How Can You Tell if a Med Spa Is Safe?

How Can You Tell if a Med Spa Is Safe?
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These days, med spas seem to be everywhere, advertising services ranging from IV hydration to discount Botox.

With so much variety — and varying levels of quality — it’s fair to ask, what exactly is a med spa? How can you make sure you are in safe, qualified hands when you choose one?

Here’s what to know when considering a med spa, what to expect when you receive care, and how to advocate for yourself wherever you go.

What Is a Med Spa?

Med spas are a type of medical practice that offer a range of wellness and nonsurgical cosmetic treatments. They might call themselves a med or medical spa, IV hydration bar, skin health center, or wellness clinic. The common thread is that the services offered at med spas are medical in nature but not medically necessary.

Med spa services can include:

  • Noninvasive body contouring with devices that use cool temperatures, laser energy, or other methods to eliminate fat cells

  • Radiofrequency or ultrasound treatments to tighten skin

  • Lasers or chemical peels to address sun damage or skin pigment concerns

  • Microneedling, a procedure to smooth uneven skin texture

  • Cosmetic neurotoxin injections (like Botox and Dysport) to temporarily reduce wrinkles

  • Dermal filler injections to add volume or enhance facial features

Benefits of Going to a Med Spa

The benefits of going to a med spa can include convenience and cost: It is often easier to get an appointment at a med spa — and care is often less expensive — than at a plastic surgery or dermatology office.

What’s more, by offering nonsurgical services, med spas fill a common gap in care. Surgery is not appropriate or affordable for everyone, and med spas make nonsurgical services widely available.

An important caveat is that sometimes surgery is the most appropriate or affordable option, and it takes a prudent and professional clinician to know when this is the case. That’s why it’s essential to find a trustworthy med spa that can help you navigate the sea of possibilities and find what’s best for you, even if it means referring you elsewhere.

Potential Issues With Med Spas

Unlike with other medical specialty practices, there is no federal regulation of med spas, and while some states regulate med spas, others don’t. These inconsistencies mean it’s possible for med spas to operate without strict adherence to safety standards. Clinicians and other unlicensed people who own and operate med spas may face little accountability for errors or high-risk practices.

One way to protect yourself? Look at the credentials of med spa clinicians to see if they have the necessary training. (More about this below.) If clinicians haven’t had the right training, they might not recognize the warning signs when things go wrong.

While most med spa procedures are low-risk, serious complications can happen. Too often, people with no or limited medical training perform procedures with real medical risks. If a complication occurs, they might not realize it in a timely manner or know how to respond.

How to Tell if a Med Spa Is Reputable

Here are signs of a high-quality med spa plus red flags that suggest a med spa does not deserve your trust.

1. Expect to Be Counseled and Treated by Qualified Clinicians

Like all healthcare professionals, people who oversee, recommend, and administer treatments at med spas all have a scope of practice — meaning what they are allowed to do — and that may vary from state to state.

But regardless of where you live, the clinicians in a med spa should share some consistent qualifications according to their role.

Explore the med spa website before making an appointment and look for the letters that come after the clinicians’ names. These credentials will correspond to their licenses and the types of certifications they hold.

Pay extra attention to the credentials of:

The medical director: This is the person who provides medical oversight of the treatments performed in the clinic. They are responsible for safety protocols and help to manage complications. In addition to providing care, they might oversee the business, daily operations, and quality of the practice.

In many states, this person needs to be a medical doctor (MD) or doctor of osteopathy (DO) physician. An increasing number of states allow nurse practitioners to practice independently, which means there is no legal requirement for physician involvement in the practice.

The clinician who does your consultation and “good faith exam”: This is the person who examines you, asks about your goals, and counsels you on appropriate treatment options. In most states, they need to be a licensed physician (MD or DO), nurse practitioner (NP), or physician assistant (PA). Too often, that is not the case; you may only see a registered nurse (RN) or aesthetician instead, and neither have the proper formal education to make medical diagnoses or treatment plans.

The person who performs your treatment: The person who treats you (if different from the others on this list) also needs to work within their scope of practice. But for this category, regulations can vary widely from state to state. Frequently nurses will perform med spa treatments — depending on the state, a nurse may be licensed as an RN or LPN/LVN (licensed practical/vocational nurse). A licensed aesthetician may also perform some skin treatments such as facials and superficial chemical peels.

As a licensed professional, the clinician is responsible for knowing their scope of practice. Ask what their credentials mean and how their training prepared them to perform med spa treatments.

“When considering going to a med spa, ask who actually does your treatment and what their credentials are,” says Amy Anderson, MBA, a plastic surgery practice management consultant and cofounder of BrinsonAnderson Consulting. “A lot of people think, oh, it’s like getting my hair done, or my nails done — no, no, no, this is a medical treatment.”

2. Expect to Receive a Well-Considered Consultation First

Before you consent to or receive any med spa treatment, a “well-considered” consultation is a must, says Melinda Haws, MD, a board-certified plastic surgeon in Nashville and immediate past president of the Aesthetic Society.

“Well-considered” means you should expect to have a conversation with a qualified clinician about your concerns. They should ask you about your medical history and lifestyle, the cosmetic or wellness issues you would like to address, and any upcoming events you may have. (After certain skin treatments, for instance, you might be advised to avoid outdoor activities that could result in sun exposure.) Likewise, they should assess you physically (for instance, by examining areas of skin you are concerned about).

Be wary if the clinician fails to ask questions about your medications and medical history. Without that information they won’t know, for instance, if you have an allergy to a particular product they might use.

For example, the neurotoxin injection Dysport, which temporarily smooths wrinkles, is not safe for people with a cow’s milk protein allergy.

3. Expect Your Clinician to Discuss Risks, Benefits, and Goals With You

You need to know the risks, and (importantly) you need to know that the person treating you knows the risks. If a clinician can’t answer simple safety questions it should raise a red flag because they may not know what to do if something goes wrong.

If you are considering dermal filler injections, for instance, “The clinician should discuss the risk of blindness with you,” says Haws. “It’s very rare, but does happen.” Complications are always possible even if you have been getting cosmetic injectables for many years with no issues.

If you’re a person of color, your clinician should carefully consider your heightened risk of burns and depigmentation (loss of skin color) when planning and performing laser treatments. This is because many lasers work by targeting pigment in the skin, so with darker skin there can be overheating that results in a burn and pigment changes.

It’s important to know who to call for help if you have a concern or experience a bad reaction from a procedure after you go home. You don’t want to feel abandoned when you need help the most.

4. Expect a Clean Environment (‘Pretty’ Is Not Enough)

“You need to look around,” advises Haws. “In 2018, people got HIV from vampire facials [at an unlicensed med spa in New Mexico], and the investigation reported there were needles laying everywhere in those offices — they were reusing stuff.” (In so-called vampire facials, clinicians may inject or use a special microneedling device to apply a component of the patient’s own blood — platelet-rich plasma, or PRP — into the skin.)

You can tell if a place feels clean, hygienic, and professional, continues Haws. But if you’re not sure what to look for, she says, some clean-clinic guidelines include the following:

  • All instruments should be single use or come in sterilized packages.
  • Clinicians should wash hands or sanitize every time they enter and exit the room.
  • The facility should exclusively use medical-grade cleaning products designed for healthcare settings (you shouldn’t see or smell everyday household cleaning products like floral-scented floor cleaners).

Treatments can be done in a pretty, spa-like setting, but “pretty” doesn’t always mean clean. These are still medical procedures — they need to follow medical hygiene standards.

5. Expect Good, Clear Answers to Your Questions

Trust your instincts and speak up if something feels off. A prudent and caring clinician will be eager to answer your questions. If they’re rude or dismissive towards your concerns that, in itself, is a warning sign. Simple questions often can be the most telling.

Ask how your planned treatment (or the device used to deliver the treatment) works. If your clinician cannot explain it in clear terms, you should question their ability to perform the treatment. If they can offer an explanation but it sounds made up or too good to be true, it probably is.

6. Expect Before-and-After Photos

“Ask to see before-and-after photos of people they [personally] have treated, not just the practice,” Anderson says. If they don’t take before-and-after photos, that is concerning from a medical documentation perspective. “It ties into their professionalism and how detail-oriented they are if they are consistently getting before-and-after photos.”

7. Be Wary of Clinics That Offer Discounts or Claim to Be ‘the Only’ Place Offering a Particular Treatment

A promotion or discount may be tempting, but just say no to discounts or services advertised on discount platforms like Groupon. Also be leary of any prices that are far below the market rate for a particular service.

For instance, with Botox, Anderson explains, the profit margins are small. That can drive clinics’ efforts to find cheaper drugs or dilute their product. “We see that more commonly in certain pockets of the country,” says Anderson, “Miami seems to be an area where there are a lot of things getting injected that are not approved by the U.S. Food and Drug Administration.”

This is very risky because these products could be counterfeit and outright dangerous.

What’s more, if you cannot find any other clinic offering a particular treatment, don’t trust it. Just because a treatment has a trademarked name (“TM”) doesn’t mean it’s safe. Often, it’s nothing more than a marketing gimmick.

If a Place Doesn’t Seem Legit, Walk Out

It’s important to make informed choices when seeking treatment at a med spa. If you don’t get the answers you need from a clinic it’s okay — and a good idea — to walk out and go someplace else.

The Takeaway

  • Because government regulation of med spas can vary from state to state, it’s important for consumers to evaluate a practice’s safety protocols before committing to a treatment.
  • Note the credentials of the people running the med spa and administering treatments to make sure they have received the necessary training.
  • Be wary of med spas that are quick to offer discounts but slow to answer basic questions about the procedures they offer and safety practices.

Resources We Trust

Susan-Bard-bio

Susan Bard, MD

Medical Reviewer

Susan Bard, MD, is a clinical instructor in the department of dermatology at Weill Cornell Medicine and an adjunct clinical instructor in the department of dermatology at Mount Sinai in New York City. Her professional interests include Mohs micrographic surgery, cosmetic and laser procedures, and immunodermatology.

She is a procedural dermatologist with the American Board of Dermatology and a fellow of the American College of Mohs Surgery.

Dr. Bard has written numerous book chapters and articles for many prominent peer-reviewed journals, and authored the textbook The Laser Treatment of Vascular Lesions.

Chelsea O. P. Hagopian, DNP, APRN, AGACNP-BC

Author

Chelsea O. P. Hagopian, DNP, APRN, AGACNP-BC, is an assistant clinical professor at the Emory University Nell Hodgson Woodruff School of Nursing in Atlanta. She also serves as executive director for the Georgia Nursing Workforce Center, which uses data and community building to tell and actively shape the story of nursing in Georgia.

As a doctor of nursing practice in health systems leadership, Dr. Hagopian pursues research and scholarship focused on informed consent, nursing ethics, and professional identity in nursing. She has authored peer-reviewed publications in the nursing literature on informed consent and ethical challenges with nonsurgical medical aesthetic devices, and in the plastic surgery literature on informed consent and patient decision aids in aesthetic plastic surgery.

Hagopian’s clinical nursing background began in perioperative nursing as a circulator and scrub nurse. She has practiced clinically in the field of plastic and reconstructive surgery as a registered nurse for more than 12 years, and as an ANCC board-certified adult-gerontology acute care nurse practitioner for more than nine years.

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
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