Lasers can seem like magic wands. They make unwanted hair, age spots, and fine lines disappear. But in the wrong hands they can also cause serious burns and permanent scarring. In one recent study, dermatologists found that more than 1,200 reports of laser or light-device injuries were filed with the FDA from 1994 through 2013. “And those are just the cases that are reported—the tip of the iceberg,” says one of the authors, dermatologist Anne Marie Tremaine, a lasers and cosmetics fellow at Massachusetts General Hospital. The most common problems are blisters, burns, and pigmentation changes. Laser hair removal was the treatment that went wrong most often.
“Lasers are only as safe as the person using them,” says dermatologist (and lawyer) Mathew Avram, director of Massachusetts General Hospital Dermatology Laser & Cosmetic Center. And more and more of these powerful machines are being used in spalike settings and “laser centers” by people with no medical training. In a study published last year in JAMA Dermatology, Avram found that, in 2011, 78 percent of lawsuits filed over laser procedures involved treatments performed by nonphysicians. Just three years earlier that number was 36 percent. In most states, a medical degree is not required to operate a laser. Many states require “physician supervision,” but this could mean simply having a doctor available by phone. “And in some states there’s no regulation at all,” says Avram. “It’s really the wild west. Don’t assume that this is a regulated area, that the government has protections in place.” Lasers can work wonders, but you need to do your own due diligence. Start with these questions:
• Who will administer the laser treatment—a doctor? A nurse? An aesthetician?
• How many times has this person performed this procedure? The answer should be in the hundreds.
• If a doctor isn’t performing the treatment, will a doctor be on-site? Will you see a doctor for a consultation before the first treatment?
• What type of doctor is performing or overseeing the procedure? Dermatologists and plastic surgeons will have the most laser training. (The American Board of Medical Specialties website, abms.org can tell you which board a doctor is certified by.)
• How many lasers are on the premises? The more lasers a medical practice or spa has access to, the higher the likelihood that you’ll be treated with the very best one for you.
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