Medical Spa Requirements In Texas

Ever wondered why opening a medical spa in Texas feels more complicated than in other states? You’re not imagining it. Texas has unique legal and regulatory hoops for anyone looking to start or run a med spa. These rules don’t just apply to doctors. They affect business owners, nurses, estheticians, and even marketers.

Medical spas combine cosmetic procedures with clinical oversight. Think Botox, laser treatments, or IV therapy — often done in a setting that looks more like a boutique than a doctor’s office. But here’s the catch: because these involve medical procedures, they fall under the Texas Medical Board’s jurisdiction.

So, if you're planning to open a med spa or already run one in Texas, there’s no room for guesswork. Let's clear up the confusion once and for all.

Medical Spa Requirements In Texas

When it comes to regulations, Texas doesn’t cut corners. Medical spas must meet medical standards, not just spa standards. That changes everything.

Here’s what you must have in place:

• Medical Director: A licensed physician must supervise all medical procedures. That includes Botox, fillers, microneedling with PRP, and laser treatments.
  
  
• Proper Licensure: Even if your spa doesn’t look like a clinic, it still performs clinical services. That means all medical staff need proper licenses — RN, NP, PA, or MD.
  
  
• Facility Guidelines: Your location must comply with OSHA standards. Think sanitation, sharps disposal, and infection control.
  
  
• Texas Medical Board Oversight: The Board actively audits med spas. If you’re not in compliance, expect penalties.
  
  

The takeaway? Every procedure involving skin penetration, prescription drugs, or medical advice needs medical oversight.

Staffing Rules and Provider Qualifications

Not everyone can poke a needle in someone’s face — at least not legally.

So, who can perform medical spa treatments in Texas?

• Only licensed healthcare professionals. That means:
  
  
• Physicians (MD or DO)
  
  
• Nurse Practitioners (NP) with delegation
  
  
• Physician Assistants (PA)
  
  
• Registered Nurses (RN), under supervision
  
  
• Licensed Vocational Nurses (LVN) can assist, but not independently treat
  
  

Estheticians and cosmetologists? They can perform facials or waxing, but not injectables, laser procedures, or microneedling that penetrates the skin.

What’s more, physicians must delegate procedures to qualified staff and remain involved. They can’t just sign a paper and vanish. The Texas Medical Board requires real supervision — even if it’s remote through telemedicine.

Training is another key piece. Even if someone holds a license, they must be trained in the specific treatment. That includes device certifications and CEUs for ongoing education.

Ownership and Business Structure Rules

Thinking about investing in a med spa if you’re not a doctor? Better pump the brakes.

Texas follows the Corporate Practice of Medicine Doctrine, which means only doctors can own and profit from medical practices.

So here’s how you can work around it — legally:

• MSO Model (Management Services Organization): Non-physicians can run the business side — marketing, HR, leasing — through an MSO. But the medical part must remain in the hands of a physician.
  
  
• Professional Association (PA) or Professional Corporation (PC): Only licensed physicians can form these entities and bill for medical services.
  
  
• Written Agreements: MSOs need formal contracts with the physician practice. That includes service fees, roles, and decision-making boundaries.
  
  

This setup lets entrepreneurs partner with doctors without crossing legal lines.

Record Keeping, Safety, and Liability Compliance

No one wants a lawsuit or a surprise audit. But if your records are a mess or you cut corners on safety, that’s exactly what you’ll get.

Here’s what you need to check:

• Medical Records: Keep complete documentation of every procedure, consent form, and patient visit. Texas requires retention for at least 7 years.
  
  
• Consent Forms: These must be signed before treatment. They should list risks, alternatives, and physician oversight.
  
  
• Malpractice Insurance: Every provider — from MDs to NPs — should carry insurance. It’s not legally required, but skipping it is a risky move.
  
  
• Infection Control Protocols: Follow CDC and OSHA standards. That means gloves, sterilized tools, and clearly labeled sharps disposal containers.
  
  

This isn’t just about avoiding lawsuits. It’s about patient trust and professional credibility.

Marketing and Patient Consent Laws

Think you can advertise Botox specials on Instagram without oversight? Think again.

Texas medical spa marketing laws are strict. Here’s how to stay clean:

• No misleading claims: Ads must be honest. You can’t say something is “FDA-approved” unless it truly is — and for that exact use.
  
  
• Name Disclosure: The supervising physician’s name and license must be easily found on your website and materials.
  
  
• No Before-and-After Tricks: If you use photos, they need to reflect actual patients or clearly say they’re not.
  
  
• Consent Procedures: Patients must get a full explanation before treatment. That includes side effects, downtime, and expected outcomes.
  
  

And remember — no procedure should happen without physician delegation. Period.

Consequences of Non-Compliance

Breaking the rules in Texas isn't just a slap on the wrist.

Here’s what could happen if you cut corners:

• Hefty fines: The Texas Medical Board can issue penalties in the thousands.
  
  
• Loss of license: Providers who act beyond their scope may lose their licenses permanently.
  
  
• Criminal charges: Practicing medicine without a license is a felony in Texas.
  
  
• Civil lawsuits: Patients injured from unqualified treatments can sue for damages.
  
  

You don’t want to be the test case for what happens when a med spa ignores the law. Keep it legal, and you keep your business alive.

Frequently Asked Questions

Can a nurse open a medical spa in Texas?
No. Only physicians can own the medical side of a med spa. Nurses can be part of the business through an MSO but not own the medical practice itself.

Do I need a doctor on-site at all times?
Not necessarily, but a licensed physician must supervise and be accessible. Telemedicine counts, but proper delegation must be documented.

Can estheticians do Botox in Texas?
No. Only licensed medical professionals like nurses or PAs under a doctor’s supervision can administer Botox.

Are there specific licenses for med spas in Texas?
Not a separate “med spa” license, but all providers must hold proper medical licenses, and the business must meet healthcare standards.

What’s the penalty for operating without a licensed physician?
You could face fines, criminal charges, and have your business shut down.

Can I advertise laser hair removal if I’m not a doctor?
You can only advertise it if a licensed physician supervises the procedure and delegation is documented. Misleading ads may trigger legal action.

Conclusion

Opening a med spa in Texas sounds exciting — and it can be. But it’s not a free-for-all. From physician supervision to tight advertising rules, Texas expects med spas to meet medical clinic standards.

Cut corners, and you risk everything. But if you understand the laws, partner with qualified professionals, and stay compliant, you’re setting yourself up for long-term success.

Want to dive deeper into legal specifics? You can read directly from the Texas Medical Board's official guidelines here.

Stick to the rules, and you’re not just staying legal — you’re building trust.