Medical spa and spa license requirements to start your wellness business

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People lead busy lives, and spas and medical spas have become part of self-care routines, contributing to the economy in both the US and the UK. In a 2024 report, the American Med Spa Association says the US medical spa industry is worth $17 billion and employs 100,000 people. As for the UK spa market, it’s valued at roughly 4 billion US dollars, and expected to grow 7% between 2024 and2032.
While spa ownership can be lucrative, running such a business legally and ethically requires understanding spa license requirements.
Licenses ensure that services are provided safely, maintaining high standards of care and compliance with local laws. As you embark on the journey of opening a spa or medical spa, knowing the legal frameworks and obtaining the necessary licenses will protect your business and build trust with your clientele.
Determining whether you need a license to open a spa or a medical spa depends on the services you plan to offer. In both the US and the UK, regulations vary by state or region and by the types of services provided. For instance, basic services like massages and facials often require different permits compared to medical procedures like Botox or laser treatments. Knowing which services require specific licenses is paramount to avoid legal repercussions and ensure your business operates smoothly.
For useful information on managing your spa, refer to the spa management guide.
Opening a spa involves acquiring several licenses and permits. Generally, you'll need a business license, health permits, and specific licenses for services such as massage therapy or cosmetology. Here’s a breakdown of the essential legal requirements:
To get a spa license, you often need to complete an application, pay a fee, and pass inspections. Each type of service may have its own licensing board and requirements, so be sure to do your research. For even more insights on starting a spa business, see the guide on how to open a spa business.
For massage spa license requirements, see The American Massage Therapy Association: Massage Therapy Practice and License Requirements by State.
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Medical spas offer advanced treatments that typically require medical oversight. Here’s what you need, broken out by role:
1. Medical director: A licensed medical professional (doctor or nurse practitioner) must oversee the medical treatments.
2. Medical spa license: This covers the provision of medical-grade treatments like Botox, fillers, and laser therapies.
3. Practitioner licenses: Each practitioner must have appropriate licenses for the treatments they provide. For example:
The requirements for a medical spa license are stringent, typically involving comprehensive applications, proof of qualifications, and adherence to health regulations.
Zenoti helps medical spas with compliance through medspa software that is secure and HIPAA-compliant.
Look for revenue-maximizing features in the applications you’re considering. The Zenoti platform offers features like automatic upsell suggestions, alternate location booking, and abandoned cart recovery. Zenoti also integrates with Reserve with Google to drive spa bookings from search results. Discover more on five revenue-boosting features.
To obtain a medical spa license in the USA, follow these steps:
Opening a medical spa involves blending the ambiance of a spa with the rigor of a healthcare facility. This guide covers essential steps like market analysis, business planning, location selection, legal compliance, and marketing strategies. Learn how to navigate regulations, create a strong medical spa business plan, and set your medspa up for success.
Obtaining a spa license calls for these steps:
For efficient spa management, consider using spa management software from Zenoti.

Not all spa services require a professional license. Here are some examples:
These services can typically be offered without a professional license, but it's still important to ensure your business complies with general health and safety regulations.
Discover how the franchise brand retooled the guest experiences across 450+ locations. The case study outlines how they unified their operations for consistent brand management and a seamless customer journey. Learn about their challenges and solutions. Read the case study.
Yes, you can open a spa with an esthetician license, but the services you can offer will be limited to those covered by your esthetician training. This includes:
With an esthetician license, you’ll be well-placed to open a spa as you can offer a range of beauty and skincare services.
Acquiring the necessary licenses for a spa or medical spa is not just a legal formality, it’s a cornerstone of operating a trustworthy and successful business. Ensuring compliance with spa license requirements protects your business and builds client confidence. As you navigate these requirements, consider leveraging tools like Zenoti software to streamline operations and stay compliant. Taking these steps will set your business on a path to success in the vibrant and competitive wellness industry.
Explore Zenoti software for beauty and wellness business management.


Written by
Gita Mani, Senior Content Specialist
Focused mostly on inbound marketing – aka wooing customers with killer content instead of chasing them with ads – Gita thrills in the power of language to shape buyer journeys. When not smithing words, she watches birds.
Learn more about Gita Mani