Urgent call to tighten control of laser process by Tony James from australiadoctor.com.au

TIGHTER controls of cosmetic laser procedures are urgently needed to ensure operators are adequately trained and supervised, NSW doctors say.

The RACGP representative on the AMA's Cosmetic Surgery Credentialling Council, Dr Sharron Phillipson, said the NSW Health Department had been slow to respond to recommendations on the use of lasers by people other than medical practitioners.

"Lasers are now being used extensively by beauticians, and I have seen several cases of burns and hyperpigmentation following inappropriate use," she said.

"There has been discussion about which authority has jurisdiction for controlling laser use, but we believe that the health department is the logical body to implement training and supervision standards."

The Cosmetic Surgery Credentialling Council was established under the auspices of the AMA after an inquiry by the NSW Health Care Complaints Commission.

Dr Phillipson, who chairs the laser subcommittee of the council, said the advent of intense pulsed light (IPL) devices was further complicating the issue.

IPL had the same biological effects as lasers and should be regulated in the same way, she said.

Sydney dermatologist Dr Jim Walter said several hundred laser and IPL devices had been sold to beauticians, at prices of up to $140,000.

Current NSW regulations did not restrict who could provide laser treatments, although the situation varied around the country.

"In Western Australia, for example, lasers must be operated by a medical practitioner, but so far there are no restrictions on IPL," Dr Walter said.

Risks of laser use by untrained operators included misdiagnosis of potentially serious lesions such as lentigo maligna, and side effects including burns, hypopigmentation and hyperpigmentation.

"We are keen to implement a formal structure to ensure training of laser and IPL operators and then adequate supervision by a credentialled medical practitioner," Dr Walter said.

"Although there has been discussion with government, there is little sign of any action at this stage."

A spokesman for the NSW Health Department said the matter had been referred to the Environment Protection Authority, which had primary responsibility for controlling the use of laser devices.