More than ever before, people turn to cosmetic laser procedures to minimize scars, even skin tone, remove unwanted hair and tattoos, and more. It’s critical for laser operators to understand their equipment, minimize professional errors, and reduce the risk of complications and side effects.
Appropriate laser procedures depend on several factors, including the treatment type, treatment area, skin type, and pertinent details about the patient or client’s medical record. Failure to apply the correct laser can result in problems such as pigmentation changes, textural changes, and scarring. Offer a safe and reliable service by knowing the most common cosmetic laser treatment errors and how to avoid them.
Error 1: Not Gathering Enough Information Before Treatment
It’s crucial for laser operators to get a comprehensive medical history of the client before treatment to determine possibly suitable options. Medications, health conditions, herbal supplements, and other factors can cause issues during or after treatment. In general, these factors make the patient’s skin more photosensitive.
Another way to gather information is to conduct a physical exam of the intended treatment area before applying the laser. During the assessment, examine moles, lesions, and pigmentation.
Common contraindications include psoriasis in the treatment area, autoimmune diseases, pregnancy, and depilatory creams in the treatment area in the previous two months. This is not a comprehensive list of factors, and laser treatment operators must consider and assess all contraindications before performing treatments as some contraindications are relative rather than absolute.
Error 2: Not Providing Adequate Pretreatment Consultation
Patients require a pretreatment consultation to learn about the treatments and manage expectations of results. Discuss alternative methods and approaches to achieve the outcome so the client can make an informed decision. During the consultation, explain the type of laser treatment you will provide, the risks associated with the procedure, and potential side effects or potential harm.
Explain how your client must prepare before treatment. You should also explain the recovery process, including recovery time and intervals between treatment sessions.
Emphasize aftercare requirements, such as staying out of the sun, cleaning the area gently, and keeping skin moisturized. Give your client contact information in case they have a concern or complication after treatment.
Patients and clients should understand that you cannot guarantee results. Emphasize the importance of following aftercare instructions. Failure to comply can make treatment less effective and increase the risk of developing complications.
During the consultation, give your client the comprehensive informed consent document providing information regarding how laser treatment works, what clients can expect to see throughout the process, and alternative treatments. Informed consent documentation will also include pretreatment and posttreatment instructions, risks, patient compliance, financial responsibilities, and disclaimers. Give the client reasonable time to consider the document and consent.
Error 3: Improper Treatment for Skin Type
Some of the most common cosmetic laser treatment errors happen by not applying the right laser for the client’s skin type. Operators can avoid this issue with training, expertise, and the right equipment and methods. These factors prepare operators to safely treat conditions such as acne scars, melasma, wrinkles, stretch marks, unwanted hair, and more.
Use an industry-accepted skin characterization model, such as the Fitzpatrick Skin Phototype model, to determine the risk of injury from light-based treatment based on the skin’s pigment content. The Fitzpatrick model categorizes skin types based on the skin’s response to ultraviolet radiation exposure. Skin type I always burns and never tans, whereas skin type VI almost never burns at all when exposed to UV light.
On skin types I–III, the operator can use a laser, such as the Alexandrite laser, that delivers a higher level of energy compared to the one used for darker skin types. For hair removal, the laser will target melanin in dark hair with pulses of light. The light turns into heat in the hair follicle, damaging it so that new hair won’t form.
For skin types IV–VI, use an appropriate laser that delivers safe and effective treatment, such as Nd:YAG lasers. When used to remove unwanted hair, the Nd:YAG laser targets the hair’s blood supply rather than melanin, helping to keep patients’ skin safe.
Error 4: Inadequate Cooling
Laser therapy uses energy to target treatment areas while minimizing injury to the epidermis. Cooling can also act as local anesthesia and restrict blood flow.
Cooling is an essential way that operators balance maximizing the laser’s directed power with protecting the epidermis. The epidermis protects the body from injury and disease, maintains the body’s hydration levels, and contains melanin. Harming the epidermis can increase the risk of infection, create scarring, and lead to pigmentation changes.
Cooling the superficial skin layers during some treatments reduces unwanted injury. As the therapy heat focuses on the treatment area, active cooling protects the epidermis.
The two most common cooling modes are sapphire tip contact cooling and cryogen spray cooling. With sapphire tip cooling, the system cools before, during, and after each laser pulse. In another method of contact cooling, the clinician will apply a cooling pack to the client’s skin for a specified time.
Cryogen spray cooling is a common noncontact skin cooling method. The dynamic cooling device (DCD) can be integrated into the laser or added on. The laser operator can program the DCD spray settings. The system will spray a short and consistent spurt of cryogen immediately before the laser pulse.
Error 5: Improper Application of Equipment
Laser operators must understand what happens when they apply lasers to patients. They must consider equipment specifications, treatment requirements, and relevant patient details.
Operators should understand the properties of laser light and the characteristics of laser wavelengths. They should calculate and measure the correct dosage to avoid excessive fluence, the number of energy particles per unit area. In addition, they should use the correct application techniques to control the laser and minimize unwanted damage.
A mix of classroom education and hands-on training can best prepare cosmetic laser treatment providers. Lectures prepare the student for clinical training. Direct supervision by a specialist will help build the operator’s skill set. After training, treatment providers can continue to comply with quality guidelines for laser treatment to uphold best practices.
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