The demand for cosmetic procedures and med spas in the United States has never been bigger, and with the interest in laser treatment and injectables only rising, there are factors to consider before you jump into the business. It’s much more than striking the right balance between branding and beauty; there are tight regulations to consider.
New owners have to consider laying the legal groundwork to avoid fines, license suspension, or criminal penalties. Here, we take you through the key legal steps and the compliance checklist you need to keep your cosmetic business safe, legal, and ethical.
Choosing your business structure
There are several options for structuring a business, such as a Limited Liability Company (LLC), a C Corporation (C-Corp), or an S Corporation (S-Corp). Each comes with its own approach to liability, taxes, and investment. However, in the med spa industry, most owners choose to operate through a Management Services Organization (MSO), which is specifically designed to meet their unique business needs.
This model allows for one entity to run the operation, and the licensed medical professional to own the clinic side of things. This is a crucial part of the setup process, as many state laws prohibit a non-physician from owning a medical practice. Ensure safety and compliance by consulting a healthcare attorney who can help you structure your business properly.
Compliance: Licensing and medical oversight
In addition to state medical board rules, med spas must also comply with relevant federal laws. If you provide a service that includes prescription devices or substances, like laser treatment or injectables, a licensed medical provider must order and supervise the process. This can be a nurse practitioner, a physician’s assistant, or a physician. However, this depends on the state where you practice.
You must consider state rules around who can own the practice, who should be supervising or administering the treatments, and whether the law requires you to appoint a medical director. California, Florida, and Texas have stricter guidelines than others, so you must familiarise yourself with your own state’s laws. Failure to comply with medical delegation laws can lead to felony charges in some states.
Risk management, insurance, and malpractice protection
There are several steps you must take before you can start treating patients, and you should have your insurance, malpractice protection, and risk management in place before you open the doors.
A medical spa should have professional liability insurance to cover you in the event of malpractice, general liability for the risk to your premises, business interruption, and cyber liability because you will be handling patient data. Your risk management plan should cover incident reporting, emergency protocols, and HIPAA compliance.
Although med spa services focus on cosmetic outcomes, they carry significant clinical and legal risks. To protect your business, every employee should be thoroughly trained in documentation, consent collection, and emergency response.
Planning, staffing, and resources
Beyond the legal requirements, it’s essential to focus on operations by creating a detailed business plan. This should outline staff licensing, supervision responsibilities, and compliance processes for documentation and prescribing. You’ll also need to design your treatment menu and determine whether a Medical Director is required to support the services you plan to offer.
Because skilled Medical Directors can be expensive and difficult to secure, many med spa owners turn to platforms like Fresh Clinics. They connect you with experienced off-site Medical Directors who provide on-demand clinical oversight — including fast, HIPAA-compliant Good Faith Exams (GFEs) — ensuring your clinic remains compliant while you concentrate on growth. Fresh Clinics also offers resources to guide new clinic owners through the legal, clinical, and operational setup process so nothing falls through the cracks.
In addition, investing in the right systems will protect and streamline your operations. An Electronic Medical Record (EMR) platform helps secure patient data, document care, and prepare for audits, while a staff training platform ensures your team maintains consistency, safety, and compliance.
Informed consent and marketing compliance
Medical spas must comply with FDA marketing restrictions and state medical advertising laws; many aren’t familiar enough with these and fall short by using before-and-after photos without any disclaimers, advertising drugs directly, or making misleading claims about the potential outcomes. Med spas should consider the FTC regulations around social media and influencers to ensure that brand endorsements are disclosed properly.
Informed consent is necessary for any type of medical treatment, and medical spas must be able to provide evidence that they have documented informed consent for every procedure they carry out, in line with state law.
Successful med spas combine their medical precision with their business savvy, and legal compliance is key to both sides of this coin. This checklist might seem long, but it’s essential to building a safe, legal, and successful med spa business, from ownership laws and medical licensing to malpractice insurance and advertising restrictions.
