The first time I was told “you are not a medical esthetician” was frustrating. I was just floored. Problem was they were right; there is no such legal designation as a medical esthetician. In some states, it is illegal to call yourself one. Without that designation, the ability to separate myself as an esthetician with advanced skills seemed impossible. There were no advanced licensing options recognized in my state, and the certifications available were not really understood by the public or employers.
This article will take a look at options for identifying an esthetician with advanced skills, but first, we will look at credentials then clarify the licensing options.
Certification or Credentialing
Credentialing or certification is different from licensing. A credential will not allow you to legally work in your state, whereas a license is needed. There are two types of certificates: assessment based and professional (see Certificate Providers).
Assessment-based certificate. When certification is tied to a certain course or education provider, it is called an assessment- based certificate program. It should not be confused with a certificate of attendance or participation. Assessment-based certification depends on completing a test at the end of the course that covers all the knowledge and practical skills taught within the course. The test is provided by the education provider and generally has limited industry oversight. Examples of this would be a class given by a manufacturer or independent education provider with a certificate that states that the esthetician is certified in a certain modality or body of knowledge.
There are no regulatory impacts other than a possible continuing education credit if the provider is registered and your state requires continuing education units (CEUs). Costs vary, and the benefit to your spa is based on how you use the knowledge. Determining the quality of the education is hard to do, as there is no commonly used continuing education accreditation process used in the esthetic profession.
Professional certification. A professional certification is different, with the focus on the assessment of knowledge, skill set and industry best standards. It is not based on any particular class or training program. The training that the esthetician receives is not tied to one provider and generally includes experience requirements. If the certification provider states that you must take its training to get certified, it's not a true professional certification but rather an assessment-based certificate program. This does not mean that it is not valid, just that it might not be considered an industry-standard credential. Testing for a professional certification is supervised, which could require an onsite testing agent or an independent testing center. The body of knowledge tested is designed by industry subject matter experts and can be legally defensible if designed correctly. These certifications are usually managed by industry associations or other for profit entities. Getting one is not an easy process, which also can add to the value of the certification.
State licensing should be focused on client safety, which includes defining the services that can be performed on the public. These decisions are influenced by a board appointed by the governor of each state. The board should be fair, impartial and educated about the industry. Some boards have more influence over others.
For example, the medical board in some states has influence over the other boards. We are seeing multiple states defer to the medical board for cosmetic medical services when many of the modalities could be performed safely by estheticians. Many boards also try to defer device guidelines to the U.S. Food and Drug Administration (FDA), which is not always interpreted correctly. The ban on class II medical devices for estheticians is a good example of this. Many boards have not updated standards to meet the new FDA interpretations or have been educated by our industry on the safety parameters of many of the devices we use. Boards are given authority by statute and are responsible for the rules that govern your scope.
Licensing does not qualify an esthetician’s skill set. The standard for passing the licensing test is minimum standards of safety, not technique or industry knowledge. To identify skill set and qualifications, a professional credential is needed.
The only way advanced licensing helps the esthetician is if the scope of practice is broadened to allow estheticians to perform advanced modalities such as energy devices and lasers safely. The most common example of this is the master esthetician license. The scope of a master esthetician includes the use of laser devices under supervision as well as other modalities performed in a medical or advanced skin care practice. If you are in a state with no master esthetician license, check with the state medical board for rules on performing laser modalities under supervision. States like Arizona have a specific certification process for laser technicians through the Radiation Regulatory Agency. Generally, the ability to perform laser treatments is a completely separate set of job tasks, and anyone regardless of license background can go to a laser school. Listed here are the states with master esthetics licenses, along with their requirements and costs.
Requirements: You must have 1,200 hours in a state-recognized school or a state approved apprenticeship. Reciprocity is not easy, with no mention of accepting other master esthetics licenses. Some education is accepted from outside of the state. Check with the board for details.
Cost: Initial education is $15,000 plus state licensing fees.
Requirements: You will need 1,200 hours from a state-approved school or 1,400 hours from a state-approved apprenticeship. There is reciprocity for out-of-state licenses. To apply without a master esthetician license, contact the board.
Cost: Initial education is $15,000 plus licensing fees $55-$110.
The District of Columbia is the first board to put together an advanced license based on rule instead of statute. This means it can be changed through a rulemaking process administered by the board.
Requirements: Individual must have 600 hours of basic esthetics training with a license and 600 hours of master esthetics manager training with subjects outlined in rule. It is important to read the amended rules to understand the requirements. Estheticians who are certified by the National Coalition of Estheticians, Manufacturers/Distributors & Associations (NCEA) will qualify or the master esthetician manager license.
Cost: The cost is $8,600 in addition to a $230 licensing fee.
Requirements: Individuals need 1,200 hours or substantially equivalent training proof with six months of experience for out-of-state education. Reciprocity (license by endorsement) is available.
Cost: There is a cost of $9,800 for initial education plus licensing fees.
Oregon has not adopted the national standard of 1,200 hours, but rather put together an advanced esthetics board and statute specific to the use of energy devices under supervision. This law went into effect on July 1, 2016.
Requirements: A basic esthetics license is required in addition to requirements outlined by statute. Rules are pending to clarify processes and approve schools. Grandfathering is in effect until 2017.
Cost: Meeting educational requirements will cost $12,000 in addition to licensing fees.
What do you need to know?
In the United States, obtaining a state license is the first place all estheticians need to start. This qualifies you to work legally in your state. Estheticians can then start to look at the advanced credentials. Be sure to represent your license title on any public documents and add advanced training or experience titles if allowed by your state. Here is one example:
Licensed WA Master Esthetician
#b88050 (some states require license #) NCEA certified, CIDESCO
Certificate in medical esthetics, aromatherapy, laser technician
Credentialing/certification is a way to define yourself as an esthetician with advanced skills, but it might not always communicate your skill set to your clients. Having a portfolio of your work as well as reviews from clients is essential to building clientele. Your resume of experience and advanced training should be made available on your website as well as any advanced credentials you hold. Keep in mind that initials after your name such as master esthetician (ME) or certified laser specialist (CLS) do not mean anything to your client. Be clear about who you are, and represent your legal title as your state board has designated. Remember clients only want the what’s in it for me (WIIFM)!