AmSpa CEO Reflects on the Sonya Dakar Case

The Sonya Dakar case has become a closely watched controversy in aesthetics, not simply because of the allegations involved, but because of the questions it raises about patient safety, scope of practice and regulatory enforcement. The dispute stems from allegations by former client Victoria Nelson, who claims she suffered severe burns and permanent facial injuries following a chemical peel treatment in 2021.

After years of pursuing legal and regulatory action, Nelson’s claims gained widespread public attention through social media, ultimately culminating in a settlement that requires Dakar to surrender her California aesthetician and establishment licenses and pay Nelson $70,000. The case has also renewed scrutiny of prior disciplinary actions involving treatments regulators determined fell outside the legal scope of practice for an aesthetician in California.

Industry observers debate whether the situation represents an isolated failure, a symptom of broader problems within aesthetics or evidence that stronger oversight is needed across the board. Alex Thiersch, JD, founder and chairman of the American Med Spa Association (AmSpa), shared his thoughts with Beauty Independent.

“The Sonya Dakar case is an important cautionary tale for the public and the aesthetics industry, but it should not be viewed as representative of the medical spa industry as a whole. The issue appears to be very specific. Sonya Dakar, a self-described ‘facialist,’ was performing treatments that were outside the scope of an aesthetician’s license in California.

“That is not a gray area. California has for years been clear that medical-grade chemical peels, microneedling and energy device-based treatments are medical treatments and therefore outside the scope of practice for aestheticians. These treatments should never have been performed by an aesthetician at a day spa in the first place, which appears to have happened here.

“A properly run medical spa, on the other hand, is built around medical oversight, licensed and trained providers, appropriate delegation, protocols and the ability to respond to complications when they occur. As such, this case should not, as some have claimed, be used to question the safety and professionalism of properly run medical spas.

“This is not to minimize what happened to Victoria Nelson. Her experience is extremely sad and troubling, and it should never have occurred. Unfortunately, situations involving rogue actors operating outside the rules are becoming far too common. One of the biggest issues our industry faces is individuals doing things they should not be doing without fear of consequence.

“But when someone without the proper license or medical training performs medical-grade treatments for years, that is not a med spa problem as much as it is a scope-of-practice and enforcement problem. It should not take a horrific experience and five years of dedicated effort by an injured patient to shut down a facility that was operating blatantly and openly against the rules.

“Nevertheless, the broader lesson is that the public needs more education about what makes a medical spa safe and compliant, and why these treatments should be sought at responsible medical aesthetic practices such as medical spas, dermatology offices or plastic surgery centers. Patients should feel empowered to ask who is performing the treatment, what license they hold, who is supervising the care, what product or treatment is being used, and what happens if there is a complication.

“Responsible med-spas should welcome the chance to work with regulators to ensure patients can distinguish between compliant medical aesthetics practices and actors operating outside the rules.”

Other industry leaders who weighed in saw it as part of a broader challenge facing aesthetics as a whole. Several pointed to growing pressure on providers to offer increasingly aggressive treatments and adopt new technologies, sometimes without sufficient regard for training, patient selection or legal limitations. Others emphasized that cosmetic procedures are still medical procedures, requiring proper oversight, informed consent, documentation and clear protocols for managing complications when they occur.

Across the discussion, there was broad agreement that practitioners must understand the boundaries of their licensure, resist the temptation to chase trends at the expense of safety and prioritize patient welfare over business considerations. The consensus was not that the industry itself is inherently unsafe, but that continued growth must be matched by rigorous clinical standards, accountability and a commitment to operating within established professional and legal frameworks.

Ultimately, the Sonya Dakar case should serve as both a cautionary tale and a call to action. While the circumstances surrounding the case appear highly specific, they have sparked an important conversation about how providers are trained, regulated and held accountable, as well as how patients evaluate the professionals performing their treatments.

For Thiersch, the path forward is to strengthen the distinction between compliant practices and those operating outside the rules. The industry’s future depends on maintaining public trust through transparency, education, medical oversight and unwavering adherence to patient safety.

Empower your aesthetic patients

The Sonya Dakar case reinforces several questions patients should ask before undergoing aesthetic treatment:

• Who is performing the procedure?
• What license does that person hold?
• Is the treatment within that provider’s legal scope of practice?
• Who provides medical oversight?
• What happens if a complication occurs?
• What emergency protocols are in place?

Explore AmSpa’s resources for more about what makes a med spa safe:

• A Patient’s Guide to Medical Spas
• What to Look for in a Safe Med Spa Visit
• How Safe Are the Top Med Spa Treatments?
• How Safe Med Spas Manage Complications
• Training Safe, Responsible Med Spa Practitioners
• How Much Training Do Safe Med Spa Practitioners Need?
• How Much Training Do Aesthetic Laser Providers Need?