By Alex Thiersch, CEO, AmSpa

John Oliver, Texas Governor Greg Abbott and med spa injectors—I never thought I'd write those words in the same sentence, but here we are.

This past week was an important one for our industry. In Texas, legislation we’ve worked on tirelessly is awaiting the governor’s signature… which might not be as certain as we once thought. At the same time, our entire profession was featured—loudly and publicly—on HBO's Last Week Tonight With John Oliver.

Let’s break it down.

Texas update: HB 3749, Governor Abbott, and... barbers?

Things have gotten a little weird in Texas.

HB 3749—aka the Texas IV bill we’ve spent months working on—has passed both chambers and now sits on Governor Abbott’s desk. I’d like to give a huge shoutout to everyone who helped make critical changes to this bill.

You’d think its signing would be a no-brainer, especially in the wake of Jenifer Cleveland’s death and the growing consensus that rogue med spas need reigning in. But then came Governor Abbott’s veto of SB 378—a separate and lesser-known bill that aimed to prohibit cosmetologists, aestheticians and barbers from making incisions or injecting medications while acting under their cosmetology licenses. Sounds reasonable, right?

SB 378 was already a bit of a conundrum because, under Texas cosmetology laws, aestheticians, cosmetologists and barbers already cannot perform medical treatments while acting under their cosmetology licenses; nothing prevents them from doing so under the direction and supervision of a physician, however, provided they aren’t acting under their cosmetology licenses.

SB 378 was therefore a bit redundant. But, no matter—any law in this area that further specifies the boundaries of what people can do and when they can do it, is a good thing.

But then the governor vetoed SB 378. His reasoning? That it might negatively affect... barbers. He claimed the bill could put barbers at risk of losing their license if they nick someone during a straight razor shave. His office literally said, “Barbers who nick a customer’s neck during a straight razor shave should not fear the loss of their licenses.”

I’m not sure that an accidental “nick” during a shave was meant to trigger an investigation under this law. That seems to be a bit of strained interpretation. So why was it vetoed? The answer is unclear, but I’m sure it has nothing to do with patient safety or the medical aesthetic industry. And, given that SB 378 was merely restating a law that already existed…no biggie, right?

We’ll see. Now, HB 3749 is sitting on Abbott’s desk, and we’re left wondering: Will he sign it? After the straight-razor veto, I’m not as certain as I was before.

John Oliver: A brutal, necessary mirror

As if that weren’t enough, Last Week Tonight aired a segment this week putting med spas directly in its crosshairs.

If you’ve seen John Oliver’s show, you know what to expect: smart, sharp satire that exposes bad actors. And, in this case, there was no shortage of material.

The Last Week Tonight team reached out to AmSpa beforehand for background, which we appreciated. They made an honest effort to get the legal details right. But, let’s be honest: No amount of context can soften the impact of what aired.

Botched procedures. Infections. Fake products. Patient deaths. Providers with criminal records. The worst of the worst were all on display—and they are, unfortunately, part of our reality.

And, while it’s easy to be defensive, here’s the hard truth: This segment is what the public sees when they think of med spas. Not the thousands of responsible, highly trained medical professionals we know. Not the providers who follow the rules, who put safety first and who care deeply for their patients. They see the circus. And we’re the ones who suffer for it.

A wake-up call

If we don’t take charge of this moment—if we don’t demand standards, enforcement and accountability—we are going to lose control of our own industry. We need to take action.

• We need minimum and consistent safety standards, including minimum levels of training.
• We need to define what it means to be a "qualified" medical director or a "qualified" provider.
• We need education from the industry that doesn't unleash injectors on the public after one day of training.
• We need our state attorneys general to actually enforce the laws that are meant to prevent unlicensed idiots from injecting patients with poison.
• We need the public to know that yes, med spas are overwhelmingly safe, but that yes, they need to be mindful of the bad actors who are out there.

What is AmSpa working on?

In the coming weeks, we’ll have a number of initiatives ready to roll out and talk about:

• We will reintroduce and update our medical spa practice guidelines.
• We will launch a national safety credential for injectors—a way to distinguish trained, ethical providers from the rest.
• We will roll out a coordinated, nationwide advocacy program to support common-sense legislation and fight dangerous loopholes.
• And we will speak directly to the public, to educate and reassure them that med spas can be safe—when done right.

But AmSpa can’t do this alone. We need every single one of you to join us. To hold yourself, your colleagues and your peers to a higher standard. To speak up when something isn’t right. To say enough when shortcuts or recklessness put patients at risk.

This isn’t just about regulations—it’s about responsibility, and it’s about protecting the integrity of this industry we’ve all worked so hard to build.

We love this profession. Let’s prove it by fighting for it.

With urgency and gratitude,
Alex R. Thiersch, JD
Founder & CEO, American Med Spa Association