Susanne Schmaling, founder and president of the Esthetics Council, discusses the importance of understanding what employers are looking for and what estheticians often miss that can make a meaningful difference in getting hired and staying employed.
Medical spas continue to be one of the most competitive employment paths for estheticians. I regularly speak with professionals who are eager to move into medical environments but feel frustrated when interviews do not lead to offers or when positions do not turn out to be what they expected.
In many cases, the issue is not talent. It is preparation and, frankly, how the medical spa is run. Understanding both sides of that equation can make a meaningful difference in getting hired and staying employed.
Technical Skill Must Be Proven
Technical skill you can clearly demonstrate is essential. Medical spas expect more than interest in advanced treatments. They want evidence. Hands-on experience, strong foundational skin knowledge, and advanced certifications, such as laser technician or non-ablative device education matter.
Employers are looking for estheticians who understand both how treatments work and why they work, and who can explain that confidently to clients and clinical staff. That depth of understanding signals professionalism and reduces risk in a higher liability environment.
But technical ability alone is not enough.
Legal and Compliance Knowledge Is Mandatory
One of the biggest gaps I see is a lack of legal and compliance awareness. In a medical environment, this knowledge is not optional. Estheticians must understand HIPAA, proper charting practices, medical terminology, and state specific regulations that govern scope of practice and supervision.
Employers expect this baseline knowledge and are often hesitant to hire candidates who require extensive education in these areas. Charting accuracy, informed consent, and knowing when to escalate concerns are part of daily work in a med spa.
Simply being able to define these terms is not sufficient. Let me give a common example I have witnessed more times than I can count. A client arrives in a public waiting room. The front desk hands her an intake form. So far, so good. Then the provider begins discussing the treatment details in the middle of that public space. This is a privacy violation and puts the client in an uncomfortable position. Many estheticians recognize this behavior, yet it continues to happen.
Knowing better and doing better are not the same thing.
Sales and Communication Matter More Than You Think
High-level sales and communication skills are also critical. Med spas operate at the intersection of care and commerce. Estheticians are often expected to educate clients, recommend services or products ethically, and support treatment plans without overpromising outcomes.
Strong consultative selling skills signal professionalism, confidence, and business awareness. Employers value estheticians who can communicate clearly, manage expectations, and contribute to the overall success of the practice without compromising integrity.
Teamwork Is Not Optional
Medical environments are team driven. Estheticians must work well with nurses, physician assistants, doctors, front desk staff, and management. This requires respect, humility, and an understanding of clearly defined roles.
Employers are cautious about candidates who appear rigid, dismissive, or overly focused on autonomy. The ability to collaborate smoothly with everyone in the practice is essential, not optional.
Not All Medical Environments Are the Same
The environment matters. A dermatology practice functions differently than a cosmetic surgeon’s office, and both differ from a hybrid medical spa. Each setting has its own pace, expectations, and skill requirements.
In addition, any medical spa offering services under the cosmetology scope must hold a facility license with the cosmetology board. This means you must perform according to your scope while also working under medical supervision. Understanding these distinctions and aligning your strengths accordingly can significantly improve job fit and long-term satisfaction.
Interviewing Goes Both Ways
Just as employers evaluate candidates, estheticians should be evaluating employers. Any business calling itself a medical spa must have a supervising physician or physician assistant. Access to that individual should be clear, and they should be involved in oversight and ideally in the interview process.
Offices where the supervising provider is completely absent and only signs supervision orders are highly suspect. This type of arrangement can put an esthetician’s license at risk. Asking direct questions about supervision, training, adverse event protocols, and documentation expectations is not only appropriate, it is necessary.
Preparation Builds Longevity
Med spa careers are not built by rushing into the first opportunity. They are built through preparation, clarity, and informed decision-making. Estheticians who invest in advanced education, compliance knowledge, teamwork skills, and professional judgment position themselves not just to get hired, but to build sustainable careers.
Susanne Schmaling will be teaching two classes at Be+Well | Beauty and Wellness Show New York (IECSC is now a part of Be+Well), "Science to Skin: Exosomes, Biotech & Biomimetics for Real Treatment Results" on March 8, 2026 and "Spa to Med Spa: Career Pathways That Expand Your Earning Potential" on March 9, 2026. To learn about the classes offered at the show, be sure to register to attend Be+Well New York from March 8-10, 2026. What's more, use code EDSPA20 to get 20% off education classes.