Question 1

Who can inject Botox and dermal fillers in Louisiana?

Accepted Answer

Injecting neurotoxins and fillers is the practice of medicine, so it may be ordered/performed by physicians (MD/DO), and by NPs and PAs practicing with a physician; a qualified NP with a board-approved collaborative practice agreement may perform cosmetic injections independently as a subspecialty. A trained RN may inject FDA-approved neurotoxins (e.g., Botox) when ordered by a qualified prescriber with a physician or NP physically present, but the Board of Nursing expressly excludes ALL dermal fillers (collagen, Restylane, Juvederm, etc.) from the RN scope. Estheticians and medical assistants may not inject.

Question 2

Does Louisiana require a good-faith exam before treatment?

Accepted Answer

A good-faith evaluation is required before treatment: aesthetic procedures must be preceded by a history and appropriate physical exam and a diagnosis by a qualified physician (or an NP practicing in collaboration with one), and the LSBME's IV-therapy position requires a 'full in-person or virtual history and examination' establishing a bona fide doctor-patient relationship. Telehealth is expressly permitted to establish that relationship, but pre-set menus and blanket 'standing orders' in lieu of individualized evaluation are unlawful.

Question 3

Does a med spa in Louisiana need a medical director?

Accepted Answer

Louisiana has no med-spa-specific 'medical director' license, but because cosmetic injectables, lasers, peels, and IV therapy are the practice of medicine, any non-physician performing them must act under the direction and immediate personal supervision of a Louisiana-licensed physician who is physically present on the premises. The Board's rules bar the sham arrangement of a physician who serves 'as medical director or otherwise' in title only while an unlicensed person practices medicine, so a genuinely supervising/directing physician is effectively required.

Question 4

Can a non-physician own a med spa in Louisiana?

Accepted Answer

Louisiana enforces a corporate-practice-of-medicine doctrine: a business corporation cannot itself practice medicine, and only a Professional Medical Corporation (owned and governed exclusively by physicians) is authorized to practice medicine. However, the LSBME's Dec 2024 position holds that a physician's employment by a non-professional corporation is not per se unlawful, provided the entity does not control or interfere with the physician's independent medical judgment — so lay/non-physician ownership of a med-spa entity is permissible with autonomy safeguards, and strict physician-only ownership is not required.

Question 5

What supervision does Louisiana require for med-spa procedures?

Accepted Answer

For delegated medical aesthetic acts (injections, lasers, chemical peels, IV therapy) performed by an RN or other non-physician, the physician (or collaborating NP) must be physically present on the premises and immediately available at all times, retaining full responsibility; the non-physician may not act independently or exercise independent medical judgment. PA supervision generally does not require the physician's physical presence under the PA statute, but the Board applies its stricter on-site direction standard to cosmetic/laser/IV delegation; a qualified NP with an approved collaborative practice agreement may perform cosmetic procedures independently within approved clinical practice guidelines.

Question 6

What can an esthetician legally do in Louisiana?

Accepted Answer

Estheticians are licensed by the Louisiana State Board of Cosmetology and are limited to services affecting only the epidermis — makeup, facials, superficial chemical peels, dermaplaning, microdermabrasion, and nano-needling. Board rules prohibit any procedure that penetrates or invades living tissue or affects the dermis/skin below the epidermis, the use of lasers, injections, acids that exfoliate below the epidermis, and the use of any apparatus classified as a medical device by the FDA — so injectables, medical-grade lasers, and medical peels are outside the esthetician scope.

Question 7

Who can operate a cosmetic laser in Louisiana?

Accepted Answer

Use of medical lasers for therapeutic or cosmetic purposes is the practice of medicine; by statute only persons licensed to practice medicine (and dentists, podiatrists, veterinarians within their fields) may perform laser surgery. A non-physician may operate a laser only under the direct, on-site supervision of a Louisiana-licensed physician — an appropriately trained RN may perform non-ablative laser resurfacing and laser hair removal under a prescriber's order (ablative laser is excluded from the RN scope), while estheticians are barred from operating lasers entirely.

Question 8

What are the rules for IV therapy and vitamin drips in Louisiana?

Accepted Answer

Retail IV hydration therapy is the practice of medicine: diagnosing a patient and recommending/prescribing an IV may be done only by a licensed physician or an authorized practitioner working with a physician (PA, CRNP/NP, or CNM), after a full in-person or telemedicine history and examination establishing a bona fide doctor-patient relationship. RNs may only administer patient-specific orders after a physician's pretreatment evaluation; independent RN diagnosis or prescription, blanket standing orders, and 'pick-from-a-menu' models are unlawful.

Question 9

Does a med spa have to register or hold a license in Louisiana?

Accepted Answer

Louisiana has no med-spa-specific license or registration; a medical spa operates under the general Medical Practice Act through its supervising/employing physician and the applicable board rules for each service. There is no dedicated med-spa facility permit, though office-based surgical/aesthetic procedures that exceed exempt anesthesia thresholds (i.e., beyond local, topical, or regional anesthesia or a single oral analgesic/sedative dose) must comply with the LSBME Office-Based Surgery rules (LAC 46:XLV.7301 et seq.), and non-medical cosmetology services must occur in Board of Cosmetology-licensed salons.

Question 10

What are the penalties for practicing outside scope in Louisiana?

Accepted Answer

Performing or facilitating unlicensed practice of medicine (e.g., a non-physician injecting, lasering, or ordering IVs without proper physician direction) is a criminal offense: each offense carries a fine of $250–$500 or imprisonment of 10 days to 5 months, or both. The Board may also obtain an injunction plus a penalty up to $500 and attorney's fees, and may suspend, revoke, fine, or restrict the license of any physician who knowingly assists an unlicensed person to practice medicine or who improperly delegates or supervises.

Louisiana Med Spa Regulations