Medical spas in Michigan

We found no Michigan statute that names who may inject Botox or fillers. The Code defines the practice of medicine as diagnosing, treating, preventing or relieving a human disease, ailment, defect or other condition "by attendance, advice, device, diagnostic test, or other means".³ A person may not practise medicine without a licence, and practising without one is a felony, except as the Code allows delegation.³⁸

A licensee may delegate selected acts to a licensed or unlicensed individual who is qualified by education, training or experience, where the acts fall within the licensee's own scope and are done under the licensee's supervision. A licensee may not delegate an act that, under accepted practice, needs the level of education, skill and judgment of the licensee. A physician may delegate an act that needs surgical instruments only to a licensed individual, with exceptions for supervised students.¹ A licensing board may by rule restrict delegation of specific acts or require closer supervision.¹

Supervision, as the Code defines it, means three things: the supervised person can always reach a licensed health professional directly, in person or by radio, phone or other telecommunication; a licensed professional is available on a regular schedule to review their practice and records; and the supervisor provides predetermined procedures and a drug protocol. Being in the room is not one of the three.² Negligent delegation or supervision is a ground for discipline.⁷

A physician assistant may practise only under a practice agreement with a participating physician, and the Board may prohibit or restrict delegation of a medical service or require higher supervision.⁹¹⁰ Nurse practitioners hold a specialty certification from the Board of Nursing, and titles such as "nurse practitioner" and "advanced practice registered nurse" are restricted.¹¹ An advanced practice registered nurse (APRN) may prescribe non-scheduled drugs; controlled substances in schedules 2 to 5 only as a delegated act of a physician.¹² We found no full practice authority provision for Michigan nurse practitioners.

We found no Michigan text that says whether registered or practical nurses may inject cosmetic toxin or filler, or whether an unlicensed medical assistant may. Ask who will inject you, what their licence is, and which licensed professional supervises them.

Michigan's laser statute names no licence. It says a licensee, a registrant or any other individual may not perform a procedure using a laser for dermatological purposes unless a licensed physician supervises it, and the patient must have knowledge of it and consent. It does not apply to a licensed physician. It does not apply to a physician's assistant or a certified nurse practitioner who performs the procedure in a health care facility.⁴ "Supervision" has the three-part meaning above, so the physician need not be present.²⁴ The practice of dermatology, the statute says, includes cosmetic conditions of the skin, hair and nails.⁴

The statute says "laser".⁴ The sources we read do not say whether intense pulsed light or radiofrequency devices are covered. Michigan has no licence or registration for the person who runs a laser that we found, and no training-hours figure appears in the sources we read.

LARA says laser use by health professionals is a medical or dental practice and the practice of medicine, and that corporations and LLCs using lasers for medical or dental services may organise only as professional corporations or professional LLCs. It cites an Attorney General opinion.¹⁵ If you are booked for a laser treatment, ask who will run the device, which physician supervises, and how that supervision works.

Michigan defines an esthetician as someone who performs or offers to perform skin care services.¹⁶

Since 2 April 2025 a licensee, registrant or other individual may not perform a medical exfoliation procedure unless a licensed physician supervises it, with the patient's knowledge and consent. The statute defines it as exfoliating skin cells in the layers of the epidermis below the stratum corneum by dermaplaning or microdermabrasion. It does not apply to a physician.⁵ The legislature's summary line for the bill that added the section reads "certain esthetician and cosmetologist services; exempt from the practice of medicine and osteopathic medicine and surgery". The enacted section as we read it requires supervision, and we could not reconcile the two.⁵⁶

We found no Michigan statute on microneedling or chemical peels in the sources we read. Ask who will do the treatment, what their licence is, and whether a physician supervises it.

We found no Michigan Board of Pharmacy or Board of Medicine statement on semaglutide or tirzepatide. Physician's assistants prescribe under a practice agreement.⁹ APRNs may prescribe non-scheduled drugs on their own and controlled substances in schedules 2 to 5 only as a delegated act of a physician, with both names on the prescription.¹² Ask whether your medicine is FDA-approved or compounded, and which pharmacy prepares it.

We found no Michigan statute, rule, board statement or Attorney General opinion on IV hydration. The general rules above apply to any treatment: the practice of medicine needs a licence, and a licensee may delegate selected acts under supervision.¹³ Ask who ordered the drip, who evaluated you, and who will place the IV.

We found no Michigan statute that creates a med spa licence or registry, or that requires or defines a medical director. The Code speaks of the licensee who delegates and the supervision they provide.¹²

On ownership, a professional corporation that provides a service under the Public Health Code must have only shareholders licensed or legally authorised in Michigan to provide the same service. A professional LLC that provides such a service must have only members and managers so licensed.¹³¹⁴ Physicians and physician's assistants may organise together, subject to the physician's assistant provisions.¹⁰ Whether a nurse practitioner may own such an entity is not settled by the sections we read. The Code also makes dividing fees for referrals, and accepting kickbacks, a ground for discipline, and false or misleading advertising another.⁷

Michigan licenses body art facilities, defined as places where tattooing, branding or body piercing is done, under Part 131 of the Public Health Code.¹⁷ We do not know whether permanent makeup done in a medical office is exempt or whether individual artists need a licence.