Ultrasonic Cavitation License Requirements by State (2026)

The license you need for ultrasonic cavitation depends on your state. Some states class it as medical: New York's Department of State lists it as a medical procedure, and the Texas licensing agency says body cavitation must be done under a physician's order and delegation. Other states never name cavitation at all and leave it to their general esthetics rules. This guide covers the 15 most populous states plus a few others, all checked against official board pages in October 2026.

If you only want the short yes-or-no answer, we cover it in our guide to do you need a license to do ultrasonic cavitation. This page is about the state differences, because that is where most people get caught out.

Quick answer

• No state hands out a "cavitation license." What you need is the right existing license, such as esthetician, cosmetologist or a medical license. Some states also require physician delegation.
• New York lists ultrasonic cavitation as a medical procedure, so esthetics and cosmetology licenses don't cover it.
• Texas's licensing agency (TDLR) says body cavitation and contouring are medical treatments, given under a physician's order and delegation.
• California's barbering and cosmetology board lists cavitation and body contouring as out of scope for estheticians and cosmetologists.
• Illinois, Ohio and South Carolina don't name cavitation. Their rules do bar estheticians from affecting living skin cells or the deeper layers of the skin.
• Most other large states have no specific guidance, so you need to ask the board before you start.
• A training certificate is not a license. It shows you were trained. It does not give you legal permission to treat clients.

This is general information, not legal advice. Rules change, so confirm with your state board before you treat anyone.

What ultrasonic cavitation is, and why regulators care

Ultrasonic cavitation (also called "cavi lipo" or ultrasound cavitation) uses low-frequency sound waves, applied through a handpiece with gel, to target fat under the skin. It is non-invasive. Nothing pierces the skin. It is usually sold as a body contouring treatment for areas like the stomach, flanks and thighs.

The New York Department of State describes it this way in its procedure chart: a "treatment that utilizes ultrasound waves to cause fat cells to rupture, emulsify, and be eliminated from the body." That description explains why some regulators put it in the medical column. A beauty license generally covers the surface of the skin. Cavitation is designed to act on the fat layer below it.

FDA status of ultrasound body contouring devices

The US Food and Drug Administration regulates the machines. It does not license practitioners. Here is what the official FDA records show:

• Device classification. Focused ultrasound devices for aesthetic use fall under 21 CFR 878.4590, "Focused Ultrasound Stimulator System for Aesthetic Use." They are Class II medical devices under product code OHV.
• Example of a cleared body device. The UltraShape Power System (510(k) K160896) is cleared for "non-invasive reduction in abdominal circumference." Its 510(k) summary describes it as a prescription-use-only device.
• FDA's consumer guidance. FDA's page on non-invasive body contouring says ultrasound "may rupture fat cells and reduce the treated area's circumference." It lists risks including blisters, burns and nerve damage. FDA also states that non-invasive body contouring is not a weight-loss treatment.

Why this matters for licensing: several boards, including California's, tell licensees to check a machine's FDA classification themselves. California's board says Class II and Class III devices may fall outside a beauty licensee's scope. A machine sold to you as "FDA approved" is not proof of anything. Search the brand and model in the FDA 510(k) database. Check the cleared use, and whether it is labeled prescription or over-the-counter.

The general rule across the US

Most states follow one of three patterns.

1. Cavitation is named as medical. New York says this directly. Texas's licensing agency groups body cavitation with treatments that need a physician's order and delegation. In these states you work under a medical license, or under proper delegation in a medical practice.
2. Cavitation is named as outside beauty scope. California's board lists cavitation and body contouring under "Prohibited/Out of Scope" in its esthetician and cosmetologist fliers. Massachusetts lists body contouring among services its cosmetology licensees may not perform.
3. Cavitation isn't named, but general limits apply. This is the most common pattern. Illinois says estheticians may not use "techniques, products, and practices intended to affect the living layers of the skin." Ohio says estheticians "shall not provide services that ablate, damage, or alter any living cells." South Carolina's board guidance prohibits procedures that claim to affect the dermis or tissue below it, "such as muscle or fat." These rules don't say "cavitation." But a treatment whose whole purpose is to act on fat is hard to fit inside them.

A few states take the opposite view. Nebraska's health department lists "Cellulite Cavitation" as "within cosmetology and esthetic practice" in a 2018 advisory opinion. So there really is no single national answer.

State-by-state table: who can perform ultrasonic cavitation

How to read this table. A definite answer appears only where we verified it on an official state source in October 2026. Where the official rules don't mention cavitation, we say so and name the board to call. "Not specifically addressed" does not mean "unregulated." It means you need a written answer from the board before you start.

The big states in more detail

Ultrasound cavitation license in Texas

Texas is one of the clearest states. The Texas Department of Licensing and Regulation (TDLR) runs cosmetology and esthetics. Its medical spa page lists "body cavitation and contouring" alongside Botox, fillers and laser skin treatments. It says these "fall under medical treatments that must be provided under the order and delegation of a licensed physician." TDLR's "Who Regulates What" page gives a one-line answer for body contouring: contact the Texas Medical Board. For certain medical equipment, it also points to the Department of State Health Services.

TDLR also says a Texas esthetician may only work at an establishment licensed by TDLR. An esthetics license alone does not cover cavitation in Texas. If you want to offer it, talk to the Texas Medical Board about the medical director and delegation setup first. Our full guide is here: body contouring license in Texas.

Ultrasound cavitation license in California

California's Board of Barbering and Cosmetology publishes one-page scope fliers for estheticians and cosmetologists. Both list "Body Contouring/Sculpting," "Cavitation," "Cryolipolysis or Any Fat-Reduction Treatment," "Radio Frequency" and "Ultrasound" under "Prohibited/Out of Scope." The board's older skin-care device guidance points the same way. It allows ultrasonic devices only when they are "low frequency, low powered, topical devices intended for skin cleansing, exfoliation and product application." It flags "any type of fat-reduction treatment" as possibly invasive or the practice of medicine.

At a 2023 committee meeting, the board said "body slimming" machines are being marketed to its licensees. It plans to remind them the service is out of their scope. If you are licensed in California, treat cavitation as outside your esthetics license. Read our California guide: navigating body contouring licensing in California.

Ultrasound cavitation license in Illinois

Illinois has no rule that names cavitation. But the esthetics definition in 225 ILCS 410/3A-1 is narrow. Estheticians may beautify, massage, cleanse, exfoliate or stimulate "the stratum corneum of the epidermis," the outer dead layer of skin. They may use any electrical or mechanical device to do it. The same law says estheticians "are prohibited from using techniques, products, and practices intended to affect the living layers of the skin."

IDFPR's Statement on Prohibited Practices (April 2026) lists procedures outside cosmetology and esthetics. Radio frequency is on that list. Cavitation is not mentioned either way. IDFPR's medical spa memo (updated October 2025) says med spas must be owned and operated by physicians or APRNs. Because cavitation targets fat, not the outer skin, get IDFPR's view in writing before offering it. More detail in our article do you need a license to perform ultrasonic cavitation in Illinois.

Ultrasound cavitation license in New York

New York's Department of State publishes a Procedure Licensure Chart, revised July 15, 2026. It is the most direct official answer in the country. "Ultrasonic Cavitation (Cavi Lipo)" is listed under the NYS Education Department as Medical. The same chart lists Cool Sculpting, cryotherapy and superficial ultrasound as medical too.

Some body treatments are on the beauty side in New York. Vacuum therapy, Endermologie, body wraps and electromagnetic muscle toning devices (such as EmShape) are listed under cosmetology or esthetics. The Department notes the chart is informational and not a full list. See our New York body contouring license guide.

Ultrasound cavitation license in Florida

Florida's cosmetology law (Chapter 477) defines cosmetology as treatment of "the head, face, and scalp for aesthetic rather than medical purposes." "Skin care services" on the rest of the body must be done by a licensed cosmetologist or facial specialist in a licensed salon. The statute describes those services as applying or removing a chemical preparation with a sponge, brush, cloth or similar device. It says they "may not involve massage therapy." Cavitation devices are not mentioned anywhere in the statute.

So Florida's written law doesn't settle the question. Ask the Florida Board of Cosmetology and the Board of Medicine before you buy a machine. Our Florida body contouring license guide covers the rest of the setup.

Ultrasonic cavitation in Arizona

Arizona's Barbering and Cosmetology Board adopted a scope-of-practice policy statement in September 2024 (revised December 2024). It includes a table with a "Cavitation" row under its Ultrasound heading, and a "Body Contouring/Tightening" row. The statement also says lasers, radiofrequency devices and IPL must be registered with the Arizona Department of Health Services Bureau of Special Licensing. Laser services need a separate Certified Laser Technician license. The board calls the statement "advisory only." Check the table on the official PDF for which license types are marked. Our Arizona guide walks through it.

Pennsylvania, Ohio, Georgia, North Carolina, Michigan, New Jersey, Virginia and Tennessee

In these eight states we found no official rule or guidance that names ultrasonic cavitation. That leaves you with each state's general limits:

• Ohio limits estheticians to "beautification, relaxation, and non-invasive services only." It bans services that claim "a medical or healing benefit," and services that "ablate, damage, or alter any living cells" (Ohio Adm. Code 4713-8-04, effective January 2, 2025).
• North Carolina's board ruled in 2022 that esthetic devices must be FDA-cleared where required. Licensees may not use anything that "penetrates the client's skin beyond the epidermis," or devices in FDA classes 3, 3A, 3B or 4.
• Virginia requires spas to make sure no licensee works "beyond the scope of practice" of the esthetician license. Its regulation does not list body devices.

Where the rules are silent, the safest move is to email the board. Describe the exact device (brand, model, FDA status), what it is marketed to do, and your license type. Ask whether it falls inside your scope, and keep the reply.

Washington

Washington is a two-tier state. Department of Licensing guidance says regular estheticians may use devices only if they are FDA-cleared as "over the counter." Master estheticians may use "medical devices for care of the skin." The department lists ultrasound among those devices. For prescriptive devices, a master esthetician works under a licensed physician's authority. Before using a cavitation machine in Washington, check its FDA labeling and which license tier it needs.

Why the same treatment gets different answers

It comes down to three things regulators look at.

1. Which skin layer does it affect? Most esthetics laws are written around the outer layer of skin. Illinois says "stratum corneum." Ohio says no altering "living cells." South Carolina names "muscle or fat." Cavitation is marketed to act on fat. Under that kind of wording, it sits outside a beauty license unless the board says otherwise.

2. What does the device do, and how is it labeled? Boards in California and North Carolina tie scope to FDA classification. Washington ties it to over-the-counter versus prescription labeling. FDA lists focused ultrasound aesthetic devices as Class II, and the cleared UltraShape body device is prescription-only.

3. What are you claiming? California's device guidance warns that a machine claiming to "reduce cellulite or manage pain" could be treated as practicing medicine. Ohio bans any esthetic service that claims a medical or healing benefit. Fat-loss and inch-loss claims in your ads can move a service into medical territory, whatever your machine is.

Step-by-step: how to start offering cavitation legally in your state

1. Find your state's official answer. Use the table above. Then read the board page or chart yourself. If cavitation isn't named, email the board with your device details and license type, and keep the written reply.
2. Get the right license, or the right setup. In states where cavitation counts as medical or outside beauty scope (New York, Texas, California), plan to work inside a medical practice with a physician or other authorized provider. In other states, an esthetician or cosmetology license may be required as a minimum.
3. Register your business. Form your business entity with your Secretary of State and get an EIN from the IRS. Check whether your state needs a licensed establishment. Texas, for example, requires estheticians to work in a TDLR-licensed establishment, and Florida requires skin care services in a licensed salon.
4. Check local permits. Your city or county may need a business license, zoning approval or health permit. Call the local business licensing office.
5. Check the machine. Search the brand and model in the FDA 510(k) database. Note the cleared use and whether it is prescription or over-the-counter. Keep the manufacturer's manual and training records.
6. Get insured. Professional liability insurers usually ask about your license and training for each device. Tell them exactly what you offer.
7. Train properly. Learn contraindications, settings, skin checks and aftercare. Our Ultrasonic Fat Cavitation & Radiofrequency Certification covers protocols and client safety.
8. Use consent and intake forms. Screen for the contraindications FDA lists, such as open wounds, compromised skin and implants. Record every session.
9. Set up a medical director where needed. If your state requires physician order or delegation, put a written agreement in place before your first client.

Common mistakes

• Treating a training certificate as a license. A course certificate shows you completed training. It does not let you legally perform a treatment your state restricts.
• Trusting the seller. "FDA approved," "no license needed" and "estheticians can use it" are sales lines. Check the FDA database and your board.
• Assuming silence means yes. If your state doesn't name cavitation, that is a reason to ask, not permission.
• Making medical or weight-loss claims. FDA says non-invasive body contouring is not a weight-loss treatment. Several boards treat health claims as a sign of medical practice.
• Copying another state's rules. Nebraska's advisory opinion means nothing in New York, and New York's chart means nothing in Nebraska.
• Working from home without checking. Many states require a licensed establishment for esthetics services.
• Bundling services without checking each one. A package of cavitation, RF and lymphatic massage may touch three different rules. Massage, for example, needs a massage license in some states.

Getting trained

Whatever your state says, good training matters. An online certificate is a great place to start. It helps with insurance applications and gives clients confidence. It does not replace any license your state requires. Body Contouring Courses is a CPD accredited provider. Students receive a certificate of completion. Our single courses are $98.50 USD, and we have trained 7,500+ students (4.8/5 average rating from 600+ reviews).

For a full skill set, the 11-in-1 Body Contouring Certification bundle includes all 11 courses. If you are setting up a clinic properly, Practitioner Pro adds the complete clinic system.

FAQ

Do you need a license to do ultrasonic cavitation in Texas?

Yes. TDLR lists body cavitation and contouring as medical treatments that must be given under a licensed physician's order and delegation. It says to contact the Texas Medical Board about body contouring.

Can an esthetician do ultrasonic cavitation in California?

Not under the esthetician license. The Board of Barbering and Cosmetology's esthetician flier lists cavitation and body contouring as prohibited or out of scope.

Do you need a license for ultrasound cavitation in Illinois?

Illinois doesn't name cavitation. Its law bars estheticians from practices "intended to affect the living layers of the skin," and cavitation targets fat. Get a written answer from IDFPR before you offer it.

Is ultrasonic cavitation legal in New York for estheticians?

No. The Department of State's procedure chart lists ultrasonic cavitation as medical, under the NYS Education Department.

Do you need a license to do cavitation in Florida?

Florida's cosmetology law doesn't mention cavitation. Body skin care services must be done by a licensed cosmetologist or facial specialist in a licensed salon. Ask the Board of Cosmetology and the Board of Medicine about cavitation devices.

Is there a specific ultrasonic cavitation license?

No state we checked issues a cavitation-only license. You need whichever existing license your state requires, sometimes with physician delegation.

Is an ultrasonic cavitation certification the same as a license?

No. A certification or certificate of completion shows training. A license comes from your state and gives legal permission to practice.

Are cavitation machines FDA approved?

Some ultrasound body contouring devices are FDA-cleared through 510(k) as Class II devices, such as UltraShape Power for abdominal circumference reduction. Many machines on the market are not. Search the exact model in the FDA 510(k) database.

Sources

• FDA: Non-Invasive Body Contouring Technologies
• FDA 510(k) summary K160896: UltraShape Power System (21 CFR 878.4590, product code OHV)
• FDA 510(k) Premarket Notification database
• California Board of Barbering and Cosmetology: Esthetician scope flier
• California Board of Barbering and Cosmetology: Cosmetology scope flier
• California Board of Barbering and Cosmetology: Skin care device guidance
• California Board of Barbering and Cosmetology: Enforcement and Inspections Committee minutes, Sept 11, 2023
• TDLR: Medical Spas
• TDLR: Who Regulates What
• Florida Statutes Chapter 477 (Cosmetology)
• New York Department of State: Procedure Licensure Chart
• Illinois 225 ILCS 410/3A-1 (Esthetics)
• IDFPR: Statement on Prohibited Practices
• IDFPR and IDPH: Medical Spa memo
• Ohio Administrative Code 4713-8-04
• North Carolina Board of Cosmetic Art Examiners: Esthetic scope declaratory ruling
• Virginia Administrative Code 18VAC41-70-250
• Washington Department of Licensing: Laser rules and requirements
• Arizona Barbering and Cosmetology Board: Scope of Practice Substantive Policy Statement (2024)
• Massachusetts Board of Cosmetology and Barbering: Policy on practices outside the scope of licensure
• Nebraska DHHS: Cosmetology, Esthetics and Body Art Advisory Opinions
• South Carolina Board of Cosmetology: FAQ Board Guidance

This article is general information, not legal advice. Always confirm with your state board before treating clients.

Last updated: October 2026