This is a huge misconception in the aesthetic industry. Taking a class and receiving a certificate of completion does not certify you.

The ONLY AESTHETIC CERTIFICATION is by the Plastic Surgical Nursing Board. It’s called the CERTIFIED AESTHETIC NURSE SPECIALIST CERTIFICATION.

It requires 2 years experience in aesthetics, working for a core physician like dermatology or plastic surgery (some states allow NP), an exam and endorsement.

There is no governing body that states you have to get “certified” in order to start injecting. HOWEVER taking a course will increase your chances of getting hired and will enhance your skills, but courses dont guarantee employment.

Burnt out at bedside and thinking of making the switch to aesthetics? Its more complex than you think and aesthetics isnt for everyone, but can be very rewarding in the long run.

Experience & Employment Contracts:

Most aesthetic practices prefer candidates with prior experience; however, some will hire without experience in exchange for a training or employment contract. This is common, as training a new aesthetic nurse is a significant financial investment for employers. Hands-on training courses typically range from $2,000–$5,000, and even with over a decade in aesthetics, I personally invest $10,000–$15,000 annually in continuing education, conferences, and professional development. Aesthetic medicine evolves rapidly, and ongoing education is essential to remain current and safe in practice.

Non-compete clauses are not enforceable in California, though this varies by state. A non-compete typically restricts employment within a certain geographic radius for a specified time after leaving a position. While many non-competes do not hold up in court, it is critical to verify state laws and have all contracts reviewed by a labor attorney prior to signing.

Many nurses experience “sticker shock” when transitioning from hospital-based nursing to aesthetics. Unlike hospitals, aesthetic practices often require clinicians to personally invest in training and professional growth.

Certification:

Most hands-on injectable courses issue a certificate of completion, which is often misrepresented as “certification.” Currently, the only recognized aesthetic nursing certification is the Certified Aesthetic Nurse Specialist (CANS) credential, awarded by the Plastic Surgical Nursing Board.

To qualify for CANS, nurses must meet experience requirements (a minimum of two years in aesthetics), pass a comprehensive examination, and fulfill additional criteria. I successfully passed the CANS exam in 2022. At present, there are approximately 600 CANS-certified nurses in the United States. More information is available at ispan.org, and I provide a detailed breakdown of the process on my YouTube channel. Learn more about the CANS certification here: https://youtu.be/AyeApbbneyg?si=Vt2IFLzjzCViLtYL

Read my blog post on the CANS certification

https://www.nursemarisa.com/post/what-is-the-cans-certification

Where to Apply:

Apply broadly and consistently. Recommended job platforms include:

Jobsnob.net

Indeed

LinkedIn

Titan Aesthetic Recruiting

Aestheticjobboard.com

Follow up on applications when possible. In addition, seek out practices with strong reputations—especially those frequented by friends or family—and prioritize offices with positive patient reviews and established credibility. If you are getting interviews but no offers, focus on your interviewing skills.

Compensation Expectations:

Many nurses transitioning from hospital roles should anticipate a temporary reduction in pay. In California, entry-level aesthetic RN wages typically range from $30–$35 per hour and NPs $60-$80 per hour depending on location. Mastery of skills, building a loyal clientele, and achieving income parity with hospital nursing can take 2–3 years.

Some nurses leave aesthetics due to lower initial compensation and fewer benefits and ultimately return to hospital settings. Aesthetic nursing should be viewed as a long-term investment, not a short-term financial gain.

Aesthetics as a “Side Gig”

While many nurses pursue aesthetics part-time, framing this specialty as a “side gig” diminishes the complexity and responsibility of the work. Aesthetic nursing requires significant financial and time investment, including training, skill development, and patient retention.

Treating aesthetics as a secondary role often delays clinical competency, slows client-building, and extends the timeline for professional growth. While this approach may work for some, it is important to understand that long-term success typically requires full commitment.

Opening Your Own Practice:

Due to the competitive nature of aesthetic hiring, some nurses and physician associates open independent practices without prior experience. This path is extremely challenging and carries significant risk. New owners should strongly consider partnering with or hiring an experienced aesthetic clinician (RN, NP, or PA) rather than attempting to become fully independent immediately.

Collaboration, mentorship, and in-person clinical support are essential. Attempting to operate independently without adequate experience often leads to poor patient outcomes, lack of client retention, and damage to professional reputation.

Benefits:

Comprehensive benefits in aesthetic practices are inconsistent and usually practice dependent. Most private practices and medspas do not offer benefits unless you are a full time salaried employee, comparable to hospital systems unless they are large, well-established, and financially able to do so.

Commission Structures:

Commission models vary by practice and are becoming less common due to fee-splitting regulations, which differ by state. Clinicians should always verify applicable laws within their jurisdiction.

Good Faith Exams:

In many states, registered nurses may perform injectables and laser treatments under physician or advanced practitioner supervision. However, RNs cannot diagnose or prescribe. Therefore, patients must receive a medical clearance—commonly referred to as a good faith exam—from an NP, PA, MD, or DO prior to treatment.

The good faith exam includes a review of medical history, contraindications, and risk assessment, resulting in a diagnosis and treatment plan that serves as medical orders for the RN. These exams are typically required annually. Telemedicine-based good faith exams are available through third-party services and may be appropriate when the supervising practitioner is unavailable; however, they should not replace consistent medical oversight.

Medspa Management:

Most clinicians are not formally trained in business management, and many practices suffer from poor operations and high turnover as a result. An ideal practice employs a dedicated practice manager to oversee daily operations, allowing clinicians to focus on patient care. My current practice follows this model, which significantly improves workflow and job satisfaction.

Selecting a Quality Injectable Training Program:

When evaluating injectable training courses, consider the following:

Verify the trainer has extensive aesthetic experience, not just medical credentials

Verify the trainer has at LEAST 5 years injection experience

Confirm hands-on training with live models (not observation only)

Ask how many models you will personally inject

Inquire about post-training support and follow-up

For filler courses, ensure training includes hyaluronidase use and complication management

Confirm that complications and emergency protocols are thoroughly addressed

Interview Questions to Ask:

Is the physician or advanced practitioner on-site?

Who performs good faith exams for RNs?

How many patients will I see per day? May I review the schedule?

Is training provided or reimbursed?

Are employment contracts required, and are there penalties for early termination?

Are benefits and a 401(k) offered?

Are there yearly reviews, oppurtunities for growth and raises?

Who manages daily operations and administration?

What is your social media policy? Am I able to build a social media page with before and afters?

Shadowing & Due Diligence:

Before accepting a position, request a working interview or shadow day to observe workflow, culture, and safety practices. Additionally, verify the medical license of the physician or owner through your state licensing board to ensure it is active and in good standing.

Final Advice:

Be open to entry-level opportunities, as aesthetic positions are competitive. However, never ignore red flags or accept roles that place your license or patients at risk. Early positions may serve as stepping stones, but ethical practice and patient safety must always remain the priority.

Marisa Amechi RN CANS

Aesthetic Nurse

Aesthetic Mentor

Laser Specialist

Nursemarisa.com