The line
In California, injecting Botox or filler is a medical act. It can be done by a physician, a nurse practitioner, a physician assistant, or a registered nurse — but with a physician involved, and only after a good-faith exam. An aesthetician (esthetician) is licensed for skincare: facials, peels, waxing. They cannot legally inject. If an aesthetician is putting a needle in your face on their own, that's unlicensed practice of medicine, full stop.
So 'can a nurse do Botox?' — yes, a properly licensed nurse, the right way. 'Can an aesthetician do Botox?' — no, not legally, ever.
Why the line matters
Injectables carry real risks — including rare but serious ones like a blood vessel getting blocked. A licensed medical provider is trained to recognize and handle those complications. An unlicensed person is not. The license isn't bureaucratic box-checking; it's your safety net if something goes wrong.
How to check in two minutes
Ask who is injecting you, get their name, and look them up at search.dca.ca.gov — California's free public license database. You want an active license and a clean record. A good spa is glad to tell you; the question only lands wrong where there's something to hide.
See the California med spas that passed