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The rapidly growing field of Aesthetic Medicine in South Africa has seen a surge in associative practices involving therapists, somatologists, and medical professionals. This has resulted in significant challenges in terms of standardisation, qualifications, legislation, and defining the scope or range of medical aesthetics treatments. To tackle these issues and promote professionalism, the South African Association of Health and Skincare Professionals (SAAHSP), in consultation with the Aesthetics and Anti-Aging Society of South Africa (AAMSSA), have developed clear guidelines for the scope of practice across various levels of beauty industry qualifications. Dr Debbie Norval elaborates…
Not all beauty therapy qualifications are equal
Qualifications in the beauty therapy sector vary. They include nail technicians, beauty therapists, somatologists and advanced dermal aesthetic therapists. Research has indicated a competency gap between three-year qualified somatologists and the expectations within the medical aesthetics industry (Swanepoel, 2017). In the field of Aesthetic Medicine, therapists working under the supervision of doctors are expected to hold a Somatology Diploma or an Advanced Diploma in Dermal Aesthetics.
The need for public awareness
Appropriate qualifications are essential to uphold standards for the safety and benefit of the public. It is important for the public to be aware of the qualifications and scope of practice of professionals in the aesthetics industry. This helps individuals to make informed decisions and seek the appropriate professionals for their specific aesthetic concerns or treatments.
Clarifying job titles and roles in the aesthetics industry
Nail Technician: There are qualified and non-qualified Nail Technicians. A qualified Nail Technician has a qualification from a registered accredited provider. A non-qualified Nail Technician has no formal qualification, e.g. a manicurist, pedicurist, or someone who has received brand-specific training without any formal exams.
Beauty Therapist: Beauty Therapists complete a two-year formal diploma in skincare and non-medical beauty treatments. They provide services such as facials, waxing, massages, manicures, and other non-medical beauty treatments.
Somatologist: Somatologists have a three-year diploma in skin and body care and often work alongside doctors. The term ‘somatology’ (Greek origin) means the study of the body. Somatologists have training in skin anatomy, physiology, skin conditions, cosmetic chemistry, and science. They are trained to analyse and treat skin and body conditions through a variety of advanced techniques. They have advanced training in laser, IPL, skin peels, photo rejuvenation, and microneedling.
The term “aesthetician” is often used instead of Somatologist, and this term can become confused with Aesthetic Practitioner. An aesthetician is not a doctor, and they are not qualified to perform medical procedures.
Laser Therapist: a beauty therapist or somatologist who specialises in working with lasers for cosmetic purposes. They perform laser hair removal, skin rejuvenation, or other laser-based treatments under appropriate supervision.
Advanced Aesthetic Therapist: a somatologist who has engaged in further studies and achieved an Advanced Diploma or Degree qualification (4 year Advanced Diploma in Dermal Aesthetics in South Africa). Graduates typically work alongside aesthetic practitioners, dentists, dermatologists, and plastic surgeons assisting with aesthetic treatments.
In a medical setting, aestheticians must hold the correct qualifications, and there are medicolegal consequences to working outside the scope of practice. Although a doctor might believe their therapist is capable of performing medical procedures, e.g. administering injections, if anything went wrong, the supervising doctor would be charged with aiding and abetting in the unauthorised practice of medicine and could be disciplined, fined, or even lose their medical license. The therapist could be criminally prosecuted (Rammanhor, 2014).
Lack of a regulatory body for beauty therapy
Unlike doctors and dentists who are registered with the HPCSA, there is a lack of a regulatory body for the beauty therapy industry in South Africa. The mandate of regulatory bodies is to guide the professions and to protect patients and the public. The absence of regulation exposes patients to unsafe practices, so there is an urgent need for the somatology profession to register with a statutory body.
A scoping review is underway to examine somatology practices and regulations for non-medical aesthetic treatments and identify high-risk procedures if not administered ethically or correctly (Borg 2021 ).
What about injections?
In South Africa, beauty therapists, somatologists, and advanced aesthetic therapists are not legally allowed to perform injections of any kind. This includes fat-dissolving injections, botulinum toxin, dermal fillers, PDO threads, or IV therapy. Injecting falls totally outside of their scope of practice as it is unsafe and illegal.
The merging of Aesthetic Medicine with beauty therapies can lead to consumer confusion. When medical aesthetic treatments are offered in a spa or salon setting, there is a risk of trivialising Aesthetic Medicine. This leaves consumers unaware of the risks associated with procedures and unsure of who holds responsibility.
The integration of appropriate qualifications will lead to professionalism and specialisation in advanced aesthetics somatology treatments, ensuring compliance with medical, ethical, and industry standards.
While non-medical practitioners such as somatologists and beauty therapists are valued for their accessibility and service, accredited training in physiology, anatomy, infection control, and the ability to recognise and address complications is crucial for consumer safety.
To report any unsafe practice or if you have any queries, please feel free to contact AAMSSA email@example.com
Find a doctor practising aesthetic medicine in South Africa by visiting www.aestheticdoctors.co.za
Disclaimer: This article is published solely for informational purposes and should not be considered a substitute for professional medical guidance.
- Swanepoel, Yolandè Winifred. The Perceived Competency of Somatologists Working in the Medical Aesthetic Industry. University of Johannesburg (South Africa), 2017.
- Rammanhor, K. (2014) An analysis of the somatology programme offered at South African universities of technology to determine whether it meets the needs of industry. Unpublished MTech: Somatology dissertation, Durban University of Technology, South Africa.
- Esthetician Education Organization, (2017) Esthetician licensing requirements Available at: http://www.estheticianedu.org/esthetician-licensing-requirements
- Dorinda Raphine Borg, Ashley Hilton Ross, Kabelo Garosi et al. Somatology Practices in Non-medical Aesthetic Treatments: Towards Development of Good Practice Guidelines for Somatology in South Africa: a Scoping Review Protocol, 15 November 2021, PREPRINT (Version 1) available at Research Square [https://doi.org/10.21203/rs.3.rs-1059407/v1]
MBBCh (Rand) Dip Pall Med (cUK) M Phil Pall Med (UCT) Adv Dip Aesthetic Med (FPD)
Dr Debbie Norval graduated as a medical doctor from the University of the Witwatersrand, in 1991. Post graduate training includes a Diploma in Palliative Medicine through the University of Wales, Masters of Philosophy from the University of Cape Town, an Advanced Diploma in Aesthetic Medicine through the Foundation for Professional Development and a City and Guilds Diploma in Adult Teaching and Training.
Dr Norval is the convenor of the Johannesburg Aesthetic Doctors Journal Club and sits on the scientific committee of the Aesthetic Medicine Congress of South Africa (AMCSA). She is the Past President of the Aesthetic and Anti-Aging Medicine Society of South Africa (AAMSSA) and serves on the International Advisory Board of CMAC (Complications in Medical Aesthetics Collaborative).
“Dr Debbie Norval Aesthetics” is a busy clinical practice in Parktown North, Johannesburg.