Three women have been diagnosed with HIV in what federal health officials in the US believe are the first documented cases of the virus being transmitted through a cosmetic procedure involving needles.

The Centers for Disease Control and Prevention (CDC) reported the cases last week, stemming from an investigation into an unlicensed medical spa in New Mexico between 2018-2023. The investigation found the spa was reusing disposable needles and equipment meant for one-time use during the popular platelet-rich plasma (PRP) microneedling facials, also known as “vampire facials.”

The New Mexico Department of Health launched the probe in summer 2018 after a woman in her 40s tested positive for HIV despite having no other risk factors. She had received a vampire facial at the spa earlier that year.

The spa was subsequently shut down in fall 2018, and the owner was prosecuted for practicing medicine without a license. Investigators found poor record keeping made tracking clients who may have been exposed more difficult.

Vampire facials involve drawing a client’s blood, separating out platelet-rich plasma, and then injecting or microneedling that plasma back into the face to ostensibly rejuvenate the skin.

While the procedure has grown in popularity, the CDC case highlights the infection risks of any cosmetic treatments involving needles when proper safety protocols are not followed. Other common examples include Botox, lip fillers, and tattoos.

The report recommends cosmetic service providers maintain detailed records to aid investigations and ensure all equipment is sterile and disposable needles are discarded after a single use.