IPL & Laser Safety - Regulate From The Ground Up!

Would it shock you to know that in NSW, you can buy and use a laser /IPL machine with NO training, NO industry regulation, and NO oversight? I know it’s shocked everyone I’ve ever told!

To date, anyone in NSW is able to purchase an IPL/laser or energy based device with NO TRAINING. These people do not need a degree in health, medicine, dermal science or physics… It’s absolutely dumbfounding and highly dangerous! What I’m really saying is that you can go out and buy yourself a machine, label yourself a laser technician and in NSW it is PERFECTLY LEGAL to do so! Moreover, there is no industry body that oversees training, skill, knowledge, or even that the machine you’re using is in working order!

Okay, now that I’ve scared you… Sorry… What does this all mean for you, the consumer? I’ve put it primarily down to RISK.

• A lack of regulation has led to a crisis in patient care, such that IPL and laser complications are now one of the top reasons for medico-legal claims in NSW.

• Regulation in the laser industry is, at present, in its infancy and still has a long way to go to regulating ALL medical grade devices.

• Safety and regulation is left to the practitioner, it is a voluntary exercise and one that the consumer should look into BEFORE undergoing treatment.

Now for the good news… Thrive Skin Clinic ensures that the only staff in our clinic who are allowed to even touch the IPL machine are our registered nurses, dermal clinicians, and Dr. Jemima Grant, who have ALL had the necessary and ongoing safety training needed to provide our clients with the best in care. We are not shy in saying that we have put a significant amount of money and time into staff training, machine servicing, and ongoing education. This doesn’t take into account the years of study our doctors, nurses and dermal therapists have spent at university or obtaining post graduate studies in physics, chemistry and basic skin science. Our equipment is medical grade (powerful) and TGA approved. While it is much more expensive to invest in this equipment and education, for us it's is a no brainer -  patient safety comes FIRST. Burning clients, blindness and scarring are UNACCEPTABLE outcomes for us.

Our clinical model is such that our medical director, Dr. Jemima Grant, ensures oversight to ALL clients. In practical terms, this means that Dr. Grant is available to advise, research current evidence, and can reach out to her aesthetic peers to provide safe protocols for clients. As an example, it is occasionally difficult to know the cause of pigmentation, the optimal laser setting, or to know what medications and medical issues are going to effect a treatment. In these instances, it is better to delay treatment, seek help and try a few test patches before proceeding. Or sometimes, it is safer to not treat at all.

Increasingly,  we are referred clients presenting with issues from other salons and clinics with laser and IPL related complications. The main issue we see is post-inflammatory pigmentation, where the face or body responds to a heat treatment with unsightly, dark pigmentation. Another issue we all too often hear about is blindness (YES! Blindness!) from NdYag laser. Lasers and IPL machines are not toys! As a community, we all need to speak up about this to try and improve patient safety. Regulation is under review, but it has taken years to achieve mere discussions… Unacceptable, really.

We believe that the best way to increase patient safety is to educate our client population: a grassroots kind of regulation! So, this is our #TopFiveTips that you can take with you if you choose to have an IPL or laser treatment in NSW.

1. Ask questions about the machine

   • “Is this machine approved for use in Australia?”

   • “How often is this machine serviced?”

   • “What kind of a machine is this, is it a medical grade machine?”

   • “Do these eye protectors comply with current industry standards?”

   If your technician can’t answer these simple questions without hesitation, it’s time to get out! It’s not worth playing with fire (literally) when it comes to your skin.

2. Ask questions about the technician

   • “What kind of training have you had in this field?”

   • “Do you have your laser and IPL safety certificate?”

   • “Can you show me evidence of your ongoing education and training?”

   If your technician can not show sufficient evidence that they are fully qualified for the job, you know what to do!

   Get out of there… It’s just not worth it!

3. As a patient, have you been thoroughly assessed?

   • Has the technician assessed your skin using the Fitzpatrick Scale?

   • Has your technician assessed your current medications, allergies, and medical issues?

   • Has your technician told you the risks or contraindications of your treatment?

   If your technician does not ask you a few simple questions to assess your suitability for treatment, you should reconsider! It’s important that your technician knows what is going on with your skin and health! This can effect the treatment outcome and it may not be in a positive way… These treatments aren’t cookie-cutter treatments! They rely on unique settings and patient care when it comes to an ongoing treatment plan.

4. Spot test?

   A spot test is when we check a small area of the skin to ensure laser or IPL settings are safe and optimised for your skin. For those of you with lighter skin, this is less important but still optimal if you’d like to do so. For those of you with darker skin tones or of Asian, Indian, Aboriginal or Mediterranean backgrounds THIS IS ESSENTIAL. These are the clients we are seeing weekly who present with dark scarring on their face and body from inappropriate settings… Not ideal!

5. Consider the cost

   You should always consider the cost of your safety. The cost of treatment should be the last point of order on your checklist! Yes, treatment might be $5 but have you weighed up how viable this price is? Will your cheap treatment cause you more financial pain in the long run? Please make sure you weigh up all your options before proceeding with treatment!

Let’s be clear - This post is not a rant stating that all laser technicians must be doctors and nurses. This is not the case at all! In fact at Thrive Skin Clinic, our medical team therapists work and collaborate all the time and our dermal therapists who are all extremely proficient at laser and IPL. Laser safety is not about operator’s background, but about training, experience, and the clinic culture of support and ongoing education to keep us clinician’s accountable and patients safe!

IMAGE: © THRIVE SKIN CLINIC

How does the face age?

How does the face age?

We all hear about ‘ageing’, but what does it really mean?

Although most of us think of wrinkles as the main culprit of ageing, the reality is far more complex. The entire structure of the face, including skin, subcutaneous fat, muscles and bones change over time.

Before you read on – this post is not meant to shock or shame. The reason it’s important to understand the science behind ageing is because once understood, it allows clinicians to tailor clinical interventions to the root cause.

By using a scientific approach to ageing and combining synergetic modalities, we are getting vastly better outcomes and can achieve natural-looking results non-surgically.

What causes ageing skin?

Collagen

Collagen is the mesh-like component that makes up around 75% of the skin. It gives skin structure and support and holds the landmarks of the face in position. With age, the number of collagen fibres decreases, and the ones that remain become less organised, weakening the tissues. This results in stretching of the skin, pores become larger, wrinkles, and sag.

For women, collagen loss is accelerated in the years around menopause, when up to 30% of collagen is lost. This is compounded by the a tendency of skin to thin out and become more dry in the latter stages of perimenopause, due to reduced oestrogen This is why some women come to us feeling they have “aged overnight”, and why having a collagen inducing treatment in perimenopause is so important.

Clinical interventions that increase collagen include: wearing sunscreen, using retinol, peels, and collagen induction therapies such as dermal needling, Tixel (for skin), and High-Frequency Ultrasound (for skin sagging and laxity). Last on the list are surgical modalities such as a facelift or neck lift. surgery, make sure you see a qualified plastic surgeon, not a cosmetic surgeon, as plastic surgeons are regulated and recognised as specialists (anyone can call themselves a cosmetic surgeon - beware!)

Fat

All faces have fat, and these areas of volume help support the skin and keep us looking healthy, particularly in the midsection (cheek and lower eyelid regions) of the face.

Unfortunately, as we age, or due to other factors such as weight change, medical illness, or medications, these fatty areas reduce in volume which leads to deflation, and sunken, tired-looking eyes.

Don’t ask me why we lose fat on the face and put it on in the middle! There is no justice! Catherine Deneuve famously quipped that “at a certain age, you have to choose between your face and your arse” …and to some degree this is true!

Clinical treatments that improve fat pad loss include judicious use of dermal fillers, fat grafting, and plastic surgery. These procedures should be done AFTER skin tightening (the adage “lift then fill”) to minimise overfilling and bloating the face. Despite what the filler companies may tell you, fillers do not lift… they fill.

Ligaments

Skin is anchored to the facial skeleton via ligaments. As we age, these ligaments slacken and gravity pulls them down, causing the face to descend, forming jowls and an uneven jawline.

Currently, the best non surgical intervention to improve ligament laxity is HIFU (High Frequency Focused Ultrasound). This where the Ultraformer 3 is in its element, and the reason why we love it so much. The Ultraformer 3 has revolutionised the HIFU world with the introduction if the 4.5mm cartridge, that heats and tightens the aponeurosis and ligaments that sit above our above our facial muscles,

Although the gold standard treatment for laxity is a surgical facelift, for most people, this is not attainable due to the cost. However, the Ultraformer 3 is a viable alternative for mild to moderate skin laxity, especially when used early and regularly. Most plastics surgeons have a device like Ultraforrmer, which again is a testament to the validity of the technology, and many surgeons will advocate an annual treatment to maintain surgical results.

Bones

Just like the bones in our hips and back, our facial bones shrink and become more porous with age.On the face, this is most notable around the eye socket, the base of the nose, and the chin. This contributes to the look of “tired eyes”, drops the tip of the nose, and pulls the mouth and chin downward.

There are several interventions to manage these issues such as dermal fillers to disguise volume loss, and neuromodulators (“Botox” or “Dysport”) to reduce overactive muscles in the lower face. Make sure you see someone who knows what they are doing if they are treating the lower face as these are tricky areas.

If you want to talk or learn more about your skin and ageing, please book a consult. Having a consultation with an experienced practitioner is THE most important aspect of any treatment, as it will allow us to formulate a bespoke plan based on your concerns, your clinical issues, and your budget.