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Contradictory State Administrative Regulation of Minimally Invasive Cosmetic Procedures in Kentucky and North Carolina

Jason D. Gillum, JD; Robert P. Dellavalle, MD, PhD, MSPH
JAMA Dermatol. 2013;149(2):137-138. doi:10.1001/jamadermatol.2013.1524.
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The regulation of minimally invasive cosmetic procedures (MICPs), such as laser skin rejuvenation and hair removal, should be of keen interest to dermatologists for a number of reasons, the most important of which is patient safety.

In the United States, the US Food and Drug Administration regulates the manufacture and sale of laser equipment,1 but the state governments regulate MICPs. In all states, boards of medicine, nursing, and cosmetology perform this function. These boards generally do not operate in concert; they may make policies based on limited evidence, and particularly in today's increasingly competitive health care setting, boards may become advocates for their respective professions. Ultimately, policy makers may lose sight of true priorities such as patient safety. In the MICP setting, physician involvement is critical in ensuring proper diagnosis, preoperative evaluation, and management of complications. However, under current regulation, some MICP patients are not guaranteed physician attention. The states of North Carolina and Kentucky are case studies for this problem, as their medical and nursing boards have asserted conflicting interpretations of state law. Herein, we discuss this problem and its possible solutions.

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