Who can legally inject Botox and dermal fillers in Hawaii?

MD, DO only; NP/PA/RN injection not permitted No; Hawaii does not permit RN injection of neurotoxins or fillers

Hawaii · Strict

Who Can Inject Botox & Fillers in Hawaii?

In Hawaii, 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 Hawaii handles both.

By Evan at Inside MedSpa

Who can inject

MD, DO only; NP/PA/RN injection not permitted

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

The exam that makes it legal

Required; in-person exam required before treatment 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.

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.

See the full Hawaii regulation profile →

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