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  • Writer's pictureJustin Marti

Understanding Scope of Practice at Medical Spas

What is scope of practice? 

Scope of practice refers to the range of services and activities that a healthcare professional is legally permitted to perform. It’s based on their education, training, and licensure. In the context of medical spas, scope of practice regulations delineate which procedures can be performed by specific healthcare professionals, such as physicians, nurse practitioners, physician assistants, registered nurses, and estheticians. 

Like many regulations in medical aesthetics, the scope varies dramatically from state to state.  However, we found  some consistent themes to consider by procedure type below. Like always, it is important to speak with your legal counsel to ensure that all the providers in your medspa are acting within their scope of practice and that proper oversight exists as necessary.  

Scope of Practice Considerations for Medical Spa Procedures

Botulinum Toxin and Dermal Fillers

With little exception, “Tox” and fillers generally must be performed by a licensed physician, nurse practitioner, physician assistant, or registered nurse under physician supervision, depending on state laws.  While requirements generally call for some level of training prior to injecting, there remains a lack of clarity as to what qualifies in most states.

In the United States, there is no singular accrediting body for injector training, nor for most other medical aesthetic procedures conducted in the medspa. Many aspiring injectors take a weekend course and begin seeing patients immediately thereafter. While this may translate into a rapid revenue stream, the risk for potential malpractice claims runs high. The key for medspa owners and clinicians alike is to keep in mind that your license is on the line. As such, it is important to ensure proper oversight of both new and experienced injectors alike.

Laser Treatments 

Laser hair removal and skin treatments typically require certification in laser operation. Unsurprisingly, the level of supervision (direct or indirect) and who can perform these treatments can vary depending upon a number of factors. 

In some states, laser technicians can perform procedures without direct physician supervision if they have received “appropriate training and certification”. There again remains a lack of a unified accrediting body, thus much of the responsibility for determining a laser technician’s ability falls on the Medical Director’s clinical opinion.

Chemical Peels and Microneedling 

While estheticians can generally perform chemical peels, the depth of the peel and the type of chemicals used might require a higher medical professional, such as a nurse or physician, especially for more invasive treatments. 

When it comes to microneedling, states tend to take a more restrictive approach, due to the depth of penetration. In fact, some states, such as New York,  limit microneedling to physicians and acupuncturists. 

Importance of Compliance

Ensuring that all medspa procedures are performed within the legal scope of practice is not just a matter of compliance, but also of patient trust and safety. Noncompliance can lead to serious legal consequences, including fines, the revocation of licenses, business closures and even criminal charges. Regular training and updates for all staff members on the latest regulations and best practices are recommended to maintain compliance and deliver safe, effective treatments.


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Disclaimer: This website is solely intended for the purpose of providing general information. This blog post is not a substitute for legal advice, thus no attorney-client relationship is created. An attorney-client relationship is only formed with Marti Law Group after you have signed an Engagement Letter. Nothing on this website constitutes legal advice. Every situation is different and fact-specific, and a proper legal analysis is necessary. The best way to get guidance on your specific legal issue is to contact a licensed attorney in your jurisdiction. To schedule a consultation with an attorney at Marti Law Group, please contact: or 860-552-7770

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