Scope of Practice
Who Can Legally Perform Aesthetic Treatments in Hawaii?
Which license types can legally perform each treatment in Hawaii, with the conditions — sourced from official state boards.
Last reviewed June 2026
Neurotoxin injections (Botox / Dysport) in Hawaii
Details →Esthetician (LE)
Master Esthetician
Medical Assistant (MA)
Registered Nurse (RN)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Nurse Practitioner (NP/APRN)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician Assistant (PA)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician (MD/DO)
Permitted for this license type.
Dermal filler injections in Hawaii
Details →Esthetician (LE)
Master Esthetician
Medical Assistant (MA)
Registered Nurse (RN)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Nurse Practitioner (NP/APRN)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician Assistant (PA)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician (MD/DO)
Permitted for this license type.
Weight-loss injections (semaglutide / tirzepatide) in Hawaii
Details →Esthetician (LE)
Master Esthetician
Medical Assistant (MA)
Registered Nurse (RN)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Nurse Practitioner (NP/APRN)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician Assistant (PA)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician (MD/DO)
Permitted for this license type.
Kybella (deoxycholic acid) injections in Hawaii
Details →Esthetician (LE)
Master Esthetician
Medical Assistant (MA)
Registered Nurse (RN)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Nurse Practitioner (NP/APRN)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician Assistant (PA)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician (MD/DO)
Permitted for this license type.
PRP / PRF ("vampire facial") in Hawaii
Details →Esthetician (LE)
Master Esthetician
Medical Assistant (MA)
Registered Nurse (RN)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Nurse Practitioner (NP/APRN)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician Assistant (PA)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician (MD/DO)
Permitted for this license type.
Laser hair removal in Hawaii
Details →Esthetician (LE)
Permitted under general physician supervision — a physician is available (e.g., by phone) but need not be present. Requires a physician to be available but not on-site.
Master Esthetician
Permitted under general physician supervision — a physician is available (e.g., by phone) but need not be present. Requires a physician to be available but not on-site.
Medical Assistant (MA)
Registered Nurse (RN)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Nurse Practitioner (NP/APRN)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician Assistant (PA)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician (MD/DO)
Permitted for this license type.
Laser skin resurfacing in Hawaii
Details →Esthetician (LE)
Master Esthetician
Medical Assistant (MA)
Registered Nurse (RN)
Nurse Practitioner (NP/APRN)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician Assistant (PA)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician (MD/DO)
Permitted for this license type.
IPL / photofacial in Hawaii
Details →Esthetician (LE)
Permitted under general physician supervision — a physician is available (e.g., by phone) but need not be present. Requires a physician to be available but not on-site.
Master Esthetician
Permitted under general physician supervision — a physician is available (e.g., by phone) but need not be present. Requires a physician to be available but not on-site.
Medical Assistant (MA)
Registered Nurse (RN)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Nurse Practitioner (NP/APRN)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician Assistant (PA)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician (MD/DO)
Permitted for this license type.
RF microneedling (e.g. Morpheus8) in Hawaii
Details →Esthetician (LE)
Master Esthetician
Permitted under general physician supervision — a physician is available (e.g., by phone) but need not be present. Requires a physician to be available but not on-site.
Medical Assistant (MA)
Registered Nurse (RN)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Nurse Practitioner (NP/APRN)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician Assistant (PA)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician (MD/DO)
Permitted for this license type.
Microneedling in Hawaii
Details →Esthetician (LE)
Permitted under general physician supervision — a physician is available (e.g., by phone) but need not be present. Requires a physician to be available but not on-site.
Master Esthetician
Permitted under general physician supervision — a physician is available (e.g., by phone) but need not be present. Requires a physician to be available but not on-site.
Medical Assistant (MA)
Registered Nurse (RN)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Nurse Practitioner (NP/APRN)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician Assistant (PA)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician (MD/DO)
Permitted for this license type.
Chemical peels in Hawaii
Details →Esthetician (LE)
Permitted under general physician supervision — a physician is available (e.g., by phone) but need not be present. Requires a physician to be available but not on-site.
Master Esthetician
Permitted under general physician supervision — a physician is available (e.g., by phone) but need not be present. Requires a physician to be available but not on-site.
Medical Assistant (MA)
Registered Nurse (RN)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Nurse Practitioner (NP/APRN)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician Assistant (PA)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician (MD/DO)
Permitted for this license type.
Dermaplaning in Hawaii
Details →Esthetician (LE)
Permitted for this license type.
Master Esthetician
Permitted for this license type. Unclear, assume no unless you can verify with state data.
Medical Assistant (MA)
Registered Nurse (RN)
Permitted when delegated by, and performed under the authority of, a licensed physician. Performed under a physician’s delegation/orders and authority.
Nurse Practitioner (NP/APRN)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician Assistant (PA)
Permitted under a written protocol or collaborative agreement with a licensed physician. The physician does not need to be on-site. Requires a written protocol or collaborative agreement with a physician.
Physician (MD/DO)
Permitted for this license type.
Med-Spa Rules in Hawaii
Does this state require a physician medical director for a med spa?
Permitted
Is a good-faith exam (by a physician, NP, or PA) required before treatment?
ConditionalA good-faith exam is required before treatment by a physician, NP, or PA.
Do nurse practitioners have full (independent) practice authority in this state?
Not permitted
May a physician delegate cosmetic injections to qualified staff (e.g., RN) under supervision?
ConditionalA physician may delegate cosmetic injections to qualified staff under supervision.
Can a non-physician legally own a medical spa in this state? (corporate practice of medicine)
Not permitted
Looking for a qualified provider in Hawaii?
Every provider on Elite Aesthetics Guide is independently evaluated, and many are credential-verified.
Find providers in Hawaii →Elite Aesthetics Guide provides consumer information to help you find and vet qualified providers. This is general information, not medical or legal advice, and regulations change — always confirm with the official state board. Consult a licensed provider for any treatment decision.