Cosmetic medical procedures can be performed in a variety of settings including doctor's offices, hospitals, and medical spas. Most locations, including doctor's offices and hospitals, are controlled by both national and state-specific regulations that provide strict guidelines for the qualifications of medical professionals who work there.
“Medspas” however are left largely unregulated: they face no national standards and are left to states' individual discretions. These businesses offer many kinds of cosmetic treatments, from Botox to laser skin resurfacing to hair transplants.
In most states, medspa regulations are a new, developing field.
In 2007, there were about 800 medical spas in the United States. By 2012, there were over 4,500 self-described medspas, and the industry was worth 1.94 billion dollars. The market is expected to grow by 18% each year, and in 2016 the medical spa industry is supposed to reach a net worth of 3.6 billion dollars.
Since individual states are in control, regulations vary widely across the US. In New Jersey, only a physician can perform laser hair removal while in New York practitioners from electrologists to cosmetologists to aestheticians can perform the procedure. In Maryland registered nurses (RNs) can perform the procedure, but only when they are directly supervised by a physician, nurse practitioner, or physician's assistant. To see a full list of state requirements just for laser hair removal, click here. Read more about individual state laws for medspas here (not all states have been updated).
The erratic regulations of medspas go beyond the qualifications of doctors; these offices can also offer new, unregulated treatments. Whole body cryotherapy is a growing treatment that submerges the body in liquid nitrogen vapors that range from -166 to -319 degrees Fahrenheit. It has become popular with sports teams and celebrities from Europe to the United States with claims that it heals muscle soreness, helps manage chronic pain, and tones the skin.
But there is almost no scientific evidence to back up these healing claims. The coldest temperature ever recorded on Earth is only -135.8 degrees Fahrenheit, so medical professionals don't really understand the effects of these temperatures.
The Food and Drug Administration does not regulate the use of whole-body cryotherapy chambers because manufacturers of the chambers do not make the medical claims that some medspas do (that cryotherapy can reduce muscle soreness and shorten injury times).
A chiropractor in Denver who uses the treatment on the Denver Broncos football team said he does see a decrease in recovery time after injuries with whole body cryotherapy, but openly admitted that “some of it is psychological.”
Without further studies, medical professionals cannot tell what the exact benefits and disadvantages of cryotherapy really are.
But disadvantages are easy to spot.
In November of 2014, a 24-year-old woman who worked at a cryotherapy medical spa died while performing the treatment on herself after hours. A Texas woman brought a lawsuit against a cryotherapy center after suffering third-degree burns on her arm from the treatment. The American athlete Justin Gatlin suffered frostbitten feet after a cryotherapy treatment.
Medspas often come across as medical treatment centers, but it is important for patients to be aware of the sometimes-limited regulations supporting both the treatments offered and the medical professionals performing them.
Before seeking treatments at a medspa, get to know your state regulations. Ask the medical professionals in charge of the treatment about their qualifications, and research the risks associated with new and unregulated treatments.