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Washington State Laser Tattoo Removal Regulations

Laser devices are considered by the Food and Drug Administration (FDA) to be prescription devices, and in the state of Washington, their use constitutes the practice of medicine under RCW 18.71.011. This means that only those licensed to practice medicine can utilize the devices. The use of laser devices is not, however, considered to be a surgical procedure. Before you start operating your Quanta Q plus C laser, Q-Switched Nd YAG laser from Cynosure or Q-Switched laser from PicoSure, be sure that you are following all of the local rules and regulations.

Who can provide laser tattoo removal treatments in Washington?

Since laser procedures for tattoo removal are considered to be the practice of medicine, they must be performed or supervised by a licensed medical doctor. The medical doctor must be fully trained in the operation of laser equipment and laser procedures and stay up to date with all types of laser equipment he or she uses.

A physician can also delegate cosmetic laser tattoo removal treatments to approved personnel, such as physician assistants. Physician assistants that perform laser tattoo removal services must meet certain requirements:

  • Has the appropriate hands-on training, education, and experience to perform the laser treatment procedure
  • Has explicit consent to perform the procedure from the supervising physician
  • Has examined the patient, determined that laser tattoo removal is the appropriate treatment, and received the patient’s consent

Physician assistants may in turn delegate the use of laser technology to properly trained professionals, as long as they provide written protocol that includes (but is not limited to):

  • The name of the responsible physician assistant
  • A clear plan that the delegate must follow when performing laser tattoo removal procedures
  • Criteria to determine a patient’s approval for laser technology tattoo removal treatments
  • A list of the specific laser devices to be used and a description of how they should be used
  • Protocol for patient follow-up care

As with laser technicians and other professionals, physician assistants must have hands-on training and experience with the laser(s) being used, and they must be on-site at all times to assist with any complications that might arise or provide medical advice.

Rules for delegation of treatment

If a physician or a physician assistant delegates a laser services procedure to a qualified laser technician delegate, the patient must be informed prior to signing consent. Regardless of who ultimately performs the high-power laser removal treatment, the licensed physician is responsible for the actions of the delegate and for the patient’s well-being. The physician must be on-site and immediately available in case of emergency or complication.

Outside of performing the laser tattoo removal treatment itself, delegates are not authorized to otherwise engage in the practice of medicine. This means that they cannot:

  • Offer medical advice, provide diagnoses, or give treatment advice
  • Provide prescription drugs or other pharmaceutical aids to the patient
  • Perform invasive procedures on a patient or engage in any unapproved medical practices

Prerequisites for laser tattoo removal procedures

Before approving a patient to receive laser tattoo removal treatments, a physician or physician assistant must examine the patient, including retrieving the patient’s full history and performing a physical exam. Then, the physician must diagnose and recommend treatment. The patient must provide written consent for the treatments, and if he or she is under the age of 18, a legal parent or guardian must provide consent.

Please note that this article is not intended to provide legal advice. For legal advice regarding laser tattoo removal procedures, contact the Washington Medical Board or call one of our reps at to discuss.  Direct Regulations Consulting Line: 888-685-3081

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