May 29, 2024 - Health

Warnings grow about unlicensed cosmetic treatment providers

Illustration of gloved hands injecting someone's face with needles with abstract shapes and textures.

Illustration: Shoshana Gordon/Axios

The increasing demand for cosmetic procedures like Botox injections, dermal fillers and fat-dissolving treatments at popular medical spas has raised growing alarm about risky care from unlicensed providers.

Why it matters: A patchwork of state rules governing these facilities are often poorly enforced, leaving consumers more vulnerable to infection and potentially disfiguring and even life-threatening consequences, experts say.

The big picture: The global medical aesthetics industry is projected to grow from $15.4 billion in 2023 to $25.9 billion by 2028, according to a Markets and Markets analysis.

  • Social media platforms like Instagram and TikTok have driven increased awareness and acceptance of medical aesthetics, helping juice demand for smoother skin, plumper lips and contoured bodies, experts say.

Yes, but: There is no federal oversight for these clinics, leaving it up to state and local health departments to police thousands of med spas across the United States.

  • Even though most states require that clinics have medical supervisors and set minimum education standards for those providing procedures, there are varying estimates of how many providers aren't properly licensed. It may be as high as 90%, the National Med Spa Association told Axios.
  • "The vast majority are people doing it illegally and they have no idea what they are doing," said Kate Dee, physician-owner of Glow Medispa in Washington state and author of an upcoming book on the dangers of the industry.
  • An October study in the journal Dermatologic Surgery found far higher complication rates for the same cosmetic services provided at med spas compared with physician offices.

Driving the news: Federal officials last month warned consumers about counterfeit Botox tied to hospitalizations across several states. One of those patients later told Glamour she experienced arm paralysis, shortness of breath and dizziness as a result of contracting botulism.

  • The Centers for Disease Control and Prevention also recently said three women got HIV after receiving "vampire facials" at a New Mexico med spa, which were the first reported cases of people contracting the virus through cosmetic injections.
  • Months earlier, officials warned about the use of fat dissolvers not approved by the Food and Drug Administration resulting in scarring and dangerous infections. They have also previously warned about IV hydration therapy and pharmacy-made copycats of drugs offered at med spas and other unlicensed facilities.

Between the lines: It's often hard to tell the legitimate, well-run med spas from unscrupulous providers, because their setups are so similar, experts said.

  • Consumers are often drawn to bad actors by lower prices, not realizing they may be getting fake or adulterated products, said Jamie Ravitz, who leads law firm McDermott Will and Emery's FDA practice.
  • "There's plenty of folks that really don't have a good grasp that many of these products are, in fact, regulated as drugs and therefore, the source of the products becomes incredibly important."

What we're watching: Trade groups representing these facilities said they're pushing for tougher state laws that could help weed out bad actors.

  • The American Med Spa Association said it supports requiring facilities to have on-site medical directors trained in all procedures and requiring direct on-site supervision of any non-physician providers.
  • Meanwhile, experts say consumers who are considering getting procedures at these facilities should seek out proof that providers are appropriately credentialed and trained.
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