Kentucky Board of Nursing Revises Cosmetic and Dermatological Procedure Guidance

The June 2026 revision to AOS #35 addresses nurse roles in cosmetic and dermatological procedures, including updates involving IV hydration, evidence-based practices, standards of care, and applicable laws.

AOS #35 Addresses Nurse Roles, Procedure Categories, and IV Hydration

In June 2026, the Kentucky Board of Nursing revised Advisory Opinion Statement #35, updating guidance on the roles and responsibilities of nurses in cosmetic and dermatological procedures. The advisory opinion is relevant to Med Spa and aesthetic practices because it reviews applicable Kentucky laws, best practices, and standards of care for medically directed cosmetic care, including IV hydration services.

Revised AOS #35 Outlines Nursing Scope and Medically Directed Care

Key points from the revised guidance include:

• Nursing accountability: Nurses remain responsible for decisions based on their educational preparation, current clinical competence, and ability to practice with reasonable skill and safety under KRS 314.021(2).
• LPN and RN roles: The guidance states that LPNs and RNs may perform certain cosmetic and dermatological procedures when they meet competency expectations and follow applicable supervision requirements.
• Scope of practice limits: AOS #35 states that LPNs and RNs may not independently practice, order products, prescribe treatments, or perform medical aesthetic procedures such as Botox or dermal fillers outside the scope of nursing practice identified by the Kentucky Board of Nursing under KRS Chapter 314.
• APRN role and population focus: The revised APRN table addresses which APRN roles and population foci may support training for aesthetic and cosmetic practice, when consistent with the APRN’s scope, certification, licensure, and applicable law.
• IV hydration: The IV hydration section states that mobile and freestanding IV hydration clinics are not regulated in Kentucky, but IV fluid administration is considered a treatment and requires an order from a qualified healthcare provider.

The revised guidance also addresses standing orders, treatment plans, consent, IV documentation, additives, adverse effects, and immediate-use compounded sterile products. For aesthetic practices, this advisory statement offers guidance for reviewing whether nursing services are supported by qualified provider orders, documented assessments, appropriate supervision, and procedure-specific competency.

Source: Kentucky Board of Nursing Advisory Opinion Statement #35

According to the Kentucky Board of Nursing, the June 2026 revision of AOS #35 provides practice guidance for nurses involved in cosmetic and dermatological procedures. The document also notes that KBN advisory opinions are intended to guide safe nursing practice.

Compliance Context for Aesthetic Nursing and IV Hydration

Kentucky AOS #35 provides nurses and practice operators with a board-level reference on cosmetic and dermatological procedures that may be performed within nursing practice. The advisory opinion addresses how these procedures should be performed based on educational preparation, current clinical competence, supervision, and a medically prescribed plan of care.

The guidance applies to Kentucky practices using LPNs, RNs, or APRNs for procedure categories identified in AOS #35, including:

• Level I procedures: Microdermabrasion, dermaplane exfoliation, microneedling under 0.5 mm, light chemical peels, LED therapy, facials, and non-invasive fat destruction.
• Level II procedures: Pulsed light therapy, photodynamic therapy with ALA, high-intensity focused ultrasound, medium-depth chemical peels, non-ablative hair removal, and non-ablative skin treatments.
• Level III procedures: Neuromodulators, dermal fillers, sclerotherapy, PRP injectables, absorbable threads, deoxycholic acid injections, microneedling at 0.5 mm or greater, cryolipolysis, laser procedures, IV hydration/vitamin therapy, hormone pellets, and nitrous oxide for cosmetic or medical aesthetic procedures.

For LPNs and RNs, this advisory opinion separates task performance from independent practice, product ordering, prescribing, or treatment-plan authority. Oklahoma’s nursing board guidance on the scope of cosmetic procedures for nurses addressed similar role-boundary issues for nurses performing aesthetic services.

For Kentucky aesthetic practices, the compliance focus is whether nurse-performed procedures are supported by provider direction, documented assessment, appropriate supervision, and procedure-specific competency. State IV therapy oversight may also vary by jurisdiction, including Maine’s joint rule for IV therapy in Med Spas and medical aesthetics, which directly addresses IV therapy operations.

Practical Implications for Kentucky Med Spa and Aesthetic Practices

• Match each procedure to the nurse’s license type, training, and documented competency.
• Confirm that medical aesthetic procedures follow a qualified healthcare provider’s assessment and treatment plan.
• Review standing orders and protocols before using them for cosmetic services or IV hydration.
• Document IV hydration details, including additives, timing, consent, and adverse effects.
• Separate nursing tasks from provider-level responsibilities for diagnosis, prescribing, product ordering, and treatment-plan authority.

What to Watch Next

Any future updates from the Kentucky Board of Nursing to AOS #35 or related advisory materials could further clarify how nurse roles apply to cosmetic, dermatological, and IV hydration services. For Med Spa and aesthetic operations, additional guidance may apply to documentation, procedure assignment, and competency expectations.

About Spakinect

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Image Attribution: “The south facade of the Kentucky State Capitol building located in Frankfort, Kentucky,” by Tedd Liggett, via Wikimedia Commons, licensed under CC BY-SA 4.0.