Background
Summary of Council decision:
Two issues were investigated, both of which were Upheld.
Ad description
Claims seen on the website for a laser treatment clinic, www.thelasertreatmentclinic.com, in March 2018:
1. A web page entitled "Laser Treatment for Acne" stated "We provide the most advanced acne treatments including acne laser treatment within the London area with all procedures carried out by our trained staff from our Harley Street Clinic. Our cutting edge Derma White Treatment and Marine Fluid Treatment is [sic] an extremely popular choice for those suffering from acne who want clear healthy looking skin again with permanent results. As a professional and experienced clinic we are able to treat all skin types including Asian and Afro-Caribbean. For most patients, 6 to 12 treatments are required to completely solve your acne issues, though we tailor each treatment program to the number of sessions you need". Further text stated "Before & After (Results may vary)". Beneath this was a slide show featuring before and after photos of eight people.
2. A web page entitled "What to Expect from a Derma White Treatment Consultation?" stated "Our award winning Derma White Treatment was formulated specifically for the treatment of Post-Inflammatory Hyperpigmentation (PIH) and acne for all skin types".
3. A web page entitled "Rosacea Treatment" stated "The Laser Treatment Clinic experts are specialists in rosacea treatment...our cutting edge Marine Fluid Treatment is an extremely popular choice for those who want a fast, non-invasive solution to naturally healthy clear skin, with permanent results". Further text stated "Before & After (Results may vary)". Beneath this was a slide show featuring before and after photos of four people.
Issue
The complainant challenged whether:
1. the claims that the advertiser's laser treatments could treat acne, post-inflammatory hyperpigmentation and rosacea were misleading and could be substantiated; and
2. the "before and after" photos misleadingly exaggerated the effects that could be achieved by the treatments.
Response
1. The Laser Treatment Clinic Ltd said that they offered Intense Pulsed Light (IPL) treatments. They said they had removed references to “laser” treatment and made amendments that they believed were in line with CAP guidance. They provided evidence which they believed substantiated the efficacy claims made for their treatments. This comprised two articles, one clinical trial summary, three clinical trials and one systematic review.
2. The Laser Treatment Clinic said that the images were indicative of the kind of results that could be achieved, however, the suppliers’ companies who provided the images did not have full records. They said that many of their competitors used the same images, and any IPL supplier would be able to provide information showing the same results on acne and rosacea. They said they had removed some of the images and replaced them with others provided by an established company in China that supplied the UK market, and by the supplier of their peel treatments.
Assessment
1. Upheld
The website stated “Laser Treatment for Acne”, “We provide the most advanced acne treatments including acne laser treatment”, “an extremely popular choice for those suffering from acne who want clear healthy looking skin again with permanent results”, “For most patients, 6 to 12 treatments are require to completely solve your acne issues”, and featured detailed information about different types of acne. Another page stated “formulated specifically for the treatment of Post-Inflammatory Hyperpigmentation (PIH) and acne for all skin types”. A further page stated “Rosacea Treatment”, “The Laser Treatment Clinic experts are specialists in rosacea treatment” and featured information about the condition of rosacea. We considered that consumers would understand these claims to mean that the treatments offered by The Laser Treatment Clinic could treat acne, PIH and rosacea.
We assessed the evidence provided in full by The Laser Treatment Clinic. The two articles described the different applications of light-based technologies in dermatology and did not constitute clinical evidence for efficacy claims.
The systematic review covered clinical trials on different types of light-based therapies for acne treatment. It concluded that the strongest evidence base was for blue-red light treatment, though this was limited by small sample sizes and lack of effective controls. It did not identify any randomised controlled trials for IPL therapy and indicated that more research was needed.
A trial on 75 patients with mild to moderate acne reported a significant reduction in more than half of the participants. However, the study was uncontrolled and the specific IPL therapy device and treatment methodology was unclear.
A single-blind split-face trial on 74 participants with mild to severe acne compared the efficacy of an IPL device with another light-based treatment, which we did not consider an adequate control to minimise the chance of any effect being incorrectly attributed to the treatment as opposed to other factors. Furthermore, female participants were over-represented in the sample, and the device used differed to that used by The Laser Treatment Clinic, including in terms of the energy exerted per area unit of the patient’s skin.
A randomised controlled trial evaluated the efficacy of IPL alone versus IPL in combination with a topical cream, which we did not consider to be an adequate control. Furthermore, it was not clear whether the trial was blinded on the part of the assessors; analysis was per-protocol rather than on-treatment; and some of the inclusion factors for participants could have resulted in bias. The IPL device used was not the same as the one used by The Laser Treatment Clinic.
We considered that we had not seen sufficient evidence to substantiate that the treatment offered by The Laser Treatment Clinic could treat acne, PIH or rosacea, which was how consumers were likely to understand the claims.
We acknowledged that The Laser Treatment Clinic had made some changes to their website to state “we can help improve certain types of acne” and “we can help improve certain types of acne rosacea”. However, we considered that consumers were still likely to understand these claims to mean that the treatments could alleviate acne and rosacea. As we had not seen robust evidence that the treatments could treat or improve any type of acne or rosacea, we considered that the amendments were not sufficient to resolve the issue.
The ads breached CAP Code (Edition 12) rules
3.1
3.1
Marketing communications must not materially mislead or be likely to do so.
(Misleading advertising),
3.7
3.7
Before distributing or submitting a marketing communication for publication, marketers must hold documentary evidence to prove claims that consumers are likely to regard as objective and that are capable of objective substantiation. The ASA may regard claims as misleading in the absence of adequate substantiation.
(Substantiation) and
12.1
12.1
Objective claims must be backed by evidence, if relevant consisting of trials conducted on people. Substantiation will be assessed on the basis of the available scientific knowledge.
Medicinal or medical claims and indications may be made for a medicinal product that is licensed by the MHRA, VMD or under the auspices of the EMA, or for a CE-marked medical device. A medicinal claim is a claim that a product or its constituent(s) can be used with a view to making a medical diagnosis or can treat or prevent disease, including an injury, ailment or adverse condition, whether of body or mind, in human beings.
Secondary medicinal claims made for cosmetic products as defined in the appropriate European legislation must be backed by evidence. These are limited to any preventative action of the product and may not include claims to treat disease.
(Medicines, medical devices, health-related products and beauty products).
2. Upheld
The website featured a number of before and after photos. We considered that consumers would understand that these were genuine photos of customers before and after undergoing the treatment provided by The Laser Treatment Clinic, and that they were representative of the results that could generally be achieved using the treatment. We noted that The Laser Treatment Clinic had removed some of the original images and replaced them with others from different suppliers. However, we had not seen any evidence to substantiate that the images were genuine, or that they represented the results that could generally be achieved by customers of The Laser Treatment Clinic. We concluded that the ad was misleading on that point.
The ad breached CAP Code (Edition 12) rules 3.1 3.1 Marketing communications must not materially mislead or be likely to do so. (Misleading advertising), 3.7 3.7 Before distributing or submitting a marketing communication for publication, marketers must hold documentary evidence to prove claims that consumers are likely to regard as objective and that are capable of objective substantiation. The ASA may regard claims as misleading in the absence of adequate substantiation. (Substantiation), 3.11 3.11 Marketing communications must not mislead consumers by exaggerating the capability or performance of a product. (Exaggeration), 3.45 3.45 Marketers must hold documentary evidence that a testimonial or endorsement used in a marketing communication is genuine, unless it is obviously fictitious, and hold contact details for the person who, or organisation that, gives it. and 3.47 3.47 Claims that are likely to be interpreted as factual and appear in a testimonial must not mislead or be likely to mislead the consumer. (Endorsements and testimonials).
Action
The ad must not appear again in the form complained about. We told The Laser Treatment Clinic Ltd to ensure they did not state or imply that their treatments could treat or alleviate acne, rosacea or post-inflammatory hyperpigmentation if they did not hold sufficient evidence to support their claims. We also told them not to use before and after images unless they held evidence to demonstrate that they were genuine and representative of the results that could generally be achieved using their treatments.
