We can provide cover for laser treatment within your medical malpractice insurance policy.
If you are looking for insurance to cover laser treatment, please contact the team on 0800 634 3881 or email cosmeticsales@hamiltonfraser.co.uk.
Hamilton Fraser covers doctors, nurses, dentists, dental therapists, dental hygienists, beauticians (NVQ Level 3 General Beauty or equivalent qualification), podiatrists, pharmacists, paramedics, operating department practitioners, dental nurses and physiotherapists.
Practitioners must undertake both theoretical and face-to face practical training and they must be presented with a certificate of completion.
Laser is a popular treatment option that many aesthetic and laser clinics offer. ‘Laser’ stands for light amplification by stimulated emission of radiation. Laser therapies use focused light, which is tuned to specific wavelengths, allowing it to be focused into powerful beams. Lasers allow aesthetic practitioners to practise at high levels of precision by focusing on a small area, damaging less of the surrounding tissue.
The two main laser skin treatments that aesthetic practitioners use are:
● Ablative lasers – these lasers make microscopic holes in the dermis (outer layer of the skin), so they can target damaged cells deep in the dermal layer. This is often known as laser resurfacing, although there are many different levels of skin resurfacing. An ablative treatment, for example with a CO2 laser, will involve a longer healing period but will produce superior and longer lasting results. This treatment is used for deep acne scars and stretch mark removal, and can also be very effective in improving sagging skin on the face and neck
● Non-ablative lasers – non-ablative lasers work by producing heat in the skin without injuring the surface. Non-ablative lasers are unable to penetrate as deeply as ablative lasers, but are still an effective treatment for skin concerns such as rosacea, broken or burst blood vessels and fine wrinkles on the face, neck and hands
One treatment that often gets mistaken for laser therapy is Intense Pulsed Light (IPL) treatment. Although similar, laser focuses just one wavelength of light on the patient’s skin, while IPL releases light of many different wavelengths, like a photo flash. The light from IPL is more scattered and less focused than a laser.
There are many other laser treatments that can be used for various cosmetic reasons, including laser hair removal, laser liposuction for fat reduction (laser lipolysis), and laser tattoo removal.
The two basic types of lasers (ablative and non-ablative) include many subcategories of laser types and hundreds of variations and brand names. The main difference between lasers is the wavelength – different laser wavelengths target different skin issues.
Ablative laser treatments use an intense wavelength of light to remove the outer layer of skin and heat the underlying skin to stimulate the growth of new collagen fibres. Types of ablative treatments include the CO2 laser, Erbium YAG laser and combination systems. As the skin heals and regrows, the treated area appears noticeably smoother and tighter.
Non-ablative laser treatment is less invasive. It works by delivering a precise wavelength of light below the skin’s surface to induce a controlled injury, which promotes cellular renewal and the production of collagen - a structural protein that is responsible for skin elasticity, integrity and density. The surface of the skin remains undamaged. This type of treatment is best for improving skin texture and tone, fine lines, mild wrinkles and pigmentation issues.
While ablative laser therapy works mainly on the epidermis (surface skin cells) and non-ablative treatments work solely on dermal collagen (mid-layer of the skin) only, fractional CO2 laser treatment works at both the epidermal and dermal layers of the skin.
There are many different cosmetic uses for laser treatment, including:
● Fine lines and wrinkles
● Skin tone and texture
● Skin tightening
● Laser treatment for pigmentation
● Sun damage
● Acne and acne scars
● Precancerous and vascular lesions
● Tattoo removal
● Hair removal
● Fat removal
An ablative treatment such as with a CO2 laser will involve a longer healing period but will produce superior and longer lasting results, usually between three to five years, depending on how well the patient looks after their skin. As non-ablative laser treatment does not resurface the skin as invasively as ablative lasers, multiple treatment sessions will be necessary to achieve modest clinical results.
As there are numerous types of laser cosmetic treatments for different patient indications, a lot of patients can benefit. Non-ablative laser treatment is suitable for patients who:
● Are relatively young (between 20 and 65 years of age)
● Have mild to moderate signs of ageing, with minimal skin sagging
● Are willing to undergo multiple treatments before seeing results
● Cannot afford to take time off from work
Ablative laser resurfacing, on the other hand, is the best choice for patients who:
● Show signs of significant facial ageing
● Have deep facial scars
● Want to see significant results over a longer period of time
● Can take time off work to recover
Laser resurfacing treatment will start by numbing the patient’s skin with medication. During ablative laser resurfacing, an intense beam of light energy (laser) is directed at the patient’s skin. The laser destroys the outer layer of skin while, at the same time, heating the underlying skin, which stimulates collagen production over time, resulting in better skin tone and texture. Ablative laser resurfacing typically takes between 30 minutes and two hours, depending on the technique used and the size of the area treated. This approach usually needs only one treatment.
For non-ablative laser treatment or fractional laser resurfacing, the patient will likely need one to three treatments scheduled over weeks or months to get the results they are looking for.
Laser resurfacing may cause side effects, which patients should be advised on prior to treatment. Side effects are milder and less likely with non-ablative approaches than with ablative laser resurfacing. Side effects may include:
● Redness, swelling, itching and pain – treated skin may swell, itch or have a burning sensation. Redness may be intense and might last for several months
● Acne – applying thick creams and bandages to the face after treatment can worsen acne or cause the patient to temporarily develop tiny white bumps (milia) on treated skin
● Infection – laser resurfacing may lead to a bacterial, viral or fungal infection. The most common infection is a flare-up of the herpes virus — the virus that causes cold sores. In most cases, the herpes virus is already present but dormant in the skin
● Changes in skin colour – laser resurfacing can cause the skin to become darker than it was before treatment (hyperpigmentation) or lighter (hypopigmentation). Permanent changes in skin colour are more common in people with dark brown or black skin
● Scarring – ablative laser resurfacing poses a slight risk of scarring
After ablative laser resurfacing, the treated skin will be raw, swollen and itchy, which is perfectly normal. A thick ointment should be applied to the treated skin and an airtight and watertight dressing may be used. It is advised for patients to take a pain reliever and use ice packs. New skin usually covers the area in one or two weeks and full recovery takes at least a month. During this time patients should not use products that may irritate their face, such as cosmetics, and they should wear sun protection following treatment.
After non-ablative laser resurfacing, recovery time is minimal. The patient’s skin might be swollen or inflamed for a few hours. Ice packs can be used as needed. Typically, patients can resume their usual activities and skin routine immediately.
There are numerous training courses available depending on the type of laser treatment. Practitioners should have a Level four qualification in laser and light treatments, with levels five to seven also recommended for more intense treatments.
For laser hair removal training, practitioners should have a fully accredited Level 4 Laser and IPL Certificate.
Practitioners need to be fully qualified in the treatment they are performing. Practitioners must also adhere to manufacturer guidelines at all times, as failure to do this will invalidate the policy.
Laser claims are amongst the most common that we see at Hamilton Fraser, so it is very important that practitioners are aware of and comply with the policy conditions, as we are unlikely to make payment if an incident occurs while policy holders aren’t in compliance.
For any laser or IPL treatment, policy holders must make sure that prior to treatment, a skin patch test was performed in accordance with the manufacturer’s guidelines, or related industry associated guidelines, without any adverse reaction in the following scenarios:
● On any new clients to be treated
● On any existing clients, where the treatment is to be administered to a previously untreated area of the body
● On any existing clients, where a period of six months has passed since their last treatment of that kind
● Where a new laser or IPL machine or a replacement laser or IPL head is to be used, since the client’s last treatment
● Where the laser or IPL machine has undergone maintenance, repair or a part has been replaced since the client’s previous treatment
● It’s important that practitioners keep up with regular servicing and maintenance of their medical aesthetic equipment and devices such as a laser or IPL, to protect their investment but also to avoid the risk of invalidating their insurance policy or worse, causing injury to a patient. Find out more in our article, How to get the most out of your medical aesthetic equipment , which includes input from experts in the laser industry.
● In addition, the policy wording states the following:
● Subject to the relevant training, policy holders can perform laser hair removal on the genital area
● Subject to parental / guardian written consent and that it is within the manufacturer guidelines, policy holders can perform laser or IPL hair removal on patients aged 11-17
● Hamilton Fraser does offer insurance to cover electronic business equipment, such as laser machines, against damage or theft for example.
With any laser treatment, there will always be potential side effects All known side effects must be explained to the patient in the consultation and a consent form with the risks laid out must be signed by the patient prior to the procedure.
An example of the type of claim that we receive, is that the patient followed the before care to the letter, doing exactly what they have been told to do. A patch test was carried out as per the policy conditions, prior to the procedure, and there was no adverse reaction. However, on treatment day, the patient complained that their legs were burning practitioner and it turned out that the practitioner had used the wrong setting. Although the treatment was stopped immediately, the patient’s skin was extremely red and had started to blister.
In this situation, liability falls with the practitioner as the recommended settings were changed. The solicitor would appoint a specialist to assess the burn and the extent of the scarring. A suitable offer would then be made to the patient (or their solicitor if they appointed one). There may be some negotiations on settlement amounts, but once the offer is accepted, the insurance company would pay the costs for the amount awarded, the patient’s solicitor costs and the defence costs for their own solicitor. The client would only be responsible for their excess amount and any VAT element on the defence costs, if they are VAT registered.
Another example, is a scenario where a patient has had a patch test with no adverse reactions. They’ve then been in for treatment, and all has gone well. The recommended settings were used and there were no issues on the day. However, the client then receives a solicitor’s letter a month after treatment alleging that the patient suffered burns to the legs following treatment. We gather all the relevant information and the insurer’s panel solicitors start to investigate. They request a copy of the patient’s GP medical records and hospital records (as the patient had a trip to A&E with the burn), and it transpires that the patient went on holiday to a hot country just after the treatment. They did not follow the aftercare advice and sunbathed a few days after the procedure.
In this situation, liability will be denied as there was no negligence on the practitioner’s behalf. Once a claim has had liability denied, the solicitor would normally keep it open for a 12 month period following last contact to give the patient’s solicitor time to challenge the denial, but this would be subject to extensive medical evidence, proving that our practitioner has been negligent. This situation would incur defence costs only, so the client would be responsible for the excess amount as usual or the defence costs if they fall within the client’s excess amount.
For more information on these claims case studies, read our article on the lifecycle of a laser hair removal claim.
Claims top tip: If the patient has had previous laser treatments with you, please make sure that the last session was within six months. If more than six months has passed, in line with the policy conditions, you will need to do another patch test. You will also need to patch test all new areas being lasered. You will also need to do another patch test if any maintenance or repairs have been carried out to the laser machine since the last session.
The policy has a laser endorsement, so policyholders need to be aware of the endorsement to make sure that they adhere to the policy conditions.
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