You got a License for that?

In the wrong hands, the tools of the medical spa can be dangerous

Mandy Shaw (left) and Elizabeth Shaw demonstrate a laser procedure at Louisville Laser in Spokane. - YOUNG KWAK
Young Kwak
Mandy Shaw (left) and Elizabeth Shaw demonstrate a laser procedure at Louisville Laser in Spokane.

Wonderful things, lasers. They can mend eyes, annoy lecturers, blast TIE fighters. And they can re-sculpt the surface of the skin. At medical spas, skilled laser technicians can erase freckles, moles, hair and spider-veins. But lasers aren’t just a matter of point, click, and — zap — blemish-be-gone. Choose the wrong medical spa, and you could get burned. Literally.

Most lasers target dark pigment, whether it’s hair or skin, says Cindy Napier, owner of Louisville Laser in Spokane. So if your hair contrasts well — say, black hair against pale skin — the laser burns just the hair.

The wrong type of laser, however, will burn darker skin along with the hair. Those with white or blonde problem hair are usually out of luck when it comes to laser therapy. And a number of medications — from blood pressure pills to immune suppressants — can cause complications for laser therapy.

The dangers of lasers were revealed clearly in 2005 at Laser Works of Seattle, where patients went in with the promise they could say goodbye to excessive hair, wrinkles and unsightly veins. They came out, however, with skin covered in blisters, “color changes, welts, rashes, swelling.” 

The state investigated and the three technicians — Cheri Winterstein, Merilyn Gelnette and Shaney Shoengarth — at Laser Works never had a license to practice. Yet they were using prescription-strength lasers and handing out prescription-strength numbing cream.

While numbing cream can sound innocuous, consider the cases of Shiri Berg and Blanca Bolanos. Berg, 22, liberally applied a prescription-strength anesthetic cream called Lasergel Plus 10/10 (10 percent lidocaine and 10 percent tetracaine) to her legs and wrapped them in cellophane prior to hair removal at a North Carolina spa in 2005. She was found inside her car, unconscious and having convulsions, and died 10 days later. Bolanos, of Tucson, Arizona, suffered a similar fate, following a two-year coma, after using she used 6 percent cream prior to laser hair removal. The FDA investigated the deaths and found that applying the creams over too large a portion of the body and covering the areas with any type of dressing can increase the risks associated with numbing creams.

“You and I can’t just go get medication and give it to people,” says Department of Health staff attorney Mike Farrell. “And estheticians would never dream of giving Oxycontin to treat pain.”

It isn’t just improper use of medications that concerns Farrell. “The same logic applies to prescription devices,” he says. But, “You can buy prescription hair-removal devices on eBay.” The eBay sellers rarely mention that, without a license, the device is illegal to use in the state of Washington.

Still, there wasn’t much of a downside to the abuses at Laser Works. The state sent the three technicians a cease-and-desist order and, after the technicians never showed up at court, a $1,000 fine.

In March 2007, the Washington state legislature passed a law requiring a medical director — a professional physician — to be on staff at medical spas that apply lasers, light, radiofrequency and plasma devices to the skin. The physician must be trained in the use of lasers and must train any laser operators at the facility. And the physician must also meet the patient, take a history, recommend a course of treatment and inform the patient if a non-physician will be operating the laser.

But that doesn’t mean everyone follows the rules.

In some situations, Farrell says, medispas will have a medical director, but the medical director isn’t on the premises. Sometimes he or she never even visits. In these cases, Farrell says, invariably, the technicians are exceeding their licenses. Sometimes dangerously so.

Currently, there are five other cases involving unlicensed laser use under investigation, says Patty Latsch, director of the Department of Health’s Investigation and Inspection Office. The office gets about 300 unlicensed-practice concerns a year.

The complaints are usually fairly specific, Latsch says. How extensive the practice is, and whether the clinic is licensed, determines which agency will investigate and punish the violation.

“When you seek out a medispa, make sure they have a medical director,” says Louisville Laser’s Napier. “Find out how long they’ve been in business, the background from the staff, get references.” She also suggests using the Better Business Bureau Website to see if any complaints have been filed.

“Basically, bottom line, consumers: Research,” Napier says. “Learn.”