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The following information is not meant to provide any legal advise and it is recommended you check with your your respective state boards, attorney, or malpractice carrier to ensure you are practicing within the letter of the law.  Regulations regarding aesthetic treatments and medical spas vary from state to state and can also change .

Which procedures at medical spas constitute medical treatment?

Pennsylvania  defines a cosmetic medical procedure as any procedure performed on a person that is directed at improving the person’s appearance and that does not meaningfully promote the proper function of the body or prevent or treat illness or disease.   The following procedures are including in a cosmetic medical procedure:  hair transplants, cosmetic injections (botulinum toxins and soft tissue fillers) dermaplaning, dermastamping, dermarolling, dermabrasion that removes cells beyond the stratum corneum, chemical peels using modification solutions that exceed 30% concentration with a pH value of lower than 3.0, laser hair removal, laser skin resurfacing, laser treatment of leg veins, sclerotherapy and other laser procedures, IPL and the use of class II medical devices designed to induce deep skin tissue alteration.

Who can own a medical spa?

A medical spa is considered a medical practice.  Therefore, every medical spa must be owned by a physician or a physician group.

Pennsylvania has a corporate practice of medicine doctrine meaning that physicians cannot be employed by non-physicians, and an entity that practices medicine may only be owned by licensed physicians. 

What type of training is needed?


Pennsylvania requires that any physician, physician assistant, advanced practice nurse or registered nurse who performs cosmetic medical procedures must a) be actively practicing in the state; and b) have received education or training from an institution of higher education or professional organization to perform cosmetic medical procedures and have experience performing such procedures.

Who can perform the procedures?

Only a physician, physician assistant, advanced practice registered nurse or registered nurse may perform the cosmetic medical procedures identified above.

Is a good faith examination needed?

Yes.  A physician, physician assistant or advanced practice registered nurse must perform an initial physical assessment.

If I’m not a doctor, can I employ a “medical director” to provide medical services for my medical spa?


No.  For the reasons stated above, having just a “medical director” on staff will not satisfy the regulatory requirements.

For a more complete list of questions and answers (see below) regarding regulations for the med spa, click In addition, you will get a referral to an attorney specializing in medical spas and aesthetic practices.

If I’m not a doctor, can I share in the profits of a medical spa?

Can a nurse, physician assistant or nurse practitioner take a commission for administering laser treatments or injectables like Botox?

Can a physician assistant practice independently

How many physician assistants can a physician supervise?

Can a certified registered nurse practitioner (“CRNP”) practice independently? 

Do I have to be a doctor to own medical spa equipment, like lasers, or real estate?

Do I need to charge sales tax on procedures like Botox?

Who can legally fire a laser under Pennsylvania law?  

Does a physician need to be on site during laser and intense pulse light (IPL) devices?

Can an Aesthetician perform laser procedures? 

What kind of physician supervision is needed for a registered nurse (RN) in a medical spa? 

Is Informed Consent required?  

Does a medical spa need to obtain a license to operate? 

Must I follow OSHA regulations? 

What type of records are medical spas required to keep of their patients? 

How long do I have to keep the patient’s records?  

Can a med spa text or email patients to convey confidential medical information? 

Are Botox parties legal?   

What type of insurance does a medical spa need?  

What type of information must a medical spa post?   

All content in this blog is for informational purposes only. It is not medical or legal advice. Please consult with lawyer or a medical professional.