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<regulation prefix="Regulation" num=".02" citation="COMAR 10.27.25.02" title_num="10" subtitle_num="27" chapter_num="25" heading="Definitions.">
  <paragraph num="A.">
    <text>The following terms have the meanings indicated.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Terms Defined.</text>
    <paragraph num="(1)">
      <text>“Body treatment” means cellulite lymphatic drainage and cellulite vacuum massage.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>“Cellulite lymphatic drainage”  means a therapy in which the practitioner uses a range of specialized and gentle rhythmic pumping techniques to move the skin in the direction of the lymph flow.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>“Cellulite vacuum massage” means:</text>
      <paragraph num="(a)">
        <text>The massage of peripheral blood, lymph, and inter-tissue liquid with the goal of reducing stagnation of these fluids and increasing the skin’s elasticity; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The external use of a vacuum component directly on the area to be massaged followed by a straight line, circular, or zigzag movement to massage the area.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>“Chemical peels” also called deep skin peels, means the removal of the top layers of skin using chemicals applied directly to the skin.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>“Clinical preceptor” means a licensed or certified individual who is:</text>
      <paragraph num="(a)">
        <text>Proficient in the procedure for which they are precepting; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Permitted by the appropriate health occupation licensing board to provide care and treatment for cosmetic services.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(6)">
      <text>“Cryotherapy” means the application of:</text>
      <paragraph num="(a)">
        <text>Extreme cold to destroy abnormal or diseased tissue, warts, moles, skin tags, and solar keratoses; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Liquid nitrogen to freeze tissues at the cellular level.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(7)">
      <text>“Dermal fillers” means various types of natural or man-made materials which are injected intradermally to correct imperfections in the skin and subcutaneous tissue.</text>
    </paragraph>
    <paragraph num="(8)">
      <text>“Direct supervision” means on site, physically present, accessible in the immediate patient care area and available to intervene if necessary.</text>
    </paragraph>
    <paragraph num="(9)">
      <text>“Injectable treatments” means the use of FDA approved medication and includes the following:</text>
      <paragraph num="(a)">
        <text>Dermal fillers;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Micropigmentation, also known as cosmetic tattoo or permanent make-up; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Neuromuscular agents.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(10)">
      <text>“Laser treatment” means a technique in which exposure to low-level laser light or light emitting diodes are used to stimulate or inhibit cellular function possibly leading to beneficial clinical effects.</text>
    </paragraph>
    <paragraph num="(11)">
      <text>Light Treatment.</text>
      <paragraph num="(a)">
        <text>“Light treatment” also known as phototherapy, means the use of non-ionizing electro-magnetic radiation for therapeutic benefit.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Light treatment” does not mean laser treatment.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(12)">
      <text>“Lipodissolve” means a procedure that uses subcutaneous micro-injections of drugs with the sole purpose of dissolving fat for body contouring.</text>
    </paragraph>
    <paragraph num="(13)">
      <text>Magenta Light.</text>
      <paragraph num="(a)">
        <text>“Magenta light” means a non-invasive technique that combines infrared and magenta light with subdermal tissue massage to produce a penetrating light that affects the epidermis, alters cellulite formation,  and controls cellulite formation at the cellular level.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Magenta light” does not mean laser or intensive pulse light.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(14)">
      <text>“Mesotherapy” also known as intradermotherapy, means a non-invasive cosmetic treatment which employs multiple intra or subcutaneous injections of pharmaceutical and homeopathic medications, plant extracts, vitamins, and other ingredients for the treatment of fat or cellulite.</text>
    </paragraph>
    <paragraph num="(15)">
      <text>“Micro current treatment” means passing radio frequency electricity through the skin to:</text>
      <paragraph num="(a)">
        <text>Heat up tissue;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Cause the tissue to contract; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Stimulate collagen production.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(16)">
      <text>“Neuromuscular agents” means injectable drugs that cause muscle weakness for the purpose of cosmetic softening of wrinkles and includes, but is not limited to, Botox and Dysport.</text>
    </paragraph>
    <paragraph num="(17)">
      <text>“Nurse” means a registered nurse (RN) or a licensed practical nurse (LPN).</text>
    </paragraph>
    <paragraph num="(18)">
      <text>“Peels” or “Topicals” means:</text>
      <paragraph num="(a)">
        <text>Chemicals peels;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Cryotherapy; or</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Microdermabrasion.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(19)">
      <text>“Photochemotherapy” means the use of a photodynamic light source to destroy dystrophic cells.</text>
    </paragraph>
    <paragraph num="(20)">
      <text>“Photodynamic (PDT)” means the use of a light source, combined with a light-sensitive drug to destroy dystrophic cells.</text>
    </paragraph>
    <paragraph num="(21)">
      <text>“Photosensitizing agent” means a drug used with a photodynamic light source to produce a therapeutic photosensitivity.</text>
    </paragraph>
    <paragraph num="(22)">
      <text>“Precepted clinical practice” means after theoretical learning and until competency is achieved:</text>
      <paragraph num="(a)">
        <text>Working directly with patients;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Performing cosmetic or dermatologic procedures on patients; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Working under the direct supervision of a clinical preceptor who has the knowledge and ability to perform the procedure independently.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(23)">
      <text>Radio Frequency and Current.</text>
      <paragraph num="(a)">
        <text>“Radio frequency and current” means:</text>
        <paragraph num="(i)">
          <text>Magenta light;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Microcurrent treatment;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Photochemotherapy;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Photodynamic;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Thermage; and</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>Ultrasound (therapeutic only).</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>“Radio frequency and current” does not mean laser.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(24)">
      <text>Theory.</text>
      <paragraph num="(a)">
        <text>“Theory” means the body of knowledge regarding the principles underlying the safe execution of a cosmetic procedure and is obtained through didactic instruction provided by a licensed health care provider who has the knowledge and skill to perform the procedure.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Theory” includes didactic instruction by the licensed health care provider which may be augmented by a manufacturer’s representative.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(25)">
      <text>“Thermage” means the use of radio frequency technology to:</text>
      <paragraph num="(a)">
        <text>Target collagen in the dermis layer of the skin around the eyes and forehead; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Cause the dermis and underlying tissue to tighten.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(26)">
      <text>Ultrasound.</text>
      <paragraph num="(a)">
        <text>“Ultrasound” means the therapeutic use of inaudible sound in the frequency range of approximately 20,000 to 10,000,000,000 cycles per second for therapeutic use at low intensity producing a heating effect to stimulate collagen production.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Ultrasound” does not mean the use of ultrasound for diagnostic purposes.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>