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your niche Rising to the Top Anna Rinehart calculates that she possesses 47 skills not offered by any other health-care provider in the Killeen, Texas, hospital where she works: acne management, chemical peels, permanent hair removal, scar reduction, and tattoo removal, to name just a few. Rinehart is a licensed and CIDESCO- certified esthetician, former nurse, licensed continuing education provider, and author of a book on medical esthetics. But she does not call herself a medical esthetician. "I am a clinical esthetician," she says. "Botox is a trend that will come and go. What I bring to the table are the clinical, diversified skills that can move an esthetician into a $25 to $30 an hour role." The US Bureau of Labor Statistics shows that medical esthetics is among the highest-paying career paths for skin care professionals, with salaries of more than $50,000 per year. But Rinehart warns that medical esthetics isn't for everyone. "This is a tough road," she says. "There's such scrutiny of your skills, scrutiny of your education, constant scrutiny of your credentials as an esthetician, standards that a lot of estheticians are just not used to. And they're long days." Those hoping to land such a job shouldn't simply talk about what skin care products they know how to use, or how much they can generate in sales. Employers are looking for "clinical skills that can be a service to their hospital, to the patients, and to the community. They're looking for the best of the best, the estheticians that rise to the top." The life of a medical esthetician by Rebecca Jones Diane French, shown here before and after makeup, uses her esthetics training and personal medical history to help others learn to disguise their scars. Medical estheticians typically work with patients whose skin is impacted by disease, surgery, or other trauma. They may work for dermatologists or plastic surgeons, helping patients with pre- and postoperative skin care. Others work independently with clients who have been referred by a doctor, or even in places like women's shelters and children's summer camps. Diane French knows about the latter two places. She has her own one-room spa near San Diego, and often teams up with two psychologists to provide treatment to burn patients and survivors of domestic violence—clients who suffer from psychological as well as physical trauma. For years, French has offered her services to Angel Faces Retreat, an annual camp for adolescent girls who have suffered severe permanent facial burns and disfigurement. It's a deeply personal ministry for French, who was born with a large nevus—a colored growth—on the left side of her face, forehead, and scalp. As a child, she endured years of surgeries. Today she is an expert at camouflaging her scars, and she loves sharing that skill with others. "One 11-year-old girl who was born with a nevus, like I was, told one of the other volunteers that I was the first person ever to touch her face, except for her mother," French says. "That's exactly why I got into this. I know how important human touch is. I can't wait to get my hands on my clients, to soothe them emotionally. That's just as important as doing a corrective treatment." French advises estheticians thinking of moving into the medical side of the profession to begin by clarifying the reasons behind what they want to do. "What treatments are your specialty, and why?" she says. "Do you like the fact you can clear up someone with acne? If so, maybe you would like to work with a dermatologist. If chemical peels are your thing, or treating hyperpigmentation, maybe a plastic surgeon is best for you." Once you have clarity of focus, put together a resume listing all your strengths, and get out there and introduce yourself, French says. "The main thing is just getting the word out. Think outside the box. I've heard of dentists and obstetricians working with estheticians." Rebecca Jones is a longtime newspaper reporter and freelance writer based in Denver, Colorado. Contact her at killarneyrose@comcast.net. Get connected to your peers @ www.skincareprofessionals.com 11