The path to "Medical" Aesthetics: Esthetician or Nurse?

Private equity interest in the delivery of Botox injections, laser hair removal, and specialized facials across the U.S. is growing rapidly. As the medspa industry matures, investors recognize these services have become routine for many consumers. With the increasing demand for medspas, the need for skilled personnel to deliver aesthetic treatments such as Botox is also on the rise.

Estheticians vs. Nurses: A Comparative Look

Administering Botox requires medical knowledge, but achieving a pleasing aesthetic outcome is a specialized skill. Estheticians, favored by consumers for their expertise in enhancing beauty through procedures like microneedling, mild chemical peels, results-driven facials, dermaplaning, and more, are now seeking higher education to perform more invasive treatments.

The primary pushback against estheticians performing treatments like Botox is their lack of traditional medical training. However, nursing degrees often include 500 clinical hours that may not focus on aesthetics. In contrast, estheticians complete a minimum of 600 practical training hours, with Master Estheticians in some states completing up to 1200 hours. This training includes treating the skin, recognizing skin conditions, sanitation, and technique training dedicated to facial anatomy and aesthetic outcomes.

Training and Legalities

Estheticians receive stringent training in facial anatomy, sanitation, and bloodborne pathogen safety control. For treatments like Botox, which use needles of 4-8mm—the same length used by millions of Americans to inject insulin—estheticians in states like Texas can legally perform injections with appropriate training and certification. Under Texas law, estheticians can perform Botox injections, provided they meet certain standards such as carrying a manufacturer’s certification and the client’s health chart is cleared by a medical professional overseeing the treatment.

This pathway allows estheticians to begin with foundational aesthetic training and progressively advance to medical aesthetics, contrasting with nurses who typically start with a medical background and later acquire aesthetic skills, often without obtaining a dedicated esthetician license. Doctors might choose to hire estheticians in their med spas because of their deep foundational knowledge of aesthetics. This expertise, combined with proper medical delegation, ensures that estheticians can perform these procedures safely and effectively, offering a unique advantage over nursing- where the primary training does not include aesthetic treatments.

The Path Forward

Becoming an esthetician that provides Botox involves detailed legal considerations and registrations. Doctors must delegate procedures like Botox or medical microneedling to estheticians working in their offices and be available for clients treated by these medical estheticians. Although Botox carries a lower risk of adverse reactions compared to hyaluronic acid fillers, the demand for doctors to delegate Botox has led to the creation of companies like Aesthetic Medical Partners to help estheticians and doctors navigate the correct legal path to administering such treatments.

As the aesthetic industry continues to soar, estheticians are increasingly recognized for their specialized training and expertise in providing safe, effective treatments. With continued education and proper oversight, estheticians are well-positioned to meet the growing demand for aesthetic procedures, offering consumers a trusted option for enhancing their beauty.