This year, estheticians in the United States have seen many issues arise regarding the scope of practice of their state’s license. Here is a quick overview of the issues you need to be aware of to protect your right to work.
1. Master esthetician licensing may not work for every state.
The impact of California’s bill AB 1153, which aimed to create a master esthetician level of licensing, is a good example of what can happen. In this case, Ted Lieu, Senate business chairman of the Professions and Economic Development Committee in California, felt there was not enough reason to have such a license, which influenced changes in the bill before it could even go to the committee.
The California Society of Dermatology & Dermatologic Surgery also stepped up to voice its objection against the use of lancets by estheticians, as well as making the statement that estheticians are not well-trained enough to offer skin care advice.
What this means. Unless estheticians can agree on how to promote the profession and create their own coalition to do so, the entire industry will continue to face these challenges. Everyone involved in esthetics—product and equipment manufacturers, schools, associations and individual estheticians—must get involved at the state level. It is vital that lawmakers understand the daily job tasks an esthetician performs, and that they do not confuse them with the types of medical esthetic treatments that are performed under physician supervision.
2. When it comes to scope of practice, rules are just as important as statute.
A good example of this is the rule that was passed by New Jersey in 2012. Rule 13:28–2.15, “Prohibited Practices,” says estheticians cannot “perform or offer to perform massaging, cleansing or stimulating of the skin, with or without cosmetic preparations, by hand, mechanical or electrical appliances, below the stratum corneum, thereby affecting the living cells of the epidermis.”
What this means. At first glance, this does not seem like a major problem, but estheticians’ most common modalities affect the epidermis. Take a look at massage, galvanic current and high-frequency—even water will affect the epidermis below the stratum corneum. This mistake will affect estheticians tremendously unless it is repealed or revised.
3. Deregulation is still an issue.
There is a political movement that is still happening in regard to the deregulation of the cosmetology profession. Essentially, there are well-funded organizations that oppose any type of licensing for cosmetology, because they believe licensing harms the economic independence of minority groups. Deregulation would allow any individual—trained or untrained—to offer those services.
What this means Whether or not estheticians view their work as being related to cosmetology, this movement still affects them and they need to add their voices to those of cosmetologists to prevent deregulation. The good news is that there is a strong opposition effort of deregulation in place—but that doesn’t change that estheticians still need to help support it.
4. Skin care professionals are seen as uneducated and unprofessional by many legislators and state boards.
Before you scream at the top of your lungs from frustration, think about this for a moment. You know your job required, and continues to require, in-depth education, and you consider yourself a professional—but how are those outside the industry supposed to know this?
It is common for society to think of a serious profession as solely one that exists in a field such as medicine, law or engineering—something that requires long, intensive academic preparation—a four-year degree or twice that long, in many cases. Considering that, do you feel estheticians can say they have been through comparable intensive academic preparation for a profession?
What this means. Although the ideal amount of training that should be required for an esthetics license has long been an open question, it needs to be decided. The industry needs uniform educational standards, scope of practice and licensing requirements throughout the United States. This may not happen in the lifetime of current skin care professionals, but it’s not impossible. In the meantime, it is up to those in the industry right now to be ambassadors for the esthetics profession, follow a code of ethics, and obtain additional education and certifications so that others will start to see estheticians as a professional, educated group.
5. Scope of practice affects more than public safety—it affects the economy.
The mantra of public safety is always used in discussions of licensing and scope of practice, and that is exactly what state boards have been mandated to focus on. Changes to rules usually happen when pressure is placed on a state board from an outside group, due to a new modality being released or some unusual incident that causes panic among the uninformed. However, many scope-of-practice restrictions now lead to little real change in safety, and have a negative economic impact that affects everyone—not just estheticians.
When legislation shrinks estheticians’ scope of practice and educational requirements, it limits their access to employment in medical spas, skin care clinics, and destination and resort spas. Business owners in these sectors already complain about the lack of qualified estheticians and the difficulty of finding employees. Ensuring a fair, equitable and safe scope is needed to make sure estheticians can work, business owners can hire an skilled team and clients can access the services they want.
What this means. The skin care industry’s arguments for changes in the profession need to take these issues into account, too. Limiting the scope of practice limits job creation and economic growth—employers will not find qualified skin care professionals or provide industry-standard services; licensed estheticians will not compete against those in the medical field who are performing esthetic services as an adjunct to a medical practice; and, because esthetics is a female-dominated profession, women-owned business growth will decline.
I know this sounds challenging, but I also know this is a profession filled with smart, driven, compassionate people. The core of what you do, no matter where you work or what modalities you perform, is to help people. Anyone who has had a client tell them how skin care treatments changed her life can attest to this.
Susanne Schmaling is the director of education for Associated Skin Care Professionals. A licensed esthetician and experienced instructor with more than 15 years of experience, Schmaling is also a member of the 2014–2015 Skin Inc. Editorial Advisory Board.