What is a med spa? What they do, who works there and how they differ from a day spa

In one sentence: a med spa is a business that performs medical procedures — injections, laser services and skin treatments — under medical oversight, meaning a medical director answerable for medical decisions and licensed professionals working within the scope their state allows.

No federal law defines "med spa." The word on the door is not, by itself, a legal category.

What a given med spa may do, and who may own it, is determined by each state's medical-practice, nursing and corporate-practice rules.

AmSpa, the industry's professional association, is direct about what that makes a med spa: "They are medical practices, and many of the services they render are considered the practice of medicine."

The category is large and still growing.

AmSpa's 2024 industry survey estimated the number of US medical spas grew from 8,899 in 2022 to 10,488 in 2023, with 81% operating a single location.

Its survey sketches the customers, too: 89% of med spa patients are female, and 73% are repeat patients.

Not everyone in the industry accepts the label: LaserAway says every treatment it performs is done by a registered nurse, nurse practitioner or physician associate, with clinics overseen by board-certified dermatologists — and it calls itself "an aesthetic dermatology clinic—not a med spa." How the two kinds of practice differ is covered in med spa vs dermatologist.

Menus are built differently from one business to the next: the published menus of three aesthetic and wellness chains — LaserAway, Sev Skin and Restore Hyper Wellness — show how wide the range is.

• Injectables: neurotoxin injections such as Botox and Xeomin, and dermal fillers such as Juvéderm, all listed on LaserAway's published price page.
• Laser hair removal: offered by LaserAway and Sev Skin (formerly SEV Laser), and priced by body area (our laser hair removal guide covers sessions and pricing).
• Skin treatments: LaserAway's price page lists Hydrafacial, SkinPen, Potenza RF microneedling, Clear + Brilliant and Thermage.
• Body treatments: CoolSculpting appears on the same LaserAway list.
• Laser tattoo removal: priced by the size of the tattoo on LaserAway's page.
• Wellness services: Restore Hyper Wellness lists IV drips, cryotherapy, infrared sauna, red light therapy and compression among its services.

Not every business offers all of this.

Sev Skin says it was founded in 2010 as a laser hair removal practice inside a hair salon, and says its laser hair removal single sessions and monthly memberships are priced by treatment, area and location.

Notice how much of these lists is product names rather than generic terms.

Before you book, ask which treatment, which device and which product you would actually be getting.

Whether a menu entry is a medical procedure depends on what it is: botulinum toxin is a prescription drug, and AmSpa's position is that injecting it is the practice of medicine.

The medical director sits at the top of the medical side.

AmSpa describes the role as responsible for all the medical decisions in the practice — decisions that are often delegated, but where "the buck stops with the medical director."

The specialty varies: in AmSpa's 2024 survey, 74% of medical directors came from outside the core specialties of plastic surgery, facial plastic surgery, oculoplastic surgery and dermatology.

Injection work sits under that umbrella.

AmSpa's position is that injecting botulinum toxin is the practice of medicine, because a prescription drug is being used on living tissue, so it must be done by a physician, an independent-practice nurse practitioner, or another licensed professional acting within their scope — under rules that vary by state.

The first appointment follows the same logic.

AmSpa explains the "good faith exam": before a first treatment, a physician, PA or advanced practice nurse takes a medical history, performs an appropriate physical exam and creates the treatment order, and an RN may assist but cannot generate that order.

Day to day, the person holding the syringe varies by clinic.

LaserAway says every one of its treatments is performed by a registered nurse, nurse practitioner or physician associate, and that it does not use estheticians or technicians.

Sev Skin describes a different roster: nurse practitioners, registered nurses, licensed estheticians and laser specialists.

What each of those license holders may actually do is bounded by state rules, not by the spa's job titles.

Ownership skews non-physician, too: 67% of single-owner med spa practices are owned by non-physicians — nurse practitioners, RNs, PAs, entrepreneurs and aestheticians, per AmSpa's survey — and state ownership rules, covered below, are what constrain that.

In the same 2024 survey, 48% of med spas had hired a medical director in the past year.

The difference is not the lighting or the robes — it is whether the appointment counts as medical care.

AmSpa's framing is the plainest starting point: med spas "are medical practices, and many of the services they render are considered the practice of medicine."

A concrete example of what that means: botulinum toxin is a prescription drug, and AmSpa's position is that injecting it is the practice of medicine.

AmSpa's description of how that works in practice includes a medical director answerable for the medical decisions, and a good faith exam — a medical history, an appropriate physical exam and a treatment order — from a physician, PA or advanced practice nurse before a first treatment.

One caution cuts the other way: the shorthand that a med spa is just a day spa with a doctor somewhere in the background gets the oversight wrong, because on-site supervision requirements vary by state and by procedure — there is no single, nationwide rule about a physician being in the building.

So when you compare two businesses side by side, the useful question is not which lobby is nicer.

It is who is responsible for the medical decisions, and what your state requires for the specific procedure you are considering.

By the industry association's own description, yes: AmSpa says med spas are medical practices, and that many of the services they render are considered the practice of medicine.

Legally, the answer is set state by state.

No federal law defines a med spa; whether one is regulated as a medical practice, and who may own it, is determined by each state's medical-practice, nursing and corporate-practice rules.

Ownership is where this becomes concrete.

AmSpa explains the corporate practice of medicine (CPOM) doctrine: many states bar non-physicians from owning a medical practice directly or through a business entity, out of concern that lay control could interfere with physician judgment.

AmSpa describes the range as wide — it cites Alabama, Idaho and North Carolina as more permissive and California as strict — and says management services organization (MSO) arrangements are commonly used where lay ownership is restricted.

This is the machinery behind the ownership statistic above: a med spa's structure has to fit the state it operates in, and the rules for a procedure such as a toxin injection vary across state lines.

One published price page shows how pricing can follow the treatment: LaserAway — which, as noted above, calls itself an aesthetic dermatology clinic rather than a med spa — quotes prices per unit, per syringe, per session or area, or per package.

At LaserAway, neurotoxins are priced per unit.

Its price page (read October 16, 2026) listed Botox at $15 per unit, or $10 per unit in a 300-unit bank, and Xeomin at $12 per unit, or $7 per unit in a 300-unit bank — LaserAway's own published prices. (Botox and Xeomin units are not interchangeable, so their per-unit prices are not directly comparable.)

Fillers are priced per syringe or per treatment there.

The same page listed Juvéderm lips at $450 per full syringe, with face filler at $450–$900 and cheek filler at $750–$1,500 per treatment.

Laser hair removal is priced per session and by area: LaserAway listed $99–$649 per treatment depending on the area, sold as single sessions or in packages of 3, 8 or 10 — and LaserAway says prices may vary by location.

LaserAway prices skin and body treatments per session, with package discounts: Hydrafacial at $200 per treatment ($170 each in a 6-pack), SkinPen at $400 ($300 in a 6-pack) and CoolSculpting at $550 per treatment, with 25% savings at 4–7 treatments and 50% at 8 or more.

Two national figures add context, if you keep their scope in mind.

In AmSpa's 2024 survey, patients spent an average of $527 per visit — an average of what patients spent, not a menu price.

And ASPS says the average cost of botulinum toxin injections is $435, an average fee reported by ASPS member plastic surgeons — a plastic surgery figure, not a med spa price, and not a per-unit number.

Because each figure above comes from a different source and setting, treat them as illustrations of how pricing works, not as the price you will be quoted.

Ask a practice for its current per-unit or per-syringe price before you book.

Some of the clearest selection advice comes from consumer guidance the FDA and CDC have published on botulinum toxin and fillers.

For fillers, FDA advises choosing a licensed provider experienced in dermatology or plastic surgery and trained to inject fillers, who uses properly labeled, sealed vials or pre-filled syringes of FDA-approved filler.

FDA also says not to buy fillers sold directly to the public, not to self-inject, and notes that needle-free filler "pens" are not FDA-approved.

For botulinum toxin, FDA advises confirming with your provider that the product comes from an authorized source and asking whether the provider is licensed and trained to give the injection.

The CDC's wording is blunter: get botulinum toxin injections only if the product comes from an authorized supplier and the provider is licensed and trained — "If in doubt, don't get the injection."

You can check the credentials yourself rather than taking a website's word for them.

Nurse licenses — RN, APRN and LPN/VN — can be looked up in Nursys, NCSBN's national nurse licensure and disciplinary database, via its QuickConfirm search.

That data comes directly from participating boards of nursing, so boards that do not participate must be checked directly.

For physicians, ABMS member boards certify doctors in 38 specialties, and ABMS board certification can be checked free at CertificationMatters.org — so when a provider says "board-certified," ask which board.

Those rules translate into questions worth asking before you book: who will perform the treatment and under what license, who the medical director is, whether a good faith exam comes first, and where the injectable product comes from.