title: Treatment errors resulting from use of lasers and IPL by medical laypersons: results of a nationwide survey.
abstract: BACKGROUND
  The demand for hair and tattoo removal with laser and IPL technology (intense pulsed light technology) is continually increasing. Nowadays these treatments are often carried out by medical laypersons without medical supervision in franchise companies, wellness facilities, cosmetic institutes and hair or tattoo studios. This is the first survey is to document and discuss this issue and its effects on public health.
  
  
  METHODS
  Fifty patients affected by treatment errors caused by medical laypersons with laser and IPL applications were evaluated in this retrospective study. We used a standardized questionnaire with accompanying photographic documentation. Among the reports there were some missing or no longer traceable parameters, which is why 7 cases could not be evaluated.
  
  
  RESULTS
  The following complications occurred, with possible multiple answers: 81.4% pigmentation changes, 25.6% scars, 14% textural changes and 4.6% incorrect information. The sources of error (multiple answers possible) were the following: 62.8% excessively high energy, 39.5% wrong device for the indication, 20.9% treatment of patients with darker skin or marked tanning, 7% no cooling, and 4.6% incorrect information.
  
  
  CONCLUSIONS
  The causes of malpractice suggest insufficient training, inadequate diagnostic abilities, and promising unrealistic results. Direct supervision by a medical specialist, comprehensive experience in laser therapy, and compliance with quality guidelines are prerequisites for safe laser and IPL treatments. Legal measures to make such changes mandatory are urgently needed.
authors.affiliation: Laser Clinic Karlsruhe, Kaiserstraße 104, Karlsruhe, Germany. info@raulin.de
authors.forename: Stefan
authors.initials: S
authors.lastname: Hammes
authors.forename: Syrus
authors.initials: S
authors.lastname: Karsai
authors.forename: Hans-Robert
authors.initials: HR
authors.lastname: Metelmann
authors.forename: Laura
authors.initials: L
authors.lastname: Pohl
authors.forename: Kathrine
authors.initials: K
authors.lastname: Kaiser
authors.forename: Bo-Hyun
authors.initials: BH
authors.lastname: Park
authors.forename: Christian
authors.initials: C
authors.lastname: Raulin
mesh_terms: D000328:Adult; D016390:Allied Health Occupations / Q000706:statistics & numerical data*; D002056:Burns / Q000453:epidemiology*; D003357:Cosmetic Techniques / Q000706:statistics & numerical data*; D003625:Data Collection; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D053685:Laser Therapy / Q000706:statistics & numerical data*; D008297:Male; D019300:Medical Errors / Q000706:statistics & numerical data*; D010859:Pigmentation Disorders / Q000453:epidemiology*; D012307:Risk Factors