Can laser treatments cause third degree burns?

By Elizabeth Yow, Fashion Wire Daily

WITH THE incidence of complications such as burns and permanent scarring on the rise, the American Society of Dermatologic Surgery (ASDS) issued a warning last month about the potential dangers of cosmetic procedures that are either performed by non-physicians or without the direct supervision of an on-site physician.

"This is a public health and consumer awareness issue," says Harold J. Brody, M.D., president of the Illinois-based ASDS.

A recent survey of ASDS members found that since the beginning of 2001, 45 percent of members reported an increase in the number of patients they had seen with scars, burns, pigmentation problems and infections resulting from non-physician treatments. The patient breakdown included: microdermabrasion (78 incidents), chemical peels (90 incidents), laser hair removal (111 incidents) and Botox injections (approximately 260 incidents).

"These are wonderful instruments and techniques for rejuvenating skin or removing hair,' says Roy Geronemus, M.D., vice president of ASDS and director of the Laser and Skin Surgery Center of New York. "The results are often terrific. However, wonderful can quickly turn into monstrous," he explains.

Case in point: As a result of undergoing laser hair removal at the hands of a poorly trained cosmetologist, Terri of Pennsylvania (she cannot provide her last name or identify the name of the centre due to pending litigation) suffered severe burns on her legs, bikini line and underarms. She also experienced circulatory problems stemming from swelling. Terri had heard an ad on the radio for a dental medical spa that was having a 50 percent off sale.

"I went in because it was a great deal," she says. The cosmetologist she saw used a laser set to seek out dark hair on her fair skin. But Terri had a tan and the laser targeted the pigment in her skin instead of the hair follicle. "The skin was coming off on the tip of the laser and I was getting red welts everywhere she touched."

"If you're not careful this could happened to you," she says. "Don't fall for a bargain. You'll be looking at these results for the rest of your life. And I didn't bargain for this."

DEMAND HIGH

Part of the problem, report experts, arises from the fact that these high-tech procedures are becoming more accepted by the public at large, causing an increase in demand. Unfortunately, the suppliers aren't necessarily interested in the health and well-being of their clients but the bottom line-putting the unsuspecting public at risk.

"As these technologies become more popular it's a quick way to make money," says Geronemus, "and so they're getting into the hands of unqualified people."

Unfortunately, the ASDS reports that laws regulating the use of these devices, specifically laser or light source technologies, vary widely: only 15 states require a medical doctor to operate a laser; 17 states and the District of Columbia have different standards as to the level of training a non-physician must have to operate the devices and whether they need "supervision," "direct supervision" or "on-site supervision" of a medical doctor; and 18 states have no rulings on this matter at all.

Nevertheless, physicians stress that "anything below the dead cell level is living tissue. Treating living tissue is practising medicine," says Brody. "And when the dermis or living skin is invaded there are potential for side effects."

MISDIAGNOSING

The ASDS is also concerned that non-physicians are misdiagnosing problems at spas or "walk-in" centres and subsequently mistreating them-only to exacerbate the condition.

"They're not just using devices improperly but problems are misdiagnosed," says Dr. Brody. In some case, patients are wrongly told they have rosacea. To treat it, they undergo a light device treatment, which results in scarring.

Also, as in Terri's case, non-physicians are not qualified to quickly treat complications which can result in further damage.

Of course, complications can occur even with a physician performing - or directly supervising - a cosmetic procedure on-site. But the risks may be minimised, and at the very least better managed.

SAFETY GUIDELINES

Experts suggest that a consumer ask a series of questions before committing to a treatment: "How many procedures has the physician done? Are they trained in cosmetic procedures?" says Brody. Other questions include: asking about risks involved and seeing if you can speak to people who have had the same procedure?

Confirm that there is a physician on-site and that physician is trained in cosmetic procedures. But be careful, Terri went to a physician supervised site-only to learn after the fact that the physician was a dentist - and obviously not trained to deal with these complications.

Make sure that the laser or chemical treatment is appropriate for your skin type, hair colour and complexion to avoid the possibility of pigmentation problems or burns. Ask for a test patch before undergoing a complete procedure to ensure there will not be an adverse reaction. Call a physician immediately if you have any sign of discomfort from a treatment including redness, burning, swelling and pain.

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