Know the Law: Legal Considerations for Owning a Medical Spa

Photo of Eleanor M. Walker
Eleanor M. Walker
Associate, Corporate Department
Published: Union Leader
August 6, 2023

Q: What legal considerations should you keep in mind when opening and operating a medical spa?

A: With face injections and other aesthetic medical treatments becoming more popular and mainstream, the businesses providing these services, often referred to as medical spas, are likewise becoming more common. Since many of the treatments offered by medical spas are medical procedures, and subject to some regulation, those desiring to operate a medical spa should take into account the following considerations as they explore this type of business venture.

First, the umbrella term “medical spa” can refer to any medical or beauty clinic, walk-in clinic, spa, salon, wellness center, salon, or other retail store that administers aesthetic medical treatments.  It does not matter what the business is called, but rather what services are provided and whether the relevant regulatory body qualifies those services as medical. For example, in New Hampshire, use of light and heat energy devices, Botox injections, collagen injections, and soft tissue filler are all considered medical treatments.

Second, medical spas generally require some form of licensing, but the exact licensing regime depends on the jurisdiction. In New Hampshire, a medical spa does not require a license to operate, but any spa employee who performs procedures that require licensing must be appropriately licensed to perform those procedures. Licensing is regulated by the applicable state regulatory board. For example, nurse practitioners are regulated by the Board of Nursing and physicians by the Board of Medicine.

Third, it is important to consider who will own and operate the medical spa. While some states do not allow the corporate practice of medicine, New Hampshire does, which means that non-physicians can own all or part of a medical spa and employ licensed medical practitioners to perform the medical procedures.

Finally, the treatments offered by medical spas, particularly those administered via injection, will often require a prescription. Therefore, one must consider the state’s regulations on medications – more specifically, who can prescribe them, who can administer them, and what supervision, if any, is necessary. Unlike in some states, nurse practitioners licensed in New Hampshire have full practice authority and independent prescribing authority, so they can prescribe and administer prescription medications without the supervision of a physician. On the other hand, New Hampshire physician assistants can only prescribe and administer prescription drugs under the delegation of a supervising physician.

While cosmetic and elective, many of the treatments provided by medical spas qualify as medical procedures. Those entering the medical spa industry and desiring to offer these services must consider the regulation of clinics, medical providers, and prescription medications as part of their business strategy and operations.


Know the Law is a bi-weekly column sponsored by McLane Middleton. Questions and ideas for future columns should be emailed to Know the Law provides general legal information, not legal advice. We recommend that you consult a lawyer for guidance specific to your particular situation.