Due to the proliferation of spas, salons and walk-in clinics offering cosmetic procedures performed by non-physicians, the American Surgical Dermatology Society (ASDS) has noted a significant increase in patient complications. In response to this alarming national trend, ASDS has launched a campaign warning consumers that cosmetic treatments, such as those using lasers, high-tech light devices, chemical peels, soft tissue fillers, botulinum toxin and microdermabrasion techniques, are medical/surgical procedures that should be performed by a fully qualified physician or under the direct supervision of the physician.

There has been a proliferation of “skin care clinics” and “spas” throughout the United States since 2002. Many such clinics are owned and run by absent businessmen. There may be no physician ever on site, just “technicians”. Others use “figurehead” doctors who just lend their name or come in occasionally to review charts. Some clinics advertise that the have “board certified physicians” but the training and board certification of these physicians attempting to treat your skin might have been in gynecology, family practice, emergency medicine, naturopathic medicine or dentistry!

You may see advertisements that don’t even mention the name of a doctor at all. Shouldn’t you wonder why? Do physicians rotate through there so quickly that they can never keep the same name on the letterhead or website? You should be very suspicious of a salon that doesn’t even mention the name on any physician – who they are, where they came from, where they were trained, or how long they expect that physician to be there.

Suddenly we see doctors proclaiming that they “do dermatology”. They may have had no post graduate training at all in dermatology. They have reinvented themselves. Having an interest in something doesn’t qualify one as an expert.

The danger is that if there is a complication with any of these treatments, who is going to treat it? Who is going to pay for it? In addition, there is a severe danger of misdiagnosis. They may have been treating a freckle that was a melanoma, or not understood why you kept blistering after your light treatments. It has been documented that non-dermatologists do not approach the accuracy of dermatologists in diagnosing the 20 most common skin diseases.

There have been 2 deaths in these med spas so far because the staff were not trained to understand how much (strength and quantity) topical anesthetic is safe to use, http://www.fda.gov/cder/drug/advisory/topical_anesthetics.htm. When it comes to medical practice, winging it by untrained people is just not safe for the public.

The laser companies will unabashedly sell a laser to anyone who has the cash or financing. Even worse, some of the people who greet you and talk to at these spas may be professional “closers”. They are only there to make the sale, and get paid a commission. Is it really in their best interest to turn you down if you are not an appropriate candidate?

Board Certification in Dermatology requires three years of additional training in the structure and function of the skin. It involves studies in dermatopathology, skin surgery, lasers and additional training in diseases of the skin, hair and nails. After completing the extra years of residency, a physician is then qualified to take the board examination. Dermatology is one of the true American Board of Medical Specialties; unlike Aesthetic Medicine.

If a med spa doctor advertises many years in practice, was that exclusively for skin? Ask questions.

Large color advertisements, flashy and excited announcement of new lasers or untested procedures like mesotherapy, self proclaimed expertise in dermatology or aesthetic medicine, and lots of radio and television commercials are not the same as proper training in an accredited program with Board Certification in Dermatology.

If you want a “spa experience”, go to a spa and get a massage. If you want expert care and treatment of you skin, see a Board Certified Dermatologist.
In the interest of public protection, in January 2006, the Oregon Health Licensing Agency clarified what estheticians can legally do and what they cannot.

If you are aware of estheticians performing outside of their scope of practice, you can report their “supervising” physician to the Board of Medical Examiners. http://www.oregon.gov/BME/

The BME website is also where you can see if your Oregon doctor has an active medical license and their true specialty according to their residency training, as well as if any action has been taken against them.

In summary, find out:

  • Credentials of the doctor
  • Credentials of the assistants
  • Is the doctor is in the clinic when the assistant is working
  • How many offices does the doctor supervise

Avoid clinics that advertise on the radio or in the newspaper heavily. Avoid doctors who say they have trademarked their own procedures. Don’t get sucked into mesotherapy just because it sounds good. Don’t let estheticians do medical procedures on you. Photoshop is easy and you can’t trust every before and after picture you see, nor can you believe every salesperson in medical spas. Don’t believe places that promise unrealistic results like “your wrinkles and acne scars will all disappear”. Don’t go to places that advertise cellulite effective treatments (there aren’t any that have long-term results).

Avoid places that require full payment up front, and don’t let you have your money back if you change your mind and cancel within a reasonable time. Avoid clinics that use hype and high pressure sales techniques. Avoid chain medical spas.

Trust friend’s referrals. Trust your primary care physician to refer you to someone qualified. Do your homework.