As spas decide to keep up with the trend of becoming more technical, and consequently more solutions-based, the implications of incorporating safe medical services into spas are becoming more acute, according to Dr Diane Wong, owner and founder of Glow Medi Spa in Toronto’s Yorkville, Canada.

The Spa Industry Association of Canada’s (SIAC) subsidiary of leading industry spas, Leading Spas of Canada, provided a platform for a 10 June webinar for Dr Wong to explain the benefits, risks, complications, regulations, costs and alternatives to medi-spa services.

The webinar was organised by Spas2b, a full-service international spa development company that specialises in spa business management education and training.

Wong, a general practitioner dedicated to non-surgical cosmetic treatments and enhancements, told webinar viewers – spa owners, managers, physicians, nurses and educators of medical aestheticians – about the different treatments on the market and how advances in technology have allowed for a boom in “lunchtime” express treatments with no real need for a long recovery period, known as “down-time”.

As a course director of the Laser Training Institute (Canada Division), Wong stressed the need for medically-trained staff in a medi-spa to operate the often dangerous equipment.

“Doctors have a level of expertise that the average aesthetician does not. Medically-trained people are necessary in a medi-spa so that they can deal with potential complications that arise during or after a treatment,” Wong added.

Therefore, while these non-invasive procedures can produce ‘wow results’, it is crucial that the person operating the machine, which Wong often describes as a potential weapon, has a deep understanding of both the skin, plus the theory and physics of the equipment in use. For example, Wong illustrated the dangers of using lasers. “Hyper and hypo-pigmentation are always a risk, plus vascular impairment can occur too. That’s why we never laser the feet because the veins in the feet are all crucial for circulation.”

The most common causes for complications during a procedure are usually down to the therapist’s inexperience, inadequate training or knowledge, poor follow-up and communication with the client, or even a laser malfunction, according to Wong.

Common pitfalls for medi-spas include poor communication with the client about strictly avoiding sunlight for four weeks prior to a treatment, confusion over the client’s skin type and skin conditions such as melasma – an incurable dark pigmentation that is different to regular sun damage and caused by a hormonal imbalance.

“Medi-spa employees need to be able to decide what skin type a client has according to the Fitzpatrick scale which dictates what laser to use based on their sensitivity to burning. Type four skin – Asian, Italian, Persian and sometimes Greek – is particularly important to get right. While this skin type looks light, it reacts with sensitivity to laser treatments,” said Wong.

Wong pointed out that there are currently no regulations in Canada for medi-spas – except for those covering injectible treatments – but she expects this to change as more complications arise and the need to protect the public from increasing cases of laser burns becomes a priority. She was unsure about who the regulatory body that would carry out these measures should be.

Texas and Florida were highlighted by Wong as examples of neighbouring US states which have regulations for anyone owning or operating a laser or light-based device. To operate such a machine, an exam must be sat after a training course. Wong suggested this was perhaps the way forward for similar regulations in Canada, because the system of regulating the technology and its owners is far more beneficial than regulating the many different categories of physicians in charge of operating it – such as nurses, doctors, aestheticians and therapists.

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