1. What is a medical spa?

A medical spa is quite different from a regular spa. It’s essentially a hybrid between a medical center and a day spa. It provides non-surgical medical treatments, most of which are aesthetic. Some common examples include laser treatments, botox and ultrasounds. Many medical spas also include spa treatments such as facials and hair regrowth treatments that are not considered medical treatments.

Treatments that are considered medical must be performed under the supervision of a physician. Additionally, a medical spa has to have on-site supervision by a health care professional, such as a doctor or nurse practitioner.

2. What type of treatments does a medical spa perform?

A medical spa does not perform invasive procedures, such as plastic surgery. They do perform treatments that impact the living tissue of the body and that require professional expertise. Many of these treatments are aesthetic.

Medical spas perform a variety of different procedures, including face lifts, botox, fillers, microneedling, dermabrasion, laser hair removal, liposuction, skin rejuvenation, ultrasounds and vaginal rejuvenation.

3. Who is permitted to work at a medical spa?

Treatments at a medical spa must be performed by qualified practitioners. Providers must be professionally trained to perform that specific procedure, and they have to be supervised by a medical professional such as a doctor or nurse practitioner. Different treatments have different requirements for who is qualified to safely perform it, and requirements also vary by state law.

In general, treatments requiring needles or a scalpel must be performed by a medical professional. For example, Botox, face lifts and microneedling all fall under this category. Those treatments can be performed by either a registered nurse or a higher-level provider such as a doctor.

On the other end of the spectrum, laser treatments do not usually have to be performed by a medical professional of any kind. Instead, they can be provided by anyone with sufficient training and experience. For example, laser hair removal is often performed by aestheticians, though technically it is considered a medical treatment in most states. Most states have yet to develop specific legislation regarding laser hair removal, but you should check your own state board of medicine or nursing to be sure.

Whether you are being treated by a nurse or aesthetician, the most important thing is that they’re experienced, trained, and qualified. Simply being a licensed nurse doesn’t necessarily mean that they’re trained to perform a specific aesthetic treatment. Since there’s no universal licensing process to become a medical spa practitioner, you should ask the provider for references and speak to their supervising physician.

4. Do I need to go to a doctor before going to a medical spa?

Medical spas often perform medical treatments as well as treatments that are not considered medical. Thus, to determine whether or not you need to consult with a doctor before treatment, you must first ascertain whether your desired treatment is defined as medical by the state. Generally, any procedure that impacts the cells below the outer skin layer — known as the “living tissue” of the body — is considered medical.

If you are aiming to receive a medical treatment, you need to speak to a medical professional first. You cannot simply walk into a medical spa and receive treatment. By law, you have to consult with a doctor, nurse practitioner or physician assistant. However, since medical spas are required to have an on-site medical practitioner, a safe medical spa will offer you a consultation with this person before proceeding with any treatment.

If a medical spa offers to provide medical treatment without a consultation with a doctor, do not proceed with the service, as this is against the law and indicates malpractice.

That said, it can sometimes be confusing to differentiate which treatments are medical and which are not. Laser hair removal, for example, is often a point of confusion. However, laser hair removal is considered a medical treatment in most states. Thus, although it’s often performed by aestheticians, you should still consult with the on-site medical professional before receiving laser hair removal treatments.

5. Does there need to be a doctor on-site at the spa?

Yes and no. Most states require that a medical spa retain a doctor or medical professional to supervise medical treatments as well as to consult with new patients. However, the medical professional doesn’t necessarily have to be on-site for every medical spa procedure. Still, you should always have an in-person consultation with the on-site medical professional before receiving any medical treatment.

6. How can I verify the safety of a particular medical spa?

There are a few steps you can take to ensure that a specific medical spa is meeting its legal obligations and operating safely.

The first item on your checklist should be that there is a doctor available on-site at the spa. If there’s not a doctor, there should be a physician assistant or nurse practitioner. You should be able to meet with this medical professional in person before receiving treatment. If this does not happen, it means that the medical spa is not complying with the law and therefore is not operating safely.

Secondly, your treatments should be performed only by a medical professional under the supervision of a physician, with the exception of some laser treatments. The latter procedures can be performed by anyone with sufficient training. When in doubt, ask for more information about the training and experience of the practitioners in question.

Doing your due diligence is perhaps the most important way to tell whether a medical spa is safe. Exercise caution and do your research on the specific spa in question. Check the laws regarding medical treatments in your state, and dig up any information you can find about that particular medical spa. This is easy to do with a simple well-worded Google search. If you find any suspect reviews or lawsuits, steer clear.

A good rule of thumb is to only patronize medical spas with good references that have a doctor on-site.

7. What defines a “medical treatment”?

A medical treatment is defined as any procedure that impacts the living tissue of the body. The term “living tissue” refers to anything below or beyond the epidermis, which is the outer skin layer consisting of dead skin cells.

Of course, there is some room for interpretation when it comes to whether specific treatments meet this definition. When in doubt, refer to your specific state’s laws regarding medical treatments.

8. Is it legal for an aesthetician to inject Botox?

No, it is not legal for an aesthetician to inject Botox. There are two reasons for this.

Firstly, since Botox involves the living tissue of the body, it is considered a medical treatment. Secondly, since Botox involves the use of needles, it must be performed by a medical professional. This could be a registered nurse, nurse practitioner, physician assistant or physician.

Keep in mind that you are also required to consult with a nurse practitioner, physician assistant or doctor before receiving this treatment. Even if you are being treated by a nurse, you must still consult with a higher-level medical provider before receiving treatment from the nurse. Stay away from offices that offer to give you Botox without consulting with a medical professional of this level.

9. Can I receive a medical spa treatment away from a doctor’s office?

Yes, medical spa treatments can be performed anywhere, provided they comply with all aspects of the law. They do not have to be performed at a spa or at a doctor’s office. For example, sometimes these treatments will be offered at a private residence as part of a “Botox party” or similar event.

However, no matter where you receive treatment, all the same rules apply. You should be seen by a doctor or mid-level provider before receiving the treatment, unless you are already a patient and have had a consultation prior to the event.