Are clinical laser beauty treatments like IPL safe?

A lack of standards and regulations have experts concerned about the risks to consumers.

Living in the age of airbrushed celebrities and the ever-present selfie, it's no wonder that laser beauty treatments are a tempting prospect for many.

There are multiple clinical treatments to choose from, such as laser hair removal, laser tattoo removal, carbon dioxide and erbium lasers, and intense pulsed light (IPL) treatments – the latter two are used to 'rejuvenate' skin and reduce wrinkles. 

But are these treatments safe? And how can you protect yourself?

In this article:

The risks of laser beauty treatments

In the wrong hands, laser or IPL can cause a range of injuries.

"I see a lot of scars, burns and pigmentary changes; 'stripes' of white or brown," says Sydney-based cosmetic and medical dermatologist Dr Ritu Gupta, from Platinum Dermatology, who's also a media spokesperson for The Australasian College of Dermatologists.

"If people are treated at incorrect doses, it can also cause an increase in hair growth rather than a decrease. Or it might turn the hair white, so it will never respond to any form of laser or light therapy hair removal. That's just the tip of the iceberg."

Most lasers used in Australia are Class 3B or medical-grade Class 4, while IPLs produce a beam of broad-spectrum white light often used to treat skin pigmentation, broken capillaries and excess hair.

But laser devices can also cause disfigurement, permanent laser eye injuries, and infections. Laser treatment to remove moles may also mask signs of melanoma, delaying diagnosis and treatment.

A 2012 survey identified 416 cases of injury due to unsafe use of cosmetic lasers and IPLs

"If people go to a a nurse, lesser qualified doctor, beautician or beauty therapist for these treatments, and an injury occurs, it's dermatologists like me who are left to pick up the pieces," adds Gupta.

In 2017, NSW Fair Trading received 287 complaints about beauty services, mainly regarding consumer dissatisfaction with the quality of the service.

And although recent figures aren't available, an anonymous survey in 2012 by the Radiation Health Committee identified 416 cases of injury over the previous 12 months due to unsafe use of cosmetic lasers and IPLs. 

Of these cases, 268 of the injuries including burns and scarring were classified as severe, and there were 62 reported cases of skin cancer being delayed or missed (and in 22 of those cases, the cancer was identified as melanoma).

The risks of laser beauty treatments

  • Scars, burns and pigmentary changes 
  • Increase in hair growth 
  • Hair turns white 
  • Disfigurement 
  • Permanent eye injuries and infections 
  • May mask signs of melanoma (laser mole removal only)

Are at-home IPL hair removal devices safe?

Studies reporting injuries from home use devices are limited, says Dr Rick Tinker, director of assessment and advice at the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA).

"[But] there is potential for harm to the eyes from exposure to these intense light sources, or skin injuries from inappropriate use," he says. 

"ARPANSA's health advice for consumers about lasers and IPL applies only to consumers seeking treatments in service provision settings – but the health risks associated with home use devices may be similar to those detailed within our advice."

Because consumers aren't trained to know what they're doing or what they're treating, you can potentially make [skin conditions] worse

At-home IPL hair removal devices are readily available at department stores and online. According to ARPANSA, there are no regulations around the import or marketing of home use cosmetic devices that emit intense light, and while there is limited evidence that such devices are generally less powerful, this information is provided by manufacturers and is not independently assessed.

Gupta believes all laser and IPL devices – whether for use by a consumer or trained professional – need to be regulated, even if at home devices are cheaper and less powerful.

"IPL hair removal devices work by a wavelength of light targeting the hair follicle, and because consumers aren't trained to know what they're doing or what they're treating, you can potentially make [skin conditions] worse," she explains.

"Laser devices can cause the hair to become de-pigmented – it will lose its colour and will never respond to any laser or light. An IPL device can also cause [excessive] hair growth.

"So I think if you're serious about hair removal, you should go to a specialist practice."

  • As Dr Gupta and Dr Tinker warn, the risks associated with at-home devices may be similar to those used in clinical settings. But if you still want to use one, we've tested a small number of IPL devices.  

An industry on the rise

In 2017, there were over 35,000 beauty therapists employed in Australia. The non-surgical cosmetic health services industry generates over $1 billion annually, according to figures from the Committee on the Health Care Complaints Commission Report (2018).

Demand has led to laser services popping up everywhere – from the beautician who used to do your facials, to laser clinics conveniently located in local shopping centres. Many advertise discounts, loyalty cards and ZipPay type credit payment schemes to draw customers in.

However, this rise in non-specialist laser providers is putting consumers at risk, warn experts.

What type of training is required to operate a laser?

Currently, there's no standard for training – a beautician could do a one-day online course or weekend workshop to operate a laser. There are also concerns that many laser operators aren't trained at all, or are operating cheap devices that 'aren't tunable' and essentially have an 'on and off switch', says Gupta.

"If you go to a specialist dermatologist, you're getting someone with 16–18 years training," she adds. "What happens when you go to these non-specialists is that they're not equipped to diagnose or treat [skin blemishes or conditions], and they don't follow the proper duty of care. So much can go wrong."

These non-specialists… they don't follow the proper duty of care. So much can go wrong

You also need to consider what will happen if you do sustain an injury, as non-medical therapists may not be able cope with follow-up and care.

"Patients who've sustained an injury and returned to the clinic are often told it will 'get better by itself'," says Gupta.

"And it won't get better by itself. It needs to be treated, often with medicine, which requires writing a script. And these people aren't doctors. They can't write a script. And even if they could, they wouldn't necessarily know what script to write."

Don't be fooled by a white coat

Another issue is the rise in commercial establishments over clinical ones, and laser operators being able to call themselves a 'laser specialist' or 'skin specialist' when they're not accredited.

Personal injuries lawyer Kate Avery from Kare Lawyers in Brisbane has dealt with claims arising from laser treatment injuries, and believes the line between the business model and the medical model in cosmetic beauty services is becoming increasingly blurred.

"There's this move towards what would be regarded as semi-medical procedures being carried out by people who don't have medical qualifications, and the community doesn't seem to recognise that difference," she explains. 

"This is partly because of the way these clinics are marketing themselves and using the language of medical centres, which leaves consumers confused."

Who regulates your local laser clinic?

It's complicated. 

Queensland, Tasmania and Western Australia have regulations in place for the use of lasers, while IPL is currently only regulated in Tasmania. In the other states and territories, there are no regulations in place at all, which means anyone could essentially 'set up shop'.

Often the devices used for cosmetic treatments can be bought cheaply online, and aren't necessarily approved by the Therapeutic Goods Administration (TGA) because their use for cosmetic purposes is not considered medical.

In 2015, a Regulatory Impact Statement by ARPANSA found that the industry would benefit from a system governing the use of lasers and IPLs for cosmetic treatments, but there was insufficient information given in submissions to support a national regulatory framework.

And the push for national standards continues, with a new initiative by the Committee on the Health Care Complaints Commission tabled in 2018, containing 16 recommendations to the NSW Government. 

These included the regulation of lasers and IPL devices used for hair removal, tattoos, pigmentation and skin rejuvenation, preferably at a national level but at the very least in states and territories currently without regulation.

We deserve to trust that the products we buy are safe. Join us in calling for a better product safety law.

How to choose a good laser provider

It's a no-brainer, say experts: ask your GP for a referral to a cosmetic dermatologist or plastic surgeon.

"Or look up dermatologists in your area," says Gupta. "They'll have the letters 'FACD (Fellow of the Australasian College of Dermatologists)' after their name – and phone to ask if they perform specific cosmetic services such as laser or IPL. 

"If they don't, they'll refer you to someone who does."

Also be aware that cost isn't necessarily an indication of expertise, as some laser clinics may well have untrained operators and charge hundreds for treatments you don't need.

"In some cases I've seen, clients whose hormonal pigmentation was incorrectly diagnosed and treated as sun damage by laser or IPL was made much, much worse, when an inexpensive cream would have treated it," says Gupta.

Another resource is ARPANSA's advice for consumers and advice for treatment providers.

"The consumer guidance offers advice on what quality service they should be looking for, the types of questions they should be asking a service provider, and where they should go if they want to make a complaint," says Tinker.

What should I do if I've been injured by laser or IPL?

If you've suffered an injury at the hands of a non-medical laser or IPL operator, you should consult a medical professional as soon as possible and report your adverse reactions to the Health Care Complaints Commission in your state or territory. You can also lodge a complaint with the ACCC.

Getting legal advice may be another avenue, however Avery says "establishing negligence can be a bit of a hollow victory if these operators aren't insured and have no money to pay compensation".

"Larger or more reputable providers are more likely to have insurance, so it's really important to carefully consider who you go to for treatment, both for quality assurance and insurance," she says.

"If you do suffer an injury as a result of negligence on the part of a beautician, beauty therapist or laser clinic, you should consult a solicitor promptly about the possibility of recovering compensation as there are time limits applicable in every state for lodging claims."

When Victorian woman Niki Richardson went for erbium laser treatment at a new clinic in the Mornington Peninsula, she had a long phone consultation with the therapist and one in person.

"She wore a white medical jacket, had a very professional looking clinic including framed certificates, used medical terminology and led me to believe she was a dermatologist," says Niki.

During her treatment, Niki smelt burning flesh and was in intense pain. Afterwards, she was in shock and shaking uncontrollably but was sent home with a bleeding face, some gauze and "absurd" instructions to scrub her face with it. 

Swelling, pain and infection set in and Niki even temporarily lost sensation in the bottom half of her face.

After six weeks she saw a plastic surgeon, who was horrified at her appearance and tried to report the beautician, but was unable to as she wasn't a registered medical professional.

"I learnt that the laser machine used on me was a Class 4 machine, which is generally used by plastic surgeons."

Niki went public with her story and along with other consumers who attended the same clinic and also suffered injuries, considered a class action lawsuit. It was dropped as the laser operator was not insured.

It took six months before feeling returned to Niki's face, and she was diagnosed with PTSD for two years after the laser treatment.

"I'm now left with white patches on my skin from loss of pigmentation, and the laser operator is now in business in Canberra," she says.

"Authorities have been informed, but nothing has been done to stop her."

Sydney mother Alison Hutchinson* was no stranger to laser beauty treatments, but was surprised and shocked when she was badly burned by a clinic she'd been to before.

"I'm half-Indian, so I have hairy arms and legs and my sister had just had her arms done so I thought I would do the same and have my bikini area touched up too," she says.

"I was given a new therapist I'd never had before, and when she applied the laser to my arms and bikini area, it was quite hot and painful. At home the burning sensation just kept increasing."

The pain in her arms continued even after Alison submerged herself in a cold bath – and was so bad she even found it hard to breastfeed her baby.

"I couldn't cradle him [properly] as his body heat against my arm was unbearable."

Alison returned to the clinic and was told to keep her arms covered and that they would 'scab up'.

"The person I spoke to at the clinic said quite calmly that I had been burned and that yes, the setting was too high on the machine or something to that effect – I don't know if the therapist I had was let go after that.

"My arms did scab up – it was right before Christmas and of course, hot weather and very inconvenient. The treatment also caused some discolouration to my bikini area."

Alison says she's surprised at how easily beauticians can operate these machines. 

"I was lucky that my burns healed, but I also think what if they hadn't? They make you sign a waiver so you'd have no recourse."

*Name has been changed to protect privacy.