Loading
/post

How Do I Get Into Aesthetics?

In this article, I answer one of the most frequently asked questions, "How do I get into aesthetics?" Everyone, from high schoolers to parents, practicing nurses, estheticians, and aspiring NPs, has been asking this question for over 20 years. Nursing and nurse practitioner (NP) schools doesn't include cosmetics (barely dermatology) in the standard curriculum. This is because when NPs were created, it was to address the gap in primary care providers. Therefore, aspiring cosmetic NPs have to create their own path to obtaining education and training.

Nursing >>> Cosmetics

The Nurse Practitioner (NP) role was created in 1965 by Dr. Loretta Ford, EdD, RN, and Dr. Henry Silver, MD. They established the first-ever NP program, a pediatric nurse practitioner program, at the University of Colorado to address a national shortage of primary care physicians and increase healthcare access for underserved communities. Dr. Ford, a nurse, and Dr. Silver, a physician, collaborated to expand the role of public health nurses, focusing on health promotion and disease prevention. This is the foundation of our practice as APRNs or Advanced Practice Registered Nurses.

Admittedly, many people enter nursing solely to practice cosmetics. Given the lack of standardized practice, competencies, and varying state regulatory guidelines, the outcomes and the current state of nursing aesthetics is anything but predictable. This is one of the motivating reasons for forming the Alliance of Cosmetic Nurse Practitioners:

The only professional membership designed to help Nurse Practitioners who specialize in Cosmetics and Entrepreneurship build a business on the side or start an empire, founded on the 9 Pillars of Advanced Nursing Practice, with an emphasis on skin of color, business acumen, and digital fluency. After you complete your on-demand, weekend, or academic training, we pick up where they leave off offering ongoing coaching and mentorship.

Let's take a look at the advice given to aspiring Cosmetic NPs who want to know: How do I get into aesthetics?

Go to Nursing School: The Most Common, and Most Flawed, Piece of Advice

"Just go to nursing school. Then you can be an injector."

It is, without a doubt, the single most common piece of advice given to bright-eyed, ambitious individuals who dream of a career in aesthetic medicine. And while it is not entirely wrong, it is an incomplete and often misleading roadmap. This advice is a byproduct of our profession's own complex history. To understand why it's so flawed, we must first understand the very reason nursing school was created. Before Florence Nightingale established the first formal training school in 1860, "nursing" was not a respected profession. It was an informal, untrained job, often performed in squalid conditions by women of ill repute.

Nightingale's revolutionary vision was to solve a massive public health crisis by transforming nursing from an uneducated trade into a disciplined, scientific, and respected profession. She architected a system, a formal curriculum, selective admission, a focus on hygiene, to create a new class of practitioners who could provide safe and effective care. The modern nursing school is a direct descendant of that legacy. Its core, unwavering mission is to prepare us to be exceptional clinicians of patient care, primarily within the acute care and primary care settings. It is a rigorous, science-based education that forges us into the skilled clinicians who form the backbone of the entire healthcare system.

But here is the hard truth: it is "patient-care school."

It is not, and was never designed to be, business school. It is not financial literacy school. And it is certainly not advanced aesthetic nursing school. Too often, nursing practice is compared to medicine. People see nursing as being easy simply because it is not medical school. While nursing school is not as long (although over the course of a nurse's career they may spend an average of 8-10+ years in nursing school at various levels), it is challenging, stressful, and costly. Many students who enter a CNA, LVN, LPN, AD, BSN or MSN program struggle with the coursework which leads them to invest time and money into tutoring and study groups, or choose an alternative career. It's not uncommon for students to experience anxiety, depression, miscarriages, divorce, financial instability, high blood pressure, diabetes, and insomnia. Nursing school requires time away from your family, it may limit your income potential (if you can work at all), forces you to choose between studying and being present for major life events, and to face your own biases and trauma as you care for people from various walks of life. Yes, nursing school is shorter, but we work in the same institutions, care for the same patients, answer many of the same questions, are exposed to the same stress, are required to meet unrealistic expectations, must abide to evidence-based practice, and fear losing our license or getting sued.

Deciding to pursue nursing should not be taken lightly. Admission into a nursing program typically requires the prospective student to take prerequisites like statistics, anatomy and physiology I and II, microbiology, biology, chemistry I and II, English, etc. and an entrance exam in conjunction with other general education requirements mandated by the college or university. The number of standardized exams eliminates a significant percentage of hopefuls who are not good test takers, even though they may turnout to be exceptional clinicians and scholars. Similarly to medical students, you will learn a large volume of information in a short period of time under the stress of needing to earn a certain grade, and be internally motivated, disciplined, and highly efficient with your time management. There is not a manual for that. The strict curriculum does not include business, financial literacy, insurance, leadership, internal conflicts, malpractice, grief, vicarious trauma, compassion fatigue, or bullying to the degree that we are exposed to it in practice. It does cover drug and alcohol abuse, addiction, racism, fraud and waste because of the high stress environment and access. Despite all that is required to enter and graduate, most still experience culture shock and imposter syndrome when we realize all the things we still don't know when we start practicing.

Professors are the backbone of nursing education, sacrificing their own time and energy to help students meet graduation deadlines and requirements. Not all nursing schools are created equal and not all nursing professors will have your best interest in mind. At the end of the day, professors are people too with their own stressors, biases, and financial concerns. Many enter academia after being burned out at the bedside, receive little to no formal training, and encounter microaggresions or isolation in the workplace, particularly professors of color. Professors have also been cited as inflicting trauma onto their students, particularly students of color, who fear retaliation or receiving a failing mark if they speak up.

The most important thing to know about nursing school is it doesn't teach you everything you need to know about being a nurse. It only teaches you how to care for patients. You have to continue to invest in your learning, network with others who can open doors for you, volunteer your time by serving on boards and committees, and join your professional nursing organizations for ongoing support and exposure to opportunities. Nursing is not a solo venture. It is ever evolving and we can do anything and work anywhere. No one understands nursing as much as another nurse, and even then, they may have limited thinking.

Nursing school doesn't teach you everything you need to know about being a nurse.

While nursing school provides an essential foundation, it is only the first, foundational step in a much longer and more complex journey. For the aspiring cosmetic NP, this is a critical distinction. A nursing degree is your non-negotiable ticket to entry. It gives you the license, the clinical judgment, and the profound understanding of patient safety that must be the bedrock of any ethical practice. But it will not, on its own, prepare you for the realities of the highly competitive, commercially driven, and entrepreneurially demanding field of cosmetics. To succeed, you must commit to a second, parallel education, one that is not found in a traditional curriculum, but in the world of business, finance, and strategic mentorship.

I wrote The State of Nursing Education: Pathways, Purpose, and the Future of Cosmetic and Dermatology Practice for you and because of the gaps in advice that I've witnessed when it comes to answering the question, "How do I get into aesthetics?". It's a free downloadable PDF designed to answer your questions, give you insight from someone who's been in this industry 15 years, accumulated 6-figures of debt, and sacrificed my youth as a young woman along the way. I love my profession, the lives I've touched, and the legacy it's allowed me to solidify. But it's not for everyone. I want you to be well informed about the decision you're about to make.  My passion at this stage in my career is in supporting you as you care for patients or build your business. I love mentoring and teaching - that's what my business is founded on. It's my Ministry of Medicine. You're who I'm here to serve and I do it with gladness.

Go to NP School

I believe, if you're going to put yourself through the stress of studying; examinations; balancing work, rotations, and school work; finding and then struggling with an unprepared preceptor, desperately look for an entry-level job and magically figure out how to pay back loans with that entry-level salary - then you need to want to a nurse practitioner as much if not more than you want to practice cosmetics. Some of our biggest challenges that NP school does not prepare you for:

  • Finding a preceptor (free or paid)
  • Finding an NP preceptor (especially when they are not listed on the practice website) - this is especially important when you are learning the intricacies of what it means to be an NP so that you can answer the other common question: What's the difference between an NP and MD that goes beyond the obvious years of training.
  • Passing boards
  • Imposter syndrome
  • Defending and explaining our education and training and why the term mid-level is demeaning
  • Finding a physician who is well versed and respectful our education and training (this goes both ways, we also tend to lack a full understanding of their curriculum and the pressures they have)
  • Negotiating a fair salary
  • State regulations and scope of practice
  • Navigating professional development as a post-graduate, revenue-generator, and entrepreneur

Sign-up for Botox and Filler Training

If you want to be a Cosmetic Nurse Practitioner Entrepreneur then there are 3 areas of expertise that require your investment: cosmetics, advanced practice nursing, and business. The advice to just take a botox and filler course is woefully incomplete. First, you're being asked to invest a lot of money. Every botox and filler course is designed differently and many fail to teach you long enough or how to manage complications (a commonly asked question from new and experienced injectors). Some trainers won't let you touch the patient, only observe. Others, you only get a few practice runs and then you're still left on your own. Newly trained nurses and NPs soon find out that just receiving a certificate (not required to practice) of completion is not enough to get hired, because employers are looking for someone with 2+ years of experience. The trainer likely didn't receive any standardized training on how to create evidence-based curriculum, they're just trying to help you the best way they know how.

Because most struggle to find a job, the next advice that's given is to practice on friends and family. While many express a lack of confidence and concern with this advice, this is a common entry-point given the inability to secure a job. For a variety of reasons, new injectors transition to finding a place to continue to practice on friends and family, and attract a growing clientele. Even though the first question is, "How do I get into aesthetics?", I think the real question is how do I become an entrepreneur who specializes in aesthetics. So, after securing a place either inside of another beauty business like a salon, a salon suite, or in-person (concierge), the interest to grow faster and attract more clients leads the injector to sign a lease and not too soon after invest (go into debt) in expensive devices (not advised) like lasers to attract more clients who might pay more and help offset the cost of rent, training, marketing, and devices. At this phase, the injector may work alone, hire their teenager to manage social media, or pay a freelancer, web designer, or virtual assistant for design needs, marketing, and daily tasks like answering emails and scheduling. Within 2-3 years the injector is still struggling with how to manage complications, high cost of running a business, low profit, and managing a team.

"How do I get into aesthetics?" A lot of people give the advice to patiently wait (sometime years) until someone hires them so they can receive proper mentorship and training. The focus of this advice is one-sided. It centers on what benefits the new injector, not on how the new injector can be of value to the business/practice. As a result, the experienced injector looking to hire staff and grow their team, also seeks advice on how to find good talent and reduce high turnover. The experienced injector is also feeling imposter syndrome. Transitioning from being self-employed to a business owner requires trust, systems, policies, clearly defined roles and responsibilities, and an understanding of asset management - things that take time. Additionally, they experience fear that the people they hire will soon leave and open their own med spa in the same town - a reality that is not farfetched. While I believe it's possible to create an environment where someone who originally wanted to open their own med spa finds enough fulfillment and compensation that they turn into a loyal employee, I also believe you can hire someone who admits they want to open their own med spa and turn the working relationship into a mutually beneficial mentorship-coaching relationship that benefits both parties for a longtime. I discussed in detail different ways to benefit from this mentorship-coaching relationship on my YouTube channel under the playlist for Aesthetic NPs and Entrepreneurs.

"The advice we give to new injectors turns out to be harmful for the solo injector looking to grow their team."

How Do I Get Into Aesthetics? Clinical Pearls.

When you take a botox and filler course, you need to have a waitlist of patients ready to treat so you can hone your skills.
You can create a waitlist of patients, begin your didactic education, establish your authority, and learn about business, leadership, communication, employee retention, and managing finances long before you take any training course. You might even learn about other ways to practice cosmetics along the way.
When you have questions about what you can and cannot do legally as an nurse or NP injector, and what your colleagues can and cannot do, call your Board of Nursing. Facebook communities can be helpful for advice and pointing you in the right direction, but it is not a regulatory board and you cannot verify credentials from anonymous posters who have nothing to lose.
Just because someone is experienced, doesn't mean they are adequately prepared to teach you everything you need to know. You have to own that. You need to be willing and able to invest in ongoing education, training, mentorship, and coaching. You get in what you put out. I've shared multiple ways to be of service to get the mentorship, training, and education you need while also helping a business owner solve their problems. Every business owner has problems and needs help. You just have to listen to their pain points and believe you can be of value or be willing to learn (take the initiative) how you can help.
Aesthetics is not like acute care and primary care that you learned in nursing and NP school. No one owes you anything. There are no clear guidelines regulated by the Board of Nursing; there are multiple ways to get to the same destination as evidenced by the variety of advice. You need to know what that destination is. Nevertheless, there are well established organizations, NP entrepreneurs, peer-reviewed studies, training programs, and networking groups (in and outside of healthcare) that can help you.

Why Do People Leave Aesthetics?

One of the most important things you can do when you're interested in pursing something in your personal or professional life, is learn from people who have already been where you're trying to go. Despite the long-windy road many have traveled to practice aesthetics or even open their own medical spa, many leave due to:

  • High overhead, low margins - meaning they don't make enough money given how much money they spend to stay in business.
  • Consumer demand and dissatisfaction - aesthetics is generally seen as an elective practice. Some nurses lose interest in the vanity of aesthetics when they compare the acuity of concerns in aesthetics to that of terminal diseases, morbidity and mortality experienced in other specialities.
  • Unethical practices by business owners or colleagues who may or may not be medically-licensed to perform cosmetic treatments - nurses and NPs leave for fear of losing their license when people who they work with and for put profit over patient safety or medical necessity.
  • Lack of credibility, visibility, and competition over collaboration - the aesthetic and beauty industry is a multi-billion dollar business attracting a lot of people with various interests; this creates more of a competitive market than one of collaboration and in this setting, the people who get the attention often had to pay to play; not everyone can afford it and not everyone is welcomed.
  • All that glitters isn't gold - despite profit, passion or social media following, many entrepreneurs have admitted to filing for bankruptcy or divorce, and experiencing mental health concerns due to the demands (working 7 days a week, being a solo injector, struggling with employee retention, low clientele, saturated market, competition, lack of proper training).

A Solution

I have addressed several problems or gaps in education, training, and business in this article that are ripe for someone like you to address. I know your desire to care for patients and help them look and feel their best is what drove you to read this article. I too was motivated to help patients solve their problems. But when I encountered some of the problems aforementioned, I decided to address them rather than continue to add to the problem. This has been the founding principle upon which my businesses were founded. I encourage you to believe that you too can help solve problems in our industry, it just takes one step at a time and a village.

"When NPs have the tools to stay in business. Doors stay open. When businesses stay open, patients get the care they need when they need it. Ultimately, we end up achieving the first mission." - Dr. Kimberly Madison, DNP

Building Your Founder's Education: The Real Curriculum

The crucial takeaway is not that nursing school has failed us, but that its mission is specific. To thrive as a founder, you must commit to a second, parallel education focused on business. The question is no longer if you need this education, but where you can get it.

If you are ready to begin your founder's education, here is your curriculum:

1. The Foundational Text: The State of Nursing Education White Paper

Before you can build the future, you must understand the present. This comprehensive, data-driven report is your foundational reading. It deconstructs the educational pathways, the systemic gaps, and the economic realities of our profession, giving you the C-suite level context you need to make informed strategic decisions about your cosmetics career.

2. The Core Textbook: Nursing Aesthetics: An Introductory Guide for Nurse Practitioners & Entrepreneurs

This is the business and legal framework that "patient-care school" never provided. My book is a step-by-step roadmap that takes you from clinician to CEO, covering the non-negotiables of building a practice that is not only profitable but also legally sound and ethically grounded. It is the practical "how-to" guide for turning your clinical expertise into a valuable and sustainable asset. It was written for both the employer and employee learning to navigate this industry for the first time.

3. The Community & The Mentorship: The Alliance of Cosmetic Nurse Practitioners™

You cannot and should not build an empire alone. The Alliance is your professional home. It is your "board of directors," your peer support network, and your source for ongoing, high-level mentorship. It is the community that will challenge, support, and celebrate you at every stage of your journey.

4. The Clinical Deep Dive: Professional Organizations

While the Alliance focuses on business, deep clinical mastery is still a non-negotiable. Organizations like the Dermatology Nurses' Association (DNA), the Society of Dermatology Nurse Practitioners (SDNP), and Diversity in Dermatology (DID) are essential resources for advanced clinical education, conferences, and networking within dermatology.

5. The Ethical Compass: The ANA Code of Ethics

In a commercially driven industry like aesthetics, your ethical foundation is your most important asset. The American Nurses Association's Code of Ethics is a living guide for decision-making. It is the framework that will help you navigate complex challenges and build a practice that honors the depth and dignity of our profession.

This is the real curriculum. This is how we train founders, not followers.

About the Author

Dr. Kimberly Madison, DNP, AGPCNP-BC, WCC, is a Board-Certified, Doctorally-prepared Nurse Practitioner, educator, and author dedicated to advancing dermatology nursing education and research with an emphasis on skin of color. As the founder of Mahogany Dermatology Nursing | Education | Research™ and the Alliance of Cosmetic Nurse Practitioners™, she expands access to dermatology research, business acumen, and innovation while also leading professional groups and mentoring clinicians. Through her engaging and informative social media content and peer-reviewed research, Dr. Madison empowers nurses and healthcare professionals to excel in dermatology and improve patient care.

/Let's talk/

Ready to build experiences your audience will love?

Are you still trading time for money?
Get my free guide to 10 repeatable revenue streams for Aesthetic and Derm NPs — delivered instantly to your inbox!
Email Me Now!