Dermatologist urges limiting microneedling, dermaplaning and injectables to medical settings

Dr. Gopal Patel, a board-certified dermatologist, told the committee that certain cosmetic procedures carry risks beyond the traditional scope of cosmetology and should be limited to medical settings.

"Anything that is done that will either penetrate, heat, or injure the skin really should be in the practice of medicine," Patel said, listing microneedling, dermaplaning and laser-related burns as examples. He described complications he has treated, including bleeding, scarring, nerve injury and missed diagnoses of underlying disease after nonmedical cosmetic procedures.

Patel also criticized the current med-spa model'which he said often allows remote medical directors who are not routinely on-site'and argued that some procedures using blades, needles or lasers require on-site physician supervision and training in sharps handling and blood-borne pathogen protocols. "Dermaplaning... is a blade device... there's a risk of absolutely cutting the skin," he said, and recommended the committee consider narrowing the cosmetology law to distinguish clearly what belongs to aestheticians versus medical practitioners.

Committee members asked whether dermaplaning could be done safely with proper training and oversight in salons; Patel replied his bias is that it is better suited to medical practices because of the sharps and liability concerns.