Medical Spa Legislation, Regulations, and Guidelines in the United States

BACKGROUND The growing popularity of medical spas in the United States (US), which combine medical procedures with spa-like services, has led to increased regulatory scrutiny. These facilities operate in a complex legal environment with varying state-level regulations governing ownership, operation, and scope of practice for nonphysician providers (NPPs). OBJECTIVE To summarize the legislative landscape governing medical spas across the United States, identify common regulatory challenges, and explore implications for dermatologists, dermatologic surgeons, and medical spa operators. MATERIALS AND METHODS A review was conducted using state statutes, administrative codes, case law, and professional board guidance, including resources from the American Society for Dermatologic Surgery Association (ASDSA). Data were collected from legal databases, state documents, scholarly articles, and ASDSA materials to identify key legislative themes and trends. RESULTS Significant variability exists in state regulations regarding medical spa ownership, roles of Doctor of Medicine (MD)/Doctor of Osteopathic (DO) supervisors, and scope of practice for NPPs. Key challenges include inconsistent standards, regulatory gaps, and patient protection concerns. CONCLUSION The fragmented regulatory landscape poses challenges for physicians and patients. Standardizing state laws, strengthening training and certification requirements, and enhancing patient protections are recommended to ensure medical spas operate safely and ethically.