American Academy of Dermatology

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I contacted the American Academy of Dermatology (AAD) about wanting to submit a review on lasering, a consumer perspective that had to do with my concern about the harm caused by facial lasering and how the problem is not being conscientiously addressed by dermatology offices, state medical boards, and now the AAD. Neither Mr. Mark Ramsey (Member Resource Center Representative) nor Ms. Katie Domanowski (Associate Director of Publishing) responded to my laser letter, and I tried to contact them another FIVE times (including the General Support people via the AAD online submission form) from April 3 to May 12 indicating that I would still please like to know what the Academy does with this information, the review I provided, and if it plans to further study/monitor/help control the dangers and repair the harms of lasering. On April 3 Ms. Domanowski apologized and wrote that she was out of the office and would get back to me by the end of the week. On April 28 when I emailed, she responded that she was out of the office that day. I replied to her/Mr. Ramsey/General Support people that if I received no further communication from them I would consider their position to be a no response. The AAD credo on their website states they are to honor: Patients first: Compassion, caring and listening are at the heart of delivering the highest-quality dermatologic care. We are working to ensure members' ability to facilitate access to dermatologic care and deliver the highest quality of care. Professionalism: Adhering to an uncompromising code of clinical and ethical standards among ourselves and with the public. The cornerstones of these standards emphasize honesty, integrity, transparency and mutual respect. Lifelong learning: Pursuing knowledge and continuous improvement, embodying a spirit of intellectual curiosity and interchange through self-assessment and ongoing evaluation. Rigorous inquiry and creative work: Pursuing excellence through innovation, creativity, critical evaluation and open dialogue. Collaboration: Working together with mutual respect, collegiality and transparency. Collective and coordinated efforts through partnerships and teamwork encourage engagement, inspire ideas, create essential dialogue, and foster synergistic results. Social responsibility: A dedication to the greater good. Community leadership, volunteerism and stewardship are hallmarks of our ability to contribute to public health. Diversity: Acknowledging, respecting and valuing differences. An inclusive approach to people, ideas and practice styles includes a willingness to listen to all points of view. The result is collectively better because the whole is greater than the sum of its parts. As my letter to the Academy stated, I was deeply troubled by my experience at a dermatology office. The Nevada Medical Board chose to not respond to my claims of breaches of the NV Statutes. In addition, the technicians purported licensure and credentialing (even a tech surname) could not be disclosed to me in spite of my repeated attempts to obtain that information. Still, the office wrote/claimed the tech was a "Board Certified Aesthetician" practicing "medical aesthetics." Neither would the Stateline, NV, dermatology office nor the NV Medical Board provide me with the doctor's malpractice insurance information. The NV Board simply informed me after ten months that the case was closed. (Patients in Nevada, incidentally, have one year to file a malpractice claim.) The NV Medical Board chose not to respond to my questions and request for explanations and took no public actions with the dermatology office even in spite of the dermatology's breach of the patient-doctor contract and the documented improper treatment approach. Apparently, a medical expert's opinion that I had experienced "pronounced" facial "damage" (from my dated photos) was not significant to the AAD and the NV Medical Board, nor are the many patient reviews or articles I submitted that also warn of lasering complications. My treatment was for one tiny acne spot, nothing else. That spot never got treated. But the lasering of other unnecessary areas on my face was so extensive that it resulted in widespread damage that I was subsequently referred by the doctor to a cosmetic surgeon. It is incumbent on you, the AAD, as well as doctors and state medical boards to help protect patients from unethical and unqualified people who use lasers carelessly and dangerously. If you don't honor your code of ethics, what purpose do you serve?________________ [part of my review sent to AAD, also a shortened version] As stated on the AAD website regarding the practice of lasering, "Where we see a problem [with lasering] is lack of oversight, education, knowledge, and judgment... If one of those is missing, there's a potential problem. If all four of those are missing, you're really asking for trouble" [Dr. Dover, www.aaa.org/dw/monthly/2014/September/safety-first#allpages]. JAMA Dermatology reports that "further studies are needed to examine this troubling trend in laser safety" [2014:150 (4): 407-411]. Researcher Dr. Jalian with the University of California confirmed that these procedures do cause harm if not done correctly (HealthDay News, 10/16/13). Another doctor and Yale professor (Dr. Salomon in same article) goes on to say that "Treating a patient or a client with any type of light energy can cause permanent damage." Furthermore, he says, "a certificate indicating proof of training on the laser should be readily provided on demand when a patient wants to check the credentials of the user of the laser." Supervision in the use of lasers along with research and the honest reporting of lasering results are critical factors in patient care. As stated in the Journal of Clinical Aesthetic Dermatology [2012, June: 5 (6): 45-53], as the "understanding of the biological efficacy of various wavelength distributions evolve... it will be incumbent on clinicians who use these devices to report their clinical experiences in order to sustain our continued understanding of the technology's long-term safety and efficacy profile. Patients are led to believe that lasering is safe and that not much qualifications are needed to use such machines. Legal and ethical obligations for doctors and their assistants--accountability--are crucial for the responsible caring of their patients. The JAAD states on its website that dermatological lasering damage must be addressed and evaluated. I have documentation of my own case that I would be willing to provide the field for further study if needed as I know I am not alone in the lasering harm that I experienced and continue to experience. I would implore the American Academy of Dermatology and state Boards to better prevent, assess, and correct the damage that lasering can cause to unsuspecting people. Please help protect and properly inform patients about the real dangers involved. [Other related reviews on this case have been posted to this website.]