Name: Cosmetic Applications – Treatments, Risks & Regulation
Uploaded: 2022-07-29T07:19:14.405Z
Description: In partnership with HealthBox. Prof. Ken Karipidis, Assistant Director, Assessment and Advice Section, Radiation Health Service Branch, Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) discusses the use of non-ionising radiation (NIR) for cosmetic applications.

Ken Karipidis_ARPANSA_v3.vtt

Non-ionising radiation cosmetic applications - types of treatments, potential risks and regulation in Australia

{{00:00:10}}
Hello.

{{00:00:10}}
My name is Ken Karipidis and I'm the
assistant director of health impact

{{00:00:15}}
assessment at the Australian radiation
protection, nuclear safety agency.

{{00:00:20}}
My background originally, I'm a
physicist and I've also got a PhD.

{{00:00:24}}
Epidemiology.

{{00:00:26}}
And I'm also an adjunct associate
professor at Swinburn university.

{{00:00:31}}
Today I'm gonna be talking
about non-ionizing radiation,

{{00:00:35}}
cosmetic applications.

{{00:00:36}}
So I'll be talking about the
types of treatments the potential

{{00:00:39}}
risks and regulation in Australia.

{{00:00:43}}
Just a little bit of a warning.

{{00:00:44}}
I will be using graphical images
of injuries in this presentation.

{{00:00:51}}
The other thing I wanted to speak
a little bit about at the start

{{00:00:55}}
is the place that I work for.

{{00:00:58}}
So that's our Panza it's the
Australian radiation protection nuclear

{{00:01:01}}
safety agency with the Australian
government's primary authority on

{{00:01:05}}
radiation protection, nuclear safety.

{{00:01:07}}
Now, what we aim to do is to protect
the Australian people in the environment

{{00:01:11}}
from the harmful effects radiation.

{{00:01:13}}
Now, some of the ways we do this is we
undertake research on the effects of radi.

{{00:01:18}}
We develop radiation protection standards.

{{00:01:21}}
We collaborate with other national
international authorities and

{{00:01:26}}
experts in the field of radiation.

{{00:01:28}}
And we also engage with the
community to provide information

{{00:01:30}}
and radiation and health.

{{00:01:34}}
So the, the word radiation is
often actually misunderstood.

{{00:01:38}}
So what I do when I don't understand
something, I usually go to doctor Google.

{{00:01:42}}
And if you go to Dr.

{{00:01:43}}
Google the first thing that will come up
for radiation is the Wikipedia definition.

{{00:01:47}}
So radiation describes any process in
which energy emitted by one body travels

{{00:01:53}}
through a medium or through space,
ultimately to be absorbed by another body.

{{00:01:57}}
So what that basically means
is all radiation is, is energy

{{00:02:00}}
going from one place to another.

{{00:02:03}}
And radiation is not one thing
that are different types of radi.

{{00:02:08}}
And some of the things
that I've listed there.

{{00:02:10}}
So you've got gamma rays x-rays
from radioactive sources.

{{00:02:15}}
You have ultraviolet radiation
coming from the sun lasers, which

{{00:02:19}}
we're gonna talk about today.

{{00:02:20}}
Infrared radiation radio frequency,
electromagnetic fields, which are

{{00:02:25}}
common from things like wifi and
mobile telephones and the like, and

{{00:02:29}}
also low frequency electromagnetic.

{{00:02:31}}
In all these different radiation
types, you can actually split

{{00:02:35}}
them up into two main groups.

{{00:02:37}}
So the first group, which includes
gum, rays and x-rays is called

{{00:02:42}}
ionizing radiation and ionizing.

{{00:02:44}}
Radiation has enough energy to to
break chemical bonds and they can cause

{{00:02:48}}
DNA damage and can cause cancer, for
example, and there's non izing radiation.

{{00:02:54}}
So non izing radiation does not
have enough energy to break and.

{{00:02:58}}
But it, it does have enough energy to
cause vibration or excite molecule.

{{00:03:04}}
So now that we've spoken, we have this
demystified, what radiation actually

{{00:03:09}}
is, what we really wanna talk about
in this presentation is cosmetic

{{00:03:14}}
non izing, radiation treatments, and
cosmetic radiation treatments have

{{00:03:19}}
become very popular in, in recent years.

{{00:03:22}}
And you can see some examples of.

{{00:03:24}}
Treatments in the, in the pictures
in the left, you can see that's

{{00:03:28}}
a laser hair removal treatment.

{{00:03:30}}
In the MI in the middle, that's
a I P skin tightening treatment.

{{00:03:36}}
And on the right hand side, that's
a laser tattoo removal treatment.

{{00:03:40}}
But before I go on, I just wanna
make a distinction between cosmetic

{{00:03:46}}
non-ionizing radiation treatments
and medical non-ionizing radiation.

{{00:03:51}}
Non-ionizing radiation treatments.

{{00:03:54}}
And the distinction is that
cosmetic treatments they're used

{{00:03:58}}
for the elective treatment of
perceived problems in appearance

{{00:04:02}}
for purely aesthetic treatments.

{{00:04:03}}
And that's what makes them
different to medic treatments.

{{00:04:10}}
I do.

{{00:04:10}}
Now I wanna talk about a little bit
about the types of applications and.

{{00:04:15}}
The main ones that have been used for
quite a number of years now actually

{{00:04:18}}
use optical radiation sources.

{{00:04:21}}
So that includes lasers,
intense pulse light through

{{00:04:25}}
IPL and light emitting diodes.

{{00:04:29}}
And more recently we've had
sources that use electromagnetic

{{00:04:32}}
fields or EMF for short, and that
includes live frequency, magnetic

{{00:04:36}}
fields and radio frequency fields.

{{00:04:38}}
But also ultrasound.

{{00:04:40}}
So these, these devices are
quite, are used quite frequently.

{{00:04:44}}
In recent years, we also have combined
devices and by combined devices, what we

{{00:04:50}}
mean is they're combined two different
types of non eyes and radiation.

{{00:04:54}}
So you might have a device that combines
lasers with radio frequency, or you might

{{00:04:59}}
have IPL combined with radio frequency.

{{00:05:03}}
And finally, we'll also
have home use device.

{{00:05:06}}
So these devices that can be
used at home, they're usually

{{00:05:09}}
lower PA they're lower power.

{{00:05:12}}
But they have less robust safety features.

{{00:05:16}}
If we look at the types of treatments,
there's, there's a lot of types of

{{00:05:20}}
treatments and I've listed some examples.

{{00:05:22}}
So hair removal, hair growth tattoo
removal, pigment reduction, skin

{{00:05:27}}
tightening, wrinkle reduction,
fat reduction, ane therapy, star

{{00:05:31}}
reduction, and many, many more.

{{00:05:33}}
Now I'm not gonna get into the
detail, how the different non-ionizing

{{00:05:38}}
radiation treatments actually
make those treatments possible.

{{00:05:41}}
But I will generalize by saying,
remember what I said earlier that

{{00:05:45}}
radi all radiation is, is energy
moving from one point to the next.

{{00:05:49}}
Now the way non nine eyes and radiation
treatments make these treatments

{{00:05:54}}
possible is by the deposition of
energy into specific target tissue.

{{00:05:58}}
Now there's a common public
perception that cosmetic non-ionizing

{{00:06:05}}
radiation treatments are quick,
easy, painless, and low risk,

{{00:06:09}}
and they're often marketing such.

{{00:06:11}}
So here's an example of advertisement
that I found on the internet

{{00:06:15}}
that says laser hair removal,
handset, permanent, and pain free.

{{00:06:20}}
Here's another advertisement
that I found on the internet.

{{00:06:23}}
It says IPL photofacial and quick and
painless way to improve your skin.

{{00:06:28}}
And, and, and that might be true.

{{00:06:29}}
It might be true that there can be
quick and painless and low risk,

{{00:06:34}}
but it's not necessarily true.

{{00:06:37}}
Now, this was a recent case of
a woman that had an IPL hair

{{00:06:41}}
removal treatment in Queensland.

{{00:06:43}}
And, and she received second degree burns.

{{00:06:46}}
So risks are possible with
these, with these treatments.

{{00:06:52}}
So although there might be advertisers
risk three, it is important to note

{{00:06:56}}
three key facts about non izing
radiation, cosmetic treatments.

{{00:07:01}}
And the first one is that they actually
use high energy into targeted tissue

{{00:07:05}}
to ensure the efficacy of treat.

{{00:07:08}}
The second one is this procedures
are complex and they require a

{{00:07:12}}
high level of application skill and
experience and after treatment care.

{{00:07:16}}
And the third one is in Australia,
they may be performed by medical pro

{{00:07:21}}
professionals, as well as non-medical
providers, such as beauty and D therapists

{{00:07:25}}
with various levels of training.

{{00:07:29}}
Now, if we look at the actual potential
adverse effects, the, the first thing

{{00:07:34}}
I wanna say, The research investigating
the risks is actually quite limited.

{{00:07:42}}
Most of the studies that have been
conducted actually investigate

{{00:07:46}}
the efficacy of treatment.

{{00:07:48}}
And adverse effects is like a side
thing rather than the main, but from the

{{00:07:54}}
research that is available, we know that
most adverse effects tend to be transient

{{00:08:00}}
and less serious and they include pain.

{{00:08:03}}
Temporary erythema, which is
basically Reding of the skin

{{00:08:07}}
swelling and changes in pigmentation.

{{00:08:09}}
And you can see in the pictures, there's
some of those less serious effects,

{{00:08:14}}
which go away after a little bit of time
in terms of serious adverse effects.

{{00:08:21}}
They, they don't occur.

{{00:08:22}}
They're less common according to
the research that's available.

{{00:08:25}}
And they occur.

{{00:08:27}}
When devices are misused in
particular and they include burns

{{00:08:33}}
blisters scarring and eye damage.

{{00:08:36}}
And you can see some of the the
pictures that are shown there.

{{00:08:39}}
Some of those series adverse effects.

{{00:08:43}}
Now, even though the research that's
available says adverse effects, Don

{{00:08:49}}
knock over very often, severe injuries
are certainly highlighted in the.

{{00:08:53}}
And these are just some of the
headlines that are found on

{{00:08:57}}
the internet of recent stories.

{{00:08:59}}
So as soon as a serious adverse
effect occurs, it's certainly

{{00:09:03}}
highlighted in the media.

{{00:09:04}}
Now that doesn't necessarily mean that
these effects occur very often but

{{00:09:08}}
the media loves to highlight them.

{{00:09:11}}
So I wanna talk a little bit about the
reasons why these injuries might be occur.

{{00:09:19}}
So the first reason might
be lack of training.

{{00:09:21}}
So it could be unqualified
providers performing the procedure.

{{00:09:25}}
The second one might be inappropriate
use of a device, including

{{00:09:30}}
incorrect energy settings or wrong
device for the actual treatment.

{{00:09:37}}
The third one is safety procedures
not followed, for example,

{{00:09:40}}
not using protective eyewear.

{{00:09:42}}
And you can see in the picture on the.

{{00:09:45}}
The person is conducting a non-ionizing
radiation treatment in the face,

{{00:09:49}}
very close to the eye, and the
client is not wearing protective eye.

{{00:09:55}}
The fourth is poor equipment.

{{00:09:57}}
So that includes cheap imported
devices with poor design or function.

{{00:10:01}}
And the final one is there are other
risk factors which make the client

{{00:10:06}}
more sensitive to these treatments.

{{00:10:09}}
And these are not considered
or not disclosed by the client.

{{00:10:11}}
And I wanna talk a little bit about these.

{{00:10:13}}
I'm not gonna talk about them in
detail, but I do wanna list, I do

{{00:10:16}}
wanna list the possible risk factors
and that includes the client having

{{00:10:22}}
dark skin, high sun exposure using
photo sensitizing, medications or

{{00:10:28}}
supplements damaged or compromised skin.

{{00:10:32}}
There are certain medical conditions
which make this, the skin more sensitive.

{{00:10:36}}
And finding implanted medical devices.

{{00:10:39}}
The last one that's only if you're using
non-ionizing radiation treatments that use

{{00:10:44}}
radio frequency or ultrasound it's very
important that the client, that the client

{{00:10:49}}
doesn't have implanted medical devices.

{{00:10:51}}
So with the two important things to
consider with other risk factors is

{{00:10:56}}
that there should form part of the
provider's risk assessment of the client.

{{00:11:01}}
And it's important for clients
to disclose this inform.

{{00:11:06}}
the other thing I want to talk
about is it is important to consider

{{00:11:10}}
sensitive groups and that includes
children and pregnant women.

{{00:11:16}}
The first thing to say is that
I've said already that research is

{{00:11:20}}
limited on potential health effects.

{{00:11:23}}
It's even more limited when
it comes to sensitive groups.

{{00:11:25}}
So we don't have a lot of inform.

{{00:11:27}}
Whether children are really
more sensitive and pregnant

{{00:11:31}}
women are really more sensitive.

{{00:11:33}}
However, because of the lack of
information, I think it's wise

{{00:11:38}}
to be a little bit proportional.

{{00:11:40}}
So what we advise for pregnant women
is that medical advice should be sought

{{00:11:44}}
by pregnant women before conducting
non-ionizing radi, radiation treatments.

{{00:11:50}}
And for children, we think.

{{00:11:52}}
It's important for parents to consider
treatments under medical supervision.

{{00:11:58}}
Now, so obviously there is the
potential for injury with these devices.

{{00:12:05}}
So what is the regulation in
Australia for for these treatments?

{{00:12:10}}
It is important to mention there
is non national regulation.

{{00:12:13}}
In fact, the agency that I work for.

{{00:12:16}}
Doesn't regulate these devices will
only provide information and advice.

{{00:12:20}}
And in terms of the devices themselves
the therapeutic good goods administration

{{00:12:26}}
generally has no restrictions on
importing non-ionizing radiation, cosmetic

{{00:12:30}}
devices into Australia because they're
not classified as medical devices.

{{00:12:35}}
So they're, they're, Don's
restrict their importation.

{{00:12:39}}
Now we know COVID has actually
taught us that it's the state.

{{00:12:44}}
That have a lot of the powers.

{{00:12:45}}
And that is the case with
cosmetic and IO treatments.

{{00:12:49}}
It is the states that have
the power for regulation.

{{00:12:53}}
And there are three states that
regulate cosmetic and IO devices,

{{00:12:58}}
Western Australia, regulates
lasers, focused treatments.

{{00:13:02}}
So does Quins lane.

{{00:13:05}}
And, and Tasmania regulates both
lasers and IPLS, there are no

{{00:13:10}}
cosmetic non-ionizing regulations
in the Northern territory, south

{{00:13:14}}
Australia, new south Wales or Victoria.

{{00:13:17}}
And there's no regulations for things
like radio frequency, all ultrasound

{{00:13:23}}
in any of the states in Australia.

{{00:13:27}}
So only three of the states, like
I said, have some regulation.

{{00:13:33}}
All the other states don't
have any regulation, but is

{{00:13:36}}
greater regulation warranted.

{{00:13:38}}
There's certainly a push for greater
regulation and certainly there's

{{00:13:42}}
a lot of media stories that push.

{{00:13:44}}
So you can see every time there's
a story that somebody got injured.

{{00:13:48}}
The media course for greater regulation.

{{00:13:51}}
So he is greater regulation warranted.

{{00:13:53}}
In 2015, our pans have wanted
to investigate this issue.

{{00:13:57}}
So we conducted a regulatory impact
statement that investigated the cost

{{00:14:02}}
benefit analysis of having greater
regulation in this space and what

{{00:14:06}}
the regulatory impact statement
found was that the industry would

{{00:14:12}}
benefit from uniform regulation.

{{00:14:14}}
However, there is not enough
information on their health burden

{{00:14:18}}
to pursue regulatory oversight.

{{00:14:20}}
So those in media actually you know, every
time there's an injury there's a story.

{{00:14:26}}
We actually don't know the overall half
burden of Cosmetica and I are treatments.

{{00:14:34}}
So what, what, what needs to happen
for grad reg regulation to happen?

{{00:14:39}}
And the answer to that
is we need more research.

{{00:14:41}}
We need research on the public
health impact and the research

{{00:14:45}}
has to answer three things.

{{00:14:47}}
It has to answer.

{{00:14:48}}
And I mentioned a lot of this earlier,
but we don't know the exact impact.

{{00:14:53}}
And what we need to know is exactly the
types of injuries that are occurring,

{{00:14:57}}
how often they're occurring and the
circumstances that led to the injury.

{{00:15:01}}
So a lot of the reasons that I said
earlier, is it because the person wasn't

{{00:15:04}}
trained that was performing the procedure,
was it because the wrong device was used?

{{00:15:10}}
Was, was it.

{{00:15:11}}
The practice had achieved device
that was employed from overseas.

{{00:15:15}}
We need to understand the circumstances
that lead to these injuries.

{{00:15:22}}
But what do we do in the meantime?

{{00:15:23}}
It is important given the, given the
possible risks and then consistent

{{00:15:28}}
regulatory oversight across Australia
Panza has published national advice.

{{00:15:34}}
So we've published advice for consumers.

{{00:15:37}}
And that includes information
on the possible risks, how to

{{00:15:40}}
choose the reputable provider and
what to do if an injury occurs.

{{00:15:45}}
And we've also published advice for
providers for these treatments, which

{{00:15:48}}
includes information on the standards
of service delivery, the qualification

{{00:15:53}}
and training that's required, and
the risk communication to clients.

{{00:15:58}}
Thank you very much.

My name is Ken Karipidis and I'm the
assistant director of health impact

assessment at the Australian radiation
protection, nuclear safety agency.

My background originally, I'm a
physicist and I've also got a PhD.

And I'm also an adjunct associate
professor at Swinburn university.

Today I'm gonna be talking
about non-ionizing radiation,

So I'll be talking about the
types of treatments the potential

I will be using graphical images
of injuries in this presentation.

The other thing I wanted to speak
a little bit about at the start

So that's our Panza it's the
Australian radiation protection nuclear

safety agency with the Australian
government's primary authority on

Now, what we aim to do is to protect
the Australian people in the environment

Now, some of the ways we do this is we
undertake research on the effects of radi.

We develop radiation protection standards.

We collaborate with other national
international authorities and

And we also engage with the
community to provide information

So the, the word radiation is
often actually misunderstood.

So what I do when I don't understand
something, I usually go to doctor Google.

Google the first thing that will come up
for radiation is the Wikipedia definition.

So radiation describes any process in
which energy emitted by one body travels

through a medium or through space,
ultimately to be absorbed by another body.

So what that basically means
is all radiation is, is energy

And radiation is not one thing
that are different types of radi.

And some of the things
that I've listed there.

So you've got gamma rays x-rays
from radioactive sources.

You have ultraviolet radiation
coming from the sun lasers, which

Infrared radiation radio frequency,
electromagnetic fields, which are

common from things like wifi and
mobile telephones and the like, and

In all these different radiation
types, you can actually split

So the first group, which includes
gum, rays and x-rays is called

Radiation has enough energy to to
break chemical bonds and they can cause

DNA damage and can cause cancer, for
example, and there's non izing radiation.

So non izing radiation does not
have enough energy to break and.

But it, it does have enough energy to
cause vibration or excite molecule.

So now that we've spoken, we have this
demystified, what radiation actually

is, what we really wanna talk about
in this presentation is cosmetic

non izing, radiation treatments, and
cosmetic radiation treatments have

Treatments in the, in the pictures
in the left, you can see that's

In the MI in the middle, that's
a I P skin tightening treatment.

And on the right hand side, that's
a laser tattoo removal treatment.

But before I go on, I just wanna
make a distinction between cosmetic

non-ionizing radiation treatments
and medical non-ionizing radiation.

And the distinction is that
cosmetic treatments they're used

for the elective treatment of
perceived problems in appearance

And that's what makes them
different to medic treatments.

Now I wanna talk about a little bit
about the types of applications and.

The main ones that have been used for
quite a number of years now actually

So that includes lasers,
intense pulse light through

And more recently we've had
sources that use electromagnetic

fields or EMF for short, and that
includes live frequency, magnetic

So these, these devices are
quite, are used quite frequently.

In recent years, we also have combined
devices and by combined devices, what we

mean is they're combined two different
types of non eyes and radiation.

So you might have a device that combines
lasers with radio frequency, or you might

And finally, we'll also
have home use device.

So these devices that can be
used at home, they're usually

But they have less robust safety features.

If we look at the types of treatments,
there's, there's a lot of types of

treatments and I've listed some examples.

So hair removal, hair growth tattoo
removal, pigment reduction, skin

tightening, wrinkle reduction,
fat reduction, ane therapy, star

Now I'm not gonna get into the
detail, how the different non-ionizing

radiation treatments actually
make those treatments possible.

But I will generalize by saying,
remember what I said earlier that

radi all radiation is, is energy
moving from one point to the next.

Now the way non nine eyes and radiation
treatments make these treatments

possible is by the deposition of
energy into specific target tissue.

Now there's a common public
perception that cosmetic non-ionizing

radiation treatments are quick,
easy, painless, and low risk,

So here's an example of advertisement
that I found on the internet

that says laser hair removal,
handset, permanent, and pain free.

Expert Insight

In partnership with HealthBox. Prof. Ken Karipidis, Assistant Director, Assessment and Advice Section, Radiation Health Service Branch, Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) discusses the use of non-ionising radiation (NIR) for cosmetic applications. 