When should I consider referring a patient for laser therapy rather than managing their skin condition in primary care?

Consider referring a patient for laser therapy when their skin condition is not adequately controlled within primary care despite optimal management, or when specialist assessment is needed for advanced treatment options.

For example, in acne vulgaris, referral to a consultant dermatologist-led team or a nationally accredited GP with an Extended Role (GPwER) is recommended if the patient has mild to moderate acne that has not responded to two completed courses of treatment, moderate to severe acne unresponsive to oral antibiotics, acne causing scarring, or persistent pigmentary changes. Such cases may be suitable for specialist interventions including laser therapy ¹.

Similarly, for atopic eczema in children under 12, referral for specialist dermatological advice is advised if the eczema is not controlled satisfactorily with primary care management, or if the patient may benefit from specialist advice on treatment application techniques, which could include advanced therapies ².

In general, laser therapy is considered a specialist treatment modality and should be initiated or supervised by dermatology specialists after primary care treatments have failed or when the condition severity or complications warrant specialist intervention ¹,².