Perform photo rejuvenation of the skin using intense pulsed light or laser systems

This standard is about using intense pulsed light (IPL) and laser systems for photo rejuvenation of the skin. It stresses the importance of safe working practice and places emphasis on identifying and controlling hazards in the workplace. You will carry out a thorough consultation with the client to identify skin conditions, formulate an individual treatment plan, provide treatment and aftercare advice.

To carry out this standard you will need to maintain effective health, safety and hygiene throughout your work. You will also need to maintain your personal appearance and demonstrate effective communication and consultation skills.

The main outcomes of this standard are:

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1. maintain safe and effective methods of working when performing photo rejuvenation using intense pulsed light or laser systems

2. consult, plan and prepare for treatments

3. perform intense pulsed light or laser photo rejuvenation treatments

**Maintain safe and effective methods of working when performing photo rejuvenation using intense pulsed light or laser systems

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1.  maintain your responsibilities for health and safety throughout the treatment

2.  prepare and protect your client and yourself with personal protective equipment within the controlled area

3.  maintain your client's modesty and privacy at all times

4.  position your client to meet the needs of the service without causing them discomfort

5.  ensure your own posture and working methods minimise fatigue and the risk of injury to yourself and others

6.  ensure environmental conditions are suitable for the client and the treatment

7.  use working methods that minimise the risk of cross-infection

8.  ensure the use of clean equipment and materials

9.  promote environmental and sustainable working practices

10. follow workplace and suppliers' or manufacturers' instructions for the safe use of equipment, materials and products

11. dispose of waste materials to meet legal requirements

12. complete the service within a commercially viable time

Consult, plan and prepare for treatments

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13. use consultation techniques to determine the client's treatment plan

14. recognise any contra-indications and take the necessary action

15. agree the treatment and outcomes that meet the client's needs

16. obtain signed, informed consent from the client prior to carrying out each treatment

17. identify the client's medical history, skin classification, treatment aims, area to be treated, skin condition and sensitivity

18. take pre-treatment photographic evidence of the area to be treated following organisational practices

19. explain the physical sensation created by the treatment to the client

20. set up the controlled area to meet legal and organisational requirements

21. prepare the area to be treated and carry out a test patch to establish response and suitability for treatment

22. ensure the client signs for receipt of written aftercare procedures, following the test patch

23. identify and agree achievable outcomes of the treatment for the client's skin classification and skin condition

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Perform intense pulsed light or laser photo rejuvenation treatments

24. illuminate the area to be treated to ensure maximum visibility

25. ensure the area to be treated is clean, oil free and dry prior to treatment

26. mark out the area to be treated to ensure treatment precision

27. carry out cooling methods according to treatment aims

28. enable and set the equipment specifications and variables to meet the agreed treatment plan

29. ensure the hand-piece is used at the correct angle and pressure

30. manipulate the skin to gain access, depending on the area to be treated

31. work systematically to cover the area to be treated

32. check your client's wellbeing and monitor the level of skin reaction throughout the treatment

33. conclude treatment by returning the equipment into stand-by mode 

34. apply a cooling and soothing product to the treated area

35. take clear post-treatment photographs of the treated areas

36. give your client advice and recommendations on the treatment provided

37. ensure the client's records are completed and signed by you and the client

Maintain safe and effective methods of working when performing photo rejuvenation using intense pulsed light or laser systems

1.  your responsibilities for health and safety as defined by any specific legislation covering your job role

2.  the importance and reasons for adhering to organisational and treatment protocols

3.  the responsibilities under local authority licensing regulations for yourself and your premises and the importance of following local rules where applicable

4.  your responsibilities for following organisational procedures for the delivery of laser treatments 

5.  your legal responsibilities for checking current insurance guidelines for the delivery of laser and intense pulsed light (IPL) treatments

6.  the importance of undertaking Core of Knowledge to meet with insurance guidelines

7.  the causes and hazards of accidental exposure to optical radiation and the importance of wearing personal protective equipment and the principles of Maximum Permissible Exposure

8.  why it is important to maintain the client's modesty and privacy

9.  how the position of your client and yourself and your working methods can affect the desired outcome and reduce fatigue and the risk of injury

10. the necessary environmental conditions for services such as heating and ventilation and why these are important

11. methods of cleaning, disinfection and sterilisation

12. why it is important to avoid direct and indirect cross-infection by working safely and hygienically

13. the hazards and risks which exist in your workplace and the safe working practices which you must follow

14. the different types of working methods that promote environmental and sustainable working practices

15. suppliers' and manufacturers' instructions for the safe use of equipment, materials and products which you must follow

16. the causes and hazards of accidental exposure to clinical waste such as razor blades

17. the legal requirements for waste disposal

18. the reasons for completing a service in a commercially viable time

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Consult, plan and prepare for treatments

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19. the importance of communicating with clients in a professional manner

20. how to complete a consultation taking into account client's diverse needs

21. the reasons why intense pulsed light and laser treatments must not be carried out on minors under 18 years of age

22. the importance of agreeing the service that meets the client's needs

23. the legal significance of gaining signed, informed client consent to receive the service

24. the legislative requirements for storing and protecting client data

25. the contra-indications that would prevent or restrict the service and why

26. the necessary action to take in relation to specific contra-indications when referring clients

27. the importance of and reasons for not naming specific contra-indications when referring clients

28. how to match treatment specifications and variables to suit skin classifications and treatment aims

29. the legal significance of producing clear high-quality photographic evidence before and after treatment

30. how to describe the physical sensation of the treatment to the client

31. how pain threshold and sensitivity varies from client to client

32. why is it important to carry out test patches and how to carry them out to determine the client's suitability for treatment

33. the reasons for providing written aftercare instructions immediately after test patch

34. other skin care treatments which may inhibit IPL and laser treatments such as self-tanning and micropigmentation

35. the treatments that could be given in conjunction with or after photo rejuvenation of the skin

36. how to prepare consultation records

Perform intense pulsed light or laser photo rejuvenation treatments

37. the importance of good lighting in the controlled area and illuminating the area to be treated

38. the preparation of the area to be treated and why this can vary in accordance with manufacturer's instructions

39. the correct marking out tool and techniques to be used

40. the different types of cooling methods used and when and how to use them

41. how to match treatment specifications and variables to suit skin classifications and treatment aims

42. the specifications and variables and terminology of IPL and lasers in relation to treatment practice

43. the different treatment effects of photo rejuvenation of the skin

44. why and how to manipulate the skin during treatment

45. why it is important to follow manufacturer's instructions to position the hand piece at the correct angle and pressure

46. the different types of IPL and laser equipment and their advantages and disadvantages

47. how to interpret the warning labelling on IPL and laser equipment

48. the characteristics of light and how it interacts with skin and hair

49. how to work systematically, avoiding excessive treatment overlap across the areas to be treated

50. monitoring procedures for checking the client and the treatment area

51. the different types of superficial telangiectasia that can be treated including: Spider Naevi and Campbell De Morgan spots

52. possible contra-actions which may occur and how to deal with them

53. the principles of the electro-magnetic spectrum

54. the potential hazards of using IPL and laser equipment

55. the anatomy and physiology of the skin

56. the advice and recommendations on products and services

**Controlled area

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1. enclosed area

2. lockable entry and exit points

3. signage

4. minimum reflective surfaces

5. suitable window coverage

6. adequate fire precautions and suitable service

7. adequate ventilation

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**Equipment

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1. laser

2. intense pulsed light (IPL)

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**Consultation techniques

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1. questioning

2. listening

3. visual

4. physical examination

5. written

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**Treatment aims

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1. reduction of fine lines

2. evening out of pigmentation

3. reduction of superficial telangiectasia

4. improving the appearance of photo aged skin

5. improving the appearance of blemished skin

Area to be treated

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1. face

2. neck

3. chest

4. hands

5. other body areas that include suitable lesions for treatment

**Specifications and variables

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1. wavelength(s)

2. fluence

3. pulse duration or width

4. pulse delay

5. pulse repetition rate

6. spot size

7. cooling devices

8. hand piece

Advice and recommendations

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1. suitable aftercare products and their uses

2. avoidance of activities which may cause contra-actions

3. time intervals between treatments

4. present and future products and treatments

**Health and safety

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1. Health and Safety at Work Act

2. The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR)

3. The Health and Safety (First Aid) Regulations

4. The Regulatory Reform (Fire Safety) Order

5. The Manual Handling Operations Regulations

6. The Control of Substances Hazardous to Health Regulations (COSHH)

7. The Electricity at Work Regulations

8. The Environmental Protection Act

9. The Management of Health and Safety at Work Regulations

10. The Health and Safety (Information for Employees) Regulations

**Organisational and treatment protocols

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1. clinic management

2. client consultation

3. record keeping

4. waste management

5. IPL and laser safety and security

6. aftercare procedures

Environmental and sustainable working practices

1. reducing waste and managing waste (recycle, reuse, safe disposal)

2. reducing energy usage (energy efficient equipment, low energy lighting, utilising solar panels)

3. reducing water usage and other resources

4. preventing pollution

5. using disposable items

6. using recycled, eco-friendly furniture

7. using low chemical paint

8. using environmentally friendly product packaging

9. choosing responsible domestic products (Fairtrade tea and coffee)

10. encouraging carbon reducing journeys to work

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Diverse needs

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1. cultural

2. religious

3. age

4. disability

5. gender

Contra-indications which prevent

1. suntanned and fake tanned skin

2 pregnancy

3. some herbal remedies

4. some photo-sensitive medication in conjunction with the British Medical Laser Association guidelines

5. inappropriate skin type and colour

6. keloid scarring

7. skin cancer

8. lupus

9. melasma

10. uncontrolled diabetes

Contra-indications which restrict

1. micropigmentation

2. diabetes – vascular treatment for lower leg

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Consultation records

1. client history

2. previous skin treatments

3. medical history

4. emotional and physical condition

5. treatment restrictions and limitations

6. sun tanning history

7. skin classification

8. skin condition

9. client signature

10. practitioner's signature

Contra-actions

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1. skin greying or whitening

2. erythema

3. blistering

4. pigmentary changes

5. excessive discomfort

6. oedema

7. scarring

8. changes in colour to vascular lesions

Anatomy and physiology

1. the structure and function of the skin

2. the principles of the circulatory system and lymphatic system

3. the ageing process of skin including the effects of lifestyle and environment

4. skin diseases and disorders

Advice and recommendations

1. additional services

2. additional products

3. the lifestyle factors and changes that may be required to improve the effectiveness of the treatment

4. the future treatment needs and on-going maintenance to retain optimum results

5. visual skin changes and recovery time

6. the use of recommended skin care products during the healing process such as high factor sun protection

7. post-treatment contra-actions and reactions and how to deal with them

8. post-treatment assessment through client feedback such as questionnaire, telephone call, next visit follow up

9. post-treatment effects and the importance of clients avoiding sun exposure, heat treatments and vigorous physical activity

The following key values underpin the delivery of services in the beauty, nails and spa sectors

1. a willingness to learn

2. a flexible working attitude

3. a team worker

4. a positive attitude

5. personal and professional ethics

The following behaviours underpin the delivery of services in the beauty, nails and spa sectors. These behaviours ensure that clients receive a positive impression of both the organisation and the individual

1. meeting the organisation's standards of behaviour

2. greeting the client respectfully and in a friendly manner

3. communicating with the client in a way that makes them feel valued and respected

4. treating the client courteously and helpfully at all times

5. adapting behaviour to respond effectively to different client behaviour

6. checking with the client that you have fully understood their expectations

7. responding promptly and positively to the client's questions and comments 

8. recognising information that the client might find complicated and checking whether they fully understood

9. explaining clearly to the client any reasons why their needs or expectations cannot be met

10. maintaining effective, hygienic and safe working methods

11. adhering to workplace, suppliers' and manufacturers' instructions for the safe use of equipment, materials and products  

12. meeting both organisational and industry standards of appearance.

The following key skills underpin the delivery of services in the beauty, nails and spa sectors

1. the ability to self-manage

2. excellent verbal and non-verbal communication

3. using the most appropriate ways of communicating with a client

4. responding promptly to a client seeking assistance

5. quickly locating information that will help the client

6. providing the client with information they need about services and products offered by the organisation

Core of knowledge

This course, approved by the British Medical Laser Association - BMLA, is intended for operators and other staff in Clinics using Lasers and Intense Pulsed Light systems for hair removal, skin toning, dentistry, tattoo removal and other similar procedures. It is designed both to provide a grounding in the basics of the safe use of lasers and IPL systems, and to satisfy the training requirements contained in the MHRA Device Bulletin DB2008(03) "Guidance on the safe use of lasers, intense light source systems and LEDs in medical, surgical, dental and aesthetic practice".

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Energy

Energy is measured in Joules (J) and is the product of laser power (watts) and time (seconds).

Ethnic colour scale

The ethnic colour scale is a measure of the degree of natural pigment in the skin of clients of ethnic origin.

Fitzpatrick classification scale

Devised in 1975 at Harvard University, this is a skin classification on a scale of 1 to 6 based on photosensitivity reaction to ultra violet radiation.

Fluence

Fluence is the treatment variable set by the laser practitioner according to patient evaluation and skin type and determines the effectiveness of the treatment.

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Maximum permissible exposure (MPE)

This is the highest power of light source that is considered safe, in other words that has a negligible probability for creating damage.

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Power

Rate at which we deliver the energy, measured in watts (w).

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Skin classification

See Fitzpatrick classification scale.

Test Patch

Tests to determine the degree of skin reaction and sensitivity. Test patches can be used to test the degree of heat sensitivity and pain response plus skin reaction. Test patch can incorporate patch test, thermal test or tactile test.