How to Become a Medical Esthetician

If you want to work in beauty while making a difference in people's health, a medical esthetician career may be right for you. Medical estheticians perform traditional and advanced esthetics treatments help people who have undergone physical trauma or medical issues regain confidence and health.

Read on to learn about what medical estheticians do, how to become a medical esthetician, and whether this is the right career path for you.

What Is a Medical Esthetician?

Medical estheticians—sometimes called "paramedical estheticians"—are skincare professionals who work in more clinical settings than standard estheticians typically do. Medical estheticians can perform the same work as traditional estheticians and more in-depth treatments.

Medical estheticians can have transformative impacts on people's lives by helping them care for their skin to help imrpove their health and increase their confidence. For example, you might work with cancer patients to treat skin-related side effects of chemo or post-radiation burns or soreness. You could also work with burn victims to help them care for their skin and teach them about makeup application techniques to hide scarring if they so desire.

However, not all medical estheticians work in medical environments, instead opting for medical spas (medspas) or esthetics establishments offering specialty treatments. These medical estheticians often perform cosmetic treatments that require the oversight of a healthcare professional.

Esthetician vs. Medical Esthetician: What's the Difference?

Estheticians—sometimes spelled aestheticians—perform skincare services such as cleansing, massaging, toning, and hair removal. Medical or paramedical estheticians provide many of the same services as estheticians. However, these professionals tend to have additional training that allows them to perform specialized treatments and work in clinical settings.

Both estheticians and medical estheticians must have an esthetician license. There isn't a specific medical esthetician license.

Though they do help individuals address issues like dry skin or sunspots, medical estheticians also often work with those facing serious skin disorders or traumas. Estheticians often work in spa and salon settings, while medical estheticians can be found in plastic surgeon’s offices, rehabilitation centers, or medspas.

Can I Get Licensed to Be a Medical Esthetician?

You must be licensed as a general esthetician to practice to be a medical esthetician; no specialized licenses currently exist for medical estheticians. The most common way to become a medical esthetician is obtaining an esthetics license and seeking additional training and certifications in areas of interest, like microblading and chemical peels. Not all states require certification for many specific services performed by medical estheticians, so check with your licensing board when you choose your path.

What Does a Medical Esthetician Do?

A medical esthetician's role is typically to assist dermatologists, plastic surgeons, nurses, and an other medical professional in advising patients on healthy skincare practices and providing treatments. Treatments could include microdermabrasion, hair removal, or LED light therapy. Medical estheticians also provide recommendations to patients about maintaining healthy skin independently.

Medical estheticians often perform treatments that standard estheticians can't, depending on state laws. Some of these are:

Pre- and Post-surgical Skincare
As the name implies, this involves helping with skincare needs before and after surgery. This can include patients with skin trauma due to burns, abrasions, or other types of damage. But it's also common to help people having cosmetic surgery prepare for or recover from their procedures. Medical estheticians provide cleansing treatmentsand instructions on keeping skin disinfected and healthy.

Manual Lymphatic Drainage (MLD)
MLD is used to drain lymph nodes, increase blood flow, and support circulation. Medical estheticians typically provide MLD services to those with lymphedema.

Advanced Hair Removal
Designed for individuals who want to permanently remove hair from specific parts of their body, this technique uses lasers and intense pulsed light to keep follicles from growing. As these treatments are often considered medical instead of cosmetic, medical estheticians may assist doctors and laser technicians rather than operate the lasers directly.

Of course, these are just a few of the unique services medical estheticians provide.

Can a Medical Esthetician Do Botox?

No, medical estheticians can't perform Botox treatments. Because Botox is considered a medical treatment, it can only be administered by a medical doctor (such as a dermatologist or plastic surgeon)

Medical Estheticians vs. Nurse Estheticians: What’s the Difference?

Medical estheticians are estheticians without a healthcare degree, while nurse estheticians are registered nurses who specialize in esthetics. Nurse estheticians can perform more intensive medical treatments than medical estheticians can.

Estheticians, medical or otherwise, can generally only perform cosmetic treatments versus medical treatments. Strictly medical treatments typically must be administered by someone with a nursing or other medical license.

If you want to work as a nurse esthetician, you need to return to school to become a registered nurse, typically through an ADN or BSN program.

Can a Medical Esthetician Open a Medical Spa?

Many states only allow physicians or physician-owned companies to own medical spas. However, the American Med Spa Association (AmSpa) notes that non-doctors can own medical spas through a management services organization (MSO). In this, they partner with a physician's company. The physician's company provides the medical services, and the MSO handles the administrative, marketing, and other non-medical tasks.

Where Do Medical Estheticians Work?

Medical estheticians may work in dermatology, plastic surgery, or other doctors' offices, as well as medspas. In medical offices, they might helps treat skin illnesses, assist with treatments such as microdermabrasion, or assist with post-surgery care. Medspas are set up like spas but offer medical treatments under the management of physicians.

Some medical estheticians are self-employed, though their permitted services depend on state laws.

Medical Esthetician Salary

Average salary expectations for medical estheticians range from about $44,377 to $56,270. Your location and employer will impact your salary expectations. For example, Glassdoor estimates an average base salary of $49,139 per year for medical estheticians in Florida and an average base salary of $60,044 for those working in New York.

Do Medical Estheticians Make More Money than Other Estheticians?

Generally, medical estheticians have the opportunity to make more than other estheticians. Salary potential vary greatly depending on the state, your job responsibilities, workplace, training, and experience.

READ MORE: How much do estheticians make?

How Much Do Self-Employed Medical Estheticians Make?

There's no simple answer for this, as it depends widely based on which state or city in which you're practicing, the clientele you work with, and your ability to find clients. As a freelance medical esthetician, what you make largely depends on how much work you can secure.

Being self-employed also requires business expenses, such as a business license and workplace that meets state mandates, so you need to factor in those costs that might eat into salary. However, the flexibility you have being self-employed could be worth the added expenses.

How Long Does It Take to Become a Medical Esthetician?

It can take about six months to a year to become a medical esthetician, depending on your state’s license requirements and how much additional training you choose to pursue.

READ MORE: Training hour requirements for an esthetician license

Some states have master esthetician licenses, which may be a good fit for those pursuing medical esthetics. Master esthetician training almost always incorporates the advanced treatments medical estheticians perform.

You should also consider taking continuing education classes related to medical esthetics. Not only could this help you meet your state's required continuing education hours, but it should also show potential employers you've gained expertise in the areas they desire.

From the Expert: Is a Medical Setting Right for You?

Susanne Warfield

Susanne Warfield

Susanne S. Warfield is the leading expert on the business, legal and liability issues that affect physician and esthetician relationships working in a medical or spa setting. Warfield is a 27-year Licensed Esthetician and is NCEA Certified. Her career started as an Esthetics Instructor at Sheridan College in Oakville, Ontario, Canada, where she taught the 2nd year of a two-year degree Esthetics Program. When she moved to the United States, her advanced training was put into use and she spent almost 14 years working with a dermatologist in New York City.

Today's esthetician enjoys a broad range of esthetics career options in the traditional salon/spa setting, theatrical makeup for stage, or the film industry. Cosmetics companies offer numerous opportunities, from sales and training to management and executive positions. All of these, however, lie outside the scope of this article, which is devoted to career options for estheticians in medical settings.

Two questions should come to mind when considering working as an esthetician in a medical setting: would I like it and would I be good at it?

“part of the professional satisfaction comes from the knowledge that when a job is well done, the esthetician has helped other people in a wide variety of ways”

The answers may not be as obvious as you think. Physicians and estheticians may not be that different. The reasons for choosing careers in esthetics or medicine differ in many respects, but they also overlap in more ways than you might think, which makes combining the two a natural choice.

Esthetics as a Helping Profession

People pursue esthetics careers for various reasons. Obviously, one of the essentials is the enjoyment of working with people. There's really no room in the profession for people who don't genuinely enjoy dealing with others and helping them be their best. It takes real skill to put people at ease to the point where they trust others to keep their interests at heart. Often, the esthetician has to learn to listen between the words to find out what the client really wants, and also develop sophisticated psychological skills.

Respecting our clients' privacy is important: remember the hair coloring commercial that posed the question “Does she or doesn't she [today it could well be does he or doesn't he]? Only her hairdresser knows for sure!“The ad may sound old-fashioned but the concept of respecting the trust people place is not.

The esthetician enjoys work that centers on esthetic sensibility, and quality esthetics training refines that sensibility and focuses it on helping people look their best. In a sense, estheticians are one of the so-called helping professions, and as such, it has quite a bit in common with the other helping professions: part of the professional satisfaction comes from the knowledge that when a job is well done, the esthetician has helped other people in a wide variety of ways.

Responsibility in the Esthetics Profession

Estheticians also like to work independently. That is, the esthetician is personally and directly responsible for the job he or she does. That's true of just about any job, but some work, like that of an esthetician, allows the person performing it to assume complete responsibility for the end results. If done well, the results are obvious, but their effects may be more subtle, revealing themselves in a patients' increased self-confidence. If done poorly, the results are equally obvious and the effects for the patient are genuinely painful.

And let's not forget that we do it to be profitable.

The Esthetics and Medicine Overlap

What I said about estheticians is equally true of physicians in many ways. The clinician (the physician actually engaged in patient care as opposed to research physicians and certain specialties that often involve very little actual patient contact) must enjoy dealing with people. Physicians need to be able to put people at ease and win their trust.

The Hippocratic oath that all physicians take when they get their medical degrees demands that the physician put the interests of his or her patient first and that the physician be governed by what is best for the patient, even when his or her own interests must be sacrificed. And the good physician respects his or her patients, always guarding their privacy and the confidential nature of the relationship.

Differences in Education Requirements

In comparing the esthetician with the physician, I don't mean to equate the two.

"Estheticians also need to keep abreast of the field and continue esthetics education on a national basis."

In terms of education and training, there's simply no comparison. The physician generally spends a minimum of eight years beyond college, and frequently longer, training for his work.

Physicians continue their formal education throughout their working lives and spend countless hours on their own reading journals, attending conferences, watching technical videos and generally keeping abreast of developments in medicine and in their specialties in particular.

Estheticians also need to keep abreast of the field and continue esthetics education on a national basis, such as becoming NCEA Certified. The Society of Dermatology SkinCare Specialists recognized early that if an esthetician is working with a physician, one needs to be at the top of their game and that is why all SDSS members we urged to become certified.

Estheticians and Clinicians Working Together

It's also important for estheticians considering working with physicians to understand that establishing professional limits and understanding their scope of practice as defined their state regulatory board is sometimes difficult but absolutely necessary.

"When examining your career options as an esthetician and deciding whether you really want to work in a medical context, you need to consider whether you're the kind of person who needs to be dominant in all situations."

The trained, licensed esthetician brings to the medical practice an expertise in the knowledge of skin care that the physician may not necessarily have and this expertise can play a vital role in the physician's practice, especially in specialties such as dermatology and plastic reconstructive surgery. At the same time, it's important to understand that egos - yours and the physician's - are involved in any working relationship.

I bring it up because when examining your career options as an esthetician and deciding whether you really want to work in a medical context, you need to consider whether you're the kind of person who needs to be dominant in all situations. While the esthetician working in a medical setting is the expert in his or her sphere, that sphere is secondary to medical/physician issues, and ultimately the doctor is the boss.

How much independence you achieve in a medical practice will depend on the relationship you work out with the physician(s) you work with, but in the final analysis you'll never have the kind of ultimate authority in a medical setting you would enjoy in your own facility. As usual, the first step in making a career decision is taking a good, honest look at yourself.

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