Not only should you be making sure the medical spa you are visiting is one of high standing that offers a safe, clean, legally compliant environment for you to have your treatments, but also ensure that the professional performing the procedure is the right person for the job. Did you know that each state has different requirements in regard to what type of licensed professional can do what type of treatment in a medical spa and medical aesthetics environment? For specific treatments, check out the question “Who can safely administer this treatment?” in our Medical Spa Treatment Directory to help guide you on what to expect in regard to the professional administering your procedure.

As a general rule, however, all medical treatments should be performed by medical professionals under the supervision of a physician. This is not always an easy distinction to make, however, as many treatments offered at medical spas are clearly not medical (European facials, for example) and some, at least at first blush, are sort of medical (i.e. microneedling and some laser treatments). As we discuss in the Medical Spa Treatment Directory, legally speaking, most states consider any treatment that “affects” the living tissue to be a medical treatment, although there are exceptions to this rule, depending on which state you are in.

The reality is that most treatments you’ll receive at a medical spa—lasers, fillers, Botox, radiofrequency, ultrasound, microneedling, to name a few—are considered to be medical treatments by the state. This is important because medical treatments require an in-person medical exam by a doctor (either MD or DO) or a mid-level practitioner (nurse practitioner or physician assistant) before the treatment is performed. They should also be performed by trained, experienced, and supervised professionals.

Every treatment is different and every state is different, so determining who can do what is not an easy task. But as a general rule, anything with needles or a scalpel should be performed by a practitioner who is, at a minimum, an RN. Laser treatments can usually—but not always—be performed by anyone with sufficient training, but many states are passing laws with specific requirements for firing a laser.

Bottom line, call your state board of medicine or nursing, a health care lawyer, or AmSpa to get updated information.