Medical spas in Nevada

Two Nevada statutes use the same list. A person may inject a botulinum neuromodulator (Botox-type) or a dermal filler only if they are a physician or physician assistant, a dentist or podiatrist who has completed Board-prescribed training, or a registered nurse or advanced practice registered nurse (APRN), and only within their scope of practice.¹² Licensed practical nurses, medical assistants and estheticians are not on the list. A person who may inject may not delegate the injection to someone who is not on it.¹² Breaking the filler rule is a misdemeanor.²

The statutes also say where. Injection is allowed only at a medical facility, which is a listed type of licensed facility such as a hospital, surgical centre or rural clinic, or at the office of a physician, physician assistant, dentist, APRN or podiatrist.¹²³ A med spa is not on the medical facility list. Whether a med spa owned by someone else, with a physician as its "medical director", counts as the office of a physician is not settled by anything we read.

The Nevada Board of Nursing's practice decision on aesthetic procedures says an RN needs an order from a qualified practitioner who has assessed the patient and established a patient relationship, and that only a qualified practitioner may control and provide access to the drugs. It marks neuromodulators and fillers as not within scope for licensed practical nurses.⁴

The Nevada Board of Osteopathic Medicine's 2019 information sheet takes a position on this. It says a business owned by someone with no medical licence that employs osteopathic physicians, physician assistants and nurses is a medical practice for the doctor or assistant who works there, and that every patient must first be examined by the physician or assistant.⁹ It is the Board's statement, not a rule, and we found no equivalent statement from the Medical Board.

Medical assistants work for a physician or physician assistant, and the rule requires the delegating practitioner to be immediately available in person when a medical assistant is given a task that involves an invasive procedure.⁶ They are not on the injection lists.¹²

We found no Nevada licence, certificate or facility registration for cosmetic lasers or IPL devices. Who may use one depends on the person.

Cosmetologists and basic estheticians may not use lasers or other esthetic medical devices.⁷ Nevada has a separate licence, the advanced esthetician, who may do nonablative procedures with lasers, intense pulsed light, radiofrequency, ultrasound, cryotherapy and plasma devices, but not ablative ones.⁷⁸ An advanced esthetician may work only in a cosmetology establishment licensed for advanced esthetics, under a collaboration agreement approved by the Cosmetology Board, with a physician, physician assistant or APRN who stays within 60 miles or 60 minutes. A registered nurse does not satisfy that supervision requirement.⁷⁸

For nurses, the Board of Nursing's decision lists non-ablative laser hair removal and IPL for both RNs and LPNs, with the supervising practitioner available and laser certification.⁴ Whether a medical assistant may run a laser is not addressed in anything we read.

Nevada law treats microneedling and medium-depth chemical peels as advanced esthetic work, done for esthetic purposes and not to treat a medical ailment.⁷ Basic estheticians do cleansing, extraction and exfoliation that does not go below the surface layer of skin.⁷ Ask who will perform your treatment and what their licence is.

We found no Nevada statute on IV hydration or drip bars. The Board of Nursing's decision says an RN, or an LPN with an approved IV course, may give IV solutions out of hospital on an order from a practitioner who has assessed the patient first, and that only a qualified practitioner may control and provide access to the solutions.⁵ The Board of Osteopathic Medicine's sheet lists a "hangover clinic (IV Therapy)" among businesses it treats as a medical practice.⁹

On 2 June 2025, the Nevada Board of Pharmacy told pharmacies to stop compounding, distributing and dispensing compounded tirzepatide and semaglutide injections, and reminded pharmacies that they may not sell compounded medications to practitioners.¹⁰ The notice is addressed to pharmacies. It does not say what a clinic may obtain elsewhere.

A practitioner who charges a patient for a drug dispensed from the office needs a certificate from the Board of Pharmacy and must issue a written prescription.¹¹ Ask whether your medicine is FDA-approved or compounded, and which pharmacy prepares it.

We found no Nevada statute or rule that creates a "medical director" position or licenses med spas. The Board of Osteopathic Medicine's 2019 sheet says the same of the title.⁹ Nevada law lets a professional entity render a professional service only through its officers, managers and employees who are licensed.¹²

The Medical Board has drafted proposals for the 2027 session that would create a med spa registry listing each spa's medical director, to take effect on 1 January 2028. It is a draft in a board packet, not a bill and not law.¹³