson at a time when there is a massive amount of hardware possibilities on the market, it is not easy at all, therefore, for the assessment of technology, we must know the necessary parameters and guidelines that we follow when purchasing. Thanks to this knowledge, we can later adjust the treatment parameters to the patient’s needs and to ensure the best results.
Prevention Of Side Effects
To ensure operational patient safety using lasers, it is necessary to prepare equipment, rooms, and PPE.
Inadequate safety glasses – of dubious quality, poorly selected OD (optical density) or their absence cause irreversible damage to the eyes for all those in the treatment room.
Maladjusted, unmarked treatment room, non-compliance with the recommendations for ventilation, lack of skin cooling during the procedure or surfaces reflecting light – such as mirrors, watches, jewellery create further threats, which would be very easy to avoid.
Regular service and inspection of equipment, as well as their skilful use and regular audits, can ensure their reliability.
Consultation Before The Procedure
It is unquestionable to say that for an IPL, laser treatment to be effective and safe three primary variables are necessary: proper quality equipment, well-qualified specialist, good individual patient response.
Individual patient response is a factor that we do not have a direct impact on. We can not be 100% sure that the patient complies with the pre- and post-operative recommendations. What we need to ensure is a very detailed, reliable consultation that includes not only contraindications, indications for surgery, checking medical history, but also determining – also crucial – scrupulous determination of the patient’s skin phototype – which may not be easy for a multicultural community. We do not know until the end how the skin reacts – that is why patch-test and voluntary, informed consent of the patient is crucial.
Sometimes, however, even if properly prepared and performed, side effects occur. We can determine which are acceptable and natural for a given treatment – e.g. reddening of the skin subjected to laser hair removal, which is completely unacceptable and result from poorly chosen treatment parameters, poorly chosen device, or insufficient skin cooling or poor surgical technique, For example, post-burn bubbles after photorejuvenation. During the consultation, it is necessary to inform patients about all possible complications but also about the alternatives to the procedure.
It very often happens that people performing treatments using lasers and IPL have only product training from equipment manufacturers, which is why their knowledge is limited only to the use of a selected laser or IPL.
Professional Qualifications Of Specialists Performing Laser / IPL Treatments
The level of education and professional qualifications are undeniably what not only allows the specialist to be verified but also becomes a requirement on the continually growing market of aesthetic services. Also, the growing awareness of the safety of lasers is conducive to the development of educational needs on the market of cosmetic lasers at the highest level.
In Great Britain, according to the Care Act 2008, (currently Care Act 2014) Health Education in England Established was established in 2012. It regulates educational standards also for the aesthetic market, ensuring first of all patient safety.
After the Keogh report published in January 2016, recommendations for new qualification requirements for the British aesthetic industry, including laser, IPL and LED, were included. According to these assumptions, qualifications are divided into the following levels within higher education.
- Initial level – Core of Knowledge, which is an attitude to further education in the field of laser and IPL application in aesthetic procedures.
- Level 4 (first level of Foundation Degree) – qualification for the use of lasers, and IPL for hair reduction, non-ablative photorejuvenation of the skin.
- Level 5 (2nd Foundation Degree) – qualifications entitling to the use of lasers, IPL for tattoo removal, and vascular changes.
- Level 6 (Graduation / BSc level) – qualifications entitling to the use of lasers, and IPL for the removal of pigmentation as well as treatments using fractional lasers excluding the near-ocular zone.
- Level 7 (final MSc level) for ablative lasers or other periorbital treatments.
What is extremely important is the fact that similar educational solutions do not limit any of the professional groups performing treatments using lasers / IPL and allow you to continually train for each of them to achieve the best results.
Principles Of Laser Generation
Students during classes within these modules will learn, among others, the basic principles of laser generation and differences in the characteristics of laser and non-laser light emission.
- Analyse the essential components needed to generate and produce a laser, analyse and evaluate critical differences in laser and non-glare properties of light.
- They understand the phenomenon of the electromagnetic spectrum and can determine the position of the laser and light in this range.
- They also appreciate theories of selective photothermalysis and the basic parameters of laser and IPL devices – and can use them in the future in treatments.
- They understand the mechanisms of laser-tissue interaction and the transmission of light of different wavelengths through the skin and eye.
- They will get acquainted with the classification of laser threats and the importance of associated warning signs on devices.
- They can analyse injuries that may occur during accidental exposure of the skin and eyes, assess the concept of maximum allowable exposure and a nominal danger distance for the eyes. Choose and use appropriate protective equipment.
- They can apply appropriate procedures in case of accidental exposures or adverse events within the clinic.
- They know the indications, contraindications, and limitations of the chosen method.
- They understand the relevant legislation, standards, and guidelines for the safety of laser products in Europe.
- They will learn about the review and changes in legislation regarding the use of lasers and devices that produce light in medicine and aesthetics in the last decade.
Familiarise yourself with the different types of laser / IPL devices available on the market and therapeutic options that they can provide. Also, they participate in practical classes, after which they can, among others, use the Fitzpatrick Scale, LES scale, or Kirby-Desai scale to ensure safety and effectiveness of treatments. Students who do not have sufficient surgical experience are required to submit 10 case studies for assessment. Each module is topped with a skills verification and a written exam. Graduates receive certificates along with CPD points.
Documentation And Accreditations
Documentation and accreditation of persons and places where treatments are performed with the participation of lasers / IPL
Persons performing procedures using lasers and IPL to obtain an exclusive license for their practices (clinics or hospitals) are obliged to register this fact in local councils, which after registration and evaluation the preparation of the clinic itself, but also check the training and qualifications of persons performing the above treatments are checked.
For a similar registration, it is necessary to meet conditions such as cooperation and contract with a person called Laser Protection Adviser – which is responsible for ensuring local rules specific for a given unit and by applicable laws and regulations.
Laser Protection Adviser is a person who has accreditation and membership in recognised organisations and societies/associations such as the British Medical Laser Association and is characterised by experience and knowledge of the application of applicable regulations.
Local Rules is a set of rules and local policies for all who are working with lasers such as:
- Specification of the used equipment, location and characteristics of the surgeries in which the procedures are performed.
- Identification of possible threats, authorisation and accreditation of persons performing treatments based on their professional qualifications.
- Product training, protocols and treatment procedures and their confirmation by EMP (Expert Medical Practitioner).
- Procedures in emergency situations, contacts to hospitals with departments treating eye diseases and burns.
- A register of performed procedures, audits regarding medical documentation, or checking the operation of equipment.
As part of each practice, one person called the Laser Protection Supervisor is responsible for checking all medical and hardware records and is the primary contact for a working team of specialists from LPA.