Add-On Services

Spa Med

When the doctor is in, client expectations go up. How will the relatively new and still-small medical spa category impact your salon or spa? Consultants prescribe advanced education, enhanced awareness, and referral relationships.

Wouldn’t it be very cool to get a pedicure and have your teeth whitened at the same time? Martha Vucsko thinks so — and so does a cosmetic dentist who recently approached the spa owner about offering the service through Martha’s LaLook Medi-Spa in Chagrin Falls, Ohio.

Teeth whitening certainly would complement the spa’s service menu, which includes collagen and Botox injections, laser surgery, microdermabrasion, and liposuction in addition to traditional spa services like massage, body treatments, facials, and nails.

Martha’s LaLook falls into a small but fast-growing segment of the industry known as medical spas — a hybrid facility that looks and feels like a regular spa, but incorporates medical procedures ranging from laser hair removal to liposuction, collagen injections, and “cosmetic enhancement” surgical procedures.

“A medi-spa is a cross between a day spa and a medical office,” explains Jane Crawford, founder of one of the first U.S. medical spas and president of Jane Crawford Associates, a consulting firm to the medical spa industry based in Simpsonville, S.C. “Medi-spas are focused, nurturing environments in which clients can experience one-stop shopping for facials and body treatments, massages, anti-aging services, and nutritional advice, as well as cosmetic enhancement procedures.”

Over the past decade, a number of plastic surgeons and dermatologists have incorporated skin care into their practices by hiring estheticians to provide a range of pre- and post-operative spa services as well as beautifying and “medical-grade” anti-aging treatments so-called because they can only be administered by or under the supervision of a physician. More recently, they’ve gone a step further by adding a spa to their practices (in the same fashion a salon adds a spa) or by creating separate, stand-alone spas that also give clients access to many of the services available in their medical practices.

Medical spas still represent only a small segment of the spa industry, says Hannelore Leavy, executive director of the Day Spa Association (West New York, N.J.), but it’s one that’s growing fast. “The trend toward the medical aspect of spa services is tremendous,” Leavy says. “Plastic surgeons and dermatologists have been on the bandwagon for a while.”

Nor are plastic surgeons and dermatologists the only physicians examining the spa industry. Like “wellness center,” the term “medical spa” sometimes can seem to defy definition, as the range of medical services varies widely. The common denominator, Crawford says, is that a medical spa provides a spa setting for personal consultation with medical specialists ranging from obstetrics and gynecology, family practice, internal medicine, maxillofacial dentistry, plastic surgery, and dermatology. Nor are these simply referral relationshipsa true medical spa is operated by a medical professional or has an on-staff medical director.

“Patients would much rather come here for these services than go to a doctor’s office,” Vucsko says. “We offer a holistic approach to beauty without invasive procedures, but if you choose something more invasive, a plastic surgeon is here for you. You’re working that inner and outer beauty, and it’s OK to want a little Botox to get rid of those frown lines. What’s great, too, is that if someone comes in and has a mole they’re worried about, there’s a doctor here who can look at it.”

Spas benefit from an enhanced credi­bility with clients and access to advanced technologies. “We didn’t need a physician to offer microdermabrasion, but we did so we could get the medical-grade equipment,” Vucsko says. The physician con­nection also provides Martha’s LaLook clients with access to medical-grade skin care products, including prescription-grade hydroquinon for age spots.

“We now offer Obagi Blue peels, which have to be performed under a doctor’s care,” she adds. “Before, we couldn’t do these things. These are powerful benefits for clients, and it’s definitely bringing more business. We’re getting people in for Botox injections, and the physician will recommend facials and microdermabrasion. The next thing you know, she’s getting her nails done. Her skin is looking great, she’s looking great, and she wants more.”

In medical spas, Crawford says, East finally meets West with the best of alternative therapies and modern medicine. Young and old alike express a growing awareness of health’s role in beauty, and the holistic view extends to treatments new and old that not only help to prevent disease, but also minimize the signs of aging.

Think right time, right place, right products and services.” [Medical spas] now will be successful because the technology exists and consumers are ready,” says Dr. DeAnn Nicks, who this month launches Club Spa Med, a Beverly Hills-based firm that will customize and implement a medical spa program for any spa or medical practice.

“We’re going to be living longer, and the top anti-aging treatments can be offered in spas. Laser treatments now are so sophisticated that you can get collagen rejuvenation in three treat­ments. I compare the anti-aging market today to the computer industry, in that every six months we’re getting better and better equipment that delivers excellent results.”

Which is exactly what the people want “I had a big cosmetic medical practice in Beverly Hills, and patients kept asking for more and more and more,” Dr. Nicks continues. “So I developed treatments utilizing medical equipment to help people stay young-looking.”

As technologies advanced and treatments became less invasive, clients began to want a spa-like environment. “We were doing more maintenance programs with weekly treatments, and no one wants to go to a doctor’s office on a weekly basis,” she says. “Relaxation and meditation are key elements of anti-aging, and you don’t get those in a doctor’s office.”

Health and Beauty Aids

Dr. Nicks isn’t alone in this realization. Doctors from every specialty recognize both the benefits and the potential of spa services, and they’re looking to leverage both in their practices.

Frank Barone, M.D., a plastic surgeon and a director of Reconstructive and Aesthetic Surgeons and the associated Bella Via Therapeutic Wellness Spa in Toledo, Ohio, was an early adopter, incorporating skin care into his medical practice in 1993.

“I heard a presentation by a company that had a lot of good research at that time on the early AHAs and the benefits of micropeels,” he says. “And over the past five years, there’s been an explosion in skin care with microdermabrasion and light therapies.”

Dr. Barone views skin care and plastic surgery as synergistic. “Any improvement in skin is a perfect complement to cosmetic surgery, which doesn’t affect the quality or appearance of the skin. Then, treatments such as shiatsu massage and lymphatic massage also complement in that they help reduce swelling and pain, and speed a person’s return to work and other normal activities.”

Most of the skin care services Bella Via and other medical spas offer are more aggressive than those found in a typical day spa. Accordingly, these treatments must be administered by a physician, trained registered nurse, or medical esthetician with advanced certification (depending on the service). As technologies and products continue to advance, Dr. Barone and others expect licensing requirements to become even more stringent, which will further separate medical spas from the typical day spa. In Ohio, Vucsko says the state board wants to remove glycolic peels and microdermabrasion from an esthetician’s repertoire unless they’re performed under a doctor’s care. Some states already have toughened up, and Dr. Nicks expects more to follow suit.

Many argue that more stringent requirements benefit consumers and, in the long rim, the spa industry. “There’s always an abuse potential,” Dr. Barone explains. “Microdermabrasion, for example, is being used to treat many skin conditions it shouldn’t, such as acne.

Microdermabrasion inflames the skin, and when you add inflammation to skin that’s already inflamed by acne, it can strip the skin and make the condition worse. It’s important to combine the best of medical treatments and skin care-based services and products.”

By the same token, Dr. Nicks says spas retain some advantages. “Existing spas have the upper hand, in my opinion, because it’s easier to put medical treatments into a spa than it is to put the spa environment into a medical practice,” she says. For this reason, she’s skewed Club Spa Med to the spa industry.

Spas that sign up with Club Spa Med gain a license to use the Club Spa Med name and pre-developed packages of products and services. Dr. Nicks provides advice on equipment selection as well as training and support on technical, business, and marketing issues. She also partners salons with medical professionals.

It’s not feasible for every salon and spa to develop a close enough relationship with a medical practitioner to qualify itself as a medical spa, but looser relationships such as referral or consultation programs can be worth the effort. “We work with an off-premises chiropractor, and it’s great,” says Dee DeLuca-Mattos of DePasquale The Spa in Morris Plains, N.J. “He has a brochure we hand out, and he comes in twice a year to do solutions seminars where he discusses wellness and how he ties in to what we offer.” In exchange, the chiropractor gains access to the spa’s 2,000 clients per week.

Will there come a time when spas go completely full circle? Leavy believes medical spas will remain as distinct from day spas as those are, in turn, from destination spas.

“People who have problems or who want to make a major change in their appearance will look to the medical profession,” she says. “People who are pursuing the spa lifestyle with facials and massage and general upkeep will not.”

Walk the Walk, or at Least Talk the Talk

Whether or not your clients would seek spa services from the medical profession, have no doubt the medical profession will raise the bar in terms of heightened awareness and expectations.

“We need to be very careful, because if we’re not smart and savvy about how we market, the medical industry will eat our lunch,” says DeLuca-Mattos. “It’s not enough to just do pampering services.”

She cites the spa’s attempt to add hydrotherapy as a fitting example. “Everyone tried to talk us out of it by saying we’d spend $20,000 and that no one would use it,” she remembers. They proceeded anyway — only to prove the naysayers right when the equipment had only 20% productivity after four months.

Rather than write off the investment, DePasquale repositioned hydrotherapy as a rehabilitative service and pursued a different market. Around the same time, DeLuca-Mattos read that the nearby Kessler Institute for Rehabilitation was eliminating its hydrotherapy program, so she contacted them to discuss a referral program. “They said yes, if we would promote their personal trainer program,” she says.

Since, DePasquale has built a strong hydrotherapy clientele — and a new approach to marketing. When the spa took on wigs and cranial prostheses, DeLuca approached hospitals and oncology centers offering seminars geared to people in chemotherapy. “Hospitals love it because they now have a place to refer these patients, and we’re able to effectively reach the market that needs these services.”

Nor is it just about marketing. “I can take a vichy shower and hydrotherapy tub and develop highly effective treatments,” Dr. Nicks says. At their core, she says, is a results-oriented approach that focuses on maintaining health.

Expect many more needs-based products to enter the market to complement solution-oriented services. This is one area in particular where the medical profession has a leg up, so to speak. Pharmaceutical companies are making significant investments in researching and developing skin care products, but expect most of these products to be available only by a physician’s prescription. Still, the industry eventually will benefit as research benefits trickle down to professional salon products.

In the near future, Vucsko says the services to watch are non-invasive treatments such as TCA peels (also known as Obagi Blue peels) over services such as laser resurfacing because they are proving to be highly effective with less downtime. As for products, her clients are interested in anything to do with anti-aging and skin lightening. “Baby boomers were sun-worshippers, and it’s starting to show.” Copper peptide, vitamin C, and hydroquinon are the current anti-aging buzz words.

On a broader level, you can leverage the medical spa trend by staying on top of consumer buying habits. “For this century, we’re looking at a baby boomer population that makes up 51% of the population,” says DeLuca-Mattos. “That’s a great statistic, but what does it mean? That they have a lot of money but not a lot of time, for one. So don’t market eight-hour days of beauty.

“They’re also looking for balance — they want to live longer and healthier, so they’re very in tune with services that offer wellness, even in beauty,” she says. “One of our best-selling services right now is the Sinus-Relieving Facial. Almost everyone deals with this condition, so we created a service that emphasizes results while also delivering relaxation.”

And remember that baby boomer attitudes and approaches have a trickle- down effect. By 2010, teens will comprise the largest segment of our population, and they’re just as solution-oriented as their parents. “We’re launching The Teen Scene at DePasquale. The Spa with solution seminars,” she adds. “One, Stages of Your Face, will talk to teens about all the changes their skin will go through and how they can handle them.”

Look for manufacturers to introduce increasingly solutions-oriented treatments. For example, DePasquale’s product line, Avance, has introduced Avance Cares in a Box, a collection of pre-assembled spa treatments and therapies hat comes complete with step-by-step manicure and pedicure therapies guides. The therapeutic services emphasize the results with names such as Muscular Ease Spa Manicure, Anti-Aging Spa Manicure, Tired Leg Spa Pedicure, and Detoxifying Pedicure.

Results-oriented treatments will become increasingly relevant in the future. “Anti-aging treatments and attitudes are evolving rapidly,” Dr. Nicks says. “People are living longer. If we live to 150, we’re going to work beyond age 100 — and we’re going to need to look and feel younger to do that. I’m not talking about trying to look 20 when you’re 70, but tomorrow’s 70-year-old will be the equivalent to today’s 35- year-old. We need to be prepared to address these needs.”

Health Through Water

Spas enjoy a long, rich history as healing centers. The Romans are renowned for their bathhouses built around mineral springs, but spa roots can be traced to ancient Egyptian, Arab, and Chinese civilizations The word “spa’’ itself is thought to be an acronym for the Latin phrase, sanitas per aquas, which means “health through water.”

Spas developed as early as the 1600s in the United States, building on a history of Native American practices that ascribed mineral springs as cures for a host of ailments Through the 1900s, spas were entrenched as valid medical facilities. By the mid-20th century, however, they had fallen out of favour with the advent of modern medicine — which literally translated medical treatment from art to science as scientists gained not only new knowledge on disease processes, but discovered medications to treat them.

Spas fell back on services promoting relaxation and rejuvenation, and by the early 1990s had rebounded as time-starved Americans sought relief from the rigors of daily life. As alternative medicine enjoyed a resurgence, many got back to their roots with wellness centers.

“This spa generation belongs to 80 million-plus people who use alternative medicine as their primary health care and who spend over $27 billion per year out-of- pocket for wellness and nutritional supplements, vitamins and herbs, and other natural remedies,” states Medical Spa Sciences, a Boston-based chain of medical spas and consultants to the medical spa industry. “Their 629 million visits to alternative practitioners double the number of visits to all primary care physicians in the United States”

Hands and Feet Have Needs Too

In the medical spa, the nail department grows to include the hands and feet, and treatments play a far larger role than “the finishing touch” often ascribed to nail care.

“Wherever there’s skin; you can treat it,” says Dr Micks “Hands arid feet show age as well, so the whole process of keeping skin healthy-looking applies there We do microdermabrasion for the hands and arms, legs and feet and we have special hydrating treatments that are results-oriented as well as pampering”

At the extreme end of the spectrum, a medical spa can add an entirely new dimension to “hand rejuvenation:’ For example, James Romano, a cosmetic surgeon in San Francisco, offers patients a host of options ranging from pigment removal creams and peels to eradicate age spots, to sclerotherapy to remove large veins and crevices between the tendons and ligaments, to fat grafting, a surgical procedure that, fills in the deep crevices between tendons on the back of the hands.

You don’t need a medical director or an operating table to cake a results-oriented approach, however. Rather, think functional by identifying a need, then creating a service to fulfill it. You may even already have the service and need only to reposition it.

If your spa-type manicure incorporates sea salt scrubs or glycolic products for ex­foliation, change the name to “rejuvenating manicure (or ‘youth glow manicure” or “non-surgical hand lift”) and emphasize the skin-renewing aspects of the service rather than the pampering parts.

Vucscko says her nail department grew from one nail technician to four when the emphasis became more treatment-oriented.”We do skin-care-based assessments of the hands, so it’s not just about nails,” she explains, “We have magnifying lights at the nail stations, and it’s really no different than a facial in terms of assessing the condition and addressing the client’s concerns.”




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