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Can LPNs and LVNs do Botox?

Last checked November 5, 2026. Information, not legal advice.

It depends on the state. Of the 10 states we reviewed, North Carolina and Texas are the two where we found explicit permission for LPNs or LVNs to inject Botox and dermal fillers, and both require a prescriber's order and an RN or higher-level provider supervising. California, Arizona and Georgia say no. In Colorado, Florida, Illinois, New Jersey and New York we did not locate guidance specific to cosmetic injections by LPNs, so it is unsettled there: neither confirmed nor ruled out.

LVN (licensed vocational nurse) is the title Texas and California use. Federal job data treats LPNs and LVNs as one occupation, and the answers below cover both.

Can LPNs and LVNs inject Botox? State by state

StateBotoxDermal fillersConditions
ArizonaNoNoThe Board of Nursing's aesthetics opinion marks injectables for RNs and APRNs only. The only Level III procedures LPNs may do are the ones marked for them, microchanneling and skin tag or benign skin lesion removal, with on-site supervision.
CaliforniaNoNoThe Board of Vocational Nursing and Psychiatric Technicians held, in a precedential decision, that Botox and fillers such as Juvederm are outside LVN scope, even under physician supervision. A 2022 amendment to the vocational nursing law names Botox and Juvederm injections as acts it does not authorize.
ColoradoNot addressedNot addressedNo board statement found on cosmetic injections by LPNs. The statute lets LPNs give prescribed medications under supervision. The Board's LPN scope policy (30-12) does not mention cosmetic injections.
FloridaNot addressedNot addressedWe did not locate a statute, rule or Board statement specifically addressing cosmetic injections by LPNs; every aesthetic order we found involved RNs. LPNs work under the direction of an RN, physician, podiatrist or dentist. An old Board FAQ saying Botox was outside LPN and RN scope was struck by a judge in 2015 because it was never adopted as a rule.
GeorgiaNoNoThe Board of Nursing says neuromodulator and dermal filler injections are outside LPN scope (position statement, March 2024).
IllinoisNot addressedNot addressedIDPH says "nurses" may inject under a physician's supervision but does not separate RNs from LPNs. A physician may delegate tasks to an LPN within the LPN's own licensing law, but we did not locate Illinois guidance specifically addressing cosmetic injections by LPNs. Confirm with IDFPR before injecting.
New JerseyNot addressedNot addressedNo board statement found. The LPN definition does not include executing medical regimens, and LPNs work under the direction of an RN, physician or dentist. Treat cosmetic injecting by an LPN as unsettled.
New YorkNot addressedNot addressedNo board statement found. LPNs may give most medications under the direction of an RN or authorized practitioner, usually with that person on premises. Treat cosmetic injecting by an LPN as unsettled.
North CarolinaYes, with conditionsYes, with conditionsSame order and competency rules as an RN: a physician, NP, PA or other prescriber evaluates the patient and issues an order first. An RN, physician, NP, PA or other licensed practitioner must also be on site and supervising.
TexasYes, with conditionsYes, with conditionsSame delegation rules as an RN, under a physician's written order. The LVN must always work under supervision (RN, APRN, PA or physician), and the Board of Nursing tells LVNs to check whether a supervising RN and the ordering provider are onsite.

Fillers get the same answer as Botox in every one of these states. For the other roles in each state, see the state-by-state hub.

What the conditions are in North Carolina and Texas

In both states an LPN or LVN injects on someone else's medical decision and under someone else's supervision. The details differ.

Texas

  • Who decides: a physician delegates the injection with a written order. Before the injection, a physician, PA or nurse practitioner must establish a relationship with the patient. An RN or LVN cannot do this step, because nurses who are not APRNs may not diagnose or choose the treatment.
  • Who delegates: the delegation must come from a physician. A Texas NP cannot pass physician-delegated acts on to RNs or LVNs.
  • Who is on site: a physician, PA or NP must be onsite or immediately available during the procedure, and at least one person trained in basic life support must be present. On top of that, the LVN always works under supervision, and the Board of Nursing tells LVNs to check whether a supervising RN and the ordering provider are onsite.
  • Training: documented training and competence, written policies, and medical and nursing backup, under the Board of Nursing's delegated medical acts statement.

North Carolina

  • Who decides: a physician, NP, PA or other prescriber completes the patient evaluation and issues the order before the LPN treats. Nurses cannot make a medical diagnosis or create a treatment plan.
  • Who is on site: an RN, physician, NP, PA or other licensed practitioner must be on site and supervising. This is the main difference from RNs, who do not need anyone else on site.
  • Training: documented knowledge, skill and competency for each procedure, and written employer policies. North Carolina has no state Botox or filler certificate.

LPN vs RN in aesthetics

The RN license is what opens injecting. In the 10 states we cover, RNs can inject with conditions in every state, although Florida's yes comes from Board orders issued to individual RNs who asked. For LPNs we confirmed an explicit, conditional pathway in two of them. Even where both can inject, the LPN gets less room: in North Carolina an RN can inject with no prescriber on site, while an LPN needs a supervisor on site.

LPNs still work in med spas without injecting, and two of our states spell out some of that work:

  • Arizona: the Board of Nursing's opinion says LPNs with appropriate training can do Level II procedures and certain Level III procedures, with onsite supervision by a specifically trained RN or licensed practitioner. Level II includes medium-depth chemical peels, high intensity frequency ultrasound (HIFU) and photodynamic therapy, plus non-ablative laser hair removal and intense pulsed light, which also need laser certification. The Level III procedures open to LPNs are microchanneling and skin tag or benign skin lesion removal. The patient assessment must be done by an RN or licensed practitioner, with input from the LPN.
  • Illinois: a physician may delegate laser and light procedures to an LPN who has documented training on each device. Ablative procedures need the physician on site. Non-ablative procedures need the physician on site or available by phone or other electronic means. Since January 1, 2025, an onsite physician exam is not required before a non-ablative laser procedure when a laser hair removal facility follows a physician delegation protocol, an APRN does the exam, a physician delegates the procedure to a trained RN or LPN, and a physician is available by phone or other electronic means.

We have not checked non-injection LPN work in the other eight states. Ask your board of nursing before taking on laser or peel work. Ownership is limited too: North Carolina LPNs cannot own a nursing business, and California does not list LVNs among the permitted shareholders of a medical corporation.

From LPN to nurse injector

If you want a license with an established injecting pathway in all 10 states, the usual route is to become an RN first.

  1. Bridge to RN. The Bureau of Labor Statistics notes that an LPN may complete an LPN-to-RN education program to become a registered nurse. To get licensed, you graduate from an approved nursing program, pass the licensing exam and get a license from the state where you will work.
  2. Build clinical experience. Some employers want experience, and work in dermatology, plastic surgery or a related specialty also counts toward CANS. Our guide to becoming a nurse injector covers the steps and costs.
  3. Train in neurotoxins and fillers. Compare courses in our nurse injector training guide. A course that accepts LPNs does not change what your state allows. California's vocational nursing board says vendor training does not expand LVN scope, and in Texas continuing education cannot move an LVN to a higher level of practice.
  4. Learn your state's RN rules. See Can RNs do Botox? for who examines the patient and who supervises in each state.
  5. Consider CANS later. The Certified Aesthetic Nurse Specialist credential requires a current RN or NP/APRN license, at least two years of nursing experience in the core specialties, and 1,000 practice hours in those specialties in the last two years. PSNCB's eligibility page lists RN and NP/APRN licenses and does not list an LPN or LVN license, so an LPN is not eligible until becoming an RN. See CANS certification.

When you are licensed as an RN, browse registered nurse injector jobs.

FAQ

What states can LPNs inject Botox?

Of the 10 states we cover, North Carolina and Texas allow it, both with a prescriber's order and supervision. California, Arizona and Georgia say no. In Colorado, Florida, Illinois, New Jersey and New York we did not locate guidance specific to cosmetic injections by LPNs.

Can an LPN inject Botox in New Jersey?

We did not locate a New Jersey rule or board statement specifically addressing cosmetic injections by LPNs. The LPN definition does not include executing medical regimens, and LPNs work under the direction of an RN, physician or dentist, so treat it as unsettled.

Can LPNs give injections in New York?

LPNs may give most medications under the direction of an RN or authorized practitioner, who usually must be on premises. The exception requires, among other things, that the practitioner can be reached by phone or video and can intervene in person within 15 minutes. We did not locate guidance specific to cosmetic injections by LPNs, so check with the NYSED Office of the Professions first.

Can an LVN do Botox in California?

No. The Board of Vocational Nursing and Psychiatric Technicians holds that Botox and filler injections are outside LVN scope, even under physician supervision, and state law now names Botox and Juvederm among acts the LVN license does not authorize.

Can an LPN do fillers?

Fillers follow the same answer as Botox in the 10 states we cover: yes with conditions in North Carolina and Texas, no in California, Arizona and Georgia, and not addressed in the other five.

Does Botox training let an LPN inject?

No. Training builds skill within your license but does not expand it. California's board says so directly for vendor training, and Texas says continuing education cannot move an LVN to a higher level of practice.

Sources

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