Safe Use of Laser Devices in Human Subjects

注意使用激光裝置的安全－保障消費者的安全與利益

The use of high power laser/intense pulsed light by non-medical personnel

Dr. Henry ChanAssociate ProfessorDepartment of MedicineUniversity of Hong Kong

Key points1. We believe it is of the public interest for the

government to regulate the use of high power laser/intense pulsed light source to be used by clinicians only.

2. Other western countries already have regulations to control their use.

3. Laser/IPL are “high-tech” knife.4. Most public are not aware of the danger associated

with the use of such devices and majority support further regulation.

5. Consumer Council 2929 2222 or hotline 9773 7676.

History and background

Laser - light amplification by stimulated emission of radiation

1960: laser was first used for skin diseases Different objects preferential absorbs different types of light.

By selecting the right wavelength, one can selectively destroy the object without affecting the surrounding tissue.

LaserRadiation of a fixed wavelength.

Intense pulsed light source (IPL)Consists a fixed range of wavelength, target at different depth will be affected.

The selectivity of IPL is decreased and much higher energy is often needed to achieve the clinical result.

Treatment of skin diseases

Congenital port-wine stain

Freckle

Tattoo

Laser hair removal

Laser resurfacing

Before

After

Why government should regulate the use of high power laser

1. Medical/Dental practitioners are best to determine clinical end point

To achieve the optimal clinical response, one needs to assess the tissue reaction so that the right energy can be used.

Mis-use of laser/IPL energy can lead to • Under-treatment (no effect)• Over-treatment (leading to complication suc

h as pigmentary disturbance or even scarring)

beforeBefore

After week 1After 7 days

2. Medical/Dental practitioners are best to detect and manage complications

Laser surgery, like other form of surgical procedure, is associated with known complications.

The importance of detecting and managing complications

• Leads to a better clinical outcome• Reduces the morbidity associated with the

complication

3. Medical/Dental practitioners are best to observe laser safety

Inappropriate observation of laser safety could lead to

Blindness Burn injury Even fire

4. Medical/Dental practitioners are best to diagnosis disease and offer treatment options other than laser

Medical/dental practitioners are best to diagnosis disease states and offer treatment options that may or may not necessary for laser.

E.g. patients with cancer should be treated with excision rather than laser.

Naevi

Solar damage

Our experiences

Most of the young ladies are often too embarrassed to voice their compliant out openly.

Case 1A young girl received some sort of light source to remove moles and developed multiple keloids in the forearms.

Case 2A young lady in the entertainment business was off work for a year due to hyperpigmentation developed in her arms after laser hair removal.

A local telephone survey (Department of Medicine, University of Hong Kong) looking at the use of high power light/intense pulse light source by beauty salonAim

•To assess the public awareness of the complications associated with the use of these high power laser/intense pulse light source

•To assess public opinion regarding regulation in the controlling the use of such device by clinician only

Subjects: 601 females (age range: 15-65)

Do you know laser or intense pulsed lightsource can be classified into high and

low energies?

70%

30%

yesno

Do you know high power laser / intensepulsed light source can be used for

cosmetic purpose and hair removal?

61%

39%

yesno

Classification of laser radiation levels

Class I: are not considered to be hazardous.

Class IIa: are not considered to be hazardous if viewed less or equal to 1000 seconds but are considered to be a chronic viewing hazard for greater than 1000s.

Class II: are considered to be a chronic viewing hazard.

Class IIIa: are considered to be an acute viewing hazard if viewed directly with optical instruments.

Class IIIb: are considered to be an acute hazard to the skin and eyes from direct radiation.

Class IV: are considered to be an acute hazard to the skin and eyes from direct and scattered radiation.

12%21%

7%

71%

0%

20%

40%

60%

80%

%

anyone beauty salonpersonnel

paramedical staff physician

Who you think can use high power laser /intense pulsed light source for cosmetic

purpose and hair removal?

Do you know treatment with high powerlaser / intense pulsed light source can lead

to complications?

43%57%

yesno

Do you think there should be regulation incontrolling the use of high power laser /

intense light source by non-medicalpersonnel in Hong Kong?

97%

3%

yesno

Will you choose physician or beauty salonpersonnel if you have treatment with highpower laser / intense pulsed light source?

95%

5%

physician

beauty salon personnel

Key points1. We believe it is of the public interest for the

government to regulate the use of high power laser/intense pulsed light source to be used by clinicians only.

2. Other western countries already have regulations to control their use.

3. Laser/IPL are “high-tech” knife.4. Most public are not aware of the danger associated

with the use of such devices and majority support further regulation.

5. Consumer Council 2929 2222 or HKMA 2527 8285.