The reason that laser procedures are gaining popularity so rapidly is their efficacy and safety in treating such a wide range of aesthetic skin conditions. However, that efficacy comes only with potent technology, that obviously has adjunct safety matters. Today we are looking at the safety issues that arise with the addition of a laser machine to the cosmetic clinic, and how to address them.

Eye safety

The most common adverse event involving laser machines is eye damage. Eye protection is necessary for both the practitioner and the patient, even if you have a class IV machine (classified direct and reflected viewing hazard only).

• Practitioner eye protection: Laser machine owners and operators may perform up to 20 treatments per day. Eye protection should be worn at all times, and you need to consider both the optical density of the material, and the wavelength protection it offers. Different-wavelength laser machines will require different types of eye-protection.

• Patient eye protection: The same eyewear that laser procedure practitioners use is suitable for patients, of course. However, the technology involved in making a material both protective and transparent enough to work with can be prohibitively expensive. Opaque eyewear (tanning bed style goggles) are the preferred patient protection for most practitioners. At a pinch, moist sponges or a wet towel will suffice.

• Bystanders’ eye protection: This can be achieved by ensuring that windows in the treatment room are made permanently opaque (windows and blinds can be left open accidentally), and that mirrors are excluded from the treatment room.

Other eye safety procedures for laser machines include keeping laser beam direction below standing and above sitting eye level; maintaining ambient light levels as high as possible and instructing staff never to directly approach a laser machine and never to point it into a person’s eyes.

Fire safety

Fires are a very real risk when working with laser equipment. Be aware of the materials commonly in use in your treatment room that are combustible. These may include:

• Towels

• Tissues

• Cotton pads

• Hair

• Ointments

• Some types of plastics – thermoplastics are combustible, thermosetting plastics are not.

• Anaesthetics prep solution

• Drying agents

Simply ensure your laser machine is turned off and the light has dissipated prior to pointing it elsewhere. Alternatively, arrange the workspace so that the laser can easily be turned or pointed into an empty corner of the room, but is difficult to point towards the materials area.

Air quality safety

All laser procedures create plume issues – airborne particles resulting from the destruction of tissue at high heat. These particles can include substances like benzene, formaldehyde, hydrogen cyanide, viruses and blood fragments from your patient. Over large areas of skin the risk can be significant, so while it is recommended that treatment rooms have no windows, they should still have highly efficient ventilation systems. A smoke evacuator system with a HEPA filter is the recommended air safety standard for plume issues. Always wear a laser protective mask, with a 0.1 micron filter.

General safety procedures

It helps to have a written laser machine safety procedure, even for common-sense issues such as:

• Only authorised staff should be allowed to switch on and operate the machine

• Keep doors closed and locked during procedures

• Post warning signs regarding the danger of emitted light within

• Work with a partner when performing high-risk procedures such as large areas of skin or thick, tough hair

• Never introducing reflective materials to the laser hair removal room