I want to get into laser Hair Removal but not sure where to begin. I am statring to look at equipment to lease but really stuch on which way to go. I want a machine thatwill grow wit me and my business. I will start with hair removal and go from there. In school we learned on a Cutera machine but I was just looking at the Harmoney. I could really use some advice from people who have already done this before. As well I am sure I need insurance to perform services

Ashley

no I am not a physician, I am an Esthetician.

Depending on which state you reside in there are a whole host of regulatory and legal concerns between you and your objective. If you spend a few hours looking at the posting in the "categories and topics" sections of this weblog you will learn a lot. For starters--- you need to know that in most states the performance of "laser surgery" (often considered to include IPL also) is considered the practice of medicine and restricted to licensed physicians. It may appear to be the "wild west" out there-- and you may see estheticians operating lasers all over the place-- but they and their clinic operators are subject to fines and severe penalties if the authorities happen to investigate. I know this because it happened to me-- and I was utilizing registered nurses and LPNs!

Ashley, you're discussing what could be practicing medicine without a license which is a felony in all 50 states. I'd suggest that you investigate the legal sections of this site rather than just try to find a machine what will grow wit you.

(And yes, you'll need insurance... medical malpractice.)

Ashley if you are in AZ I have an opening for an experienced Laser tech

This thread brings up a good topic, that of performance of procedures and who may perform them. I have been on the phone today with the Indiana nursing board and cosmetic board trying to find out if a nurse, or aesthetician can perform laser hair removal, skin rejuvination, etc while an MD is on-site in the facility. So far, no one can answer this. Any suggestions? Thanks

Prevention Magazine has teamed with the American Society for Dewrmatologic Surgery and is providing some very limited information about regs from state to state. Per Prevention, in Indiana at present the doc does not need to be on site and no rules restrict the doc in choosing whom to delegate to. This site can be located at www.prevention.com/spa.

A different compilation put together by MD Laser Solutions (also used on the AdeptMedicalconcepts web site) says that in Indiana the operation of lasers can be operated by RNs or PAs only under ON SITE medical supervision.

The confusion and split of authority is typical. The laws and regs are confusing and are changing fast in many states.

I am not interested in Laser surgery. I am refering to laser hair removal, photo facials, capillary treatments. A medical degree is not required. These services are performed by a medical esthetican

adrisen,

No one else is talking about laser surgery but in most states it is still the practice of medicine including what you have talked about. I believe ALL states require you to work under medical supervision.

Yes, some state allow aestheticians to work with the lasers but it is a delegated medical procedure. Therefore, you will need to find a physician willing to put up his medical license and you will have to pay them.

You need to read many of the posts on this topic. You also will need to talk to your aesthitician licensing board and also the state medical board. Once you have done that then talk to the lawyers. We had a local individual like you that started on her own bought the laser (well over $100,000) and within 3 months she was shut down by the state. Now, that is a very expensive mistake.

I am in Indiana and we also had a huge problem figuring out who could do the procedures legally. Finally a conference call between my attorney, my malpractice carrier and the states attorney general office determined that anyone that 'I' designate can do the procedures. My attorney and malpractice carrier deferred to the common sense rationale of using only licensed medical personnel, which does not include medical estheticians by the way.

My own preference is to only use medical personnel as well and the patients so far have been very receptive to that philosphy.

I am not in the US. I am in Canada in Ontario and their is now law stating that. One must have the qualifications to perform that service. IE Medical esthetician with the required training to perform the service. I have taken the required certification to perform the service here so the service can be performed without a physician.

Your facility is not one I would want to go to. These are medical procedures and can cause great harm. I hope that you rethink your position.

I am not sure what makes someone qualified after a few months training of understanding medicine, the contraindication, pharmokinetics and treatment of any possible adverse affects. Just the statement of treating capillaries, do you mean veins or something really that small?

"I am not sure what makes someone qualified after a few months training of understanding medicine, the contraindication, pharmokinetics and treatment of any possible adverse affects. Just the statement of treating capillaries, do you mean veins or something really that small?"

Dude, she isn't trying to take out your spleen she's just pointing lasers. I don't see how you'd need more than a few months of training for that.

It is the no supervision thing I have a problem with. These procedures should be for trained and licensed medical personnel. No a "medical" aesthetician does not qualify. Aestheticians only have about 10 to 15 weeks of training total. So no this does not qualify them to operate a laser on their own.

Dude, it is not just pointing a laser. It is much more complicated than that. I have seen severe burns and scarring from "just pointing lasers".

Thanks LH for the support, I guess I could have at least been Dr Dude. Supervision is extremely important and I believe medical judgement comes from a physicians traning. I know many times I tell a patient or client not to do a treatment after reviewing their medical history and medication even for lasers because of my 20 something years of traing and practice.

in regards to the amount of training I have as an esthetician. I have two years training, it is not the same here as it is in the USA. As for Medical esthetics I have a great deal of training and I am fully aware of how to handle the equipment.

As well as contraindications, side affects which can occur, and how to take a medical history for safe treatment.

Adrisen,

I find it hard to believe that you are actually considering doing this alone. Or do you have a physician who will serve as a "consultant" for any unforeseen occurrences such as burns, acneiform reactions,scars,contraindications, etc. I am also curious as to where you can obtain "malpractice" insurance in Canada?

Fiona PA-C

One does require insurance and it is not difficult to get. As for doing it without a physician sure am. Not required as for unforseen concerns a Medical Esthetician is not the same as an Esthetician that is in the US. we are very Highly trained in regards to our education and how to handle the issues that come up. this was not waht my question asked. And yes I have the necessary qualigications and training to perform many treatments outside of performing manicures and pedicures and facials, for as a Medical Esthetician I do not perform such services.

Ae ya sur adrisen? yor gramaar is godd, spell check anyone.

Adrisen,
your "qualigications"? Please.

Jeff, do we have to be subjected to this drivel? I guess that basic spelling, grammar, and sentence structure is not part of the training. Guess all that 'book learnin' didn't take. Anyone who would allow you to treat them get exactly what they deserve.

I'm hoping that anyone who's new to the site won't follow this lead and think that this is a posting board for estheticians who can't spell.

HELP,I'M MOVING TO AZ AND EVERYONE WANTS ME TO TAKE A 3 WEEK COURSE ON LASER.8 GRAND! OUCH..... I HAVE ALREADY PERFORMED LASER IN OH AND HAVE SOME TYPE OF CERTIFICATE STATING SO.DO I NEED TO BE CERTIFIED?

Sounds like a school looking for money. On this site you'll find boucoup posts on estheticians or technicians and how they can operate lasers in medical settings.

I think I speak for others when I ask to turn off the all caps. It's perceived to be yelling. Dermadoc and Vexed MD do all the yelling around here. ;)

Moving 2 Az: Don't know about Az but in MN (and many other states) only RNs or PAs can operate lasers under the supervision of a licensed physician. In some states the M>D. needs to be physically on the premises. Also need standing orders and writen prescription, etc. All estheticians doing this are practicing medicine without a license.

I don't believe one needs to be rude. I wanted info and had people feel that doing Laser Hair Removal as a Medical Esthetican is the end of the world.. I believe that everyone in entitled to their opinion in the matter. Regardless of that. I respect your feelings in that nor and I looking to interupt client base. Regardless my question was not answered.

Which line of Laser equipment would you suggest? I have been looking at the Harmoney from NexGen Lasers. Other suggestions would be apprecieated

I believe the NexGen Lasers is the Canadian distributor for Alma Lasers. I knew one doctor that in Canada that was looking into the Harmony for the Pixel and 540 handpieces for skin rejuvenation functions rather than for hair removal.
Others have commented that for hair removal the Harmony is underpowered.

My personal belief with Alma (IPL) is that they are not underpowerd. . . on day one. The problem is that their handpieces are only recommended for use of 30,000 pulses. Basically, the lamps will degrade very quickly. As they degrade, the power needs to be upped. It won't take long for the degradation to max out your power. My last dealing with them they quoted me a 5K charge to replace the handpiece. Cutera and Palomar guarantee their handpieces for 100,000 pulses and Sciton 300,000. Do the math. You will spend an extra 15K changing out handpieces when compared to Palomar and Cutera and $50K when compared to Sciton if you are using their handpieces for hair removal.

Dexter

We also need to know approximate size of vessel and degree of vascular problems on this particular patients leg.

Oops. wrong post. sorry.

i want to get into laser hair removal the school i inquired about this course say i need to complete 320hr of electrolis is this true?

I forgot to mention I was informed that I needed to become an electrologist before taking laser hair removal which is an additional 30 hrs

The laws and regulations differ in every state/country. You really need to check with the regulators (i.e. medical board, dept. of health, etc.) in the place you are planning to work in. Of course there are a few states that don't have clear guidelines. I don't think you need to become an electrologist though, that sounds more like a school requirement.

In the State of Florida one needs to be an Electrologist before they can do laser hair removal. I contacted them becasue I am moving here in 15 months.

Thank you for the information on the Harmoney. There is another unit that I am looking into and might ask about. Thanks everyone.

(NOTE FROM THE EDITOR: I've decided to leave this comment up although it's incorrect. In every state in the US, laser hair removal is considered and regulated as a medical treatment and must be performed under medical supervision at the least. Electrologists on their own, may not perform laser hair removal any more than Jane Doe on the street. There are no exceptions and every state is the same with this basic premise.)

See this post: http://www.medicalspamd.com/the-blog/electrologists-in-florida-can-perform-laser-hair-removal.html

Adrisen,

You will need to practice under the supervision of a physician. I would check with Florida laws. They recently had significant changes.

Well I had some questions but I am afraid to ask after seeing how rude some of you all are!

Thanks Jeff. jwrn if you are operating legally and within your scope of practice you will likely get honest answers. Many of us work very hard and take all the risk associated with our practice. We do not want to give information to people working outside their scope.

You will also see that most of us do not like the "medispas" set up with a physician as a director and he/she never is on site.

I would also guess that many of your questions will be answered somewhere else. So do some review of the site and then ask specific questions and you will likely get an honest answer.

To inform you about Florida and Laser hair removal. One stated that the comment was not correct. I have spoken with tbe Liscencing board regarding it. As well sitting in my office is the information regarding the matter and how to go about obtaining the certification. I will be more then happy to provide the website if anyone wants the information.

It is my understanding after reading the last Florida law,(if it hasn't changed),that electrologist can do laser hair removal but only RN's and PA's can do other nonablative laser skin care procedures. Current Florida legislation will require that only business with a Physician on site can operate lasers. If that physician is neither a Plastic Surgeon or a Dermatologist then the office must be his primary practice and he cannot serve as a medical director for any other locations. Plastic Surgeons and Derms are going to be restricted to two site.

Also, we have found that while the Cutera laser is not the cheapest, it offers the most versatility and upgrade ability of any of the numerous lasers being sold today.

It is very difficult to find exact laws on who may operate a laser in the state of florida....I am an LPN who works for a dermatologist. I do all the laser treatments...using Novalis IPL laser. Does anyone have any answers....the dr. feels that it is perfectly legal since I am working under him.....

You need to contact a lawyer that is familiar with florida medical laws. The way I read the law what you are doing is not legal. We have had the same problems in the state where I practice. It is difficult to get absolutes when defining who can use the lasers under what circumstances.

For me, I have chosen to use RN or higher only.

Sharon: It is actually easy to find the exact law you are trying to find (but I don't think you are going to like what you find). Just ask the medicalspamd regulars! You can find the statute on the Internet in seconds using Google-- it is in Chapter 458 (Title XXXII) -- you are looking for 458.348. The statute will tell you everything, but you need a law degree AND a medical degree to interpret it! It is a very complicated and restrictive piece of legislation. My fees are usually $250.00 per hour but for you it's free. I want to be the first to set up a prestigious med spa in Cuba when economic relations are finally reestablished to be able to avoid the Florida regulatory nonsense!!

Ok, what if we just get to the question of which laser for hair removal. What about the Alma Soprano? I heard it was much better than the Harmony which is a multi-use piece of equipment much better at doing other things than hair removal.

EM

Help! I am a registered nurse with expertise in the cardiac field. I have been working at a med spa performing IPL/laser hair removal treatments under a doctor's supervision. I am interested in getting "laser certified" but have been unable to find coursework that is reasonable in price and time requirements. I need direction regarding coursework. Furthermore, my state does not specificy under the nurse practice act what a registered nurse is able to perform with lasers. Is there some national guidelines I can follow? Finally, if my superivsing physician is not in the building (on a trip) then I am I able to implement treatment that he has already prescribed? Thank you to anyone who can answer these questions.

HN: If you pull your state statute which defines "the practice of medicine" you will probably see that the operation of medical lasers and pulsed light devices constitutes the practice of medicine. You will also very likely find some additional information about requirements for delegation and/or supervision of medical personnel the state allows certain procedures to be delegated to. There is a huge variance from state to state about these details. You better be following the law or you can be censured by the medical board or the nursing board. It happened to me and my nurse in Minnesota and it was horrible.

I've read this thread several times, and thought long and hard before posting. I doubt I'll be winning any popularity contests here. I am an esthetician and electrologist in Quebec. Like Adrisen, I am in the process of opening a laser/electrolysis clinic in my area. No doctor, no nurse. A PLUMBER could open one of these clinics in Quebec. And while it's very frightening, it's completely legal. The only thing regulating all of this is the insurance companies. So the plumber can rent or buy a laser - and run a clinic - but can't get insurance. Estheticians and electrolgists can. So, here we are; women with approximately 2000 hours of training in skin and hair, looking to the doctors for guidance. We humbly appreciate your input. Please be merciful.

stephilia,

What you see in most of the postings from the docs is concern for the patients. We have seen many want to get into this without training. Everyone thinks you will become a millionaire if you start a laser clinic. So they start and have no idea what they are doing.

I am going to tell you not to start the clinic unless you have physician backup. Do what is right for the patients not what is right for you. My feeling is that just because it is legal does not make it right. In this industry, laws have not caught up and can change.

LH

Thank you for your reply. I wonder how you feel about electrolysis. There was a time when only nurses were deemed qualified to perform this "microsurgery". It is now considered a beauty industry skilled trade, not requiring medical supervision.
To the best of my knowledge - correct me if I'm wrong - the incidence of personal injury has not increased since deregulation.

As for laser hair removal, there are countless cases of burns taking place in medical offices all over North America. Are there statistics showing that these burns are more frequent in non medically supervised environments? Are the RNs burning patients less often than the medical estheticians? Is the fact that the physician is on site protecting patients from potential injury? Or is it just that having a doctor present makes it easier to provide a patient with a script should something happen?

We've been taught about contra-indications, etc. We've been trained to operate the devices.

I don't mean to be confrontational or disrespectful, but I think my questions are valid.

Should you have the time or inclination to answer my possibly "remedial" questions, I would very much appreciate it.