In some states, to inject Botox or dermal filler you need to hold a nursing degree or have gotten your master’s degree as a physician’s assistant. In New York, where the regulations are more stringent, you need to have a supervising MD attached to your business. But in some states, like Nevada, for instance, you don’t need a degree at all. This means that the level of expertise can vary, depending on where you live. “It’s not a commodity,” says Dr. Kay Durairaj. “You’re not just buying the bottle, you’re buying the expertise and the placement too. So it’s buyer beware.”

For some nurses, this pivot hasn’t come without moral quandary. On the /nursing sub-Reddit, one user describes feeling guilty for moving from bedside to aesthetics: “I have no idea why but the guilt is eating me alive!” In another exchange, one user admonishes another, calling them “a sellout” for doing PRP injections on the side. In many of the exchanges, nurses go back and forth commiserating about the stress of working in a hospital setting. “Nursing in the hospital isn’t all it’s cracked up to be,” says LobsterMac_, a RN in a trauma ICU. “Ironically … many of us are looking at trying to go the aesthetic route and looking for ways out of the hospital altogether.”

The med-spa model, though mostly profit oriented, provides this way out — opening up new pathways for RNs, NPs, and PAs, many of whom are women. “One of the statistics I’m most proud of is the fact that nearly 70 percent of med-spa owners are women,” says Alex Thiersch, founder and CEO of the American Med Spa Association. “And, considering that close to 90 percent of patients are women, and that the overwhelming majority of providers are women, the medical-spa industry continues to carry the banner for female entrepreneurs in both business and health care.”

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