5 Questions to Ask At Your Medical Spa

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True or False (answers below):

1. Botox and laser treatments are easy and can be done by an aesthtician or spa staff.

2. A physician must be present at all times in a spa that performs procedures.

3. Chemical or facial peels are safe and can be done in a beauty salon.

The term “spa” is derived from a town in Belgium where healing waters have been used to promote health since Roman times. “Spa” is now loosely used to describe any relaxing environment or beauty salon where rest, health and beauty are promoted.

At one time it was easy to distinguish among a beauty salon, barber shop and a doctor’s office. Not anymore. As cosmetics has become more medical and medicine has become more cosmetic, the two have met in the ubiquitous Medi-Spa. An establishment labelled a medical spa or medi-spa is generally one where medical procedures are performed or medicines are administered in the pursuit of beauty.

There is nothing inherently wrong with extending the field of medicine to include the state of beauty. Nor do I think it is problematic for the field of cosmetics and aesthetics to use medicine and surgery to accomplish its goals of making you more beautiful. But as a consumer, the burden is upon you to know what you are buying and from whom.

The allure of income from cosmetics is great, and physicians of all specialties have incorporated it into their medical practices. Gynecologists offer Restalyne, opthamologists offer Botox, family practice physicians have laser hair removal in their offices.

You do not need to be a dermatologist or plastic surgeon to perform cosmetic medicine. In Southern California there is even a pediatrician who treats cellulite (on adults, of course). This does not mean that he is unqualified to perform your cellulite treatment — he might be quite good at it.

More concerning is the fact that many people with no medical license are performing procedures. Ultimately, it is your responsibility to ask what qualifications and experience people treating you at the medi-spa have so you can make an informed decision.

Anytime an injection is given, a prescriptive device (such as a laser) is used, or a drug is prescribed, a licensed physician must be responsible for your care. Only licensed providers such as registered nurses, nurse practioners, or physician assistants can perform procedures. Other staff such as medical assistants or aestheticians are not licensed and are prohibted from practicing medicine.

The next time you go to the spa, be sure to ask the following questions for your safety:

  1. Who is performing the procedure?
  2. What is his or her license?
  3. What experience has he or she had?
  4. What are some complications or bad outcomes that have occurred?
  5. Is a physician present in the facility or nearby to assist if there is a problem?

Photo: Axel Hecht

Answer to questions 1-3: false.

Facials Don’t Treat Wrinkles

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Last week one of my patients complained that she gets facials every month for her wrinkles, but that she still has prominent wrinkles around her eyes and mouth. “What,” she asked, “is she doing wrong?”

Facials are the third most popular treatment in spas after nails and massage. They come in many flavors like: mineral masks, steam treatments, microdermabrasions, LED light treatments, blu-light, and even oxygen facials.

Facials can be beneficial; they extract clogged pores, exfoliate dull, scaly skin, and give you a deep, invigorating cleansing, leaving your face smooth and silky. But facials cannot treat wrinkles, broken blood vessles, or brown spots.

Facials are done by aestheticians who are not licensed to practice medicine. Aestheticians cannot administer treatments that penetrate the skin or have  biologic effects (by definition, this would be considered medicine and must be administered by a licensed practitioner such as a physician or registered nurse).  Deeper problems such as wrinkles require invasive treatments which cross the line from cosmetics to medicine.

Facial massages or electrostimulations, which are supposed to tone your skin, don’t. Toning or building muscle requires intense and repeated activity. Just like building biceps, firming musles on your face would require working out. The problem is that wrinkles on your face are caused by contracting muscles — crow’s feet are caused by contracting muscles around your eyes; frown lines are caused by furrowing your brow; lip lines are caused by contracting the muscles around your mouth. Any treatment then that firms facial muscles would only make wrinkles worse.

Other treatments such as oxygen facials and mineral treatments have no evidence to support them, (unless you count “Madonna said so” as evidence). Save your money and have your daughter apply a mud mask the next time you go to the beach.

Photo: Arkansas Shutterbug (flickr)