'Vampire facials' likely infected 3 women with HIV. Here's what health experts want you to know about these beauty treatments — and how to stay safe.

From Botox to “vampire facials,” “tweakments” and the med spas offering them are everywhere you look. The number of these types of minimally invasive cosmetic procedures surged by upward of 70% between 2019 and 2022, according to the latest data from the American Society of Plastic Surgeons. But recently vampire facials have been making headlines for their link to three cases of HIV, while health officials are warning that counterfeit Botox is causing botulism, raising concerns about the safety of these popular treatments.

Here’s what you need to know about the outbreaks and how to stay safe if you’re getting a facial tune-up.

What is happening with vampire facials?

Three women contracted HIV after getting so-called vampire facials at a spa in Albuquerque, a Centers for Disease Control and Prevention report confirmed Thursday. It’s the first time the procedure has resulted in the transmission of HIV and has raised concerns about the safety of vampire facials, also known as platelet-rich plasma (PRP) microneedling procedures that aim to rejuvenate the skin.

The first case came to light in 2018, when a woman who had had a vampire facial at VIP Spa, an unlicensed med spa in Albuquerque, and who had no other likely sources of exposure, tested positive for HIV. The New Mexico Department of Health then offered free HIV testing to 59 clients who had visited the spa and who officials considered at risk. Another two women who received vampire facials tested positive for HIV.

Health officials also identified a former client of the spa, which opened in 2017, who had been diagnosed with HIV in 2012. The CDC did not say whether this person was the source of the HIV outbreak, but their viral sample was genetically very similar to those in the other spa-linked cases.

In the fall of 2018, an investigation of VIP Spa “revealed unsafe infection control practices,” including unlabeled tubes of blood and injectables, such as Botox and lidocaine, according to the CDC report.

Should I avoid vampire facials?

You don’t need to avoid vampire facials altogether, but you should make sure you’re going to a licensed, reputable provider to get one, experts warn. “In general these procedures can be done very safely,” Dr. Jeanette Black, a dermatologist and cosmetic dermatological surgeon with Union Derm in New York City, tells Yahoo Life.

The vampire facial procedure itself isn’t particularly dangerous and is considered minimally invasive. The treatment earned the nickname “vampire facial” because during a PRP microneedling procedure, a patient’s own blood is drawn from their forearm, then spun in a centrifuge to separate out the platelet-rich plasma and injected into the patient’s face with a microneedling device equipped with a dozen or more tiny needles, according to the American Academy of Dermatology.

“There are risks with any types of needles, even if you’re injecting Botox or injectable fillers or using microneedling,” says Black. “Any time needles are going into the skin, there’s always a risk for blood-borne pathogens just from needlestick injuries even.” Vampire facials are slightly riskier because “the blood, which could potentially carry a blood-borne disease, is separated from the patient and being processed, and that adds another element of risk because you don’t want to have problems with mislabeling or contamination.”

She says that proper labeling of vials of blood is crucial to making sure they aren’t switched and a client winds up being injected with someone else’s blood, which may be of a different type than theirs or contain pathogens such as HIV.

Black says that the danger comes from unsafe, unsanitary practices, like unlabeled blood vials or the reuse of unsterile needles. She says that the safest way to get a vampire facial — or any cosmetic injection — is from a board-certified dermatologist or plastic surgeon.

What other beauty treatments should I watch out for?

On April 23, the CDC issued a warning about tainted, counterfeit Botox being sold across the country. At least 22 people across 11 states have gotten sick after receiving unapproved counterfeit Botox either in unlicensed med spas or outside medical settings such as homes.

Botox is the brand name for botulinum toxin — a highly processed and purified version of the bacteria that causes botulism, which paralyzes muscles and prevents and smooths wrinkles. “It’s a very powerful toxin; it can be used as a biological weapon,” Dr. Anthony Rossi, dermatologist and dermatological surgeon with Memorial Sloan Kettering Cancer Center, tells Yahoo Life. People who received the tainted Botox developed symptoms of botulism, including difficulty breathing or swallowing, blurred or double vision, slurred speech and drooping eyelids. At least 11 have been hospitalized, according to the CDC.

“We see counterfeit products like this sometimes come into the market because the costs of these goods are very high so, if people want to skimp around, they may try to import them” from countries with fewer regulations or from black market sellers, Rossi says. “We see it not just with Botox; we see it with dermal fillers too — unlicensed or even licensed providers trying to source cheaper goods and getting sterile, improperly made products.”

What’s the best way to stay safe?

Rossi and Black both say that the gold standard for safety is to go to a dermatologist’s or plastic surgeon’s office and have the physicians themselves administer injectable treatments. “Usually, vampire facials are going to be done at optimal safety protocols with a board-certified dermatologist who has trained specifically in these types of procedures,” Black says.

Adds Rossi: “Sometimes the marketing makes it seem like [cosmetic procedures] are a lunchtime sort of event. But these are medical procedures, so you really want to seek out trained medical professionals.”

The HIV transmissions happened at an unlicensed, illegal spa, which was shut down in 2018 after the first case was detected. The CDC said that the tainted Botox injections were all given by “unlicensed or untrained individuals or in non-health care settings, such as homes or spas.” In most states, only licensed medical professionals can legally do cosmetic procedures, according to the American Med Spa Association. Even in those that don’t have this requirement, a medical director has to oversee the services of a med spa.

Rossi “doesn’t try to discourage” patients from going to med spas. But, he says, “You want to make sure the places are reputable because they are not all created equally.” He advises checking to be sure any med spa you’re considering going to has a license and good consumer reviews. Black says it’s important to be unafraid to ask if there’s a board-certified physician overseeing a med spa, and if that person is on-site when you have your appointment.

You can also keep an eye on the products and methods being used when you have your appointment. You can ask that Botox and dermal filler be drawn from the vial into the needle in front of you, so you can see it and be sure you’re getting the real product, Black suggests.

Similarly, if you’re getting a vampire facial, you can ask that a label with your name be placed on the vial of your blood while you’re watching, and you can ask to see it again after it’s been processed in a centrifuge. Questions are your friend, says Rossi. “It’s OK to ask someone their credentials; it’s OK to ask to see the vial; if they’re drawing blood from you, you want to be sure the blood they use is yours, and if your intuition is telling you it looks shady, you should listen to that,” he says.

Low prices might be appealing, but if the price looks “too good to be true,” that might be a clue that something “shady” could be going on, Rossi points out. Adds Black: “Unfortunately, a lot of patients get duped by advertising and end up going into facilities that just don’t have proper licensing and safety mechanisms in place.”