Scope of Practice Related to Cosmetic and Dermatological Procedures

Can a nurse engage in the practice of cosmetology and esthetics?

Aesthetic, cosmetic, and dermatological procedures may be performed by a nurse as a part of a medically prescribed plan of care for treatment of various dermatological conditions.

The Kentucky statutes applicable to cosmetologists, and estheticians licenses are not applicable to nursing practice. They are regulated under KRS Chapter 317A.

No person shall engage in the practice of cosmetology, esthetic practices, or nail technology for other than cosmetic purposes nor shall any person engage in the practice of cosmetology, esthetic practices, or nail technology for the treatment of physical or mental ailments. This chapter does not apply to . . . Persons authorized by the law of this state to practice . . . nursing . . . who perform incidental practices of cosmetology, esthetic practices, and nail technology in the normal course of the practice of their profession.

See KRS 317A.020.

However, you may wish to acquaint yourself with the practice standards followed by non-nurse estheticians, as there is likely overlap in terms of accepted professional practices in the provision of esthetic services.

Advisory Opinion Statement (AOS)

In the Document Library, you can find additional information in AOS #35 Cosmetic and Dermatological Procedures by Nurses, to assist nurses who wish to engage in the safe practice of nursing.

Scope of Practice of LPNs and RNs in the Performance of Cosmetic and Dermatological Procedures

LPNs and RNs are able to implement interventions and administer medications and treatments as prescribed and supervised by a physician, physician assistant, dentist, or APRN.

These healthcare providers are able to delegate tasks to the RN or LPN.

The LPN or RN may follow standing orders/protocol after the healthcare provider has established a treatment plan.

In the Document Library, you can learn about standing orders and protocols in AOS #14: Roles of Nurses in the Implementation of Patient Care Orders: Use of Protocols, Standing Orders, and Routine Orders.

Best Practices APRNs Interested in Providing Cosmetic and Dermatological Procedures

In the Document Library, you can find additional information AOS #35 Cosmetic and Dermatological Procedures by Nurses, which lists a set of recommended best practices for APRNs who are interested in providing cosmetic and dermatological procedures in a responsible, safe, and effective manner.

Nurses - Botox© and Derm Fillers

LPNs and RNs

It is not within the scope of practice for an LPN or and RN to independently practice, order products, prescribe treatments, or perform medical aesthetic procedures such as Botox© or Derm fillers.

APRNs

APRNs should consult the APRN Scope of Practice and Decision Making Model as well as AOS #35, both are found in the Document Library, to determine if it is within their scope of practice to assess, diagnosis, administer, prescribe treatments, and order products.

Offsite Botox©

No statute, regulation, or published decision precludes an APRN from lawfully taking a multi-dose vial of Botox© to a patient’s home, a hair salon, or any other place where the conditions are sufficiently sanitary for the administration of Botox©.

However, the assessment, diagnosis and administration of Botox© must be within the APRN’s scope of practice as measured pursuant to the APRN Scope of Practice Decision Making Model, which can be found in the Document Library

APRNs as Medical Director for a Med Spa

An APRN who meets the requisite educational and experiential requirements may own a med spa and function as the medical director. One of the responsibilities of a medical director is to stay informed regarding developments in both law and practice.

As a medical director of a medspa in a clinical setting without a physician or pharmacist on staff, the APRN medical director may order and stock legend drugs for the purposes of direct administration including Botox© or Derm Filler medications.

If the facility has a physician or pharmacist on staff, the applicability of the physician or pharmacist broadens the scope of what may lawfully occur at the facility.

In the Document Library, you can find the APRN Scope of Practice Decision Making Model, which can assist in determining whether you are qualified to serve as the medical director of a med spa.

Additional Suggestions

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