Warning on unregulated cosmetic procedures

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

Plastic surgery

The use of non-ionizing radiation for common cosmetic procedures such as hair removal and skin rejuvenation is becoming increasingly popular.


Cosmetic GP Dr Imaan Joshi knows all too well the risks of cosmetic procedures, having personally experienced “terrible burns” after laser hair removal went wrong.

“Those with darker skin types are particularly vulnerable to adverse events such as post-inflammatory hyperpigmentation, but rarely have a screening or medical history done prior to procedures in these unregulated clinics.”

Cosmetic surgery has been a hot topic ever since AHPRA announced it would re-examine the largely unregulated industry, following a Four corners denunciation of “disturbing practices” in the former clinics of Dr. Daniel Lanzer.

But while AHPRA has chosen to focus on cosmetic surgery because it “poses the greatest risk” to public safety, doctors and experts warn that the risks of other cosmetic procedures should not be ignored.

Dr. Joshi is one of many who are calling for a reform of the entire beauty industry, not just cosmetic surgery, including common procedures using non-ionizing radiation, such as laser hair removal and skin rejuvenation.

‘Bad things can happen if you don’t pay proper attention.’

A group of leading Australian experts has also taken a similar stance and is calling for more research into the potential dangers of common cosmetic procedures in a recently published paper, as well as more industry regulation.

“There is currently no national approach to regulating devices or services that use non-ionizing radiation for cosmetic purposes, with the exception of a ban on solarium,” lead author Associate Professor Ken Karipidis of the Australian Radiation Protection and Safety Agency nuclear power (ARPANSA) said.

“Despite the public opinion that cosmetic radiotherapy 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 supervision and casual approach to potentially dangerous procedures rings true.

“When I went for laser hair removal, there was no preliminary consultation to determine my skin type or assess risk, and I never saw the same person in subsequent sessions,” she said.

“There was no continuity of care and safety features were never discussed.”

Then, after starting her own cosmetic clinic a few years ago, Dr. Joshi says she was shocked by the sheer lack of regulation.

“The ability for medically unprepared people to buy one of these machines is limited only by the amount of money they have to pay for it,” he said.

‘You will find that many large corporate chains buy top-of-the-range machines and then offer deep discounts on their prices to get people to cross the threshold.

“But many of these clinics also have a high turnover of technicians who don’t always know how to operate the machines safely.”

One of his other concerns is that the quality of the machinery varies considerably.

“Estheticians typically buy unregistered TGA machines at a fraction of the cost,” said Dr. Joshi.

“But then they have no guarantees on safety or standardization of settings for different skin types.

‘At best, they are less effective, but at worst, they risk burns and damage from [the] lack of standardization and security against which registration would protect. ‘

And despite the obvious problems, consumers remain largely oblivious to the risks.

‘Unfortunately, many consumers do not understand [the industry] because it is such an unregulated market, which is why they opt for the cheapest option which is often the riskiest, “he said.

“The cost of similar procedures through qualified medical professionals is often more expensive, but this is because doctors are properly trained and also provide counseling, where an appropriate assessment is made and where the risks and benefits are discussed in detail.”

According to the authors of the article, consumers risk a variety of adverse effects from non-ionizing radiation used in many common cosmetic procedures.

Temporary adverse effects include pain, rash, swelling, and pigmentation changes, while more serious lesions that can become permanent include burns, blisters, scars, persistent rashes, altered pigmentation, and eye damage.

“This research reinforces the need for consistent and well-defined training requirements across all Australian jurisdictions,” said associate professor Karipidis.

‘Further [research and] understanding the burden of injury will aid in further policy considerations by state and territorial regulators. ‘

ARpansa has since published national advice for consumers and treatment providers to address the possible risks associated with cosmetic radiation procedures and inconsistent supervision across Australia.

Dr. Joshi hopes vendors 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 for beauty or skin treatments,” she said.

“Your advice could prevent harm, and if you are not particularly experienced or interested in skin medicine, then refer to a fellow physician.”

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