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What Are the Botox® Laws By State?

Botox® injection is a minimally invasive procedure with far-ranging cosmetic and therapeutic benefits. On the cosmetic side, it’s the most popular injectable treatment, with millions of doses given annually in the U.S. alone.

Whether you operate an internal medicine practice or pain clinic and plan to use Botox to treat medical complaints like chronic migraine, or you run a medical spa that will offer Botox treatment for cosmetic issues like glabellar lines, adding this treatment could be good for business. But Botox is a controlled substance that’s not available over the counter — nor to all medical and aesthetic practitioners.

Before advertising your practice’s Botox services, make sure you’re operating within the bounds of applicable state law. Here’s what you need to know about Botox laws by state — specifically, around who can offer botulinum toxin treatments — and how to find accredited Botox courses that satisfy local credentialing requirements.

Botox Laws By State: Who Can Inject Botox

Laws governing botulinum toxin treatments and other aesthetic injectables vary by state. 

One predictable constant is that state-licensed, board-certified medical doctors and plastic surgeons can administer these treatments themselves, provided their practice complies with all applicable regulations. Dentists and oral surgeons are generally permitted to administer Botox as well, though some states restrict them to treatments conducted “within the scope of dental practice” as defined by state law.

Rules for Other Providers

Other medical providers are generally permitted to give Botox under the supervision of a medical doctor or plastic surgeon:

In this case, “supervision” means acting under the authority of a licensed medical or aesthetic practice. The supervising provider doesn’t necessarily have to be in the room where the procedure occurs (but could, depending on state law).

Some states go further and permit certified medical aestheticians and aesthetic nurses to administer Botox under physician supervision. These providers need to complete applicable training and certification programs and may be restricted to certain types of duties.

Learn More About Your State’s Botox Laws

State laws governing injectable treatments may change from time to time. To ensure you’re compliant with local rules, you can do the following:

  • Contact your state professional association and ask whether other local providers administer Botox
  • Contact your state’s medical licensing board
  • Find the relevant statues in your state legislature’s archives — this can be time-consuming, however

This is especially important if you’re not a trained medical professional yourself. Different states have different rules about non-provider owners employing licensed “medical directors” to oversee their practices’ treatment programs.

Find an Accredited Botox Course Program

The best way to be sure that you or your provider team can legally administer Botox in your state is to enroll in an accredited Botox course that meets applicable state requirements.

This can be a single-subject course specifically about administering Botox or part of an advanced Botox and filler training program that covers a range of aesthetic treatments. Regardless of its scope, it should cover topics like:

  • Botox treatment procedures and best practices, including where not to inject Botox
  • Safe handling and storage of botulinum toxin treatments
  • Botox laws by state 
  • Patient intake and treatment planning
  • Contraindications, side effects, and follow-up

Before enrolling, confirm that this training program accepts providers with applicable credentials — in other words, that it’s not exclusively for plastic surgeons or medical doctors.