Laser radiation emitted for the laser system can be harmful if proper procedures are not followed.
There are various regulatory agencies and standards presiding over laser safety:
- FDA (U.S. Food and Drug Administration): an agency within the U.S. Department of Health and Human Services that oversees the manufacturing and distribution of food, pharmaceuticals, medical devices, tobacco and other consumer products and veterinary medicine.
- American National Standards Institute (ANSI): Safe Use of Lasers in Health Care.
- Canadian Standards Associations (CSA).
- Canadian Centre for Occupational Health and Safety (CCOHS).
- Health Canada – Medical Devices Bureau (MDB).
Although regulations and standards should always be followed when using laser equipment, every facility that uses such equipment should also have in place internal administrative controls to ensure safety and proper equipment use. Such controls should include:
- Competency and credentials.
- Education and training.
- Policies and procedures.
- Employee eye exams.
Hazards and Safety Measures
An Optical Hazard
- Laser constitutes invisible infrared light that can cause permanent eye damage.
- Laser also consists of direct as well as scattered light.
- Scattered light from laser can result from contact with metallic and reflective surfaces.
An Electrical Hazard
- Laser also constitutes an electrical hazard that should be addressed by a facility’s operations safety protocols.
To deal with the optical, electrical and other hazards associated with laser equipment, the following operational protocols should be followed:
- Ensure proper eyewear is used worn by anyone who will be exposed to laser during treatment and use, including the client as well as the technician.
- The wavelength listed on the eyewear for the operator should correspond to the wavelength of the laser being used, cables, handpiece and lens.
- The client should wear blacked out safety glasses throughout the treatment.
- No one should ever look into the lens.
- Ensure there is nothing flammable in the laser area.
- There is to be no acetone or alcohol anywhere near the laser equipment during use. This means the equipment should be cleaned well before each use and the solutions allowed to dry thoroughly before the machine is turned on.
- Hair spray can be flammable so care should be taken when the facial area is treated.
- No oxygen is to be used during treatment.
- Paper products such as lounge paper, paper towels, and eye pads can easily ignite and should not come into contact with the laser beam.
- All cables and cords should be protected and not left exposed.
- There should be no stresses on the cable, pulling or twisting.
- Proper care and maintenance of all equipment should be routine.
- Maintenance procedures must be performed while the machine has been disconnected from the power source.
- Reflective objects must be removed from the client and the operator.
- The laser machine should be kept on standby until contact is made with the client’s skin.
- Machine indicators for standby are generally a yellow light, and a green light indicates treatment readiness.
- Ensure the correct use and amount of gel if used. Too much gel may cause interference with treatment and too little gel can result burning of the skin.
- Clean the laser lens and keep it free of hair so that the lens does not blacken and cause interference with the functioning of the equipment or reduce the energy level.
- Emergency off switch must be manually reset and checked before every treatment.
- Foot switch has protective design to prevent accidental shots and always placed on its side when not in use.
Treatment Room Safety
Requirements and protocols for a safe laser treatment room:
- A laser sign on the outside of the treatment room door must be obvious to everyone so that no one can enter the room.
- Lock the door inside so that no one can accidentally enter the room.
- A fire extinguisher must be available inside the room.
- The room must have a sink with running water in case of small paper fires.
- A room ventilator to evacuate and circulate the air from the plume of the hair treated.
- Facemasks must be worn during treatment.
- Room temperature thermostat to be set at 22 °C, with air conditioning individually controlled to keep the laser functioning.
- No windows, mirrors or pictures with glass should be exposed because the laser beam can bounce off these surfaces.
- All reflective materials must be covered and jewelry removed.
- Review the consultation questionnaire for contraindications with laser.
- The client should complete and sign an informed consent form before the treatment.
- Diabetes: What level and how well is it controlled? No laser on the lower extremities from the knee down if over forty and the client is controlled by medication. The effects of diabetes can lead to decreased circulation, sensation and poor healing if burned.
- Anticoagulants can increase the risk of bruising.
- Check for skin keloids. Where are they located, what caused them, and how severe are they?
- Ask for personal and/or family history of skin cancer. Most technologists are not qualified to determine if a skin irregularity is cancerous or benign, so, if in doubt about an unusual spot on the skin, have the client go to their doctor.
- Check for tattoos and raised moles in the area to be treated.
- For medication that is photosensitive, you must alter the settings or not treat until the medication is completed, and then wait an additional ten days before treating.
- If Accutane medication has been taken, there is to be no treatments for six to twelve months, depending on the body part that is being treated.
- If the client has active or frequent outbreaks of herpes, you will avoid treatment because the heat from the laser may cause an outbreak.
- High settings used when treating with laser can result in thermal damage to the treated skin, resulting in burning and blistering.
- Moisturizers must be removed before treatment because they can cause burning or darker pigmentation of the skin.
- Oily skin may increase the incidence of pimples and/or whiteheads after treatment.
- Shaving the hair as close to the skin’s surface as possible prior to treatment will help avoid surface burns or blisters.
- All jewelry must be removed to decrease the reflection of the laser beam.
- Cleaning the equipment, especially the lens, will maintain the efficiency of the energy level.
Cooling System Safety
Use of a cooling system during treatment will help alleviate client discomfort. Here are some factors to take into consideration regarding cooling system use:
- Avoid frostbite to the skin by not placing the hose too close to the skin or for too long a time.
- Avoid use of the cooling system if the client has these pre-existing conditions:
- Reynaud disease.
- Hypersensitivity to cold.
- An open wound in the treatment area.
- Previous frostbite in the area being treated.
The Responsibilities of the Clinic
There are various responsibilities a clinic using laser must accept within its facility when conducting treatment, including:
- The training and skill of any person using laser.
- The proper use of the laser, including wavelength, power settings, duration of each energy pulse, amount of time between pulses, and number of pulses per treatment.
- Ensuring the colour of the skin and hair of the person being treated are taken into account when administering the settings and conducting the treatment.
- Ensuring the number of treatments administered during treatment are adequate for the part of the body being treated.
The above protocols are established by OMI Medical Inc. to protect both staff and clients. Please make sure that your establishment is following updated policies to avoid unnecessary accidents. Safety must be our priority.
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