54 Occupational Outlook Quarterly.Spring 2004

Michele Taylor works in a hospital, and patients in her charge sometimes fall asleep. But she’s not a nurse

and doesn’t administer anesthesia. So,

as Michele herself often must clarify,

she’s not an anesthetist—she’s an

aesthetician.

Aestheticians are licensed skincare

specialists. They treat facial skin to

maintain and improve its appearance.

Medical aestheticians, like Michele,

work with patients whose skin or

appearance is affected by trauma or

medical procedure, such as surgery. In

the integrative-medicine program

where she works, Michele also offers

stress reduction and relaxation. It’s

during these treatments that patients

are most likely to drift off. “I do put

people to sleep, but not with anesthesia,” she says. “Some people just get so

relaxed, they fall asleep.”

Anxiety reduction is a large part of

Michele’s job because of where she

works: in a Cleveland hospital’s

radiation oncology department.

Cancer patients who call Michele to

schedule an appointment find out

about the services available. Then,

Michele asks them questions to help

them identify their needs. “Do they

want relaxation? To feel better about

themselves? Some people start out

not really knowing,” she says. “With

chemo patients, for example, all they

know is they’ve lost their hair, their

eyebrows, their eyelashes—it can be

very stressful for them.”

Patients who want to enhance

their appearance spend about an hour

with Michele, learning how to

choose and apply appropriate makeup

colors and products. The products

they start with are usually colorless.

“I’m teaching them how to take care

of their skin,” says Michele, “so

cleansing and moisturizing are always

first.” This is especially important

instruction for patients undergoing

treatments such as radiation, which

sometimes causes skin irritation.

Next comes foundation. Michele

shows patients how to choose products for their skin types and to select

the best matches from a variety of

colors. Then, she applies foundation

to one side of the face, explaining

technique as she goes. The entire

process—color choice, application,

technique explanation—is repeated

for the eyes, cheeks, and lips. Only

after the patient is satisfied with the

results, even if it means removing the

makeup and starting over, are they

duplicated on the other side of the

face. Lastly, Michele applies finishing

powder and suggests complementary

colors for clothing.

In the basics of skincare and

makeup application, Michele’s job is

similar to that of most other

aestheticians. But helping patients

apply makeup after medical treatment

presents special challenges, she says.

For example, chemotherapy patients

must learn how to measure their

natural browline so that they can

draw eyebrows to replace the ones

lost to treatment. And hair that

Kathleen Green is managing editor of the

OOQ, (202) 691-5717.

by Kathleen Green

You’re a what?
Occupational Outlook Quarterly.Spring 2004 55

has fallen out sometimes

grows back in a different color, affecting the choices for makeup colors

that patients might consider.

Still, Michele leaves final decisionmaking to each patient. “I make

suggestions, but I go with what

people feel comfortable with,” she

says. “I want them to feel healthy.”

Letting patients make their own

decisions serves another purpose, too.

“An illness or injury can make

people feel like they lose control,”

says Michele. “Teaching them about

makeup and skincare gives them

some control, over how they look

and how they maintain their skin.”

Although women are the only

ones who request makeovers, they’re

not the only patients Michele sees.

Facials are popular with men, who,

Michele says, “are more concerned

about their skin than many people

realize.” And adults and children alike

enjoy her stress-reduction and

relaxation treatments.

Aestheticians’ and medical

aestheticians’ jobs vary, depending on

where they work. Aestheticians are

employed in places like beauty salons,

spas, and specialty sections of department stores; medical aestheticians,

also called paramedical aestheticians,

often work for licensed healthcare

providers, including offices of plastic

surgeons and dermatologists. According to the Bureau of Labor Statistics,

there were about 25,000 skin care

specialists, which includes

aestheticians and medical

aestheticians, in 2002. They had

median annual earnings of $22,450,

with medical aestheticians often

earning more.

Because she is employed in a

hospital, much of Michele’s work

differs from that of other medical

aestheticians. Duties of those who

work in offices of plastic surgeons, for

example, include providing pre- and

postoperative skincare treatment.

Medical aestheticians under the

supervision of a dermatologist may

perform exfoliation or other procedures. Those who work in burn units

might teach burn-recovery patients

how to apply makeup to conceal

their injuries.

In fact, it was Michele’s desire to

work with burn victims that led her

to a medical aesthetician career. She

worked in a hospital and knew she

liked the challenge of caring for

wounds. Then, she saw a TV

newsmagazine program that described medical aestheticians and

mentioned a need for them. Michele

began researching the occupation and

enrolled in cosmetology school. She

earned a diploma in aesthetics, took

an exam administered by her home

State of Ohio, and became licensed.

She also has earned several professional certifications related to her

work.

Training, licensing, certification,

and continuing-education requirements for aestheticians differ by State.

Aestheticians complete a program in

skincare at an approved school,

usually one that is regulated by the

State’s board of cosmetology. Program

quality varies, so each student should

investigate schools’ curriculums. Most

aesthetician training is general;

specialties may require additional

education or on-the-job training.

Medical specialization for

aestheticians often is defined by selfdirection. Prior to enrolling in the

aesthetician program, for example,

Michele had taken some college-level

science courses—she recommends

biology and anatomy coursework for

aspiring medical aestheticians—and

had worked in a medical setting.

She had planned to work with a

plastic surgeon but, while providing

skincare services to radiation patients,

saw a need for medical aestheticians

in cancer treatment.

Michele was aware of an existing

look-good, feel-better group program

for cancer patients, sponsored by the

American Cancer Society. She

developed the integrative-medicine

program, which the hospital then

created, to provide patients with a

one-on-one alternative to the group

setting.

Willingness to accept and design

alternatives has been a plus for

Michele in her work. “If you do

someone up and she looks great, but

she doesn’t like it,” says Michele, “you

have to let it go and defer to

her preferences. You have

to be able to take

constructive criticism.”

Openness, empathy,

and an ability to

communicate are also

important for medical

aestheticians, she says.

The biggest drawback to Michele’s job

stems from the

population she

works with: many

of the people she

sees are terminally

ill. “A lot of my

patients die, so I have to

work with that reality,” she

says. “It’s hard, especially with the

kids.”

But Michele is a firm believer in

integrative medicine, which suggests,

in part, a link between patients’

health and their feelings about

themselves. The transformation from

self-perceived beast to beauty overwhelms some patients to the point of

tears, she says. For Michele, knowing

that what she does can positively

impact their recovery, their overall

health, and their sense of self makes it

worthwhile.