Imagine visiting a facility that allows for medical grade cosmetic procedures to
restore skin health and rejuvenate the face and body, maximize health and wellness
while in a serene spa-like environment. You would be visiting a Medical Spa.

International Morpheus8 Medical Spa Association defines a medical spa as “a facility that
operates under the full-time, on-site supervision of a licensed health care
professional. The facility operates within the scope of practice of its staff, and offers
traditional, complementary, and alternative health practices and treatments in a
spa-like setting. Practitioners working within a medical spa will be governed by their
appropriate licensing board, if licensure is required.” It would provide a
multidisciplinary approach that incorporates traditional cosmetic procedures and
wellness with alternative therapies such as acupuncture, chiropractic and holistic
care to maximize both health and wellness as well as beauty care. Those that
adhere to the guidelines as put forth by the IMSA often have a physician on staff
(preferably on site), chiropractors, massage therapists, nutritionists, and holistic

Advancing technology allows for more dramatic non-invasive and minimal “down
time” cosmetic procedures to fit patients active social and career lifestyle. This,
coupled with mainstream acceptance, has led to an ever-growing consumer
demand. Numerous facilities are appearing almost daily, whether attached to an
already existing medical practice or as a stand alone new practice. Even some
traditional hair salons and day spa’s are enlisting physicians to come by their facility
periodically to perform Botox® or Restylane® injections.

With this booming demand, many investors see an opportunity to cash in on this
growing market by opening medical spas ranging from “one of” to franchises. Many
non-medical persons are opening up facilities ranging from laser hair removal
facilities to medical spa’s, staffing them with estheticians, “laser technicians”, or
nurses. For a facility to purchase a laser, a physician has to be affiliated with that
facility. Thus many physicians serve as Medical Director, yet have no direct clinical
interaction with clients in their evaluation, treatment or follow-up.

Indeed, for some
facilities the physician is not even located in the same community. Some Medical
Directors have residency training in Dermatology or Plastic Surgery, while others are
from different medical specialties. However, since many of these procedures and
technologies are relatively new, current and ongoing postgraduate medical
education and training are important.

With this rapid growth, many states medical regulations are not keeping pace with
the evolving technologies, which result in loose regulatory oversight. In fact many
states allow non-physicians to own and operate laser hair removal spas.

increasing popularity and availability of these services, the incidence of injury from
these “low risk” procedures is increasing. While very rarely serious injury occurs
(there have been two deaths, including one, associated with laser
hair removal and use of topical anesthetic), troublesome injuries requiring
evaluation and treatment by a medical specialist are becoming more commonplace.
Injuries can include scarring, pigmentation changes, and even blindness. A study on
complications from laser procedures by Vic Narurkar, MD was presented this year at
the American Society of Laser Medicine and Surgery. He found that 82% of all laser
related complications occurred in facilities that had no direct physician supervision.