Scope of Practice
Who Can Legally Perform Aesthetic Treatments in Virginia?
Which license types can legally perform each treatment in Virginia, with the conditions — sourced from official state boards.
Last reviewed June 2026
Neurotoxin injections (Botox / Dysport) in Virginia
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 Virginia
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 Virginia
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 Virginia
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 Virginia
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 Virginia
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 general supervision by a licensed physician.
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 Virginia
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 Virginia
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 general supervision by a licensed physician.
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 Virginia
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 general supervision by a licensed physician.
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 Virginia
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 general supervision by a licensed physician.
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 Virginia
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 general supervision by a licensed physician.
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 Virginia
Details →Esthetician (LE)
Permitted for this license type. Unclear, assume no unless you can verify with state data.
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 Virginia
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 Virginia?
Every provider on Elite Aesthetics Guide is independently evaluated, and many are credential-verified.
Find providers in Virginia →Sources
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.