Medical Devices & Estheticians

It's true, medical devices are used by Estheticians.

In most clinics in the US, esteticians are often used to perform treatments... but outside the US not so much. Here's an email I received from Susanne Warfield, Executive Director of NCEA, taking us to task for 'misinformation'.

Susanne Warfield - Executive Director NCEA

I received a call from one of our members regarding your website and the statement about estheticians using medical devices.

Estheticians are using medical devices every day...- even an electric tooth brush is a medical device as defined by the FDA. It is very important that we understand that any device sold and marketed in the United States must be registered with the FDA and laser and light therapy devices are just another medical device that have "Indications for Use" and "Intended Use".

Please update your misinformation on your website as it it incorrect. Thank you

Anyone have thoughts on what an esthetician in the US (or each state) can or can not perform? Where's the line?

New Medical Spa Regulations for Arizona & Texas

Arizona Medical Spa Regulation Update: Esthetician & IPL Laser Technicians

Arizona requires all training providers be registered with the state to provide training to comply with their requirements. The program shall provide a provisional certificate to the applicant verifying the successful completion of the didactic training.

An esthetician who has been using laser and IPL devices before the effective date of this amendment to this section may continue to do so if the esthetician applies for and receives a certificate pursuant to this section before October 1, 2010. Arizona state legislature requires a laser technician who wishes to perform cosmetic laser procedures and procedures using IPL devices to successfully complete 40 hours of didactic training as required by agency rules at a certified training program.
More Information From State Website

Texas IPL & Cosmetic Laser Regulations Update

The Texas Legislature has passed legislation in House Bill 449that establishes a regulatory program for laser hair removal. The Department of State Health Services is charged with implementing that program. The legislation requires every laser hair removal facility to be licensed by the department. It also requires that each individual who performs laser hair removal procedures, except physicians, be certified by the department. By September 1, 2010, every laser hair removal facility must be licensed and each individual who performs laser hair removal must be certified.

However, the adoption of the laser hair removal rules and implementation of the laser hair removal program has been delayed for a number of reasons, including the request from state leadership for each state agency to submit a plan to reduce budgets by 5%, as well as implementing an agency hiring freeze to help address the state's budget situation. Work on implementation, however, does continue forward.
More Information From State Website

Information adapted from Aesthetic Trends & Technologies

Guest post by Paula D. Young RN, author of Advanced IPL & Laser Training and the Medical Esthetician Training Manual & Study Guide and head of operations at Young Medical Spa.

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Estheticians: Learning About Acne & Laser Therapies

Ten-to-one you talked about acne briefly during your esthetics program. The acne patient at a medical spa, however, differs greatly than the patient you would see in a day spa. With the proper understanding of the etiology of acne and treatment modalities available, you can help keep your acne client's flare-ups under control.

In the Advanced Medical Spa Aesthetics Training Course, Chapter 12, Acne Vulgaris is discussed in depth. Understanding the disease itself is the key to deciding what therapies would be efficacious for your clients. The first section of the chapter discusses the etiology of Acne Vulgaris, various representing characteristics from the comedone stage to the cystic and scarring stage, medical treatment modalities such as antibiotic regimens or lightening agents, and the use of lasers.

At a medical spa level, most estheticians are involved in the treatment and care of acne patients. Their involvement typically includes product dispensing, facials, perhaps some light chemical peels (Chapter 4), or even microdermabrasion(Chapter 3) for acne scarring. Depending upon the State an esthetician is practicing in, therapy for some acneic clients can involve laser therapies. This chapter will help the esthetician learn how IPL therapies can be used to treat active acne as well as fractional lasers that can treat the scarring left behind (Chapter 15).

Acne is more than skin deep and, whether or not you can provide laser therapies to your clients, having knowledge of them and when to use them is quite valuable to your client and to your medical director.

Paula D. Young RN runs internal operations and training at Young Medical Spa and is the author of the Medical Spa Aesthetics Course, Study Guide, and Advanced IPL & Laser Training course for medical estheticians and laser technicians.

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Re-evaluating Your Medical Spas Skin Typing Practices

If patients haven't already started coming to your practice for laser hair removal for silky smooth summertime skin, they're probably starting now. And now is a more dangerous time than ever for them to start laser therapies especially if you or your staff isn't adequately trained on proper skin typing and assessment.

If you're like most practices, you will request a patient complete a skin typing worksheet to determine their Fitzpatrick Skin Type. A couple of problems arise here. First, you're depending on your client to complete the chart and be accurate and honest. Many technicians only look at the final score and never really go over each question. Are they really blonde, or is their hair colored? Do they really tan easily without burning if they're a freckled red-head? Verifying each answer the client has chosen is the responsibility of the technician who should be comfortable "overruling" an answer upon using their own eyes to verify.

Another problem that can arise is exposure to the sun, tanning beds, spray or bottle tans. This is the time of the year where your client may start false tanning. This pigment applied to the skin can very much interact with the laser parameters you have set; therefore, you will need to make an adjustment. Or, they could walk in on a Monday after getting some sun on Saturday and their legs will be a little "pink" to them which should look like a big red flag to you!

Even though a patient may be a repeat client, that shouldn't rule them out from completing a new form and being reassessed prior to treatment this time. Just because they weren't tanned last year when they had their chin and upper lip done doesn't mean they won't be tanned this year when they come in to have their legs treated.

Skin typing should be performed at every laser session, not just the initial visit, as there could be subtle changes each session. If you are a laser technician or aesthetician who is uncomfortable with skin typing your clients, or you have staff personnel you feel lack the necessary understanding of proper skin typing, you might want to consider the Medical Spa Aesthetics Course, Study Guide, and Advanced IPL & Laser Training course available on MedicalSpaMD exclusively. The Patient Selection Chapter discusses Laser Applications, Patient Selection, Skin Color, Skin Typing, The Fitzpatrick Classification Scale, Skin Classification by Ethnicity Type, Medical History, Physical Examination, and Contraindications for Treatment.

Great patient results begin with proper education to develop solid standards of practice. Your patients don't want to get burned, and neither do you.

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Career Advancement for Medical Estheticians

Awhile back I posted an aesthetician position on a local job search website. In my requirements, I had stated that only those aestheticians who have been trained in the proper use of laser technology should apply. I must have received over 100 resumes with barely a few who have ever laid their hands on a laser or even observed any procedures.

I selected a few resumes who I felt had years of experience and; therefore, would know the basic concepts of how skin reacts to laser light, Fitzpatick Skin Typing Scale, etc. I was surprised at how many of them had no idea how to answer what I was asking them.

It's obvious there are many skilled aestheticians out there seeking employment, or desiring to advance their career. I would highly suggest the Advanced IPL & Laser Training Course for Estheticians & Medical Spa Laser Technicians.

Advanced IPL & Laser Training Course is much more than knowing what the difference is between 532nm and 2940nm of light; or how different wavelengths affect blood, pigment and water; or even how laser light affects the stem cells of a hair shaft during the anagen growth phase. It's about broadening your knowledge of the aesthetic field, becoming a more valuable member to a medical aesthetic team, increasing your revenue by commission and upselling with your knowledge, and benefiting your patient by being able to explain various treatment options for them (some performed by you and other treatments by the physician). Even though you may not perform every treatment in a medical spa, such as injectable procedures or laser skin resurfacing, your knowledge of those procedures is very important in the patient advocate and educational process.

Even if you have no hands on training at this point, the Advanced IPL & Laser Training Course for Estheticians & Medical Spa Laser Technicians will lay down the foundation you need to secure a position in a medical spa. If one of the candidates had any understanding of some of the principles of laser technology, I would have brought them in for a personal interview with the physician. Hands on training is the easy part, the hard part is the theory behind laser technology.

Author: Paula D. Young RN runs internal operations and training at Young Medical Spa and is the author of the Medical Spa Aesthetics Course, Study Guide, and Advanced IPL & Laser Training course for medical estheticians and laser technicians.

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Medical Assistant's can not inject Botox!

I've seen and head about medical estheticians, medical assistants and even front desk staff administering Botox injections.

It's not legal, as this story on the prosicution of a medical assistant clearly shows.

Betty Guerra’s monthslong nightmare is over.

The 45-year-old former medical assistant learned today from her attorney that the 10 felony counts against her on allegations of “unlawful practice of medicine” will be dismissed, she said.

“I always believed things would work out the right way,” she said tearfully. “I cannot be punished for something I didn’t do.”

Guerra’s July arrest sparked controversy over what medical assistants can and cannot do. Specifically, there was confusion over whether they are able to give shots.

Guerra was accused of unlawfully administering cosmetic injections, an act commonly performed by medical assistants throughout Nevada.

The state attorney general’s office did not specifically say charges against Guerra would be dropped but indicated it won’t be pursuing the case.

“The complaint against Betty Guerra submitted to the Attorney General’s Office by the Board of Medical Examiners has been contradicted by the subsequent actions by the Board,” Attorney General Catherine Cortez Masto said in a statement. “Therefore, it is fair for us to conclude that it would be difficult to prosecute this case beyond a reasonable doubt.”

Guerra’s attorney, Jason Weiner, said this evening that the attorney general’s office had sent him a copy of an unfiled motion dismissing the case earlier in the day. He would not be able to provide the Review-Journal with a copy of that motion until Wednesday, he said.

After Guerra’s arrest, physicians became concerned about what duties their medical assistants could perform.

Former medical board director Louis Ling said that upon reading a 30-year-old law, he concluded that the assistants could not give shots. With flu season coming on, he then attempted to draft emergency regulations that would allow them to give flu shots, but not Botox or other cosmetic injections.

However, that effort was shot down when a judge recently ruled that the board, in considering the regulations, had violated the open meeting law.

The board later reversed its position, determining that state law allows medical assistants to administer everything from flu shots to Botox. Medical assistants could give shots as long as they are under the “direct supervision” of a physician. Most health officials and doctors take that to mean the physician is on premises.

Ling resigned on Friday.

Guerra, a mother of three who was a physician in her native Peru, said she has been under incredible stress since her arrest and lost her job because of the publicity surrounding her case.

“It was a nightmare. I could not even sleep or eat all this time, wondering what was going to happen.”

Still, she said she harbors no anger.

“Now, I start all over. But it’s just another experience in my life.”

Via Review Journal story.

Medical Spa Training Manuals Launched!

We've successfully launched the Medical Spa Training Manuals... finally.

It was something of a struggle for the last few weeks trying to get everything edited and designed but the result is extrordinary. I'd like to congratulate Paula for excellent work and Melissa for the final editing and the very long days getting everything together. We couldn't be happier being given the opportunity to publish them.

If you haven't yet taken a look you can download the tables of content for both the Advanced IPL & Laser Training for Non-Physicians and the Advanced Medical Spa Aesthetics Training Manual & Study Guide.

If there are cudos, and there are certainly going to be, the're most correcty directed at Paula, who has done a fantastic job on the content, from differences in technology to a fantastic sense of what's the needed amount of information in each areas.

Of note: a number of our first orders have been made by medical spa consultants and trainers who know how important training your laser clinc or med spa staff actually is.

Medical Spa MD Training Courses

Finally available! The Medical Spa  MD Training Courses for Laser Clinics, Medical Spas, Plastic Surgery Centers and Cosmetic Dermatology Practices.

Your medical spa staff's knowledge and expertise is a critical componant to your medical spa or cosmetic clinic's success.

From IPL training to skin typing, Botox, Restylane, and Juvederm filler injections, the Medical Esthetician Training Manual & Study Guide, and the Advanced IPL & Laser Training for Non-physicians is required material for smart medial spas, plastic surgeons and cosmetic dermatologists.

Now it's easy to train every new hire on what non-surgical cosmetic proceedures you offer, how they work, and what alternatives there are. Ensure that your front desk, estheticians and laser technicians have the information that they need to answer patient questions with confidence.

For the first time, your laser clinic or medspa staff has the latest information on the newest nonsurgical medical treatments. From Botox, Restylane, and the newest filler injections, to fractional CO2 laser resurfacing, skin tightening and IPL treatments, now you have a uniform and tested training system. This is a must have for any serious cosmetic clinic.

Download Advanced IPL & Laser Training TOC
Download Medical Spa Aesthetics Training Course TOC

Advanced IPL & Laser Training Manual

The Advanced IPL & Laser Training Manual for Non-Physicians is required training material for every new hire working in a medical spa.

From IPL to fractional laser treatments, this manual covers the non-surgical IPL & Laser treatments your staff should know. Give your staff the information that will make you successful.

Advanced IPL & Laser Training - $227

Medical Estheticain Training Manual & Study Guide

 
The Advanced Medical Spa Esthetics Training Course & Study Guide is a two part learning cirriculum for non-physicians.

With 165 pages of quality content, this course is delivered in two parts that include a text book and a study guide. Already being used by leading medical spas and esthetician schools.

Medical Spa Aesthetics Training Manual & Study Guide - $247

Get all three and save: The Medical Spa Aesthetics Training Manual & Study Guide AND The Advanced IPL & Laser Training Manual

Buy the Medical Spa Aesthetics Training Course & Study Guide AND the IPL & Laser Training course and save almost $200!

 
Medical Spa Aesthetics Training, Study Guide, and Advanced IPL & Laser Training - $297

These training manuals are a critical component to the success of any Laser Center, Med Spa, Plastic Surgery or Cosmetic Dermatology practice. Use them to train every new medical spa staff member on what cosmetic proceedures are available, how they work, and what alternatives there are.

Written for non-physicians, both of these advanced training courses are already being used in leading medical spas and laser clinics to provide every new medical estheticians, laser techs, and front desk staff with current information about cosmetic information, and test their knowledge before they're hired.

Written by Paula D. Young, RN, these training manuals are designed to meet the real-world needs of cosmetic practices by those who know how to run a succesful cosmetic practice and how important it is that your staff is trained and has the information they need to become trusted avisors to your patients.

Everyone who has owned or run a med spa or cosmetic practice knows how long it takes to train new staff, and how much damage can be done with the wrong information. These new manuals and study course from Medical Spa MD make it easy to provide consistant, quality information to staff and ensure that everyone is on the same page from day one. Your entire staff now knows what your education expectations are and have the materials to meet them.

From Thermage to IPL to fillers and chemical peels, how they work, who they're for and when to use them. These courses give your laser techs, medical estheticians and front desk staff a deep understanding of the landscape of nonsurgical cosmetic medicine and save you endless hours of repetitive individual trainging. It's the single best investment you'll make in your medspa.

Give your staff the benefits of insider knowledge and make sure they're making the right decisions.

The Medical Spa Aesthics Training Course & Study Guide for medspas & laser clinics.

The Medical Spa Aesthetics Training Course & Study Guide for Medspas, Laser Clinics & Cosmetic Medical Practices.

NOW AVAILABLE!

Written by Paula D. Young, RN, the Advanced Medical Spa Esthetics Training Course & Study Guide is a two part learning cirriculum for non-physicians. The course is delivered in two parts that include a text book and a study guide.

This is an invaluable tool for any Laser Center, Med Spa, Plastic Surgery or Cosmetic Dermatology practice to train every new medical spa staff member on what cosmetic proceedures you offer, how they work, and what alternatives there are.

This study course is being used in medical esthetic schools and leading medical spas and laser clinics to provide every new esthetician and laser tech with a study course, and test their knowledge before they're hired.

For the first time, your laser clinic or medspa staff has the latest information on the newest nonsurgical medical treatments, from Botox, Restylane, and the newest filler injections, to fractional CO2 laser resurfacing and IPL treatments.

Your medical spa staffs knowledge and expertise is a critical componant to your success. Now you can be confident that your front desk, estheticians and laser technicians have the information that they need, and can answer patient questions with confidence.

Memberswill only be available to existing Medical Spa MD Members so be sure that you've signed up for your free membership.

Laser treatment? Skin clinic? Who's in charge here?

It’s happened in Florida and now in Massachusetts. State legislators and physicians are trying to establish some guidelines and laws to protect the public from sustaining injury by unlicensed or untrained service providers.

We’ve read the of the lipodissolve horrors where people are offering lipodissolve, laser treatments and botox in their garage for heaven’s sake! It’s hard to believe it has come to this, but cosmetic medicine has turned into a “cash cow” for anyone!

I’m getting so sick of the turf wars amongst doctors of which specialty should be doing what... I mean seriously... can’t you all get along? Instead of fluffing your feathers to establish dominance over cosmetic medicine you should ban together to eliminate the bottom feeders who are performing services in their garages to protect the practice that IS cosmetic medicine! These are the people who are ruining your reputations! The unskilled, the unlicensed, money grubbers (and yes, I am also including lawyers here!)!

Let us also not forget that nurses and aestheticians are fighting over positions as well. There’s no certifying board for aesthetic nurses, or medical aestheticians. Here’s a funny story... when I started our medical spa with my husband years ago, I contacted both the heads of the nursing board and the cosmetology board. Since I hold both licenses I asked if I was allowed to perform a facial. I was told it’s a gray area. The nursing board said I could, in fact, perform a facial under the direct orders of a physician if the facial were deemed medically necessary. What physician do you know who will write an order for a facial? What physician wants to manage facials, and waxing, and massage, and the products which are dispensed? The cosmetology board said I could not perform a facial because the practice isn’t licensed or inspected by the board.

Huh?

With the economy the way it is, it’s no wonder everyone is jumping on the “medical spa” bandwagon! I mean, it’s like an ATM machine with no fees and no penalties. The perspective boards are all looking at each other and wondering who’s responsibility it is to be monitoring them.

The time is now upon us where legislation will take precedence, once again, on how we perform medicine and who may perform it. The powers that be will decide for us exactly if IPL is a medical device, or not. If the removal of a sunspot or tattoo can be removed by a physician, PA or nurse. Who may do cosmetic procedures, what training they must have and what certifications must be obtained prior to plucking an eyebrow (I digress, but you get my point).

Although we agree that certain treatments be performed or directly supervised by a physician, the fact is, there are many other services that aren’t deemed medical in nature. Should a physician be controlling those as well?

No current board has jurisdiction over all professions within a medical spa or laser clinic so, most likely, a new board will emerge with regulations, standards and licensing fees to add to our current practice.

It will take a few years to establish a task force and develop legislation for most states. But when all is said and done, what will arise is higher fees for service for the client, more inspectors showing up on our doorstep, higher licensing fees and insurance rates, and less control, once again, on how we treat our patients.

Are you ready for another government agency to take control of YOUR profession?

Author: Paula D. Young RN runs internal operations and training at Young Medical Spa and is the author of the Medical Spa Aesthetics Course, Study Guide, and Advanced IPL & Laser Training course for medical estheticians and laser technicians.

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