Aesthetician vs. Esthetician: Roles in Spas and Medspas

Aestheticians vs. Estheticians: What They Do and Why It Matters

It’s a common confusion in skincare: What are the differences between an esthetician and an aesthetician? These job titles look and sound alike, and they’re sometimes used interchangeably. But they point toward different scopes of practice, treatment environments, and career paths.

Estheticians tend to focus on cosmetic treatments, while aestheticians handle more advanced skincare procedures. Understanding how these roles overlap and where they diverge can shape your business’ hiring decisions and service offerings.

Read on for a detailed comparison of aestheticians versus estheticians, including their career paths and their contributions to traditional spas and medspas.

What's the Main Difference Between an Aesthetician and an Esthetician?

The best way to explain the differences between an aesthetician and an esthetician is to look at the level of treatment each role provides.

Estheticians focus on cosmetic services designed to maintain skin health and appearance. These professionals typically work in spa and wellness businesses and focus on repeatable, maintenance-driven skincare services like facials and hair removal.

Aestheticians handle more advanced, results-driven treatments. They often work in medspas and physicians’ offices, where licensed providers support rehabilitative care for skin trauma and signs of aging.

As a general rule, the more invasive a skincare treatment is, the more likely an aesthetician will administer that service. While estheticians stay on the surface of the skin, aesthetician training prepares providers for more advanced procedures. 

What Does an Esthetician Do?

An esthetician, sometimes called a skin esthetician, provides cosmetic treatments that support appearance and comfort. This work centers on routine, surface-level services that keep skin clear, smooth, and healthy.

Common esthetician services include facials, exfoliation treatments, and makeup application. These professionals might also provide non-invasive hair removal, including waxing and threading. In addition, estheticians guide clients toward products and treatment schedules that fit their skin types and goals. 

You’ll most often find esthetician services in salons and other wellness businesses. An esthetician’s success depends on repeat visits and long-term client relationships, which in turn relies on treatments that pair relaxation with visible cosmetic results.

Estheticians vs. Dermatologists

Estheticians and dermatologists may work collaboratively to promote healthy, aesthetic results. While you won’t always find an esthetician in a dermatology office, dermatologists often recommend estheticians to provide complementary cosmetic services, such as deep cleansing and specialized facials that support medical treatments. 

What Does an Aesthetician Do?

An aesthetician is a skincare specialist who focuses on more advanced, results-driven treatments. Aestheticians typically work in medically aligned environments like medspas. You’ll often hear the term medical aesthetician used in these settings, where providers support patients dealing with skin concerns tied to aging or recovery. 

In practice, aestheticians perform treatments like chemical peels, laser services, and other advanced skincare procedures. These services are designed to improve skin tone and remove visible signs of damage. An aesthetician’s work often extends beyond the treatment, with a focus on pre and post-procedure skincare for stronger recovery.

Training and Education Requirements for Aestheticians and Estheticians

Aestheticians and estheticians are licensed skincare professionals who start out with a similar educational baseline. Many schools offer combined pathways that let students begin with esthetics training before continuing into advanced medical aesthetics. 

Candidates must have high school diplomas or GED certificates to apply to esthetic or medical aesthetician programs. To qualify for licensure, these programs must be state-approved and administered by a cosmetology school, vocational school, or junior college. 

In both types of programs, students must pass written and practical board exams to obtain licensure. Depending on the state, they may need to complete hands-on instruction via internships or apprenticeships. Some states also require continuing education and regular license renewals.

Esthetician Training Programs

Esthetician programs typically last nine months and require between 300 and 600 hours of instruction, depending on state and individual school requirements. This training focuses on the fundamentals of cosmetic skincare and premium client experiences.

Coursework and hands-on instruction may include: 

• Color theory 

• Cosmetic chemistry

• Cosmetic treatments, including makeup application and waxing procedures

• Hair removal methods

• Introduction to dermatology

• Physiology

• Salon safety and sanitation

• Skin analysis

• Skin anatomy

• Skin health and skin condition management

• Skincare treatments, including exfoliation methods and hydration

Aesthetician Training Programs

Aestheticians can opt for a simple certification to pursue state licensure or complete an associate’s degree in medical aesthetics. Their training is similar to esthetician coursework in many ways, covering topics like skin analysis and physiology.

However, medical aesthetics programs go more in-depth, with additional courses on:

• Advanced treatments, including chemical peels and hydrofacials

• Dermaplaning and microdermabrasion

• Medical microneedling

• Medical practice operations

• Phlebotomy

• Stem cells and exosomes protocols

Specific license requirements vary from state to state. Before enrolling in any program, verify your state board’s standards. To find local licensing requirements, you can check out the Associated Skin Care Professionals website. 

Aesthetician vs. Esthetician Salaries and Career Paths

ZipRecruiter data suggests that the average annual salary for an esthetician is roughly $45,000. That’s just a starting point, however, since earnings in the beauty industry are widely variable and often underreported. Take-home income can climb over time with high value specialization and a steady base of repeat clients, and wellness employers may offer product commissions and performance-based bonuses to attract top talent. 

The average annual salary for a medical aesthetician is about $53,000, although Boulevard customers and other top earners can bring in well over six figures. Since this role is tied to high-value treatments in medspas and clinical settings, compensation scales more dramatically based on skill level and service complexity. Medical aestheticians are also more likely to expand into leadership positions or medspa ownership, which offers new opportunities for growth.

Roles of Estheticians and Aestheticians in Medspas

Medspas often juggle relaxing spa treatments alongside targeted medical procedures. That creates room for both estheticians and aestheticians to deliver quality client experiences.

Estheticians provide the cosmetic, comforting services that keep clients coming back, while aestheticians handle results-driven, medically aligned treatments. Together, these professionals help you offer multi-step care that blends pampering with advanced skincare outcomes.

Support Your Growing Medspa Team With Boulevard

Coordinating high-quality client experiences requires powerful aesthetic clinic software that helps you manage payments, treatment schedules, client data, and service tracking. Boulevard gives your medspa team the tools they need to manage everything in one place, so your providers can focus on client-centric care. 

Learn how Boulevard’s Medspa Software helps your team provide consistent, high-quality experiences and prepare for growth.