Registered nurses (RNs)
No; Hawaii does not permit RN injection of neurotoxins or fillers
Nurse practitioners & physician assistants
NP/PA cannot inject; physician collaboration required but does not permit independent or delegated injection
Supervision & the medical director
Required; must be a Hawaii-licensed physician
The exam requirement
Required; in-person exam required before treatment
What to verify in Hawaii
Confirm that a Hawaii-licensed physician owns or has controlling interest in the medical spa; verify that only MDs/DOs perform injections.
Primary source: Hawaii Board of Medicine
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.