Currently, in North Dakota, as in most states, estheticians can provide a number of skin care services but are unable to provide treatments that qualify as the practice of medicine. For example, they can exfoliate dead skin cells but may not penetrate past the stratum corneum layer of skin and may not use invasive treatments. If passed, HB 1126 creates an advanced esthetician license with an expanded scope to include a number of cosmetic procedures that are currently restricted to the practice of medicine and nursing.

Under HB 1126, advanced estheticians, in addition to the current esthetics scope of practice, would be able to perform advanced cosmetic preparations or procedures using the hands or a mechanical or electronic apparatus for aesthetic purposes; this includes advanced chemical peels, microneedling and extractions using lancets. They would be prohibited from performing any treatment that excises, vaporizes, disintegrates or removes living tissue.

In order to qualify for an advanced esthetician license, a person would need to complete a 500-hour course in a board-approved school. Currently, licensed estheticians could qualify for the advanced licensed if they:

1. Have one year of practical experience;
2. Complete a four-hour safety and infection control training;
3. Obtain an OSHA bloodborne pathogen certification; and
4. Provide either an affidavit of working for at least 300 hours under direct medical supervision or complete a 150-hour board-approved advanced esthetics course.

Notably, even with the advanced esthetics license, practitioners would need to complete additional board approved training or certification before being able to perform advanced chemical peels; use microneedling pens, rollers or devices; or use non-ablative devices. HB 1126 would also affect the scope of practice for regular estheticians. Estheticians would be able to perform microdermabrasion, dermaplaning and high frequency treatments as well as cosmetic chemical peels of certain concentrations.

An unusual element of HB 1126 is that it includes a definition for the term “non-ablative esthetic procedures” but does not use the term anywhere in the bill. Non-ablative aesthetic procedures include laser, light and energy treatments to rejuvenate skin, body contouring, cellulite or dyschromia reduction, and hair and tattoo removal. It isn’t clear if this is an editing mistake or if it is meant to refer to the “non-ablative devices” that advanced estheticians can use with additional training. These types of bills often get changed and amended significantly as they move through the process; that will likely be the case here, as well. If you would like additional information, to read the language of this bill or to contact the sponsors or committee, you can find the information you need through here HB 1126.

This Act becomes effective on January 1, 2026.