The Australian Radiation Protection And Nuclear Safety Agency (ARPANSA) has reported a large increase in cosmetic applications using non-ionising radiation (NIR) and published advice for both consumers and service providers on the treatments and potential risks involved.
A new ARPANSA study has warned that, while increasing use of various types of NIR such as lasers and ultrasound for numerous cosmetic outcomes such as epilation, skin rejuvenation and tattoo removal is marketed as a low-cost and low-risk alternative to more invasive procedures, treatments with these devices ‘always result in high NIR exposure to targeted tissue in order to ensure efficacy of treatment’.
Consequently, ‘there is always a risk of adverse health effects from these procedures, which may be temporary of longer lasting’.
Importantly, ARPANSA noted:
- research on the health risks of cosmetic NIR applications is lacking, particularly on the extent of poor treatment application or misuse; and
- in Australia, except for the banning of solaria, there is no national regulation for the use of NIR devices for cosmetic purposes and only three states have established regulatory controls for certain optical cosmetic applications.
To mitigate the ‘impacts of this gap in oversight’, ARPANSA has published national advice for consumers and service providers who give information on cosmetic NIR treatments and the potential risks involved. (See breakout box.)
The new study, led by ARPANSA’s assistant director of health impact assessment Associate Professor Ken Karipidis and published in Public Health Research & Practice,
noted ‘there is a common public perception that cosmetic NIR procedures are quick, easy, painless and low risk, and are often marketed as such.
‘However, many of these procedures are complex and require a high level of application skill and experience, and after- treatment care.’
In Australia, cosmetic NIR procedures may be performed by medical professionals as well as non-medical providers such as beauty and dermal therapists.
The lack of consistent regulation and poorly defined training requirements across different Australian jurisdictions have resulted in service providers having various levels of training and expertise.
Further, cosmetic NIR procedures can also be performed using home- use devices.
Reports of injuries, increased media coverage and industry calls for greater regulation of non- surgical cosmetic procedures using NIR have led health authorities to consider these potential problems within the cosmetic industry.
The ‘aim of this paper is to increase awareness of the possible risks associated with cosmetic NIR applications, present an overview of the regulatory framework for these procedures in Australia and provide information and advice to the wider community’.
The researchers reported common adverse effects from cosmetic radiation procedures such as pain, redness or swelling, were usually temporary; but injuries could also be more severe and longer lasting, including blisters, burns, scarring, pigmentation changes or eye damage.
They found the main causes of injuries were:
- untrained service providers;
- inappropriate use of a device;
- contraindications not considered or disclosed;
- safety procedures not followed;
- poor equipment design or function.
‘It’s Cowboy Country’
Clinical Associate Professor Kurt Gebauer, a dermatologist at Fremantle Dermatology, told medicalrepublic.com.au that he saw patients every few months who had been damaged by laser and light- based devices and had scarring or pigmentation changes.
‘Quite often people have poor outcomes, but it doesn’t get identified or reported. There’s no regulation, and anyone can buy a machine, put out a shingle and start a business.
‘Lots of these machines are bought second-hand and have never been checked, serviced or calibrated. It’s cowboy country.’
Professor Gebauer said consumers needed to be aware the industry was unregulated and emphasised: ‘Do your homework and remember that just because a procedure can be done, it doesn’t mean it’s appropriate to have it done.’
He warned social media was saturated with unrealistic body images that affect patients’ self- perception.
‘In the media, everyone looks like a 16-year-old Scandinavian with no body hair,’ he said. AMP
ARPANSA ‘Advice for Providers’
ARPANSA has recently published a detailed paper titled ‘Advice for providers: Lasers, IPL devices and LED phototherapy for cosmetic treatments and beauty therapy’ on its website (arpansa.gov.au).
ARPANSA warns providers that ‘light-based cosmetic treatments carry a risk to the client during their application – and potentially even after the treatment.
‘There is also a risk to the person providing the treatment. There are no nationally uniform laws and regulations with oversight of the use of lasers, intense pulsed light (IPLs) and light emitting diode (LED) phototherapy in the cosmetic industry. Requirements are determined by the state or territory jurisdiction in which your business practices.’
ARPANSA warns that as a light-based cosmetic treatment provider:
- you should always provide a pre-treatment consultation with clients;
- all equipment, such as lasers, should comply with the Australian laser safety standards;
- you should promote safety in your practice when lasers are in use, including your technicians and clients using appropriate personal protective equipment (PPE) during procedures and when entering areas where lasers and IPL devices are in use;
- in the case of an injury occurring to a client receiving treatment, the treatment should be discontinued immediately. The injured person(s), whether they’re a client or a technician providing treatment, should be referred to a medical professional.
ARPANSA then emphasises the advice in its paper ‘gives information to assist you, as a treatment provider, in safely applying light- based therapies, specifically laser, IPL devices and light-emitting diode (LED) phototherapy, for non-surgical cosmetic outcomes’.
The advice covers a wide range of safety aspects, including qualifications and training, client assessment, relevant standards and hazard management.
It includes:
- Who can I provide laser, IPL and LED phototherapy cosmetic treatment services to?
- Do I need a licence to perform cosmetic treatments using lasers or IPLs?
- What information do I need to know about a client and what assessments should I conduct before performing any cosmetic treatments on them?
- What information should I provide to clients before they agree to undergoing treatment?
- What qualifications and training do I need to perform cosmetic treatments?
- Does my equipment need to comply with standards?
- Does my place of practice have to comply with any standards and what safety measures can I implement to make my practice safer?
- What personal protective equipment should be used during cosmetic treatments with lasers, IPLs and LED phototherapy?
- What do I do if an injury occurs to the client receiving treatment or to staff performing treatment at my practice?
