Your question is a very common one with a complicated answer. Who CAN perform laser treatments will be determined by state law. In the state of Texas almost anyone CAN perform laser treatments as most cosmetic laser treatments are not legally considered medical procedures. The more important question is who SHOULD perform laser treatments. In my practice, I perform all laser treatments. If you choose to go to a practice where someone other than the physician performs the treatments, be sure to at least be evaluated before and after the procedure by a physician and that the physician is trained in dealing with possible complications of laser treatments.
Both M.D. s and estheticians do fraxel work. In my office the evaluation and post- op work is done by myself, the actual lasering is done either by myself or a technicion. An esthetician can certainly do it but its nice to have a physician involved in the process to make sure all is done correctly and goes well.