Scope of Practice for Nurses and Estheticians in Texas Med Spas

Operating a med spa in Texas requires a clear understanding of the scope of practice for nurses and estheticians, as defined by the Texas Medical Board (TMB), the Texas Board of Nursing (BON), and the Texas Department of Licensing and Regulation (TDLR). Understanding these regulations is essential for ensuring compliance and avoiding legal issues. This article provides an overview of the scope of practice for nurses and estheticians in Texas med spas.

Scope of Practice for Nurses:

Nurses, including Registered Nurses (RNs), Licensed Vocational Nurses (LVNs), and Nurse Practitioners (NPs), play a vital role in the administration of medical treatments at med spas. Their practice is regulated by the Texas Board of Nursing (BON) and must be performed under the delegation of a licensed physician.

Registered Nurses (RNs)

• Supervision: RNs must work under the delegation of a physician or an advanced practice registered nurse (APRN) with proper authority.

• Procedures Allowed:

  • Administer Botox and dermal fillers under physician delegation.

  • Perform laser treatments and microneedling if properly trained and delegated.

  • Conduct medical assessments and obtain patient histories.

  • Assist in advanced aesthetic treatments such as platelet-rich plasma (PRP) therapy.

• Restrictions:

  • Cannot practice independently or make medical diagnoses.

  • Cannot prescribe medications unless they are an APRN with prescriptive authority.

Licensed Vocational Nurses (LVNs):

• Supervision: LVNs must work under an RN, APRN, or physician.

• Procedures Allowed:

  • Can assist with Botox and fillers but cannot inject independently without proper delegation.

  • Perform laser treatments and microneedling under physician delegation.

  • Provide post-treatment care and patient education.

• Restrictions:

  • Cannot independently assess patients or develop treatment plans.

  • Cannot prescribe or delegate medical procedures.

Nurse Practitioners (NPs/APRNs):

• Supervision: Can practice independently but must have a delegation agreement with a physician.

• Procedures Allowed:

  • Can perform and delegate Botox, fillers, and laser treatments.

  • Can prescribe medications and develop treatment plans under a delegated prescriptive authority agreement.

  • Can assess, diagnose, and treat patients within their scope of practice.

• Restrictions:

  • Must follow Texas Medical Board rules on physician collaboration and delegation.

Scope of Practice for Estheticians:

Licensed estheticians in Texas are regulated by the Texas Department of Licensing and Regulation (TDLR) and are limited to non-medical cosmetic services without the appropriate delegation agreements in place.

Allowed Procedures:

• Basic facials, chemical peels (within non-medical grade limits), and microdermabrasion.

• Skin exfoliation treatments that do not penetrate the dermis.

• Waxing, threading, and other hair removal techniques.

• Application of makeup and superficial skincare treatments.

Limited Procedures:

• Botox, fillers, and other injectables unless a delegation agreement with a physician is in place.

• Laser hair removal, IPL treatments, and microneedling deeper than 0.3 mm (requires physician delegation and proper licensure).

• Medical-grade chemical peels beyond the scope of esthetic licensure.

• Providing medical advice or diagnosing skin conditions.

Legal Considerations for Med Spa Owners:

• Physician Oversight: Any medical procedure must be overseen or supervised by a licensed physician.

• Proper Delegation: All non-physician providers must have written delegation agreements for services considered medical procedures.

• Licensing Compliance: Ensure that estheticians do not perform medical treatments beyond their legal scope.

• Training and Certification: Proper training for laser treatments, injectables, and advanced skincare is required for compliance with Texas regulations.

Conclusion on the Scope of Practice for Nurses and Estheticians in Texas Med Spas

The scope of practice for nurses and estheticians in Texas med spas is strictly regulated. Estheticians and nurses have broad authority under physician delegation. But med spa owners must ensure that all staff members operate within their legal scope to maintain compliance and provide safe, effective treatments. Understanding these rules helps avoid legal risks and ensures high-quality patient care in Texas med spas.

Feel free to reach out if you need more specific information or further clarification.

Weitz Morgan is a leading law firm in Texas in providing comprehensive advice and guidance to med spas. With a deep understanding of the unique challenges and complexities faced by this rapidly growing industry, our team of experienced attorneys is dedicated to helping med spas navigate the legal landscape successfully.

We recognize that med spas operate at the intersection of healthcare and beauty, which necessitates a multifaceted approach to representation. Our firm offers a range of services, including a flat-fee med spa formation package and an outside general counsel subscription, tailored to meet the specific needs of med spas, ensuring compliance, mitigating risks, protecting licenses, and fostering a legally sound business environment.