- Get educated on the theory of lasers, IPL, safety and clinical presentations. If you understand wavelengths, principles of photothermolysis, pulse width, fluence, spot size, clinical end points, Fitzpatrick Skin Types, expected side effects and possible adverse outcomes then you will be able to be discerning and make a well-educated decision. Choose theory courses that are accredited, endorsed or recognised by radiation health departments or health professional bodies to ensure they are quality and evidence based.
- Check out your state/territory regulations. Are you able to operate a Class 4 laser in your state? Are there licensing requirements? Did you know that IPL are only regulated in Tasmania and that guidelines are being developed by ARPANSA currently? What about the fact that the AUS/NZ Lasers in health care standard is under review?
- Be a critical reader. Examine the claims and the clinical papers that are associated with them. Don’t take anything for face value and get independent information too.
- Decide what services you’d like to deliver. Will it be hair removal, skin rejuvenation, skin resurfacing, tattoo removal or all of these? There is no one machine (yet) that does it all. How much can your population afford to pay? Where will you find your customers?
- Machine settings should be customisable. You want the machine with parameters that are able to be adjusted to suit the different targets and skin types to get the results you really want.
- Ongoing education and support from the manufacturer is essential. After they show you the basics of how to use the machine will they return to show you advanced applications? Do they have marketing in place that supports your practice? They should provide signage for the door for controlled access and laser safety eye wear as standard. Just because you have been orientated to the use of the machine and its accessories, doesn’t mean you have completed a Laser Safety Officer course, if you don’t have one, get one (see number 1).
- Consider the costs both initial outlay and ongoing. The initial cost of your equipment isn’t the end of the story. Consider disposable handpieces, handpieces that need refurbishment or repair and other disposables such as gel, spatulas and linen. Ask for information on the numbers of treatments needed to start to get a return on your investment.
- Practice. Provided consent is obtained, you work within your scope of practice/skill set under supervision and safety protocols are adhered to; colleagues, friends, family, volunteers, paid models or paying clients can all help you hone your skills. We have short practical workshops that you can do as stand-alone modules. Choose practical workshops that are accredited, endorsed or recognised by radiation health departments or health professional bodies to ensure they are quality and evidence based.
- Determine your budget. Shop around, there are hundreds of choices on offer. Some are TGA approved, some are not. Some are in the hundreds of thousands of dollars and some are not. Consider if you will buy outright, rent to buy, seek finance or how you will pay your machine off.
Cover your legal bases. Have adequate professional liabilities insurance. Work within your legal scope. Develop your practice based on exceptional education, evidence based practice and the discerning choice of equipment.
We have workshops that cover all of these points and more! For more information please contact us.
This case will hit home for health professionals!
Why? Because it happened to a 56 year old nurse in Victoria. In the current edition of the Medical Journal of Australia authors (2017) Bala, Pan and Nixon report on a case where the nurse had sought treatment for a pigmented lesion on her cheek at a non-medical cosmetic clinic. They say that at no time was the lesion formally assessed either clinically or with a dermatoscope. Initially the lesion cleared but then recurred over the next twelve months which prompted her to seek medical advice. A biopsy showed lentigo maligna.
The authors have urged that the general public be made more aware of the dangers and that all pigmented lesions be medically diagnosed before any cosmetic treatment.
"Performing laser treatment on undifferentiated pigmented lesions
can delay diagnosis and lead to more devastating
outcomes including metastases"
Currently only Queensland and Tasmanian regulations have the requirement for pigmented lesions to me medically assessed. Regulation is not going to be national but a guidance document from ARPANSA will be drafted soon. We expect that medical assessment will be built into this in order to raise the standards of patient care in Australia.
We have a comprehensive continuing professional development module on Managing hyperpigmentation and it includes a significant section on assessing pigmented lesions (4 CPD points). This is also built into our Advanced laser & intense pulsed light accreditation course (applied cosmetic practice) (10 CPD points).
Bala, Pan and Nixon (2017) The dangers of non-medical laser therapy for pigmented lesions. Medical Journal of Australia, 205 (5), pp229
Stuff happens because:
1. User is untrained.
This is pretty easy to prevent though isn’t it? We are constantly gobsmacked at how little some people value their own and their staff’s education. For a thousand bucks of educational investment you can save yourself a world of heartache and a lawsuit!
STEP 1: Do a laser course on light physics, laser safety, machines and regulation
STEP 2: Do a laser course and learn about how to do clinical treatments like hair reduction, resurfacing and rejuvenation, pigmentation, vascular conditions, PDT andtattoo removal
STEP 3: Love your machine(s) and get to know it intimately
STEP 4: Undertake some practical experience while under the guidance of a senior mentor
2. Wrong device was used
Here is why steps 1-4 are essential because if you are educated, trained and supervised you’re not going to use the wrong machine! This stuff up is akin to using the dishwasher to juice!
3. Poor quality devices
You may have noticed that we only collaborate with companies who are TGA approved. There’s a good reason why and why you should only buy a machine from a reputable manufacturer. They have the clinical research to support the clinical indications they are promoting which is a good start. Other reasons are they provide great device-specific training, revisit laser safety, give you protocols for treating different conditions and can help you if you need it. You can also rely on the labelling and manufacturing quality. Remember all the people in Queensland that got burnt in 2015 when the tattoo removal machine they were treated with was mislabelled and dodgy?
4. Medical information wasn’t provided by the patient
This is a reminder about taking a comprehensive health history at the initial consultation and as a matter of usual practice, asking the patient each and every time whether anything has changed with regard to their health or medicines.
5. Safety procedures weren’t followed
There’s no excuse for this one really. Work place health and safety is ingrained in law. Wearing the correct laser eyewear, fire safety plans and test patches are just a few examples of essential areas for laser safety.
Did you know that we are running a series of practical workshops? Our June one is almost full but we have great Early Bird specials for the August and November workshops. Full details on our website www.bravuraeducation.com
I was delighted to be asked to contribute to Kate Marie's latest book Slow Ageing Guide to Skin Rejuvenation. Not only is it a beautiful to look at but it explains what happens to skin as it ages, de-mystifies cosmetic medicine, and presents clear, no-nonsense advice on the many options available ̶ including surgery-free, non-invasive techniques that clients want to know about.
It is the second book in the successful Slow Ageing series and again consults the pros on the topics they know best. Familiar names include internationally renowned light based energy device expert Dr Glen Calderhead and home grown Professor Merlin Christopher Thomas known for his work on diabetes, preventive medicine and ageing.
- You can fit it around your jam-packed life. Friend running late for your coffee date? Kids at swimming lessons? Work has a sudden lull? Log on and do a bit in between your commitments.
- You don't have to travel. Do you have kids or fur-kids that are really hard to part with? What about a crazy busy workplace? You don't have to go anywhere and your household or business will tick along as usual.
- It saves the planet. You don't have to burn fuel or waste paper.
- You won't be under time pressure to finish the coursework or exam. You can learn at your own pace and study topics as deeply or not as you like.
- You can study in the nude or in your pyjamas! Depends on where you are really...**
**One of our core values is "Have fun" xx
There are so many people in the cosmetic industry flaunting these advertising guidelines, especially on Instagram with before and after photos. It is good to know that we have a resource from AHPRA to guide and maintain our integrity as health professionals.
The other thing that we see is nurses advertising themselves on websites as nurse practitioners when they are not endorsed as one. Again, AHPRA is very clear that this breach in professional conduct is unacceptable.
In our CPD modules and our Advanced laser & intense pulsed light accreditation course we have a significant section devoted to helping you learn about your professional obligations.