Aesthetic Laser Treatments on the Rise!!

The use of aesthetics laser and energy-based devices among dermatologists increased 34% in 2013. This information is courtesy of a  a new survey from the American Society of Dermatologic Surgery (ASDS).

When the ASDS surveyed its members, it found that 2.25 million laser, light and energy-based treatments were performed in 2013, compared to 1.68 million in 2012. This is an astounding increase!!!

“Not only have treatments become much more effective, but they also have become safer, so patients typically are experiencing less downtime,” said ASDS President-elect George Hruza, MD.

Treatments for facial redness, including rosacea-related erythema, topped the list at 454,000 procedures in 2013. Several other procedures saw increases of more than 50%, according to the survey:

• Birthmark removal (up nearly 90%)
• Laser facial resurfacing to erase fine lines and wrinkles, smooth and tighten eyelid skin, improve crow’s feet around the eyes and improve skin tone and texture (up 85%)
• Surgical and traumatic-injury scar treatment and removal (up 79%)
• Tissue tightening (up 75%)
• Tattoo removal (up 52%)

Dr. Hruza attributes these increases to advancements in the field that make treatments safer and more effective; a growing awareness of these technologies; and a recovering economy. “Patients may have been waiting to see a dermatologist about that facial redness or removing unwanted hair,” he said. “Now many are more informed, plus they have more economic freedom to act on their desire to improve their appearance.”

Paddy Deighan J.D. Ph.D

http://www.medicalandspaconsulting.com

Non-Physician Owned Medical Spas

It is really frustrating to see soooo many medical spas violating basic state and federal laws. I had occasion to visit a medspa in Las Vegas this week. I was SHOCKED at the number of state and federal violations I noticed. Medical assistants injecting Botox® cosmetic, non-licensed individuals operating a laser, equipment not available in the USA, and a “supervising” physician that has never been on the site!! In fact, a medical assistant should not be employed in that capacity by a non-physician owned medical spa!! It amazes me that there is so much clear violation of so many laws and the arrogance of those that defend the un-defendable when approached with the issues.
Compliance is on the rise and states, the FDA and other federal agencies are becoming more aware of the issues. Physicians are more aware of the duties and responsibilities of being a medical director or in medically supervising another facility.
Folks, it is time to wake up and appreciate that a non-physician owned medical spa is a huge concern, It is very difficult for such facilities to operate in any manner of compliance. They are called “medical” spas for a reason. I am not saying that it is impossible; but it is problematic!! Websites frequently provide so much information of violations that regulators would not even have to visit the site! Websites and advertising are the biggest source of compliance triggers. The facility that I visited this week had CLEAR indication that the physician was the owner of the medical spa!! AS I mentioned, the physician had never even been on the site!! Peer complaints are next – many of your peers will complain to the boards of cosmetology or medicine. The boards, by charter, must investigate EVERY complaint – no matter how deficient on its face. The cost of defending a compliance audit is HUGE and the fines and penalties are high. There is even criminal prosecution and loss of professional license possibilities. Yes, this does happen!!

Are Laser Hair Removal Centers Medical Practices???

There have been waves of laser hair removal centers since the first FDA cleared laser was introduced for permanent reduction of hair (1995).  Centers open and close with regularity. It is difficult to maintain a profitable business if it is solely a laser hair removal business.

Eventually, those that open the laser hair removal centers realize this and expand their product and service. Frequently, this is not legally supportable.

The long and short of the situation is that hair removal is not considered to be the practice of medicine.  There are dozens of therapies to remove hair dating back to the ancient Egyptians. Sugaring, waxing, electrolysis, needle free electrolysis, chemical de-epilation are all effective but none are permanent.  The only permanent treatment is laser.

Their are several types of laser for hair removal and a center should have at least three in order to treat the most patients in the most effective way.  This is because of different skin type (color), different hair color and the location of the body.  So, it is not as easy as leasing a laser and opening a location.

Even though laser hair removal is not a medical procedure, the devices are MEDICAL devices. It is unlawful for non-physicians to own or operate the lasers because they are medical devices.  you would never know this if you attend a spa expo and see the laser companies falling over themselves to sell a laser to a non-physician. As I have been known to say, any laser company would sell a laser to my dog Stoli if he could pony up the money!! The laser companies invariably claim to have a letter from a "guy" that indicates that it is acceptable to sell a medical device to a non-physician.

there are some light based devices that are a lower class of ,medical device that can be utilized and owned by non-physicians. These are non effective and low power.

Non physicians can own and operate laser hair removal centers, but care must be made in the formation and implementation of the business plan. As with everything, there is a right way and a wrong way...but the penalties for doing it the wrong way can lead to substantial fines and penalties and loss of professional license (cosmetologist, nursing etc).