New Hampshire Med Spa Regulations
New Hampshire has no med-spa-specific statute; medical spas are governed by the general Medical Practice Act (RSA 329), Nurse Practice Act (RSA 326-B), and Physician Associates Act (RSA 328-D), under which injectables and lasers are the practice of medicine that physicians, independent APRNs, collaborating PAs, and delegated RNs may perform.
Last reviewed: 2026-07-21
Who can inject Botox and dermal fillers in New Hampshire?
Injecting cosmetic drugs is the practice of medicine (diagnosing, treating, prescribing) under RSA 329:1, so it must be performed or ordered by a licensed prescriber. Physicians (MD/DO), APRNs/nurse practitioners (who have plenary authority to prescribe and administer drugs under RSA 326-B:11), and physician assistants (who may prescribe and administer drugs under RSA 328-D:3-b) all qualify; a registered nurse may administer an injectable pursuant to that prescriber's order as part of registered nursing practice (RSA 326-B:2, XI), and RSA 313-A:25 confirms nurses act within their own professional scope, not cosmetology licensure.
Source: RSA 329:1 Practice (definition of practicing medicine), RSA 326-B:11 APRN scope — plenary authority to prescribe/administer drugs, RSA 328-D:3-b Physician Assistant Scope of Practice (prescribe/administer), RSA 326-B:2 Definitions (registered nursing)
Does New Hampshire require a good-faith exam before treatment?
New Hampshire has no med-spa-specific good-faith-exam statute, but before a physician prescribes there must be a physician-patient relationship that includes an in-person or telemedicine exam, history, diagnosis, and treatment plan (RSA 329:1-c), and prescribing without one is unprofessional conduct subject to discipline. RSA 326-B:2, I-a imposes the equivalent APRN-patient relationship (exam, history, diagnosis, treatment plan). Both statutes expressly allow the examination to be conducted via telemedicine.
Source: RSA 329:1-c Physician-Patient Relationship (exam/history/diagnosis; telemedicine), RSA 326-B:2, I-a APRN-Patient Relationship (exam via in-person or telemedicine)
Does a med spa in New Hampshire need a medical director?
New Hampshire has no statute requiring a medical spa to appoint a medical director. APRNs practice independently with no physician collaboration requirement (RSA 326-B:11), while a physician assistant with fewer than 8,000 post-graduate hours (or practicing where no NH physician is in the group) must maintain a written collaboration agreement with a NH-licensed physician who is accessible for consultation (RSA 328-D:3-b). Thus physician involvement is tied to the specific provider's licensure, not to a mandated med-spa medical director role.
Source: RSA 326-B:11 APRN independent scope of practice, RSA 328-D:3-b PA collaboration agreement requirement
Can a non-physician own a med spa in New Hampshire?
New Hampshire has no codified corporate-practice-of-medicine prohibition; the Medical Practice Act (RSA 329) contains no restriction on non-physician or corporate ownership of a medical practice. Professional services may be delivered through a professional corporation organized under RSA 294-A, but the state does not require a med spa to be physician-owned. (Absence of a prohibiting statute is confirmed by the governing acts; confidence is medium because it rests on the absence of any CPOM statute rather than an affirmative permissive provision.)
Source: RSA 294-A:2 Permissible Purposes of Professional Corporations, NH Board of Medicine Laws and Rules (RSA 329 Medical Practice Act — no CPOM/ownership bar)
What supervision does New Hampshire require for med-spa procedures?
Supervision requirements turn on the provider's license. APRNs/nurse practitioners practice independently with full prescriptive authority and no supervising or collaborating physician (RSA 326-B:11). Physician assistants must have a written collaboration agreement with a NH-licensed physician unless they have 8,000+ post-graduate hours (waiver required), and a physician must be accessible in person, by phone, or electronically at all times a PA is practicing (RSA 328-D:3-b). RNs and unlicensed staff perform delegated tasks under the direction of a physician, APRN, or PA (RSA 326-B:2; RSA 328-D:3-b, X).
Source: RSA 326-B:11 APRN scope (independent, plenary), RSA 328-D:3-b PA collaboration agreement and delegation, RSA 328-D:1 Definitions (collaboration; participating physician)
What can an esthetician legally do in New Hampshire?
A licensed esthetician's scope under RSA 313-A:1, VIII is limited to giving facials, applying makeup, therapeutic (non-medical) skin care treatments, removing superfluous hair, applying eyelashes, and beautifying/cleansing/stimulating the skin with cosmetic preparations. It does not include injections, prescription drugs, or any procedure that cuts, burns, or structurally alters tissue, which are the practice of medicine and outside esthetics licensure.
Source: RSA 313-A:1 Definitions (esthetics/esthetician scope), RSA 329:1 (surgery/altering tissue is the practice of medicine)
Who can operate a cosmetic laser in New Hampshire?
RSA 329:1 defines "surgery" — the practice of medicine — to expressly include laser procedures (any procedure in which tissue is cut, shaped, burned, vaporized, or otherwise structurally altered), unless another statute authorizes the person to perform it. No New Hampshire statute authorizes estheticians or cosmetologists to operate medical/aesthetic lasers, so laser treatments must be performed by a physician or by an APRN, PA, or RN acting within their scope and under appropriate physician delegation/oversight.
Source: RSA 329:1 Practice (laser defined as surgery/practice of medicine), RSA 313-A:1 Definitions (esthetics scope excludes laser)
What are the rules for IV therapy and vitamin drips in New Hampshire?
New Hampshire has no med-spa-specific IV-therapy statute. Administering IV fluids or vitamin infusions is a medical/nursing act: it requires an order from an authorized prescriber (physician, APRN, or PA) issued after establishing the required patient relationship and exam, and may be administered by a registered nurse within registered nursing practice (RSA 326-B:2, XI). Confidence is medium because the rule is inferred from general prescriber and nursing-scope statutes rather than an IV-specific provision.
Source: RSA 326-B:2 Definitions (registered nursing — implementing treatment), RSA 329:1-c physician-patient relationship required before prescribing
Does a med spa have to register or hold a license in New Hampshire?
New Hampshire has no medical-spa registration or licensing scheme. A bill to create one — HB 105 (2024), "AN ACT relative to the registration of medical spas" — was found Inexpedient to Legislate and did not become law, so med spas are regulated only through the general professional-licensure statutes administered by the OPLC (RSA 329 Medical Practice Act, RSA 326-B Nurse Practice Act, RSA 328-D Physician Associates). There is no separate facility registration for a med spa.
Source: NH Board of Medicine Laws and Rules — governing statutes (no med-spa chapter), RSA 329:1 (medical procedures governed by the Medical Practice Act)
What are the penalties for practicing outside scope in New Hampshire?
Practicing medicine (including performing or ordering injectables/lasers) without a license or delegated authority is unlawful practice under RSA 329:24. A first offense is a misdemeanor; a subsequent offense is a misdemeanor for a natural person or a felony for any other person (e.g., an entity). The Board of Medicine may also impose an administrative fine up to $50,000, an additional $1,000 per day for continued unlawful practice after notice, issue an enforceable cease-and-desist order, deny licensure, and seek an injunction.
Source: RSA 329:24 Unlawful Practice (penalties, fines, cease-and-desist)
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This information is provided for general educational purposes only and is not legal advice. Regulations change — verify current requirements with your state medical/nursing board before acting.