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« Botox for facial scars. | Main | An anesthesiologist moving into cosmetic medicine. »

How to: Hire estheticians for your medical spa or clinic. Part 1

How to hire an esthetician for your medspa or laser clinic.

Aestheticians are probably the most commonly used staff member in medical spas to perform treatments. (Although I have seen medical assistants and 18 year old girls off the street, aestheticians tend to be the first pick.)

Surface Medical Spas exclusively uses master aestheticians. (In Utah we have what is called a master aesthetician license which is an extra 600 hours of education. Basically, doubling the usual aesthetician license of 600 hours.) Legally, aestheticians are not necessary or able to perform treatments. Staff members in most states are operating under the medical supervision of a physician and it is the physicians medical license that allows treatments to be legally performed. Read Medspa legal how to...

Medical Estheticians: There are those calling themselves ‘medical estheticians’. There is no such license in any state. Medical estheticians are a nonsense term being used to denote some kind of training and licensure where there is none.

So, how do you hire an aesthetician? Read Estheticians and the doctors who love/hate them parts1, part 2.

There are two reasons that I hire master aestheticians in order to perform treatments at Surface:

  • One is that they are highly attracted to this industry. Aestheticians want to be providing the very most advanced care that they possibly can, and this is a way for them to get into the medical field or be using lasers and other treatments that they could not have access to on their own or in day spas. Motivation and fit are prime ingredients for any hire.
  • Number two is that aestheticians have some "sense" of patient care. There is nothing worse than having a laser or IPL treatment where you just feel zap, zap, zap and there is no sense of nurturing or comfort or touch. Aestheticians tend to have a better than average sense of patient comfort and care.

That’s the good part. Now let's talk about what potential problems you'll face.

Aestheticians typically were desi to operate in day spas, about the worst business situation imaginable. While they have a minor amount of education, usually between 600 and 1,200 hours, the way they are educated is such that they feel often end with a high degree of confidence. This over-confidence is something that can get you into trouble. In fact, many aestheticians feel that they are very nearly on par with the physician as a provider. This can of course cause problems. Worse, aestheticians come from a day spa environment where they either rent a space and are dealing exclusively with their own clients (they therefore view the business as just a support mechanism but the clients as their own), or they do a commission split, which a lot of physicians offer as well in an attempt to keep their costs down. Day spas are rife with employee problems since every there is working for themselves in a competitive environment. Coming from either booth rent or a commission structure, it’s common for estheticians to think of patients as ‘theirs’. Not good.

(Surface never pays commissions: First, it unethical in my opinion. Second; it promotes a hard aggressive sell and treatment which detracts from patient care and service while over-promising and under-delivering. Third; it’s no way to run a real business.)

Read: How to hire estheticians for your medical spa or clinic, Part 2 

Reader Comments (53)

We are having a real hard time hiring a good aesthetician for our new business. We are in Atlanta. Any help would be greatly appreciated.
01.7 | Unregistered CommenterKim
This article sits very uneasy with me, as I am an esthetician. I feel that we are a very valuable asset to any spa or medical setting. Often times the Doctor is so busy with other things they don't interact with the patient as they should. Not to mention most doctors don't take the time to really learn what products are on the shelves and the ingredients in them, they rely on pharmaceutical companies to do the work for them. If something sounds good-then it goes on the shelves. As an esthetician we take a lot of time researching ingredients in EVERYTHING and we are very educated. Doctors are a quick fix and we are wanting to help patients in the long run!!!!
Well Donna,
You just illustrated the point made in the article: Estheticians can be over-confident and competitive against the docs.
03.27 | Unregistered CommenterEssdee
Estheticians have been a revenue loser in my medspas. Coming straight out of school demanding large hourly rates plus commissions with no expectation to help build a pastient base.Knowledge base is very small yet they think they know more about skin than a medical doctor.The schools give them unrealistic expectations.Many have left lucrative but less glamorous jobs thinking being an esthetician will bring them more fulfillment and the same wage as a non-retail environment.And yes they usually compete rather than work as a team, and worse yet contradict the doctor. I still hope to find a good practice building esthetician so the rooms I built for her don't go to waste and she can be happy and prosper and add to our office services.
Where can I find an aesthetician? Do we just advertise on career builder? Is it word of mouth?
05.23 | Unregistered CommenterJk

I would look up locations for "The International Dermal Institue' in your area. It is a continuing ed school for aestheticians who are already licensed. They offer a post grad program of an extra 100 hours. The school was developed by Jane Woodward (sp?), an aesthetician who started the line, Dermalogica.

I went through the post grad program and was really impressed. If you call the school and tell them what kind of personality and skill set you're looking for, they may be able to match you with someone with advanced training.

So many aestheticians want to break into the medical field, it may be worth offering an internship first that rolls into a position with your clinic????

Just a thought. Here's their link:

Depending on what area you're in, I would strongly consider recruiting from Utah because they have such an amazing training for medical aestheticians and require far more hours of training for the state regulations and licensing. I almost relocated to train there a few years ago.

I also caught wind that many of the Aveda Institute training facilities are starting to really push more curriculum on the 'medical' opportunities of aesthetics and are incorporating a lot more training with high frequency, galvanic, peels... You could possibly contact the instructors to keep an eye out for students who really excel.

I am currently working with a community college to help write the curriculum for an esthiology division of their cosmetology department. They have even agreed that the students will trainn with one of the lines I'm carrying. This will be convienent because I can hand pick students who are already trained on one of my lines and several of the treatment protocals it has.

That's my two bits.
Take care. Midwest
05.23 | Unregistered CommenterMidwest
You Rock Midwest let me look into this THANK YOU!
05.23 | Unregistered CommenterJk
Hey there:

Just saw that the school you mentioned is not in AZ where I reside. I have given my job posting out to all the schools in the area any other sites or suggestions you could give would be great.
05.24 | Unregistered CommenterJK
To start, I would say contact the schools in your area and see if any students want to intern at your center. Many would like to earn hours and learn about "medical aesthetics." Start them learning about the procedures you offer and find out if they can gain a good understanding of what you do. Once you gain confidence in their knowledge and abilities, you can hire them full-time. Even if you don't hire them and you've made a good impression on them and leave things on a good note, you've just added to your word-of-mouth and referral network.

While I think it is a good sign when you see on an aesthetician's resume that they are continuing to educate themselves through classes such as those offered by International Dermal Institute. I wouldn't recommend sending your own aestheticians to their courses. They are many years behind on technology and may talk down on your services.
05.25 | Unregistered CommenterRichard
Thank you Richard:
Here is the dilemma I am really looking for a lead aesthetician-someone experiences and sales oriented, and guidance on finding someone with that profile?
05.25 | Unregistered CommenterJK
JK-- An add posted on might bring you some good candidates.

You might also try
05.25 | Unregistered CommenterDexter
Thank you all so much!
05.26 | Unregistered CommenterJk

In response to the article how to hire an esthetician-I am an esthetician, author and owner of a advanced training company for estheticians. I agree that is hard to find qualified estheticians, yet they do exist. The professional esthetician does not feel that we "know more than the dr." or that we are in competition. The reality of our industry is that in the early 90's Dr.s started to expand into what we considered our domain "the spa". This has caused some to be very nervous.

The issues that many estheticians have are:
Liability-our liability insurance does not cover medical procedures and medical liability does not cover estheticians. We are generally described as medical assistants in most practices.
Respect-Our initial education is much less than a Dr. but the well qualified esthetician continues to learn for life. Also many of us have undergraduate degrees. We are a valuable asset to a medi-spa.We do have a different approach to skin care which can be an asset to a Dr.s practice. Look for a CIDESCO certificate,ITEC or the new NCEA certification.Even states with higher licensing requirements dont always prepare an esthetician well. Advanced training is a good way to tell if your esthetician is dedicated.
Compensation-our career is short lived. About 5 years is the average. It is hard work and we are a licensed professional. Compensation should be well above minimum wage.Many estheticians will look for the employer that provides advanced education as part of their compensation package.

Overall an esthetician is a valuable asset to a medical practice and can greatly increase the bottom line. Look for independant educators that can come in and train the staff or provide classes you can send your employees to. Definately do not just pay a commision for compensation. That is unethical as well as creates an enviroment of competition. Salary plus small commission works well.

First of all, although it is true that there is not a specific license for a "medical aesthetician, the comment made suggests that professionals claiming this title is false. The truth is there is additional education available in several states from many different accredited schools offering courses in medical aesthetics. Unlike a basic aesthetics program which consists of 600-800 hours, a medical aesthetics program focuses on working in a medical environment and specifically working with laser, intense pulse light and fractional machines and is an additional continued education of 300 hours. Furthermore, many of these “medical aestheticians”, have obtained further training and education on the specific laser and IPL products they use, attend training seminars and workshops several times each year. Furthermore, although a physician has obviously more education than an aesthetician or medical aesthetician it does not mean that they are more experienced or more educated in “laser technology”. For example, there is no physician that obtains laser training while in med school except and OGBYN. The education and training that a physician receives to operate these laser and IPL systems is the exact same training that an aesthetician or medical aesthetician would receive. In most cases the aesthetician has more experience working with this equipment than the physicians do themselves due to their own hectic scheduled. Furthermore, many physicians do not make an effort to continue to grow their education in the laser industry because they feel their medical background is sufficient. Therefore many studies show that there are more cases of physicians burning or causing adverse side effects than the aestheticians themselves!!
On the other hand I would have to agree with you that many of these professioanls feel that the clients are their clients which is completely incorrect. Many of them do gain a big head in thinking that they are the provider. However, if an aesthetician is the main professional treating these patients and if they are the professionals with the most experience in treating patients than it isn't uncommon for them to recommend advice on how to get a better treatment, result or how to provide an experience to your patient that ends in a positive and successful result. If the aesthetician has the experience, knowledge (and by this I am how the lasers work, understands the technology and effects of the technology, has key training on how to provide a good, safe and succecssful treatment), and has a report with your clients that builds your practice, I feel that aestheticans should be paid well.

For a key reference, an aesthetician usually makes 50% of his/her service sales in a spa environment which can average to be approximately 45k. In a medical setting where the treatments are more expensive and provide better results.... if the aesthetican is the main person providing the treamtents, helping to grow the practice by referrals and sales than they should be paid accordingly.

I myself have owned my own medical laser clinic for three years now. I hire both “medical” aestheticians with experience and nurses to perform the treatments. The average aesthetician in this industry in makes between $14-16 per hour. However the more experienced aesthetiicans make anywhere from $18-$30 an hour.

Although I do agree with a lot of the subjects discussed in this article, I do feel that your research about “aestheticians” isn't accurate.

01.8 | Unregistered CommenterAZ

Dear AZ: I am curious if you have ever read the most recent Arizona rules on the subject of performing hair removal and other cosmetic procedures with lasers and IPL systems? The law was changed in March 2005 to permit laser/IPL hair removal only (NOT photo facials, laser peels, vascular lesions, etc.) under indirect physician supervision provided that a number of stringent conditions are met (including 40+ hours of laser training). As I read the current rules I cannot imagine how anyone in Arizona can be offering more than hair removal without having a licensed physician on site. The physician must also have appropriate training within his/her relevant scope of practice. Even in Arizona, the use of lasers and IPLs is considered "the practice of medicine".

this is in response to MIDWESTS' post about the aveda institute pushing more education into the medical side. i dont think this is very accurate. im a liscensed esthetician in california who uses only aveda products and has taken many aveda courses and they do not believe in using galvanic, high frequency, ect. or standard microdermabrasion or peeling practices. their approach is very high touch & does not use any equiptment other than a facial vaporizer. i dont necessarily share their view so this has been a conflict for me. however, i do agree with the benefits of a high touch approach. anyhoo, thats all :)

Because of my bkgrnd etc I have been offered managerial and in-room positions by MDs to work in their practices - and have not yet accepted/probably will never accept a position as they never offer me a living wage, let alone what my background supports (former dental hygienist, masters in allied health, a former managerial positions, in-room experience and extensive medical esthetics training, plus much more). I believe that though I have a supportive bkgrnd, they automatically think I am worthless since I am an esthetician (CIDESCO), They just have blinders on that just possibly I could have a brain even though I am an esthetician! They offer me low wages and expect me to be grateful. Bad business, MDs.
One more thing. Hire right out of school, even in nursing, dental hygiene and other professions, you get what you pay for in expertise and experience. So unless you are willing to pay for good training or are willing to compensate for someone with the training you need, I don't want to hear how terrible estheticians are...

02.9 | Unregistered CommenterJanMc


So right you are. We have been running lasers for over 5 years with only estheticians. The medical boards seem to think that only nurse practicioners, physician assistants, and nurses are the only people qualified to run lasers.

Oh Contraire! Estheticians have more knowledge about skin care than 95% of the nursing community. Now don't get me wrong. Any qualified individual can learn and be trained in this business.

I am a firm supporter of the medical community in this business. However; this is the BEAUTY business no matter what the state medical boards say.

Most medical people don't even know what CIDESCO is! (We are 1 of 8 certified CIDESCO day spas in the U.S.) They don't realize that even some dermatologists have failed the CIDESCO exam.

As to your last comment, this is why so many physicians fail in this business. They just can't comprehend why their standard medical protocols and practices aren't working in this industry.

Best of Luck to you!

02.9 | Unregistered CommenterWPS

Knowledge about skincare and knowledge about medicine are two very different things. An esthetician probably knows more in general than an MD/DO/PA/NP about skincare products and the ingredients contained within, but absolutely does not know more about the practice of medicine, which usually the category the use of lasers falls into. Because estheticians are not qualified to diagnose or utilize prescription medications to treat any adverse reaction they may cause from using a laser, perhaps they should at least respect the opinions of other healthcare providers who are qualified to do so. I think estheticians are a vital part of the team, but they must not try to practice medicine!

03.10 | Unregistered CommenterTony PA-C

Tony PA-C:

Just because the state medical board says that the use of lasers is the practice of medicine does not make it so. It's just that no one has been willing to take the medical board to court.

Your comment about esthetician's knowledge is way off course. For the most part, they know a hell of a lot more than most MD/DO/PA/NP about skin care and more than just products and ingredients. Don't get me wrong, the latter, with the proper esthetic training, is more qualified. Unfortunately, as of this date, this just hasn't been the case. Most of you are getting into this field without any formal training. Given that I will go with the majority of estheticians every time.

You should take a look at This is the highest level of accredidation available in the esthetic field. Derms and Plastics have been known to fail the certification process and testing.

As I have said many times on this blog, there is room for all qualified individuals in this area, but it's getting a little old when the medical community statesthat this is their turf, when for all practical purposes they have invaded the turf of the esthetic industry.

I'm still waiting to see those stats that make this a high risk business that only the medical community can serve!!

03.10 | Unregistered CommenterWPS

I am currently going to school for advanced esthetics in CO. I am in no way currently qualified to dispute any of your posts. I stumbled across this page doing some research for a paper that I am writing. I have to say that I was highly dissapointed at the attitude and general bashing of estheticians in the original post. I personally am not trying nor are interested in being an MD of any kind. I simply love skin care and would like to help individuals in obtaining healthy beautiful skin and give people confidence in thier appearance. I am not aiming to take any business away from physicians branching out into the beauty world. I have worked for several physicians and surgeons and have yet to be so offended as I was after reading this post. I believe that we are all valueble assests to this industry. It seems that the author of the original post is holding a grudge or wants to MDs to monopolize the industry. We DO recieve highly specialized training that most MDs providing similar services do not. A client recently came into our clinic that had what should have been a simple chemical peel done by an MD turn into a nightmare skin condition that lasted for months, her poor face looked like ground beef simply because the solution used was far too strong and stayed on her skin for longer than it should have. I believe that this is a prime example of what has been said over and over.... that the medical industry is branching out into the spa world. It seems to me that the author of the original post is stating personal opinions about estheticians - NOT FACTS.

03.10 | Unregistered CommenterJG


You are 100% wrong. This is the practice of medicine. I want you to take an honest look at a lot of the garbage that aestheticians do. Many of the procedures microderms, light chemical peels are almost useless. They have very short term results. Look at the studies that supposedly support these procedures. Look at many of the cosmaceuticals and there benefits. Most are minimally benefical at best. I read their studies and a short term 10 to 20% improvement in fine lines is not worth while in my book. It is not even truely visible without magnification.

I have a very good aesthetician and I am 100% sure I know more about skin than she does. How do I know this? Because I am the one she comes to when she has a question. She asks me about topicals procedures etc.

I have read many of your posts and apparently you are a businessman and know nothing about skin or the practice of medicine. You seem to love Cutera and the garbage they sell as procedures like Genesis. The reason many of us do not like this procedure is that we expect more and so do our patients. You are a business person so please do not try to tell me what is or is not the practice of medicine.

You are talking about CIDESCO and that some physicians can't pass these. Well first of all CIDESCO is meaningless in the PRACTICE of aesthetic MEDICINE. I can guarantee a 100% failure rate of aestheticians if they were to take any form of medical boards. So is that a valid argument?

I do think that handing an aesthetician a laser without any medical oversite is 100% wrong. My nurses come to me if they have questions as I want them to. I am available at all times. I do not want someone out there using my medical license and me not be in control. I assume that you have a medical director of some type or another. If they are the type that just signs off on everything they are an idiot.

I do hate to tell you this but if the state medical board says it is the practice of medicine then it is legally the practice of medicine. So according to your post you are smarter than the state medical board.

I do not want any aestheticians taking this as an attack on them. I feel my aesthetician is a great service to my patients. She always comes to me if she has a skin lesion she is worried about or has questions. She works for me and my patients.

You also mention above that the physicians are the ones failing at this business but if you look at most of these posts they are mostly about businessman having troubles. Too many business people are trying to take the practice of medicine out of this business and then they are failing. The failing physicans on this site seem to only be the ones associated with business people running the show as in many of the franchises.

03.10 | Unregistered CommenterLH


I would have to question the patient that had the chemical peel done by a physician. If a physician did it, it was not superficial which is all that you can do. It was likely a 30% TCA peel or more likely something much stronger like a phenol peel. Some of the deeper peels have the same risk as deep resurfacing with a laser. They can stay red for months and even have permanent hypo-pigmentation. So my assumption is that this was not just some simple peel and the patient did not tell you the entire story. So I highly doubt this was some physician "branching out into the spa industry". Another thing you would have to think about in a case like this is was the patient using any topicals on their skin. I have seen the same thing and it was simply a contact dermatitis.

I agree that aestheticians can be of great benefit to clients/patients. I have a top notch aesthetician that works for me and will soon hire a second one for my second facility. I just think that some do not know their limitations (at least from some of the posts I see). I agree you have some training I do not. This is mostly because I could care less about using a steamer or doing a neck massage on someone.

I also want you to understand where I am coming from. I do not own a medspa. I hate the term medspa. You can have the spa industry for all I care as I practice aesthetic/cosmetic medicine. My personal opinion is that many physicians have lost their credibility by using the term medspa. I do not understand why you would want to do a lot of spa procedures as a physician. There are much more cost effective ways to use the space in my facility. My aesthetician at most will bill out $200 in an hour. I can bill out $500 in 5 minutes doing botox injections or 2 to 5 thousand in an hour doing a laser procedure. So as far as things go you can do all the body wraps and endermology you want.

03.10 | Unregistered CommenterLH


Medical Board Regulations are regulations for the Medical Board. That does not make it law and even if a state board comes after someone for the "practice of medicine", that indiviual has the right to defend himself in a court of law. My point is that in most states, no one has questioned these regulations with a few exceptions. You don't have to believe me, but take a look at what is going on Texas and what has happened in Michigan.

It is the courts and the legislature that are the ultimate judges of what is and is not the practice of medicine.

There never has been any confusion on skin peels. There is a dividing line as to the strength of the peel that determines whether an esthetician can apply the peel or a physician's office must apply the peel. Either one can do serious damage if applied inapropriately. Why is this not being applied to lasers? Same situation!!

There is a dividing line here between ablative and nonablative lasers just as there is with chemical peels. You and the medical community can have all the ablative laser business and the injectables along with the smart lipo.Estheticians are not crossing the line. It is the medical community who is doing so. The esthetic industry has the right to take advantage of new technology.

Oh! and you are right, I know just enough about skin to be dangerous. However; I am surrounded by people who do know skin and have the education and experience to back it up.

03.11 | Unregistered CommenterWPS


Nowhere did I say you know just enough to be dangerous. From your previous posts you are a business person. Also,I am not sold that individuals with 600 hours of "training" know skin that well.

I would disagree with you on the idea that there is a significant dividing line between ablative and non-ablative lasers. The non-ablative lasers can cause severe scarring. IPL can cause significant problems as well.

I do think we agree on one thing though. You feel that the physicians can have all of the fillers, botox and ablative lasers and I feel you can have all of the body wraps and facials. I only offer facials, microderms and light chemical peels to my patients. I offer these because I do not want some cosmetologist telling them that they have some topical which is better than botox.

One more thing. I watch the aesthetic industry as well as the medical side of things. The aestheticians tend to buy cheap inferior technology because they do not want to spend the money. Then when it does not work for clients I have to explain why.

You also made the statement that "aestheticians are not crossing the line". It just depends on who draws the line. This depends on which state you are in. Where i am at they can not touch a laser or IPL system.

03.11 | Unregistered CommenterLH

I am not interested in bantering back and forth with any of you simply because I have seen this aruguement over and over. It is the same beef that psychiatrists have with psychologist, counselors, and social workers. The same beef that nurses have with PAs, it is never going to change. I was simply stating my personal disappointment with the slant of the original post. I am not looking to open a medspa, so please do not tell me what you are content with me having. You do not know me as a person or the services I wish to provide when I am ready to open my own business. I am also not interested in the comparision of how much you can bill vs. your esthetician. I was simply offended by the general attitude and opionions being stated. As I said I have worked for Drs and surgeons and have not been so offended. The professionals I have worked for were remarkable Drs, that I guess didn't feel the need to compete and were always positive in general. There is no need to reply as I do not care to return to this forum or any other of a negative nature.

03.11 | Unregistered CommenterJG

Tony PA-C

Where are you in Florida? Shoot me an e-mail, see if we can network.

03.11 | Unregistered CommenterFlorida PA


What is a medspa anyway?

If your an ENT, GI or OB/GYN you need extensive training not to mention a license to use a laser on "inside skin". Why not on the outside?

03.11 | Unregistered CommenterFlorida PA

Florida PA,


03.11 | Unregistered CommenterLH

My goodness, I didn't realize that there could be such animosity between estheticians and MD's. I am currently finishing up my esthetic license in Illinois and was simply looking for information regarding medspas when I came across this post.

Initially, I was planning to obtain my BSN and I had been admitted into a program after taking the required prerequisite courses: A&P I&II, Organic and Reg. Chem., Gen. Bio, Microbiology, Nutrition, Stats., etc. However, after much thought and soul searching, I decided that I would rather focus on a holistic approach to skin health and beauty with the use of aromatherapy, ayurvedic massage, etc. Unfortunately, I have become aware that focusing on these types of therapies is not likely to offer much in the way of decent compensation. Additonally, I certainly do not wish to be looked upon as an uneducated individual and be relegated to the back room to provide those procedures that are beneath a RN or physician. Therefore, I am again considering completeing my BSN.

Honestly, while I do feel that esthetician training has taught me a lot with regard to skincare and treatment protocols, I do not believe that estheticians have the proper training in the sciences to consider themselves somehow "on par" with physicians or nurses. Not to toot my own horn, but, due to my previous educational coureswork, I am the one that students at my school come to with questions about skin histology, etc. And, while it is never my intent to "one up" anyone, I've even had to correct our instructor several times when she is discussing human anatomy, physiology, and histology. This worries my greatly, as the students graduating from such programs are not always receiving accurate information. Worse yet, they aren't ever aware that they are not receiving accurate information.

That having been said, I am curious to get an MD's perspective regarding employing an RN who is also a licensed esthetician. Would the dual licensure be looked at favorably and compensated accordingly, or should I just have not wasted my time or money on the esthetic training? Conversely, are estheticians paid well at all without the additional nursing licensure?

Thank you!

03.30 | Unregistered CommenterPD

PD: It all depends on whether your goal is to be able to operate light based devices in a med spa. The big advantage you would have with a nursing degree is the MEDICAL credentialing recognized by most state boards that regulate the operation of light based devices. As much as aestheticians (and the docs who employ them and often allow them to operate lasers and IPL) hate to hear it, without a medical license most state boards simply do not allow delegation to them. There are a few exceptions such as Arizona where an individual who meets certain training requirements can legally perform a limited number of treatments.

I think in the aesthetic field, your dual trainings would be a big plus. Whether the practice would pay you more than the RN's salary is another matter though since doing esthetician work in general is compensated less.

03.30 | Unregistered Commenterpmdoc

Thanks for your input.

While I wouldn't mind working with IPL and LED light-based therapies, my main goal in obtaining my nursing degree would be to simply have a broader scope of practice. Right now, I'm limited to the stratum corneum of the epidermis. Now, come on, I really needed to go to school for 6 months and be licensed to rub cream on someone's face? Clients can and do apply creams and scrubs to their own skin on a daily basis! Why come to me and pay to have it done? Perhaps for the massage? I guess I should have just become a massage therapist then, at least they can affect muscle tissue as well. Really though, I do believe that the licensing laws in my state need to be updated just a bit with regard to an esthetician's scope of practice. At the very least, they should be allowed to perform some forms of advanced treatments with additional training and perhaps with a physician's direction.

Regardless of my above stated beliefs, I do feel that the most fulfilling and lucrative career path for me would be to obtain my BSN. Honestly, I'm not too keen on spending the next 2 1/2 yrs. doing hospital rotations, but...I have to put in my time like everyone else I suppose. Now, if those 2 1/2 years could be rotations in dermatology and plastic surgery instead of the ER and psych ward....well....that would be a different story!

03.30 | Unregistered CommenterPD

Dear PD,

It seems i am in the same boat as you. After receiving my bachelors in Philosophy, I took all the nursing prerequisites so that i could go to nursing school and one day become a cosmetic laser nurse because my true passion has always been skin care. I was detered from going though, because of the long waiting lists. I am now a licensed aesthetician and have been looking to break into the medical spa arena and have had no such luck yet. So now, i have been looking into further training in medical aesthetics but there is still no guarantee that i would be able to actually perform any of the lasering, injectables, medical-grade chemical peels, etc..because i am in california and the medical board states that only the MD/PA/RN/NP can perform these. So, now, i am reopening all the research i did on nursing schools one year ago because i feel that getting my nursing degree is the best career move for me. Anyway, so my question to you is: which nursing school are you going to? Getting your BSN in only 2 and half years is really short! Any help or suggestions would be much appreciated. :)

05.15 | Unregistered Commentercali girl

Hi Cali Girl,

Sorry for not getting back to you sooner. I have not checked this post for quite some time!

To answer your question about schooling, I already have my Associates Degree. Therefore, I would only need to go for 2 1/2 more years to obtain my bachelors degree. However, I just recently was made aware of the fact that, in Illinois, estheticians can use IPL and lasers with an order from a physician. Actually, the wording is such that "any other person" can operate IPL and lasers with an order from a physician as long as the individual has documented training in the use of such devices.

In light of the above, I am considering applying to a few dermatologist's offices who are doing cosmetic procedures and see what happens. As I have 83 semester credits toward a bachelors degree with many science classes under my belt, I am hoping that this will give me an edge over high-school only estheticians.

We'll see! Do you have an Associate's degree already or will you be entering an AAS RN program?

06.4 | Unregistered CommenterPD

There is animosity between the physician and the aesthetician. The physician with a broad background in science and years of residency did not come up with the term of Medical Aesthetics. The physician/surgeon from any ivy league school of medicine did not develop the background research for implementing the first teaching program for physicians, nurses and aestheticians since 1992. No physician and no nurse ( RN-PHD ) recognized the void of patient care that was presented to patients from dermatology to plastic surgery ,as it had been done since God knows when. It was an aesthetician that had garnered the clinical knowledge, clinical research and wrote the first books in Medical Aesthetics. It was an aesthetician that performed the facial peels, clinical skin care management and preoperative management that surgeons and nursing did not perform/ nor mimmicked or competed with the physician. It was an aesthetician that took a beating from mainstream dermatology organizations because this information was considered " only a physician/nurse could possibly know". Take a look at the physicians that are so hostile to aestheticians and you will find a physician that does not know Medical Aesthetics Concept and Practice. Find an aesthetician that resents the physician it is most often because the physician demeans her background as so menial in comparison to theirs. Nurses have always hung on to the coat tails of the physician to become validated, respectable and integrated within their medical train. As the nurse moved from the bedside to find the Nurse wants autonomy. On the other hand, the new incoming skin health care provider ( aesthetician ) comes with an attitude they are already autonomous and does not mirror the nurses background.If, physicians since the history of its inceptions, take Medical Aesthetics and say this is practicing Medicine then we need Doctors to go back to medical school and take a class from its recognized pioneer/s. Medical Aesthetics is not practicing is providing facial aesthetics on a comprehensive level that can be integrated within any physician/surgeon/medical office and or hospital based program with tremendous postive outcomes for patients on a biopsychosocial level. Please recognize that the aesthetician have a a strong ability to make a difference in patient care and business building. I do not have any hositility toward the physician that puts an aesthetician down. Take a good look around, Medical Aesthetics has much to offer the physician, nurse and aesthetician that wants to postively effect societal standards of beauty.


Would you please get off your soap box and join the discussion. You likely have the knowledge to be beneficial to the discussion, but the way you continue to rant and rave about how great aestheticians are is just making most of us write you off as a "nut". Most on this site are likely not reading your long winded rants that are meaningless. I started to read it as I have not been on in a few days and see that you are still making the same complaints.

So my advice to you is to move on with the conversation or move on to another site and vent your frustrations.

Just so you know, I have 1 aesthetician and she is a very important part of my team. She is young and understands that she has a lot to learn but continues to strive for knowledge.

07.5 | Unregistered CommenterLH

Since you represent “most everybody” that reads this website, I will relinquish the keyboard to you after I write a couple pointers specifically directed to you. LH, I only wanted you to know that the aesthetician does have more clinical knowledge, skills, and facial aesthetics educational background then you might have appreciated. You do have an aesthetician on board within your office and hopefully she is of great value to you. I am not criticizing you for your lengthy negative remarks you made on this site towards aestheticians, i.e. your quote “I want you to take an honest look at a lot of the garbage that aestheticians do”. I just wanted the readers to know that aestheticians have grown exponentially in their educational background and can be a positive contributor to the continuity of patient care. Some physicians (derms) just always put down the aestheticians. I did not mean to rant and rave about how good aestheticians are in the physicians practice. I reviewed the remarks being made in this site and just wanted you, the reader, to know there is a lot more to the skin care specialists role than just thinking they use cheap equipment, have menial education, and question their ability to perform a laser and on and on. Your remarks sound so combative to anyone who is of a different opinion. Hey, let’s be friends!!!!!!

Wow I am glad I read this. I have been researching becoming an aesthetitian for a while now and I am glad to know the issues from both the doctors and the aesthetitions sides. I wanted to become an aesthetition because of skin problems as well as stress problems that I have suffered. I was researching ways to help myself and thought "wouldn't it be great if I could help other people with the same problems as I have"? Well I haven't decided weather I want to work for a doctor or a spa your comments (plus the article) have brought a little extra knowledge of this profession that I am sure I will use in the future. My hopes are to make this my life-long commitment weather it be with a doctor or a spa I just want to help people and by doing that I hope to help myself as well. I will keep in mind everything I have read here today along with all of the other research that I have done and I just hope to find my place!

09.20 | Unregistered CommenterBrandie fhahnwnrvgtb

09.24 | Unregistered CommenterRuchoppot

Yes, I call my self a medical or clinical esthetician...why??? Becasue that is what I am trained at and the only kind I personaly know. I couldn't give you a regular facial if it meant saving my life, however I will give you the correct information and perform the correct medical treatments for your skin type. Do I have a degree with that name NOOO, however calling myself anything other than that would be misleading and just plain lying. So, don't be so quick to judge us. And YES, good Estheticians are hard to find. May I sugest you just simply steal one from your competitor by offering her a higher salary??? :) Just a thought!

WOW.... I am so taken back by all this info, I am a current student and will be done in 8 weeks and I am excited to get out there but now I am not so sure how welcoming the industry will be.?!? I was actually looking for more info on how to further my education as an esthetician when i came across this website. I decided to get into this industry because I want help people. I have worked for numerous makeup and photograpy companies and just got tired of selling beauty products for tons of money (that obviously didnt work). Since I didnt feel like i knew enough about the skin and the ingredients, I decided to get into this field. So I guess my questions are... should you continue your education threw seminars? and do they truly benefit you or is it just another way for people in this industry to "sell you products, equipment ECT..? and what is the next step up? What are dermatologist looking for?? I would really like to work with a dermatologist but if all fails.. (i'm kinda new in my area) How would I find a reputable dermatologist in my area to refer clients to? any help would be greatly appriciated!!!

09.27 | Unregistered CommenterSW-FLORIDA

Are you a real Medical Doctor? Why would you bicker back and forth with someone so "beneath" you? You have been nothing but offensive to aestheticians.

10.31 | Unregistered Commenterjs, RN

js RN,

What? I just get frustrated when the aestheticians get on here and think that their 12 weeks worth of school is equivalent ot my 4 years of undergrad then 4 years of medical school plus a residency. That is where i have anissue.

If you think I am nothing but offensive to aestheticians then I better stop teaching them. I occasionally lecture at one of the schools. I also make sure that my aesthetician gets to learn new peocedures and get training and education. I am hoping my aesthetician continues to learn.

10.31 | Unregistered CommenterLH

im sorry but you people are all pretty darn rude...everyone nowadays is just so mean and judgemental. This world just plain old sucks now with everybody thinking they know everything and talking down on individuals. where are the nice people??

11.23 | Unregistered Commenteroh my

All of you should realize that you appear uneducated with the large number of typographical errors and misspellings. Don't you know how to use the spell-check function on your computers?

12.29 | Unregistered Commenterdwa

I couldn't agree more with dwa. If you wish to be taken seriously, please use spell check, forget the ALL CAPS, and please check the correct usage of words; for instance, "through" instead of "threw." Sigh...what ever happened to communication skills?

12.29 | Unregistered CommenterFiona

Doctor's and Estheticians are two Very different professions. We all know that the training for a doctor in FAR more intensive, as it should be. I am training to be an esthetician and I'm well aware of my boundaries. The name says it all--esthetics--the most we do is offer helpful advice on beauty no matter which facet you may be working with. As long as you know where to draw the line. Estheticians have clients, doctors have patients; there's a difference. As for the cockiness--that's a personality thing not an esthetic thing.

Sarah, age 23, Toronto, Ontario

I'm a nurse (BSN) and an esthetician and have been praticing the former for over 25 years; the latter for the past 12.

I'm educated and highly trained. But I would never presume to know more than physicians I have worked with and for.

There have been some pretty hostile comments made in this thread, and I will have to agree with the poster who said that the cockiness is a personality thing. Just like there are good and bad CPAs, chefs, teachers and truck drivers; there are good and bad estheticians and physicians. The generalizations that have been made are offensive.

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