Professional competences in aesthetics – the boundaries between cosmetology and medicine
The scope of the Minister of Health's opinion – interpretation versus the facts
The opinion of the Polish Minister of Health refers exclusively to medical devices (8% VAT) and does not apply to cosmetic devices. Medical devices are intended specifically for therapeutic treatments only, and their certification is specific.
Devices such as:
- HIFU
- RF
- aesthetic lasers
- plasma
sold at the 23% VAT rate are commercial devices and may be used in the beauty industry. What is more, the market offers many devices using these technologies, with a range of power outputs, intended for independent home use
No legal changes have been introduced in this respect.
The scope of cosmetologists' competences
Aesthetic treatments aimed at improving appearance are a core element of the education of:
- cosmetic services technicians
- cosmetologists
For many years, cosmetologists have performed treatments using a wide range of technologies:
- laser
- ultrasound
- RF
- HIFU
In the past, curricula also included compulsory training in treatment technologies such as lasers; however, owing to the high costs for universities this has changed, and it is now mainly high-quality private universities that offer such training as part of their degree programmes.
The problem of definitions – no clear legal framework
A significant problem is the lack of clear definitions of:
- a cosmetic treatment
- an aesthetic treatment
- aesthetic medicine
- reconstructive medicine
The absence of these definitions leads to conflicting interpretations.
The key functional distinction
- medical treatment → action within a disease entity, therapy
- aesthetic treatment → improvement of appearance
Are medical lasers reserved exclusively for doctors?
The claim is sometimes made in public debate that medical lasers may be used only by doctors.
In practice, however:
- in dentistry, laser procedures are performed by a dental technician or dental assistant
- in physiotherapy, lasers and ultrasound are used by physiotherapists
The scope of use of a technology depends on professional competences, not solely on holding a medical degree.
Indisputably medical procedures
There is no doubt that procedures such as:
- injections
- implants, including non-permanent ones
- the use of medicinal products (e.g. botulinum toxin)
require medical qualifications and should be performed by doctors, as they involve introducing foreign substances into the body and carry a high risk of complications.
The cosmetologist's role in skin therapy
Cosmetologists are educated with a focus on:
- improving skin function
- regenerative treatments
- supporting dermatological therapies
The doctor–cosmetologist model of collaboration is widely used, particularly in dermatology.
Aesthetics versus treatment – the social and economic aspect
Aesthetic treatments:
- are not aimed at treating diseases
- respond to social and aesthetic needs
The market for these services is growing rapidly, and their profitability makes them an important segment of activity for doctors as well as for specialists and lay practitioners in the beauty industry. Anyone can open a clinic and start performing treatments after a short course.
The systemic gap – the need for regulation
The current system allows:
- training to be delivered without supervision
- access to advanced technologies without any verification of competence
A possible solution could be:
- introducing an accreditation system for training
- regulating training centres
- standardising professional competences
