Augusta attorney Victor Hawk knows the dangers of inexperienced hands behind a laser machine.
A client, whose name he couldn't reveal for confidentiality reasons, received severe burns on her face during a laser hair-removal procedure at an Augusta facility in February 2008.
"It involved a temporary technician that was called in to cover an absent employee, and she turned the laser up too high and caused a checkerboard pattern on the client's face," Hawk said. "It took about a year to a year and a half to heal and fade significantly."
The burns stretched from his client's cheeks down to her chin on both sides of her face and across her chin. Luckily, the burns weren't deep enough to destroy the skin pigmentation.
"She was very upset about it. She had to change her lifestyle for a significant period of time as a result of it," Hawk said.
In the end, his client was compensated monetarily for her injuries.
To be fair, Hawk said, he knows several people who have had laser treatment without incident and were pleased with the results. He has, however, found the cosmetic laser industry to be relatively unregulated in Georgia.
"There's no real certification that I know of," Hawk said.
Years ago, only plastic surgeons operated medical facilities where patients could receive cosmetic laser treatment. Today, physicians of all specialties are opening medical spas and getting technicians to do the work, said Dr. William Welsh, a board-certified plastic surgeon in Augusta.
Consumers don't have to look far to find someone to perform cosmetic laser hair removal or laser treatment for redness, spider veins, wrinkles, tattoo removal and more.
"You have a spa on every corner now. There's hardly any real medical involvement in the whole situation," Welsh said.
THE MOST RELEVANT LAW to regulate cosmetic laser services in Georgia is the Georgia Cosmetic Laser Services Act, which was signed in 2009. It stipulates that the Georgia Composite Medical Board may issue licenses to those performing cosmetic laser services and require education and training of the practitioners to help ensure the health and safety of consumers, said Dr. Alexander Gross, a dermatologist and board chairman of the Georgia Composite Medical Board.
"However, when the law was passed and signed, there was a provision at the very end of it, which often happens," said Robert Jeffery, the director of operations for the Georgia Composite Medical Board.
"It says this law should become effective upon funding by a specific act of the Legislature. The Legislature to date has not funded it. So, it's not actually effective yet."
Today, there is still no regulation of cosmetic laser services in Georgia. Most other states have laws regulating the services, Gross said.
"From a standpoint of who does the procedure, what type of license they have, what type of supervision they require, there is no set of rules and regulations. I'm certainly concerned about it. The board is very eager to start issuing laser licences," he said.
The Georgia Composite Medical Board has estimated that it needs $71,000 to implement the licensing program and $65,000 each subsequent year. The board would charge licensing fees and would probably be able to cover its costs after the first year, Jeffery said.
Clients who are injured at a medical spa during a laser procedure can file complaints with the Georgia Composite Medical Board. The board periodically receives complaints about laser injuries, but the number isn't significant, Gross said.
"Most of the laser injuries that we see are minor and are treatable with no residual defect," he said.
He recommends that consumers find a location with a physician supervisor who is an expert at laser procedures, understands the skin and is able to handle complications that might arise. The physician must also be easily accessible.
They should also find out the level of training for the people operating the laser, how long they've been doing it and whether they have had an unusual number of complications. If the doctor is not on site, ask how to get in touch with the doctor and where he or she is located, he said.
"The Golden Rule of having any type of cosmetic procedures done is buyer beware," Gross said.
The industry also is unregulated in South Carolina. The South Carolina Board of Medical Examiners has written a guidance document for physicians, but it is not an official regulation, said Teresa Higgins, the assistant director of communications for the South Carolina Department of Labor, Licensing and Regulation.
SOME LOCAL FACILITIES that perform cosmetic laser procedures say they are taking precautions to protect their patients.
At Augusta Laser & Skin Center on Walton Way, technicians are required to undergo extensive training, said Kym Cunningham, a licensed esthetician at the facility. Technicians at the center are overseen by plastic surgeons.
"At this particular center, we want you to have a skin (esthetics) license, and we do want you to have taken laser courses," Cunningham said.
She earned her esthetics license at Esthetics International in Columbia, which included classes on how to use laser equipment. To maintain the license, technicians must attend continuing-education classes, she said.
Every few months, a representative from the laser machines' manufacturers, Sciton and LightSheer, trains workers on site.
Cunningham said that it's her duty to be prepared for her job.
"I couldn't sleep at night ... That wouldn't be fair to them, and I wouldn't want that on my conscience," she said.
It's not just technicians who are untrained. Some physicians trying to supplement their income are purchasing laser machines and performing cosmetic laser procedures.
Welsh said that people often seek his assistance in treating burns and hypertrophic scarring caused by laser procedures.
"I see people come in all the time who have laser treatments by say an OB-GYN or somebody that just bought a laser, and they've got terrible burns on the skin from it," Welsh said.
"It's because they really haven't got the experience to know how to use it yet. You have to have a good bit of experience with lasers to know exactly how to regulate your beams and densities to get good results."
Welsh has been using lasers since 1979, and he's the only person in his building who uses the equipment.
Many technicians who use laser equipment are unsupervised, and the physicians "aren't even in the building while they're being used," he said.
He doesn't think that laser-related injuries are a major problem locally, but he does see many people who are disappointed with their results.
DR. STEVEN TIERNAN, a board certified emergency medicine physician, opened a Jon Ric Medical Spa and Salon franchise on Furys Ferry Road six years ago. He offers laser hair removal and laser liposuction, called smart lipo, where he contours a figure if the person is within 25 pounds of ideal body weight. He also uses lasers for skin tightening, resurfacing and spider veins and to remove blemishes and tattoos.
Some clients ask that a woman perform the procedure, so he sets the controls and supervises a female technician, he said.
"When they work with me, before they even touch a laser, they've actually sat through about 10 procedures with me. I train them very much like I would train an intern or resident. I don't like the idea of physician-directed places because that physician has no contact. They could be somewhere off in Savannah or Atlanta," Tiernan said.