Medical devices have long figured into the specialty of dermatology in a variety of ways, from treatment of acne and acne scarring to cosmetic procedures. While the device market grows to encompass more nuanced procedures that demand increased sophistication from the physicians operating them, the next big development in the field of lasers may actually involve greater participation from the general public in the administration of laser therapies.

At the 2011 Meeting of the American Society for Laser Medicine and Surgery, presenters discussed the formation of guidelines for the at-home use of lasers and light devices. The announcement of the guidelines suggests that at-home administration of lasers is fast becoming a reality in a much broader scope than is currently seen. The guidelines will likely be published by a major medical journal in coming months, and according to lead author Godfrey Town, Laser Protection Adviser in the United Kingdom, they represent a significant step in the increased accessibility of laser procedures to the general public. “Previously in the US, an athome laser device would go through the FDA 510k review process, and then once-cleared would be accessible through the direction of a physician,” notes Mr. Town. “What we're seeing now is the democratization of laser access and use, with more devices going over-the-counter,” he adds.

Already, some medical devices are available over-the-counter, says Mr. Town. “We are seeing more and more specialty 'electronic' devices being sold at retail outlets for medical conditions, such as acne and cold sores, that use specific wavelengths of light because they have been shown to be effective in clinical studies,” he notes. This has opened the door for different kinds of device-based products and procedures, and more are on the way. “Demand for at-home laser treatments has increased dramatically in two particular areas: hair removal products and skin rejuvenation,” he observes. Several established companies in dermatology are partnering with device companies such as CyDen, Syneron, Cynosure, and Palomar, to ready products to compete on the market. “Large corporations like Unilever, J&J, P&G, L'Oreal, Alliance, Boots, etc., are now preparing to enter this exciting new market of miniaturized lightbased devices to complement their ranges of cosmetic anti-aging creams and serums,” explains Mr. Town.

Before solidifying their place in a new realm of procedures/products, these companies want to ensure that their products are well-studied. “They will not sell branded products under their names unless they are completely safe,” Mr. Town adds. While there is no way to completely ensure that a product may not be misused or mishandled and result in injury, Mr. Town notes that these devices should be placed in the context of a larger realm of electronic devices on the market. “Someone who is unfamiliar or simply ‘too casual' with a hair straightener can burn themselves very easily, so it's important to note that these kinds of devices require a certain level of intelligence and understanding in order to use them safely,” notes Mr. Town. There will likely be increased efforts from marketing departments to ensure that all safety standards are upkept and that enough is being done to promote and educate consumers about the safe use of these devices. “These companies are working very hard to ensure that consumers would have to go to extraordinary lengths to cause harm with these devices,” says Mr. Town. He observes, however, that one of his greatest concerns regarding athome laser development is that smaller companies could potentially try to beat the larger companies to the market, and in doing so release a less safe product.

Another consideration of a blossoming at-home laser subdivision of the device industry would be its potential impact on other physician-directed procedures and products. In this regard, Mr. Town believes that an upswing in at-home laser sales may actually spur interest in more advanced procedures, such as those provided by a cosmetic dermatologist. “For as many advantages that at-home laser devices will offer consumers, not everyone will be ideal candidates for the types of treatment they offer,” Mr. Town observes. And for those who are candidates for at-home therapy, many of these individuals will still require professional treatments for difficult body areas and conditions not treatable at home, says Mr. Town. “These areas or conditions include intimate body areas, backs, pseudo-folliculitis barbae, acne, as well as benign pigmented and vascular lesions.”

While at this time it is still not clear how exactly the at-home laser market will evolve, its growing presence in the broader cosmetic realm is a nearguarantee, according to Mr. Town. “Clinicians should recognize that home-use products are already here and growing in number and popularity, whether we want it or not,” he says. The presence of over-the-counter laser devices could introduce many new patients to the concept of laser procedures and potentially introduce a new clientele to laser dermatology offices. Mr. Town likens the situation with at-home lasers to teeth whitening procedures. “When the whitening procedure became much more reachable, it drove the demand back into the hands of professionals who administered the procedure with the most knowledge and expertise,” Mr. Town says. He further notes that clinicians should explore opportunities to use proven at-home devices alongside their own professional treatments, e.g. for ongoing home-care or top-up treatments as part of a total professional treatment regimen.

With the majority of the lay public largely ignorant of the potential of lasers and intense pulse light for hair removal and other procedures, athome laser devices should increase general knowledge of light-based procedures, giving professionals who provide services more exposure and potential to grow their brand, according to Mr. Town.

The guidelines for at-home laser use that Mr. Town authored and co-presented at this year's ASLMS meeting are expected to be published later this year and should provide a structure for how physicians can confidently and effectively approach this technology while maintaining their professional positions.