by: Rhoda S. Narins, MD, President
American Society for Dermatologic Surgery (ASDS)

In today’s society, images of the picture-perfect body continue to bombard consumers. From billboard and magazine advertisements to the immensely popular reality makeover shows such as ‘Extreme Makeover’ and ‘The Swan,’ consumers cannot escape images of thin, beautiful, flawless women. In their quest to attain the ideal body and the face of perfection, consumers have become more willing to do anything to alter their appearances—at any cost.

Although all cosmetic procedures are medical, the portrayal of surgeries in the media is often seen as simple and easy, and risks or complications are rarely ever revealed or discussed. Because of this, more and more consumers have become comfortable seeking cosmetic procedures outside of a physician’s office.

As a result of the relaxed attitude being taken toward cosmetic surgery, business is booming at spas, salons, walk-in-clinics and even private homes where consumers are led to believe that it is safe to have procedures such as laser hair removal, chemical peels and Botox® injections performed by a non-physician in settings unsuitable for the practice of medicine.

What consumers do not know is that a physician is not always on- site at these facilities and any invasive cosmetic procedures performed by someone other than a qualified physician can pose harmful threats and potentially permanent damaging results. But there is a lot of money to be made by performing cosmetic treatments and “phony physicians” have rapidly become aware that the fountain of youth could be their pot of gold.

The inexperience of the unqualified practitioners becomes apparent when laser hair removal treatments, laser resurfacing, Botox® injections, or chemical peels result in severe burns or infections, scarring, removal of undetected cancerous lesions, or in some cases even death.

That is why the American Society for Dermatologic Surgery (ASDS), has launched a campaign warning consumers that cosmetic treatments, such as those using lasers, intense pulsed light devices, chemical peels, soft tissue fillers and botulinum toxin treatments are medical procedures that should only be performed by a fully-qualified physician, or under the direct supervision of a physician.

With more than four million skin-related procedures performed in 2003, it is not surprising a recent ASDS survey showed that nearly 41 percent of responding physicians reported an increase in patients seeking treatment due to damage caused by untrained non-physicians performing laser and light rejuvenation techniques, chemical peels, acne therapy and other skin procedures. In the year 2001 alone, 24 percent of the total number of cosmetic procedures performed was for repeat surgeries—either due to complications or the dissatisfaction of the patient.

The ASDS urges consumers to choose a qualified dermasurgeon to evaluate and perform each cosmetic medical procedure. It is important to check the provider’s qualifications and credentials to help avoid complications due to inadequate treatment.

To illustrate this point, the following are examples of the results of some consumers being deceived by non-physicians:

In 2002, a man posed as a dermatologist in New York City. He advertised treatments such as laser hair removal and collagen treatments and operated out of what he called ‘a skin and laser center.’ In an office setting, filled with fake credentials, he treated many patients for more than a year.

A young investment banker sought a laser treatment from him, a seemingly minor procedure. However, when the patient experienced complications from the anesthetic used during the procedure, the man panicked and did not know what to do. The patient died as the result of his treatments and her body was later found buried in his garage. The patient never knew the man was not a real doctor. He is now being held awaiting trial.

In November 2004, a Florida couple fell victim to a non-physician practicing medicine while seeking a Botox® treatment.

Botox®, now a common cosmetic product, is safe and effective when used by a trained physician with extensive knowledge of the facial anatomy and cosmetic procedures. Many people use Botox® to lessen the appearance of wrinkles, treat muscle spasms, excess sweating, migraines and painful scars and most treatments involve little recovery time.

The Florida couple that sought Botox® wrinkle injections at a clinic allegedly did not receive Botox®, but instead received a deadly dose of a non-FDA approved form of botulinum toxin. The product had no manufacturing regulations, was not approved for use in humans, and was administered by someone whose license was revoked. The couple became paralyzed as a result of their mistreatment and required extended hospitalization.

In the news most recently on this topic was a 22-year-old woman from North Carolina who died as a result of a predictable reaction to a topical pain relieving cream she used before receiving a laser hair removal treatment at a local spa. The cream, which contained lidocaine, was not FDA-approved. A local pharmacy made the mixture for the spa without knowing the side effects of the ingredients. There was not a doctor on-site or associated with the clinic to deal with complications from the procedure, although a doctor’s name was still being used.

Unfortunately these are just a few of the hundreds or more cases of what can happen when patients do not receive cosmetic procedures by qualified, trained physicians.

In an effort to raise awareness among consumers on what they need to know before undergoing any cosmetic procedures, the ASDS has outlined the following precautions:

• Make sure a doctor is on-site. Most cosmetic procedures should be performed by a board-certified physician, specifically trained to perform the procedure. If a procedure is not being performed by a dermasurgeon, make sure that the supervising physician is properly trained in the procedure and is on-site and immediately available to respond to any questions or problems that may occur while the procedure is being performed. Make sure that the physician performs a consultation and discusses how the procedure is performed, the possible risks and alternatives, how many treatments will be required and what will be the expected final result.

• Check credentials. Is the doctor overseeing the procedure board-certified in dermatology? Just because there are diplomas on the walls, does not mean they are legitimate. Check with your state Medical Board to see if any complaints have been filed against this person. Also, is the physician a member of the American Society for Dermatologic Surgery? (to verify ASDS membership status, visit www.asds.net.)

• Ask questions. Is this treatment right for you? Is this laser, device or technique appropriate for your skin type? Has the physician performed this procedure before on the part of the body on which you are having it done? Is the suggested product/procedure approved by the FDA?

• Have you had an initial evaluation by a physician with special expertise in the skin?

• Discuss pain management options to avoid the risks associated with general anesthesia.

• Pricing: If it’s too good to be true, then it probably is. If you are offered special pricing to commit to receiving a procedure, or if a procedure costs significantly less than usual, you can assume you are not receiving the best treatment. Remember that you are trusting this person with your body, your health and your life.

To find out more ways to protect yourself from non-physicians practicing medicine, visit www.asds.netor call 1-800-441-ASDS (2737).