Laser hair removal has ballooned in popularity since becoming commercially available in the mid-1990s. But this rise in popularity has a downside – a dramatic rise in litigation, particularly against non-medically trained practitioners.

Laser hair removal is now one of the most common cosmetic procedures carried out in the US. Researchers from the University of California, Los Angeles, state that in 2011, dermatologic surgeons carried out 1.6 million treatments.

But that is just the tip of the iceberg, as many more treatments were performed by physicians from other disciplines and nonphysician operators (NPOs).

Although currently there are no federal guidelines for laser hair removal or cosmetic laser procedures, more and more states are drafting laws to regulate this practice. A new study, published in JAMA Dermatology this month, warns practitioners to be aware of the state laws.

In the study, Dr. H. Ray Jalian and his team point out the inherent dangers of the ambiguity with the state laws, saying:

“For example, in Maine only a physician may operate a laser for hair removal. At the other end of the spectrum, Nevada as of June 2011 had no regulations regarding the use of a laser.”

Laser skin surgery is becoming more and more widespread and it is increasingly popular in so-called medical spas – non-medical facilities offering aesthetic procedures. Although many of these will be supervised by physicians, most of the treatments will be carried out by NPOs with varying levels of certification, depending on the state’s regulations.

As with any cosmetic surgery, a healthy dose of common sense is needed when choosing either a physician or technician to perform the procedure. The American Society for Dermatological Surgery warns that “many clinics promise results that are just not realistic.”

Dr. Jalian also says:

When a physician delegates duties to a physician extender (PE), responsibility and liability remain squarely on the supervising physician, provided that the services rendered fall within the scope of duty of that PE. This holds true for physician supervision of NPOs in the setting of cutaneous laser surgery.”

With this in mind, the researchers set out to establish how many medical professional liability claims stem from skin laser surgery performed by NPOs. Focusing on the period from January 1999 to December 2012, they studied data collected from an online national database of public legal documents.

The researchers identified 175 cases of injuries following skin laser surgery, with NPOs involved in almost 43% (75 cases). Laser hair removal was the most common procedure, with NPOs carrying out one-third of the treatments.

Significantly, the number of lawsuits involving NPOs accounted for 75% of the total from 2004 to 2008, rising to 85% between 2008 and 2012.

The study concludes:

“A dramatic increase in litigation has been filed against NPOs performing cutaneous [involving skin] laser procedures in medical and non-medical office settings. This has important implications for the safety of patients undergoing these procedures.”

The researchers say that further studies are now needed to examine the trend of greater lawsuits in laser surgery.