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In Hawaii, Botox injections are considered medical procedure and must be administered by doctors or private practice nurse practitioners if they fall within their area of practice. Physicians can delegate Botox injections to a physician assistant (PA), registered nurse (RN), or licensed practical nurse (LPN) if they have the education, expertise, and ability to perform the procedure competently and safely.

Botox injections can be assigned to an RN or LPN if [1] it falls within the scope of practice of the NP, [2] it is performed in compliance with nursing delegation laws, and [3] the RN and LPN have the expertise, ability, and training to safely and competently perform the operation.