May 2, 2002 -- A day at the spa can be relaxing and invigorating: a facial, a massage, maybe a fabulous skin treatment with intriguing ingredients — even exotic foods.
The spa industry is growing, with American women spending almost $9 billion on spas in 2001 alone. Spas offer a wide range of services, which they say can promote health, beauty and a sense of well-being.
Primetime decided to investigate claims about some of the more exotic treatments offered by spas. During a two-month investigation, Primetime staffers visited spas and beauty clinics in New York City, recording their visits — and the spa operators' claims — on hidden cameras. Primetime then showed the tapes to medical experts, and confronted the spa operators with what the experts said.
Truffles and Caviar — for the Face
Primetime first focused on upscale spas and some of their popular treatments. One of the most popular ingredients at the moment is exotic foods. At the Brigitte Mansfield European Spa, the signature treatment is a facial using rare truffles, an expensive delicacy imported from France. The mushroom-like truffles are chopped and mixed with fragrant oils, then brushed on the face. The spa, which ended the treatment with a caviar cream, says the $140 treatment replenishes the skin with minerals and nutrients.
But experts consulted by Primetime said it is impossible for humans to absorb nutrients through the skin — whether they are from truffles or any other source. Dr. David Leffell, a leading dermatologist, said the spa's claim that clients can absorb truffles' goodness through the skin is "pseudoscientific gibberish."
"You can't absorb truffles through your skin," said another leading dermatologist, Dr. Debra Jaliman. "If you ate them you would get the nutrients of the truffle, but just putting them on the skin surface and washing them off is in my estimation a waste of truffles."
The spa also offers a $140 oxygen facial called the Supercharge, a three-step oxygen treatment. "We stimulate the oxygen production, right, so we have more oxygen in the skin," said the spa's owner, former model Brigitte Mansfield.
But Primetime's experts said the only way for humans to take in oxygen is through the lungs and into the bloodstream — not through the skin. They disputed Mansfield's claim that the treatment puts oxygen into the skin. "If it were true, we would have to rewrite all the high school biology textbooks," said Leffell, who is professor of dermatology at the Yale School of Medicine.
Another popular ingredient in facials is collagen, a naturally occurring substance that stops skin wrinkling. At the Georgette Klinger spa in Manhattan, for instance, a technician offered "a warm mask with 100 percent collagen that will help extra-nourish" the skin. But according to Primetime's experts collagen is a large molecule that cannot penetrate the skin. "You can't put it in by creams or potions, lotions — it doesn't work" said Jaliman.
The two experts were also skeptical about the Mansfield spa's Parafango Detox, a mud and wax mixture applied to the body that Mansfield claimed can "loosen up" toxins so they can be flushed from the system by drinking water. The doctors said the only way to release toxins from the body is through the kidney or liver. "Your skin is not a detoxifying organ," said Leffell. The experts said it is also impossible to sweat out toxins through the skin.
Mansfield said the spa uses mineral-rich mud from hot springs in Hungary. "It has a much higher content of minerals and of silicon dioxide — and silicon dixode is found in collagen." Primetime asked a laboratory to compare a sample of the Hungarian hot spring mud with some mud from a back yard in the Northeast United States. The lab found that the back yard mud actually had higher levels of the common minerals. And Jaliman pointed out that the special ingredient is not so special: silicon dioxide is sand.
When told that experts did not think their claims stood up to scientific scrutiny, the two spas stuck by their treatments, saying that regardless of the experts' accounts, they see a beneficial effect in clients.
Mansfield said "we consider different studies ... and we find a lot of things that are not approve by doctors still work."
The doctors said the spas often latched onto scientific-sounding buzzords and then used them incorrectly. People, the doctors said, would probably not know the words were being misused. The doctors did not, however, find anything actually harmful in any of the skin treatments, and said that spa visits can feel good regardless of the scientific efficacy of the treatments. "It's a beauty treatment," said Jaliman. "It's luxurious. It's relaxing .... as long as you know what you're getting."
Laser Hair Removal
More troubling to the experts Primetime spoke with is the rise in popularity of laser treatment to remove body hair. Such treatments are becoming available at more and more spas, and more than 1 million Americans had laser hair removal in 2001.
According to Dr. Roy Geronemus, a leading expert in laser treatments, dermatologists are seeing a "dramatic" increase in the number of complications from laser hair removal treatments. "These complications may have lifelong consequences," he said
Primetime met one woman who received first- and second-degree burns on her cheek and neck while undergoing laser hair removal at an upscale spa in New York City. The woman, who is suing the spa, says she has been left with permanent scarring, and now, more than a year later, still does not uncover her face in public.
Geronemus is particularity concerned about training: some operators have only a weekend's worth. And even with much more training, mistakes are made, he said. There are many different lasers for different skin types and too many operators use the wrong laser for the wrong skin, he said.
Furthermore, only 15 states require that only physicians can perform laser hair removal. In 20 states, including New York, there are no regulations at all.
To see if testers would be accurately told what to expect and what risks they might take, Primetime sent employees to spas in New York to document their consultations on hidden camera. The testers were all deemed high risk or poor candidates for laser hair removal by Geronemus.
Experts Primetime consulted say one of the most important things in laser treatment is assessing a customer's suitability. Some lasers can be dangerous for some darker skin types, they add, and are ineffective on blond hairs. Primetime's hidden cameras found that while some laser operators were careful to consider clients' skin and hair type, others were willing to proceed with laser treatments without giving adequate warning of the potential dangers involved.
Lasers Ineffective on Blond Hair...
At one spa in New York City, the operator told a Primetime tester with fair skin and blond hair that she could get rid of unwanted hair and would not face side effects because of her skin and hair color.
The operator promised that after three sessions costing a total of $1,000, the tester's hair would be gone "permanently." But Geronemus said that was misleading: "Lasers just don't work on blond hair at this time.... It simply doesn't work," he said. "There's no point in even attempting this procedure on this patient."
When Primetime told the operator of the doctors' opinion, she said that while the laser won't work on many blonds, it will on some, and that you don't know until you do it.
Laser hair removal works by targeting melanin, the pigment that gives hair and skin its color. The melanin absorbs the laser's heat, thereby damaging the hair follicle. Blond and gray hairs do not have enough melanin for the system to work.
... And Can Be Risky on Darker Skin
Those with darker skin, and higher melanin, are at a much higher risk for side effects. Some lasers cannot distinguish the dark hair from the dark skin, so the skin may absorb the laser's heat, which can cause burns.
When Primetime sent a black tester to a laser hair center in New York, the operator promised she would be safe and said any reaction would last only a few days. Primetime's experts were shocked to hear the operator's reassurances, explaining that the laser she planned to use on the black tester was the wrong laser and increased the risk of burning and scarring. There are more than 30 models of hair-removal laser on the market, but operators need to choose carefully which laser to use on which skin type, the experts said.
Dr. Elliott Battle, who has studied the effects of lasers on people with darker skin, said that all people of color, not just blacks, are at risk, including those of Mediterranean, Asian or American Indian background.
When contacted by Primetime, the operator insisted she could provide a safe procedure because she is careful and well-trained — though she wouldn't give any details about that training.
If You Have a Tan, Hold Off
Even more risky, many experts say, is having laser treatment with a tan. When Primetime sent out a tester who goes to a tanning salon regularly, the first two laser salons she visited asked about her tan and turned her away, saying a tan was a problem. But at the third salon, the laser operator didn't seem to notice the tester's tan and never asked her about it.
Geronemus said the chance of complications goes up dramatically when a laser customer has a tan, and said spas should tell consumers with tans to come back a few weeks later, after staying out of the sun.
When confronted by Primetime, the laser operator said she had extensive training and can treat tanned people safely. She said her spa has a laser model approved by the FDA for use on tanned people. She had even told the Primetime tester she would use that model on someone which tan skin — but that was not the one she showed the tester.
"The mistakes that were made were fundamental mistakes and should not be made," said Geronemus. "These are fabulous procedures if performed properly, but there can be significant consequences if not performed properly."