On Sunday, June 8, 2025, HBO’s Last Week Tonight with John Oliver covered med spas and the regulatory concerns that impact public safety, from unlicensed providers and fake products to the lack of consistent standards for licensing, training and supervision. The succinct segment, delivered with Oliver’s trademark wit, showcased the very real dangers of bad actors taking advantage of an underregulated industry.

Med spas provide both medical and non-medical procedures and are regulated as medical practices—though not consistently. That lack of federal standards to provide even a legal definition of med spas, coupled with the rising demand for aesthetic treatments, has led to an influx of investors in this cash-based business. Unfortunately, as the segment highlights, this growth has also come with a rise in disreputable med spas cutting corners to dangerous effect.

Last Week Tonight highlighted a wide range of adverse outcomes, including burns and scarring after laser hair removal, illegal injections from unlicensed providers, paradoxical adipose hyperplasia (PAH) after cryolipolysis, bacterial infections after B12 shots, last summer’s string of illnesses from counterfeit Botox, and HIV after PRP injections. It called out the potential dangers of getting weight loss medication from highly unregulated compounding pharmacies, along with multiple instances of people performing non-FDA approved treatments and injecting product purchased from Alibaba.

White coats and lofty claims can obscure the reality of an unsafe practice. It's essential not to place blame on the patients, who should be able to trust health care services. If you are a patient trying to decide whether a med spa will act in your best interest, see these resources for insights from respected clinical trainers:
•    A Patient's Guide to Medical Spas
•    What to Look for in a Safe Med Spa Visit
•    How Much Training Do Safe Med Spa Practitioners Need
•    How Safe Are the Top Med Spa Treatments

For patients who experience a bad outcome, the lack of accountability for unlicensed providers with inadequate supervision makes it more difficult to find legal recourse. Even for responsible med spas, laws vary widely from state to state regarding what license you need to provide treatment, how much training is enough, and how and by whom med spa treatments are supervised.

“It’s both reasonable to want these services and to expect the people providing them to be licensed and adequately supervised,” Oliver said in the segment.

Oliver highlighted the tragic death of Jenifer Cleveland after receiving IV treatment at a Texas med spa where providers were not licensed to give IVs, providers were not trained to manage complications, and the medical director was more than 100 miles away. In response, the Texas legislature recently passed HB 3749 to provide guidance stating that elective IV therapy must be administered by an RN or above. (It is currently waiting for Governor Greg Abbott’s signature.)

As Oliver states, “bare minimum, state laws and regulations must be clearly written, well publicized and enforced.”

This callout serves as a reminder that the bad actors taking shortcuts produce bad outcomes that color public opinion of an entire profession of aesthetic medicine. The best defense is to be known for the safety of your practice—by doing things the right way.

AmSpa represents the safe, compliant practices at the forefront of doing things the right way. There are safe ways to practice aesthetic medicine and operate a med spa with the diligence you would expect in a traditional medical office.

Oliver shared some helpful precautions to guide patients who are looking for a med spa treatment: 

• Research where you’re going.
• Look up the names and credentials of the medical director and providers.
• Make sure you’re given a thorough consultation (good faith exam).
• Ask what their protocol is if something were to go wrong.
• Ask to see the labels of the products they’re using (e.g., vials if injectables).

“Look, this is an industry badly in need of oversight,” Oliver stated. “Because right now, in too many places, it is far too easy to set up something that has all the appearances of medicine but none of the protections.”

AmSpa Members have access to national health care law firm ByrdAdatto to ensure they are in compliance with all state laws and regulations. Fortify the safety of your patients and the aesthetic community by keeping up with med spa regulations in your state and getting involved with your State Chapter.