Who may operate a cosmetic laser, state by state
The same question, answered for 41 states from each state’s own law. States disagree on this, which is the point — an answer that is right in one is wrong next door. Every entry below is a statute or board rule we verified, most recently Sep 8, 2026.
Oversight · part of The Practice Perimeter
| State | What its rule says | Cited to |
|---|---|---|
| Alabama | Only a physician, or a properly trained Level 1 or 2 delegate acting under written protocol and physician supervision for non-ablative treatments — operating a laser on tissue below the stratum corneum is the practice of medicine. | Ala. Admin. Code r. 540-X-11-.01(1) (Purpose) Sep 4, 2026 |
| Alaska | Not an esthetician for Class III or IV lasers — those fall outside the esthetics "appliance" definition. The cited rules name no laser operator class beyond that; a physician, podiatrist, osteopath, or PA may delegate only routine, non-judgment duties. | 12 AAC 09.990(b)(1)(D) (Definitions — no Class III or IV laser) Sep 7, 2026 |
| Arizona | Only if certified — an aesthetician or cosmetologist may use a laser or IPL device only after applying for and receiving a laser technician certificate from the Department of Health Services; the cited rules do not address other license types. | Ariz. Rev. Stat. § 32-516(A)–(B) Sep 8, 2026 |
| Arkansas | The cited rules do not settle this — they establish cosmetic laser use is the practice of medicine, and a delegating physician must personally diagnose and prescribe, delegate only to trained nonphysician personnel, and stay available for complications. | 17 CAR § 140-1601(a)(3) (Laser surgery guidelines) Sep 4, 2026 |
| California | Only a physician or, by delegation, a registered nurse, nurse practitioner, or physician assistant under genuine supervision — estheticians, cosmetologists, LVNs and unlicensed staff including medical assistants may not, regardless of training. | Cal. Bus. & Prof. Code §2052; Medical Board of California — Medical Spas guidance Jul 26, 2026 |
| Colorado | The “practice of medicine” reaches energy devices without naming them: it means holding out as able to diagnose, treat, prescribe for, palliate, or prevent any human disease, ailment, pain, injury, deformity or physical condition — “whether by the use of drugs, surgery, manipulation, electricity, telemedicine, the… | Colo. Rev. Stat. § 12-240-107(1)(a) Sep 2, 2026 |
| Connecticut | Only the physician, PA or APRN a medical spa employs or contracts with, or a licensed RN, may perform laser or IPL at that spa; the cited rules don't settle other settings, though esthetician licensure excludes use of prescriptive laser devices. | Conn. Gen. Stat. §19a-903c(a)(2), (b) Sep 3, 2026 |
| District of Columbia | The practice of basic esthetics is limited to listed skin care procedures done for cosmetic purposes and not for the treatment of medical, physical, or mental ailments, and its hair-removal component is limited to removing superfluous hair by means other than electrolysis, laser procedures, or intense pulsed light. | 17 DCMR § 3799.1 (Definitions — “Practice of basic esthetics”) Sep 8, 2026 |
| Florida | Only if appropriately trained and under a physician's direct supervision — that is the rule for laser or light-based hair removal by a non-physician; other laser uses aren't addressed. An office whose only service is APRN/PA laser hair removal is exempt. | Fla. Stat. §458.348(2) Sep 1, 2026 |
| Georgia | A senior laser practitioner may perform cosmetic laser services and supervise assistants; an assistant may perform them only under a Board-licensed physician or a senior laser practitioner. An esthetics license alone does not cover the use of lasers. | Ga. Comp. R. & Regs. 360-35-.05 Aug 17, 2026 |
| Illinois | The use of a Class 3b or Class 4 laser, an intense pulsed-light device, a radiofrequency device or a medical microwave device for dermatologic conditions or cosmetic procedures that disrupt the epidermal surface of the skin — ablative or non-ablative — is the practice of medicine, and may be performed only by a… | 68 Ill. Adm. Code 1285.336 (as stated in the IDFPR/IDPH med spa memo) Aug 17, 2026 |
| Indiana | Only as the practice of medicine — a laser that cuts, burns, or vaporizes tissue is medicine, and it isn't in Indiana's closed esthetician list; the cited rules don't settle who may operate lasers that do none of those things, or the terms of any delegation. | Ind. Code §25-22.5-1-1.1 Jul 26, 2026 |
| Iowa | Only within a medical spa do the cited rules settle it: physicians, plus qualified licensed or certified nonphysician persons and qualified laser technicians (120 hours accredited training) performing services delegated by the medical director. | Iowa Admin. Code r. 481—655.6(3) (Medical director) Sep 4, 2026 |
| Louisiana | Not a cosmetologist or esthetician — no license or permit issued by the cosmetology board authorizes the use of lasers or any FDA-classified medical device in a salon. The cited rules do not settle which medical licensees may operate one. | La. Admin. Code tit. 46, pt. XXXI, § 717(A)(2), (8) (Prohibited Services) Sep 7, 2026 |
| Maryland | The cited rules do not settle this — they only exclude laser light–based hair removal from licensed esthetic practice; the nearest pathway given is a physician delegating a nonsurgical technical act to a trained assistant under direct or on-site supervision. | Md. Code, Bus. Occ. & Prof. §5-101(o)(1)(iii) Sep 7, 2026 |
| Michigan | Only under a licensed physician's supervision, and only with the patient's knowledge and consent — physicians are exempt, as are PAs and NPs performing it in a health care facility. That is a bar, not a grant; the delegation limits still apply on top. | Mich. Comp. Laws § 333.16276(1)–(3), (5)(b) Sep 8, 2026 |
| Minnesota | Minnesota is one of the few states to put lasers in the STATUTE rather than a board rule, and the word “noninvasive” closes the usual argument that a surface treatment is not a medical act. | Minn. Stat. § 147.081, subd. 3(4) Sep 2, 2026 |
| Mississippi | Only physicians and those they directly supervise — Mississippi treats laser and pulsed light use, including cosmetic procedures, as the practice of medicine, and the physician must be on the premises and able to step into the treatment if needed. | Miss. Admin. Code Title 30, Part 2635, Rule 3.1 (Laser Devices) Sep 8, 2026 |
| Montana | The cited rules do not settle this — they define a procedure that cuts or alters tissue by laser energy as "surgery," and surgery may never be delegated to a medical assistant, but they name no class of operator authorized for cosmetic lasers generally. | Mont. Admin. R. 24.156.403(1)(n)-(o) Sep 8, 2026 |
| Nebraska | The cited rules do not settle this — they establish only that neither an esthetics nor a cosmetology license reaches lasers, so laser use sits outside both credentials; they do not name which license may operate one. | Neb. Admin. Code tit. 172, ch. 36, §§ 002.01(G), 002.02 (neither license reaches injectables or lasers) Sep 7, 2026 |
| Nevada | The cited rules do not fully settle this — an advanced esthetician may perform nonablative esthetic medical procedures only with a supervising health care professional readily available, and may never perform ablative laser procedures, even under supervision. | Nev. Admin. Code §644A.790(1)(b), (d), (f), (5) (Prohibited invasive procedures; exceptions) Sep 7, 2026 |
| New Hampshire | Only a licensed physician or someone another statute authorizes — laser that cuts, burns, vaporizes or otherwise structurally alters tissue is surgery, and thus the practice of medicine; the cited rules set no delegation or supervision scheme for lasers. | N.H. Rev. Stat. §329:1 Sep 8, 2026 |
| New Jersey | The cited rules do not settle this — they establish only that using a laser counts as surgery under the office-surgery rules, and separately that a cosmetology licensee may not work below the stratum corneum. No rule here names who may fire the device. | N.J.A.C. 13:35-4A.3 Aug 17, 2026 |
| New Mexico | Several license types — a trained physician (laser use is the practice of medicine), a certified medical assistant using non-incisive, non-ablative devices with the physician on site and a written protocol, and APRNs or delegated RNs/LPNs. | 16.10.13.8 NMAC (Use of medical therapeutic and cosmetic devices — supervision of medical assistants) Sep 8, 2026 |
| New York | Laser work reaching the basement membrane or deeper is the practice of medicine — it must be done by a physician, PA, or NP, or by a registered nurse carrying out their order under general supervision; laser hair removal sits outside that determination. | N.Y. State Board for Medicine — Use of Energy Devices Including Lasers as the Practice of Medicine (Mar. 7, 2025) Aug 17, 2026 |
| North Carolina | A physician, or a licensed health professional within their own scope with medical training under physician supervision (preferably on-site); licensed electrologists with a laser hair practitioner credential may do hair removal, not tattoo removal. | NCMB Position Statement 5.1.2 (adopted July 1999, amended May 2021) Aug 17, 2026 |
| North Dakota | The cited rules do not settle this — they bar cosmetologists, manicurists and estheticians from using laser, light or energy to alter, cut, puncture or damage living cells, but name no license class that may operate one. | N.D. Cent. Code § 43-11-27.2 Sep 8, 2026 |
| Ohio | Only the physician may apply a laser ablatively — that is never delegable. Non-ablative vascular lasers may be delegated only to an RN, LPN or a PA under an effective supervision agreement; hair removal also to a laser hair removal professional. | Ohio Admin. Code 4731-18-02(B) Sep 1, 2026 |
| Oklahoma | The cited rules do not settle this — they only place laser treatments outside the cosmetology and facialist/esthetician scope as "puncturing the skin," so no cosmetologist or esthetician may operate one; which licensees may is not specified. | Okla. Admin. Code § 175:10-7-29(a)(1)(D), (F) (Scope of practice — lasers, injections, dermabrasion) Sep 7, 2026 |
| Oregon | The cited rules do not settle who may — they establish only that a laser, IPL or other advanced esthetics device is not an esthetics device, so an Oregon esthetician may not operate one; no cited rule names the license class that can. | Or. Admin. R. 817-015-0040(4)-(5) (Definition of Esthetics Device) Sep 7, 2026 |
| Rhode Island | Only someone authorized to practice medicine — Rhode Island puts laser/IPL use, including non-ablative treatment and laser hair removal, inside the practice of medicine; an esthetician license does not reach it, and the cited rules don't settle PA or APRN use. | 216-RICR-40-05-1 § 1.2(A)(18), (22) (Licensure and Discipline of Physicians — “Non-ablative treatment” and “Practice of medicine” defined) Sep 8, 2026 |
| South Carolina | The cited rules do not settle this — only that a certified medical assistant may use tissue-destroying lasers on a physician's direct delegation, with that physician immediately available and the task within the CMA's competency; not by a PA or APRN. | S.C. Code §40-47-196(A) Sep 8, 2026 |
| Tennessee | Any procedure encompassed within the definition of the practice of medicine that is to be performed BY USE OF A LASER shall be considered the practice of medicine, and any person performing such a procedure must be under the supervision of a licensed physician — subject only to the narrow exceptions the rule… | Tenn. Comp. R. & Regs. 0880-02-.14(10) Sep 2, 2026 |
| Texas | A physician, or a qualified, properly trained person the physician delegates to and supervises — the physician remains responsible. Nonablative laser hair removal is the exception: it requires the appropriate TDLR certificate, not the delegation route. | Tex. Occ. Code §157.001 Jul 26, 2026 |
| Utah | The cited rules do not settle this — they list who may take delegated nonablative cosmetic procedures: PAs, RNs, master estheticians, and electrologists for laser hair removal (delegation group A); estheticians, LPNs, and medical assistants (group B). | Utah Code § 58-1-506(1)(a)-(b) (Supervision of cosmetic medical procedures) Sep 4, 2026 |
| Vermont | Not estheticians or cosmetologists — Vermont excludes laser use from esthetics, treating it as the practice of medicine; the cited rules don't settle which medical licensees (physician, APRN, PA) may operate lasers or on what delegation terms. | Vt. Stat. tit. 26, §1(4)(B)(ii) (Barbers and Cosmetologists — definitions) Sep 3, 2026 |
| Virginia | Only for laser hair removal (no rule for other lasers): a trained MD/DO — six subjects, 10 proctored cases, pre-8/7/2019 doctors exempt — may perform or delegate to a PA or NP, or others so trained, while readily available and personally seeing complications. | 18 Va. Admin. Code § 85-20-91(A) Sep 2, 2026 |
| Washington | A physician, or a supervised professional whose own license allows it, under a written seven-part protocol. The physician must be on the premises for a patient's first treatment, which the delegate may finish only if the physician is called to an emergency. | Wash. Admin. Code 246-919-605(1) and (2) Sep 2, 2026 |
| West Virginia | Only a physician, or another licensed health care provider acting within their own scope of practice — West Virginia counts the use of lasers, pulsed light and radiofrequency devices on humans as surgery, and therefore the practice of medicine. | W. Va. Code §30-3-4 Sep 3, 2026 |
| Wisconsin | The cited rules do not settle this — a cosmetology licensee's electromagnetic-radiation or thermal-energy work is a delegated medical procedure needing physician direction unless board-approved training keeps it above the stratum corneum. | Wis. Admin. Code ch. Med 10 (surveyed via the chapter index) Sep 2, 2026 |
| Wyoming | The cited rules do not settle this — they only place laser hair removal outside the esthetics scope of practice and outside the add-on hair removal endorsement for hairstylists and nail technicians; no cited rule names who may operate a cosmetic laser. | Wyo. Bd. of Cosmetology Rules ch. 1 § 6(c)(ii), (e) (Scope of Practice — Esthetics; Add-On Hair Removal; ref. 033.0001.1.04012026) Sep 8, 2026 |
Every state, in its own words
Alabama
(1) The use of lasers/pulsed light devices, or any energy source, chemical, or other modality that affects living tissue (when referring to the skin, anything below the stratum corneum), whether applied for surgical, therapeutic, or cosmetic purposes, is the practice of medicine.
Ala. Admin. Code r. 540-X-11-.01(1) (Purpose) · verified Sep 4, 2026
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An appliance in the field of esthetics also (D) is not defined as a Class III or Class IV laser device under 21 C.F.R. 1040.10, revised as of April 2, 2018, and adopted by reference;
12 AAC 09.990(b)(1)(D) (Definitions — no Class III or IV laser) · verified Sep 7, 2026
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An aesthetician or a cosmetologist who wishes to perform cosmetic laser procedures and procedures using IPL devices must apply for and receive a certificate from the department of health services and comply with the section and department rules, and an aesthetician or cosmetologist who has been certified as a laser technician by the department may use a laser or IPL device.
Ariz. Rev. Stat. § 32-516(A)–(B) · verified Sep 8, 2026
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(3) The board further finds that the use of medical lasers on human beings, for therapeutic or cosmetic purposes, constitutes the practice of medicine.
17 CAR § 140-1601(a)(3) (Laser surgery guidelines) · verified Sep 4, 2026
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A physician may delegate injectable and laser procedures only to appropriately licensed personnel — registered nurses, nurse practitioners, or physician assistants — under genuine supervision. Unlicensed staff (including medical assistants) and improperly licensed staff (estheticians, cosmetologists, LVNs) may not perform them, regardless of training. A “paper” medical-director arrangement is aiding and abetting the unlicensed practice of medicine.
Cal. Bus. & Prof. Code §2052; Medical Board of California — Medical Spas guidance · verified Jul 26, 2026
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The “practice of medicine” reaches energy devices without naming them: it means holding out as able to diagnose, treat, prescribe for, palliate, or prevent any human disease, ailment, pain, injury, deformity or physical condition — “WHETHER BY THE USE OF DRUGS, SURGERY, MANIPULATION, ELECTRICITY, TELEMEDICINE, the interpretation of tests … OR ANY PHYSICAL, MECHANICAL, OR OTHER MEANS WHATSOEVER.” Colorado wrote a catch-all rather than a device list, so a modality invented after 2019 is inside it by construction.
Colo. Rev. Stat. § 12-240-107(1)(a) · verified Sep 2, 2026
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Connecticut classes laser hair removal, laser skin resurfacing, laser treatment of leg veins, other laser procedures and intense pulsed light as cosmetic medical procedures, and such a procedure performed at a medical spa may only be performed by the physician, physician assistant or advanced practice registered nurse the spa employs or contracts with, or by a registered nurse licensed pursuant to chapter 378.
Conn. Gen. Stat. §19a-903c(a)(2), (b) · verified Sep 3, 2026
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The practice of basic esthetics is limited to listed skin care procedures done for cosmetic purposes and not for the treatment of medical, physical, or mental ailments, and its hair-removal component is limited to removing superfluous hair by means other than electrolysis, laser procedures, or intense pulsed light.
17 DCMR § 3799.1 (Definitions — “Practice of basic esthetics”) · verified Sep 8, 2026
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Laser and light-based hair removal is carved OUT of that regime and handed a stricter one. Any protocol for electrolysis or electrology using laser or light-based hair removal or reduction by a person other than a physician must require that person to be appropriately trained and to work only under the DIRECT supervision and responsibility of a physician licensed under chapter 458 or 459.
Fla. Stat. §458.348(2) · verified Sep 1, 2026
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An assistant laser practitioner may perform cosmetic laser services under the supervision of a Board-licensed physician or a licensed senior laser practitioner. A senior laser practitioner may perform cosmetic laser services and may supervise assistant laser practitioners performing them.
Ga. Comp. R. & Regs. 360-35-.05 · verified Aug 17, 2026
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The use of a Class 3b or Class 4 laser, an intense pulsed-light device, a radiofrequency device or a medical microwave device for dermatologic conditions or cosmetic procedures that disrupt the epidermal surface of the skin — ablative or non-ablative — is the practice of medicine, and may be performed only by a licensed physician or under delegation as the Section provides.
68 Ill. Adm. Code 1285.336 (as stated in the IDFPR/IDPH med spa memo) · verified Aug 17, 2026
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The “practice of medicine” includes prescribing or administering any form of treatment and procedures that cut, burn, or vaporize tissue by mechanical means, laser, or penetration of the skin — the statutory basis for treating cosmetic injectables and energy-device procedures as medicine.
Ind. Code §25-22.5-1-1.1 · verified Jul 26, 2026
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A medical director at a medical spa shall: a. Hold an active unrestricted Iowa medical license to supervise each delegated medical aesthetic service; b. Possess the appropriate education, training, experience and competence to safely supervise each delegated medical aesthetic service; c. Retain responsibility for the supervision of each medical aesthetic service performed by qualified licensed or certified nonphysician persons or qualified laser technicians;
Iowa Admin. Code r. 481—655.6(3) (Medical director) · verified Sep 4, 2026
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No license or permit issued by the board authorizes the performance of any of the following services in a salon licensed by the board: use of lasers; the use of any mechanical or electrical apparatus classified as a medical devise by the U.S. Food and Drug Administration.
La. Admin. Code tit. 46, pt. XXXI, § 717(A)(2), (8) (Prohibited Services) · verified Sep 7, 2026
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Providing esthetic services includes removing superfluous hair by the use of electrical, mechanical, or any means other than by the use of a laser light–based device.
Md. Code, Bus. Occ. & Prof. §5-101(o)(1)(iii) · verified Sep 7, 2026
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A licensee, registrant, or other individual shall not perform any procedure using a laser for dermatological purposes unless the procedure is performed under the supervision of a licensed physician, and unless the patient has knowledge of and consents to the procedure being performed by that individual. The supervision requirement does not apply to a licensed physician, to a licensed physician's assistant who performs such a procedure in a health care facility, or to a certified nurse practitioner who performs such a procedure in a health care facility. Practice of dermatology means the diagnosis and treatment of medically necessary and cosmetic conditions of the skin, hair, and nails by various surgical, reconstructive, cosmetic, and nonsurgical methods.
Mich. Comp. Laws § 333.16276(1)–(3), (5)(b) · verified Sep 8, 2026 · read at Internet Archive snapshot — evidence of a page, not the current rule
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A person is “practicing medicine” if the person OFFERS OR UNDERTAKES TO PERFORM ANY SURGICAL OPERATION INCLUDING ANY INVASIVE OR NONINVASIVE PROCEDURES INVOLVING THE USE OF A LASER OR LASER ASSISTED DEVICE, upon any person. Minnesota is one of the few states to put lasers in the STATUTE rather than a board rule, and the word “noninvasive” closes the usual argument that a surface treatment is not a medical act.
Minn. Stat. § 147.081, subd. 3(4) · verified Sep 2, 2026
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The use of laser, pulsed light or similar devices, either for invasive or cosmetic procedures, is considered to be the practice of medicine in the state of Mississippi
Miss. Admin. Code Title 30, Part 2635, Rule 3.1 (Laser Devices) · verified Sep 8, 2026
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"Supervision" may be of the following types: (i) "Direct supervision" means the supervisor is physically present with the person being supervised; (ii) "On-site supervision" means the supervisor must be in the facility and quickly available to the person being supervised. (o) "Surgery" means any procedure in which human tissue is cut or altered by mechanical or energy forms, including electrical or laser energy or ionizing radiation.
Mont. Admin. R. 24.156.403(1)(n)-(o) · verified Sep 8, 2026
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The practice of esthetics does not include using injectables and lasers. The same chapter says the same of cosmetology: The practice of cosmetology does not include using injectables and lasers.
Neb. Admin. Code tit. 172, ch. 36, §§ 002.01(G), 002.02 (neither license reaches injectables or lasers) · verified Sep 7, 2026
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a licensee shall not perform any invasive procedure that includes, without limitation: (b) The application of a topical lotion, cream or other substance which is not intended for use by a practitioner of a branch of cosmetology for the purpose of beautifying the skin or which affects anything below the stratum corneum; (d) The abrasion of the skin below the stratum corneum; (f) The injection or administration of any substance, including, without limitation, a controlled substance. The provisions of subsection 2 of NRS 644A.545 which prohibit an advanced esthetician from performing any ablative esthetic medical procedure apply regardless of whether the advanced esthetician is under the supervision of a health care professional and regardless of the delivery method, device or technology used, including, without limitation, radio frequency dissection, laser, scarlet or ablative microneedling or skin tag removal.
Nev. Admin. Code §644A.790(1)(b), (d), (f), (5) (Prohibited invasive procedures; exceptions) · verified Sep 7, 2026
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Any person is regarded as practicing medicine who diagnoses, treats, performs surgery, or prescribes any treatment of medicine for any disease or human ailment, and surgery means any procedure, including but not limited to laser, in which human tissue is cut, shaped, burned, vaporized, or otherwise structurally altered, except that the section does not apply to any person to whom authority is given by any other statute to perform acts which might otherwise be deemed the practice of medicine.
N.H. Rev. Stat. §329:1 · verified Sep 8, 2026
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For the purposes of the office-surgery rules, surgery means a manual or operative procedure, INCLUDING THE USE OF LASERS, performed upon the body to preserve health, diagnose or treat disease, repair injury, correct deformity or defect, prolong life or relieve suffering.
N.J.A.C. 13:35-4A.3 · verified Aug 17, 2026 · read at Cornell Legal Information Institute
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A physician who is trained in the safety and use of medical therapeutic or cosmetic devices may supervise medical assistants who perform hair removal and other therapeutic or cosmetic procedures using devices that use waveform energy, provided the supervising physician first provides the patient history, physical examination, diagnosis, treatment protocol, and preparation of the medical record; reviews any adverse outcomes or changes in the treatment protocol; assures the patient is informed that the individual performing the procedure is a medical assistant under the physician's supervision; provides emergency and follow-up instructions; and prepares a written protocol for the medical assistant to follow when using the device.
16.10.13.8 NMAC (Use of medical therapeutic and cosmetic devices — supervision of medical assistants) · verified Sep 8, 2026
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On March 7, 2025 the New York State Board for Medicine determined that using any energy device, including a laser, which affects the basement membrane or deeper tissue (the dermis or fat) to treat a physical condition is the practice of medicine. The Education Department has adopted that determination for every physical condition EXCEPT laser hair removal, on which — relying on People v. Lehrman — it has not acted. So laser skin rejuvenation, tattoo removal, lesion removal and spider-vein treatment are medical acts in New York, while laser hair removal sits outside the adopted determination.
N.Y. State Board for Medicine — Use of Energy Devices Including Lasers as the Practice of Medicine (Mar. 7, 2025) · verified Aug 17, 2026
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The Medical Board’s position is that the revision, destruction, incision or other structural alteration of human tissue using laser technology is surgery. It may be performed by a physician, or by a licensed health care professional acting within their own scope with appropriate medical training and under the supervision — preferably on-site — of a physician.
NCMB Position Statement 5.1.2 (adopted July 1999, amended May 2021) · verified Aug 17, 2026
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The practice of cosmetology, manicuring, or esthetics is limited to noninvasive care; a cosmetologist, manicurist, or esthetician may not alter, cut, puncture, or damage any living cells, whether superficially or through the use of laser, light, or energy; and certain advanced esthetic services, as determined by board rule, may be limited in scope or required to be performed under the supervision or direction of a physician or physician assistant licensed under chapter 43-17, or an advanced registered nurse licensed under chapter 43-12.1, who is sufficiently trained or certified in the procedure being supervised.
N.D. Cent. Code § 43-11-27.2 · verified Sep 8, 2026
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A physician shall not delegate the application of light based medical devices for ablative procedures. This is the one absolute in the chapter: there is no training, certification or supervision arrangement that makes an ablative treatment delegable to anyone, and none of the carve-outs for vascular lasers, hair removal or phototherapy reaches ablative work.
Ohio Admin. Code 4731-18-02(B) · verified Sep 1, 2026
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Puncturing the skin, which cosmetology expressly does not include, also covers: (D) The use of laser treatments; ultrasound and high intensity focused ultrasound (“HIFU”) treatments; radiation; plasma pen; injections, including, but not limited to, injections performed by means of needle-free injection devices; and Food and Drug Administration (“FDA”) approved Class 3 medical devices; (F) Dermabrasion, which is a procedure that uses a specialized instrument to “sand” or scrape away the top layers of the skin;
Okla. Admin. Code § 175:10-7-29(a)(1)(D), (F) (Scope of practice — lasers, injections, dermabrasion) · verified Sep 7, 2026
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An esthetic device is not a: (a) Laser; (b) Intense pulse light; (c) Other advanced esthetics devices as specified in OAR 819-030-0000(3); (d) Needle-free device for injection of dermal fillers or fillers. An esthetician may not perform skin care or facial care practices or use a mechanical or electrical apparatus, appliance, or device for medical diagnosis or treatment of disease or physical or mental ailments.
Or. Admin. R. 817-015-0040(4)-(5) (Definition of Esthetics Device) · verified Sep 7, 2026
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RHODE ISLAND PUTS THE LASER INSIDE THE DEFINITION OF PRACTICING MEDICINE, SO OPERATING ONE IS NOT A COSMETOLOGY QUESTION. “Any person shall be regarded as practicing medicine within the meaning of the Act who holds himself or herself out as being able to diagnose, treat, perform surgery, use a laser/intense pulsed light, or prescribe for any person for disease, pain, injury, deformity or physical or mental condition”. And the same Part closes the obvious escape hatch in one sentence: “Non-ablative treatment is part of the practice of medicine.” “Non-ablative treatment” is defined to mean “any laser/intense pulsed light treatment or other energy source, chemical, or modality that is not expected or intended to remove, burn, or vaporize tissue”, and — the sentence a med spa needs — “This shall include treatments related to laser hair removal.” So both halves of the device menu, ablative and non-ablative, sit inside the practice of medicine.
216-RICR-40-05-1 § 1.2(A)(18), (22) (Licensure and Discipline of Physicians — “Non-ablative treatment” and “Practice of medicine” defined) · verified Sep 8, 2026
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Specific tasks may be delegated to a certified medical assistant (CMA) by a physician, by a physician assistant if authorized to do so in the scope of practice guidelines, or by an advanced practice registered nurse if authorized to do so in the practice agreement; but the following tasks must not be delegated to a CMA by a physician assistant or advanced practice registered nurse: administering controlled medications, intravenous medications, contrast agents, or chemotherapy agents; injecting neurotoxin products, neuromodulatory agents, or tissue fillers; using lasers or instruments that result in tissue destruction; and placing sutures.
S.C. Code §40-47-196(A) · verified Sep 8, 2026
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⚠️ A LASER PROCEDURE IS THE PRACTICE OF MEDICINE. Any procedure encompassed within the definition of the practice of medicine that is to be performed BY USE OF A LASER shall be considered the practice of medicine, and ANY PERSON PERFORMING SUCH A PROCEDURE MUST BE UNDER THE SUPERVISION OF A LICENSED PHYSICIAN — subject only to the narrow exceptions the rule cross-references for other licensed professions.
Tenn. Comp. R. & Regs. 0880-02-.14(10) · verified Sep 2, 2026
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A Texas physician may delegate a medical act — including cosmetic injections, dermal fillers, and cosmetic laser use — to a qualified, properly trained person acting under the physician’s supervision, where a reasonable and prudent physician would find it consistent with sound medical judgment. The delegating physician remains responsible for the delegated act.
Tex. Occ. Code §157.001 · verified Jul 26, 2026
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"Delegation group A" means the following who are licensed under this title, acting within their respective scopes of practice, and qualified under Subsections (2)(f)(i) and (iii): (i) a physician assistant, if acting in accordance with Chapter 70a, Utah Physician Assistant Act; (ii) a registered nurse; (iii) a master esthetician; and (iv) an electrologist, if evaluating for or performing laser hair removal. (b) "Delegation group B" means: (i) a practical nurse or an esthetician who is licensed under this title, acting within the nurse or esthetician’s respective scopes of practice, and qualified under Subsections (2)(f)(i) and (iii); and (ii) a medical assistant who is qualified under Subsections (2)(f)(i) and (iii).
Utah Code § 58-1-506(1)(a)-(b) (Supervision of cosmetic medical procedures) · verified Sep 4, 2026
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Esthetics does not include any practice, activity, or treatment that constitutes the practice of medicine, as defined in section 1311 of this title, including injections of any substance and the use of lasers.
Vt. Stat. tit. 26, §1(4)(B)(ii) (Barbers and Cosmetologists — definitions) · verified Sep 3, 2026
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A doctor of medicine or osteopathic medicine may perform or supervise laser hair removal only on completing training in six named subjects: skin physiology and histology; skin type and appropriate patient selection; laser safety; operation of the laser device to be used; recognition of and response to potential complications; and A MINIMUM OF TEN PROCTORED PATIENT CASES with demonstrated competency in treating various skin types.
18 Va. Admin. Code § 85-20-91(A) · verified Sep 2, 2026
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Using a laser, noncoherent light, intense pulsed light, radiofrequency or plasma device that topically penetrates skin and alters human tissue — an “LLRP device”, and one the FDA classifies as a prescription device — IS THE PRACTICE OF MEDICINE under RCW 18.71.011. Washington settles the threshold question in the rule itself rather than leaving it to be argued.
Wash. Admin. Code 246-919-605(1) and (2) · verified Sep 2, 2026
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“Practice of medicine and surgery” means the diagnosis or treatment of, or operation or prescription for, any human disease, pain, injury, deformity or other physical or mental condition. “Surgery” includes the use on humans of lasers, ionizing radiation, pulsed light and radiofrequency devices.
W. Va. Code §30-3-4 · verified Sep 3, 2026
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⚠️ Wisconsin publishes NO cosmetic-procedure rule and no energy-device rule — there is no counterpart to Ohio’s four light-based lanes, Washington’s LLRP rule or Virginia’s laser hair removal training. A Wisconsin med spa cannot look up a procedure checklist, because the state did not write one; what governs is the competence test above and the general standard of care.
Wis. Admin. Code ch. Med 10 (surveyed via the chapter index) · verified Sep 2, 2026
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The esthetics scope includes the removal of superfluous hair by means other than electrolysis and laser, and the add-on hair removal endorsement available to licensed hairstylists and nail technicians is limited the same way, to removal by means other than electrolysis and laser.
Wyo. Bd. of Cosmetology Rules ch. 1 § 6(c)(ii), (e) (Scope of Practice — Esthetics; Add-On Hair Removal; ref. 033.0001.1.04012026) · verified Sep 8, 2026
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