IPL for Rosacea by a Technician or a Dermatologist?

Question

I have just returned from a second consultation at our local University in Canada. Although I already saw the dermatologist for a consultation, I had to make a second appointment with one of his technicians, who will actually conduct the IPL treatment for my rosacea. Can I trust a technician or would you recommend to search for a dermatologist who conducts the IPL treatment by himself? Thank you very much in advance for your answer.

Jordana S. Gilman, MD · Answer

It is important that you receive your IPL treatment from a nurse or physician who fully understands and has experience with the procedure.  IPL does have risks, it can cause burns or leave marks that can last a long time.  
Even if you are evaluated by a physician first, who tells the "technician" what settings to use during the treatment, there may be a reaction that is unexpected.  A technician may not recognize potential warning signs.  You could end up with a treatment that was too strong and that leaves you with marks that take a long time, and additional expense, to go away.  
On the other hand, sometimes the settings that I start the treatment with are not high enough and I need to increase the energy.  Dermatologists are able to recognize the dynamics of the treatment while it is underway, and raise or lower the energy settings so that you get the best possible treatment-- minimizing the risk and maximizing the benefit.

Parham Ganchi, PhD, MD · Answer

As long as the technician is performing the IPL procedure under the supervision of a plastic surgeon or dermatologist, you should be fine. Good luck.

Susan Goodlerner, MD (retired) · Answer

It would be important for you to find out the credentials of the "technician" In most states in the US, a medical, nursing or physicians's assistant license is required to operate a laser or light device. And, the treatment must be done  under the supervision of an MD. The degree of supervision varies from clinic to clinic. Ideally the doctor should be on site so if the RN or PA has a question about laser settings, he or she can consult with the doctor. 
It would be important to know what training the in laser/light therapy the "technician" has and how long they have been performing these treatments. In my opinion, IPL treatment performed by a nurse or PA would be safe if the provider is experienced and is under the direct supervision of an MD.

Arnold R. Oppenheim, MD (retired) · Answer

This may seem a little contradictory since in another answer this afternoon I lambasted the idea of a tech administering the Pearl treatment. However, my reasoning is that the Pearl is an ablative treatment, and the IPL is not. If the tech is under the medical supervision of a dermatologist, who is on site, and has experience, I see no problem. 
   Interesting story but unfortunately true: a few months ago one of my patients told me that his daughter had been hired as a secretary at a local medi-spa. When one of the technicians called in sick, she was enlisted to perform IPL treatments. She was given five minutes of instruction and suddenly was an IPL technician. 
    With a dermatologist on site, I do not think you are stepping into that potentially disasterous jungle.

IPL for Rosacea by a Technician or a Dermatologist?

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