Laser And Intense Pulsed Light Therapy

The focus of this assignment is to examine the current legislations applicable to an establishment of a laser or Intense Pulsed Light (IPL) practice within England. The aim is to demonstrate an understanding of the current market and undertake a critical review and evaluation of the range of equipment for the removal of hair and skin enhancement. The equipment is to include treatment of photo rejuvenation, acne and vascular abnormalities.

The discussion points will outline the key requirements of the Care Quality Commission (CQC) in registering the use of IPL or laser treatments in a beauty clinic. It is vital to undertake a critical review of the latest advances in laser or IPL equipment on the market, including the types of conditions they can treat, and to ensure the equipment covers skin types 1 to 6 on the Fitzpatrick scale. When consider purchasing IPL or laser equipment for a new clinic discuss what factors need to be consider when selecting appropriate systems.

Methodology

The methods used to gain information regarding this assignment were secondary from books and websites. By using the search engine Google and taking information from books data was gathered to put this assignment together. Also primary research was carried out when discussing, with other managers, the registration process and equipment used within their establishment.

Findings

Outline the key requirements of the Care Quality Commission (CQC) in registering premises for the use of IPL or laser equipment.

In April 2009 the CQC took over the Healthcare Commission and is established under the Health and Social Care Act (2008). The CQC outline specific standards that are adhered to by each type of independent healthcare provider such as non surgical cosmetic procedures including IPL. “By law, certain establishments and agencies providing healthcare in the independent sector must be regulated by the Care Quality Commission” (Care Quality Commission, 2009) it is the duty of the CQC to ensure the equipment is properly maintained and all staff involved in the use of the machinery are fully trained to operate it. This is to maintain standards of health and safety towards members of staff and clients. This includes annual checks on the establishments and paper work that includes training certificates and records of clients undergoing treatment.

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Before beginning the registration process there are requirements that a manager undergoes to ensure the process is dealt with efficiently. These include the set up of the treatment room, customer complaints policy, a statement of purpose, and a medical report, all of which should be written and documented to show proof to the CQC.

When setting up a treatment room for the purpose of laser or IPL the area must be suitable for the procedure which includes no reflective surfaces, a cool cabinet or fridge, a treatment bed, room for the machine to manoeuvre, equipment for performing the treatment, razors and a sharps box. The lighting must be to a high standard and a lock on the door means no one could potentially walk in during the treatment. This is to ensure all health and safety measures have been taken to provide a safe working environment. Risk assessment of the laser controlled area is vital and needs to be updated yearly or when any new equipment is acquired. The risk assessment includes PAT testing, treatment room standards, COSHH on the products used and the appropriate health and safety guidelines.

When applying to register for the first time the manager must first read the guidance on applying for registration. It is compulsory to complete application forms R1 and R1SOP, along with a self-assessment form available from the CQC website. If it is required to have a registered manager, the form R1A needs to also be completed. When apply for registration, there is a non-refundable application fee. A series of other information is required to fill out the forms mentioned above, which includes a copy of the applicants birth certificate, any certificates of a change of name, a recent passport photograph, a copy of certificates relating to any relevant professional qualification obtained, a copy of each applicant’s up-to-date curriculum vitae (CV), a medical report, two personal references and a pre-interview self-assessment questionnaire should be filled out sent to the CQC. A statement of purpose consists of information on the intention of the equipment; this should be outlined and up dated when necessary and a copy should be sent to the CQC. The registration process cannot start until the appropriate fee has been submitted for laser and IPL from then on annual fees are applied. The registration process can then take eight to twelve weeks to complete.

Key staff involved in the process of laser and IPL include the manager and owners of the business and the staff who will be operating the machinery. Staff training can be provided by appointed Colleges that have the facilities, alternatively when buying the machinery specific companies provide training. For staff to be eligible for training the minimum qualification is NVQ level 3 or equivalent in the Beauty sector. This is to ensure the therapists using the equipment have a high standard of anatomy and physiology. It is imperative that the employees are trained to a high standard as the equipment can be dangerous. It is the managers’ responsibility to ensure all therapists are competent and trained in the equipment before providing treatments.

The policies needed to ensure the correct standards are maintained include consultation forms, records clinical controls and client protocols. It is the responsibility of the manager and all employees to maintain current accurate records of clients’ medical history, skin conditions and personal information and to ensure they are signed by both the client and the member of staff performing the treatment.

Undertake a critical review of the latest advances in laser and IPL equipment on the market and the types of conditions they can treat. Ensure work covers equipment for skin types 1 to 6

Laser and IPL machines are ever advancing with technology. This provides companies with up to date knowledge and expertise which can enhance the treatments given and adapt to new ones. It is important to discover clients’ needs and expectations to find a treatment that can help with the majority of concerns. Research is obtained to ensure the products produced will have an impact and be successful.

It is vital that the equipment chose by a business appeals to the majority of clients. As there are many different skin types the machinery has a Fitzpatrick Scale (see fig 1) the equipment should cater for all 6 skin types on the chart.

The equipment neodymium-doped yttrium aluminium garnet; Nd:Y3Al5O12 (ND:Yag) and IPL are the only pieces of equipment that work on all 6 skin types of the Fitzpatrick Scale. See Appendix 5 for a table on a wide range of products that use laser and IPL. This table shows the ND:Yag and IPL equipment is versatile and adaptable to accommodate all skin types. Appendix 1 shows a comparison of the equipment which demonstrates the qualities and uses.

It is shown that the IPL works on the upper layers of the skin to aid with skin rejuvenation and hair removal amongst other treatments. IPL treatments are well established and have had many studies and independent surveys performed on them.

ND:Yag is the new technology so it does not have all information on long term affects and results. This equipment works on the lower layers of the skin and hair follicle to enhance the treatment. The ND:Yag provides treatments for acne treatment and works more effectively on darker skin types.

Lynton are a leading recognised company in the UK providing equipment for the use of hair removal and skin rejuvenation using IPL Laser and ND:Yag technology. ‘Lumina’ is a piece of equipment that is versatile and works on many skin conditions (see appendix 3) and has options to select from ‘Intense Pulsed Light only’ or ‘Intense Pulsed Light with laser’. This piece of equipment is high powered for fast results and has the flexibility and adaptability to perform well in most businesses. The ‘Lightseries’ is a piece of equipment that has the latest multifunctional Alexandrite technology (see appendix 4) to perform treatments similar to the Lumina. Both machines have benefits to the business and it would be down to the manager to decide which would be most suitable to the individual clientele.

Consider purchasing IPL or laser equipment for a new clinic, include what factors need to consider when selecting appropriate systems

When a manager decides to invest in a new piece of machinery there are many factors that need to be considered to ensure the purchase it suitable for the business. There are many points to a new piece of machinery including, latest technology, design, cost and function which need to be researched.

Demonstrations from the different company’s to provide presentations on the information gathered on the product can be invaluable to making a decision on where to invest. This provides an opportunity for the manager to see the machinery, packages, ask all questions and see a presentation on the results. It is important to gather all information and have written proof of offers; this provides some security with facts and figures, to refer to at a later stage.

The company providing the machinery needs to be reputable and information on the company’s back ground can be fundamental to evaluate whether an investment is worthy. The longer the company and product have been established can make impact on a manager’s decision. The company need to provide a good basis of knowledge and results of the equipment to prove its functionality. Independent studies are effective in sourcing information on a product and confirming results produced. Questions such as how likely the machine is to break down, and if it does how easily is it to call out an engineer and have the parts available for replacement should be clearly outlined by the company. It is vital to know how many engineers are close by, how often does it need servicing and how much time will this take away from clients receiving treatments. What is the contingency plan of the company, what happens when it does not go according to plan and how efficient and proactive are the company at providing results. What organisations are the company affiliated with and what customer support is provided will prove to a manager that the company are committed to the success of a business.

The machine needs to suit a certain criteria including size, design, mobility, presentation and function. The function of the machine needs to appeal to the majority of clients’ skin types and conditions. From an accounts point of view cost is an important issue. How much are the start up costs, replacement parts, how much are servicing costs and how often are they performed. Profit needs to be considered as to how much could the machinery make for the business, how long before a return will be seen and how much will the marketing and advertising cost. The manager will asses staff training, what is required, how often and where the training will be carried out. The company should explain if the training is an additional cost or included in the cost of the equipment or package. With all of this information a manager can make an informed decision on the investment.

Conclusion

To summarise, the first task was to research the process of obtaining the permission of the CQC to provide laser and IPL treatments. The legislation process involves a lot of paperwork, time and effort. This venture takes planning and determination from a manager and thorough meticulous, attention to detail.

The outcome of the assignment is to show understanding of the different companies that provide equipment and the types of equipment available. With good understanding of what is involved in the decision process a manager can make an informed choice of what is suitable for the business needs. From a manager’s point of view the information gathered can be the deciding factor on whether or not to invest in such a venture.

From this assignment I found it interesting to look at the tasks from a manager’s point of view and reflect on what I may consider doing in the future to encourage expanding the treatment range available to clients.

Bibliography

ABC lasers (2010) Home (online) available from www.abclaser.co.uk accessed 1st April 2010

Aesthetic lasers (2010) IPL and Laser (online) available from http://www.laseroffers.com/category/risk-and-safety-issues-in-aesthetics/ipl-and-lasers/ accessed 1st April 2010

Alma Lasers (2009) Alma Lasers (online) available from www.almalasers.com accessed

http://www.almalasers.com/products.jsp accessed 28th October 2009

Bickmore, R.H( 2004) Miladys Hair Removal techniques

British Medical Laser Association (2010) Medical Laser Resource (online) available from http://www.bmla.co.uk/index.php/medical-laser-resources accessed 1st April 2010

Care Quality Commission (2010) Laser Lights (online) available from http://www.cqc.org.uk/_db/_documents/Lasers_Lights.pdf accessed 1st April 2010

Eden Aesthetics (2010) Products (online) available from http://www.edenaesthetics.com/products.php accessed 29 the November 2009

Ellipse (2010) Ellipse Micro light (online) available from http://www.ellipseipl.co.uk/pdfs/Ellipse-MicroLite-Brochure.pdf accessed 13th February 2010

Goldberg, D. (2000), Laser Hair Removal. Martin Dunitz, London

Godfrey, S. (2002), Principles and Practice of Electrical Epilation. Butterworth Heineman

Lanigan, W.S. (2000) Lasers in Dermatology. London Springer Verlag Ltd.

Lucid Training (2010) Core Knowledge (online) available from http://www.lucidtraining.co.uk/coreofknowledgecourses.htm accessed 13th February 2010

Reference

Aesthetic lasers (2010) IPL and Laser (online) available from http://www.laseroffers.com/category/risk-and-safety-issues-in-aesthetics/ipl-and-lasers/ accessed 1st April 2010

Care Quality Commission (2010) Laser Lights (online) available from http://www.cqc.org.uk/_db/_documents/Lasers_Lights.pdf accessed 13th February 2010

Care Quality Commission (2010) Guidance on applying for Registration (online) available from http://www.cqc.org.uk/_db/_documents/Guidance_on_applying_for_registration_Independent_private_and_voluntary_healthcare.pdf accessed 13th February 2010

Care Quality Commission (2009) Guidance for Professionals (online) available from http://www.cqc.org.uk/guidanceforprofessionals/registration/independenthealthcareservices/howtoregister.cfm accessed 28th October 2009

Laser hair removal review(2009) Fitzpatrick Scale (online) available from http://www.laserhairremovalreview.com/comparison.html accessed 29 the November 2009

Lynton (2010) Lumina (online) available from http://www.lynton.co.uk/product_details.php?id=45 accessed 1st April 2010

Appendix

Appendix 1

YAG 1064 nm Lasers

Intense Pulsed Light (IPL) Devices

Applications

Hair Removal, Photo rejuvenation, Skin Tightening, Active Acne treatment, Telangiectasias (spider veins), Rosacea, Sun & Age Spots, Pseudofolliculitis Barbae.

Hair Removal, Photo rejuvenation, Sun & Age Spots, Rosacea.

Efficacy

High power to dermis: more energy to follicles, vessels, collagen, sebaceous glands.

High power absorption in epidermis: less energy to deep dermal structures.

Comfort

Less painful due to shorter pulse durations.

Painful due to tendency to super heat epidermal melanin. Skin cooling gels or equipment needed.

Risk of Side Effects

Safe on all Skin Types.

all Skin Types.

Consumables

Few or none.

Frequent head replacements (on average after 30,000 pulses), filters and gels – annual cost $5,000-$10,000.

Aesthetic lasers (2010) IPL and Laser (online) available from http://www.laseroffers.com/category/risk-and-safety-issues-in-aesthetics/ipl-and-lasers/ accessed 1st April 2010

Appendix 2

Lynton New Product information

company

equipment

description

use

Lynton

LP YAG HANDPIECE

long pulsed Nd:YAG to add to a LUMINA base system

hair removal for darker skin, skin rejuvenation, and leg veins for darker skin

Lynton

OMNILUX

ideal for small treatment rooms, or those just starting out

non invasive light therapy. Multiple treatment heads for use on acne, skin rejuvenation, wrinkles, non-melanoma skin cancer and psoriasis.

Lynton

Q-PLUS SERIES

active q-switched Nd:Yag Laser with out puts at 1064nm and 532nm

for use on epidermal and dermal pigmentation lesions and multicoloured tattoo fading and removal

Lynton

Q-PLUS C

a single system combining actively Q-Switched YAG and Ruby Lasers providing outputs of 1064nm. 532nm and 694nm.

For use on fading and removing tattoos of all colours and treatment of epidermal and dermal pigmented lesions.

Lynton (2010) Lumina (online) avalabie from http://www.lynton.co.uk/product_details.php?id=45 accessed 1st April 2010

Appendix 3

Lynton Lumina

LUMINA The flexible dermatological tool-box with Intense Pulsed Light, Laser and Q-Switched Laser technology. This clinically proven medical system leads the aesthetic sector in application versatility and revenue capability, with combined Intense Pulsed Light and Laser treatments. LUMINA is unrivalled in its system lifetime and flexibility, treating deep and superficial vascular lesions, unwanted hair, superficial and dermal pigmentation, photo-rejuvenation, active acne and multi-coloured tattoos. LUMINA has many unique features, including integral printer for treatment record keeping, patient database for instant and accurate records and digital imaging, as well as Interchangeable Light Guide (ILG) technology, all in a platform designed to accept application upgrades. Uniquely, LUMINA can be taken as an ‘Intense Pulsed Light only’ specification at first and upgraded to add further Intense Pulsed Light handpieces and Laser accessories as required onto its compact single platform, giving a truly lifetime service.

Please note LUMINA Intense Pulsed Light and Laser options require registration with the Care QualityCommission.

KEY FACTS

• Select from ‘Intense Pulsed Light only’ or’Intense Pulsed Lightwith laser’ options

• High power for fastresults

• Lifetime flexibilityand adaptability

• The leading UKaesthetic system

Lynton (2010) Lumina (online) avalabie from http://www.lynton.co.uk/product_details.php?id=45 accessed 1st April 2010

Appendix 4

LIGHT SERIES

The latest multifunctional Alexandrite, KTP and Nd:YAG Laser Platforms

LIGHT Series systems are characterized by the best long pulsed laser technology available today, and the ability to combine multiple wavelengths into a single unit results in an extremely cost-effective system that allows a wide range of treatment possibilities and a rapid return on investment.

The LIGHT A is an alexandrite laser at 755nm, the Gold Standard in permanent laser hair reduction for skin types I-IV and pigmented lesions.

The LIGHT A* combines long pulsed Nd:YAG and alexandrite, resulting in the most comprehensive hair removal system on the market. It can also operate in short pulsed Nd:YAG mode, which is specifically designed for collagen remodelling and skin rejuvenation.

The LIGHT C Long/Short Pulsed Nd:YAG (1064nm) & Long Pulsed KTP (532nm) is ideal for practitioners who want to offer a wide range of treatments such as port wine stains, vascular treatments, post-sclerotherapy matting, rosacea, pigmented lesions, hair removal for all skin types, skin rejuvenation and tightening, and leg veins all in one system.

Lynton (2010) Lumina (online) available from http://www.lynton.co.uk/product_details.php?id=45 accessed 1st April 2010