Does a med spa in Arkansas need a medical director?

Short answer
Not directly — the cited rules require no titled "medical director," but laser treatment is the practice of medicine, so a physician must personally diagnose and prescribe each case, delegate only to trained staff, and stay reachable for complications.

Arkansas says the cosmetic laser is the practice of medicine, and writes the delegation protocol around it. 17 CAR § 140-1601 finds that using medical lasers on human beings, for therapeutic or cosmetic purposes, constitutes the practice of medicine, and lets a physician delegate a minor procedure only on a protocol. The delegation rule adds a factor test before any task reaches an unlicensed employee, two of which are that the practice can be performed without requiring the exercise of judgment based on medical knowledge and that its results are reasonably predictable. The delegating physician remains responsible for the employee’s acts throughout, and may not hand that supervisory responsibility to anyone but another physician who knowingly accepts it, nor delegate anesthesia to an unlicensed person at all. The Department of Health’s cosmetology rules define the aesthetician by EXTERNAL work: any person who engages in the practice of beautifying the body by cleaning, waxing, externally manipulating or stimulating the body by means of the hands, devices, apparatus or appliances, with or without cosmetic preparations, antiseptics, tonics, lotions and creams — a definition that stops at the surface and names no procedure that penetrates it.