Who Can Inject Botox in South Dakota? Nurses and Licenses

South Dakota does not have one agency for injectors. A person's license board depends on the license they hold, so the name on a med spa's door does not tell you which board to check. Start by asking for the full name and license type of the person who will treat you and the person who authorizes the treatment. Our guide to verifying credentials covers the general steps.

We found no South Dakota page that creates a license or registration category for medical spas or cosmetic injectors, and no Board of Medical and Osteopathic Examiners statement on cosmetic injections in the pages we reviewed. The Board of Nursing's statement is the main South Dakota document we found that names Botox.

The Board of Nursing's statement, Dermatological Procedures by Licensed Nurses, says dermatologic and medical aesthetic services may be performed by a licensed RN or LPN as part of a medically prescribed plan of care. The page shows an initial approval date of 2002 and a most recent revision of November 2024. The board says its opinions do not have the force and effect of law but guide licensees toward safe practice. The same statement says South Dakota law does not allow an RN or LPN to perform these procedures without a medical order or protocol, and that nurses perform them according to agency policy.

The statement lists neuromodulators (botulinum toxin, such as Botox) among injectable treatments an RN may perform using FDA approved products, and lists injectable neuromodulator treatments among LPN procedures. It lists temporary dermal fillers for RNs but does not list them for LPNs. It also says an RN or LPN may not prescribe or perform these procedures without a medical order or protocol, even for elective services requested by a client in a non-traditional setting.

The nursing statement expects an authorized medical provider (a physician, certified nurse practitioner or physician assistant acting within their South Dakota scope) to review the client's history, assess whether the procedure is appropriate for each episode of care, develop a treatment plan and write a medical order before delegating a procedure to a nurse. The assessment may be in person or by telehealth.

A protocol must be in writing, dated and signed by the medical provider and reviewed annually. It must set the nurse's required licensure level, experience and training, the level of supervision, when to consult the provider, and contraindications. The statement also expects the practice to keep client assessments, consent and procedure records, and to obtain substances from a South Dakota licensed wholesale drug distributor or licensed 503B outsourcing facility.

These are the board's expectations for nursing practice. Ask the clinic which provider assessed you, which order covers your treatment and where it is documented. Our guide to RN injector delegation explains why the order matters across states.

The Board of Medical and Osteopathic Examiners licenses MD and DO physicians and physician assistants. Its physician assistant page quotes SDCL 36-4A-1.1, which describes a collaborative agreement signed by a physician assistant and a licensed physician. SDCL 36-4A-1.2, quoted on the same page, lets a physician assistant practice without one if the assistant is nationally certified and files an affidavit with the board attesting to at least 6,000 practice hours. The page does not mention Botox or cosmetic injections.

In the pages we reviewed, we found no Board of Medical and Osteopathic Examiners statement on cosmetic injections. The board has a March 28, 2012 declaratory ruling on laser delegation. As we captured it, the ruling states that lasers and light emitting devices are surgery and the practice of medicine, and that the board held physicians may not delegate laser procedures. It also says the Board of Nursing defines nurses' scope and the ruling does not affect nurses. Our capture of the ruling is incomplete, so read the full ruling. The Board of Nursing's statement separately reports that the Board of Medical and Osteopathic Examiners determined that only physicians, nurse practitioners and physician assistants may use lasers.

A laser treatment and a Botox injection raise different questions. Ask for the individual's license type and what authorizes the specific treatment you were offered.

The Cosmetology Commission says it regulates skin care and esthetics and that in no case may the regulated procedures be invasive or medical treatments. Its scope document quotes SDCL 36-15-2.2, which limits esthetics to noninvasive care confined to the nonliving cells of the outer skin layer, not for treating medical disorders. The document is dated July 3, 2017, so check the commission for later changes.

The same document quotes SDCL 36-15-16, which says the cosmetology chapter does not apply to licensed physicians, physician assistants and nurses when exclusively engaged in their own professions. Combined with the limits above, an esthetician license alone is not a basis for injecting. Our esthetician scope guide goes further.

We found no South Dakota license or registration for medical spas, and no state list of cosmetic injectors, on the board pages we reviewed. Practitioners hold the license for their own profession.

The nursing statement does require one registration. A CNP or RN who owns a business providing dermatologic or medical aesthetic services must register it with the Board of Nursing as a nursing corporation. That concerns the owner's board, not the patient's safety check.

For a nurse, use the license verification portal that the Board of Nursing links from its home page. Search by name, license number or NCSBN ID, choose the license type (RN, LPN or an APRN type) and click View Report for the full details. For a physician or physician assistant, use the Board of Medical and Osteopathic Examiners' licensee lookup, which shows the profile and expiration date at no charge. For an esthetician or salon, use the Cosmetology Commission's license verification.

To report a nurse, use the Board of Nursing's complaint form. To report a physician or physician assistant, use the Board of Medical and Osteopathic Examiners' complaint form; the board says it has no jurisdiction over fees, registered nurses or most facilities. Cosmetology complaints go to the Commission in writing on its complaint form. See also our complaint guide.

Compare the name and license type you find with the person assigned to your appointment. A lookup confirms licensure status, and each board publishes public discipline separately. Neither shows whether a given order or protocol exists.