Hawaii · Strict

Can RNs and Nurse Practitioners Inject Botox in Hawaii?

Q: Can registered nurses and nurse practitioners inject Botox and fillers in Hawaii?

No; RNs may not inject neurotoxins or fillers in Hawaii NP/PA may not independently practice or inject; physician collaboration required but injectables restricted to MDs/DOs

Nurses do most of the injecting in this industry — but Hawaii draws specific lines around what an RN versus an NP can do, and who has to supervise.

By Evan at Inside MedSpa

Registered nurses (RNs)

No; RNs may not inject neurotoxins or fillers in Hawaii

Nurse practitioners & physician assistants

NP/PA may not independently practice or inject; physician collaboration required but injectables restricted to MDs/DOs

Supervision & the medical director

Required; physician must directly supervise all aesthetic procedures

The exam requirement

Required; in-person exam before treatment

What to verify in Hawaii

Verify that your medical spa is physician-owned or physician-controlled, and ensure only MDs or DOs perform all injections; do not delegate injectables to RNs, NPs, or PAs.

Primary source: Hawaii Medical Board

General business information for Hawaii medical-spa owners, current as of 2026 — not legal advice. State boards update rules often; confirm specifics with the Hawaii board (and your own counsel) before you act.

See the full Hawaii regulation profile →

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