Performing Test Spots

Monday, January 26, 2009 by Renee Lierly, RN

Performing Test Spots serve several different purposes and are an important part of a skin care treatment plan. Infrared technology used in laser-tissue interactions produces thermal effects on the tissue.

 

The primary reason for performing a test spot is to observe epidermal response and to determine safe treatment parameters when treating tissue because of absorption by the chromophore. Immediate epidermal damage presents as a blanching or graying of the skin (common with the Nd:YAG). Epidermal damage may take up to 72 hours to be visibly evident especially when treating melanin. A burn from an IPL may take 48-72 hours to appear.  It is very important to perform a test spot when treating pigmented lesions.

 

A test spot may be beneficial for skin types IV-VI to evaluate risk for developing post inflammatory hyperpigmentation. However, this test spot must be evaluated 4-8 weeks post procedure as it takes this amount of time for the PIH to develop. Laser based technology on skin types IV-VI may increase the risk of pigmentatary changes.

 

Port Wine Stains require test spots as the parameters will vary widely due to the different types and involvement of these vascular malformations. Starting parameters for vascular treatments are usually lower then an average vascular treatment. A cluster of veins is a better target then a single leg vein so there is a higher risk of a burn.

 

There are advertisements on the internet offering "Free Test Spots" prior to Laser hair removal in order to determine if the treatment "will work before the client pays for the treatments". This perhaps could be beneficial to help determine proper parameters; however, the time period for evaluating the test spot for efficacy may be 4 to 12 weeks or longer depending on the growth cycle.

 

Test spots are considered an "Industry Standard of Care" and therefore have Medical/Legal implications. The elements of a malpractice suit are the "Breach of a duty that causes harm".

 

Informed Consent should be obtained for Test Spots and should include any potential complications that can occur from performing a test spot. It is better for the practitioner see the patient back to observe the test spot rather then allowing to patient to report on the results. This allows the practitioner to learn what the end result is and eliminates uncertainty if there is a complication.

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