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Top 10 reasons you know you've hired an aesthetician...

cp_photo_esthetician.jpgYou know you've hired an aesthetician when...

...most of your staff is now wearing high heels.'re constantly set upon in an attempt to cleanse your pores.

...microderm is referred to as real medicine.'re instructed that 'aestheticians know anatomy too'.

...there is now green tea and spring water in the break room. own a hot towel cabbie, a skin scope, and 'mood' music. have $30,000 of toner, cleanser, and other stuff that you don't use.

...the esthetician wants to get rid of all the old stuff that the previous esthetician liked because it doesn't work and buy another $30,000 of the new stuff that the new esthetician likes that really does work. hear 'detoxify the skin' for the millionth time. ask what the hell all these toxins are in the skin and how did they get there and hear the reply, 'toxins'. are now selling knock off purses in the treatment rooms.

...the amount of mascara used per employee quadruples.'re asked to carry lip plumping gloss in your practice. offer spray on tanning.

...MySpace is on the history list of every computer. start to chew gum.

This list is completely in jest and not meant to represent any individual or group, especially not any of my staffs who are wonderful, thoughtful, and intelligent. No, I mean your staff.

(No aesthetician was consulted during the formation of this list.) 

Reader Comments (32)

Glad your aestheticians are intelligent. I've run into some who state they are "medical aestheticians" when there is no such training (correct me if I'm wrong). Sometimes a little knowledge is a dangerous thing...Don't mean to disparage anyone, but I'll never forget the one I encountered who had no idea what to write in a patient's chart!!
11.20 | Unregistered CommenterLS
'Detoxify the skin?' This has me laughing so hard I nearly lost a lung. So true. Those nasty skin toxins just gotta go. Love this post.
11.20 | Unregistered CommenterDermdoc
Funny, and for the most part very true. Luckily I have been blessed to work with some great aestheticians who have made a big diffference in our practice. They know way more about daily skin care than I did and could better relate to the clients and their concerns. I think as medical prodivers we can sometimes get caught up in the treatments we provide and not as well address the psychological aspects of skin care and diseases. Teach and train them well and they will reward you, even if it means you receive weekly detoxifying treatments and lip plumpers (they sell!).

11.21 | Unregistered CommenterKaren PA-C
I almost forgot the funniest part - this was better than detoxifying the skin. They now refer to my Restylane Lip enhancements as "DSL's" . I'm too embarrassed to tell you what it stands for but your aestheticians will know.
11.21 | Unregistered CommenterKaren PA-C
Come on Karen. What's a DSL?
11.21 | Unregistered CommenterpertMD
I hired an esthetician that came in the first day wearing fishnet hose under her lab coat. She looked like a stripper. I should have sent her home but didn't. I did however institue a rather draconian dress code the next day.

I have to admit it was unusual.
11.21 | Unregistered CommenterSkinDoc
As an esthetician, I love the list, and don't do any of those things. Having been in the industry for 12 years I can relate. Funny thing is we don't detox the skin, wear high heels etc. I do send my clients to a plastic to get injected and I may never see again! I guess the "medical esthetician" (there is no such thing) is selling them lip plumpers! Go figure.
11.22 | Unregistered Commenterskingrl
skingrl - you are definately a good exception to the rule. I do feel that the docs underestimate the value of a skilled aesthetician!

as for DSL , the S stands for sucking and the L stands for lips - I'm sure you can imagine what the D stands for now.

Two of my co-workers even exclaimed that they looked like strippers after I enhanced their lips, I guess to a 23 yera old that's a good thing but I'm sure not going to here that from my 40 year olds.
11.24 | Unregistered CommenterKaren PA-C
Well, I have to admit I giggled over a couple of these. There are some funny differences between spa professionals that come in through the beauty side of the industry vs. the medical side.Yet these aestheticians do make a med spa a "spa." They're used to working in a cash-based practice, and get the customer-service connection in ways that busy physicians need.
But yes...some of them really need to borrow some of the medical side's professionalism!
There actually is a course for medical estheticians, there are actually only a few technical colleges that have a continuing course after regular esthetician training. It is another 6 months course that has plenty of science and training. I know this because I am on the Board of Advisors for it.The only one in the Western United States is in Tacoma, Washington. I do agree there are many that are lacking in professionalism. If you hire someone who has that appearance it is your own fault for not creating standards in your practice. Anyway....I like the green tea, spring water and mood music.......
05.1 | Unregistered CommenterDerm RN

I read the list and chuckled at a few of the "reasons." LOL! You have to have a sense of humor. Let me tell you my story...

As an esthetician (who is also a former biologist), I have worked very hard to achieve the level of knowledge that I have. For years I toughed it out, working in a med practice for a less-than-appreciative dermatologist who acted like I didn't know jack!

But that was okay. I read voraciously, attended every training session, took every class. I was like a sponge. But I was also a good employee. I worked hard and showed up every day.

Soon, the income generated by my billable procedures, esthetic treatments and retail sales gained me a modicum of respect. My role expanded in time.

His acne patients started to see results in less time - a result of a more comprehensive approach to treating the condition. He saw scores of patients each day and had no time to spend discussing how to use the meds, the proper use of skin care, etc. That became my job.

But all good things must come to an end. As a 48 year old, I knew the time was ripe to strike out on my own. I now own a successful skin care practice.

I didn't wear fishnets or high heels, and I sure as heck knew how to chart. Working in the derm practice was an invaluable experience. I will remain indebted to the derm for the opportunity to work in his practice and learn about skin.

Well Mr. Barson I see you haven't lost your sense of humor. However when I worked for / with you I never wore heels, plumped my lips, promoted tanning, was clueless about my space, pushed retail items such as mascara or mineral makeup, let alone a trendy purse.

I did however buy my own equipment and decided to go solo. I love my occupassion and am happy to report things are going well in the majestic tetons ! I do have to admitt it would be nice to have a doc on board to increase my treatment menu. wink. A final thought... skinceuticals sold out to loreal and i never was that impressed with the line anyway !

GREAT SITE VERY INFORMATIVE ! Thanks for your time, effort and wonderful knowledge !

Jayme O'brien
ps if you don't quite remeber me I am the aesthetician who did NOT faint while assisting you in a procedure in Layton !

09.20 | Unregistered Commenteragelater

Darn it Jeff, why didnt you tell us non-MD owners of Med-Spa's that we can save a few bucks by "performing procedures" with the assistance of our aestheticians. Of course you will get in more trouble if the procedure agelater is refering to had nothing to do with aesthetics. Sorry,long day,just needed a laugh.

09.20 | Unregistered CommenterMark


Your bad day showed up in your post. Dr. Barson offers a fantastic medi-spa treatment menu and AESTHETIC services. Your post is unfortunate. I have tremendous respect for Dr. Barson , Surface Medical Spa and this amazing resource site. I would guess you do as well or you wouldn't be here in the first place. Better luck tomorrow.

09.20 | Unregistered Commenteragelater

Agelater, I have no doubt thatthe Dr. Barson you referred to is a fine physician. However to the best of my knowledge the Jeff Barson responsible for this site and Surface Medspa is not a doctor. Hence the humor ofyour post.Again, please dont take it personal, I just think its important to laugh once in a while. Even more so when you are trying to drive a medspa into the black.

09.21 | Unregistered CommenterMark

Mark is right of course. Jeff Barson is not a doc. But I did sleep at a Holiday Inn last night.


OK...My mistake I confused the Barson's MY BAD.
I agree humor especiallly witty humor is essential.
Just ask me about my OATH OF SILENCE ! wink...
Have a great day !

09.22 | Unregistered Commenteragelater

I am a medical aesthetician (that means I work in a med spa) thats all! I just booked a meso appt. had a girl friend in for Botox and booked another friend next week. My hair dresser puts our menu of services in her salon. All the girls there come to me for Brailian LHR (Laser Hair Removal). I just filled the Dr. in on the DSL's. Very naughty. I also am going to school for nursing, have 3 kids and am training for an Ironman next year. All in all have knowledge and capabilities that other people do not. That is why we all need eachother. Have a fantastic day!

By the way I thought the list was hilarious.

11.8 | Unregistered CommenterDe

Am I worried? The practice I use has an adjunct medical spa---great for many things, however I am looking into IPL at the suggestion of my dermatologist, so I also checked out the spa. Imagine my suprise to learn that an aesthetician, certified/licensed/monitored by Virginia's Board of Barbers & Cosmetologists (and forgive me, what is a cosmetology education offering in the area of science & physiology?) can perform what I consider medical procedures---and no mention of a doctor presence on 'the floor.' Yikes, if I am damaged, what's my recourse---small claims court?
In other countries, master spa staff are medical practitioners of some degree and under the auspices of a Medical Board & doctors---what's with the USA? Money & agressive equipment companies, I think. Why would doctors allow this?
Thank you, I will go to a physician for any such IPL treatments,

To new client:
I posted this on another thread:
To LH and Patriciarobinson:
Just some anecdotal evidence
"When I was at ALC, every week or so, a client would come in for a consultation that had scars from burns caused by LHR from other doctors/practices. The scars were usually on the face and the clients were usually of East Indian or Middle Eastern descent.
A dermatologist, not a nurse/PA/laser tech, ALWAYS caused the burns. I would hear comments like "I chose to go to dermatologist because I thought they would be better" or " I checked out his credentials and I thought he/she was the best"
I’m not knocking dermatologists, but in my opinion, these burns were caused by improper skin type assessments. It got to be so routine that I would typically ask if they were treated by the derm him/herself and the clients were always surprised that I guessed"
What is your recourse if you're damaged by a physician?

I see your point, there can be problems with all procedures affecting the body--but one has better recourse for successful litigation in an action affecting one's being (and essentially medical---the informed consent is much more viable) if a Board of Medicine (and truly medically educated personnel) is involved in a treatment rather than a Board of Barber/Cosmetology---the professional responsibility (and educational level-thus expectations of treatment) and insurance coverage is at a higher place for realistically filing a claim & winning an award of medical malpractice.

11.10 | Unregistered CommenterNew Client

this is extremely rude.

05.12 | Unregistered CommenterPam

This is insulting for all aestheticians that ever considered working with physicians in the first place! You may find amusement in putting down aestheticians because some may not know how to chart like you do. The physicians need the entrepreneurship of the medically trained aesthetician that knows both sides: the health care system and facial aesthetics. Physicians (dermdoc) sometime put down the aesthetician because they are not "nurses" that are accustomed to taking orders. You need to have nurses around you to do your own job. You put down nurses from the beginning and now the aesthetician. This is intended for the physician whom hired an aesthetician and she came in “dressed" like a stripper... Just because you are use to having nurses in "little house on the prairie dress" does not mean all aestheticians do not know how to dress.

Medical Aesthetics was started by a aesthetician.The first teaching program for physicians, nurses and aestheticians was pioneered from an aesthetician. ( No...she did not wear stockings that looked like a stripper ). There would be no physician today practicing Aesthetics without the forward thinking, energy and concepts of this aesthetician. There would be no nurse ( LPN/ RN/ PA-C ) performing outside of standardized nursing w/o this aestheticians incredible work. It is sad to read this site and know exactly who owns this and propugate such a negative view of the aesthetician. The dermdoc needs aestheticians to promote her own product line.For the PA-C...remember your history. Nurses were considered all prostitutes at one time. Tisk..tisk how soon we forget...

I loved the list! Very witty! Of course would docs say the same seeing a list of witticisms aimed at themselves? One would hope so. I will tell you a quick story. I remember going to a med-spa conference in Dallas a few years ago. I was an aesthetician working in a booth. Apparently docs because they have gone from school to medical school, to internships get where I'm going. When these folks were let "out" it was truly shocking how socially inept they were. They must need to make up for those formative teen years where they missed out on dating. In the after-hours of the conference, these august medical professionals were acting like adolescents let out for the first time...Quite a lesson in social science for me.

All that to say we ALL have our strengths and areas where others can fill in to make a med-spa practice a well-rounded, profitable business. I will say this. Retail could be done SOOO much better in most med-spas.

09.10 | Unregistered Commenterlpt

Well, in my acne clinic, my estheticians are trained (by me, another esthetician) to do serious skin care and we do not do any of those things on your "list".

I would say over 90% of my clients have already gone to medical doctors already and have been HIGHLY disappointed in how they were treated and also HIGHLY dissapointed in not getting the results they wanted in getting their acne under control. Medical protocol is so predictable - give them antibiotics that don't work, give them a retinoid that just irritates the hell out of their skin and doesn't work; and then push them to do Accutane when the first two don't work.

They come to us and get clear in three months. If you don't believe me (or believe about their frustrations with doctors) then see their own reviews on, listing under Face Reality Acne Clinic in San Leandro, CA. Here's a quote from one of the reviews

" I tried lots of different things, from dermatologists to facials, and nothing worked and just made it worse. Most dermatologists don't really care, from my experience. They look at you for two seconds and then write you some prescription that makes your skin worse."

Put us down if you will (it doesn't surprise me), but who's getting the job done here?

Another Classic dermatologists' gaffe, prescribing the cream form of retin A for acne patients. Read the label, if you have time. It's loaded with isopropyl myristate. In case you don't know, it's a terrible pore clogging ingredient that causes acne prone skin to break out horribly. Thank you for giving us the opportunity to rescue some of your poor, irate patients.

We also had an esth., working for a derm who took Laura's class on treating acne. She was so frustrated that her patients were crying in her office, having spent many months and many $'s with NO results. When she learned what needed to be done and what products needed to be used to get the derm's patients clear, she informed her of the results that we were getting. WHOA, don't tell a derm that an esth. gets better results than them. The esth. was tersely told " I'm the one with the MD after my name, I think I know a little more about this than you do." Well anecdotal evidence can't compete with empirical evidence, but why is nobody surprised by this story. You know, that makes me wonder, how come the AMA isn't looking for empirical evidence about the best treatment for the most common skin disease in the world.

BTW, I'm Laura's partner at Face Reality Acne Clinic

Hello, I live in California and planning to get an associates degree in nursing. I want to eventually get into medical esthetics and I wanted to know how you break into this industry. Most of the job postings that I've searched states over 3 years experience.

It is really frightening when clients come in to me for acne treatment and they tell me what their MD dermatologists have them using to cleanse their acneic skins -- Cetepil or Neutrogena, to name just a couple. With no results, of course.

I am a professional -- dress like a professional, talk like a professional, give professional services and skin care advice. This article really is insulting to those of use who truly are professional in our chosen line of work. The 18 year olds who are just out of high school and who just graduated from esthetician school may not know any better. But then doctors always try to find the cheapest help without wanting to pay for an experienced esty who just may know what she is doing.

Doctors need estys -- and sometimes estys need to refer to a doctor -- but my treatments take care of my client's skin 99% of the time within a short period of time. Not years on antibiotics and Accutane, etc.

09.11 | Unregistered CommenterEsty in CA

wow - you can treat acne 99% of the time without anti-biotics - would love to know what you do. I cant treat acne 99% of the time even with systemic anti-biotics, prescription skin care, acne laser etc etc. You must be some sort of a god! I didnt think even Roaccutaine treated acne in 99% of cases!

11.18 | Unregistered CommenterTopher

I agree--wow--a 99% cure rate without medications.
Please report this amazing treatment in a peer reviewed medical journal ASAP so that the "clueless" dermatologists can immediately adopt this treatment.

11.18 | Unregistered CommenterWowedMD

Why can't we all just get along? Ha Ha Ha

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