Frequently Asked Questions

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Frequently Asked Questions

Cosmetic Treatments

Who may use lasers or intense pulse light devices to remove hair, spider veins and tattoos?

Physicians may use lasers or intense pulse light devices to remove hair, spider veins, and tattoos. In addition, physician assistants and registered nurses (not licensed vocational nurses) may use lasers or intense pulse light devices to perform these procedures under a physician's supervision. Unlicensed medical assistants, licensed vocational nurses, cosmetologists, electrologists, or estheticians may not legally perform these treatments under any circumstances, nor may registered nurses or physician assistants, without supervision of a physician.

Who may inject Botox?

Physicians may inject Botox, or they may direct registered nurses or physician assistants to perform the injection under their supervision. No unlicensed persons, such as medical assistants, may inject Botox.

I've been approached by a nurse to be her "sponsoring physician" for her laser and Botox practice, would that be legal?

No, it is not legal to be a “sponsoring physician, nor is there such a thing as a "sponsoring physician." Nurses may not, under California law, employ or contract with a physician for supervision. A nurse may not have a private practice without supervision. While the laws governing nursing recognize "the existence of overlapping functions between physicians and registered nurses" and permit "additional sharing of functions within organized health care systems that provide for collaboration between physicians and registered nurses", nurses only may perform medical functions under "standardized procedures." The Board does not believe this allows a nurse to have a private medical cosmetic practice without any physician supervision. (Business and Professions Code section 2725).

I've been asked by a layperson to serve as "medical director" for a "medi-spa" that provides laser and other cosmetic medical services; would that be legal?

No, it is not legal serve as a “medical director” for a “medi-spa” for a layperson. If a person is not a licensed physician, he or she cannot legally offer or provide medical services. A physician contracting with, or acting as, an employee of a lay-owned business would be aiding and abetting the unlicensed practice of medicine. To offer or provide laser and other cosmetic medical services, the business must be a physician-owned medical practice or professional medical corporation with a physician being the majority shareholder. (Business and Professions Code section 2052, 2264, 2286, and 2400.)

Are "Botox Parties" illegal?

The law does not restrict where Botox treatments may be performed, as long as they are performed by a physician or by a registered nurse or physician assistant under a physician's supervision.

Who may perform microdermabrasion?

If the microdermabrasion is a cosmetic treatment and only affects the outermost layer of the skin or the stratum corneum, then a licensed cosmetician or esthetician may perform the treatment. If the microdermabrasion is a medical treatment, penetrating to deeper levels of the epidermis, then the treatment must be performed by a physician, or by a registered nurse or physician assistant under supervision. Treatments to remove scarring, blemishes, or wrinkles would be considered a medical treatment. Unlicensed personnel, including medical assistants, may not perform any type of microdermabrasion.

Can a physician hire an esthetician to perform non-medical dermabrasion, cosmetic facials, and skin treatments?

Yes, a physician can hire a licensed esthetician to perform non-medical dermabrasion, cosmetic facials, and skin treatments.The esthetician must have obtained an Establishment License from the California Board of Barbering and Cosmetology. All licensed cosmetologists, including estheticians, must perform their services in a licensed establishment.

Why can't I use a medical assistant instead of a nurse?

Medical assistants are not licensed professionals. . They are not required to have a degree, pass an examination, or be licensed. For these reasons, the law only allows medical assistants to perform technical supportive services as described in sections 2069-2071 of the Business and Professions Code, and Title 16, California Code of Regulations, sections 1366-1366.4.

What is the penalty if I get caught using, or helping, an unlicensed person to perform a medical treatment?

Physicians could be charged with aiding and abetting unlicensed practice, and the unlicensed person could be charged with the unlicensed practice of medicine. In addition, to a number of other sanctions,including, but not limited to, license discipline and criminal prosecution.

What can I do if I see advertisements for illegal practices?

You may file a complaint with the Board. The complaint shall include: the advertisement, the publication name and date, and your address and telephone number where you may be contacted for further information. The material shall be mailed to the Board’s Central Complaint Unit at 2005 Evergreen Street, Sacramento, CA 95815. The Board will contact the business, inform them of the law, and direct them to cease any illegal practice. If it is simply the advertisement that is misleading, they will be directed to change or clarify the ad.

For additional information, you may want to consult with your attorney or malpractice carrier. In addition, the Board has a number of written materials with more thorough information on cosmetic treatments. To request any of these materials, please contact the Medical Board of California, 2005 Evergreen Street, Sacramento, CA 95815, or call (916) 263-2389.