Q: Can RNs and LPNs in North Carolina legally perform cosmetic procedures like Botox, chemical peels, or laser hair removal?
A: Yes, the North Carolina Board of Nursing allows both RNs and LPNs to perform cosmetic and aesthetic dermatological procedures as long as they are prescribed or ordered by a licensed healthcare provider with prescriptive authority, such as a physician, nurse practitioner, or physician assistant, who is acting within their legal scope of practice.
Q: What procedures are considered cosmetic/aesthetic dermatological procedures under this guidance?
A: The Board includes but does not limit this category to: chemical peels, microdermabrasion, sclerotherapy, aesthetic laser treatments, light therapy, hair transplants, micropigmentation, and injectable treatments like Botox, Restylane, and collagen fillers.
Q: Can RNs perform these procedures without the ordering provider present?
A: Yes. Registered Nurses (RNs) do not need the prescribing provider to be physically present on-site during the procedure.
Q: What about LPNs—do they need supervision?
A: Yes. Licensed Practical Nurses (LPNs) may only perform these procedures if a supervising RN, physician, nurse practitioner, or physician assistant is physically present on-site.
Q: Are there training or competency requirements for nurses performing these procedures?
A: Absolutely. All nurses must have documented education, skills, and demonstrated competency specific to the procedures they are performing. They must also follow facility policies, including emergency protocols.
Q: Can a nurse perform cosmetic procedures if a client walks in without a prior prescription or medical evaluation?
A: No—unless the nurse also holds the appropriate license under the North Carolina Electrolysis Practice Act or the Cosmetic Arts Act, depending on the services offered. A valid medical assessment and prescription/order must precede any procedure unless alternate licensure
allows otherwise.
Q: What if the nurse is offering services like massage or bodywork as part of a cosmetic treatment?
A: If those services go beyond what’s covered under nursing practice, the nurse must obtain proper licensure (e.g., massage and bodywork therapy license) before performing them.
Q: Can a nurse open their own aesthetic or cosmetic dermatology practice?
A: Only RNs may establish a professional nursing business in North Carolina, such as a Professional Corporation (PC) or Professional Limited Liability Company (PLLC). They must comply with all requirements in the Board’s position statement and are encouraged to seek legal counsel. LPNs are not authorized to own or co-own nursing businesses under NC law.
Q: What if the procedure involves lasers?
A: Nurses planning to perform procedures involving lasers—such as laser hair removal or tattoo removal—should first review the North Carolina Medical Board’s position statement on laser surgery to ensure compliance.
Q: Is this position statement legally binding?
A: No. While it doesn’t carry the force of law, it represents the Board’s official interpretation of safe nursing practice and is used as a guideline in disciplinary reviews and scope-of-practice decisions.
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The information included here is for informational purposes only, is not exhaustive of all considerations when creating documents, is not intended to be legal advice, and should not be relied upon for that purpose. We strongly recommend you consult with an attorney and do not attempt to create your own documents.