The view from the vendors' side of the medspa debate

Key Points

National report - According to the head of the International Medical Spa Association (IMSA), one of the reasons for the spa industry's burgeoning growth is the aggressive participation of pharmaceutical companies and device manufacturers, whose products are used for treatment in these facilities.

"In my view, there are four major reasons for medspa growth," says IMSA president Eric Light. "One is awareness of consumer desire for anti-aging services. Second is that doctors are losing income to insurance companies, and medspas are a cash business. Third, entrepreneurs are offering medspa franchising, and fourth, there is a growing number of vendor companies that offer a higher level of training and educational services on the use of their products and equipment."

For example, BioForm Medical of San Mateo, Calif., maker of dermal filler Radiesse, created the Radiesse Medical Education Faculty (MEF), which is composed of about 120 United States physicians who hold preceptorship training for colleagues who desire peer-to-peer learning and want to be certified as a Radiesse injector.

Dermatology Times asked a sampling of companies to discuss their guidelines on the sale of their products to medical spas.

Allergan Medical, the Irvine, Calif., maker of Botox (botulinum toxin A), sells its products only to licensed healthcare professionals - and, in some cases, to specialty pharmacies that service hospitals - as defined by state licensing laws, says Allergan President Robert Grant.

"At the time new accounts are established, we require proof of the healthcare practitioner's license, and we verify the status of their license by checking the state's board of medicine Web site," he says. "We also require the physician to sign a document in which he certifies that he is responsible for the administration of the drug or (that) someone under his supervision that is medically licensed by the state authority to inject Botox Cosmetic" will be responsible.

Mr. Grant says that because aesthetic injectable treatments are technique-sensitive procedures, Allergan recommends that patients see an aesthetically trained physician - a plastic surgeon, facial plastic surgeon, dermatologist or oculoplastic surgeon - for treatment to ensure optimal results.

"The efficacy of treatment with Botox Cosmetic is best assured when it is administered by a well-trained aesthetic-specialty physician with an intimate knowledge of the facial anatomy, the product and the area of injection, and who has the qualifications to evaluate and determine the best treatment for each individual."

Mr. Grant says only medspas operated by a licensed healthcare professional are permitted to purchase Botox or any other Allergan product.

"Allergan goes through all appropriate measures to ensure that any new facilities or practitioners purchasing Botox Cosmetic or other Allergan products hold a valid state's license," he says. "However, Allergan is dedicated to educating licensed healthcare professionals on appropriate product use and injection technique in an effort to ensure positive patient outcomes."

Rhytec, of Waltham, Mass., the maker of Portrait plasma skin-regeneration technology, says the Food and Drug Administration restricts sales of its devices to "by or on the order of a physician."

A Rhytec spokesman says the company "advocates the sale of Portrait to a physician who is familiar with the medical literature, complications and hazards associated with the use of light-based energy systems in the treatment of facial rhytides and the removal of benign skin lesions."

The spokesman adds that Rhytec conducts on-site training with "clinical education specialists who are all registered nurses (who) train the physicians and observe their first treatments."

Medicis of Scottsdale, Ariz., maker of Perlane and Restylane, declined comment on the use of its products in medical spas.