The public perception of cosmetic medicine is that it is quick, easy, painless and with little risk, but many procedures are extremely complex and require a high level of surgical skill and aesthetic appreciation.
With the rise in the use of illegal laser devices, an increase in the number of reported cases of severe burns and injuries, and missed or misdiagnosed skin cancers, the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) has issued an evaluation of IPL and laser regulations, making a range of amendment suggestions.
Among ARPANSA’s recommendations include an industry-wide accreditation scheme and extensive training requirements for use of laser and IPL machines.
Currently, only Queensland, Tasmania and Western Australia regulate Class 3B and Class 4 laser operators. Non-medical professionals in Tasmania and Queensland need a licence to operate lasers for cosmetic purposes. In Tasmania, a licence is also required to operate an IPL for non-medical use. In Western Australia, operators of laser devices must be registered medical practitioners.
Australia’s two most populous states, NSW and Victoria, remain unregulated and have no legal framework to deal with the operation and use of lasers and IPLs. Both state governments say they are waiting for national regulations to be put in place.
ARPANSA has put forward a statement of options:
• Status quo: no change to current practices
• Option 1: Educational awareness
• Option 2: Self-regulation by industry/industry accreditation scheme
• Option 3: Licensing (or registration) of service providers based on prior qualification and training.
According to the ARPANSA consultation draft:
Option 1
(educational awareness)
This relies on providing sufficient information through public health campaigns to empower consumers to be aware of the risks of cosmetic treatment with IPLs and lasers and to be able to make informed choices in selecting treatments and properly qualified service providers. By empowering consumers it is hoped that service providers would voluntarily seek and obtain the appropriate training and qualification, but there is no way of ensuring that this happens.
Option 2
(self-regulation through voluntary accreditation)
This also relies on the will of the industry to adopt and comply with a safety guide or standard produced by the industry. For this model to
be successful enough, operators must belong to a professional organisation and the professional organisation needs to be influential.
It is possible that some industry bodies will decide not to participate. For operators that are unlikely to join a professional organisation, there is no incentive to comply with non- mandatory standards. In this regard, the RHC working group notes that a recent review by the UK Department of Health found that self-regulation in the industry has failed. The report found that: “Previous attempts at self-regulation in the (cosmetic intervention) industry have failed, largely because voluntary codes have meant that only the best in this disparate sector commit themselves to better practice, whilst the unscrupulous and unsafe carry on as before.”
Option 3
(licensing on the basis of training and qualification)
This can potentially reduce serious injuries from the use of IPL and laser for cosmetic treatments as operators will be required to have practical training for the procedure they wish to be licenced to perform. It is acknowledged that option 3 involves costs to industry related to training and authorisation of operators and the assessment of the suitability of a patient for treatment by a medical practitioner. However there is greater likelihood that the risks in relation to burns, scarring and retinal damage and, in particular, the risk of masking skin cancers or melanomas could be minimised with an intervention that tries to ensure that service providers are appropriately trained and qualified.
There is also evidence that a regulatory approach is preferred overseas. For example, a regulatory framework is currently being considered in the UK, where controls over lasers and IPLs are currently regional. However, the 2013 UK Department of Health review of the regulation of cosmetic interventions has made recommendations for registration of practitioners, including those using lasers and IPLs. The review recommended that everyone “performing cosmetic interventions must be registered” and the Government’s “mandate should include the development of appropriate accredited qualifications for providers of non-surgical interventions…..”.
Whichever option is implemented, it will be proposed to be done in a nationally uniform manner.
Should the proposed model for licensing of service providers be recommended to the COAG Health Council, if approved, it is intended to be adopted into the National Directory for Radiation Protection (NDRP) and applied in each jurisdiction by regulation or licence conditions for the Cosmetic and Beauty Therapy profession in their use of IPLs and lasers. The aim of the NDRP is to provide nationally uniform requirements radiation safety together with clear regulatory statements to be adopted by the Commonwealth, states and territories.
Submissions closed 31 July, 2015.
To read the consultation draft, visit:
