Recent Studies Demonstrate the Importance of Regulating Medical Spas to Protect Patients

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SCHAUMBURG, ILL., OCT. 19, 2023 – Studies recently published in Dermatologic Surgery analyzed physician involvement in medical spas and the public perceptions of medical spas compared to physician’s offices as places to receive cosmetic medical procedures. The findings emphasize the patient safety risks medical spas may currently pose and highlight the need for public protection measures, such as the American Society for Dermatologic Surgery Association’s (ASDSA) “Medical Spa Safety Act” to ensure patient safety and proper oversight of care in medical spas.

Who Is Holding the Syringe? A Survey of Truth in Advertising Among Medical Spas” surveyed 127 medical spas in the Chicago area and revealed that non-physicians perform most cosmetic medical procedures at medical spas often without patients’ knowledge of the significant variation in medical supervision and training. In fact, at 81.1% of the medical spas surveyed, there was no on-site physician. Without a physician on-site and immediately available, patient safety could be compromised without even being informed of the possibility. This also means there is little to no medical evaluation and management by a physician at medical spas. This study highlights the need for patient safety in medical spa settings and increased regulation of non-physicians performing medical procedures without on-site physician supervision.

Evaluating Public Perceptions of Cosmetic Procedures in the Medical Spa and Physician's Office Settings: A Large-scale Survey” analyzed public perceptions of medical spas compared to physicians’ offices as places to receive cosmetic medical procedures and revealed that most people surveyed believed physicians’ offices to be safer than medical spas. Certain procedures, such as minimally invasive skin tightening, had a significantly higher complication rate of 77% at medical spas compared with 0% at physician’s offices. Non-surgical fat reduction had a complication rate of 80% at medical spas and 36% at physicians’ offices. This study illustrates medical spa safety concerns expressed by the public and the correlation between less physician involvement and higher complication rates of certain cosmetic medical procedures.

“These studies emphasize growing patient safety concerns regarding the proliferation of non-physicians practicing medicine, especially in medical spas with minimal to no physician oversight,” said Seth Matarasso, MD, ASDSA’s incoming president. “Lack of regulation and enforcement has enabled many medical spas to offer cosmetic medical procedures performed by inadequately trained or unsupervised staff to unsuspecting patients. For optimal patient safety, ASDSA supports medical spa procedures based on patient outcomes and quality care, as well as appropriate on-site physician supervision, oversight and training.”

ASDSA encourages patients to ensure medical procedures are performed or directly supervised by a physician, especially by a board certified dermatologist as recommended in the “Medical Spa Safety Act.” This model legislation calls on states to regulate medical spas and keep medical procedures under the oversight of physicians, along with requiring medical directors to have training on all procedures being performed. The model bill also includes additional staff education requirements, notification to the public if a physician is not on-site and options for mandatory adverse event reporting.

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With a membership of 6,400+ physicians, ASDSA is a 501(c) (6) association dedicated to education and advocacy on behalf of dermatologic surgeons and their patients. For more information, visit

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