person lying on medical table for consultation from dermatologistShare on Pinterest
Pyrosky/Getty Images

If you have a skin care concern you’d like to address, you can consult two different kinds of experts: estheticians and dermatologists.

While both are skin care professionals, they have distinct expertise and offer different kinds of services.

An esthetician, or skin care specialist, provides services geared toward improving the external appearance of your skin. A dermatologist specializes in the health of your skin.

Dermatologists are doctors trained to diagnose specific skin conditions and treat them. They might, for example, prescribe prescription medications or perform in-office procedures, from removing cysts and growths to performing skin cancer biopsies.

Estheticians, on the other hand, perform treatments that target the surface of your skin, like facials and mild chemical peels.

Understanding the difference between estheticians and dermatologists will help you figure out which expert is better suited to resolving your specific skin issues. Here’s what you need to know about these professionals to make an informed decision.

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

Dermatologists can:

  • perform diagnostic and preventive exams
  • offer counseling and education about skin conditions
  • provide treatment

While many dermatologists offer both medical and cosmetic dermatology procedures, some dermatologists might specialize in either medical or cosmetic services.

A dermatologist who specializes in medical procedures will typically focus on the health of your skin. They can diagnose a wide range of conditions and concerns, including:

Dermatologists who specialize in cosmetic procedures might focus on offering treatments that, while not strictly necessary for health, may help you make aesthetic improvements to your skin.

For instance, you might consult a cosmetic dermatologist if you’d like to reduce the appearance of wrinkles and fine lines or sunspots.

Other procedures they offer include:

Any dermatologist can recommend prescription medications to treat acne, for example. But a dermatologist who specializes in cosmetic procedures like deep peels and laser resurfacing can help you explore options for lessening the appearance of acne scars.

That said, all dermatologists are qualified to practice both medical and cosmetic procedures.

Another key difference lies in where they practice.

Dermatologists often work at specialty clinics and private practices, but typically, only dermatologists who specialize in medical procedures will work for larger healthcare organizations or hospitals. Dermatologists who specialize in cosmetic procedures may also work at medical spas.

It’s also important to note that insurance companies generally cover medical dermatology procedures considered essential for your health, but they won’t cover elective cosmetic treatments.

Training and credentials

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

  • attend medical school to become a doctor
  • participate in a year-long internship
  • complete three years of residency, treating patients alongside experienced dermatologists

After that, some dermatologists may continue their training to pursue a specialization. For example, they may participate in a fellowship program to become a dermatopathologist, who diagnoses skin diseases and disorders under a microscope, or a Mohs surgeon, who can perform a special technique to remove minimal amounts of skin cancer.

Following residency training, a dermatologist can also take an exam to become board certified. If a dermatologist is board certified, the letters FAAD (Fellow of the American Academy of Dermatology) will appear after their name.

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

Other boards can also grant this certification, but these three require the highest level of training and expertise.

Estheticians are professionals trained to provide treatments to the outermost layers of your skin. They can offer guidance with caring for and improving the appearance of your skin.

Unlike dermatologists, they don’t have medical training, so they typically can’t do things like:

  • diagnose skin conditions
  • prescribe medications
  • perform any kind of invasive treatments, including injectables and fillers

In some states, estheticians may be able to perform injectables and other procedures with a dermatologist’s supervision.

Some examples of services an esthetician can offer include:

Estheticians often work at salons or day spas.

Medical estheticians (sometimes called aestheticians), however, might work alongside dermatologists or cosmetic surgeons in more clinical settings, like dermatology clinics and other healthcare facilities. These professionals might offer treatments like:

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

There is no specific license to become a medical esthetician, but they typically pursue further education and training covering the specific treatments they’ll be performing.

Training and credentials

In all 50 states, estheticians need a license to practice. First, aspiring estheticians need a high school diploma or GED certificate to attend cosmetology school. These programs typically last between 4 and 6 months and require 600 hours of training.

Program requirements vary from state to state, but they generally range from 250 to about 1,000 hours of coursework.

After completing training, an esthetician must take a state-approved exam to obtain their license. These exams include a written portion and a hands-on or “practical” portion, which involves performing treatments on a mannequin or volunteer model.

Once they have a state license, an esthetician may also choose to pursue national certification through the National Coalition of Estheticians Associations (NCEA). This is the highest level of training for an esthetician, and it involves more in-depth training on advanced laser, facial, and drainage techniques.

Both dermatologists and estheticians are licensed professionals who can help with your skin care needs. Your choice will typically come down to your individual concerns.

When to connect with a dermatologist

You’ll generally want to consult a dermatologist for any medical issues, including:

Was this helpful?

If you don’t have any specific symptoms but want to address your skin’s appearance, an esthetician can offer microdermabrasion, facials, and other superficial treatments.

Just keep in mind that in most states, only dermatologists can perform more invasive treatments like Botox, dermal fillers, and scar revision surgery.

A few more distinctions to keep in mind:

  • Peels. Estheticians can perform mild peels, like those containing alpha hydroxy acids. In some states, they can also offer moderate peels with glycolic acid. Only dermatologists can perform deep peels that fully penetrate the middle layer of skin, including peels containing phenol or trichloroacetic acid.
  • Laser treatments. In most states, only dermatologists can perform laser treatments. But a few states do allow estheticians to perform certain laser procedures, like laser-based skin rejuvenation and laser hair removal.
  • Microneedling. Most states classify this service as a medical treatment, meaning estheticians typically can’t provide it. In some states, estheticians working in medical environments may perform microneedling under the supervision of a licensed physician.

When you’re dealing with acne, skin discoloration, or persistent dryness, you’ll generally want to connect with a dermatologist first.

They can offer a diagnosis and help treat the skin condition by prescribing medications or medical treatments. They might then refer you to an esthetician who can offer services and help you build a skin care routine to maintain optimal skin health.

Before scheduling an appointment with a dermatologist, you’ll generally want to check in with your insurance provider first. Many will only cover your visit if you have a referral from your primary care physician (PCP). If that’s the case, your PCP can examine your skin and refer you to a local dermatologist if necessary.

If you’re searching for a dermatologist on your own, you can start by finding out which dermatologists are in-network for your insurance.

Considering your specific needs can also help you find the right professional. For example, a medical dermatologist can help you address severe rosacea or acne, while a surgical dermatologist can remove skin cancer or benign growths.

It never hurts to verify their board certification, either. They may list these credentials on their website, but you can also search the databases provided by the American Academy of Dermatology or the American Board of Dermatology.

When choosing an esthetician, you might start by asking trusted friends or family members for a recommendation.

Always make sure they have a license to practice in your state. You may also want to find one certified by NCEA, as mentioned above.

Also helpful? Reading any reviews for their services or business and asking them about their areas of specialty before scheduling an appointment.

When it comes to dermatologists and estheticians, one type of professional isn’t necessarily better than the other. Ultimately, it comes down to the specific skin care concerns you want to address.

As a quick rule of thumb, consult a dermatologist for any skin conditions that may require medication or surgery. Reach out to an esthetician for surface-level aesthetic concerns or general skin maintenance guidance.

At the end of the day, what’s most important is finding an accessible skin care professional you can trust. You might even find that working with both offers the best way to achieve your skin goals.

Rebecca Strong is a Boston-based freelance writer covering health and wellness, fitness, food, lifestyle, and beauty. Her work has also appeared in Insider, Bustle, StyleCaster, Eat This Not That, AskMen, and Elite Daily.