Botched Beauty: How to Protect Yourself and Respond If a Treatment Backfires

While TikTok isn’t always a reliable source, it can be an eye-opening one—especially when it comes to beauty and aesthetics. Recently, we saw Founder of Undeniable Entertainment Victoria Nelson’s video with a powerful reminder to always do your research prior to any cosmetic treatments. In the viral video, Nelson recounts how a routine facial with celebrity aesthetician Sonya Dakar took a devastating turn. What began as a standard appointment ended with a clinical-strength chemical peel that left her with burns and permanent scarring. Instead of urging her to seek medical help, Dakar advised follow-up microneedling sessions. Unbeknownst to Nelson at the time, both microneedling and medical-grade chemical peels fall outside the scope of an esthetician’s license in California.

Nelson’s cautionary tale reminds us that we have to take an active role. We need to understand who’s qualified to do what, confirm credentials, and know what to do if something backfires. In the following article, we’ll break down the different types of providers and their scopes of practice, give you the tools to find and interpret licenses, and the knowledge of what to do if something goes wrong mid- or post-treatment.

Types of Providers and Scopes of Practice

Not all types of aesthetic providers are equal. Licensed aestheticians (also known as estheticians) focus on cosmetic, non-invasive services on the surface of the skin, like cleansing facials, superficial chemical exfoliation, and non-medical skincare. They’re typically regulated by state cosmetology boards and are not permitted to perform any medical procedures, like injectable neurotoxins and fillers, lasers, medium/deep peels, and microneedling. Nurse injectors, physician assistants (PAs), dermatologists, and plastic surgeons, on the other hand, can perform these types of treatments, but the exact rules depend on state law, supervision requirements, and device classifications. Nurse injectors and physician assistants typically need to work under a licensed physician’s supervision, and their scope depends on state law and that physician’s specialty. They can perform non-surgical cosmetic treatments but they can’t independently diagnose, prescribe, or treat without medical oversight.

Dermatologists and plastic surgeons, on the other hand, are fully licensed physicians. They can diagnose conditions, prescribe medications, and perform both cosmetic and medical procedures, like surgical excisions, skin cancer treatments, and complex laser resurfacing, without supervision. Their advanced training allows them to manage complications and tailor treatments safely, something nurse injectors and PAs aren’t licensed to do on their own.

But, here's where it gets complicated: the rules aren’t the same everywhere. AEDIT Founder and board-certified facial plastic and reconstructive surgeon Dr. William Kennedy cautions, “Every state regulates aesthetic medicine differently, the line between cosmetic services and true medical care can get confusing. What’s allowed in one state might be banned in another, therefore the lack of uniformity can make patients think that all providers are equally qualified, even when that isn’t the case.”

How to Find and Interpret Licenses

It’s easier than you might think to verify a provider’s license—and it’s completely free. For non-medical providers like estheticians and cosmetologists, most states have online lookup tools where you can confirm a provider’s name, license type, and whether their credential is active or under disciplinary review. In California, for example, consumers can search the Department of Consumer Affairs’ BreEZe License Verification System to check details like an esthetician’s or cosmetologist’s license type, status, expiration date, and any disciplinary actions.

For medical professionals, such as dermatologists, plastic surgeons, nurses, or physician assistants, you need to search your state’s medical or nursing board. You can also use national databases like the Federation of State Medical Boards’ DocInfo, which compiles physician licenses and disciplinary actions, or Nursys, which provides official license verification for nurses across most U.S. states.

When checking a license, make sure the credential matches the treatment you’re seeking, that it’s active, and that there are no disciplinary notes like “probation.” In Nelson’s case, a quick search would’ve shown that Dakar was licensed under California’s Board of Barbering & Cosmetology, a credential that doesn’t permit medical-grade chemical peels or microneedling.

Red Flags & Questions to Ask Before a Treatment

Prevention starts with due diligence. Before any procedure, confirm who will perform it, what their credentials are, and whether a physician oversees or is available for complications. Ask about the specific product or device, its strength, and potential risks. Blanket statements like “no downtime,” "completely safe” or “for all skin types,” should raise your antenna, especially for treatments that normally involve recovery or risk, such as peels, lasers, or injectables. Every skin type reacts differently, and truly personalized care starts with honesty about risks and limitations.

Be wary of high-pressure sales tactics, like being urged to purchase a package or add additional treatments on the spot; a reputable provider will give you time to think, research, and even seek a second opinion before committing. Transparency is another key marker of professionalism. Providers should always be open to sharing what products, strengths, or devices will be used and provide a clear explanation of how they work.

Lastly, if a provider hesitates or refuses to share their license information, explain their training, or outline what happens in case of complications, run the other way. And, remember that depending on the state, some clinics need to have a physician on-site or supervisory oversight where required.

Here is a list of questions you may want to ask ahead of your treatment:

• What exactly is the procedure, and what active ingredients or devices will be used?
• Who will perform it, and what are their credentials?
• What is your experience with this procedure, and what is your complication rate?
• What are the risks, possible side effects, and signs of a complication?
• What happens if something goes wrong? Is follow-up care or referral included?
• How many times have you performed this procedure on my skin type?

Asking these questions doesn’t just help you make an informed decision, it also sets the tone for a transparent, respectful relationship with your provider. The right professional will welcome them.

What to Do If Something Goes Wrong

If something feels wrong mid-treatment (e.g. burning, sharp pain, or unexpected discoloration) speak up and stop the procedure immediately. Once you leave, document everything: take photos, note the date and time, what was done, how you felt, and whether the provider acknowledged the issue.

Then, seek medical care right away, ideally from a board-certified dermatologist or plastic surgeon. “These specialists are trained to assess burns, scarring, or pigment changes with a medical lens,” Dr. Kennedy explains. “They can identify the severity of the issue and initiate the appropriate treatment right away.” In Nelson’s case, she hadn’t gone to her dermatologist until much later when Dakar should have referred her to a burn unit.

Afterwards, collect all of the information you can (e.g. what products were used, the device settings, consent forms, etc) and file a complaint with the relevant state board if you believe the provider acted outside their scope. Serious reactions tied to products or devices can also be reported through the FDA’s MedWatch system to help regulators track safety issues. “I routinely see complications from products and devices that were marketed as ‘safe for anyone,’” Dr. Kennedy notes. “Burns, pigment changes, severe rashes — these aren’t rare. They often stem from treatments performed by someone who didn’t fully understand the skin’s response or the device’s settings. That’s why proper medical training is so critical in aesthetics.”

If damage is significant, seek legal or patient-advocacy guidance, and don’t neglect your emotional recovery. Injuries that affect your appearance can deeply impact self-confidence, as Nelson shared in her heart breaking video. Even when things go wrong, acting quickly, keeping detailed records, and involving qualified professionals can make all the difference in your recovery and your rights.

The Bottom Line

Even when everyone follows the rules, aesthetic treatments carry risk. Your best protection is staying informed, verifying credentials, asking questions, and trusting your instincts. While we’re heartbroken by Nelson’s experience, it is a powerful reminder that doing your homework before any treatment can make all the difference. We thank her for opening up and being so candid with all of us!