The Department of Health is currenty undertaking a major review of cosmetic procedures, including laser treatments. In particular, they are considering:

• The regulation and safety of products used in cosmetic interventions
• How best to ensure that the people who carry out procedures have the necessary skills and qualifications
• How to ensure that organisations have the systems in place to look after their patients both during their treatment and afterwards
• How to ensure that people considering cosmetic surgery and procedures are given the information, advice and time for reflection to make an informed choice
• What improvements are needed in dealing with complaints so they are listened to and acted upon

BMLA’s response

Light based devices (e.g. laser and IPL) are capable of meeting the needs of the majority of transpeople.

Clinical experience suggests that fewer adverse events occur with longer wavelength infra-red lasers such as the diode and Nd:YAG in darker skin types.

People with light hair, such as blonde or grey hair, are not suited to any type of light based treatment, as the hair is not able to absorb adequate light energy. Dying the hair does not improve treatment efficacy in these cases.

For individuals with no underlying hormonal drivers of increased hair growth one would expect around 6-8 treatments to be adequate in any one area. The interval between treatments typically ranges between 4 weeks and 10 weeks. Thus, a 6 month treatment programme may be commmon, but a course lasting more than 1 year would not be unusual. Clinics should be able to offer treatments at appropriate intervals to meet patient needs.

For those individuals with hormonal imbalances contributing to hair growth such as certain medications, and for example Polycystic Ovarian Syndrome PCOS, results may be more short lived with recurrence of hair growth after a variable period of time.

A course of 6 treatments for facial hair removal would cost about £700. The cost may vary but should be freely available from each provider.

Each provider should have at least the following:

• Clinical experience in treatment of unwanted hair in different skin types at different body areas in both sexes.
• Use of one or more infra-red lasers, in order that transwomen of all skin types may be treated appropriately.
• Continued evidence of suitable training of staff in laser or IPL treatment.
• Treatments should be protocol driven with appropriate consent and patient information.
• Ideally the clinic should have outcome data appropriate for the treatment.

There are no universal standards of regulation currently available in the UK. As a minimum, the BMLA recommends the following:

• The BMLA supports the opinion of the MHRA (DB2008) which recommends that all laser and IPL users must have completed a Core of Knowledge safety course as well as specific training in the use of the laser or IPL device for depilation.
• The individual taking overall responsibility for the patient’s care should be a HCPC registered health care professional and able to demonstrate competence in the treatment provided.
• The provider should have access to a registered and suitably qualified clinician (e.g. dermatologist, plastic surgeon).
• The provider should have access to an appropriately qualified Laser Protection Advisor.
• The provider should operate within a system of clinical governance with a robust clinical incidence reporting system and complaints procedure.