I don't know anyone who would pass up a facial. There's the spa-luxury aspect for sure, but then you hear the fairytale stories—that once you find the right aesthetician, finicky skin is solved, and it's nothing but clear-complexion sailing from here on out. But what happens when your trip to the facialist fails to leave your skin glowing for any sizable length of time? Although opting for peels, scrubs, and light therapy isn’t necessarily bad, they might not be what your skin really needs. Before you splurge on another treatment, consider the possibility your latest skin woe might in fact be a job for the dermatologist. To help you determine which expert’s opinion to seek when, here are a few points explained to make the most of your visit.

To get it out of the way: What's the primary difference between a dermatologist and an aesthetician?

To state the obvious: A dermatologist is a doctor and an aesthetician is not.

“A dermatologist is a medical doctor who has completed pre-medical studies in undergrad, four years of medical school, a one-year internship most commonly in internal medicine, three years of dermatology residency, and has passed national examinations for licensure and board certification,” explains Dr. Hadley King, dermatologist at NYC’s Skinney Medspa.

But aestheticians study, too, explains Joanna Vargas, celebrity skincare aesthetician and founder of the eponymous spa and skincare brand. The best of the bunch are schooled in various skin conditions, as well as on how to treat common problems with non-invasive procedures and non-prescription products. However, she notes, an aesthetician’s ability is primarily relative to their amount of experience in the industry. “Someone who has been doing facials for 10 years is going to have better skills in, say, extraction than someone fresh out of school,” she says.

So what skin problems can be addressed and solved from a trip to an aesthetician?

Acne, mild breakouts, sensitivity, dry patches, and aging concerns, says Vargas. Ultimately, it depends on your aesthetician’s expertise and your exact needs, but call your aesthetician if you’re looking for: microdermabrasion, extractions, pore cleansing, acid peels, exfoliating treatments, waxing, superficial skin peels, and various light, laser, ultrasound and radiofrequency procedures.

And what requires a dermatologist's eye?

Anything more than just basic skincare concerns. This includes skin cancer checks, checking moles or other skin growths, hair loss, severe acne, eczema, psoriasis, rashes, hives, etc., explains Dr. King. And if you’re looking for some serious cosmetic treatments, many dermatologists these days are trained in cosmetic dermatology and can even perform fillers, injections, and laser treatments.

*Is there a quick rule of thumb for deciding to see the dermatologist versus getting a facial?

*Although both an aesthetician and a dermatologist can offer advice for proper daily skin care, some skin issues require advanced medical treatment—think anything that might require a biopsy, surgical removal, an aggressive treatment, or an invasive procedure. However, there are other non-medical times when a dermatologist is also needed. Dr. King suggests visiting a doctor for even the most straightforward procedures like facials or peels if you think you might be at a higher risk for adverse side effects. She suggests those with darker skin or a history of scarring be cautious and seek out a dermatologist for these specific treatments. Better safe than sorry.

At the end of the day, which pro you see can also boil down to sheer personal preference. “Some people are really medical and like to have a doctor’s advice and a prescription,” says Vargas. “Most of the people who come to me are the opposite—they are seeking less invasive, more organic ways of treating their skin.”

Do dermatologists and aestheticians ever work together?

“Yes, it's a great relationship when one—the derm—oversees skin health on a global basis and the aesthetician helps to carry out the plan outlined by the derm,” says Dr. Elizabeth Tanzi, founder & director of Capital Laser & Skin Care in Washington, D.C. She suggests asking your dermatologist about specific ingredients that would be helpful for your particular skin type, then refer to your aesthetician to help find them in products.

How much time does each appointment take?

This will ultimately depend on your personal circumstances. When visiting a dermatologist's office, expect to see the doctor anywhere from 10 to 30 minutes per visit—longer if a procedure is required. If you’re not suffering from any specific problems, you only need to see your dermatologist once a year for a skin check. Otherwise, your frequency and length of visits will correlate with the issue at hand.

As far as your time with your aesthetician, this can also vary, but the standard facial time is an hour. Plan to see your aesthetician once a month for mild skincare problems. Call them mandatory facials.

Bottom line:

If you’re just having a bit of a flare up, are concerned about recurring pimples, need new product recommendations or just want to relax to the sweet soundtrack of a babbling brook, hit the spa. If you’re having some serious battles with your skin, think meds might be the solution, or want a more invasive procedure done, book an appointment with your derm. And for the best treatment around, see both.

—Caitlin Miller

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Caitlin Miller is a beauty writer who cherishes her vast collection of cleansing oils above all else, including Netflix. She listens to Bob Dylan daily, eats nachos weekly, and would never travel without running sneakers and eyeliner.

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Photo by ITG.

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