Strict rules needed in Canada to curb laser hair removal injuries, dermatologist says

A dermatologist who treats at least two clients a week with injuries from laser hair removal says it's "frustrating" to see clients suffering due to a lack of regulation in the Canadian beauty industry.

Toronto dermatologist Dr. Lisa Kellett says she sees "tons" of patients — about 200 a year — with the type of burns and scars recently experienced by a British Columbia woman who underwent laser hair removal. 

This week, B.C. Health Minister Adrian Dix said the government is in no hurry to regulate laser hair removal.

But Kellett, a member of the Canadian Dermatology Association, says laser treatments are dangerous when performed by anyone who lacks the proper training and experience, and she believes the government needs to take this more seriously.

"I'm hoping that the government will step in and say, 'This can no longer happen,'" said Kellett, whose practice offers laser hair removal.

"They have an opportunity to prevent people from getting hurt, and they should take advantage of that and do something about it."

Furthermore, the risk of permanent injury means anyone considering laser hair removal should only have it done by a trained physician, dermatologist or plastic surgeon who can do a proper assessment and discuss the risks and side effects, she said. 

'We saw a phenomenal increase in the risks'

Until 2003, anyone practising beauty services like hair styling, esthetics or nail art in B.C. had to pass an exam to be certified under the Cosmetologists Act, ensuring service providers had a minimum level of training.

That act was repealed in 2003, leaving the industry unregulated.

Last week, Dix said there were "clearly concerns" about the industry, but the B.C. government was not considering new regulations.

"It would obviously be a significant thing to choose to re-regulate the industry now," the health minister said.

"It's something that we can look at in the future, but not something that we have [before us] right now."

Across Canada, procedures like laser hair removal are largely unregulated, and can be performed by almost anyone with as little as one hour of training, Kellett said.

Laser hair removal has existed for 20 years, but has exploded in popularity over the last decade, she said. Initially, it was primarily done in physician offices by dermatologists and plastic surgeons, Kellett added. 

The technology has improved over the years with better systems to cool the surface of the skin during the procedure, but there is still no minimum standard of training required to use the laser on clients.

"Health Canada has allowed these devices to be basically anywhere," Kellett said.

"They could be in someone's basement, they could be in a hair salon, they could be in a spa, so once that happened, and we saw a phenomenal increase in the risks and also the burns, pigment change, scarring, infections."

The problems due to a lack of mandatory training will continue until governments impose more regulation, according to industry professionals in B.C.

Dariush Honardoust, an instructor with the BC Academy of Medical Aesthetics & Skin Care, ​​​​​has been calling on the government for years to set and maintain minimum standards. The academy offers multi-day training courses in laser hair removal.

"This is how it's supposed to be [for] any other areas of practice," said Honardoust, citing regulations for chiropractors, acupuncturists and dental hygienists.

"I don't see that laser technicians and medical estheticians are exceptions because they are dealing with tissue, sometimes biological fluids of the patients and skin … and that's something that needs to be regulated."

9 claims of injury reported to Health Canada since 2015

Health Canada has received nine claims of injury related to laser hair removal between 2015 and 2019. Of those, six claims involved burns, two involved burns and blisters and one involved scarring.

However, it is often not possible to determine whether an adverse reaction is a result of "using a specific health product," a Health Canada spokesperson said in an email.

The prevalence of injuries caused by laser hair removal in B.C. is difficult to determine.

Vancouver Coastal Health and Consumer Protection BC say they do not have data on injuries such as burns that are specifically related to laser hair removal. 

Because the industry in unregulated, the College of Physicians and Surgeons of British Columbia also does not have data on the prevalence of injuries suffered.

If Kellett's practice is any indication, injuries from laser hair removal are "very, very" underreported, she said. 

The government needs to intervene in the unregulated industry before it becomes more of a public health risk, she said.

The first step should be to make it mandatory that lasers be used only in a medical centre under the direct supervision of a physician, Kellett said. 

"We need to protect the patient," she said. "We are trying very, very hard to try to get this better regulated."

"I don't know what it's going to take."