You’ve heard of aestheticians and estheticians — now it’s time to learn who’s who and understand how their responsibilities differ.

You’re ready for your spa day, all robed up and relaxed, and now it’s time to meet your esthetician. Or are they your aesthetician? Don’t worry if you’re confused, you’re not alone. One little letter makes a big difference in this case, since aestheticians and estheticians are not technically the same and they usually don’t even do the same things. Let’s look at the difference between the two job titles and explore the details of what an aesthetician does and the kinds of services they typically provide.

What is an aesthetician?

An aesthetician is a licensed professional who provides health and beauty services related to the skin in a medical setting. While some people use the terms “aesthetician” and “esthetician” interchangeably, they’re technically very different. Aestheticians provide clinical services and administer minimally invasive procedures, while estheticians typically focus on surface-level solutions like facials, massages, and makeup application.

To make matters more confusing, aestheticians’ official professional titles can sometimes include words like “clinical,” “medical,” or “paramedical.” That gets at the heart of the real source of all the different industry lingo: licensing rules. Each state’s licensing board maintains its own set of rules of and regulations that govern what services an aesthetician can provide with a given license and how much training is required in order to earn each one. The point of differentiation is really about which services each state considers purely cosmetic versus what they consider medical.

Typically, the more invasive (or risky) a service is, the more likely it will be considered a medical offering. The logic is that aestheticians require more training and a more rigorous licensing exam in order to facilitate medical services than estheticians do in order to provide cosmetic offerings. Even still, there are degrees of what qualifies as medical; many services that are considered minimally invasive (including certain injections) can only be administered by doctors.

What do aestheticians do, and where do they do it?

Aestheticians can work in a number of settings that all share a clinical or medical nature. While some of the services aestheticians provide do involve tools like scalpels and needles, they’re usually voluntary procedures that have to do with the aesthetic appeal or appearance of the skin (hence the name). Some venues and institutions where aestheticians work include:

• Medspas

• Health clinics

• Doctors’ offices

• Hospitals 

• Trauma, burn, and rehabilitation centers

• Dermatology clinics

• Cosmetic and reconstructive surgery clinics

These are prime locations for aestheticians because they typically work below the surface of the skin, which means they require specialized tools and workspaces. Sanitization protocols and general hygiene best practices are incredibly specific when it comes to tools that cut, inject, or insert beyond what they eye can see. These are some of the most common types of services that aestheticians provide:

• Laser services: like tattoo and hair removal, microlaser peels that zap away dead skin cells, etc.

• Skin rejuvenation: tightening the skin by encouraging collagen production

• Scar reduction: healing scar tissue formed from trauma or blemishes, for example

• Varicose vein treatments: a chemical injection that eliminates discoloration

• Permanent/semi-permanent makeup: like eyeliner, eyebrow fillings, eyelash extensions, lip color, etc.

Well then what’s the deal with estheticians?

Unlike aestheticians, estheticians typically do their work in salons and spas. Other venues focused on self-care, health, and wellness also make a good home for estheticians to practice — think resorts, retreat centers, or even fitness boutiques. The quickest way to envision the difference between aestheticians and estheticians is to distinguish between Medspas and salons. Your facialist is probably an esthetician, but your laser technician is probably a licensed aesthetician. Let’s look at some of the services estheticians commonly provide:

• Skin analysis: Consultations about how to improve skin health 

• Cleansing and exfoliation: Basic skin health treatments and education

• Product application: Masks, scrubs, and chemical peels all treat the surface of the skin

• Massage: Working on the skin manually to either relax or rejuvenate it

• Facials: Often all of the above, rolled into one!

• Hair removal: Non-laser options like waxing, tweezing, threading, etc.

• Makeup application: Non-permanent makeup styling falls in the esthetician’s domain.

Estheticians can certainly focus on diagnosable areas of concern, like skin that is particularly dry or oily, sun or weather damage, deep wrinkles, or blemishes and acne. But estheticians would most likely apply products, pressure, or other kinds of care to the skin in question, instead of getting into the lower layers with a sharp tool or laser. An esthetician might prep a patient for an injection of something like Botox, but she wouldn’t be able to administer the actual injection herself.

Although some people still think the difference between aestheticians and estheticians is purely a question of spelling, now you understand why state licensing boards say otherwise. Each role is highly specialized! Understanding who’s who in the world of beauty professionals — and using the terminology to match — can help us all do a better job communicating to clients that they’re in the right place and in safe hands.