Are you considering adding laser tattoo removal to your scope of services? Before you take the plunge, there are a few factors to be considered. This article aims to clarify some of the questions aesthetic professionals often ask the Australasian Academy of Cosmetic Dermal Science (AACDS) about practicing laser tattoo removal.
In which states of Australia can I legally perform laser tattoo removal?
You can perform laser tattoo removal using a class 4, Q-switched laser without any qualification (go figure) in the states of NSW, NT, VIC, SA and ACT. However, not holding a valid qualification may impact on your ability to secure adequate medical malpractice insurance.
The situation is different however in the states of WA, QLD and TAS. The Radiological Council of WA regulates class 3B and 4 lasers categorising license exemptions into Superficial Cosmetic (vascular and pigment), Hair Reduction and Laser Tattoo Removal. The criteria to apply for a WA laser licence exemption in laser tattoo removal includes the following:
- Recognised laser safety course (laser safety officer’s certificate);
- Laser tattoo removal course;
- Five (5) years-experience as a Div. 1 Registered Nurse;
- Current AHPRA registration as a Div. 1 Registered Nurse.
QLD Radiation Health regulates class 3B and 4 lasers in QLD. They too have a similar licensing criterion to WA with categories for Hair Removal, Skin Rejuvenation (vascular and pigment) and Tattoo Removal. The licencing criteria for laser tattoo removal involves the following:
- Recognised laser safety course (laser safety officer’s certificate);
- Nationally recognised unit in infection control;
- Trainee licence;
- 100 hours of direct supervision by a supervisor holding a QLD laser licence in laser tattoo removal.
The Department of Health (Tasmanian Government) regulates class 3B and 4 lasers and lntense Pulsed Light devices in Tasmania. They do not have licence categories but do require the licence applicant to hold the following:
- Recognised laser safety course (laser safety officer’s certificate;
- Evidence of training in the laser or IPL device proposed for licensing;
- Supervised hours (number not stipulated) evidenced by a letter of recommendation by the supervisor (i.e. a laser licenced operator).
The vast majority of practitioners operating a laser tattoo removal device in other non-regulated states recognise the associated risks and therefore hold (at least), a foundation qualification in either health or beauty.
Investing in a laser tattoo removal device will take time and research and whatever you do, don’t go for the cheapest device available! Your choice should be limited only to well-known Australian suppliers as this should guarantee the device will be TGA approved.
Top of the range laser tattoo removal devices are those in the picosecond pulse width range. Picosecond technology enables a high amount of energy to be released in a very small timeframe. This shatters tattoo ink more effectively, into tiny particles and allows for treatment of a wider range of ink colours (Choi, 2018). Picosecond lasers are also reported to minimise the collateral damage to surrounding tissues (Choi, 2018).
Your investment in a new picosecond laser is around $180k to $285K+. Some examples of picosecond lasers available in Australia include;
- PicoSure® by Cynosure
- PicoWay® by Syneron Candela
- FractTatt® by Fotona
- PicoCare® by Cryomed
- Enlighten by Cutura
If a picosecond laser is out of your budget, a Q-switched laser device is still an excellent option. Q-switched (quality-switched) means that the pulse width is within the nanosecond range. This still provides good clearance of tattoo ink and most models come with multiple handpiece options to address all ink colours.
Your investment in a new Q-Switched laser is around $90k to $180K. Some examples of Q-switched lasers available in Australia include;
- Pastelle® by Cryomed
- Revlite® SI by Cynosure
- Q Plus Evi Series by Aussie Medi Tech
- Alma Q by Alma Lasers
Both picosecond and Q-switched laser technology can be used beyond the scope of tattoo removal. Treatments such as superficial benign pigmentation, pigment toning (sometimes referred to as a “laser toning” or “Carbon Peel”), hair bleaching, collagenesis (sometimes referred to as “laser genesis”) and scar reduction are additional services you can offer.
Your final choice should be dependent on the extent you intend to grow your laser tattoo removal services. If your intention is to grow laser tattoo removal as your primary service, it’s recommended you invest in picosecond technology.
Consultation and patient assessment form the basis to successful laser tattoo removal procedures. The patient's treatment objectives and expectations need to be counselled and treatment options, expected outcomes, potential risks, downtime and post-treatment care must be emphasised. In addition to establishing a realistic number of treatment sessions, it is important that practitioners inform the patient about the potential side effects, treatment discomfort, costs, clearance effectiveness and associated complications/reactions and how to manage them.
Training: Which laser tattoo removal course?
Both government radiological authorities (WA and QLD) recognise that laser tattoo removal procedures carry additional risk to patient and operator hence the more stringent licensing criteria. Laser tattoo removal operators need to have knowledge and skills in the following areas:
- Laser and light physics
- Tissue and light interaction
- Parameter selection
- Types of tattoos (ink and application)
- Infection control
- Wound care post procedures
- Laser safety
It is your duty of care to your patients to ensure you have adequate training to meet state laser regulations (if applicable) and to secure medical malpractice insurance to perform laser tattoo removal.
The laser supplier will offer training on the laser device you’ve purchased. This is a crucial part of your training but should not be the only training you receive. You firstly need the underpinning theoretical knowledge before switching on the laser. This will make your initial hands-on training safe and effective. For candidates who don’t have any Q-switched laser experience and/or need supervised hours to meet state laser licensing requirements, it’s recommended you complete a course with both a theory and hands-on component. Training options include:
(Suitable for WA laser licensing)
(Suitable for QLD laser licensing)
Choi, M. S., Seo, H. S., Kim, J. G., Choe, S. J., Park, B. C., Kim, M. H., & Hong, S. P. (2018). Effects of picosecond laser on the multi-colored tattoo removal using Hartley guinea pig: A preliminary study. PloS one, 13(9), e0203370. https://doi.org/10.1371/journal.pone.0203370
Department of Health Therapeutic Goods Administration. Medical Devices Overview. Retrieved 7th November, 2020 from https://www.tga.gov.au/medical-devices-overview
Queensland Health. Use licence for laser apparatus for cosmetic purposes. Retrieved 6th November, 2020 from https://www.health.qld.gov.au/system-governance/licences/radiation-licensing/specific-licences/health-related/cosmetic-laser
Radiological Council of Western Australia. Fact Sheet for the Cosmetic use of Lasers. Retrieved 6th November, 2020 from http://www.radiologicalcouncil.wa.gov.au/PDF/FAQ/lasers_cosmetic_fact_sheet.pdf
Tasmanian Government Department of Health. Information sheet: Radiation licence information for applicants. Retrieved 6th November, 2020 from https://www.dhhs.tas.gov.au/__data/assets/pdf_file/0008/384596/Radiation_Licence_Information_for_Applicants_3Jan2020.pdf