Spot removal mystery shop

Our mystery shop

We sent mystery shoppers to beauty clinics across the country to see if therapists would offer to treat the raised spots they were shown. They aren’t meant to. The New Zealand Association of Registered Beauty Therapists president Judy West said members were prohibited from removing unidentifiable lesions and skin tags without permission from a registered medical practitioner. However, association membership is voluntary.

Auckland Council’s health and hygiene code of practice states only health practitioners can remove skin lesions and moles.

The risk for the consumer is a beauty therapist may not recognise the spot as a symptom of skin cancer. Given New Zealand’s high skin cancer rate, we think beauty therapists should steer clear of the issue and leave diagnosis to the doctors. A Brisbane research institute study recently found New Zealand had overtaken Australia as having the highest per capita rate of invasive melanoma.

Treatments offered

Our concerns were backed up with seven of the 46 clinics offering a treatment to get rid of the spot. None of the clinics that offered a treatment are members of the Association of Registered Beauty Therapists. Treatments offered included laser, Surgitron (a machine that uses radio waves) and Dermastamp (a skin-needling process). One therapist told our shopper they would be happy to “cut it out”, while another said they had a machine on the way that could simply “electrocute” it off.

All the clinics that said they could remove the spot were in Auckland and were visited by the same mystery shopper. She described the spot on her arm as a mole but on her rounds it was described by therapists and clinic office staff as a scar, skin tag, blemish and “warty lesion”. We sent a picture of it to Dr Amanda Oakley, a consultant dermatologist at Waikato Hospital and honorary associate professor.

Why the concern

Dr Oakley says our shopper had dermal melanocytic naevi, which can be removed after being diagnosed correctly. “However, basal cell carcinoma, amelanotic melanoma and some other, less common, malignant tumours can resemble dermal melanocytic naevi,” Dr Oakley says.

In 2010, the Middlemore Hospital Dermatology Department and Registered Beauty Therapists Assocation surveyed beauty therapists. Of the 79 who completed the questionnaire, 39 percent said they had not received formal training in identifying skin cancer. When asked how they would respond if a client was worried about a skin pigmentation, 90 percent said they would refer to a doctor.

However, 29 percent said they would treat a lesion that had been histologically confirmed as being in the early stages of melanoma. When shown a photo of the spot, 22 percent were unsure whether to treat it.

Dr Oakley says she has attended a therapists conference where attendees were asked if they would treat lesions that had been photographed and displayed.

“I was disappointed in the lack of knowledge of attendees and I didn’t feel confident that they could distinguish skin cancers from harmless lesions,” she says. “They receive very little relevant training. If they cannot confidently name a spot, they should decline to treat it until a doctor has told the client that it’s safe to do so.”

She wasn’t surprised by the results of our mystery shop.

“The concern is that melanoma is a dangerous cancer and must be diagnosed as early as possible. And early melanoma is very difficult to distinguish from a harmless mole or freckle.”

Melanoma NZ chief executive Linda Flay says anyone can buy laser devices that could be used to remove spots.

“We believe the classification of medical devices under Medsafe should take into account the risk of using them. Some people should never be able to get their hands on them. Therefore, a level of regulation is important,” Ms Flay says.

“Removing the lesion itself, or reducing the pigmentation from a potentially cancerous lesion by radio frequency can lead to misdiagnosis or delayed diagnosis by a skin specialist and by then it could be too late. No attempts to remove skin lesions should be performed using IPL [intense pulsed light] or laser by the clinic.”

Given the high incidence of melanoma in New Zealand, caution is “absolutely warranted”, she says. The organisation strongly recommends treatment is only carried out after consultation with a medical practitioner.