Does a med spa in Louisiana need a medical director?

Short answer
The cited rules do not settle this — none names a medical director; they only require a Louisiana license to practice medicine and make improper delegation or supervision, or enabling unlicensed practice, grounds for board discipline against the physician.

Louisiana names the med spa failure modes inside one definition of unprofessional conduct. r.s. 37:1285(a)(13) makes unprofessional conduct a cause for refusing, suspending or revoking a license, and its enumerated examples read like a list of how a cosmetic practice goes wrong: Failing to maintain independent medical judgment, improperly delegating or supervising, exercising undue influence, enabling the unauthorized practice of medicine, practicing or enabling practice by an impaired provider, and failing to practice within the scope of education, training and experience. A separate cause reaches the arrangement rather than the act: knowingly performing any act which in any way assists an unlicensed person to practice medicine, or having professional connection with or lending one's name to an illegal practitioner. Physician assistants have their own cause — utilizing one without approval and recordation as required by law, or permitting one within the physician's employment to conduct activities outside the designated scope of the assistant's approval and registration. The practice of medicine is defined broadly enough to catch cosmetic work: holding oneself out as engaged in, or actually engaging in, the diagnosing, treating, curing or relieving of any bodily condition, defect or injury in another person, by any drug, instrument or force, or any other agency or means. The cosmetology board’s rules then name the procedures a salon license does not reach. No license or permit issued by the Board of Cosmetology authorizes, in a salon it licenses, the use of lasers, MICRO-NEEDLING, micro-blading, any service or procedure which penetrates or invades the live tissue or dermis by any means — instruments, product insertion, puncturing, cutting, needling or chemical exfoliation — or the use of any mechanical or electrical apparatus classified as a medical device by the FDA. Estheticians shall not perform any procedure which will affect the dermis or skin below the epidermis; esthetic services are the work performed on the epidermis, and the board’s definition of nano-needling is a non-invasive technique that does not penetrate beyond the epidermis by more than .25 mm.