Four years ago, a Chicago resident called Steve Perez walked into a PureLight medical spa for a $900 laser hair removal procedure. The 34-year-old walked out with a blistering burn on his chest.
This is a scenario that’s become all too familiar. It happens more often that poorly trained technicians with no medical experience are carrying out medical procedures such as Botox injections, chemical peels and laser hair removal at so-called medical or medi-spas in major cities across the US.
The number of medical spas, estimated to be more than 2,000 nationwide, has grown 160 percent in the period of 2005 - 2008, according to the International Medical Spa Association. It’s estimated that more than 1 million laser hair removal procedures were performed in 2006, up from 300,000 in 2003.
And, just as the number of surgeries is growing, so are the horror stories. According to the American Society for Dermatologic Surgery, the number of botched procedure complaints grew 41% between 2005 and 2006.
A dozen states, including Delaware, New Jersey, North Dakota and Hawaii, allow only physicians to perform laser hair removal, with many others requiring physicians to supervise these procedures. But 19 states, such as Arizona, Idaho, Ohio, Rhode Island and Minnesota, have no laws regarding use of laser technology.
Oversight is desperately needed in all 50 states, physicians say. But that’s easier said than done.
"It is basically buyer beware," said Carolyn Jacob, a dermatologist who later treated the 34-year old following his laser hair horror.
"These are medical procedures designed for physicians or at least to be guided by physicians. The state of Illinois has no law regarding (laser hair) devices and they don’t treat them as medical devices, which is exceedingly frustrating. They have been working on regulations for several years. Other states already have them. But to get all 50 states on board, you have to work with 50 different governments."
Perez later learned that many medi-spas, like the one he used, which since has closed down, circumvent the medical licensing process by operating as a beauty shop.
"When you walk in, everyone’s got on lab coats and it’s set up just like a doctor’s office," Perez said. "It’s unbelievable that these places keep popping up. How many other people walk in the door trusting that these are doctors and nurses?"
Shortly after beginning the hair removal process on Perez, the laser technician noticed a discoloration on his chest. She told him it could be removed with the laser.
"I was like 'go for it,'" said Perez, who believed the technician to be a nurse. "I figured she knew what she was doing."
Once the technician began to "remove" the large discoloration using an Intense Pulsed Light (IPL) treatment, Perez said he felt immediate pain and smelled burning hair.
"There was literally smoke coming off of my chest," he said. "She said it’s OK; that’s just the hair follicles burning. So I didn’t think nothing of it. I ended up walking out of there with a 1 1/2-inch-by-2-inch test area that was very pink and reddish, but I thought that was part of the process and that when it healed it would be gone."
Perez continued experiencing pain throughout the night and the area began to blister. It eventually formed brown scab in some areas and hypopigmented or turned white in other areas, he said.
"Before the IPL, my chest had just the brown discoloration," he said. "Now I'm left with three different colored patches on my chest and shoulder from the laser burn," Perez said.
"I have to look at this scar every day, and it's a constant reminder of how much pain I suffered and the bad judgment I used, because I just didn't know the dangers of going to a medi-spa.
"They’re in the business to make money," he continued. "There’s no ethics; there’s no morals. The laser hair removal didn’t even work because of my skin tone. The laser they used on me was for Caucasians and not for a guy whose last name is Perez."
He later consulted Jacob to see if there was anything she could do for the scarring.
"My initial reaction was why in the world did anybody laser this," said Jacob, a member of the American Society for Dermatologic Surgery. "I could see just by looking at this that it was something unusual and a dermatologic disorder that needed to be diagnosed first."
Jacob biopsied the area and sent it to Northwestern University for testing. When testing determined the lesion to be something different than what Jacob perceived it to be, Perez was sent to Northwestern for its monthly ground rounds in which 40 specialists from around the world examine unusual cases and discuss what they might be.
Perez was later diagnosed with an unusually shaped, very late-onset birthmark.
Jacob believes a colleague of hers may be able to eliminate Perez’s scarring with a different type of laser device.
"I passed the torch to someone who can perform the procedure that I think would work best," she said. "I don’t own the device so I was happy to have him receive the right treatment from someone else."
Perez hopes one day he will be scar-free and though he’ll likely spend hundreds, if not thousands, of dollars by the time it’s all said and done, he has chosen not to sue the medi-spa he blames for the injury.
"They’re out of business now and by the time the lawyers get involved, what’s left over, $1,000 and a lot of headaches," he said.
Still, he admits to holding a grudge against the spa and the woman who treated him.
"Why didn’t she say, 'let’s have a doctor look at this first,'" he said. "That would have been the solution to the problem, not let’s turn this laser up as high as it goes and burn it off. Somebody’s going to get hurt pretty bad if they haven’t already."
Jacob agreed that Perez’s experience could have turned out much worse.
"The failure to diagnose lesions on the skin that are harmful or cancerous is dangerous and they shouldn’t be treated with these devices," she said. "If it’s a melanoma and you use one of these devices on it, it will go away temporarily, but it will come back all the worse and that could be devastating."
Both Jacob and Perez encourage anyone considering laser hair removal to make sure an actual physician is performing the work or supervising.
Said Jacob: "Sometimes these devices malfunction and if someone gets burned, you need someone on staff trained in wound care that can possibly prevent an injury from permanently scarring somebody."