What’s the Difference Between an Esthetician and a Dermatologist?

If you have a skin concern you want to address, you can seek help from two types of professionals: estheticians and dermatologists.

Although both work with skin, their expertise and the services they provide differ.

An esthetician, often called a skin care specialist, focuses on treatments that enhance the outward look of your skin. A dermatologist is a physician who concentrates on skin health.

Dermatologists are medical doctors trained to diagnose specific skin disorders and manage them. For example, they may prescribe medications or carry out in-office procedures, from excising cysts and growths to performing biopsies for suspected skin cancer.

Estheticians, by contrast, deliver treatments aimed at the skin’s surface, such as facials and light chemical peels.

Knowing how estheticians and dermatologists differ helps you choose the right professional for your particular skin needs. Here’s what to know to make a well-informed decision.

What is a dermatologist?

A dermatologist is a physician who specializes in skin, hair, nails, and mucous membranes. They can identify and treat more than 3,000 conditions.

Dermatologists can:

• carry out diagnostic and preventive examinations
• provide education and guidance about skin issues
• deliver treatments

Many dermatologists perform both medical and cosmetic procedures, though some concentrate on one area.

A medically focused dermatologist usually emphasizes skin health. They can diagnose a broad array of problems, including:

• alopecia
• eczema
• psoriasis
• skin cancer
• contact dermatitis
• nail fungus
• dandruff
• allergic responses
• rashes
• warts
• scalp and hair disorders
• subcutaneous growths

Cosmetic dermatologists often concentrate on procedures that aren’t medically necessary but can improve appearance.

For instance, you might seek a cosmetic dermatologist to reduce wrinkles, fine lines, or sunspots.

Other cosmetic treatments they may offer include:

• dermal fillers
• Botox
• microneedling
• chemical peels
• laser resurfacing
• laser hair removal

Any dermatologist can prescribe medications for acne, for example. But a dermatologist experienced in cosmetic procedures like deep peels and laser resurfacing can help you explore options to minimize acne scarring.

That said, all dermatologists are trained to perform both medical and cosmetic services.

Another difference is where they practice.

Dermatologists commonly work in specialty clinics and private practices; typically, those focusing on medical dermatology also work in hospitals or larger health systems. Dermatologists who emphasize cosmetic services may also be found working in medical spas.

Also worth noting: insurance usually covers medical dermatology services deemed necessary for health, but elective cosmetic treatments are generally not covered.

Training and credentials

Dermatologists undergo at least 12 years of education and clinical training before practicing independently. After earning a bachelor’s degree, they:

• attend medical school to become physicians
• complete a one-year internship
• finish three years of residency, treating patients under supervision

Some dermatologists pursue additional subspecialty training. For example, they may complete a fellowship to become a dermatopathologist who diagnoses skin disease under a microscope, or a Mohs surgeon who uses a precise method to remove skin cancer while preserving healthy tissue.

After residency, dermatologists can take board certification exams. Board-certified dermatologists may list FAAD (Fellow of the American Academy of Dermatology) after their name.

In North America, boards that can confer this certification include:

• the American Board of Dermatology
• the American Osteopathic Board of Dermatology
• the Royal College of Physicians and Surgeons of Canada

Other certifying boards exist, but these three demand the highest levels of training and expertise.

What is an esthetician?

Estheticians are trained to administer treatments to the outermost layers of skin. They provide advice on skin care and help improve skin appearance.

Unlike dermatologists, estheticians do not have medical degrees, so they generally cannot:

• diagnose medical skin conditions
• prescribe medications
• perform invasive procedures, including injectables and fillers

In some states, estheticians may perform injectables or other procedures under a dermatologist’s supervision.

Examples of services an esthetician can provide include:

• facials
• microdermabrasion
• hair removal like waxing, threading, and sugaring
• makeup application, including eyebrow tinting and eyelash extensions
• body scrubs, masks, and wraps
• superficial chemical peels — they can’t perform aggressive peels that penetrate deeply

Estheticians frequently work in salons or day spas.

Medical estheticians (sometimes spelled aestheticians) often collaborate with dermatologists or cosmetic surgeons in more clinical settings, such as dermatology practices and other health care facilities. They might offer treatments like:

• pre- and post-surgical skin care
• tattoo removal
• deeper chemical peels
• laser hair removal under physician oversight

There isn’t a separate national license for medical estheticians, but they usually pursue additional education geared to the specific procedures they perform.

Training and credentials

All 50 states require estheticians to hold a license. To begin, aspiring estheticians need a high school diploma or GED to enroll in cosmetology or esthetics school. Programs often last 4 to 6 months and commonly include around 600 hours of training.

State requirements vary, generally ranging from about 250 to 1,000 hours of coursework.

After finishing training, an esthetician must pass a state-approved exam to get their license. These tests include a written section and a practical component, where candidates perform treatments on a mannequin or volunteer.

Once licensed, an esthetician may opt for national certification from the National Coalition of Estheticians Associations (NCEA). This represents advanced training and covers higher-level laser, facial, and drainage techniques.

How to decide which to see

Both dermatologists and estheticians are licensed professionals who can assist with your skin care. Your decision usually depends on the nature of your concerns.

When to see a dermatologist

You should see a dermatologist for medical issues, including:

• rashes, persistent dryness, or changes in skin color
• lesions
• acne
• moles
• eczema
• psoriasis
• any signs of skin cancer

If you don’t have medical symptoms but want to improve your skin’s look, an esthetician can provide microdermabrasion, facials, and other surface treatments.

Keep in mind that in most states, only dermatologists are authorized to perform invasive treatments like Botox, dermal fillers, and scar-revision surgery.

Some other distinctions:

• Peels.Estheticians can do mild peels, such as those with alpha hydroxy acids, and in some states moderate glycolic peels. Only dermatologists generally perform deep peels that reach the middle skin layer, including phenol or trichloroacetic acid peels.
• Laser treatments.In many states, only dermatologists can perform laser procedures, though a few states permit estheticians to do certain laser services, like laser-based skin rejuvenation or hair removal.
• Microneedling.Most states treat microneedling as a medical procedure, so estheticians usually cannot perform it. In some places, estheticians working in clinical settings may do microneedling under a physician’s supervision.

If you’re facing acne, pigmentation issues, or persistent dryness, start with a dermatologist.

They can diagnose and treat the condition with medications or medical therapies, and may refer you to an esthetician to help with ongoing care and to develop a maintenance routine for healthy skin.

How to find care

Before booking a dermatologist appointment, check with your insurance provider. Many insurers require a referral from your primary care physician (PCP) to cover a dermatology visit. If needed, your PCP can examine your skin and refer you to a dermatologist locally.

If you’re looking for a dermatologist independently, begin by seeing which providers are in-network with your insurance.

Consider your needs when choosing a specialist. For instance, a medical dermatologist can manage severe rosacea or acne, whereas a surgical dermatologist can remove skin cancers or benign growths.

It’s also wise to confirm board certification. Many dermatologists list credentials on their websites, or you can search databases from the American Academy of Dermatology or the American Board of Dermatology.

To find an esthetician, ask friends or family for referrals.

Ensure they hold a state license, and consider those with NCEA certification for more advanced training.

Also review client feedback for their business and ask about their specialties before scheduling an appointment.

The takeaway

Between dermatologists and estheticians, neither is inherently superior — it depends on the skin issue you want to address.

As a general rule, consult a dermatologist for concerns that may need medication or surgery. Reach out to an esthetician for surface-level cosmetic concerns and routine skin care guidance.

Ultimately, the most important thing is finding a trustworthy and accessible skin care professional. Many people find the best results by working with both types of providers to reach their skin goals.