More untrained, unsupervised individuals are getting into the medspa niche, and complication rates are rising. While derms fight to persuade legislators that nondermatologist-run or insufficiently supervised spas increase the risk of medical complications or, worse, such errors as missing deadly melanomas, some states are passing laws enabling under-trained individuals to take the reins.
The enemy isn't the growth in cosmetic procedures or the entrepreneurial niche it has opened. Rather, it's the battalions of untrained, unsupervised individuals (pediatricians, ER docs, nurses, physician assistants, cosmetologists and the like) who are converging upon - and trying to make a living from - the niche.
Roy Geronemus, M.D., a New York dermatologist and former president of the American Society for Dermatologic Surgery (ASDS) as well as the American Society of Laser Medicine and Surgery (ASLMS), has been at the battle lines longer than most.
"The worst of it," he tells Dermatology Times, "just happened in Georgia, where the governor signed a bill allowing nonphysicians to do laser treatments previously restricted to doctors."
Georgia on everyone's mind
On May 29, 2007, Georgia governor Sonny Perdue signed into law HB 528.
The law's purpose is "to amend Chapter 34 of Title 43 of the Official Code of Georgia Annotated, relating to physicians, physicians assistants and others, so as to provide for the licensing of cosmetic laser practitioner."
"In fact," Dr. Brody adds, "nurses can supervise beauticians who apply to be assistant laser practitioners.
"It provides multiple opportunities for non-physicians to laser-over cancers and melanomas and allow them to spread," Dr. Brody says.
Complications, diagnostic disasters
Ranella Hirsch, M.D., a Cambridge, Mass., dermatologist who chairs the ASDS Scope of Practice Committee, calls the Georgia bill "simply and totally tragic."
She elaborates, "As more and more people are being treated by unqualified, untrained individuals, the number of complications is increasing exponentially."
Florida in the forefront
Florida, because of its large retiree population, is home to a profusion of skincare clinics.