Laser / energy devices — by State
43 of 51 states let RNs operate lasers
43 of the 51 US jurisdictions (50 states plus the District of Columbia) let RNs operate lasers; the remaining 8 do not. The table below gives each state's rule in its own words, with the statute or board rule it comes from.
Laser / energy devices in all 51 US jurisdictions
| State | Laser / energy devices |
|---|---|
| Alabama | Under Ala. Admin. Code Ch. 540-X-11, the use of lasers/light-energy-based devices affecting living tissue is the practice of medicine; ablative procedures — and endovascular ablation (EVLA), laser-assisted liposuction, and laser-assisted surgery — may be performed only by physicians. A physician may delegate non-ablative treatments (e.g., IPL/BBL, laser hair removal, photorejuvenation) under a written protocol and required supervision to a Level 1 Delegate (PA, CRNP, or RN) or a Level 2 Delegate (LPN, medical assistant, aesthetician, cosmetologist, or laser technician). Physicians who use these devices must register with the Board and renew annually. |
| Alaska | Alaska has no standalone laser-operator licensing statute. Ablative/'hot' laser treatment is medical care: 12 AAC 40.967(32) makes it unprofessional conduct to permit treatment with hot lasers (or botulinum toxin, dermal filler, or below-the-dermis chemical peels) by anyone who is not 'an appropriate health care provider trained and licensed under AS 08,' confining operation to AS 08-licensed clinicians — physicians (MD/DO) and PAs under AS 08.64 and RNs/APRNs under AS 08.68 (RNs acting under delegation/orders). Estheticians are expressly barred from Class III and Class IV laser devices (12 AAC 09). |
| Arizona | Cosmetic laser and IPL are regulated by the ADHS Bureau of Radiation Control under A.A.C. R12-1-1438 (recodified as R9-7-1438): the medical laser/IPL (Class II) device must be registered, and it may be used only by a qualified health professional acting within scope (physician, PA, NP, RN, etc., under A.R.S. §§ 32-516/32-3233) or by a certified laser technician (CLT). A CLT works under a prescribing health professional's indirect supervision for hair reduction and direct supervision for other cosmetic procedures, and the prescribing health professional must order/purchase the device and approve written protocols reviewed at least annually. Cosmetologists and aestheticians may operate lasers only if separately laser-certified. |
| Arkansas | The Arkansas State Medical Board finds that the use of medical lasers on humans for therapeutic or cosmetic purposes constitutes the practice of medicine (Regulation 22, Laser Surgery Guidelines; surgery is defined to include cutting, altering, or infiltrating tissue by lasers). Lasers must therefore be operated by, or under the responsibility and supervision of, a physician (or an APRN acting within authority); a physician may delegate the procedure to appropriately trained personnel such as an RN only after personally diagnosing the patient and prescribing the treatment, and remains legally responsible for the delegated act. |
| California | Operating a laser or IPL device on living tissue is the practice of medicine, and the Medical Board permits it only for a physician, or a registered nurse or physician assistant under a physician's supervision (NPs likewise qualify under their furnishing/standardized-procedure authority). Estheticians, medical assistants, and LVNs may not operate medical lasers, and a supervising physician who lets them aids the unlicensed practice of medicine. |
| Colorado | Use of a Class IIIb-or-higher laser, intense pulsed light, or radio-frequency device that revises, destroys, incises, or otherwise structurally alters human tissue (or is used for hair removal) is a medical service constituting the practice of medicine. It may be performed by a physician or delegated under Rule 800 to a physician assistant, registered nurse, nurse practitioner, or a trained unlicensed delegatee under physician supervision. Class I, II, and IIIa devices (including Class IIIa lasers) do not constitute a medical service and fall outside these rules. |
| Connecticut | Laser hair removal, laser skin resurfacing, laser treatment of leg veins, sclerotherapy, other laser procedures, and intense pulsed light are enumerated 'cosmetic medical procedures' under CGS § 19a-903c(a)(2). Under § 19a-903c(b), a medical spa must employ or contract a physician (licensed under Chapter 370), a physician assistant (Chapter 370), or an advanced practice registered nurse (Chapter 378), and any cosmetic medical procedure performed at a medical spa may only be performed by that physician, PA, or APRN, or by a registered nurse licensed under Chapter 378. Separately, CGS § 20-265a(4)(B) — not § 20-250, which is the unrelated hairdressing/cosmetology definition — excludes 'the use of a prescriptive laser device' from the scope of esthetics, confirming that estheticians may not operate medical/prescriptive lasers; that authority is reserved to the physician/PA/APRN/RN roles specified in § 19a-903c. |
| Delaware | Delaware has no laser- or energy-device-specific licensing statute. Cosmetic laser/IPL treatment is a medical act that a physician may delegate to a qualified non-physician under supervision (24 Del. Admin. Code 1700 § 11.0), and physicians, APRNs and PAs may perform it within their scope; estheticians and cosmetologists are excluded because they may not provide medical treatment (24 Del.C. § 5101). Because no statute names permissible laser operators, the allowed roles are inferred from the medical-delegation and cosmetology exclusion framework. |
| District of Columbia | Laser and IPL hair removal and skin treatment are Level II procedures, and ablative/vaporizing lasers are Level III; both 'constitute the practice of medicine' and must be performed within a physician-led medical practice with a physically present medical director. They may be performed by a physician, or by an NP or PA within scope, or by an RN/trained delegate under that licensed practitioner's supervision — not by an unsupervised esthetician. |
| Florida | Laser and light-based hair removal is the practice of medicine in Florida. It may be performed by a physician (MD ch. 458 / DO ch. 459) or by a qualified licensed electrologist operating under the direct supervision and responsibility of a properly trained supervising physician and jointly written protocols — on-site, or by telehealth within 150 miles with continuous synchronous communication, with no physician supervising more than four electrologists (64B8-56.002). A physician may also delegate laser procedures to trained personnel (e.g., RN/PA/APRN) as a delegated medical act under supervision; cosmetologists and estheticians may not operate lasers. |
| Georgia | Georgia is a licensure state for cosmetic lasers: the Composite Medical Board issues Senior and Assistant Cosmetic Laser Practitioner licenses. Under Rule 360-35-.05, cosmetic laser services may be performed by physicians, by PAs and APRNs who are licensed cosmetic laser practitioners, by senior laser practitioners (who may practice independently and supervise assistants), and by assistant laser practitioners under on-site supervision of a physician or senior practitioner. A consulting physician must examine each patient — or delegate the exam to a PA/APRN cosmetic laser practitioner — before any service other than laser hair removal or pulsed-light treatment (Rule 360-35-.06). Estheticians are statutorily barred from using lasers. |
| Hawaii | Hawaii has no laser statute, but the Medical Board's official interpretation is that using a laser or IPL to cut, shape, burn, vaporize, or otherwise structurally alter human tissue is the practice of medicine (HRS 453-1), and unlicensed individuals may not perform it even under delegation. Physicians and osteopathic physicians may operate lasers; PAs may under physician direction; and licensed nurses may where their practice act (HRS chapter 457) permits, with the task delegated and under the direction of a physician (APRNs may order and perform within their independent scope). |
| Idaho | Lasers and intense pulsed light are FDA 'prescriptive medical/cosmetic devices' and their use to cosmetically alter human tissue is a 'cosmetic treatment,' i.e., the practice of medicine. Laser/IPL cosmetic procedures may be performed only by a physician or by medical personnel under a supervising physician; an esthetician may operate a Class II laser/IPL skin-care device only as directed and supervised by a licensed health care practitioner. |
| Illinois | Use of lasers and related energy devices (IPL, radiofrequency, medical microwave, and similar devices that disrupt the epidermal surface) is the practice of medicine and must be performed by a licensed physician unless delegated. A physician may delegate ablative procedures to an RN, LPN, or full-practice-authority APRN with on-site supervision, and non-ablative procedures to those same persons or others with on-site supervision or the physician available by phone; the delegate must have documented training in each system, and eye-risk procedures may not be delegated. |
| Indiana | Indiana has no dedicated laser statute or laser-operator license, so cosmetic laser/energy-device use is treated as the practice of medicine that a physician may perform or delegate to appropriately trained personnel under supervision (IC 25-22.5-1-2(a)(20)). SB 282 now defines the nonsurgical use of a laser or energy device for cosmetic purposes (rejuvenation, anti-aging, hair removal) as a med-spa service, meaning it must be provided at a registered medical spa under a responsible practitioner; no rule sets a minimum operator credential, so delegation to trained unlicensed staff is legally gray. |
| Iowa | Nonsuperficial/ablative and vaporizing laser therapy is a 'medical aesthetic service' (the practice of medicine) under 653—13.8. A physician may perform it or delegate it, under physician supervision at a medical spa, to a 'qualified laser technician' (licensed or unlicensed, who completed >=120 hours of training — 40 didactic + 80 clinical — at an accredited laser program and may use lasers only for delegated services) or to a qualified licensed nonphysician such as an NP, PA, or RN. Laser/IPL used solely for hair removal is expressly excluded from the medical-aesthetic definition and may instead be performed by board-certified estheticians, electrologists, or pre-2005 cosmetologists under 645 ch. 60 (40 hours of device-specific training). |
| Kansas | Kansas has no laser-specific licensing statute. Operating a medical laser or IPL to alter living tissue (hair removal, resurfacing, vascular/pigment treatment) is the practice of the healing arts under K.S.A. 65-2869 and must be authorized by a licensee. A physician may delegate laser operation to qualified personnel who can competently perform it under the physician's direction and written protocols per K.S.A. 65-28,127; APRNs and PAs may operate within their own scope/delegation. Because Kansas relies on general delegation rather than a laser rule, trained non-licensed staff may fire the laser only under a delegating physician's protocols and responsibility. |
| Kentucky | Kentucky has no separate laser-technician license; laser is a delegated medical procedure that must be part of a medical plan of care ordered by a qualified provider. Physicians and APRNs (and PAs, as qualified prescribers) may operate lasers; RNs may perform non-ablative laser (hair removal, skin treatment) under supervision and ablative/fractionated laser under supervision by an advanced-education/certification-qualified provider, while LPNs are limited to non-ablative laser under direct supervision. Estheticians may not perform laser except under the immediate supervision of a licensed physician. |
| Louisiana | 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. |
| Maine | Maine has no laser-operator licensure statute and the Board of Licensure in Medicine publishes no laser or cosmetic-procedure position statement. Cosmetic laser treatment is treated as a medical act performed by or delegated by a physician: under 32 MRS 3270-A a physician (and, within scope, an NP or PA) may perform laser procedures and may delegate them to appropriately trained staff, provided the physician ensures training/competency and remains liable. Personal presence of the physician is not statutorily required. |
| Maryland | Lasers, intense pulsed light, and radiofrequency devices are 'cosmetic medical devices' and their use is a 'cosmetic medical procedure' under COMAR 10.32.09.02. Their operation is therefore regulated exactly like injections: performed by a physician, or delegated to a physician assistant, or assigned to another licensed health care provider (NP, RN) whose licensing board deems it within scope, with physician training and supervision. Estheticians and unlicensed technicians may not operate them. |
| Massachusetts | Massachusetts has no dedicated laser-operator license; laser and energy-based procedures (hair removal, skin resurfacing) are treated as the practice of medicine. Under 243 CMR 2.07(4) a physician may delegate them only to individuals licensed to perform them — physicians, nurse practitioners, physician assistants, and registered nurses — and not to unlicensed technicians or, absent medical licensure, estheticians. |
| Michigan | Per LARA's (Dept. of Community Health) position statement, the use of lasers by health professionals constitutes the practice of medicine. Accordingly a physician (MD/DO) must own the entity and either perform or delegate laser procedures under MCL 333.16215; delegatees such as NPs, PAs, and RNs may operate lasers only under physician supervision and if qualified. Estheticians and cosmetologists may not perform cosmetic laser or IPL procedures regardless of vendor training, because that falls outside their occupational license. |
| Minnesota | Minnesota expressly defines "any invasive or noninvasive procedures involving the use of a laser" as the practice of medicine. Consequently, cosmetic laser treatment must be performed by a physician or by a provider acting within a medical scope — a full-practice APRN or a PA — or delegated to and performed by qualified personnel such as an RN under a physician's direction and supervision. Estheticians and other cosmetology licensees are not authorized to operate medical lasers. |
| Mississippi | Use of laser, pulsed light or similar devices for cosmetic or invasive procedures is the practice of medicine, limited to physicians and those directly supervised by physicians such that a physician is on the premises and would be directly involved in the treatment if required. Appropriately trained RNs may perform laser hair removal (but NOT laser vascular-lesion removal), and NPs and PAs may perform laser procedures under the required physician collaboration/supervision; estheticians may not operate lasers. |
| Missouri | Missouri has no dedicated laser-technician license. Cosmetic laser and IPL treatment is treated as the practice of medicine, so it must be performed by a physician or delegated to appropriately trained personnel (APRN, PA, or RN) under a collaborative practice arrangement or physician supervision; the RSMo 329.010 esthetician scope does not include lasers. Because there is no laser-specific statute, roles are inferred from the practice-of-medicine and delegation framework and confidence is medium. |
| Montana | Montana treats laser hair removal as 'surgery' — defined as any procedure in which human tissue is cut or altered by mechanical or energy forms, including electrical or laser energy — and ARM 24.121.1509(7) prohibits Board of Barbers and Cosmetologists licensees from performing it. There is no dedicated laser-operator license; energy-based cosmetic procedures are the practice of medicine/nursing and must be performed by, or delegated and supervised by, a qualified health care provider (physician, PA, or APRN), with RNs or technicians operating only under a provider's direction and supervision. |
| Nebraska | Nebraska's Board of Medicine treats operation of a laser for aesthetic or medical purposes as the practice of medicine, so cosmetic laser procedures may be performed only by licensed physicians (MD/DO), APRNs/NPs acting within their specialty, or physician assistants performing the service as a delegated task under physician supervision; estheticians and cosmetologists may not operate medical lasers. There is no Nebraska laser-technician license, and the state is restrictive about delegating laser use to unlicensed personnel. |
| Nevada | Lasers, IPL and RF units are 'esthetic medical devices' that basic estheticians and cosmetologists may not use. Nonablative laser/IPL/RF treatment is an advanced esthetic (nonablative esthetic medical) procedure that a licensed advanced esthetician may perform only under the supervision of a 'health care professional' as defined at NRS 453C.030 — a physician (MD/DO), a physician assistant, or an advanced practice registered nurse (APRN); a plain RN or LPN does not qualify as the supervising health care professional for this purpose, and NRS 644A.545 imposes no 'Board-approved collaboration agreement.' The supervising health care professional must be readily available for immediate real-time consultation (phone or equivalent technology) and must remain within 60 miles or 60 minutes of the procedure location, available to render in-person care if problems arise. An advanced esthetician shall not perform any ablative esthetic medical procedure — ablative laser resurfacing is prohibited to estheticians outright (NRS 644A.545). Physicians, PAs and APRNs may operate lasers within their own licensed scope of practice, and registered nurses and LPNs may perform many laser/light procedures with laser certification, a practitioner's order and provider supervision, though certain ablative/advanced laser procedures fall outside RN and LPN scope (Nevada State Board of Nursing Practice Advisory Decision — unflagged, carried over unchanged). |
| 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. |
| New Jersey | New Jersey treats cosmetic laser/IPL and injectable procedures as medical services falling under the Board of Medical Examiners' jurisdiction. This is confirmed directly by the Board of Cosmetology and Hairstyling's own rule, N.J.A.C. 13:28-2.15(b)7, which bars its licensees (estheticians, cosmetologists, shop owners) from performing 'any service that has been determined by the [BME] to be a medical service,' expressly naming laser hair removal and injections of Botox, Restylane, or similar medications — so unlicensed technicians and estheticians may not operate cosmetic lasers or inject. Because these are medical acts, New Jersey's Medical Practice Act (N.J.S.A. 45:9-5.1, defining 'the practice of medicine' broadly to include any method of treatment of a human condition) puts them under the physician-licensure framework: a physician (MD/DO) may perform them directly, or may delegate to a physician assistant under a signed delegation agreement covering services within the supervising physician's scope (N.J.A.C. 13:35-2B.4, 13:35-2B.10). New Jersey has not adopted a laser-specific delegation rule naming which non-physician roles may operate an aesthetic laser or under what training/supervision conditions — a 2015 Board proposal (N.J.A.C. 13:35-6.14A/6.14B) that would have done exactly that, including permitting delegation to a trained RN or PA for laser/IPL and restricting filler/neuromodulator injections to physicians only, was never finalized. Absent that rule, delegation to non-physician providers for cosmetic lasers rests on the Board's general delegation-of-medical-services authority rather than a device-specific rule, so this record limits the affirmatively-supported delegate role to PAs (via the general delegation-agreement framework) alongside the physician. |
| New Mexico | Laser and energy-based skin and hair removal is expressly an 'aesthetic healthcare procedure' (16.12.14.7.A NMAC), and the use of medical therapeutic and cosmetic devices is the practice of medicine (16.10.13.8 NMAC). A face-to-face exam, diagnosis and treatment plan by an APRN or other licensed independent practitioner must precede the procedure (16.12.14.10.B). Operation may be performed by a physician, an APRN, a PA (under physician supervision), an RN (delegated and under indirect APRN supervision), or an LPN (under direct supervision) per 16.12.14.8; estheticians and unlicensed medical assistants may not operate medical lasers. |
| New York | The New York State Board for Medicine determined (March 7, 2025) that use of any energy device or laser affecting the basement membrane or deeper tissue (dermis, fat) to treat a physical condition is the practice of medicine; such treatments must be conducted by or under the order of a physician, physician assistant, or nurse practitioner, and among non-physician staff only a registered nurse (under general physician/PA/NP supervision) may execute those orders. Laser/IPL hair removal is specifically excluded and, along with other surface/epidermal Class I–IIIa devices, may be performed by trained non-licensed personnel such as estheticians (Class II–IIIa under supervision). |
| North Carolina | The NC Medical Board's position is that the revision, destruction, incision, or structural alteration of human tissue using laser technology IS surgery. Laser surgery may be performed only by a physician, or by a licensed health care professional working within their scope with appropriate training under the supervision (preferably on-site) of a physician. Before a first laser hair or tattoo-removal treatment, the patient must be examined by a physician, PA, or NP. Electrologists licensed as laser hair practitioners may perform laser hair removal (but not tattoo removal) under physician supervision. Estheticians/cosmetologists may NOT operate medical (Class 3/4) lasers. |
| North Dakota | Ablative laser procedures (that excise, vaporize, disintegrate, or remove living tissue) are the practice of medicine and are limited to physicians and delegated mid-levels; basic estheticians and cosmetologists may never use laser, light, or energy on living cells (NDCC 43-11-27.2(1)). Nonablative cosmetic laser/IPL/RF may be performed directly by physicians (MD/DO), PAs, and APRNs; by RNs under a prescriber order (nurse guidance treats selecting the device/setting as prescribing, which is outside RN scope); and by licensed advanced estheticians under a collaborative agreement with a supervising MD/PA/APRN, with a written ANSI Z136.3 laser-safety program, a designated Laser Safety Officer, and FDA-cleared devices (NDAC 32-05-01-08(d)(8), 32-03-01-10.2(3)). |
| Ohio | Applying a light-based medical device is the practice of medicine in Ohio. Ablative procedures may NOT be delegated and must be performed by a physician. A physician may delegate non-ablative vascular-laser procedures to a PA (with a supervision agreement) or to an RN/LPN who completes prescribed training, subject to on-site supervision (OAC 4731-18-02/03). Laser hair removal may be delegated to a PA, RN/LPN, or a qualified cosmetic therapist / certified laser hair removal professional under ORC 4731.33. (An APRN, being licensed as an RN, is covered by the RN delegation category.) |
| Oklahoma | There is no standalone Oklahoma laser statute or dedicated laser-operator license. The med spa guidelines classify laser and intense pulsed light procedures (hair removal, dyschromia, vascular ablation) as medical-grade treatments, so laser operation follows the same physician/patient-relationship, delegation, and supervision framework as other medical services. An MD or DO, or a supervised PA or APRN, may perform or delegate; a licensed RN may operate under general supervision, while LPNs, medical assistants, and unlicensed assistants may operate only under the physician's direct on-site supervision. Estheticians may not perform laser procedures because lasers fall within the healing arts and are outside their scope. |
| Oregon | Medical laser/light procedures are the practice of medicine and may be performed by a licensee working within their scope with appropriate education, training, and experience (physicians, osteopathic physicians, podiatric physicians, physician associates), and may fall within the scope of other providers such as NPs and RNs per their own boards. A licensee must examine the patient before treatment; non-ablative treatments may be delegated to other individuals when permitted by state law, but ablative procedures (those intended to excise, burn, or vaporize skin) are restricted to licensees. Separately, certified advanced estheticians may perform FDA-registered non-ablative device treatments under ORS 676.630(1). |
| Pennsylvania | Pennsylvania has no laser-specific statute and licenses no separate 'laser technician'; using lasers, IPL, or other energy devices for cosmetic treatment is a medical service. A physician may perform it or delegate it to a PA, CRNP, RN, or other trained delegatee where the physician determines the person has the education, training, experience and continued competency and the delegation meets acceptable-practice standards (Medical Practice Act § 17; 49 Pa. Code § 18.402). No rule requires the physician to be on site, but responsibility and availability remain the physician's. |
| Rhode Island | Medical procedures using ablative lasers or ablative energy devices (those intended to excise or vaporize the outer layer of skin, e.g., CO2 and erbium lasers) may only be performed by physicians, physician assistants, and certified nurse practitioners -- RIGL § 23-105-2(f) restricts these procedures to that specific list, does not include RNs, and does not permit further delegation. Non-ablative lasers, IPL, and similar energy-device treatments are cosmetic medical procedures that a physician may perform directly or delegate to an appropriately trained CNP or PA (per RIDOH guidance); RIDOH's scope-of-practice chart marks registered nurses 'No' for both Laser Hair Removal and Laser Tattoo Removal, so RNs are not established as authorized laser operators -- ablative or non-ablative -- under current statute or guidance. Separately, a licensed electrologist who has met the training/experience requirements of RIGL § 5-32-21 (two years of laser-hair-removal practice under a medical director's oversight plus 1,000 treatments and American Electrology Association board certification, or grandfathered pre-July 1, 2019 licensure with equivalent experience and no actionable discipline) may perform laser hair removal specifically -- and only that procedure -- without physician or medical-director supervision. |
| South Carolina | The Board of Medical Examiners treats surgery using lasers, pulsed light, and radiofrequency devices (ablative and non-ablative) as the practice of medicine; the office-based surgery regulation likewise defines 'surgery' to include the use of lasers. A physician may perform these procedures or delegate them within scope to a PA (under physician supervision, §40-47-938) or an NP (under a written practice agreement, §40-33-34); non-ablative treatments such as laser hair removal may be further delegated to an RN under the direct supervision of a physician, PA, or NP, and the patient must be examined before treatment. There is no laser-specific licensing statute — the 2023-2024 'Laser Hair Removal Act' (S.853) died in committee and was never enacted. |
| South Dakota | SDCL 36-4-8.2 defines the use of a laser or ionizing radiation to cut or otherwise alter human tissue for diagnostic, palliative, or therapeutic purposes as surgery constituting the practice of medicine. Per the 2011 South Dakota Joint Board of Nursing and Medical & Osteopathic Examiners position (referenced in the Board of Nursing's dermatological-procedures opinion), only physicians, nurse practitioners, and physician assistants may be trained to operate lasers; RNs, LPNs, and estheticians may not. (RNs may operate non-ablative, non-laser light-based/IPL devices under delegation, but not lasers.) |
| Tennessee | Any procedure within the statutory definition of the practice of medicine that is performed with a laser is itself the practice of medicine, and any person performing it must be under the supervision of a licensed physician (limited cosmetology and osteopathic exceptions apply). Tennessee does not name a specific license required to operate the device; the operative requirement is physician supervision, so a physician may perform the procedure or delegate it to a trained NP, PA, RN, or other qualified personnel under that supervision. |
| Texas | Laser hair removal is regulated by TDLR under Health & Safety Code Ch. 401, Subchapter M and 16 TAC Ch. 118: an individual must hold a laser hair removal certificate (technician/senior/professional tiers), and each facility must hold a facility certificate and maintain a written contract with a consulting physician. Cosmetic laser/IPL procedures beyond hair removal (e.g., resurfacing, tattoo removal) are the practice of medicine and must be performed or delegated by a physician to a PA/APRN/RN or other trained personnel under protocol; DSHS separately requires registration of Class 3B/4 laser devices. |
| Utah | Utah has no separate cosmetic-laser-operator license. Any procedure in which human tissue is cut or altered by laser energy or ionizing radiation is prohibited for cosmetology/esthetics licensees unless it is within their scope AND performed under the appropriate supervision of a licensed health care practitioner; FDA-classified prescription devices likewise require health-care-practitioner supervision. In practice, cosmetic laser/IPL and laser hair removal must be performed or supervised by a physician, APRN, or PA, or delegated to trained personnel (e.g., an RN) operating under that supervision. |
| Vermont | 26 V.S.A. § 4404(d) establishes a narrow rule and nothing more: the Director of the Office of Professional Regulation must adopt rules for a special license endorsement authorizing a licensed electrologist to use lasers for hair removal, conditioned on satisfactorily completing a comprehensive laser-hair-removal course. § 4403(c) confirms an electrologist may not use lasers for hair removal without first obtaining that endorsement. § 4402(3) confirms the endorsement is the only basis on which 'electrology' includes laser use at all — and only 'solely for the purpose of hair removal' with FDA-approved devices; electrology's own carve-out from the 'practice of medicine' (as defined in § 1311) otherwise covers only injections of any substance and permanent cosmetics, not lasers generally. By contrast, § 271(4)(B)(ii) confirms that esthetics/cosmetology excludes from its scope any practice constituting the practice of medicine, expressly 'including injections of any substance and the use of lasers' — i.e., estheticians and cosmetologists may never perform laser procedures of any kind. Laser use outside the narrow electrologist hair-removal endorsement therefore defaults to the practice of medicine under § 1311, performable by a physician (MD/DO) or delegated by a physician to appropriately qualified personnel (e.g., a PA, or an APRN under a collaborative-practice agreement, or an RN under direct physician delegation), consistent with the general delegation standard in 26 V.S.A. § 1354(a)(26) and (29): it is unprofessional conduct for a physician to allow a collaborating nurse practitioner to perform an act outside the physician's own scope or the NP's training, or to delegate health care services to anyone not qualified by training, experience, education, or licensure to perform them. Vermont has not adopted laser-specific delegation rules beyond this general framework — Board of Medical Practice minutes from June 2025 show the Board was still gathering dermatologist input toward possible laser-specific guidance and had not yet issued a bright-line rule on which personnel may perform which categories of medical laser procedures. The value below (MD, DO, NP, PA, RN, and electrologist limited to the hair-removal endorsement) reflects who may lawfully be involved under this general medicine/delegation framework plus the one explicit statutory carve-out; it is not itself an enumerated statutory list beyond the electrologist endorsement. |
| Virginia | By statute, laser hair removal must be performed by a physician (MD/DO), physician assistant, or advanced practice registered nurse, or by a properly trained person under the direction and supervision of one of those licensees, per Va. Code § 54.1-2973.1. The supervising provider need not be physically present but must be readily available and must personally evaluate any patient who develops complications; delegatees must complete training including at least 10 proctored patient cases under 18VAC85-20-91. Other medical lasers (e.g., resurfacing, IPL) are the practice of medicine and are delegated under the same physician/NP/PA supervision framework. |
| Washington | Use of a laser, light, radiofrequency, or plasma (LLRP) device on skin is the practice of medicine in Washington. An MD or DO (or a PA under WAC 246-918-125) may perform it or delegate it, under a written office protocol, to a properly trained and licensed professional whose licensure and scope permit LLRP use — which includes RNs and can include estheticians operating under MD/DO supervision (WAC 246-919-605). The physician must complete the pre-treatment history/exam/diagnosis/consent, be on the immediate premises during the initial treatment, and remains ultimately responsible for patient safety; the device may not be used on the eye globe. |
| West Virginia | W. Va. Code §30-3-4(3) expressly defines 'surgery' to include 'the use on humans of lasers, ionizing radiation, pulsed light and radiofrequency devices,' making cosmetic laser, IPL, and RF treatment the practice of medicine and surgery. It must be performed by a licensed physician (MD or DO) or delegated to a qualified licensed professional (APRN, PA, or RN) under physician supervision; unlicensed laser technicians and estheticians may not operate these devices because they are not licensed health care providers acting within a scope of practice. |
| Wisconsin | Laser hair removal (and intense pulsed light) is expressly a delegated medical procedure in Wisconsin: it may be performed only as directed, supervised, and inspected by a physician under formal written protocols (Cos 2.025(1),(2)(a),(3)). A physician may perform it directly or delegate it; in a licensed cosmetology establishment a licensee (aesthetician/cosmetologist) may operate the device under the delegating physician's protocols, and IPL/laser may not be used on a minor except with a parent/guardian present and under general physician supervision. |
| Wyoming | The Board of Medicine rules define 'practicing medicine' to include operating, or delegating the responsibility to operate, an FDA Class II or Class III medical device (lasers, IPL, RF) 'unless operation or authorization for operation occurs in a site under the supervision of a person licensed under this chapter' (Board of Medicine Rules Ch.1 §3(n)(vii)). So cosmetic laser/energy-device treatment must be performed or supervised by a physician (or an APRN/PA who practices medicine) and may be delegated to trained personnel (e.g., an RN) only under that physician supervision. Estheticians are expressly barred from laser (Cosmetology Rules §7(c)(ii)). |
Methodology & sources
Every entry is compiled from that state's own statutes, medical- and nursing-board rules, and official guidance, and each state page links the primary source behind its wording. Last reviewed 2026-07-21. Download the full dataset as CSV.
Citing this page? Use: MedSpa Standards, "Laser / energy devices by State for Med Spas," retrieved 2026-07-21, https://medspastandards.com/med-spa-regulations-by-state/who-can-operate-lasers
Build a compliant med spa faster
Board-ready SOPs and compliance checklists mapped to these requirements.
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.