Warning over unregulated cosmetic procedures

Anna Samecki

31/03/2022 5:22:36 PM

Not enough is known about non-ionising radiation for cosmetic purposes, experts who hold safety and regulatory concerns say.

Cosmetic surgery
The use of non-ionising radiation for common cosmetic procedures such as hair removal and skin rejuvenation is growing in popularity.

Cosmetic GP Dr Imaan Joshi knows all too well the risks of cosmetic procedures, having personally experienced ‘terrible burns’ after laser hair removal gone wrong.
‘Those with darker skin types are especially vulnerable to adverse events like post-inflammatory hyperpigmentation, but they rarely have any screening or history taking performed prior to procedures in these unregulated clinics.’
Cosmetic surgery has been a hot topic since AHPRA announced it would review the largely unregulated industry, following a Four Corners exposé of ‘disturbing practices’ in Dr Daniel Lanzer’s former clinics.
But while AHPRA has chosen to focus on cosmetic surgery as it ‘poses the greatest risk’ to public safety, doctors and experts warn the risks of other cosmetic procedures should not be dismissed.
Dr Joshi is one of many calling for a reform of the entire beauty industry, not just cosmetic surgery, including common procedures that use non-ionising radiation, such as laser hair removal and skin rejuvenation.
‘Bad things can happen if appropriate care is not taken.’
A group of leading Australian experts have also taken a similar position and are calling for more research into the potential dangers of common cosmetic procedures in a recently publish paper, as well as greater regulation of the industry.
‘There is currently no national approach to regulation of devices or services using non-ionising radiation for cosmetic purposes, with the exception of the ban on solariums,’ lead author Associate Professor Ken Karipidis of the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) said.
‘Despite a public perception that cosmetic radiation procedures are quick and easy, many are complex and require skill and experience for safe and effective application.’
In Dr Joshi’s experience, this lack of oversight and casual approach to potentially dangerous procedures rings true.
‘When I went for laser hair removal, there was no prior consultation to determine my skin type or assess for risk, and I never saw the same person in subsequent sessions,’ she said.
‘There was no continuity of care, and no safety features were ever discussed.’
Then, having established her own cosmetic clinic a few of years ago, Dr Joshi says she was shocked by the sheer lack of regulation.
‘The ability for non-medically trained people to purchase any of these machines is only limited by how much money they have to pay for them,’ she said.
‘You’ll find a lot of the large corporate chains purchase top of the line machines and then offer heavy discounts on their prices in order to get people through the door.
‘But a lot of these clinics also have a high turnover of technicians who don’t always know how to operate the machines safely.’
One of her other concerns is that the quality of machinery varies considerably.
‘Beauticians typically buy non-TGA registered machines at a fraction of the cost,’ Dr Joshi said.
‘But then they don’t have assurances around safety or standardisation around settings for different skin types.
‘At best, they’re less effective, but at worst, they risk burns and harm due to [the] lack of standardisation and safety that registration would protect against.’
And despite glaring problems, consumers remain largely unaware of the risks.
‘Unfortunately, many consumers don’t understand [the industry] because it is such an unregulated market, and that’s why they opt for the cheapest option which is often the most risky,’ she said.
‘The cost of similar procedures through qualified medical professionals is often more expensive, but that’s because clinicians have adequate training and also provide a consultation service, where an appropriate assessment is done and where the risks and benefits are discussed in detail.’
According to the authors of the article, consumers risk a range of adverse effects from non-ionising radiation used in many common cosmetic procedures.
Temporary adverse effects include pain, rashes, swelling and changes in pigmentation, while more severe injuries that may become permanent include burns, blisters, scarring, persistent rashes, altered pigmentation and eye damage.
‘This research reinforces the need for consistent and well-defined training requirements across all Australian jurisdictions,’ Associate Professor Karipidis said.
‘Further [research and] understanding of the injury burden will assist in further policy considerations by state and territory regulators.’
ARPANSA has since published national advice for consumers and treatment providers to address the possible risks associated with cosmetic radiation procedures and inconsistent oversight across Australia.
Dr Joshi hopes providers will take note, and offer education and support to patients interested in cosmetic procedures.
‘My message to GPs is to listen to your patients and don’t be dismissive if they ask about beauty or skin treatments,’ she said.
‘Your advice could prevent harm, and if you’re not particularly skilled or interested in skin medicine, then refer to a GP colleague that is.’
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Dr Farid Zaer   1/04/2022 10:08:29 AM

These cosmetic organisations in Australia should stop talking about training, when you log onto their site they have a complex system of joining them, they need 2 people to stand by you, and all sorts of barriers! I have trained with the Americans and Europeans, and I think they have very strict guidelines, methods, and also punishments for deviating from standard practice. Of course, I trained as a physician and my dermal therapist trained under me in Australia with every single precaution possible. If you use laser on coloured people please follow the USA guidelines for lasers in coloured and African Americans, they have a great deal of experience and different lasers for this.

Dr Kamani Thushara Kumari Jaya Nammuni   1/04/2022 3:08:42 PM

I met an huge problem for in regard to Cosmetic issue.That patient request a prescription for a local anaesthetic agent for a beauty therapy and on further history taking I understood that beauty therapy is going to be done by a hon health professional who is not holding any provider number .Then I declined it and patient argued with me .
Any how could we prescribe any LA agent for any beauty therapy procedure .

Dr Peter James Strickland   1/04/2022 7:28:18 PM

As far as I am concerned cosmetic surgery procedures should only be done to correct serious physical abnormalities, and NOT to feed the narcissism of patients. Investment in expensive laser machines to treat anyone who simply wants to remove hair etc. when they are perfectly well is not medicine, but practising as a technician with an understanding of skin. Any argument about improving mental health or income in a patient is a furphy, and should not be part of medical practice --and those practising cosmetic surgery alone should be re-examined on their clinical ability in general medicine every 5 years minimum.