A GROWING number of Americans are seeking laser procedures for cosmetic and medical skin conditions, but a new comparative study reveals wide disparities in training, supervision, and care across practice settings. The findings offer vital insights for healthcare professionals and reinforce the need for enhanced oversight in cosmetic dermatology.
According to the study, conducted in September 2024, fellowship-trained dermatologists offer significantly more physician-led and customized laser care than medical spas and plastic surgeons. The researchers identified 124 board-certified dermatologists who completed an American Society for Dermatologic Surgery (ASDS) Cosmetics and Lasers Fellowship. Compared to other providers, these specialists demonstrated higher standards across several key parameters.
Physician involvement was one of the most striking differences. While 60% of laser procedures in dermatologist-led practices were conducted by a physician, this figure dropped to just 33% among plastic surgeons and a mere 9% in medical spas. Alarmingly, 56% of laser treatments at medical spas were handled by laser technicians, and only 41% of these spas offered on-site physician supervision.
Consultation wait times and fees further reflect the contrast in clinical focus. Fellowship-trained dermatologists had the longest average wait time for consultations, 23 days compared to just 4 days at medical spas—but charged the highest fees at $153, compared to $30 at spas and $78 among plastic surgeons. This may correlate with a greater investment in laser technology and more tailored treatment protocols.
Indeed, nearly all dermatologists (98%) and plastic surgeons (98%) reported customizing laser treatments, whereas only 63% of medical spas did so. Additionally, 19% of dermatologists spent more than half their clinical time on lasers—a level of specialization not seen at all in spa or plastic surgery practices.
The study raises important concerns about the quality of care in non-specialist settings. While cost and convenience attract patients to medical spas, the lack of physician oversight and lower training standards could jeopardize treatment outcomes.
Reference:
Coyle K, Kesty KR. Cosmetic Lasers in the US: Who’s Using Them, the Latest Technology, and What Patients Need to Know. J Cosmet Dermatol. 2025;24(6):e70235.
