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.
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.
The list
Things we do not diagnose or treat
If you bring us any of these, 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 a diagnosis and occasionally make it worse.
- Skin cancer, and any mole or mark that has changed
- Sores and lesions that have not healed within three weeks
- Unexplained rashes and skin infections
- Psoriasis, eczema and autoimmune skin disease
- Hair loss that is sudden, patchy, or comes with other symptoms
- Thyroid, hormonal and nutritional causes of hair or skin change
- Varicose veins that ache, swell, or have changed the skin around them
- Anything that needs a surgeon — face lifts, eyelid surgery, liposuction
- Cosmetic injectable treatment during pregnancy or breastfeeding
- Cosmetic injectable treatment for anybody under eighteen
Why this page exists
The failure mode of this trade is treating the wrong thing
The characteristic harm in aesthetic medicine is not a botched injection. It is a cosmetic treatment applied confidently to something that was never cosmetic — a mark that needed a biopsy, a rash that needed a diagnosis, hair loss that needed a blood test.
None of those is dramatic on the day. Somebody has a nice hour, pays, feels looked after, and leaves with the actual problem untouched and a few months further along. That is the outcome this page exists to prevent, and it is why we would rather lose a booking than take one we should not have.
It is also why the consultation asks about your health rather than only about your skin, and why "you should see a doctor about that" is a sentence said here several times a week.
Also not us
Things that need a surgeon
Non-surgical treatment is genuinely good at some things and cannot do what an operation does. Where a surgeon is the honest answer we say so, and it costs you the price of a consultation to hear it.
Skin that genuinely hangs
Heat-based tightening improves mild early laxity modestly. Skin that has been stretched and emptied, most often after major weight change or pregnancy, has lost structure that no external device rebuilds. This is the single most common reason we recommend a surgical opinion.
Eye bags
A fat pad that has come forward through a weakened barrier. Filling beneath it makes the whole area heavier, and no amount of product placed around it is the answer. This is an oculoplastic surgical problem and we will say so at the consultation.
A jowl, or a neck that needs lifting
Repositioning tissue is an operation. Radiofrequency and microneedling improve the quality of the skin over a jawline; they do not lift it, and describing them as a non-surgical face lift borrows the credibility of an operation for something much smaller.
Cellulite, if you want the best evidence
Mechanical release of the fibrous bands beneath the skin — a minor surgical procedure — has better evidence for a durable result than anything we offer. We do not perform it, and if that is what you want we will tell you rather than sell you a course of ours.
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
Scope of care — the questions we are asked most
Can you look at this mole for me?
No, and please do not wait for us to. We do not diagnose skin lesions and we are not the right people to reassure you about one. Any mole or mark that has changed shape, colour or size, or that bleeds, itches or will not heal, needs a physician or a dermatologist. That is a same-week appointment, not a someday one.
Can you treat my rosacea?
We can treat redness once somebody has diagnosed it, and we cannot diagnose it. Rosacea is a medical condition with medical treatment, and facial redness has several causes that look alike. Get the diagnosis first; we are then very happy to work on the visible redness alongside whatever your physician has prescribed.
Can you help with my eczema or psoriasis?
No. Those are inflammatory skin diseases needing medical treatment, and aesthetic treatment applied on top of active inflammation can make things worse. Once a condition is stable and your physician is content, some cosmetic treatment may be reasonable, and we would want them involved.
My hair is falling out. Can you fix it?
Possibly, and not before somebody has established why. Hair loss that is sudden, patchy, or comes alongside fatigue or weight change is a medical question, and thyroid, iron and nutritional causes are common and treatable. We insist on blood tests before any hair treatment, and a good number of people go to a physician instead of proceeding here.
Do you do anything surgical?
No. No face lifts, no eyelid surgery, no liposuction, no hair transplantation, and no thread lifts. Where what you want needs a surgeon, we will tell you so and it costs you a consultation fee to hear it. That happens most often with genuinely loose skin, with eye bags, and with cellulite.
Is a med spa regulated?
Aesthetic medicine is regulated in New York State, treatments that are medical require appropriate licensing, and a med spa performing them needs medical oversight. What varies enormously is how seriously a given place takes that. Somewhere offering injectables with no consultation and no medical director is the thing to worry about.
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.