Laser treatments are a popular and highly effective way of removing unwanted hair from areas of the body, and smoothing out skin imperfections, such as wrinkles, stretch marks, tattoos and acne scars. Laser beams can destroy hair follicles in a fraction of a second, with far longer lasting results than other hair removal methods. When directed at the skin, electrodes in the laser beam will blast away the top layers, exposing the pink lower layer or dermis. Heating the dermis stimulates the production of collagen, and this in turn causes healthy, blemish-free layers of skin to form.
Since 2010, the legal position in the UK has been that non-surgical cosmetic laser and IPL procedures, including hair removal, skin resurfacing/rejuvenation and tattoo removal, can be carried out by anyone, regardless of their level of training or experience. This means that the majority of the estimated 10,000 private clinics providing cosmetic laser and IPL treatments in the UK are unregulated, despite the well-known risks that such procedures can involve, including burns, scarring and infections. If you have been injured by a laser or IPL treatment therefore you need to speak to a solicitor, as there is no official industry body to handle complaints.
Critics of the current system advocate the creation of an approved register of cosmetic laser treatment providers. The independent regulator of health and social care in England, the Care Quality Commission (CQC), legally requires cosmetic and laser clinics to register with it if they offer invasive cosmetic procedures such as nose surgery, laser lipolysis (including Smart Lipo) or refractive eye surgery. However, laser and IPL procedures including laser hair removal and laser skin resurfacing are not regulated by the CQC, and clinics offering these procedures therefore do not need to register with the body. Until the CQC extends its remit or a new register is introduced specifically for cosmetic laser treatment providers, numerous patients will continue to be injured every year due to poorly performed procedures, and sometimes their only option will be to seek legal advice.
Possibly, as patch tests results are a strong indicator of the safety of this treatment. Even before deregulation in 2010, thousands of ‘adverse events’ were recorded annually by the British Association of Aesthetic Plastic Surgeons (BAAPS). Laser treatments require a high level of technical accuracy, otherwise powerful laser beams can burn and damage the skin, potentially causing permanent scarring. A careful medical evaluation of prospective patients is necessary to assess an individual’s skin sensitivity, and determine the correct wavelength and pulse duration of the laser beam. Skin patch and / or hair strand tests should also be carried out where required for the same purpose of assessing a person’s suitability for a laser treatment.
Human errors at laser clinics include technicians setting the laser to the wrong frequency, causing damage when the beams are directed onto the skin. The laser may also be targeted at areas for fractionally too long with similar results. Typically, these types of mistakes will burn the skin, causing blistering and temporary, or in some cases permanent scarring. The skin may also have an uneven texture or be discoloured in patches following a treatment. Where such injuries affect facial areas a person may be left disfigured, and awareness of this can lead to acute embarrassment, loss of self esteem and psychological problems.
While there are a number of potential causes of accidents at laser clinics that cause injuries to patients, by far the most common is human error on the part of the laser technician. The fact that the cosmetic laser treatment industry in the UK remains unregulated means that practitioners sometimes lack the training and experience to carry out laser procedures competently and safely, resulting in technical mistakes that can lead to second and third degree burns and long-term or permanent scarring. Such errors include setting the laser device to a frequency that is too high for a patient’s skin or miscalculating the length of time that the laser beam comes into contact with a patient’s skin. In both instances the technician and, by extension, their employer will be responsible for skin damage resulting from the error committed.
The industry’s lack of regulation also means that laser clinics on occasion fail to observe basic safety standards leaving them responsible and legally liable for any resulting injuries. Basic safety measures include maintaining a hygienic premises and providing adequate ventilation, both of which minimise the chance of patients developing infections. When a laser treatment is being carried out on skin around the eyes, protective goggles must be provided to guard against the risk of ocular damage from beam exposure. There is also the possibility of a laser machine or device being poorly maintained, of inferior quality, or simply defective, in which case liability for an injury will lie with the either the clinic or the manufacturer of the equipment. Risks of this kind emphasise the importance for prospective patients of carefully researching a laser clinic’s facilities and track record prior to engaging its services.
Laser clinics are also responsible for thoroughly evaluating patients prior to carrying out laser procedures. Most importantly, a skin patch test should be carried out by directing the laser at a small area of skin to check for any adverse reaction and to determine the optimum settings (intensity and pulse duration) for a person’s skin and hair type. This should ideally be conducted 24-48 hours before a patient’s first laser treatment session. A medical consultation and evaluation is also essential to identify any contraindications such as pregnancy, diabetes, epilepsy, and a history of keloid (raised) scarring that make laser procedures unsuitable for certain people. In the vast majority of cases therefore, laser treatment accidents and injuries will be the responsibility of the laser clinic’s operatives and employees, for which the company’s owners will ultimately be held legally liable.
Laser acne treatments are normally used to reduce the appearance of scars caused by acne. By heating the dermis layer of skin underneath the acne scars as well as hemoglobin in the blood, laser treatments prevent acne scars from regrowing by breaking down the targeted skin tissue without damaging surrounding areas of skin. Laser acne treatments are highly precise, requiring technical accuracy and extensive pre-treatment patient assessment. Laser light can cause burn injuries and skin damage that may be long-term or even permanent. To avoid this a prospective patient should ensure that a clinic or salon holds the necessary qualifications and expertise in carrying out laser acne treatments safely.
One of the most important responsibilities for practitioners offering laser acne treatments is to properly assess the suitability of a person’s skin for the procedure, and to check their medical condition via an extensive consultation. People with darker skin tones at most at risk of complications, as their skin will absorb more heat and light energy than those with lighter skin. This can lead to changes in the skin’s pigmentation, with darker skin sometimes becoming lighter in the targeted areas compared to surrounding skin. Those with darker skin tones are also more prone to hard keloid scars developing in treated areas, another unintended and avoidable side effect in some patients.
Pre-treatment evaluation of a patient should determine the wavelength and pulse duration of the laser light, a critical calculation given the damage that a laser set to the wrong frequency can cause. The laser must also be beamed onto the skin for exactly the right length of time to achieve the desired results. A skin patch test must be carried out, and the premises itself must be hygienic and properly ventilated to prevent infections. Certain contraindications make laser acne treatments unsuitable for individuals, including pregnancy, diabetes and various pre-existing medical conditions, and clinics and salons offering the procedure must identify these so as not to place a prospective client at risk of being injured.
Scarring to regularly exposed areas of the body can cause extreme self-consciousness and a perception of deformity in both women and men. Laser scar removal provides a fast, generally safe and effective solution to this problem, where previously treatments had only minimally beneficial effects. Laser scar removal is often chosen to eliminate acne scars, which patients may have suffered with for many years, or to treat scars derived from surgery or viruses, and those sustained in accidents and fights. Professionals claim that laser surgery can reduce the visibility of scars by up to 80%.
In the case of acne scars, laser surgery serves an important additional function in destroying the bacteria and damaging the oil glands which cause acne. The undeniable benefits of laser scar removal often obscures the fact that laser procedures are highly technical in nature, especially the matching of laser type and beam intensity to individual scar characteristics. The skill of the dermatologist and laser technicians are essential to the success of the procedure, and the choice of clinic is therefore of paramount importance to the prospective patient.
Scarring is caused by an excess or lack of the supply of collagen to a wound during the healing process. Keloid scars are raised scars, resulting from concentrations collagen being formed, and may develop in size and surface area over time. Hypertrophic scars are similar, but will not expand beyond the site of the initial wound and will fade over time. Keloid and hypertrophic scars are generally treated with an intense non-ablative laser (the pulsed dye laser being the most popular) which does not burn off layers of skin, but rather targets underlying layers stimulating correction from the inside out. Acne and skin disease scars are defined as atrophic scars, characterised by small, regular depressions in the skin. These scars are best corrected using ablative lasers (most commonly CO2 and Erb:Yag lasers), that blast off the damaged layers of skin, and warm the dermis layer beneath producing fresh layers of healthy skin. The technology involved in laser scar removal is evolving all the time, and a doctor should be able to explain to a prospective patient the reasons for using a specific type of laser in their particular circumstances.
Though laser scar removal procedures have a high success rate, inevitably there are certain risks and side-effects involved. The laser itself may cause burns and additional scarring if it is beamed the wound site or surrounding areas of healthy skin for fractionally too long. Local anaesthetic is normally administered, and clinics must perform medical checks to ensure the patient does not suffer an adverse reaction. There are also a number of 'contra-indications' which make laser scar removal unsuitable, including skin diseases such as dermatitis and psoriasis. Those taking certain types of acne medication also face a higher risk of complications developing. There is a moderate risk of either hyperpigmentation (darkening of skin) or hypopigmentation (lightening of skin) resulting from laser scar removal treatments. Patients should be advised by clinics of the dangers posed by sun exposure in this context, which may worsen skin pigmentation changes.
Our female solicitors regularly handle claim on behalf of clients who have been burned or otherwise injured by laser treatments. Because we specialise in laser injury claims, you can rest assured that we will obtain to maximum amount of compensation for you. Contact our specialist team today for free, confidential legal advice.
A recent client, Ms S, booked an IPL laser hair removal treatment to remove hair from her forearms and legs. A patch test was carried out a few weeks in advance of the treatment, but due to an administrative mix up, during the actual procedure, the machine’s frequency setting was turned up higher than it had been during the test. Ms S informed the therapist that the treatment was painful, but was told that this was normal, and she was later given some aloe vera cooling cream by the clinic to apply and take home with her. The following morning, however, Ms S’s skin on her face was painful, red and inflamed. She visited her local NHS walk-in centre later the same day, where she was diagnosed with second-degree burns. She was forced to take 4 weeks off work due to pain, discomfort and embarrassment over the visible burns on her arms, in particular, and having read about a case similar to her own on our website, decided to seek legal advice from Bartletts Solicitors.
Our firm went on to represent Ms S in a no win no fee claim against the laser clinic that carried out the procedure. We contacted the owners to inform them about the claim, and were subsequently put in contact with the clinic’s insurers. In support of Ms S’s claim we highlighted the fact that the laser machine’s intensity was higher during the treatment than it had been during the patch test, and that this quite clearly put our client at risk of being injured. We also provided a specialist medical report, along with before and after photographs of Ms S’s lower arms and legs, which clearly showed the burns and skin damage caused by the laser machine. The insurers were forced to acknowledge that an administrative error had resulted in the machine being incorrectly set up for Ms S’s treatment, and made a compensation offer that we deemed inadequate. Following further correspondence, the clinic accepted full liability and Ms S later received a cheque for £4,750 in compensation.