✨ Aesthetic / Medical Spa · Virginia
Virginia: medical director and delegated services for an aesthetic or medical spa
Whether Virginia requires a physician medical director for an aesthetic or medical spa, the qualifications, duties, and what the state says about the staff who deliver protocol-driven services.
Notes
Virginia has no medical-spa-specific statute naming a 'medical director' or similar title. Cosmetic/aesthetic procedures are governed by the same general medical-practice delegation and supervision statutes as any other delegated medical act (Va. Code §§ 54.1-2900-2902, 54.1-2901, 54.1-3408; laser hair removal specifically under § 54.1-2973.1 and 18VAC85-20-91 — see the `esthetician` provider entry above). Flagged because compliance vendors often market a Virginia-specific med-spa medical-director requirement that current statute doesn't separately impose.
Sources (1)
- Va. Code §§ 54.1-2900, 54.1-2901, 54.1-2902, 54.1-3408; § 54.1-2973.1; 18VAC85-20-91
Delegated services in this practice type
Business ownership and clinical authority are separate questions in this practice type. What the state says about the staff who deliver the services.
Registered Nurses
RNs (general licensure, not an APRN) are not subject to a physician-supervision or collaborative-practice-agreement requirement in Virginia. § 54.1-3000 defines 'professional nursing' (RN) with no physician supervision/collaboration language, in explicit contrast to 'practical nursing' (LPN), which the statute defines as performed 'under the direction or supervision of a licensed medical practitioner, a professional nurse... or other licensed health professional.' Current Board of Nursing regs (18VAC90-19, successor to repealed 18VAC90-20) likewise impose supervision only on LPNs, not RNs.
For medical-aesthetics (med-spa) businesses performing delegated medical procedures such as Botox or laser, RN ownership of the entity does not remove the requirement for physician delegation and oversight of the procedures themselves; ownership and clinical delegation authority are separate questions. The delegation regulation commonly cited for laser is 18VAC85-20-91; confirm it before relying on it.
Estheticians
Licensed estheticians/master estheticians (Va. Code Title 54.1 Ch. 7; 18VAC41-70) practice independently within their scope — master estheticians additionally perform chemical exfoliation and microdermabrasion. No physician involvement required. § 54.1-700 defines 'esthetics' as 'nonlaser' devices only and excludes any practice of medicine — laser/IPL is excluded by statute itself, not merely supervision-gated. Physician-delegated laser hair removal (18VAC85-20-91) is performed under the Board of Medicine's delegation authority, not under the cosmetology license — the esthetics license never confers laser authority.
Business ownership and clinical-procedure authority are separate questions.
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