Not all medical spas are equal – they don’t all provide the same quality of service and care to clients, nor do they all have the knowledge and experience of a physician-led clinic.2,3

Most med spa staff consist of aestheticians and not experienced healthcare practitioners with specialized training and education.3

Serious complications reported

Even though many procedures performed at medical spas are minimally invasive, serious complications have been reported, including:

• skin necrosis, 

• loss of vision,

• disfigurement from scarring, 

• infection, 

• stroke,

• and even death.1

Further, due to the lack of a formal reporting system, it’s believed that complications after cosmetic procedures are remarkably under-reported.1 

A poll of the American Society for Dermatologic Surgery found practitioners reporting that most cosmetic complications were related to medical spas without appropriate staffing.4

The most common cosmetic procedures with complications were:

• fillers, 

• intense pulsed light, 

• and laser hair removal.4 

These polled practitioners generally believe medical spas require stricter rules and regulations but, more importantly, follow through with enforcement.4

When looking for a medical spa, ensure there’s a licensed, full-time medical director and trained nurse on-site for supervision.2

The Canadian Association of Medical Spas and Aesthetic surgeons recommends that the doctor should be a licensed plastic surgeon.2 To promote patient safety, physicians should also be aware of the dangers of medical spas and educate patients and the public accordingly.5

It is recommended that invasive procedures (those going into or past the skin barrier) should be performed in a dermatologist’s office.3

These invasive procedures include

• dermal fillers,

• botox,

• Kybella (a “fat-melting” injectable),

• and thread lifts.3

Services acceptable to be conducted in medical spas include

• dermaplaning.

• micro-needling,

• hydrafacials,

• LED,

• and laser.3

Safe and effective performance of these procedures relies on proper training, knowledge of the associated anatomy and tissue physiology, appropriate patient candidacy, and the ability to quickly identify and manage complications.1

Recommendations

The Canadian Association of Medical Spas and Aesthetic Surgeons recommends patients should find out who their practitioner will be, how much experience they have performed the procedure, and how often serious side effects occur.2 

1.- A patient should check the credentials, training, and background of the practitioner and ensure that all medical procedures are performed by medical personnel, not unlicensed or non-medical staff.2  

2.- Avoid going to someone’s home, a hotel room, or a temporary rented space for a cosmetic treatment.1 A med spa should ideally be located within a physician’s office.2 

3.- Finally, a consumer should be wary of cheaper price offerings. Medical spas offering unusually inexpensive deals, and those that are much cheaper than other places in the same area should be questioned to make sure they provide an acceptable level of quality.2

There is a demand for services offered at medical spas. Due to the demand, there’s been an increase in medical spas.

Unfortunately, rules and regulations need to be clarified and enforced for these services.

Importantly, there should be a level of direction and supervision under a physician. Staff should be qualified, trained, and experienced.

Consumers should be sure to research before undergoing any cosmetic procedures, especially those that are invasive.

1. Cypen SG, Langelier N, Woodward JA. Transparency of medical spas in North Carolina. Journal of Community Medicine and Health Care. 2018;3(2):1027. https://austinpublishinggroup.com/community-medicine/fulltext/jcmhc-v3-id1027.php
2. Choosing a Right Medical Spa. Canadian Association of Medical Spas and Aesthetic Surgeons. Updated 2010. Accessed December 22, 2022. http://www.camacs.ca/info_for_public.php
3. Glynn T. What Treatments are Safe to Get At a Medi-Spa?. Allure. Updated Oct 26, 2022. Accessed December 22, 2022. https://www.allure.com/story/medi-spa-beauty-treatments
4. Wang JV, Albornoz CA, Goldbach H, et al. Experiences With Medical Spas and Associated Complications: A Survey of Aesthetic Practitioners. Dermatol Surg. 2020;46(12):1543-1548. doi:10.1097/DSS.0000000000002344
5. Wang JV, Munavalli GS, Zachary CB, Geronemus RG. Trends in cosmetic consumer preferences during COVID-19 pandemic: Comparing 2021 to 2020. Journal of Cosmetic Dermatology. 2022;21(1):48-50. https://doi.org/10.1111%2Fjocd.14615