Medspa vs. Dermatologist for Laser Hair Removal
The Importance of Having Direct Supervision By A Dermatologist
Medically Reviewed by Arash Akhavan, MD, FAAD
Last Medically Reviewed: March 22, 2026
Laser hair removal has become one of the most popular cosmetic procedures in the country — and in a city like New York, you can find it on nearly every block. Walk-in medspa chains, Groupon deals, boutique studios: the options seem endless, and the pricing ranges from suspiciously cheap to reassuringly premium. But here's what most people don't realize until something goes wrong — laser hair removal is a medical procedure. The device emits concentrated light energy that penetrates your skin and targets living tissue beneath the surface. When the settings are right and the operator understands your skin, the results are exceptional. When they're not, the consequences range from painful burns to permanent scarring.
Dr. Arash Akhavan, a board-certified dermatologist on Manhattan's Upper East Side, has built his practice around this distinction. At The Dermatology and Laser Group, every physician-supervised laser hair removal in NYC session is calibrated by a medical team that understands the dermatology — not just the device. This article breaks down why that difference matters, what the actual clinical risks are, and what you should be asking before anyone points a laser at your skin.
The Clinical Risks Most Medspas Won't Mention
The reason laser hair removal works is a principle called selective photothermolysis — the laser targets melanin in hair follicles, converts light energy to heat, and damages the structures responsible for hair growth. Done correctly, surrounding skin sustains minimal impact. Done incorrectly, and that same energy becomes destructive in ways that are difficult to reverse.
The most common complications from improperly performed laser hair removal include thermal burns, post-inflammatory hyperpigmentation (darkening of the skin), hypopigmentation (loss of skin color), and in severe cases, permanent scarring. These aren't theoretical risks. A peer-reviewed study published in the Dermatologic Surgery found that burns occurred in 34.8% of adverse events from non-physician providers, compared to just 7.4% from physicians. Discoloration appeared in 43.5% of non-physician cases versus 14.8% of physician-treated patients.
The root cause is almost always the same: incorrect fluence settings. Fluence — the amount of laser energy delivered per square centimeter — needs to be calibrated based on your skin tone, hair color, hair density, and the specific body area being treated. A setting that's safe for fair skin on the forearm could cause a burn on darker skin or a sensitive area like the bikini line. Board-certified dermatologists like Arash Akhavan, MD, FAAD understand these variables because they've spent years studying skin biology, melanin distribution, and photophysics. A technician with a weekend certification does not.
Laser Hair Removal Complication Rates: Physician vs. Non-Physician Settings
The data below is drawn from a peer-reviewed analysis of 401 patients who received cosmetic laser procedures, published in the Dermatologic Surgery (2019). The study compared adverse event types between physician and non-physician providers, revealing a stark gap in burn and discoloration rates tied directly to operator training and clinical oversight.
| Complication Type | Physician Providers | Non-Physician Providers |
|---|---|---|
| Burns | 7.4% | 34.8% |
| Discoloration | 14.8% | 43.5% |
Leading cause of adverse events: Among non-physician providers, 43.8% of complications were attributed to improper technique. Among physician providers, adverse events were most commonly expected side effects — not technique errors.
New York Has No Laser Hair Removal Regulations — Here's Why That Should Concern You
This may surprise you: New York is the only state in the country that does not regulate who can perform laser hair removal. There is no required license, no mandated training hours, and no oversight board specifically governing these businesses.
That regulatory vacuum has real consequences. In January 2026, the New York Department of State released findings from a statewide investigation into medspa businesses. Of the 223 facilities inspected, 87 were cited for violations including unlicensed individuals performing medical procedures, expired and suspected counterfeit products, and controlled substances like fentanyl discovered on-site. Consumer injuries documented during the investigation included burns, allergic reactions, and harmful poisoning.
Meanwhile, a separate investigation by the NYC Council’s Oversight and Investigations Division found that 86% of inspected medspas were missing required safety records and 73% were operating without any medical professional present to oversee procedures.
“I see it in my office more often than people would expect,” says Dr. Arash Akhavan. “A patient comes in frustrated — sometimes in tears — because they went somewhere offering laser hair removal at a fraction of the price, and they ended up with burns, dark spots, or scarring that will take months to treat. The worst part is they often didn’t know they could ask about the operator’s qualifications. In a state with no regulations, there’s nothing stopping someone with minimal training from performing a procedure that can permanently change your skin.”
When you choose laser hair removal at a board-certified dermatologist’s office, you’re choosing a provider who completed four years of medical school, a multi-year dermatology residency, and passed rigorous board certification exams. At The Dermatology and Laser Group, Arash Akhavan, MD personally calibrates treatment protocols using the Lumenis LightSheer QUATTRO — a dual-wavelength platform that can safely treat every skin tone from Fitzpatrick Type I through VI. That level of precision isn’t a luxury. In an unregulated market, it’s a safeguard.
Frequently Asked Questions About Laser Hair Removal Safety
Is laser hair removal safe at a medspa?
Laser hair removal can be safe when performed by a trained, qualified provider using appropriate equipment — but the setting alone doesn’t guarantee safety. A peer-reviewed study found that burn rates were nearly five times higher when laser procedures were performed by non-physician providers compared to physicians (34.8% vs. 7.4%). The critical safety factors are the operator’s medical training, their understanding of your skin type, and whether a physician is actively supervising treatment protocols. In New York, where there are no licensing requirements for laser hair removal, the risk of encountering an underqualified operator is particularly high.
Who is legally allowed to perform laser hair removal in New York?
Currently, New York is the only state in the U.S. that does not specifically regulate who can perform laser hair removal. There is no required license, training certification, or oversight board for laser hair removal businesses. The New York State Board of Medicine has recommended since 2002 that laser procedures be treated as the practice of medicine, but legislation has not passed. This means that in New York, virtually anyone can legally operate a laser hair removal device — making it essential for patients to verify their provider’s medical credentials before treatment. Board-certified dermatologists like Dr. Arash Akhavan bring the highest level of medical training to these procedures.
What should I look for when choosing a laser hair removal provider?
Start with credentials: confirm your provider is a board-certified dermatologist (look for the FAAD designation from the American Academy of Dermatology). Ask about the specific laser device being used — modern dual-wavelength platforms like the Lumenis LightSheer QUATTRO can safely treat all skin tones, while older or single-wavelength devices carry higher risks for darker complexions. Ask whether a physician personally reviews and adjusts your treatment settings, or whether a technician operates independently. Finally, request a consultation before committing to a package — a reputable practice will evaluate your skin type, hair characteristics, and medical history before any laser touches your skin.
What are the most common complications from poorly performed laser hair removal?
The most frequently reported complications include thermal burns, post-inflammatory hyperpigmentation (skin darkening), hypopigmentation (loss of pigment), blistering, and in severe cases, permanent scarring. These complications are overwhelmingly tied to incorrect laser settings — specifically fluence (energy density) that is too high for the patient’s skin type, or wavelength selection that doesn’t account for melanin levels. A 2026 New York Department of State investigation found burns among the consumer injuries documented at medspa facilities cited for violations. At a dermatologist-supervised laser hair removal practice, settings are calibrated to each patient’s unique skin and hair profile, dramatically reducing these risks.
How is laser hair removal at a dermatologist’s office different from a chain medspa?
The core differences are medical oversight, device calibration, and accountability. At a board-certified dermatologist’s office like The Dermatology and Laser Group, treatment parameters are set by a physician who understands dermatology at a clinical level — including how melanin distribution, hormonal factors, and photosensitizing medications affect treatment safety. Chain medspas typically operate on volume: standardized settings, rapid turnover, and technicians who may have completed only a short training program. A survey of dermatologists found that 53% reported seeing increased complications specifically associated with procedures delegated to non-physician providers.
Arash Akhavan, MD is founder and owner of The Dermatology and Laser Group, one of the top centers for cosmetic procedures in New York City for over a decade. Arash Akhavan, MD, FAAD is a Board Certified Dermatologist and an Associate Professor at The Mount Sinai School of Medicine. Dr. Akhavan is a Castle Connolly Top Doc, New York Magazine Best Doctor, and Super Doctor featured in The New York Times. Dr. Akhavan is a key opinion leader that has been featured on hundreds of media publications including The New York Times, Allure, Marie Claire, Women’s Health, Cosmopolitan, ABC News, Fox News, Fox 5, NY1, WPIX, and more. He has been featured on nationally syndicated television programs such as The Doctors.
Dr. Akhavan serves as an educator and lecturer for multiple aesthetic device and injectable companies. This allows his office access to newer technologies at an earlier date than other offices, as well as a higher level of expertise in the use of these devices. This, in turn, translates to more effective and safer treatments for our patients.
By Arash Akhavan, MD, FAAD | | Categories: Laser Hair Removal, Surgical Dermatology
