Alabama Administrative Code › Title 540 - ALABAMA BOARD OF MEDICAL EXAMINERS › Chapter 540-X-11 - GUIDELINES FOR THE USE OF LASERS AND OTHER MODALITIES AFFECTING LIVING TISSUE › Section 540-X-11-.03 - Use Of And Categories Of Lasers And Other Modalities Affecting Living Tissue In The Practice Of Medicine

Current through Register Vol. 42, No. 9, June 28, 2024
(1)
			 The use of lasers/pulsed light devices, or other energy source, chemical, or
			 modality that affects living tissue, for the purpose of treating a physical
			 disease, disorder, deformity, injury, or other condition, including cosmetic,
			 shall constitute the practice of medicine pursuant to the
Code of
			 Ala. 1975
, §
								34-24-50.
(2) Categories of Procedures:
(a) Ablative Laser Skin Resurfacing -These
			 procedures include the use of fractional (partially ablative) and
			 non-fractional (fully ablative) CO2 lasers, fractional and non-fractional
			 Erbium-type lasers (2940nm) used deeper than 100 microns, plasma, and any other
			 laser/device that vaporizes or removes skin beyond the dermal-epidermal
			 junction, both fractional and non-fractional types.
(b) Non-Ablative Laser Photorejuvenation -
			 These procedures include the use of LLBD for skin resurfacing and rejuvenation
			 that involves targeting certain chromophores with no purposeful vaporization or
			 removal of skin.
(c) Intense Pulsed
			 Light (IPL) and Broad Band Light (BBL) -These procedures include the use of
			 devices with pulsed light instead of a laser beam to target chromophores
			 (pigment, vascularity, water). IPL devices consist of different levels with a
			 wide range of power/energy and variable settings.
(d) Photoepilation/Laser Hair Removal, and
			 Vascular Conditions and Lesions, and Pigmentary Conditions or Lesions.
1. Photoepilation/Laser Hair Removal
			 procedures include the use of Ruby (694 nm), Alexandrite (755nm), Diode
			 (800nm-810nm), ND:YAG (1064nm) lasers that target chromophore melanin, and
			 IPL/BBL devices (when used solely for hair reduction in appropriate,
			 fair-skinned patients).
2. Vascular
			 Conditions and Lesions, and Pigmentary Conditions or Lesions procedures include
			 the use of LLBDs that target a specific individual colored target and are used
			 to treat spider veins, telangiectasias, small non-varicose vessels, rosacea,
			 pigmented spots/lesions such as freckles, lentigines (sun/age spots), melasma,
			 and hyperpigmentation, and benign colored lesions (Seborrheic Keratosis,
			 Actinic Keratosis). LLBDs include ND:YAG, IPL, BBL, Pulsed Dye Laser, KTP,
			 Alexandrite, radiofrequency probe procedure and LLBD categories (a) and (b)
			 listed above.
(e) Tattoo
			 Removal - These procedures involve the treatment of all colors of tattoos with
			 Q-switch ND:YAG, Q-switch Ruby, Q-switch Alexandrite, or other nano/picosecond
			 devices used specifically for tattoo removal. These procedures carry a
			 significant risk of complications, burns, and ulcerations.
(f) Non-Laser Skin Rejuvenation - These
			 procedures use energy sources such as radiofrequency, ultrasound, infrared, and
			 Class III lasers that work on heat-based targeting of skin and collagen. These
			 procedures include any ultrasonic treatments, treatments for skin
			 tightening/fat removal (including cryolipolysis and cryotherapy), and
			 radiofrequency micro-needling.
(g)
			 Endovascular Radiofrequency and Laser Ablation (EVLA) -These are surgical
			 procedures that may only be performed by physicians.
(h) Laser-Assisted Liposuction (LAL) and
			 Power-Assisted Liposuction - These procedures involve laser or energy-assisted
			 invasive liposuction with the use of 1064nm, 1320nm, 1440nm, 1444nm, 924/975nm,
			 1319nm, and ultrasounds. These procedures include VaserLipo, Smart Lipo,
			 Cellulaze, Cool Lipo, Tickle Lipo, Accusculpt, Slim Lipo, ProLipo, CelluSmooth,
			 BodyJet (water-assisted), and variations thereof, and may only be performed by
			 physicians.
(i) Laser-Assisted
			 Surgery- These procedures involve the use of lasers to assist surgeons with
			 cutting, coagulation, tissue removal and ablation, and other surgical
			 procedures, and may only be performed by physicians.