Thanks to the rise of skincare TikTok—a popular destination on the short-form content app where users can discover new product recommendations, skincare tips, and debunked myths from skin experts—it’s becoming increasingly difficult to determine who you should be investing your time and money into. Do I trust the skincare influencer with 6.7 million followers whose feed is chock full of product reviews, recommendations, and sponsored ads? What about the dermatologists and estheticians who debunk skin care myths in between taking appointments? It’s the hotly debated topic that gets resurrected every few weeks: Do I see a dermatologist or an esthetician?

As someone who has leaned on estheticians for most of my skincare journey, dermatologists always seemed too intimidating and impersonal. The last time I stepped foot in a derm’s office, I was given intense retinoids with no clear instructions on how to use them, thus sending me—and my weak skin barrier—running into the office of an esthetician. I formed my own bias and steered clear of a derm’s office for years. But with mounting skincare issues that don’t seem to be subsiding anytime soon, I quickly realized I needed medical intervention. Do I continue seeing my affable local esthetician or call in the big guns to whip my skin into shape? The differences are noticeable—one’s an actual doctor who sat through years of school, while the other is a licensed practitioner whose require to take specific courses—but understanding the purpose of each expert is not as overt. Ahead, I polled a few skin experts to weigh in on the dermatologist vs. esthetician debate.

Who should I see for my skin concerns?

First, you have to understand the services provided by both an esthetician and a dermatologist to help you make the right decision. An esthetician is “someone who provides non-medical skincare services to customers. These treatments may include extractions, masks, peels, massages, and some light laser or light-based treatments,” says NYC dermatologist Dr. Joshua Zeichner, director of cosmetic & clinical research in dermatology at Mount Sinai Hospital. But sister estheticians Aishe Balic and Sai Demirovic, co-founders of NYC’s Glo Spa NY, explain that estheticians don’t treat the skin as deeply as a derm.

“Estheticians focus on the face. We’re constantly working with people’s skin, whereas dermatologists focus on the skin as a whole; they treat many different skin conditions and diseases, whereas we specialize in taking care of acne, hyperpigmentation, etc. People go to estheticians if they want to try to fix things as naturally as possible, and if it’s more stubborn and extremely hormonal, they can go to a derm for a prescription. Because we see so many different variants of acne or skin conditions, most of them were able to address ourselves, but sometimes if we’re at six sessions and it’s a little bit stubborn, I might suggest, I think you should see a derm,” and we work together. Demirovic adds that bedside manners play a part as well. “I think an esthetician cares more. We are here to hear you out, listen to you, and try to solve the problem,” she explains.

On the other hand, a dermatologist is required to clock in a lot more hours in school than an esthetician. “To be a dermatologist, you need four years of undergrad, and then you need four years of medical school, and then a one-year internship and three years derm residency. So 12 years of school,” Dr. Camille Howard-Verovic, NYC dermatologist and founder of Girl+Hair explains. “We don’t just study the skin. We study the hair, the mucus membranes, and we study the nails. So usually, when you see that “board-certified” phrase next to a name, it just means that a professional body governs us; we sat down for a major exam at the end of our residency, we had to pass that exam. We are true experts of the skin, hair, nails, and mucous membrane.”

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So I should see an esthetician first, then?

Demirovic and Balic believe your first step should be to consult an esthetician. ” If I have a client, I know there’s only so much I can do to help their skin. Usually, I’ll ask them, Have you seen a derm? Because they’re probably going to help you right now more than I could. You can give as many treatments or facials as you’d like, but when it’s something hormonal, a skin treatment will not be able to control something like that.

What treatments and products can a derm recommend or prescribe that an esthetician can’t?

“Retinoids,” Dr. Howard-Verovic says. Of course, some estheticians are nurse practitioners, and prescribing products could depend on state laws. “But usually, estheticians can’t prescribe topical medications, and they can’t write prescriptions.” Dr. Zeichner adds that only derms can “perform professional strength chemical peels and lasers, injectable treatments like Botox and fillers, and surgeries like liposuction or eye lifts and skin cancer removals.”

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But dermatologists are more expensive, right?

The cost truly depends on your health insurance. Sometimes, your procedure and prescriptions can be covered by your insurance company. But you don’t always have to go through your health insurance to see a dermatologist. “You can go through insurance, and then there’s something called direct pay. Where, for instance, if you wanted to see me and you didn’t have insurance, you can see me for like $100 at the practice that I work at, and then follow-up visits are $50. And sometimes, it can cost more,” Dr. Howard-Verovic adds.

But that’s not to say that estheticians are less expensive either. Some spas, including Glo Spa, facials, and other skin treatments, can run for more than $200. “With an esthetician, our facials at Glo Spaabout $200, and people come every 1 to 2 months,” Balic says. “So you’re spending at least $200 once a month or two. Usually, if you have health insurance with a dermatologist, that prescription cream that they’ll prescribe might get covered. But some of those costly prescriptions are not always covered because they’re under cosmetics.”

What are some other misconceptions about dermatologists and estheticians?

“That we work on opposite teams. We don’t, and we’re on the same team,” Dr. Howard-Verovic says. “We work hand in hand as a skincare team. I always tell my patients like, “There’s no such thing as perfect skin. But you can get close to that by doing the work, staying consistent, and having a skincare team.”

Not all derms have the time to sit with a patient to discuss their entire skin routine. Enter: Estheticians. “We see so many different types of skin pathology throughout the day that one may not have time to go through every single product that you’re using. Whereas an esthetician may be able to book that time while they’re doing your facial, which is probably like 30 minutes to an hour.”

Balic explains that she wishes people understood that a facial isn’t a cure-all treatment for skin concerns. “A lot of people think that they can get a facial, and it’s going to fix everything. A facial can only do so much. It also has to do with your home care, your skin regimen, your product usage, what you’re doing on your time. We’re not magicians. We can only do what we can do in that one hour that you’re here,” she says. If more people understood that clients and estheticians are also a team, instead of expecting estheticians to be magicians, you could get closer to your skin goals.

“We can help you along the way, we can guide you, we can prep your skin, we can give it the nourishment that it needs to heal and do what they need it to do,” Balic says. “But they also have to follow our guidelines on what they should be doing when they’re not here.”

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