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Hepatitis C Transmission from Botox and Other Spa Treatments

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Since medical spas are offering more treatments involving the use of needles, sometimes without the supervision of a medical physician or properly sterilized equipment, the potential for Hepatitis C transmission is rising. Learn about some of the spa treatment techniques that pose hepatitis transmission dangers, as well as five ways to increase your safety in a medical spa.

Everyone wants to look good, and now there are more ways to do it. Medical spas are the fastest growing segment of the spa industry and the newest spin on the cosmetic surgery and anti-aging world – and may be contributing to the spread of Hepatitis C. Many medical spas offer services that blur the distinction between medical procedures and beauty treatments, creating a substantial void in regulation. When it comes to the transmission of the Hepatitis C virus, this lack of universal regulation poses an obscure danger.

The three primary destinations melding medical procedures with beauty treatments include:

  1. Medical Spa Franchises – These businesses are becoming increasingly popular and are capitalizing on this growing market.
  2. Existing Day Spas – More conventional spas are adding medical procedures to their list of offerings.
  3. Cosmetic Surgery and Dermatology Offices – Many of these medical professionals are creating spa-like atmospheres to profit from this growing market.

With such varied types of businesses, government agencies are challenged to implement strict regulations or defined rules for the medical spa market. As Dr. Alexander Rivkin of Westside Medical Spa puts it, “the medical spa industry is the wild west at this point… It’s a buyer beware kind of field.”

Some say the problem with the medical spa industry is that their popularity has outpaced oversight. Some state laws say only doctors can botox injections, while California and New York only require doctor supervision. Still, others have no laws in place. And even where regulations exist, no one monitors medical spas until someone complains. CBS News went undercover in California and easily found a place willing to give botox injections by a technician only, which is against the law. “Oh, you don’t need a doctor, or nurse,” says someone at the spa. “We’ve done this before.”

Hepatitis Transmission Dangers

As the number of people realizing they have the Hepatitis C virus continues to rise, so does the concern of how they were infected in the first place. Since Hepatitis C is only transmitted through the blood, a majority of infections occur through IV drug use or tainted blood transfusions. However, experts estimate that at least 10 percent of those infected cannot determine how they contracted Hepatitis C. The unregulated, burgeoning medical spa industry could be one of the culprits of mysterious Hepatitis C transmission cases.

Since medical spas are offering more treatments involving the use of needles, the potential for Hepatitis C transmission is rising. Anytime needles are involved, universal hygiene precautions must always be followed to prevent disease transmission. To maintain consumer safety, all licensed medical professionals who use needles are required to complete an approved course of study and pass an exam proving they fully understand and practice these precautions. Some of the techniques using needles in a spa environment include:

  • Permanent Makeup – Called intradermal cosmetics or micropigmentation, this procedure is also known as cosmetic tattooing.
  • Cosmetic Dermal Fillers – By injecting substances into wrinkles or folds, cosmetic dermal fillers such as Botox or Restylane are believed to restore volume and fullness to the skin.
  • Mesotherapy – A type of body sculpting, small microinjections of medications, vitamins, minerals and amino acids into the skin’s middle layer is a new technique aimed at reducing cellulite.
  • Derma Needle – Another type of body sculpting, a tattoo machine penetrates the skin with a small needle to create collagen formation, supposedly resulting in smoother, tighter skin.

While proper sterile practice eliminates the possibility of Hepatitis C transmission from any of these procedures, the lack of medical spa regulation removes this guarantee of consumer safety.

Making news in May of 2007, an incident in Ohio reminds us of the possibility of Hepatitis C transmission from a medical spa. Arrested for practicing medicine without a license, the owner of a medical spa in Westlake is accused of infecting a client with an improperly sterilized tool used in a spa procedure. It seems that a form of body sculpting was being conducted, using tiny needles on a roller. For this kind of procedure to be safe it is imperative that any needles used be in a sterile package for one-time use only – or – be properly sterilized in an autoclave.

What to Look For

When it comes to any kind of needle piercing the skin, a risk of Hepatitis C transmission exists if not properly sterilized, or is inappropriately used between clients. The Centers for Disease Control recommends that single-use instruments intended to penetrate the skin be used once, then disposed of properly. Reusable instruments or devices that penetrate the skin and/or contact a client’s blood should be thoroughly cleaned and sterilized between clients. Anything less creates the possibility of transmitting the highly contagious Hepatitis C virus.

Spa treatments utilizing needles can be safe (not transmit infectious disease) if the practitioner is following universal precautions. While the laws differ depending on the service and the spa location, here are five ways to increase your safety odds in a medical spa:

  1. Research the spa first. Medical professionals say clients should do their homework: get references, check with local licensing agencies and ask questions before agreeing to any services.
  2. Pay attention to the spa’s surroundings. Look for clues to their emphasis on safety and sanitation practices. Notice if customers are coming and going faster than instruments can be sterilized. Check to see if the staff changes the water in a footbath and sterilizes the tub between customers. If hygiene does not seem important – leave.
  3. Never get an invasive spa treatment using needles from anyone other than a licensed medical practitioner. Confirm the status with your state’s medical board. Having a physician supervising your procedure is not the same as having one perform it.
  4. When getting permanent makeup applied, make sure the technician uses a new, disposable needle for each person. Additionally, make certain they sterilize their hands and any other equipment before it touches your skin.
  5. If not using sterile, single-use, disposable needles, ask the spa to see their sterilization equipment. The spa should be willing to show you their autoclave and accompanying spore test results. An effective autoclave is a device that properly sterilizes needles by using a combination of steam and pressure. A spore test confirms the autoclave is working properly.

Until regulation agencies catch up with the times and establish universal standards for medical spas, consumers need to be aware of the possible dangers. As technology races ahead finding new ways to make us appear more youthful and beautiful, we cannot lose sight of Hepatitis C transmission prevention. While a majority of medical spas in the U.S. pay scrupulous attention to hygiene practices, it only takes one non-sterile needle to pass on Hepatitis C. Be adamant about your own safety – and make certain that only a licensed professional is allowed to pierce your skin using only sterile needles.

References:, Medical Spa Makeovers Gone Wrong, CBS Broadcasting, Inc., 2007., Medical spas alluring, but lack of oversight worries some, Christy Arboscello, The Centre Daily Times, May 2007., Needling or Needle abrasion or Intradermabrasion,, 2007., Inside the Medical Spa: What to Expect,, 2007., Restylane Filler, Medical Spa & Skin Care Hawaii, 2007., Nurses Say Many May Have Hepatitis C and Not Know It, Jennifer Lord, GateHouse Media, May 2007., Mesotherapy, New Horizons Medical Spa, 2007., Permanent Cosmetics, Perfect Touch LLP, 2007., Bella Derm Patient Says She Got Ill From Spa Procedure, NewsNet5, May 2007., Dying to be Beautiful, Coulette Bouchez, WebMD Inc., 2007.

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