Many Doctors Entering the Spa Business

Along with prescriptions and referrals, many doctors are offering cosmetic procedures in their offices like Botox, hair removal, and massages.

By Denise Mann
WebMD Feature

Reviewed By Brunilda Nazario

Aug 13, 2004 -- It used to be so simple. You went to the dermatologist to check or remove suspicious-looking moles or maybe to get an ointment to soothe your eczema. You went to your masseuse for a massage and the plastic surgeon for any nips and tucks along the way.

But times are changing. A growing number of dermatologists are entering the spa business, offering Botox and injectable wrinkle fillers, chemical peels, and other largely cosmetic procedures.

But is such one-stop shopping a good idea?

"Fifteen years ago, dermatology was purely a medical field," says David Goldberg, MD, the director of Skin & Surgery Specialists of New York and New Jersey and chairman of the Ethics Committee of the American Academy of Dermatology.

"People went to the dermatologist for skin cancer and rashes, and they went to plastic surgeons for anything cosmetic, but now fillers, peels, and Botox are actively being picked up by dermatologists," says Goldberg, the author of Light Years Younger.

Once that change started occurring en masse, the medical spa movement was born, he tells WebMD.

Calling it "a natural marriage," he says, this movement "will continue to grow. It's a wonderful trend and a natural for dermatologists and in the patient's best interest as well."

It's a ... Cosmeceutical!

The natural offspring of this marriage appears to be growing numbers of doctor-endorsed or -created product lines.

"It used to be that prescription products such as Retin-A were all that was available to get rid of wrinkles, and you had to go to the doctor to get it," Goldberg says.

But today there are an increasing number of products that are cosmetics and pharmaceuticals --known as cosmeceuticals.

Doctors understand what such products do and don't do, compared with the aestheticians at cosmetic counters, Goldberg says.

Dermatologists Jump on Spa Bandwagon

"We take spa procedures and make them more medical, which will also make them safer and more effective," says Mitchell Goldman, MD, medical director of La Jolla Spa MD, in La Jolla, Calif. "This way, we get rid of a lot of the fluff and bogus." La Jolla Spa MD offers facials, massages, and waxing; weight management and nutrition including natural hormone replacement therapy; anti-aging medicine; liposuction; spider and varicose vein treatment; hair transplantation; injectable wrinkle fillers; and acupuncture. This facility has a staff that includes a dermatologist, plastic surgeons, nurses, and aestheticians.

But that's not to say every spa with a medical doctor on board is a safe bet.

Caveat emptor ("buyer beware"), Goldman says.

"There is no regulation or industry standard of medical spas," he says. The best way to protect yourself is to make sure the medical director is a dermatologist or plastic surgeon, not a retired internist or a veterinarian.

Cosmetic dermatologist Leslie Baumann, MD, an associate professor of clinical dermatology at the University of Miami in Florida, agrees wholeheartedly. "Make sure the person doing treatments is a board-certified physician. Of course, I would even say a board-certified dermatologist."

Not all dermatologists are sold on this trend. One such doctor, Craig Leonardi, MD, a clinical associate professor of dermatology at St Louis University, has some doubts.

"Some of these treatments are actually quite legitimate. Botox and [wrinkle] fillers and chemical peels have a real effect, but I am concerned about some of the treatments that don't appear to have a clinical effect and are more consumer-driven," he tells WebMD.

Microdermabrasion, for example, he says. Microdermabrasion is a treatment in which the dermatologist sandblasts tiny crystals across the face to remove dead skin.

"If you return to work with no evidence of something having happened, odds are nothing happened," he says, referring to microdemrabraison and other lunchtime procedures that allow people to go right back to work with no visible side effects of the procedure.

"At some point, you cross the boundary from being a physician to providing consumer-driven services, and that's a sad situation," he says.

Make sure there is a doctor present when treatments are given, he says.

SOURCES: David Goldberg, MD, director, Skin & Surgery Specialists of New York and New Jersey; chairman, Ethics Committee, American Academy of Dermatology. Mitchell Goldman, MD, medical director, La Jolla Spa MD, La Jolla, Calif. Leslie Baumann, MD, associate professor clinical dermatology, University of Miami, Florida. Craig Leonardi, MD, clinical associate professor of dermatology, St Louis University, St. Louis.

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