Laser hair removal is the most common procedure used in a cosmetic laser business and in many medical spas. It can take anywhere from five to 10 treatments to get most hair removed. In our busy Google-centered world, people want answers and results now. They often don’t want to wait for 10 treatments. Part of the job of a laser professional is to make the client understand from the beginning that results are not immediate and that five to 10 treatments will be needed. The client who does not have the time or the funds to go this long might be a client that should not be worked on.
The most common lawsuits and/or complaints with laser work are burning the skin and hyper- or hypopigmentation. The burning or hyperpigmentation may arise when the laser technician feels they have to give their clients faster results and thus they do work that is not within the guidelines for the laser and for the client’s skin type. This is not the laser manufacturer’s fault, and thus liability falls back on the professional who performed the procedure. If there is no coverage in place, the operator and facility where the laser work is done will need to hire an attorney to handle the situation. If a laser operator damages a client, the operator and the facility will likely be sued. The facility often ends up having more liability than the operator. Facilities should always carry insurance on their operators or require they carry their own and list the facility as an additional insured. This is the only way to adequately protect the business.
In the 1990s, there were many insurance claims in the laser business due to the fact some lasers were not differentiating the various skin types. Over the last few years, laser manufacturers have made their lasers much safer. Most give guarantees to replace a defective laser head immediately. Defective lasers are much less common now than they were in the 1990s, but if it is known that a laser head is defective, the business must replace it immediately and then any liability could very well be the fault of the manufacturer. If the laser professional knows a part is defective and does nothing, then both the medical spa and the laser professional will be liable for any damage arising from the laser work on clients.
Assuming all equipment works properly, the consultation is a crucial part of the service. That is the time to determine if the client is someone you can control and if they will not be distressed with the procedure and the time it takes to show noticeable results. We require our insured laser clients put this question on their medical history form: “Are you on any mood altering or anti-depression medication?” If the answer is yes, this is a clue that they might have emotional issues that could make them hard to control. Answering ‘yes’ to the question is not an immediate turn down, but the laser professional should consider it a clue to their ability to be satisfied with the outcome.
If at any time during the procedure, the laser operators feel they will not be able to maintain the upper hand, that may be a sign the client is not a good candidate for the service they are receiving. Our experience shows that people who do not follow directions, cannot be controlled, and/or are not comfortable with their lives, are more likely to sue someone when the service does not meet their expectations.
It is extremely important to get adequate training prior to purchasing a laser and before starting work on the general public. Thirty hours of training is an absolute minimum required before a new professional can truly understand how a laser reacts with skin. Training from the manufacturer is important as well as general training on skin types, how to set up a consultation, and how to run a business. Part of the goal of the training should be to learn how to take charge of clients and not let them control you. Medical professionals who have worked in a traditional hospital environment often are not used to being the boss. In traditional medicine, the facility and health insurance carriers control what can and cannot be done. In a medical spa, the professional offering the laser service becomes their own boss. This requires a major change in thinking which is not always obvious to the new business owner.
Problems arise when the client loses respect for the technician. For those already set up as a laser business, or in fact those in any profession providing a physical service to another person, we find that if the client feels they can tell you what they need, they will lose respect for you as a professional. In these situations, they are more likely to sue for injuries or alleged damages. Many lawsuits arise because the laser professional did not assert themselves as the “boss” of the situation and thus the client felt they were not getting the best treatment possible. When the client is anxious for results and the laser technician tries to be pleasing rather than professional, problems arise.
Finally, this recession economy has led to more claims. There seems to be increased economic stress where more people are seeking ways to get something for nothing. Be wary of the person living on the edge. If they cannot afford the service, don’t push them. It will only lead to grief. And most importantly, do not perform any service without malpractice insurance in the name of all entities involved. This economy requires professionalism, toughness, and insurance. Be gentle but be firm with what you can and cannot do with a laser. If the client will not accept your terms, it is best to show them the door.

Susan Preston is President of her own insurance agency, Professional Program Insurance Brokerage in Novato, CA. She also is the majority owner of Face and Body Professionals, a supply business. She has provided insurance and supplies to the permanent cosmetic and beauty industries for over 20 years. She has worked with states and other governing bodies to develop industry regulations and served as an advisor to the National Environmental Health Association. In 2004 she started insuring lasers/IPLs for hair removal after studying the industry for six months and working with doctors and laser experts to get underwriting guidelines. Shortly thereafter she began insuring medispas. In 1990 Preston co-founded the Society of Permanent Cosmetic Professionals, a non-profit association setting standards for the permanent makeup industry. Her articles on beauty issues have been published by national publications including Les Nouvelles Esthetiques and Spa magazine, Skin, Inc. the Advanced Dermatologic News, MedicalSpas, American Spa, Society of Permanent Cosmetic Professionals publications, and the Woman’s Guide.