A med spa is a medical practice that offers cosmetic treatments: injectables such as Botox and dermal fillers, lasers and other energy devices, microneedling, chemical peels, and IV therapy. In New York, a business that promotes med spa services has to be a licensed medical practice, and the people who perform those treatments have to hold a professional license.
A day spa works on the surface of the skin. A dermatology practice diagnoses and treats skin disease. A med spa sits between the two, and the differences are worth knowing before you book anywhere, including with us.
Key facts about med spas
| What to know | What it means |
|---|---|
| What a med spa does | Cosmetic medical treatments: neuromodulators such as Botox, dermal fillers and biostimulators, lasers and energy devices, microneedling, chemical peels, and IV therapy, alongside skin care. |
| Who performs the treatments | Licensed professionals: physicians, nurse practitioners, physician assistants, and registered nurses carrying out a prescriber’s order. |
| Who is responsible | A medical director, a licensed physician or nurse practitioner, whose name and credentials should be easy to find on the practice’s website. |
| What New York requires | A licensed medical practice for any medical procedure, a consultation with a medical professional before treatment, and licenses you can check on the State Education Department’s website. |
| What a med spa is not | A day spa, where services stay on the surface of the skin, or a dermatology practice, where skin disease is diagnosed and treated. |
| How R.Ve Aesthetics works | Physician led, consultation first, a written plan to take home, and no pressure to book. |
What a med spa does, and what makes it medical
A med spa performs cosmetic procedures that are the practice of medicine. Botox is a prescription drug. Dermal fillers are regulated medical devices. A laser that reaches below the surface of the skin, a microneedling pen, a peel that goes deeper than the top layer, and an IV line all change something in the body, and that is the line the law draws. New York’s Department of State lists injections of any drug or filler, microneedling, laser procedures, dermal peels, radiofrequency treatments, skin tag removal, IV therapy, and vitamin infusions as medical procedures that only a licensed professional may perform. Laser hair removal is the one common exception on New York’s list.
Because these treatments act on the body, two things matter more than the name on the door: who is performing the treatment, and who is responsible for the medical care behind it. The rest of this page is about those two questions.
At R.Ve Aesthetics, the menu is organized the way the treatments work: injectables, biostimulators, skin rejuvenation, and laser and energy treatments. Every one of them begins with a consultation at our med spa in Huntington, NY, and every one of them is performed by a licensed provider.
How a med spa differs from a day spa
A day spa offers relaxation and skin care services that stay on the surface of the skin. In New York, an esthetician’s license covers services to enhance the appearance of the face, neck, arms, legs, and shoulders with makeup, lashes, waxing, tonics, lotions, sanding, and tweezing. Facials, body treatments, and massage belong there, and done well they are worth having.
The products a day spa uses are cosmetics in the legal sense: articles applied to the body to cleanse, beautify, or alter the appearance. The FDA does not require approval of a cosmetic before it is sold. A product intended to affect the structure or function of the body is a drug under the same law, and Botox and the other prescription products a med spa uses belong to that category, which is why the setting has to be medical. That is the whole difference in one sentence. A day spa cannot inject Botox or filler, cannot run a laser that reaches the dermis, and cannot place an IV, because those are medical procedures in New York and an esthetician’s license does not cover them.
A med spa can still have an aesthetician on the team, and a good one shapes the experience. At R.Ve, co-founder and aesthetician Vanessa Nelson curates the menu and the manner of every visit, and the medical treatments are performed by licensed medical providers. As our home page puts it, R.Ve is a medical practice first.
How a med spa differs from a dermatology practice
A dermatologist is a medical doctor who specializes in conditions of the skin, hair, and nails. The American Academy of Dermatology describes the training: medical school, a year of internship, and three years of residency in dermatology, after which a dermatologist diagnoses and treats more than 3,000 diseases of the skin, hair, and nails as well as cosmetic concerns. Many dermatologists treat cosmetic concerns such as wrinkles and scarring too, so the overlap with a med spa is real.
The difference is purpose. A dermatology practice exists to diagnose and treat disease; cosmetic treatment is one part of what it does. A med spa exists to provide cosmetic treatment; it does not diagnose or treat skin disease. If the thing bothering you is a mole that has changed, a rash, hair loss, or acne that keeps coming back, a dermatologist is the right first visit. If we see something during your consultation that needs a diagnosis, we will say so and point you to one.
If what you want is to soften expression lines, restore lost volume, improve texture and tone, or remove unwanted hair, and you want to know exactly who is treating you and what will happen in the room, a physician led med spa is built for that visit.
Who performs your treatment at a med spa, and who answers for it
A medical director is the licensed physician or nurse practitioner responsible for the medical care a med spa provides. New York’s Department of State says a medical facility that offers med spa services usually has a medical director who is a licensed physician or nurse practitioner in good standing, that the medical director’s name and credentials should be easy to find on the business’s website, and that it is a red flag when they are not. Licensed physician assistants and registered nurses often work in physician practices, carrying out treatment that a prescriber has ordered.
The specialty societies describe what the role should mean in practice. The American Society of Plastic Surgeons says a medical director should accept responsibility for the safety of every patient treated, write and sign the protocols for every procedure, make sure every provider is trained and qualified for what they are tasked with, and keep the practice equipped for the complications that can arise. The American Society for Dermatologic Surgery Association opposes medical directors in name only, without real supervision, oversight, and training.
At R.Ve Aesthetics the medical director is Osborne Williams, MD, co-founder of the practice. He writes the clinical protocols, reviews the treatment plans, and approves every product we use, sourced from the manufacturer or its authorized US distributor. Treatments are performed by our licensed providers under his direction, and emergency medications, including hyaluronidase and epinephrine, are kept on site. His license is a public record, and the links to check it are on Dr. Williams’s page. You can read more on our physician oversight page and meet the team before you visit.
What happens at a med spa visit
A med spa visit begins with a consultation, before any treatment. New York requires it: you must be seen by a medical professional before receiving a medical service, and every provider of med spa services must give you the chance to ask questions about the procedure you are considering. The Department of State suggests asking who will perform the procedure and what it involves, how much experience they have with it, and how they have managed complications.
At R.Ve, the consultation is where we look at your goals, your history, your medications, and your anatomy, and set honest expectations. You leave with a written plan to take home: the treatments we recommend, the doses, and the sequence, all in writing. There is no pressure. Book when you are ready, or not at all. Sometimes the best advice is to wait, and we will tell you that too. On injectables, a two week review is included, so we look at the result together and fine tune if needed. Our consultation first policy and what to expect at your first visit explain the visit step by step.
What a med spa cannot promise
A med spa cannot promise a result. Prescription drugs and medical devices carry risks, results differ from person to person, and some people should wait or should not be treated at all. What a med spa can do is name the risks before you decide, screen for the reasons to wait, and be prepared for the rare problem; our safety protocols page explains what we keep on the shelf and how the team trains for it.
A med spa also does not treat disease. It will not diagnose the spot you are worried about, and it should not try. We would rather show you than tell you: ask us what we check before treatment, who will be in the room, and what happens if something goes wrong. You will always receive a clear answer.
Questions people ask before a first med spa visit
Is a med spa a medical practice?
Yes. In New York, a business that offers or promotes med spa services must be a licensed medical practice or medical facility, and the medical treatments must be performed by licensed professionals. The name on the sign does not change that; the license behind it is what counts.
What license do you need to open a med spa in New York?
There is no single med spa license in New York. The medical services require a licensed medical practice or medical facility with a licensed physician or nurse practitioner as its medical director, and a provider organized as a professional corporation or PLLC needs a Certificate of Authorization from the State Education Department. Non medical services such as facials and waxing fall under the Department of State’s appearance enhancement licenses. Depending on what is offered, a med spa can be regulated by the Department of State, the State Education Department, and the Department of Health.
Can an esthetician do Botox or filler at a med spa?
No. Injecting a drug or a filler is a medical procedure in New York, and an esthetician’s license covers makeup, lashes, waxing, tonics, lotions, sanding, and tweezing, not injections. Botox and filler are injected by a physician, nurse practitioner, or physician assistant, or by a registered nurse carrying out a prescriber’s order after you have been evaluated.
Is a medical spa the same as a med spa or a medspa?
Yes. Medical spa, med spa, and medspa are three spellings of the same kind of practice. The societies that write about them use medical spa; most people searching use med spa. What matters is the same in each case: who performs the treatment and who is responsible for the medical care.
Do I need a consultation before treatment at a med spa?
Yes. In New York you must be seen by a medical professional before receiving a medical service, and every med spa must give you the opportunity to ask questions first. At R.Ve, every treatment begins with a consultation and a written plan, and nothing is decided in the chair.
How can I check who will be treating me?
Ask who will perform the procedure, what their license is, and who the medical director is. A physician’s or nurse’s license can be verified on the New York State Education Department’s website, and any disciplinary history for a physician on the Department of Health’s Office of Professional Medical Conduct site. The practice’s own website should name its medical director; ours does, with the verification links on Dr. Williams’s page.
Keep reading
- Our physician led med spa in Huntington, NY: the practice, the treatments, and the five standards every visit follows.
- Physician oversight at R.Ve: what Dr. Williams holds as medical director.
- Your first visit, step by step: the whole appointment, from the conversation to the written plan.
- Our consultation first policy: why candidacy is a medical question.
- Results, with permission: how we show results, and why consent comes first.
- Key terms, defined plainly: the words you will meet on the treatment pages.
- Contact R.Ve Aesthetics: hours, address, and a form for questions.
Sources
- New York Department of State. New York Department of State Issues Warning to Consumers after Investigations of Med Spa Service Providers. https://dos.ny.gov/news/new-york-department-state-issues-warning-consumers-after-investigations-med-spa-service. January 8, 2026.
- U.S. Food and Drug Administration. Is It a Cosmetic, a Drug, or Both? (Or Is It Soap?). https://www.fda.gov/cosmetics/cosmetics-laws-regulations/it-cosmetic-drug-or-both-or-it-soap. Content current as of September 11, 2024.
- American Academy of Dermatology. What is a dermatologist? https://www.aad.org/public/fad/what-is-a-derm. Last updated October 5, 2022.
- American Society of Plastic Surgeons. Appropriate Business and Clinical Management of Medical Spas (Practice Reference). https://www.plasticsurgery.org/documents/Health-Policy/Resources/2023-medical-spas-appropriate-management.pdf. Issued December 15, 2023.
- American Society for Dermatologic Surgery Association. Position on Physician Oversight in Medical Spas. https://www.asds.net/Portals/0/PDF/asdsa/asdsa-position-statement-physician-oversight-in-medical-spas.pdf. Approved October 2015, reaffirmed December 2019, updated January 2024.
Book a consultation when you are ready
Ready when you are. Start with a consultation: it begins with a conversation and ends with a written plan and honest answers. Book a consultation online, or contact the practice with a question first.