Careful not to burn a batch of cookies, Carmella Takacs wishes the medi-spa she went to was just as cautious with her skin during her laser treatment.
“All of a sudden I see all these marks from the laser burn marks,” she recalls.
The senior from Concord went in for a laser wrinkle treatment at a medi-spa that has since gone out of business inside a mall. She says the nurse who was supposed to remove her wrinkles turned the laser too high, scarring her face and causing excruciating pain.
“I was afraid to go out of the house. I was crying. I was depressed.”
Tamra Pierce of Newcastle went to a medi-spa inside a Roseville salon for Botox injections. Instead she says the nurse injected her with a different type of filler leaving her with two black eyes and a swollen face that lasted weeks.
“The doctor I went to see said I could have lost my eyesight.”
In both cases doctors names were tied to the medi-spas, but no doctor was there that day.
The medi-spa industry has exploded in popularity, growing from 225 locations a decade ago to 1750 in 2011, according to the International Spa Association.
Board Certified Dermatologist Dr. Christine Lee says consumers should not be fooled by a doctor’s name on the door of a medi-spa because they may just lend their name to the clinic to collect a paycheck. She says in many cases, nurses and even estheticians are performing these procedures.
“Most of these places are almost never operating with a doctor on site,” she said.
She shared graphic photos of what can happen. One patient who went in for laser hair removal ended up with burns resembling zebra stripes across her face. A bad botox injection caused nerve damage to another woman forcing a patient’s eye shut for an entire year. Lee warned the harm can last forever.
We went undercover to see who was on duty at three Sacramento Valley medi-spas.
At each location, our producer posed as someone wanting laser hair removal and Botox and was told no doctor was present. Instead, she was told nurses do the procedures.
Producer: “So now when it comes to the Botox and laser hair, who does it? Does a doctor have to do that?”
Medi-Spa Nurse: “Nope, nope. You don’t want the doctor doing it because he doesn’t do ‘em like we do.”
Two nurses told our producer she would meet a doctor first, although it may happen through a webcam.
Tricia Hunter with the American Nurse’s Association of California says a doctor should be in a medi-spa regularly. She says no state agency is adequately watching over the industry.
“We license barber shops,” she said. “Why wouldn’t we license a med spa?”
Hunter argues a properly trained nurse is qualified to carry out treatments as long as a doctor is within reach, but she says the California Medical Board has never defined proper supervision. Should a doctor be on site, within a few miles or halfway around the world reachable by phone? She thinks the Medical Board should have established a definition by now.
“What’s taking so long?” Kurtis asked Medical Board Spokesperson Russ Heimerich.
“That I really don’t know,” he answered. “I know that clarifications are coming.”
The Medical Board says it doesn’t dictate how doctors run their practice and if nurses are performing treatments they must follow a doctor’s “standardized procedure”, which should outline how the practice is run. The Medical Board has not weighed in on whether a patient can have an initial exam through a web cam.
The board is now proposing supervision regulations for laser treatments saying a doctor must be ”immediately available” defined as “contactable by electronic or telephonic means without delay, interruptible, and able to furnish appropriate assistance and direction throughout the performance of the procedure”.
“Based on the definition you gave, a doctor could be available by email in Europe?” Kurtis asked Heimerich.
“A doctor could be available through email in Europe yes, if they are immediately available to assist in treatment. A lot of this is going to be on the physician to exercise judgment,” Heimerich answered.
It doesn’t go far enough for Carmella who wishes a doctor was there the day she was burned. After years of follow-up treatment, her scars have faded to the point make-up covers them.
Tamra lives with what appears to be a permanent pimple on her face from her injection. The nurse who treated her now works out of another salon.
Both women think their injuries never would’ve happened, if a doctor was there when they were treated.
“I just hope other people that go, that they have learned enough from all these people that have been burned to make sure they see a doctor,” Carmella said.
The International Spa Association says its medical spa members must have a full-time licensed health care professional on-site, which is further defined as a health professional who has earned a degree of Doctor of Medicine (M.D.). These types of medical doctors may include primary care physicians, surgeons, internal medical doctors, dermatologists, gynecologists, obstetricians, emergency medicine doctors and anesthesiologists.
“The International SPA Association recommends leaving invasive medical procedures to licensed and board certified medical doctors,” said organization President Lynne McNees. She recommends “leaving the invasive medical procedures to medical professionals. Spas are not meant to serve as a replacement for your primary care doctor.”
For more information, read The Medical Board: What you need to know about Medical Spas?