Medical Spa vs. Day Spa: The Difference Most People Don't Know
Published 2026-02-27 • Summer House Editorial Team
From the outside, a medspa and a day spa can look almost identical — the same peaceful music, the same robes, sometimes the same building. But the two are fundamentally different in terms of what they can legally do, who can do it, and what level of clinical oversight is involved. Understanding the difference helps you know where to go for what — and what to be cautious about.
What Makes a Medical Spa Medical
A medical spa, by definition, operates under physician oversight and offers treatments that require a medical license to perform. In Texas, this includes injectable treatments like Botox and dermal filler, prescription-strength chemical peels, laser treatments that affect deeper skin layers, and any procedure that involves breaking the skin or altering tissue. These treatments can only be legally administered by or under the direct supervision of licensed medical professionals.
The physician oversight requirement isn't just a technicality. It means there should be a medical director with a Texas medical license who is responsible for the clinical protocols of the practice, reviews treatment guidelines, and can be reached when clinical questions or complications arise. When this structure is in place, clients have a meaningful layer of protection. When it's absent — and there are medspas operating without genuine medical oversight — the risks are real.
What Day Spas Can and Cannot Do
Day spas are licensed as cosmetology or esthetics facilities and are staffed by licensed estheticians and cosmetologists. They're excellent at what they do: facials, massage, waxing, manicures, superficial exfoliation, and relaxation treatments. Estheticians are skilled professionals with real training in skin care — but their license doesn't include administering prescription treatments, injectables, or anything that penetrates below the surface of the skin.
The issue arises when businesses market themselves in a way that blurs this line — using aesthetic, wellness, or beauty clinic language that makes them sound like medspas when they aren't operating under medical oversight. If a spa is offering 'Botox' or 'filler' administered by someone who isn't a licensed medical professional, that's not just a bad deal — it's illegal in Texas and a genuine safety risk.
How to Tell the Difference When Booking
Ask directly: who will be performing the treatment, what is their medical license, and who is the supervising physician? A legitimate medspa will answer these questions without hesitation. If the person who performs your treatment is an esthetician, that's appropriate for esthetics services and not appropriate for injectables or prescription treatments. The title and license matter.
Also look at what they're offering. Microneedling, chemical peels, and laser treatments done at the surface level are in a gray area that some esthetician licenses cover and some don't depending on depth and device. Injectable treatments are unambiguous — they require a medical license, period. When evaluating any facility, a quick check of what license they hold and what that license covers in Texas takes minutes and protects you.
FAQ
Can estheticians do microneedling in Texas?
Texas esthetics law distinguishes between superficial needling done for cosmetic purposes and deeper medical-grade microneedling. The specifics are regulated by the Texas Department of Licensing and Regulation. More aggressive microneedling devices and depths fall under medical oversight requirements. If you're unsure about a specific facility, ask what device they use and what license covers its use.
Is a higher-priced spa automatically more reputable?
Not necessarily. Price is a signal of market positioning, not clinical quality or proper licensing. A well-priced medspa with legitimate medical oversight is safer than an expensive facility that lacks it. Focus on credentials and medical structure, not price point alone.
Need help now?
Summer House Medspa operates under full medical oversight in Dallas — call 214-307-1877 to learn about our clinical team and treatments.