Some things people bring to a med spa need a doctor rather than a treatment room. Some things people bring to a med spa are not aesthetic problems and need a doctor rather than a treatment room. See a physician or a dermatologist, not us, if you have a mole or a mark that has changed shape, colour or size, or that bleeds, itches or will not heal; a sore anywhere that has been there more than three weeks; a rash you cannot explain; a patch of skin that is newly numb, hard or ulcerated; sudden hair loss in patches, or hair loss alongside fatigue or weight change; or swelling, heat and spreading redness that could be an infection. And if you have had filler treatment anywhere and the area becomes white or mottled, severely painful, or your vision changes, that is an emergency — telephone us immediately if we treated you, and go to an emergency room if you cannot reach somebody within minutes. We would far rather you rang a doctor and never rang us at all.
Most clinics keep this list on a consent form you meet for the first time in the treatment room, which is a poor place to discover that you have wasted an afternoon or, worse, to decide whether something applies to you. It is published here instead.
The list divides in two. Some items mean no, from us, regardless of what anybody else would do — a fresh tan before light-based treatment, pregnancy, an undiagnosed skin change, cosmetic injectables for anybody under eighteen. Others are a reason to talk, often to your physician, and frequently end in a plan rather than a refusal.
If something on either list applies to you, tell us when you book rather than when you arrive. Nobody here is going to be cross about it, and it is far better to move an appointment than to turn one down at the door.
Absolute
We will not treat, whatever else is true
These are not negotiable, and being asked to make an exception is not going to work. Every one of them is on this list because of something that has gone badly wrong for somebody somewhere.
- Pregnancy or breastfeeding, for injectables, lasers and medium or deeper peels
- Anybody under eighteen, for any cosmetic injectable treatment
- A tan, sunbed or self-tanner within the last fortnight, for any light-based treatment
- An undiagnosed mole, lesion or skin change in the treatment area
- Active infection, cold sore or broken skin in the treatment area
- Being unwell on the day, including a fever or a current infection anywhere
- A known allergy to the product proposed
- Cosmetic injectable treatment on somebody who has been drinking that day
Relative
Tell us, and it becomes a plan rather than a refusal
These change what is safe, what is sensible, or the order things should happen in. Several of them need a word with your physician, and most of them end with treatment going ahead in a modified form.
- Medication that thins the blood — treatment is still possible, with more bruising
- Certain oral acne medication within the last six months, for resurfacing and medium peels
- Medication that increases sensitivity to light, including several common antibiotics
- A history of cold sores, which needs antiviral cover started before facial treatment
- A history of keloid or heavy scarring, which changes what we will do and where
- An implanted electrical device or metal in the area, for radiofrequency treatment
- Heart failure, kidney disease or uncontrolled blood pressure, for any infusion
- An autoimmune or inflammatory skin condition, which needs your physician involved
- A current or past eating disorder, before any weight programme
- Unstable weight in either direction, before body contouring
- Recent treatment elsewhere that we cannot see or assess
- A deadline that the treatment cannot realistically meet
Aesthetic treatment is elective medicine, and this page is not medical advice for you. Aesthetic treatment is elective, it is medicine wherever it breaks the skin, and nothing on this website is medical advice for you in particular. We do not diagnose disease. Every treatment here begins with a consultation and a medical history, because your health, your medication, your skin type and what you have had done before all change what is safe and what is sensible. Some people are told no. Being told no is a normal outcome of a consultation here rather than a failure of one, and it costs exactly the same as being told yes.
Questions
Who we cannot treat — the questions we are asked most
Why will you not treat me while I am pregnant?
Because for most of these treatments there is no evidence either way — those studies are not done on pregnant people — and no cosmetic benefit justifies an unknown. It is not that harm has been demonstrated. Gentle facials and some topical treatment are fine throughout, and we are happy to look after your skin and pick the rest up afterwards.
I have a tan. Can you not just turn the machine down?
No, and this is the request we refuse most often. Tanned skin has more pigment at the surface to absorb the light, which is exactly the mechanism that causes a burn. Turning the energy down enough to be safe usually means turning it down below the level that does anything. We will move the appointment rather than treat, and we are not negotiable about it.
Why does acne medication matter?
Some oral acne treatment makes skin considerably more fragile and slower to heal for months after the course finishes, which changes what is safe to do to it. Resurfacing, medium peels and some other treatment are deferred until well afterwards. Tell us even if you finished the course a while ago.
I am under eighteen. Can I have anything?
No cosmetic injectable treatment, ever, and nothing cosmetic without a parent present and a conversation about why. Some medical skin treatment for acne is reasonable in a younger person, with a parent and often after a dermatologist has been involved.
What if I do not tell you about something?
Then the screening does not work, and the risk you are running is your own. Nobody here will be cross about a strong acid used nightly, a holiday, a medication or a treatment elsewhere — we simply need to know, because all of those change what is safe this week.
Can you treat me if my doctor says it is fine?
Frequently, yes. Several items on this list are relative rather than absolute, and a letter or a call from your physician turns some of them into a plan rather than a refusal. Others — pregnancy, an undiagnosed skin change, a fresh tan — are ours to refuse regardless.
What a med spa does not treat. We treat the appearance of healthy skin, hair and body. We do not diagnose or treat disease. If you bring us a mole, a changing mark, an unexplained rash, a sore that will not heal, skin that has become hard or numb, psoriasis, eczema, an autoimmune skin condition, or hair loss that came on suddenly or in patches, what you will get is the name of a doctor rather than a treatment plan. Aesthetic treatment applied on top of an undiagnosed skin problem can mask it, delay the diagnosis and occasionally make it worse. We would rather lose the booking.
A written plan and a written price before anything is booked
Book a consultation
Pick a clinician and an hour from the calendar — it shows only the times each of them genuinely has free. A consultation is a full hour at a table with no treatment couch in the room, and it costs $85, or $120 with the medical director. If you go ahead, that comes off your first treatment. If we tell you the answer is nothing, or a dermatologist, it costs exactly the same.