When Victoria Nelson visited a celebrity skin-care expert in Beverly Hills for what she believed would be a routine facial, she could not have predicted it would alter her face and her life. Nelson, who once praised aesthetician Sonya Dakar as her “L.A. mom,” later posted a viral TikTok recounting how an unexpected chemical peel left her with burns, scars and years of costly corrective treatments. The high-strength peel, along with follow-up microneedling sessions, were procedures not permitted under California’s licensing laws for aestheticians.
Her story, now circulating widely online, underscores a broader concern in aesthetic medicine: the inconsistent regulations across states that define who is legally permitted to perform certain procedures and what can happen when someone practices out of scope.
In her video, Nelson detailed how an April 2021 facial ended with Dakar insisting on finishing the appointment with a peel. What was billed as a no-downtime treatment caused immediate burning and visible whitening of the skin, a clinical sign of deep injury. “I still very much have marks on my face,” Nelson said, explaining that she has since spent more than $60,000 on corrective procedures with Dakar.
She added that Dakar continued to treat her with microneedling sessions over the next two years, even though California regulations do not allow aestheticians to perform microneedling or medical-grade peels. Aestheticians in the state are licensed by the Board of Barbering and Cosmetology. They can legally perform facials, superficial or light peels and other noninvasive skin-care services. However, they cannot perform medical-grade peels, microneedling, lasers, injectables or any procedure that penetrates beyond the epidermis.
“It shouldn’t be on the consumer to know what is within and without someone’s license,” Nelson said.
“Unfortunately, outpatient aesthetic care is unregulated and has become the wild, Wild West,” says New Orleans dermatologist Mary Lupo, MD. “People must be their own advocate. The main problem with non-core specialists doing these procedures is that a weekend course or online training does not substitute for years of accredited residency training. These non-qualified ‘providers’ quite simply do not know what they don’t know and have no idea how to recognize a complication and manage it to avoid serious and more long-lasting sequelae.”
The United States has no federal oversight of aesthetic treatments, leaving each state to set its own rules. Those rules vary widely. According to Bloomfield, MI dermatologist Linda Chung Honet, MD this variability leaves consumers exposed. “Because there is so little federal regulation in place, the responsibility falls largely to each state to provide its own guidelines. These can be rudimentary and widely variable, resulting in unsafe practices and poor outcomes.”
“It is critical to have treatments like this performed in a medical office where a properly trained physician is overseeing care and available to step in if complications occur,” says Boca Raton, FL dermatologist Jenna Queller, MD. “We need stronger legislation and oversight of med spas and aesthetic practices to better protect patients. Until then, the safest choice is to ensure advanced procedures are performed by qualified, board-certified core aesthetic physicians. A chemical peel is a medical procedure. It is a controlled chemical burn and needs to be performed correctly.”
Augusta, GA dermatologist Lauren Ploch, MDdescribed a medspa in her community: “One of the medspas in my area is owned by an entrepreneur, run by a recently graduated nurse, and the supervising physician is a pediatrician who’s never on-site. The spa is providing neurotoxins, fillers, lasers and hormone pellets. It’s terrifying.”
The experts agree that complications can be severe when procedures are performed by those without medical training. Shreveport, LA dermatologist Skylar Souyoul, MD pointed to Nelson’s outcome as an example. “The aesthetician should have known immediately that they put the wrong thing on her face. Chemical peels frost, and the frost color tells you the depth that the peel went, and her frosting was very bright white indicating it penetrated deep.”
“A chemical peel is not a beauty treatment,” adds Cliffside Park, NJ dermatologist Jason Chouake, MD. “It is a controlled chemical burn that, if done incorrectly, can cause permanent scarring, pigment loss or disfigurement. I have seen patients who went to non-core providers and ended up with lifelong damage because the person holding the acid had no idea how to judge clinical endpoints or manage a complication.”
“As a board-certified dermatologist and fellowship director in surgical and laser dermatology, I think this case perfectly highlights why we have licensure, scope-of-practice laws and years of accredited medical training,” says Ontario dermatologist Dusan Sajic, MD. “Even in the best of hands, there can be risks. Imagine what can happen with people who are not qualified and don’t have a license…The analogy I often use is this: just because a flight attendant has been around planes for years does not mean you would want them piloting one. They may know the safety speech inside and out, but when something goes wrong at 30,000 feet, the difference between training and familiarity can be life or death. Similarly, in dermatology, it’s not the routine that reveals expertise, it’s the unexpected complication.”
Nelson’s case resonates not because it occurred in a cut-rate clinic, but because it involved one of Beverly Hills’ most recognizable names in skin care. Experts say that reputation, celebrity and social media cachet are not substitutes for medical credentials.
As Dr. Ploch noted, the lure of “celebrity” providers can give patients a false sense of security. “Many of them are not trained,” she said, adding that the title of “dermatologist” or “specialist” is sometimes assumed without proper completion of residency or board certification.
Nelson explained that she reported Dakar to the California Board of Barbering and Cosmetology but, to her knowledge, no action was taken. She said the lack of accountability from regulators was one of the reasons she decided to go public with her story.
For Nelson, the warning is deeply personal. “This isn’t a woe-is-me video,” she said. “It’s a be-warned video. Not everyone offering services should be offering them.” She added that she felt a responsibility to share her experience so it does not happen to someone else.