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The Issue

Laser technology is being used for an increasing number of Medical and cosmetic treatments. Examples include reduction of localized body fat by Lipolaser, hair reduction; skin resurfacing for wrinkle reduction and/or treatment of acne scars, removal of pigmented blemishes (e.g., age spots and moles), and treatment of vascular lesions (e.g., port wine stains and spider veins). Lasers are also used to remove unwanted tattoos as well.

If a person is considering performing any of these procedures as a Cosmetic Laser Technician, Medical Aesthetician or Medical Practitioner, it is now mandatory to register his / her personal name or business name or institution name for such practices. The registration is necessary to obtain business license, malpractice insurance coverage and permit to operate a laser device on the clients. The Canadian Association of Medical Spas and Aesthetic Surgeon (CAMACS) has obtained the patent to regulate the Nationwide Canadian Medical and Cosmetic Laser Practice Registration.

Upon registration, the practitioner will receive a unique permanent registration number that is designated to his / her name and practice. A Registration card will be issued for identification and confirmation that the individual is a Registered Laser Therapist (RLT). Like other practices such as dental, medical, paramedical, naturopathic, acupuncturists and nursing, a RLT will need to renew his / her status on a yearly basis.

Sample of the Registered Laser Therapist Card
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Background

A number of medical devices using related technologies have been licenced in Canada for use in Medical and Cosmetic treatments. These technologies include various types of lasers, intense pulsed light and radio-frequency energy that have some levels of risks, side effects and complications. A thorough knowledge, experience, skills and training to operate such devices are required for a safe practice. This mandatory Laser Practice Registration, named as RLT, will ensure that individuals that work in this field are adequately trained and certified.  

Lasers emit an intense beam of light or energy (visible or invisible) with a specific wavelength, which is targeted at a type of tissue in the part of the body being treated. When the beam of energy reaches its target, it is absorbed and converted into heat. If the procedure is done properly, the heat inactivates or destroys cells in the target area without having a significant effect on the other cells that surround it.

For hair reduction, the laser system targets the melanin (or dark colouring) in the hair follicle (or root). For wrinkle reduction and treatment of acne scars, the device targets and damages cells near the surface of the skin. The results are similar to the skin-tightening effect caused by traditional skin resurfacing procedures, such as chemical peels and mechanical abrasion. To treat vascular lesions, including spider veins, the light from the laser is directed at the blood vessels. If the appropriate wavelength is used, the vessel wall is injured and is subsequently absorbed by the body. Treatments for surface blemishes and tattoos are based on a similar principle.

Risks associated with Cosmetic Laser Treatments

Even when the correct laser instrument is chosen for a given treatment, there is a risk of temporary effects, including immediate pain, reddening of the skin, bruising and swelling. Some lasers are equipped with cooling devices to reduce this risk. Other possible side effects include the formation of blisters, burns and infection. In some cases, there may be lightening or darkening of the skin, but these complications are rarely permanent. If the wrong device is used or if a procedure is not done properly, the desired results may not be obtained and there is a risk of permanent scarring. There is also a risk of eye damage if practitioner and client do not wear proper eye protection during laser treatments.

Other Concerns

Medical and Cosmetic laser procedures can be expensive, and clients may be disappointed with the results if they are not a suitable candidate or do not have realistic expectations. For example, laser hair reduction works best for people with light skin and dark hair. It is not as effective on blond, red, grey or white hair or for people with dark skin. Most people need multiple sessions in order to achieve good results. Depending on the operator and the laser system used, there may be some permanent hair reduction (about 30%), but there are no guarantees that the procedure will work for every person or on every part of a person's body. Lack of knowledge how to treat those situations by unregistered and unqualified technician can be disappointing and in many cases risky to the patient.

Also, the degree of effectiveness for many types of cosmetic laser treatments is subjective. You may not be happy with results that someone else would consider to be successful. In addition, some treatments, such as skin resurfacing, require detailed follow-up care, including up to two weeks of recovery time. A qualified and knowledgeable laser therapist must be aware of all risks and concerns, therefore, be able to use the device safely and efficiently.

Minimizing the Risk

The best way to minimize the risks is to make informed decisions based upon thorough research, education and consistent education and training. Practitioners must find out whether their clients are suitable candidates for the procedure they have in mind. As an aesthetic laser operator you should look into the requirements for recovery time and follow-up care. Investigate the risks, and weigh them against the benefits expected for your client's type of skin and/or hair.

Clients, who decide to go ahead, must be sure that the person who will operate the laser device has the training and experience needed to perform the procedure safely and effectively. Ask the operator for references. Experts in cosmetics with proper training in laser techniques should be able to perform laser treatment on skin or hair reduction treatments with minimal risks to the Canadian public.

For any other type of laser treatment, Health Canada advises the public to seek the services of a licenced health care professional with specialized training in laser procedures. This is particularly important if they are seeking treatment for growths or pigmented areas on their skin.

Health Canada's Role

Health Canada regulates laser devices under the Radiation Emitting Devices Act, the Medical Devices Regulations and the Food and Drugs Act. These Acts and Regulations ensure that laser systems sold in Canada are safe and effective when used for their licenced medical purposes by trained professionals according to the manufacturers' directions.

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