California Has Strict Laws Regarding Laser Treatments and Injectables

Brian Lett
By Brian Lett
8 Min Read

California Has Strict Laws Regarding Laser Treatments and Injectables

After numerous patients reported suffering burns, scarring, and other adverse side effects from aesthetic laser and injection procedures performed at medical spas, certain states began cracking down on such practices.

California is one of the states with stringent restrictions regarding who may fire lasers into a medispa. Usually, only doctors, nurses or physician assistants can do this.


California law considers any form of laser treatment without physician supervision illegal and only licensed physicians can practice medicine – non-ablative laser treatments may be performed by nurses or health care professionals without direct physician oversight; for more serious procedures however a licensed physician must be present at all times and supervise. Patients must be properly informed about all risks and benefits before making their decision to undergo any procedure.

Before performing Botox or dermal filler services at a med spa, patients must first be examined by either a physician, physician assistant, or advanced nurse practitioner. A physician must perform a physical and comprehensive evaluation, consult medical records, provide written prescription, as well as address any complications from procedures performed on them.

Unregulated medical spa procedures have been linked to painful and even life-threatening consequences. Some of the worst injuries involve illegal silicone injections not approved by FDA which have resulted in disfigurement, pain and even death for some victims.

Although some states regulate medical spas, others don’t. Alabama state-licensed physicians alone may own medical spas without legal recourse; any time one acts as medical director for a non-physician owned business it constitutes unlicensed practice of medicine and could face penalties under Stark law and anti-kickback statute.

Optometrists in California have thus been restricted to performing only certain cosmetic procedures within their scope of practice, including blepharoplasty (eyelid surgery), removal of skin tags and cysts and laser treatment for glaucoma such as selective laser trabeculoplasty or peripheral iridotomy. Optometrists who wish to offer additional services must obtain permission from the state Board of Optometry before undertaking them, along with attending training on laser use. AB 1548 would increase fines and jail time against those engaging in engaging in any unauthorized practice of medicine at medical spas or clinics.


Medi-spas are known for providing popular services like laser hair removal, vein and tattoo removal, microdermabrasion and Botox injections – though when offering these treatments they must adhere to stringent safety regulations. California state laws restrict laser procedures to licensed physicians or those under their direct supervision, with aestheticians or employees licensed as estheticians permitted only to administer injectable treatments like Botox or fillers without firing aesthetic lasers. Whoever violates this rule violates California law and could face severe repercussions. Recently, the California Occupational Safety and Health Standards Board adjusted their regulations in accordance with Gov. Gavin Newsom’s wider state guidelines, in order to safeguard workers and permit their return without restrictions or hindrances.


California law sets forth several rules and regulations when using laser treatments and injectables, to protect both patients and medical professionals alike, while also helping prevent malpractice claims against doctors. Physicians providing laser or injectable treatments or services must be properly trained in accordance with relevant procedures; additionally they should also be licensed within their field of practice and provide adequate information before performing procedures on patients.

Laser hair removal is a popular service offered at medi-spas, but under California law only a licensed physician or someone working under their direct supervision may perform these services. Physicians must assess each patient prior to beginning laser therapy treatment sessions while their supervisor must also be present during each laser procedure session.

If a physician isn’t present, then those operating the laser must either be PAs with board approved additional duties or nurses with protocol agreements who hold either a class 3b or 4 laser license and possess an established operating criterion and approved training programs.

Physicians looking to delegate these responsibilities must first devise standardized procedures that allow nurses to carry out treatment under their direct supervision. Furthermore, they should document each nurse’s experience, training and education requirements as well as any training they received regarding infection control or patient assessment.

Physicians must exercise great caution in assigning tasks to their staff as this could leave them open to malpractice claims. For instance, an untrained nurse could cause burns that lead to a patient filing a suit against the physician who could face investigation and potentially have their license revoked.

The California Medical Board is investigating Med Spas that specialize in cosmetic services like Botox and fillers, with the possibility of creating a regulatory body to oversee these companies. Physicians looking to open one must hire an attorney specializing in medical licensing to make sure they abide by all necessary regulations.


Laser treatments and injections can be costly. Even simple procedures like laser hair removal may cost as much as $389 in San Francisco alone; prices will likely vary depending on where you reside. Therefore, it’s crucial to find a medical spa with competitive pricing and comprehensive services available.

Make sure your practitioner is licensed within their profession. A valid license indicates they have undergone intensive training and possess experience performing the procedure you seek. When researching options, visit several locations before making your choice.

Another thing to keep in mind when choosing a medi-spa is its location. California only permits licensed physicians to perform laser procedures, and even then they must remain present during each procedure. If you are interested in laser hair removal, make sure that there is a center near either your home or place of employment so that visits can occur more regularly.

Wyoming does not restrict the corporate practice of medicine and allows non-physician owners to run medical spas; however, they must still abide by stringent rules and regulations when providing services – any violation could incur fines or even jail time.

At one time, it was commonplace for unlicensed individuals to offer laser and injectable treatments at med spas. As this industry has expanded and become more prevalent, states have started regulating who can perform these types of procedures – currently nine states allow optometrists to perform laser procedures while 22 allow optometrists use injections for small procedures like lesion removals.

Notably, while physicians can delegate the use of ablative lasers to nurses under direct supervision from them, it remains imperative for each physician to complete initial reviews and authorize treatment plans before performing procedures on any patient; as well as document examinations in each chart prior to commencing procedures.

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