Laser hair removal regulations by state

Some states have taken a position on who can and cannot perform laser hair removal. This is usually determined by each state’s state medical board, and in some cases by other professional boards. States without listed regulation have not been confirmed at the time of this writing.

Please note that this is not medical or legal advice. All information below is subject to change and may contain inaccuracies. You are responsible for confirming the most up-to-date version of your state’s laws.

Alabama

Chapter 540-X-11. Guidelines for the Use of Lasers and Other Modalities Affecting Living Tissue.

Designates Mid-Level Practitioners, Level 1 Delegates, and Level 2 Delegates; categorizes treatments as ablative or nonablative; defines energy source, direct physician supervision, and on-site supervision.

540-X-11-.03 Use of Lasers and Other Modalities Affecting Living Tissue in the Practice of Medicine.

(1) The use of lasers/pulsed light devices, or other energy source, chemical, or modality that affects living tissue, for the purpose of treating a physical disease, disorder, deformity or injury shall constitute the practice of medicine pursuant to Ala. Code §34-24-50.

(2) The use of lasers/pulsed light devices for non-ablative procedures cannot be delegated to Level 2 Delegates without the delegating/supervising physician being on-site and immediately available.

(3) The use of lasers/pulsed light devices or other energy devices for ablative procedures may only be performed by a physician.

(4) Electrocautery may be used by a Level 1 or Level 2 delegate under direct physician supervision.

Establishes guidelines on minimum education requirements for physicians and delegates, quality assurance, equipment safety, mandatory injury reporting, physician registration, and safe use of lasers

540-X-11-.05 Supervision.

Supervision by the delegating physician shall be considered adequate for purposes of this section if the physician is in compliance with this section and the physician:

(1) Ensures that patients are adequately informed and, prior to treatment, have signed consent forms that outline reasonably foreseeable side effects and complications which may result from the non-ablative treatment;

(2) Is responsible for the formulation or approval of a written protocol which meets the requirements of these rules and is responsible for any patient-specific deviation from the protocol;

(3) Reviews and signs, at least annually, the written protocol and any patient specific deviations from the protocol regarding care provided to a patient under the protocol on a schedule defined in the written protocol;

(4) Receives, on a schedule defined in the written protocol, a periodic status report on the patient, including any problems or complications encountered;

(5) Remains on-site for non-ablative treatments performed by delegates consistent with these rules and is immediately available for consultation, assistance and direction;

(6) Personally attends to, evaluates, and treats complications that arise; and

(7) Evaluates the technical skills of the delegate performing nonablative treatment by documenting and reviewing at least quarterly the delegate’s ability to perform the following:

(a) To properly operate the devices and provide safe and effective care; and

(b) To respond appropriately to complications and untoward effects of the procedures.

Alaska

Guidelines As To Who May Perform Laser Surgery

The Alaska State Medical Board has adopted the policies of the American Medical Association, following, to be its guidelines to its licensees in Alaska with regard to who may perform laser surgery. Performance of Laser Surgery American Medical Association’s Policy H-475.989, Laser Surgery, reads: “Laser surgery should be performed only by practitioners licensed to practice medicine and surgery or by those categories of practitioners currently licensed by the state to perform surgical activities.” American Medical Association’s Policy H-475.988, Laser Surgery, reads: “The board opines that revision, destruction, incision or other structural alteration of human tissue using laser is surgery.” Adopted January 16, 2004

Guideline For Physicians In Delegating Procedures To Non-Physician Personnel When Performing Certain Dermatological Procedures.

“Under the appropriate circumstances, a physician may delegate certain procedures to certified, licensed, non-physician office personnel e.g., nurse, physician assistants, or certified medical assistants). Specifically, the physician must directly supervise the non- physician office personnel to protect the best interest and welfare of each patient. The supervising physician shall be physically present on-site, immediately available, and able to respond promptly to any question or problem that may occur while the procedure is being performed. It is the physician’s obligation to insure that, with respect to each procedure performed, the non-physician office personnel possess the proper training in cutaneous medicine, the indications for the procedure, and the pre- and post-operative care involved.” Adopted January 16, 2004

Arizona

Arizona Admin. Code Article 14

R12-1-1440. Medical Lasers

Class 3 and Class 4 laser products used in the practice of medicine must have a means for measuring the level of laser radiation within specified range of error and a guard mechanism on the switch to control patient exposure and prevent inadvertent exposure.

Must calibrate a laser according to the manufacturer’s specified calibration procedure, at intervals that do not exceed those specified by the manufacturer.

In a medical facility where several medical disciplines or a number of different practitioners use Class 3b and Class 4 lasers, a Laser Safety Committee must be formed to govern laser activity, establish use criteria, and approve operating procedures.

For Class 3b and Class 4 lasers, a Physician must also establish a written laser safety training program.

R12-1-1438. Hair Removal and Other Cosmetic Procedures Using Laser and Intense Pulsed Light

Requires “registration of any medical laser or IPL device that is a Class II surgical device, certified as complying with the labeling standards in 21 CFR 801.109”

Registrant must “ensure that the device is only used by a licensed practitioner or an operator who is working under the direct supervision of a licensed practitioner, or at minimum, an operator who is working under the indirect supervision of a licensed practitioner.”

“Ensure that a licensed practitioner purchases or orders the Class II surgical device that will be used for hair removal procedures.”

A.R.S. R4-16-301 through 303 provides for a Supervising physician to delegate specific Medical procedures to a medical assistant Consistent with the CAAHEP Standards for An Accredited Educational Program for the Medical Assistant.

R12-1-1438. Hair Removal and Other Cosmetic Procedures Using Laser and Intense Pulsed Light

A registrant must “[n]ot permit an individual to use a medical laser or IPL device for hair removal procedures unless the individual completes an approved operator didactic training program of at least 40 hours duration; is directly supervised for at least 24 hours on the job by a licensed practitioner; and performs or assists in at least 10 hair removal procedures. The individual shall obtain this hands-on experience under the direct supervision of a licensed practitioner

A registrant must ensure that the operator follows written procedure protocols established by a licensed practitioner; ensure that the operator follows any written order issued by a licensed practitioner, which describes the specific site of hair removal; maintain a record of each hair removal procedure protocol , maintain each procedure protocol onsite, and ensure that the protocol contains instructions for the patient concerning follow-up monitoring; design each protocol to promote the exercise of professional judgement by the operator “commensurate with the individual’s education, experience, and training.”; require that a licensed practitioner observe the performance of each operator during actual procedures at intervals that do not exceed six months, maintain a record of the observation, verify that a licensed practitioner is qualified to perform hair removal procedures, and provide radiation safety training.

Arkansas

Regulation No. 22. Laser Surgery Guidelines

Pursuant to Ark. Code Ann. 17-95-202, the practice of medicine involves the use of surgery for the diagnosing and treatment of human disease, ailment, injury, deformity, or other physical conditions. Surgery is further defined by this Board as any procedure in which human tissue is cut, altered, or otherwise infiltrated by mechanical means, to include the use of lasers. The Board further finds that the use of medical lasers on human beings, for therapeutic or cosmetic lasers, constitutes the practice of medicine. Adopted 6/5/1998; Amended 6/2/2005

http://www.armedicalboard.org/Professionals/pdf/MPA.pdf

Arkansas statutes 17-105 to 111 governs the delegation of health care services to a physician assistant.

Physician assistants may perform those duties and responsibilities, including the prescribing, ordering, and administering drugs and medical devices that are delegated by their supervising physician. Supervision shall be continuous, but does not require the physical presence of the supervising physician at the time and place that the services are rendered.

California

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. In addition, physician assistants and registered nurses (not licensed vocational nurses) may perform these treatments under a physician’s supervision. Unlicensed medical assistants, licensed vocational nurses, cosmetologists, electrologists, or estheticians may not legally perform these treatments under any circumstance, nor may registered nurses or physician assistants perform them independently, without supervision.

Source: http://www.mbc.ca.gov/Licensees/Cosmetic_Treatments_FAQ.aspx

Are medical assistants allowed to use lasers to remove hair, wrinkles, scars, moles or other blemishes?

No. Medical assistants are not legally authorized to use lasers to remove hair, wrinkles, scars, moles, or other blemishes.

Source: http://www.mbc.ca.gov/Licensees/Physicians_and_Surgeons/Medical_Assistants/Medical_Assistants_FAQ.aspx

Colorado

Supervision – of a physician who does not have to be on site. The physician must live within the community which he is supervising. A non-medical professional or entrepreneur may own the clinic. Colorado follows the 2017 revised 2017 Rule 800 which governs the delegation responsibilities of a physician. Colorado residents must have a Aesthetician or Cosmetologist license, or be a licensed medical professional to attend laser training.

It is Board policy that the use of lasers for patient care constitutes the practice of medicine. The Board adopted a policy statement in November 1997 that lasers must be used by a Colorado licensed physician or under the direct and on-site supervision of a Colorado licensed physician. The Board expressed its intent that this be an employer/employee relationship such that the physician has direct control of the unlicensed person. Medical Devices and Esthetic Practices http://www.dora.state.co.us/barbers_cosmetologists/news/MedicalDevices.pdf

Ultrasound and Laser. In order for either the cosmetologist or cosmetician to work deeper than the dead skin cell layer (stratum corneum) of the skin, they must be under the supervision of a physician. Ultra sound, laser and the different pulse light therapies may not be performed without the supervision of a physician. Neither license allows any type of cutting or use of electricity or any other means to remove warts, tags, etc. No one in the cosmetology field may practice on any person having an ailment or condition that would create any cuts, sores or rashes that result in openings in the skin.

Colorado Office of Barber and Cosmetology Licensure: Laws, Rules and Policies

Colorado Medical Board: Laws, Rules and Policies

Colorado Rule 800

Connecticut

In December 1997, and confirmed in March 1998, the Board issued a Declaratory Ruling on Use of Lasers for Hair Removal. The Board ruled that a licensed physician with appropriate knowledge, experience and training should assess each patient prior to and during the course of hair removal treatment with laser therapy. Such physicians may delegate the operation of the laser for hair removal to a licensed physician assistant, registered nurse, or licensed practical nurse, who may render service under the supervision, control and responsibility of a licensed physician, provided the assessment of each patient is performed by the physician. The physician shall provide direct on-site supervision in the course of hair removal with laser therapy.

Connecticut Medical Examining Board Declaratory Ruling (PDF)

The Board has determined that the use of lasers for hair removal is not within the scope of practice for chiropractors in Connecticut.

Not within scope of chiropractic practice (PDF)

Delaware

16.0 Health and Sanitation; Electric Nail Files and Laser Technology

16.4 The use of laser technology for hair removal is not work generally or usually performed by cosmetologists and is prohibited.

16.5 Violation of any of the regulations, standards or prohibitions established under this Rule shall constitute a grounds for discipline under 24 Del.C. §5113 (24 Del.C. §§5100, 5101(4), 5112 and 5113)

In 1700 Board of Medical Practice, Section 2l.1.1 states that a physician who delegates medical responsibility to a non-physician is responsible for that person’s activities and must provide adequate supervision. No function may be delegated to a non-physician who is prohibited by statute or regulation from performing that function. Direct and indirect supervision are defined. Physicians who choose to have their patients followed by a non-physician must personally evaluate any patient at least every three months.

District of Columbia

1.2. Aesthetic medical procedures shall be classified as Level II and Level III procedures, as determined by the Board from time to time, including those medical procedures listed in §§ 1.3 and 1.4.

1.3 Level II procedures include, but are not limited to, procedures meeting the definition of Level II procedures, as defined in § 1.19, involving:

(a) Laser-based devices, such as:
(1) Non-ablative, non-vaporizing lasers for hair removal, only; or
(2) Non-ablative, non-vaporizing lasers for the treatment of skin;

(b) Light-based devices, such as:
(1) Light-emitting diodes;
(2) Intense pulsed light therapy for hair removal; and
(3) Intense pulsed light therapy for the treatment of skin;

Policy No. 15-02 (2014) District of Columbia Board of Medicine Policy on the Practice of Aesthetic Medicine

Florida

 

64B8-56.002 Equipment and Devices; Protocols for Laser and Light-Based Devices.

(1) The Board of Medicine approves the following equipment and devices for the permanent removal of hair by licensed electrologists if they are used pursuant to requirements established by the Board.

(a) Needle type epilators.

(b) Laser and light-based hair removal or reduction devices cleared by the United States Food and Drug Administration (FDA) for hair removal or reduction.

(2) An electrologist may not use laser or light-based devices for hair removal or reduction unless they:

(a) Have completed training in laser and light-based hair removal and reduction that meets the requirements set forth in subsections 64B8-52.004(2) and (3), F.A.C.;

(b) Have passed the Society for Clinical and Medical Hair Removal test for certification as a Certified Medical Electrologist;

(c) Are using only the laser and light-based hair removal or reduction devices upon which they have been trained; and

(d) Are operating under the direct supervision and responsibility of a physician properly trained in hair removal and licensed pursuant to the provisions of Chapter 458 or 459, F.S.

(3)(a) The supervising physician, initially upon assuming duties as the supervisor and semiannually thereafter, shall review and inspect the techniques, procedures, and equipment utilized by the electrologist in the performance of laser and light-based hair removal or reduction.

(b) The supervising physician shall ensure that the electrologist has received semi-annual training in the areas of infection control, sterilization, and emergency procedures.

(4)(a) The supervising physician and the electrologist shall develop jointly written protocols regarding the medical condition for individuals to receive laser and light-based hair removal or reduction treatment; specific conditions and the procedure for identifying conditions that require direct evaluation or specific consultation by the physician; treatment of routine minor problems resulting during or from laser and light-based hair removal or reduction; and detailed procedures to be followed in the event of emergency situations developing during the performance of or as a result of laser and light-based hair removal or reduction. These written protocols must be signed, dated, and maintained in a readily available location on the premises where the electrologist practices. One copy shall be maintained by the supervising physician and one copy must be filed with the Department of Health. The written protocols which are kept on the premises of the electrologist will be readily available for inspection and review by agents of the Department of Health. The parties to a protocol must notify the Department within 30 days of the termination of their professional relationship.

(b) The written protocol shall include and require that the initial consultation with each patient must include an examination and assessment by a physician licensed pursuant to Chapter 458 or 459, F.S.

(5) Pursuant to Section 456.072(1)(i), F.S., any physician who knows that any electrologist is engaged in unsafe practice must report that electrologist to the Department of Health immediately.

(6) Any physician who provides supervision to an electrologist must keep the Board informed of the number of electrologists the physician is supervising. No physician is authorized to supervise more than four (4) electrologists at any one time.

Rulemaking Authority 458.331(1)(v), 478.43(1), (4) FS. Law Implemented 458.331(1)(v), 458.348(3), 478.42(5), 478.43(1), (3), (4) FS. History–New 9-12-01, Amended 2-28-02, 7-23-06, 3-12-08, 11-4-14, 2-15-17.

Rule 64B8-52.004, Florida Administrative Code, Requirements for Approval of Continuing Education Courses for Laser and Light-Based Hair Removal or Reduction

Rule 64B8-51.006, Florida Administrative Code, Rule Governing Licensure and Inspection of Electrology Facilities (see (3)(g))

Rule 64B8-56.002, Florida Administrative Code, Equipment and Devices; Protocols for Laser and Light-Based Devices

Section 458.348(3) , Florida Statutes, (Board of Medicine) Formal supervisory relationships, standing orders, and established protocols; notice; standards.

Laser Information

Georgia

1. I am physician with an active Georgia license. Do I need a laser license?

No

2. Who requires a laser license?

Anyone who is not a physician with an active Georgia license that provides non-ablative cosmetic laser services. If you are a PA with Board approved additional duties or an APRN with a protocol agreement that includes performing cosmetic laser services AND you ARE NOT supervising an individual that requires an Assistant Laser Practitioner license, you do not need a separate laser license. If you ARE SUPERVISING an individual that requires an Assistant Laser Practitioner license, you need a Senior Laser Practitioner license.

COSMETIC LASER PRACTITIONER Frequently Asked Questions

https://medicalboard.georgia.gov/sites/medicalboard.georgia.gov/files/related_files/site_page/CLP_FAQv102015.pdf

Sources

American Academy of Dermatology

Federation of State Medical Boards

Image: Wikimedia