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Laser deregulation prompts debate

14 May 2008

Should the UK government deregulate the use of class 4 lasers and intense pulsed light sources that are used for cosmetic treatments? Over 700 people have already signed a petition opposing the idea.

The UK government's Department of Health has published a consultation document recommending that lasers and intense pulsed light (IPL) sources used for cosmetic treatments should no longer be regulated by the Healthcare Commission (HC). If the legislation is passed, then deregulation will start from October 2008.

"Anyone who knows anything about lasers is against this," Paul Tozer, managing director of laser safety specialist Lasermet, told optics.org. "You don't want people using a class 4 laser in a high street establishment without any checks. Many countries around the world are moving towards regulation - we are moving backwards."

The consultation document is a 60 page report that outlines the proposed change and can be downloaded as a pdf file by any interested party. Responses are being encouraged but the deadline to reply either in writing or by e-mail is looming: they must be received by 10 June 2008.

The government's approach revolves around what it terms "proportionate and risk-based regulation". "The level of risk involved in the use of lasers/IPL equipment for non-surgical purposes leads us to believe that the current regulatory regime is not proportionate to the risk of harm to patients," states the document.

Tozer takes the opposing view. "It is essential that lasers and IPLs used in uncontrolled environments such as beauty salons are regulated," he commented. "It is clear that these proposals present a serious risk."

One of the most worrying aspects is the impact deregulation could have. The report estimates that deregulation would generate an extra 1700 to 3400 adverse incidents per year. "This represents a yearly cost of treating these cases of between £900,000 and £1.8 million," says the report. "These are the direct costs of treating adverse incidents and are, in the main, likely to fall on the National Health Service."

The sources that are being lined up for deregulation are the class 3B and class 4 lasers and the IPLs that are used in non-surgical treatments. Broadly speaking this covers cosmetic procedures such as hair removal, skin rejuvenation and teeth whitening, as well as the reduction of port wine stains and birth marks. Crucially, all lasers used in surgery would still be regulated.

"This would leave providers of cosmetic laser and light treatments operating in an environment where the only regulation would be via the byelaws of certain local authorities," says the report. "People who seek these cosmetic treatments will need to take additional steps to satisfy themselves of the training, skills and experience of their treatment provider."

There are currently around 850 establishments registered with the HC that provide purely cosmetic laser/IPL services. The report estimates that the HC would save approximately £1 million annually if lasers and IPLs were to be deregulated and adds that clinics would no longer have to pay regulatory fees to the HC.

"The consultation document suggests that the HC will save money," said Tozer. "But if you read it carefully, the savings are equal to the money that the HC would receive in fees - it all evens out. This is not a cost-saving exercise."

Tozer also voiced concerns from a medical standpoint. "Part of the requirement of regulation is that the clinic must have an Expert Medical Practitioner to set boundaries and limitations on the range of treatments that can be carried out," he explained. "The proposals would in effect remove any restriction on anyone using any type of class 4 laser provided they were allegedly being used for 'skin blemishes' without any formal qualification."

According to Tozer, there is significant opposition to deregulation. He says that British Association of Cosmetic Doctors, the British Association of Aesthetic Plastic Surgeons and the British Association of Beauty Therapy and Cosmetology have all voiced strong concerns.

As well as responding to the consultation document, there is also an e-petition on the Downing Street website opposing the deregulation. More than 700 people have already signed the petition.

Jacqueline Hewett is editor of Optics & Laser Europe magazine.

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