Esthetician vs Aesthetician: A Complete Guide to Choosing Your Career Path

Esthetician vs Aesthetician: A Complete Guide to Choosing Your Career Path

If you have been researching careers in skincare and beauty, you have likely encountered two terms that appear almost identical: esthetician and aesthetician. While these words are often used interchangeably in casual conversation, they represent two distinct career paths with different scopes of practice, training requirements, earning potential, and professional environments.

Understanding the difference between an esthetician and an aesthetician is essential for anyone considering a career in skincare or medical aesthetics. The distinction affects everything from the treatments you can perform and where you can work to how much you will earn and what your long-term career trajectory looks like. Whether you are a recent graduate exploring career options, a licensed esthetician considering an upgrade, or a healthcare professional looking to expand your skill set, this comprehensive guide will help you make an informed decision.

The medical aesthetics industry is one of the fastest-growing sectors in healthcare, with the global market projected to exceed $25 billion by 2028. This growth has created unprecedented demand for qualified professionals at every level, making now an ideal time to enter the field. Let us examine exactly what separates these two career paths and help you determine which one aligns with your professional goals.

What Is an Esthetician?

An esthetician (sometimes spelled "esthetician") is a licensed skincare professional who specializes in cosmetic skin treatments designed to improve the appearance and health of the skin. Estheticians focus on non-invasive, surface-level treatments that enhance their clients' complexion, address common skin concerns, and promote overall skin wellness.

Core Services and Scope of Practice

Estheticians are trained to perform a variety of cosmetic skincare treatments, including:

• Facials: Customized facial treatments including cleansing, exfoliation, extraction, and hydration tailored to individual skin types
• Waxing and Hair Removal: Body and facial waxing, threading, and other non-laser hair removal methods
• Skin Analysis: Evaluating skin type, identifying concerns such as acne, dryness, oiliness, and hyperpigmentation, and recommending appropriate products
• Exfoliation Treatments: Microdermabrasion, enzyme peels, and light chemical exfoliation using over-the-counter strength formulations
• Makeup Application: Professional makeup services for special events and everyday looks
• Body Treatments: Wraps, scrubs, and moisturizing treatments for the body
• Product Recommendations: Guiding clients toward skincare products suited to their needs

Where Estheticians Work

Traditional estheticians typically find employment in relaxation-oriented and beauty-focused environments such as day spas, wellness centers, beauty salons, resort spas, skincare retail, and independent practices. These settings emphasize pampering, relaxation, and cosmetic improvement rather than medical treatment.

What Is an Aesthetician?

An aesthetician (also known as a medical aesthetician or clinical aesthetician) is a skincare professional who has advanced beyond basic esthetician training to specialize in medical-grade skin treatments. Medical aestheticians work in clinical settings and perform more advanced procedures that address serious skin conditions, support surgical outcomes, and deliver results that go beyond what traditional cosmetic treatments can achieve.

Advanced Services and Scope of Practice

In addition to the foundational skills of an esthetician, medical aestheticians are trained to perform or assist with:

• Laser Treatments: Laser hair removal, skin resurfacing, photofacials (IPL), and laser tattoo removal
• Medical-Grade Chemical Peels: Deeper peels using higher concentrations of acids such as TCA and phenol that penetrate beyond the surface layers
• Microneedling: Controlled micro-injuries to stimulate collagen production and improve scarring, wrinkles, and skin texture
• Injectable Assisting: Preparing patients and assisting physicians with Botox, dermal fillers, and other neurotoxin procedures
• Pre- and Post-Operative Skincare: Designing skincare regimens to optimize surgical outcomes for patients undergoing facelifts, rhinoplasty, and other cosmetic procedures
• Scar and Burn Treatment: Working with patients recovering from burns, injuries, or surgeries to improve skin appearance and healing
• Advanced Skin Diagnostics: Using tools such as Wood's lamps and digital imaging to analyze skin conditions at a deeper level
• PRP Therapy Support: Assisting with platelet-rich plasma treatments for facial rejuvenation

The Clinical Difference

The defining characteristic of a medical aesthetician is the clinical environment and the medical oversight under which they operate. Medical aestheticians work alongside physicians, dermatologists, plastic surgeons, and nurse practitioners to deliver treatments that require a deeper understanding of skin pathology, wound healing, pharmacology, and medical safety protocols. Their training includes medical terminology, anatomy and physiology, contraindications for medical procedures, and infection control standards that go well beyond traditional esthetician education.

Key Differences Between Esthetician and Aesthetician

While both estheticians and aestheticians share a foundation in skincare, the differences between the two roles are significant. The following table provides a side-by-side comparison of the most important factors.

Licensing Requirements by State

Esthetician training requirements vary significantly from state to state. Understanding your state's specific requirements is a critical first step in planning your career. Below is an overview of the licensing landscape for five major states.

It is important to note that these are baseline esthetician license requirements. To work as a medical aesthetician, additional specialized training is typically needed beyond these foundational hours. Most states do not have a separate "medical aesthetician" license; instead, professionals obtain their esthetician license and then pursue advanced certifications in medical aesthetics procedures through accredited training programs.

Keep in mind that reciprocity between states is limited. Florida, for example, does not offer reciprocity with any other state, meaning you would need to meet Florida's specific requirements even if you are already licensed elsewhere. Always check with your state's licensing board for the most current requirements before enrolling in any program.

Salary Comparison: Esthetician vs Aesthetician

One of the most compelling reasons professionals choose to advance from esthetician to medical aesthetician is the significant difference in earning potential. The aesthetician salary advantage reflects the higher level of training, clinical responsibility, and the premium that patients place on medical-grade treatments.

Esthetician Earnings

• Entry-Level (0-2 years): $17 - $22 per hour / $35,000 - $45,000 annually
• Mid-Career (3-5 years): $22 - $28 per hour / $45,000 - $55,000 annually
• Experienced (5+ years): $28 - $35 per hour / $55,000 - $65,000 annually

Medical Aesthetician Earnings

• Entry-Level (0-2 years): $24 - $30 per hour / $48,000 - $62,000 annually
• Mid-Career (3-5 years): $30 - $40 per hour / $62,000 - $82,000 annually
• Experienced (5+ years): $35 - $50+ per hour / $75,000 - $100,000+ annually

Factors That Influence Earnings

Several variables affect how much estheticians and aestheticians earn:

• Geographic Location: Professionals in metropolitan areas and affluent communities consistently earn more. Cities such as New York, Los Angeles, Miami, and San Francisco offer some of the highest compensation in the field.
• Practice Setting: Medical spas and dermatology offices typically pay 20-40% more than traditional day spas and salons due to the higher revenue generated by advanced treatments.
• Specialization: Professionals who specialize in high-demand areas such as laser treatments, injectables support, or advanced anti-aging protocols command premium rates.
• Commission and Tips: Many estheticians earn a base salary plus commissions on product sales and tips, which can add 15-25% to their total compensation.
• Business Ownership: Estheticians and aestheticians who open their own practices or work as independent contractors often have the highest earning potential, though this comes with additional business responsibilities.

Career Pathways: From Esthetician to Medical Aesthetician

Many medical aestheticians begin their careers as traditional estheticians and later transition into clinical roles. This pathway allows professionals to build a strong foundation in skincare fundamentals before adding advanced medical procedures to their repertoire.

Step-by-Step Career Progression

1. Complete an Approved Esthetics Program: Enroll in a state-approved esthetician training program and complete the required hours for your state (ranging from 220 to 1,600 hours).
2. Obtain Your State License: Pass the written and practical exams administered by your state's cosmetology or licensing board.
3. Gain Experience: Work in a spa, salon, or skincare clinic for 1-2 years to develop your core skills and build client relationships.
4. Pursue Advanced Training: Enroll in medical aesthetics training programs that cover laser technology, advanced chemical peels, microneedling, and other clinical procedures.
5. Earn Specialized Certifications: Obtain certifications in specific treatment modalities such as laser safety, injectable assisting, and medical-grade skincare protocols.
6. Transition to a Clinical Setting: Apply for positions in medical spas, dermatology practices, or plastic surgery offices where you can apply your advanced training under physician supervision.
7. Continue Professional Development: Stay current with new technologies, attend industry conferences, and pursue additional certifications as the field evolves.

Certifications That Strengthen Your Resume

While not all certifications are required by law, the following credentials significantly enhance your qualifications and employability as a medical aesthetician:

• Certified Medical Aesthetician (through accredited training programs)
• Laser Safety Officer Certification
• Chemical Peel Certification
• Microneedling Certification
• NCEA (National Coalition of Estheticians) Credential
• Advanced skincare certifications from recognized medical aesthetics organizations

Training Program Comparison

Understanding the differences in training programs helps you plan your educational investment. Below is a comparison of typical esthetician training programs versus medical aesthetician training.

The return on investment for medical aesthetics training is particularly strong. Because medical aestheticians command higher hourly rates and work with higher-revenue procedures, the additional training cost is typically recovered within just a few months of employment in a clinical setting.

A Day in the Life: Esthetician vs Aesthetician

Understanding what each role looks like on a daily basis can help you envision which career aligns better with your interests and professional goals.

A Typical Day as an Esthetician

An esthetician working at a day spa might start the morning by reviewing the day's schedule and preparing treatment rooms. A typical day could include:

• 9:00 AM - Customized anti-aging facial with LED light therapy for a returning client
• 10:15 AM - Full-body exfoliation and hydrating wrap for a resort guest
• 11:30 AM - Acne-focused facial with extractions and a light enzyme peel for a teenage client
• 12:30 PM - Lunch break and room turnovers
• 1:30 PM - Eyebrow shaping and full-face waxing session
• 2:30 PM - Bridal party makeup consultations and applications
• 4:00 PM - Product consultation and skincare regimen design for a new client
• 5:00 PM - Final facial of the day, a relaxation-focused treatment with aromatherapy

The atmosphere is typically calm, with soft music, dim lighting, and a focus on the client's relaxation experience as much as the treatment outcomes.

A Typical Day as a Medical Aesthetician

A medical aesthetician working in a dermatology practice or medical spa operates in a more clinical environment. A typical day might include:

• 8:30 AM - Review patient charts and prepare treatment plans for the day; calibrate laser equipment
• 9:00 AM - Perform a medium-depth TCA chemical peel for a patient addressing sun damage and hyperpigmentation
• 10:00 AM - Laser hair removal session using an Nd:YAG laser for a patient on their fourth treatment cycle
• 11:00 AM - Assist the dermatologist with a Botox and dermal filler procedure, including patient prep and post-treatment instructions
• 12:00 PM - Lunch and staff meeting to discuss new treatment protocols
• 1:00 PM - Microneedling treatment with PRP for a patient treating acne scarring
• 2:30 PM - Pre-operative skin consultation for a patient scheduled for a facelift next week
• 3:30 PM - IPL photofacial for a patient with rosacea, followed by post-treatment documentation
• 4:30 PM - Follow-up consultation with a post-laser patient, assess healing progress, and adjust homecare regimen

The clinical setting involves medical charting, adherence to safety protocols, patient education about post-treatment care, and regular communication with physicians about treatment plans and patient outcomes.

Where to Work: Practice Settings for Each Role

Your choice between becoming an esthetician or a medical aesthetician will also determine the types of environments where you can build your career. Each setting offers different advantages in terms of compensation, professional growth, and work-life balance.

Esthetician Practice Settings

• Day Spas: The most common employer for estheticians, offering a range of facial and body treatments in a relaxation-focused environment
• Beauty Salons: Full-service salons that offer skincare alongside hair and nail services
• Resort and Hotel Spas: High-end resort properties with dedicated spa facilities, often offering premium compensation and benefits
• Skincare Retail: Working as a skincare specialist at department stores, brand boutiques, or specialty retailers
• Independent Practice: Operating your own facial studio or mobile esthetics business
• Wellness Centers: Holistic health facilities that integrate skincare with other wellness modalities

Medical Aesthetician Practice Settings

• Medical Spas (Med Spas): The fastest-growing employment setting for medical aestheticians, offering advanced treatments under medical director oversight
• Dermatology Offices: Working alongside dermatologists to provide complementary skincare treatments and assist with clinical procedures
• Plastic Surgery Practices: Supporting plastic surgeons with pre- and post-operative skincare for patients undergoing cosmetic procedures
• Cosmetic Laser Centers: Specialized facilities focused exclusively on laser and light-based treatments
• Anti-Aging Clinics: Practices focused on comprehensive rejuvenation programs combining multiple treatment modalities
• Burn and Wound Care Centers: Specialty facilities where medical aestheticians help patients with scar management and skin rehabilitation
• Oncology Practices: Supporting cancer patients with skincare during and after treatment, addressing radiation-related skin issues and chemotherapy side effects

How Aesthetic Education Can Help You Advance Your Career

Whether you are just starting your journey or looking to transition from a traditional esthetician role to a medical aesthetician career, the right training program makes all the difference. Aesthetic Education offers accredited, hands-on training programs designed to equip skincare professionals with the clinical skills needed to thrive in medical aesthetics.

Our programs are taught by experienced physicians and clinical professionals who provide real-world instruction on the latest techniques and technologies in the field. Here are some of our most popular programs for aspiring medical aestheticians:

• Botox and Dermal Filler Training - Comprehensive instruction in neurotoxin and filler techniques, facial anatomy, patient assessment, and injection safety. This is one of the most in-demand skills for medical aestheticians working in med spas and cosmetic practices.
• Chemical Peel Training - Learn to perform medical-grade chemical peels safely and effectively, including patient selection, peel depth protocols, and post-treatment management for a range of skin concerns.
• All Aesthetic Workshops - Browse our full catalog of hands-on training workshops covering laser technology, microneedling, PRP therapy, advanced skincare techniques, and more.

Our training programs are designed with flexibility in mind, offering weekend and intensive formats that allow working professionals to upgrade their skills without putting their careers on hold. Each program includes hands-on practice with live patients under expert supervision, ensuring you graduate with the confidence and competence to perform these procedures in a clinical setting.

Frequently Asked Questions

What is the difference between an esthetician and an aesthetician?

An esthetician focuses on cosmetic skincare treatments such as facials, waxing, and basic exfoliation, typically working in spas and salons. An aesthetician, or medical aesthetician, specializes in clinical and medical-grade skin treatments, including laser therapy, medical-strength chemical peels, microneedling, and assisting with injectable procedures. Aestheticians work in medical settings like dermatology offices and medical spas under physician supervision. The primary difference is the scope of practice: aestheticians undergo advanced training to perform procedures that go beyond surface-level cosmetic care.

Do aestheticians make more money than estheticians?

Yes. Medical aestheticians consistently earn more than traditional estheticians. Entry-level estheticians typically earn between $35,000 and $45,000 per year, while experienced medical aestheticians can earn $75,000 to over $100,000 annually. The higher pay reflects the advanced training required, the clinical nature of the work, and the premium that patients pay for medical-grade aesthetic treatments. Geographic location, practice setting, and specialization further influence the salary gap between the two roles.

Can an esthetician do Botox?

In the vast majority of U.S. states, estheticians cannot administer Botox injections. Botox is a prescription medication classified as a neurotoxin by the FDA, and its administration requires medical licensure. Only physicians, nurse practitioners, physician assistants, and in some states registered nurses can inject Botox, though regulations vary by state. A small number of states, including Nevada and Illinois, allow specially certified medical estheticians to perform limited cosmetic injections strictly under direct physician supervision. However, estheticians can play an important supporting role by assisting physicians during injection procedures, which is a common function of medical aestheticians in clinical practices.

How long does it take to become an aesthetician?

The total timeline to become a medical aesthetician typically ranges from 1 to 2 years. This includes completing a state-approved esthetician program (which can take 4 to 12 months depending on your state's hour requirements and whether you attend full-time or part-time), passing the licensing exam, and then completing additional medical aesthetics training programs. Advanced training in specific procedures such as laser treatments, chemical peels, or microneedling can range from intensive weekend workshops to multi-week certification courses, depending on the program and the depth of training.

What certifications do aestheticians need?

At minimum, aestheticians need a state esthetician license, which requires completing an approved training program and passing a state-administered exam. Beyond that, medical aestheticians strengthen their qualifications by earning certifications in specific procedures: laser safety certification, chemical peel certification, microneedling training, and advanced skincare credentials. The National Coalition of Estheticians, Manufacturers/Distributors and Associations (NCEA) offers nationally recognized credentials. Additional hands-on training certificates from accredited medical aesthetics programs demonstrate competency in clinical procedures and make candidates more competitive for positions in medical spas and dermatology practices.

Is aesthetician school worth it?

For most aspiring skincare professionals, aesthetician school is a strong investment. The total cost of esthetician training combined with medical aesthetics specialization courses typically ranges from $5,000 to $20,000, which is substantially less than many other healthcare career paths. Given that experienced medical aestheticians can earn $75,000 to $100,000 or more per year, the return on investment is achieved relatively quickly. The medical aesthetics industry continues to grow rapidly, driven by increasing consumer demand for non-surgical cosmetic procedures and anti-aging treatments. This growth translates to strong job security and expanding career opportunities for qualified professionals. The flexibility of the career, with opportunities for part-time work, independent practice, and specialization, adds further value to the investment.

Final Thoughts

The choice between pursuing a career as an esthetician or a medical aesthetician ultimately depends on your professional ambitions, your interest in clinical versus cosmetic work, and the level of investment you are willing to make in your education. Both paths offer rewarding careers in a growing industry, but the medical aesthetician route provides significantly higher earning potential, a more diverse skill set, and access to one of the most dynamic sectors in modern healthcare.

If you are drawn to advanced treatments, clinical problem-solving, and working alongside physicians to help patients achieve meaningful results, the medical aesthetician path is likely the right choice. If you prefer a more relaxation-focused environment with a focus on beauty and wellness, the traditional esthetician role offers a fulfilling career with strong demand.

Whichever path you choose, the most important step is to start with the right training. Quality education from experienced instructors, combined with hands-on clinical practice, creates the foundation for a successful and sustainable career in aesthetics. Explore the training programs available at Aesthetic Education to take the next step in your professional journey.