Who can legally inject Botox and dermal fillers in Maryland?

MD, DO, NP, PA, RN under physician supervision/delegation Yes, under physician delegation and supervision

Maryland · Moderate

Who Can Inject Botox & Fillers in Maryland?

In Maryland, the answer comes down to two things: who is allowed to hold the syringe, and who has to authorize the treatment first. Here's how Maryland handles both.

By Evan at Inside MedSpa

Who can inject

MD, DO, NP, PA, RN under physician supervision/delegation

Registered nurses (RNs)

Yes, under physician delegation and supervision

Nurse practitioners & physician assistants

NP/PA may inject under physician collaboration; independent practice limited

The exam that makes it legal

Required; in-person or telehealth permitted A valid order or good-faith exam by an authorized provider is what makes an injection lawful — not simply who holds the syringe.

Training expected

No state-mandated injector training beyond licensure; facility protocols recommended.

What to verify in Maryland

Establish clear physician delegation protocols and ensure medical director oversight for all injector staff.

Primary source: Maryland Medical Board; Board of Nursing

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

See the full Maryland regulation profile →

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