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Should I go to a dermatologist or a medi-spa?
Buyer Beware

What’s Better, The Dermatologist Or The Medi-Spa?


July 23, 2017

When you’re in the market for an aesthetic treatment, skipping the clinical setting of a cosmetic doctor’s office in favor of a pampering medi-spa is tempting, but what are you sacrificing, exactly? While medi-spas are becoming increasingly popular, they run the gamut from glorified nail salon to state-of-the-art skincare clinic.


What’s the difference between medi-spa and a dermatologist’s office? Is one better than the other for certain treatments?


The term medi-spa (short for “medical spa”) has become an umbrella name that encompasses anything from a treatment room within a dermatologist’s or plastic surgeon’s office to a storefront at the mall where you can get a shot of Botox at the same time as a mani/pedi.

“I would like to think that every medi-spa has a doctor on site overseeing the staff, but that’s not always the case,” warns Gervaise Gerstner, MD, a board-certified dermatologist in NYC, member of the Charlotte’s Book advisory board, and assistant clinical professor of dermatology, Mount Sinai Medical School.  While a medi-spa may have a doctor affiliation, that can mean anything from having a qualified, board-certified cosmetic dermatologist or plastic surgeon on-site supervising every procedure to a doctor who doesn’t even specialize in skincare simply lending his or her name to the establishment (and collecting a share of the profits).

In recent years, there have been more calls for tightening regulations to govern these establishments, but we’re not there yet. California law requires that medical businesses (and medi-spas count as that) be at last majority owned by a physician (although not necessarily a dermatologist or plastic surgeon)—and all patients must be examined by a doctor, physician assistant or nurse practitioner before receiving any treatments. At least a dozen other states are working on “truth in advertising” laws that would require medi-spas to detail all practitioners’ training and credentials clearly in their marketing materials. But right now, the medi-spa industry is widely unregulated and many medi-spas aren’t transparent on exactly who their supervising doctors are and their qualifications.

“Even for procedures in which the risk of complications is relatively small, why would you take the risk?” asks Gerstner. “I think it’s just asking for trouble if you go someplace where someone without a medical background is doing your cosmetic procedure.”


“If you plan on having someone contact your skin with a laser, scalpel or needle for a cosmetic treatment, make sure you’re seeing a board-certified dermatologist or plastic surgeon, not just an aesthetician,” says Robert Anolik, MD, a board-certified dermatologist in NYC and clinical assistant professor of dermatology at NYU School of Medicine and Weill Cornell Medical College.

There’s no denying that a trip to a medi-spa feels more luxurious than a visit to a sterile cosmetic doctor’s office, even if it’s not for a not-so-relaxing procedure like laser hair removal or CoolSculpting. Medi-spas give you soft fluffy robes to wear, pitchers of cucumber-infused water to sip and healthy snacks to munch on. There’s no reason not to enjoy all that, just pick the right services to try while you’re there.                  


Don’t assume a medi-spa is as safe as a cosmetic doctor’s office just because it has the term “medi” in it. There is currently no national standard regulating medi-spas, making it difficult to know which ones are great and which ones you should steer clear of. That’s why it’s imperative to ask plenty of questions before you sign up for a cosmetic treatment. Find out who will actually be performing the procedure, what experience they have, and what the physician’s role is. If you’re not comfortable with what you find out, move on to another establishment.

So before you book a skin-enhancing service like Botox, laser hair removal, a dermal filler, microdermabrasion or even a so-called “photorejuvenation facial,” do your homework first, then decide.


Read all about the AcuFacial: half acupuncture, half facial.
Plus: here’s everything you need to know about the popular trend of microneedling.


Learn more about Gervaise Gerstner, MD and Robert Anolik, MD. Read client reviews, book appointments, and get expert advice. Only the best cosmetic doctors, skincare gurus, nutritionists, fitness and wellness professionals make it into our book.

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