Achieve Your Aesthetician Certification: A Complete Guide

If you take pride in helping others look their best, you are a great fit for a career in aesthetics (also spelled “esthetics”). But first, you need to obtain an aesthetician certification. That’s not as difficult as it sounds. Becoming a licensed esthetician typically takes no more than one to two years and may involve a combination of conceptual and practical education (accredited aesthetician training courses) and hands-on apprenticeship experience.  After obtaining their state licenses, many estheticians subsequently enroll in master esthetician programs through the National Coalition of Estheticians Association, or NCEA (also known as the National Coalition of Estheticians, Manufacturers/Distributors & Associations). Master estheticians may enjoy a wider array of professional opportunities, greater freedom in their practices (including the ability to perform more advanced procedures), and higher earning power. 

How to Become a Licensed Esthetician (NCEA Certified): What to Know

Almost all states require aspiring aestheticians to complete a formal esthetics program at an accredited esthetician school, complete an approved esthetician apprenticeship program, or both. Before enrolling in an esthetician training program, determine the requirements for licensure in your home state (or the state where you expect to obtain your license and begin practicing).

State Licensing Requirements for Aestheticians

State laws determine the licensing requirements for local aestheticians. Hours-of-training requirements range from 300 or fewer (Pennsylvania, Florida) to more than 700 (Texas, Georgia). Many states require 600 hours of training. Only after completing the required number of training hours may applicants sit for the state licensing exam. Some states allow aesthetician license candidates to complete an approved apprenticeship program in lieu of formal esthetics schools. Aesthetics apprentices may earn wages while completing training, an advantage over unpaid schooling. However, the apprenticeship hours-of-training requirements are often prohibitive. For example, Delaware requires aesthetic apprentices to train for at least 1,200 hours (compared with 600 hours in approved esthetics schools).

Aesthetician Training Programs and Course of Study

Aesthetician training programs combine theoretical (scientific), practical (skills-based), and business (practice management) education to prepare these aspiring medical professionals for real-world work:  

• Theoretical curriculum: This is the scientific basis for the field of modern aesthetics. Concepts covered in the theoretical portion of aesthetics training programs may include human anatomy and physiology, chemistry and pharmacology, bacteriology (as relates to infection risk and control), sterilization and sanitation protocols, and more. 

• Practical curriculum: Practical aesthetics curriculum encompasses common and not-so-common techniques and procedures used in aesthetics practices, from core facial aesthetics concepts like skin conditioning and makeup application to more advanced or cutting-edge procedures like oxygen therapy, ultrasonic skin therapy, and LED light treatment.

• Practice management curriculum: This is the “business side” of aesthetics training. Because many estheticians manage or help manage their own practices, it’s critical that they understand fundamental concepts like procuring liability insurance, maintaining proper business licensure, devising salary and benefits for employees, attracting and retaining clients (marketing and merchandising), keeping accurate business books, and more.

Esthetics vs. Medical Esthetics: What’s the Difference?

Many aspiring aestheticians quickly discover that what really interests them is medical aesthetics (medical esthetics), a related but distinct specialty. No state-level licensure exists for medical aestheticians, but aspiring medical aestheticians can gain procedural and practice experience by apprenticing or working under master estheticians or board-certified physician or nurse aestheticians offering medical aesthetics treatments and procedures. Medical estheticians perform a variety of advanced treatments and procedures that, while noninvasive, have a higher degree of difficulty than those typically performed by estheticians:

• Chemical peels
• Permanent makeup
• Advanced hair removal (laser hair removal)
• Manual lymphatic drainage
• Medical care for damaged skin and pre- or post-surgical skincare

Medical estheticians may perform some of these procedures under the supervision of (or in an assisting role to) board-certified nurses or physicians. Estheticians who wish to perform these procedures without supervision — along with other types of noninvasive cosmetic treatments that can’t be performed by estheticians, such as Botox® and dermal fillers — should consider nurse aesthetician licensure.

Becoming a Nurse Aesthetician: Is It Worth the Effort?

The field of aesthetics is growing rapidly. According to the Bureau of Labor Statistics, the total number of positions in the field (which the Bureau characterizes as “skincare specialists”) is increasing by about 17% each year. By 2029, roughly 13,000 more aestheticians will work in the United States than today. Clearly, becoming an aesthetician is a good career choice. And aesthetician jobs don’t pay poorly; the average esthetician salary was about $37,000 in 2020. Still, many aspiring aestheticians want more: higher pay, better advancement opportunities, more challenging job duties. These ambitious professionals often choose to pursue nurse aesthetician certification. Nurse aesthetician certification takes longer to obtain — at least four years for aspiring certificants without nursing degrees and at least two years for those who already have nursing degrees. The process is also more challenging, with formal certification requiring two big exams and thousands of hours of practical experience. From a material and career-advancement standpoint, the effort is worthwhile. Registered nurses earn about $75,000 per year, on average, according to Bureau of Labor Statistics data. Nurse practitioners earn even more. The steps required to obtain formal certification as an aesthetic nurse are:

1. Choose and Complete a Nursing Degree

Aspiring aesthetic nurses most often choose from one of three nursing degree options:  

• Associate’s degree in nursing (ADN): A two-year degree program that opens up entry-level job opportunities in the field.

• Bachelor’s degree in nursing (BSN): A four-year degree program that may be required for more desirable positions and supervisory or administrative roles.

• Master’s degree in nursing (MSN): A five-year degree program that may be necessary to land the most competitive jobs.

2. Pass the NCLEX-RN Exam

The NCLEX-RN exam is the licensing examination required of nurses who wish to practice in the United States. After passing the NCLEX-RN exam, you’ll need to obtain state-level licensure in the jurisdiction where you intend to practice.

3. Gain the Required Practical Experience in a Recognized Aesthetic Specialty

Once you are licensed to practice as a nurse, you will need to gain at least two years of practical experience in one of four core aesthetic disciplines: 

• Plastic, aesthetic, or cosmetic surgery
• Dermatology
• Facial plastic surgery
• Ophthalmology

To gain this experience, you must work under a board-certified physician who practices in one of these areas and obtain at least 1,000 hours of direct experience in one of them. In other words, working under a board-certified dermatologist for two years is not sufficient if you do not also attain at least 1,000 hours of practical experience in dermatology during the period.

4. Take a Board Certification Exam

Finally, you must take and pass one of the two aesthetic nursing certification exams administered by the Plastic Surgical Nursing Certification Board: the Certified Plastic Surgical Nurse (CPSN) exam or the Certified Aesthetic Nurse Specialist (CANS) exam.

5. Complete the Required Continuing Education for Aesthetic Nurses

Like licensed aestheticians, aesthetic nurses must successfully complete continuing education (CE) requirements as a condition of recertification or retake and pass the appropriate board certification exam.For nurses in active practice who do not wish to retake a board certification exam, the Plastic Surgical Nursing Certification Board requires at least 45 “contact hours” of continuing education every three years. This CE training must be offered by accredited providers.  The 45-hour requirement breaks down as follows:

At least 30 hours devoted to the four core aesthetic nursing specialties

• At least two hours devoted to patient safety
• The balance devoted to elective hours 

Refer to the Plastic Surgical Nursing Certification Board’s recertification requirements for more details about completing these requirements.