Texas Senate Bill 378, a.k.a. the "Botox Party Bill", and Its Impact on Existing Medical Regulations

Texas Senate Bill 378, often referred to as the "Botox Party Bill", is currently making its way through the Texas legislative process. Initiated by State Sen. Charles Schwertner, the bill aims to restrict who can perform injections, including Botox and similar treatments, in Texas.

But will it have a meaningful impact on existing regulations?

First, let’s look at the key provisions of the bill:

Summary of Texas Senate Bill 378

Texas Senate Bill 378 would amend the Texas Occupations Code to establish certain prohibited medical practices for barbers and cosmetologists, specifically restricting them from performing procedures that penetrate the dermis layer of skin or using certain devices unless they hold additional appropriate medical licensing.

Key Provisions of the “Botox Party Bill”:

1. Prohibits barbers and cosmetologists from making incisions into the dermis layer of skin, including for injecting medications or substances
2. Prohibits the use of devices as defined Section 551.003 of the Texas Occupations Code
3. Provides an exception for those who hold appropriate medical licenses in addition to their cosmetology/barbering credentials
4. Places the burden of proof on the license holder to demonstrate they are authorized to perform such acts if disciplinary action occurs
5. Clarifies that this does not affect the authority of other state agencies to enforce laws related to their regulated professions
6. Applies only to conduct occurring on or after the effective date (September 1, 2025)

Will Texas Senate Bill 378 Impact Existing Medical Regulations?

In my assessment, the new law creates a regulatory distinction without meaningful practical impact.

Here’s why:

The bill specifically amends the Cosmetology and Barbering statute. It therefore only governs activities performed by persons while they are acting as a cosmetologist or barber.

The proposed law does not amend the Texas Medical Practice Act, however, which gives physicians authority to delegate any medical act, including injections, to a qualified and properly trained person acting under the physician's supervision – including barbering or cosmetology license holders – if the physician believes it's within the scope of sound medical judgment.

To enhance patient safety or tighten Texas laws over who may administer Botox injections (and similar treatments), Section 157.001 of the Texas Occupations Code would have to be amended in a way that specifies the minimum training and/or licensure requirements for physician delegates.

The current law in Section 157.001 vaguely requires a physician delegate to be properly trained and qualified. Senate Bill 378 does not change this standard.

Without establishing clear training and qualification requirements for physician delegates, Senate Bill 378 will not change who may administer Botox injections (and similar treatments).

Implications for Cosmetologists and Barbers

While Senate Bill 378 would prohibit barbers and cosmetologists from making dermal incisions or injections while acting in their capacity as cosmetology/barbering professionals, the Texas Medical Practice Act would still allow a physician to delegate injection procedures to these same individuals if:

1. They're properly trained
2. They're under proper physician supervision
3. They're not representing themselves as practicing cosmetology or barbering when performing the injections
4. They're not representing themselves as authorized to practice medicine

A cosmetologist or barber could receive any number of paid training courses or receive training from a physician directly. So long as they perform injections without representing that they are acting within the scope of their cosmetology or barber license, the performance of the delegated injection procedure would not violate the proposed new law.

Additionally, per Section 169.25 of the Texas Administrative Code, nonsurgical medical cosmetic procedures, “including but not limited to the injection of medication or substances for cosmetic purposes”, are considered the practice of medicine in Texas and therefore already illegal to perform without physician supervision.