North Carolina medical director requirements for med spas

Physician supervision & delegation in North Carolina

The Medical Board treats an aesthetic laser as a surgical instrument: altering human tissue with one is surgery, and therefore the practice of medicine. Everything about who may hold the handpiece follows from that.

• 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

• By delegating the use of a medical laser to a non-physician, the supervising physician attests to the Board and to the public that the unlicensed or non-physician operator is competent to use it safely. The physician is expected to provide oversight of both licensed and unlicensed personnel before and after the procedure, and to remain available for emergencies.

  NCMB Position Statement 5.1.2 · verified Aug 17, 2026

• Licensed electrologists who hold a laser hair practitioner credential may perform laser hair removal — but not tattoo removal — under the supervision of a physician.

  NCMB Position Statement 5.1.2 · verified Aug 17, 2026

• The Medical Practice Act’s license requirement does not reach medical acts performed by a licensed physician assistant at the direction or under the supervision of a physician in accordance with board rules, nor nursing acts performed under rules developed jointly by the medical and nursing boards. The Act also preserves a physician’s authority to delegate acts otherwise permitted by law or established by custom.

  N.C. Gen. Stat. §90-18(c)(13), (c)(14) · verified Aug 17, 2026