Hawaii med spa & injectable regulations
What’s changing for med spas and injectors in Hawaii — GLP-1 compounding, scope-of-practice, and enforcement — plus the federal FDA and Federal Register actions that apply in Hawaii. MedSpaRadar monitors it all and tells you, in plain language, what changed and what to do.
Opening a med spa in Hawaii? Start with who may own one, the medical director rules, and who may inject in Hawaii →
Latest Hawaii changes
No new Hawaii changes in the last 8 months. We scan the Hawaii legislature daily and nothing med-spa-relevant has moved since Jan 28, 2026. The Hawaii legislature has adjourned sine die (2026 Regular Session). No further session is listed yet. A quiet state is good news — the record below still applies, and the federal changes further down apply to every Hawaii practice today.
- MONITORIntroducedLegiScanJan 28, 2026
HI SB3195: Relating To Drugs For Weight Loss.
HI SB3195 mandates coverage for GLP-1 weight loss drugs.
Federal changes that apply in Hawaii
FDA and Federal Register actions are nationwide — they govern Hawaii practices too.
- MONITORFEDERALPrimary Source MonitoringSep 21, 2026
Primary Source Monitoring: Former Connecticut Resident Guilty of Operating Websites to Illegally Sell Misbranded and Unapproved Drugs
Caution urged due to recent conviction for selling misbranded drugs.
- MONITORFEDERALPrimary Source MonitoringSep 17, 2026
Primary Source Monitoring: Korea Filler Experts - 718706 - 11/03/2025
FDA warns koreafillerexperts.com over unapproved, misbranded injectable botulinum toxin.
- CRITICALFEDERALFDA Device RecallSep 16, 2026
FDA device recall (Class II): Product Name: DermaV Laser System Model/Catalog Number: DermaV Medical laser device that delivers pulsed laser energy a…
FDA recalls DermaV Laser System; check for safety compliance.
- MONITORFEDERALPrimary Source MonitoringSep 16, 2026
Primary Source Monitoring: FDA clarifies policies for compounders as national GLP-1 supply begins to stabilize
FDA updates compounding guidelines as GLP-1 supplies stabilize.
- MONITORFEDERALPrimary Source MonitoringSep 15, 2026
Primary Source Monitoring: Hefner v. Rock Valley Compounding Pharmacy, LLC (3:26-cv-01298) — District Court, S.D. Illinois
Legal case filed affecting compounding pharmacy standards.
- MONITORFEDERALPrimary Source MonitoringSep 9, 2026
Primary Source Monitoring: Human Drug Compounding Policies and Rules
FDA's compounding policy index adds a September 2026 neonatal nutrition guidance.
What we monitor in Hawaii
- Hawaii legislature — bills on injectables, GLP-1s & scope of practice
- U.S. FDA — enforcement, warning letters, recalls, shortages
- Federal Register — new rules on compounding & aesthetics
Hawaii med spa questions, answered from statute
The same verified record, asked the way operators actually ask it — who may own one, who may inject, what the supervising physician has to do. 21 questions have a cited Hawaii answer today.
Browse the 21 Hawaii questions →Hawaii med-spa compliance rules
67 rules across 7 topics — physician delegation, the good-faith exam, ownership & corporate practice of medicine, RN/NP scope, med-spa registration, advertising, and enforcement — each linked to its primary source. Reference and monitoring, not legal advice.
Physician supervision & delegation11 cited rules
The practice of medicine includes the use of drugs, surgery, electricity, telehealth, and any means to diagnose, treat, prescribe for, or correct any human condition, and no person may practice or offer to practice medicine without a license from the Hawaii medical board.
- All 11 cited rules: Hawaii medical director requirements →
- Does a med spa in Hawaii need a medical director? →
- What must the supervising physician actually do in Hawaii? →
- Can a medical assistant give injections in Hawaii? →
- Must someone be on site while a patient is treated in Hawaii? →
- Can a physician assistant inject or prescribe in Hawaii? →
- May an esthetician or laser technician perform microneedling in Hawaii? →
Good-faith examination6 cited rules
Telehealth services must include a documented patient evaluation, including a history and a discussion of physical symptoms adequate to establish a diagnosis and to identify underlying conditions or contraindications to the treatment recommended.
Ownership & corporate practice of medicine8 cited rules
The Act defines a professional service as one that may lawfully be rendered only by persons licensed under the named chapters, medicine, nursing, and pharmacy among them, restricts share ownership to qualified persons, organizes professional corporations for a single profession, allows services to be rendered only…
RN / NP scope for injectables8 cited rules
Registered nurse practice is the full scope of nursing guided by the chapter, the board’s rules, and board-recognized standards, and includes carrying out prescribed medical orders of a physician, an advanced practice registered nurse, or a supervised physician assistant; licensed practical nurse practice is a…
Med-spa registration & licensing16 cited rules
Hawaii licenses the practitioner and, on the cosmetology side, the beauty shop; the sections cited here contain no medical-spa license. a beauty shop license names the shop, at least one licensed beauty operator, and an owner who is responsible for ensuring that only licensed individuals practice in it; no one may operate a beauty shop or practice cosmetology for commercial purposes without a license, and cosmetology may be practiced only in a licensed barber shop or beauty shop, with listed exceptions. Fees are set by the director by rule, and the fee rule prices them in dollars: a $20 application fee for a beauty operator, $50 for a beauty shop, $50 for a physician’s permanent license application, $20 for a physician assistant, and $100 for a pharmacy application with a $65 original permit fee. Physicians pay application, examination, and license fees and renew by January 31 of each even-numbered year. An esthetician applicant needs 1,200 hours of apprentice training or 600 hours in a beauty school. A pharmacy may not be opened without a permit, a permit is required to distribute or dispense samples of prescription drugs, though that paragraph does not interfere with furnishing samples directly to physicians for use in their professional practice, and a permit is required to engage in the business of preparing, manufacturing, or compounding any drug; compounding prescriptions other than by or under the immediate supervision of a registered pharmacist violates the pharmacy chapter, and the Board of Pharmacy’s rules make failure to follow USP chapters 795 and 797 unprofessional conduct.
An applicant for a barber shop or beauty shop license shall: (1) Identify the name and location of the shop; (2) Identify at least one barber or beauty operator to qualify the shop for licensure in the applicable license category; (3) Identify the owner of the shop who shall be responsible for all operations of the shop and be responsible for ensuring that only currently licensed individuals, apprentices, or temporary permittees are practicing in the shop; Hawaii licenses the beauty shop where cosmetology is practiced; nothing in chapter 453 of the Hawaii Revised Statutes or in the Hawaii Medical Board’s rules in chapter 16-85 of the Hawaii Administrative Rules licenses a facility where medicine is practiced, and Hawaii issues no license or registration specific to a medical spa.
Haw. Rev. Stat. § 439A-10(a)(1)-(3) (ch. 453 and Haw. Admin. R. ch. 16-85 surveyed)
The department’s fee rule sets the license fees for the board of barbering and cosmetology as dollar amounts. Its application fees are listed as Operator or instructor $ 20; Beauty shop $ 50; Beauty school $ 500; Apprentice $ 20.
The same fee rule sets the Hawaii medical board’s application fees at Physician for permanent license $ 50; Physician for limited and temporary license $ 25; Physician assistant $ 20.
For the board of pharmacy the fee rule lists an application fee of Pharmacy $ 100 and an Original permit fee for pharmacy and miscellaneous $ 65.
No person shall for commercial purposes practice as a barber apprentice, beauty apprentice, barber, beauty operator, or beauty instructor; operate a barber shop, beauty shop, or beauty school; or announce or advertise as being prepared or qualified to practice or operate unless the person obtains a license or permit as required by this chapter.
The practice of barbering and practice of cosmetology shall be carried on only by persons holding a license or permit to practice in the State and only in barber shops or beauty shops; provided that nothing in this chapter shall prevent or prohibit a barber to practice barbering or beauty operator to practice cosmetology: (1) At any place for educational purposes; (2) Upon persons at a health care, nursing, mental, or correctional facility; (3) At a charitable event; or (4) At a person's private home, office, or hotel room when requested to do so.
All fees required by this chapter shall be as provided in rules adopted by the director pursuant to chapter 91 and shall be deposited with the director to the credit of the compliance resolution fund established pursuant to section 26-9(o), except that the examination fee required in section 439A-8 may be paid directly to the professional testing service by the department or the examinee.
No applicant or licensee shall be granted a license pursuant to the licensing laws unless the appropriate fees have been paid. Unless otherwise provided by law, the director shall establish the amount for all fees and expenses by rules adopted pursuant to chapter 91. The fees to be established by the director may include but not be limited to an application fee, filing fee, license fee, renewal fee, examination fee, and other reasonable and necessary fees related to the department's administrative costs.
No applicant shall be examined under this chapter until the applicant has paid to the board application, examination, and license fees. The board may provide separate fees for licensure by endorsement and for limited and temporary licenses. (b) Every physician or surgeon holding a license under this chapter shall renew the license with the board no later than January 31 of each even-numbered year.
An esthetician applicant shall have an education equivalent to the completion of high school and either: (1) One thousand two hundred hours of training as a beauty apprentice in a beauty shop or barber shop under the supervision of a cosmetologist or esthetician; or (2) Six hundred hours of training in a beauty school.
It shall be unlawful for any person to operate, maintain, open, change location, or establish any pharmacy within the State without first having obtained a permit from the board.
(2) For any person to distribute or dispense samples of any prescription drugs without first obtaining a permit from the board to do so; provided that nothing in this paragraph shall interfere with the furnishing of samples or drugs directly to physicians, druggists, dentists, veterinarians, and optometrists for use in their professional practice;
(6) For any person, as principal or agent, to conduct or engage in the business of preparing, manufacturing, compounding, packing, or repacking any drug without first obtaining a permit from the board to do so;
Any proprietor or manager of a pharmacy who fails or neglects to place a registered pharmacist in charge thereof or who permits the compounding of prescriptions, or the vending of drugs, except by or under the immediate supervision of a registered pharmacist, shall be deemed to have violated this chapter. Any person who, not being a registered pharmacist, compounds prescriptions or vends drugs, while not subject to the immediate supervision of a registered pharmacist, shall be deemed to have violated this chapter.
(17) Failure to comply with the pharmaceutical compounding requirements found in chapters 795 (nonsterile preparations) and 797 (sterile preparations) of the United States Pharmacopeia National Formulary, as amended;
Hawaii writes the duty as a disciplinary ground rather than as an instruction, which is easy to miss. It is a ground for the medical board to act on a “Failure to report to the board, in writing, any disciplinary decision issued against the licensee or the applicant in another jurisdiction within thirty days after the disciplinary decision is issued”.
Advertising rules7 cited rules
The medical practice act makes false, fraudulent, or deceptive advertising a ground for revoking, limiting, suspending, or denying a license, and names excessive claims of expertise in a specialty, assuring a permanent cure for an incurable disease, and any untruthful and improbable statement in advertising a…
Disciplinary landscape11 cited rules
The medical board’s grounds and sanctions sit in the medical practice act, and the uniform licensing statute and the other boards cited here each add their own. Professional misconduct, hazardous negligence, manifest incapacity, and conduct contrary to the recognized ethics of the medical profession are grounds against a physician’s license; the board may impose probation, suspension, revocation, limitation, a fine of $500 to $5,000 per violation, further education, or censure. Practicing or attempting to practice medicine in violation of the chapter is punishable by a fine of up to $500 or six months’ imprisonment, each day a separate offense, with the tools and drugs used forfeited; under the uniform statute, unlicensed activity is a misdemeanor and draws civil penalties of up to $500, $1,000, and $5,000 or forty per cent of the goods and services provided. The Department of Commerce and Consumer Affairs reviews the complaints and information received under the sections its statute names, investigates when it appears a physician has violated the chapter, and presents the results to the board; every licensee must report a judgment or disciplinary sanction within thirty days. The Board of Nursing may fine $100 to $1,000 per violation and unlicensed nursing is a misdemeanor; the Board of Pharmacy and the Board of Barbering and Cosmetology each discipline a licensee who permits an unlicensed person to perform licensed activities, with fines of $100 to $1,000 and $500 to $2,000 per violation respectively.
(7) Professional misconduct, hazardous negligence causing bodily injury to another, or manifest incapacity in the practice of medicine or surgery; (9) Conduct or practice contrary to recognized standards of ethics of the medical profession as adopted by the Hawaii Medical Association, the American Medical Association, the Hawaii Association of Osteopathic Physicians and Surgeons, or the American Osteopathic Association;
in disciplining a licensee in a proceeding held in conformity with chapter 91, the board may impose one or more of the following sanctions: (1) Place the licensee on probation, including conditions of probation as requiring observation of the licensee by an appropriate group or society of licensed physicians, osteopathic physicians, or surgeons; (2) Suspend the license; (3) Revoke the license; (4) Limit the license by restricting the fields of practice in which the licensee may engage; (5) Fine the licensee, including assessment against the licensee of the costs of the disciplinary proceedings. Any fine imposed by the board after a hearing in accordance with chapter 91 shall be not less than $500 and not more than $5,000 for each violation, exclusive of the costs of the disciplinary proceedings; (6) Require further education or training, or require proof of performance competency; or (7) Censure or reprimand.
Any person who violates this chapter, or who offers or in any way attempts to engage in the practice of medicine as defined in section 453-1 and fails to comply with any of the requirements or provisions of this chapter, penalty for which violation or failure to comply is not otherwise provided for, shall be fined not more than $500 or imprisoned not more than six months and each day's violation or failure to comply shall be deemed a separate offense. All tools, implements, medicine, and drugs used in the practice of medicine by any person convicted of practicing medicine without a license shall be declared forfeited to the State by the court and ordered destroyed.
Any person, who engages in an activity requiring a license issued by the licensing authority and who fails to obtain the required license, or who uses any word, title, or representation to induce the false belief that the person is licensed to engage in the activity, other than a licensee who inadvertently fails to maintain licensing requirements under the appropriate licensing statute and who subsequently corrects the failure so that there was no lapse in licensure, shall be guilty of a misdemeanor and each day of unlicensed activity shall be deemed a separate offense.
Any person who violates this section shall be assessed a civil penalty of not more than $500 or forty per cent of the total amount of the goods and services provided or to be provided, whichever is greater, for the first violation; not more than $1,000 or forty per cent of the total amount of the goods and services provided or to be provided, whichever is greater, for the second violation; and not more than $5,000 or forty per cent of the total amount of the goods and services provided or to be provided, whichever is greater, for any subsequent violation.
The department of commerce and consumer affairs shall review each complaint, inquiry, and information, as applicable, received under sections 92-17, 329-44, 453-8.7, 663-1.7, and 671-5. The department shall investigate the complaint, inquiry, or information if it appears that the physician or osteopathic physician who is the subject of the complaint, inquiry, or information has violated this chapter. If the department determines that the physician or osteopathic physician has violated this chapter, the department shall present the results of its investigation to the Hawaii medical board for appropriate disciplinary proceedings.
Each licensee shall provide written notice within thirty days to the licensing authority of any judgment, award, disciplinary sanction, order, or other determination, which adjudges or finds that the licensee is civilly, criminally, or otherwise liable for any personal injury, property damage, or loss caused by the licensee's conduct in the practice of the licensee's profession or vocation. A licensee shall also give notice of such determinations made in other jurisdictions.
(6) Unprofessional conduct as defined by the board in accordance with its own rules; (7) Wilful or repeated violation of any of the provisions of this chapter or any rule adopted by the board; Any fine imposed by the board after a hearing in accordance with chapter 91 shall be no less than $100 and no more than $1,000 for each violation.
It shall be a misdemeanor for any person, including any corporation, association, or individual to: (1) Sell or fraudulently obtain or furnish any nursing diploma, license, renewal, or record or aid or abet therein; or (2) Practice nursing as defined by this chapter under cover of any diploma, license, or record illegally or fraudulently signed or issued unlawfully or under fraudulent representation; or (3) Practice nursing as a registered or as a licensed practical nurse unless licensed to practice under this chapter; or (4) Use in connection with the person's name any designation tending to imply that the person is a registered nurse or a licensed practical nurse unless licensed to practice under this chapter; or (5) Practice nursing as a registered nurse or as a licensed practical nurse during the time the person's license issued under this chapter is suspended or revoked; or (6) Conduct a nursing education program not accredited by the board to prepare for a registered nurse or licensed practical nurse unless the program has been accredited by the board; or (7) Otherwise violate any provision of this chapter. Any of these misdemeanors shall be punishable by a fine of not more than $500 for a first offense. Each subsequent offense shall be punishable by a fine of not more than $1,000 or imprisonment of not more than one year, or both.
(3) Permitting an unlicensed or unregistered person to perform activities that require a license or registration under this chapter; Any person who violates any of the provisions of this chapter or the rules adopted pursuant to this chapter shall be fined no less than $100 and no more than $1,000 for each violation.
(3) Permitting a person without a license, apprentice permit, or temporary permit to perform activities that require a license, apprentice permit, or temporary permit under this chapter; Any licensee or permittee who violates this chapter or the rules adopted pursuant thereto shall be fined not less than $500 and not more than $2,000 for each violation.
Current as of Sep 8, 2026. Verify against the linked primary source and consult qualified counsel before acting — rules change and turn on your specific facts.
Who may perform it in Hawaii?
We hold Hawaii’s own written limits for injectable (neuromodulator, dermal filler), micropigmentation / permanent makeup — read at source and cited. Check a licence against a procedure and see the rule it rests on.
Check scope in Hawaii →Hawaii med spa compliance — FAQ
- Where do Hawaii med spa and injectable regulations come from?
- Hawaii med spas and injectors are governed by a mix of state and federal authorities — the Hawaii legislature, and the state's boards of nursing, medicine, and pharmacy, alongside federal bodies like the FDA and the Federal Register. MedSpaRadar monitors all of them for Hawaii and flags what changed in plain language.
- Does the FDA's GLP-1 compounding guidance apply in Hawaii?
- Yes — federal FDA actions on GLP-1 compounding (semaglutide, tirzepatide) apply nationwide, including in Hawaii. We track those federal changes alongside any Hawaii-specific rules so you see the full picture for your practice.
- How do I keep up with Hawaii regulatory changes?
- MedSpaRadar sends a free weekly Brief on what changed across Hawaii, the FDA, and the Federal Register. Members get the exact "what to do" for their states in one daily email. It's regulatory monitoring, not legal advice.
Get Hawaii changes as they publish
We scan the Hawaii legislature and licensing boards daily, plus the FDA and the Federal Register. Free weekly Brief — what changed, in plain language, with the source.
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← All states · MedSpaRadar is regulatory monitoring and reference: it summarizes public laws, regulations and agency actions and links each to its source. It is not legal, medical, or compliance advice, and using it creates no attorney-client relationship. A summary can lag its source or leave out detail, and monitoring itself can be interrupted — so an absence of alerts means nothing reached you, not that nothing happened. Read the cited source, check its effective date, and confirm any change to your operations or clinical practice with qualified health-law counsel and your medical director.