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Estheticians must practice within the state-promulgated scope of practice and only use titles authorized by their license.
To determine their scope of practice, an esthetician should look to three places: (1) the state laws defining estheticians’ scopes of practice; (2) any rulings or opinions issued by the esthetician’s licensing board addressing scope of practice or ability to accept delegation from medical practitioners; and (3) as it pertains to medical services, the supervision and delegations rules applicable to physicians.
The confusion about the existence of medical estheticians arises from situations where state-licensed estheticians have obtained additional education, training, certification, and experience (“Competence”). These estheticians who have sought out and acquired additional Competence often believe that they have expanded their scope of practice, meaning they may (1) perform tasks or accept delegated tasks normally outside of their scope of practice, (2) perform delegated tasks with less supervision than a standard esthetician, or (3) both. However, this is not necessarily true.
The most important thing to understand about estheticians is that they are creatures of state law. They must obtain a license from the state(s) in which they practice, typically from the state board of cosmetology. These state cosmetology boards have promulgated regulations and rules that determine licensure requirements, scopes of practice, and approved titles. The esthetician license issued by a state board only allows estheticians to perform work within the prescribed scope of practice and use the approved title. By designating oneself as a medical esthetician, an esthetician can be viewed as unilaterally expanding their scope of practice or adopting a new title (or both). These actions may subject an esthetician to disciplinary action from the cosmetology board.
Complicating this further is that state cosmetology boards have no jurisdiction over the practice of medicine. By adding the term “medical,” estheticians create another issue for themselves with state medical boards. Generally, when state law defines the practice of medicine with the goal of reserving that practice to appropriately licensed persons like physicians, they include language protecting the use of titles and descriptors that would lead the general public to believe a person is licensed to practice medicine. Thus, if an esthetician describes themselves as a medical esthetician or expands their scope of practice to include services considered the practice of medicine (or both), they may be violating their state’s prohibition on practicing medicine without a license.
Often, we find estheticians have spent their own time and money on courses that purport to train them to be medical estheticians, but it is important to consider the source of the training. A quick Google search for “medical esthetician course” returns many results. But if you look at the course information provided by a company offering medical esthetician classes, you will almost always find some variation of a disclaimer that says estheticians must look to the law of the state that licensed them for the rules and regulations on their practice. This means that regardless of what the coursework purports to teach (e.g., lasers, injectables, dermabrasion, etc.), you can only perform the functions allowed by your state’s laws.
We do want to clarify that the point of this post is not to discourage estheticians (or any licensee) from obtaining education, training, and certification to expand their knowledge base. Rather, estheticians must take the time to understand fully their scope of practice and ability to accept delegated medical services before investing time and money on medical esthetician classes. Moreover, estheticians must understand that by advertising themselves as medical estheticians, they can expose themselves to some level of additional risk.
If you have any questions regarding esthetician’s, or any other licensee’s, scope of practice or your state’s supervision and delegation rules, please contact ByrdAdatto at info@byrdadatto.com.
