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
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.
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 has fallen out sometimes grows back in a different
color, affecting the choices for makeup colors that
patients might consider.
Still, Michele leaves final decision- making 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
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
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 self-direction. 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,
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.