Medical Spa Reguations Law

States are slowly responding to medical spa regulations and while some of it makes sense other parts of medical spa law that is becoming the standard per state does not. The long and short of it is we have estheticians performing services with injectibles, Erbium lasers and providing micro liposuction treatments without a physician on site and without the necessary training and licensure to see patients for these advanced and potentially deadly services. SPAA has always urged those in our industry to engage in self-regulation whenever necessary as these laws and regulations are adopted and refined.


Common responsibilities of those who choose a career as a medical spa esthetician include a wide variety of medical information, as well as psychological skills to aid in listening to the client and informing them of different resources. Some specific procedures include pre- and post-operative skin care, camouflaging cosmetics to cover scars, and lymphatic drainage. But most importantly, the esthetician in a medical spa must educate clients throughout their medical spa treatments on proper skin care. Estheticians must promote healthy skin care to its fullest by suggesting no acnegenic products, how to apply makeup, avoiding sun damage, educating them on products that are irritating to the skin or allergenic, properly caring for acne and acne-related conditions and more.

Pre- and Post-Procedure

Each physician is different in the way they handle preparing their patients for cosmetic surgery procedures; however, there is a general procedure for each one. For facial cosmetic procedures, the preparation can begin anywhere from three to six weeks or just minutes before the surgery. Lymphatic drainage is commonly used to increase healing time. Typically under the supervision of a physician, an esthetician may perform acne surgery.

Training and Licensing

Each state has different regulations on esthetician training and licensing. By separating the esthetician license from a standard cosmetology or hairdressing license, it has given some schools the opportunity to focus solely on skincare. Another option to an esthetician license would be to take advantage of programs at different companies, schools, and associations that offer certifications to estheticians by completing the required course(s). However, be careful with courses that teach advanced procedures that go beyond the typical responsibilities of an esthetician.

Legal and Liability Issues

Legal and liability issues revolving around estheticians practicing in a medical spa must be researched before entering the field. The courses that teach the advanced procedures (as mentioned above) may make obtaining liability coverage more complicated. Also, the state boards that govern the esthetician license and the facility the esthetician will be working in are making the mere availability of insurance coverage more difficult. Some state boards do not honor an esthetician license if working in a medical spa. And if the license is not valid in a medical spa, the insurance policy becomes void. Some suggest that an esthetician should maintain their own liability insurance, and to also watch for these three restrictions: All clients must see a physician first before any treatment from an esthetician, a physician must be readily available for consultation while a procedure is being preformed, and a physician must be on the premises at all times during the procedures.

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