Dermatologist vs. Esthetician: Which One Do You Need?

Dermatologists and estheticians are both skincare professionals, but there is a distinct difference between them. In short, the former is a medical doctor who specializes in diagnosing and treating conditions of the skin, hair, and nails. The latter is someone who’s undertaken training to perform treatments that improve the appearance of the skin.

The Difference Between a Dermatologist and Esthetician

What is a dermatologist?
What is an esthetician?

What is a dermatologist?

A dermatologist is a highly trained doctor who’s undergone, at the very minimum:

An undergraduate bachelor’s degree.
4 years of medical school.
A 1-year internship.
A 3-year dermatology residency. This allows them to gain experience in the dermatology field under the supervision of other experienced dermatologists.

This process takes a minimum of 12 years. Once successfully completed, they can register to become board-certified and get a license to practice as a dermatologist in the US.

In reality, most good dermatologists don’t end their training at this point. The field is continually changing, with treatments evolving as technology and understanding advances. To stay current, a dermatologist must undergo continual training and professional development to ensure they offer the very best patient care.

A qualified dermatologist has a deep knowledge of the structure of the skin. This extends to the hair, the nails, and the mucous membranes, as well as how the dynamics of the body interact with everything that’s skin-related.

This intimate understanding of the body’s largest organ means that dermatologists can:

Assess and diagnose skin conditions, including diagnostic procedures.
Prescribe medications to treat these conditions.
Carry out surgical procedures, including those done for aesthetic reasons, as well as medical.

You might find dermatologists working in specialty skincare clinics, hospitals, and medical spas.

What is an esthetician?

Estheticians don’t have any medical training. Instead, they attend college to learn how to administer non-invasive skincare treatments. In all US states, an esthetician requires a license to practice. To get this, they must:

Have a minimum of a high school diploma or GED certificate.
Attend a 4-6-month training program at a cosmetology school.
Pass a state-approved exam. This includes both theoretical and practical elements.

Once licensed, the best estheticians undergo further, more specialized training. This is done through the National Coalition of Estheticians Associations (NCEA) and culminates in a nationally recognized qualification.

Again, good practitioners continue to further their knowledge and education throughout their careers.

Which One Do You Need? The Dermatologist vs. Esthetician Comparison

Choose a dermatologist if…
Choose an esthetician if…
Or perhaps you need a combination approach

Choose a dermatologist if…

…Your concerns require any kind of diagnosis, medication, or clinical skincare. This includes any invasive procedures or surgery (both medical and elective).

Examples of conditions that dermatologists diagnose and treat include:

Rashes.
Acne.
Skin cancers.
Eczema.
Alopecia.
Psoriasis.
Fungal nail infections.
Contact dermatitis.
Excessive sweating (hyperhidrosis).

The types of procedures that require a dermatology license to perform include:

Biopsies.
MOHS surgery (the gold standard for most skin cancer removal).
Dermal fillers and injectables, such as Botox.
Deep chemical peels.
Plastic surgery.
Laser skin resurfacing.
Scar revision.

They can also prescribe prescription medication to treat a variety of skin conditions. This might include retinoids and antibiotics for acne, steroids and antihistamines for contact dermatitis, immunosuppressants for those with autoimmune conditions (like psoriasis or alopecia), and those that target hair loss.

Choose an esthetician if…

…you require non-invasive care that improves the condition and appearance of the skin. There are a wide range of treatments that an esthetician can perform, including:

A variety of facials, including HydraFacials and PhotoFacials.
Ultherapy.
Hair removal.
Mild chemical peels.
SkinPen microneedling.

There are differences in state regulations as to what an esthetician is allowed to perform, meaning that what one person can legally do in Texas might differ from California, for example. You might also see the term aesthetician. This defines a skincare professional who has undergone further training to extend their range of skills. This is usually necessary to perform treatments, such as deeper skin peels, microneedling, or any kind of laser treatment.

Estheticians who’ve taken on additional training to perform such treatments will usually be required to work in a clinical environment. This means a dermatology provider or clinic that’s doctor-led, with the clinician overviewing the suitability for any recommended interventions.

Or perhaps you need a combination approach

Very often, clinical skin needs are complemented by esthetic ones. Dermatologists will often work closely with trusted estheticians to deliver skin treatments that treat clinical conditions. Examples might include:

Microneedling for acne scars.
Microdermabrasion for rosacea and other pigmentation issues.
Post-operative skincare.
Deep moisturizing treatments.

Clinical skincare environments often have a team of both dermatologists and estheticians. The two work in tandem, with the doctor carrying out diagnosis, clinical interventions, and prescribing medication. The esthetician may then perform some of the recommended interventions, as well as provide skincare education to patients.

You might also find dermatologists recommending holistic-based treatments, such as functional nutrition, alongside clinical care. The body is a complex and dynamic work of art, and diet plays a significant role in the manifestation of many skin and other health conditions. There is a huge amount of evidence in the science of “food as medicine”, so don’t be surprised if a dermatologist recommends a complementary alternative in addition to their medical expertise.