“A lot of people assume that the person treating them in a white coat is a physician, and they don’t ask,’’ said Dr. Matthew Avram, who directs the dermatology laser and cosmetic center at Massachusetts General Hospital. Procedures done by inadequately trained clinicians may result in an increased risk of complications ranging from unsatisfactory results to injuries such as burns, scarring, and even death, in rare cases.
Massachusetts has more than 250 medical spas, ranging from upscale salons to university-affiliated medical practices staffed by dermatologists and plastic surgeons. They are not required to be licensed and are not regulated by the state if they are owned by, or affiliated with, a physician. A doctor is not required to be physically present at the spa.
Legislation to more tightly regulate medical spas - defined by the state Department of Public Health as any facility that performs cosmetic procedures using medical devices such as lasers and ultrasound machines or involving injections such as Botox or Restylane - stalled in the State House last summer. There were disagreements among doctors, nurses, electrologists, and cosmetologists who helped write it.
“We weren’t particularly pleased with the consensus,’’ said Boston dermatologist Dr. Jeffrey Dover, who served on the task force that created the medical spa bill. “Some of the stakeholders had an interest in protecting the status quo.’’
Dover would like to see laser or cosmetic treatments performed only by physicians or by those employed by a medical practice. He said he’s had patients referred to him by their own doctors for laser removal of facial brown spots that, to his specialist’s eye, appeared to be melanomas - and they were. “If those patients had gone to an aesthetician at a med spa, their spots most likely would have been lasered and their cancers missed,’’ he said.
