Dermatologist or Aesthetician: How Do You Decide which to See?

Getting a quick facial while you’re out shopping may seem like an innocent splurge, but do you take the time to learn about the qualifications of the person who’s going to treat your skin ?You should. Mistakes made by inexperienced or poorly trained skin care practitioners can damage, even scar, your skin.

That’s why it’s important to know the difference between a dermatologist and an aesthetician and when it’s best to skip the spa and go to a medical doctor for skin care or a cosmetic procedure

The Different Skills of Dermatologists and Aestheticians

The most obvious difference between a dermatologist and an aesthetician is training. Dermatologists attend college and medical school, and then complete a residency, meaning they have 12 to 14 years or more of advanced education and medical training under their belts, says Peggy Fuller, MD, founder and director of the Esthetic Center for Dermatology, a medical spa in Charlotte, N.C. “Dermatologists are experts in hair, skin, and nails,” Dr. Fuller says.

Aesthetician training varies from state to state, but aestheticians typically take a one- or two-year course that focuses on skin care, facials, and noninvasive procedures, Dr. Fuller says.

Dermatologists practice out of medical offices or medical spas, while aestheticians can be found in spas and salons as well as working under the direction of dermatologists in medical settings.

At Fuller’s center, aestheticians train with dermatologists and are available to give facials and other services to augment some of the products Fuller prescribes for her patients. Fuller has treated patients whose skin was damaged by aestheticians who weren’t qualified to do a certain procedure.

How to Avoid Problems With Skin Care Specialists

In general, it’s best to see a dermatologist before having a procedure done to be sure that what you’re having done is healthy for your skin, Fuller says. For instance, microdermabrasion can contain products such as salicylic acid, which could cause an allergic reaction. “If you’re healthy and you haven’t had complications with facials in the past, it’s okay to see an aesthetician for basic skin care procedures like a facial,” Fuller says.

She also offers the following advice:

Go to at a medical spa. A certified center for dermatology in a spa-like setting will have the best medical oversight. You’ll get the luxury of a spa with the medical expertise and supervision that’s paramount to keeping your skin healthy. And because aestheticians at medical spas are usually trained by dermatologists, they have a better idea of when to call in a doctor for a condition that’s outside their scope, she says, which will go a long way toward avoiding problems.

Avoid “mom and pop” shops. Some spa operators call themselves “skin care specialists” when they actually have very little training. There are also aestheticians who perform procedures in hotel rooms. “That’s a no-no,” says Fuller.

Look for a license. When you go to a spa for a service, always look for a certificate from an aesthetician school and a state license, which is usually hanging on the wall. It’s also a good idea to go to a spa that has a medical director. “It needs to have medical oversight and supervision,” Fuller cautions. If you’re not sure, ask.

Give your full medical history. It’s vital to let your aesthetician know if you’re allergic to anything. Someone who is allergic to aspirin may not know that an anti-aging facial contains aspirin.

It’s also important to let the aesthetician know if you have any health conditions. Someone with a history of herpes simplex who gets laser treatment without taking prophylactic (preventive) medication first could get herpes all over the face as a result. And don’t forget to mention medications you take regularly. If you’re on a blood thinner or a medication that makes you sensitive to light, for instance, getting laser treatment could cause severe bruising and irreparable white or dark spots on your skin, Fuller warns.

Keep treatments simple. When you’re at a spa, go for the basic European facial, says Fuller. It’s not complicated and it’s less likely to cause an allergic reaction.

For more complicated procedures, see a dermatologist. More involved, complex procedures, such as laser hair removal and Botox injections, should be performed by a dermatologist.

The bottom line is to always err on the side of caution. If the cosmetic procedure seems like something the aesthetician doesn’t have knowledge of, says Fuller, “it’s always good to be a healthy skeptic.”

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