How to become an aesthetic/cosmetic nurse

aesthetic nurse checks patient jawline work

Aesthetic nurse career overview

Where you’ll work: Medical spas, dermatology offices, plastic surgery offices

What you’ll do: Assist physicians with and execute a variety of cosmetic procedures.

Minimum degree required: ADN or BSN required for licensure.

Who it’s a good fit for: Nurses who are passionate about helping patients raise their self-esteem and who may prefer a more laid-back working environment.

Job perks: Since most procedures are elected by the patient, aesthetic nurses tend to work in a less stressful environment and get to work normal hours.

Opportunities if you pursue a higher degree or certification: Becoming a Certified Aesthetic Nurse Specialist through the Plastic Surgical Nursing Certification Board (PSNCB) could open up more job prospects and the possibility of a higher salary.

Median annual salary: $81,220

It’s probably not the first nursing specialty that you think of, but aesthetic nurses are just as much a part of the nursing ecosystem as any other specialty. They assist with a variety of aesthetic and cosmetic procedures, many of which help patients look and feel their best. This can be an especially attractive specialty for nurses who prefer a less stressful, more laid-back career while still making a positive impact in patients’ lives.

What is aesthetic nursing?

Aesthetic nurses—sometimes called cosmetic nurses or alternatively spelled as esthetic nurses—support plastic surgeons, dermatologists, ophthalmologists and other physicians with various cosmetic procedures. These procedures may have a medical necessity for the patient, or they may be elective procedures like injectables or skincare treatments that the patient has opted for to improve their appearance and boost their confidence.

“It’s very much a subspecialty within dermatology, facial plastic surgery, plastic surgery and ocular plastics. You’re going to find aesthetic nurses in all of those specialties,” said Rebecca Suess, an aesthetic nurse and member of the International Society of Plastic and Aesthetic Nurses (ISPAN) Board of Directors.

How to become an aesthetic nurse

In order to get a license as a registered nurse (RN), you must graduate from an accredited nursing program. For most new nurses, your options are earning either a two-year associate degree in nursing (ADN) or a four-year bachelor’s of science in nursing (BSN). Both types of programs, while different, prepare students for the same NCLEX-RN exam.

Get licensed as an RN.

nursing student works on nclex exam prep

After graduating from nursing school, you must pass the NCLEX-RN exam in order to qualify for a nursing license. You’ll need to apply for a license with your state’s nursing regulatory body (NRB) which may entail submitting additional materials on top of your transcripts and passing exam score, such as a background check or jurisprudence exam. Every state’s process is a little different, so check with your NRB as soon as possible to find out what you must do to get your RN license.

Gain experience.

aesthetic nurse injects botox into client upper lip

Once you’re an RN, you’ll want to start gaining experience right away. You can certainly play the field and try out other specialties, but in order to qualify for the aesthetic nursing certification, you’ll eventually at least two years of experience working with a board-certified physician that specializes in either plastic/aesthetic surgery, ophthalmology, dermatology or facial plastic surgery (ENT).

Get certified.

nurse confers with doctor on rounds

RNs that meet the experience qualifications can sit for the Certified Aesthetic Nurse Specialist (CANS) exam administered by the Plastic Surgical Nursing Certification Board (PSNCB). Getting certified demonstrates your experience and expertise to employers and could lead to better jobs with a higher pay within your specialty.

What do aesthetic nurses do?

Aesthetic nurses perform a variety of cosmetic procedures, most of which are patient-elected. Many of them are meant to cultivate a more youthful appearance, but there are also plenty of medical motivations behind some of these procedures. Botox, for example, is also used to mitigate sweating, prevent migraines, treat eye spasms and much more.

“…there are also plenty of medical motivations behind some of these procedures.”

Some of the types of procedures that aesthetic nurses perform and/or assist with include:

  • Dermal fillers which are used for smoothing wrinkles and/or plumping areas of the face (such as the lips)
  • Injectable neurotoxins such as Botox, Dysport and Xeomin
  • Sclerotherapy, which is used to improve the appearance and reduce the symptoms of varicose veins in the legs
  • Infrared and radio frequency skin tightening
  • Non-surgical fat reduction and body sculpting through methods such as Liposonix and Cryolipolysis (CoolSculpting)
  • Laser hair reduction
  • Tattoo removal
  • Dermabrasion (skin resurfacing)

Where do they work?

You won’t usually find aesthetic nurses in a lot of the settings that RNs typically work in, such as hospitals, extended care facilities, schools and more. Aesthetic nurses primarily work in environments where people can receive cosmetic treatments, such as: 

  • Medical spas
  • Plastic surgery practices
  • Dermatology practices

Requirements to become an aesthetic nurse

The first step in any nursing career is to get your education from an accredited nursing program. You have the option of choosing a two-year associate degree in nursing (ADN) or a bachelor’s of science in nursing (BSN) which typically takes four years to complete. Both programs are acceptable paths to licensure, but the biggest difference is that bachelor’s degrees require you to take additional classes in other subjects for a more well-rounded education. They cost more because they are longer, but they could pay off in the long run since some employers prefer (or may even require) their nurses to have a BSN.

For people that may already have a bachelor’s degree in another subject or some prior nursing experience as a licensed practical nurse (LPN/LVN) or similar role, there are also bridge and accelerated programs which fast-track you to a nursing degree by taking into account the education and experience you already have.


As you get close to graduating from your nursing program, you should consult with your state’s nursing regulatory body (NRB) to find out what you need to do to apply for an RN license. No matter where you live, you’ll need to register for and pass the NCLEX-RN exam which measures the knowledge, skills and competencies necessary to be employed as an RN in the United States.

Some NRBs may also ask that you complete several other items with your application besides just submitting your transcripts and NCLEX scores. Criminal background checks and jurisprudence exams are two common examples.


To take your career to the next level, you should consider getting certified as a way to show your commitment to your specialty and validate the experience you’ve gain in your area of practice. Plus, certification looks good to employers and could lead to better jobs with higher salaries.

Aesthetic nurses can become a Certified Aesthetic Nurse Specialist (CANS) through the Plastic Surgical Nursing Certification Board (PSNCB). To earn this certification, you must pass the associated examination. Not just anyone can sit for the exam—you must satisfy the following before submitting an application:

  • Be currently licensed as an RN in the U.S., its territories or Canada.
  • Have at least 1,000 practice hours within the core specialties within the last two years.
  • Have at least two years of experience as an RN within the core specialties, “in collaboration or in a practice with a physician that is board-certified within a core specialty.”
  • Be currently working in collaboration or in a practice with a physician that is board-certified within one of the core specialties.
  • Have your supervising core physician endorse your application.

The core specialties as referred to above are Plastic/Aesthetic Surgery, Ophthalmology, Dermatology or Facial Plastic Surgery (ENT).

Suess said that she cautions anyone thinking of getting into aesthetic nursing not to seek out an easy way in, particularly when it comes to certifications. There are many training courses out there claiming to issue certifications in aesthetic nursing, but if they aren’t offered by vetted providers, these certifications are really only certificates of attendance and little more.

“I really think the best thing to do is to take a staff nurse position at a dermatology clinic, plastic surgeon’s office, a facial plastic surgeon’s office, something like that. Then you are continually exposed to this stuff,” Suess said. “I really don’t think that there’s a quick shortcut to this industry.”

What’s on the exam?

The PSNCB’s Certified Aesthetic Nurse Specialist (CANS) exam tests applicants on two broad subject areas: clinical practice areas and nursing activities.

The clinical practice areas covered on the exam are:

Aesthetic injectables: neurotoxins, dermal fillers, sclerotherapy

Laser, light and energy-based therapies: non-ablative laser, light-based and energy-based treatments; ablative laser treatments; ultrasound; cryolipolysis

Clinical skin care: topical products, topical devices, chemical peels

The nursing activities on the exam are:

Assessing and monitoring patient status, both physical and psychosocial

Planning and administering procedures

Teaching patients to promote optimal outcomes

What to expect as an aesthetic nurse

Aesthetic nursing provides a much difference nursing experience when compared to other specialties. By the very nature of the procedures they perform, aesthetic nurses aren’t facing life-or-death scenarios on a daily basis compared to, say, a nurse working in the ICU.

“What brought me into it is that I like making people feel good. I think that’s what a lot of nurses want to do, but what’s nice about what I do is I’m never going to have to hold somebody’s hand as they’re dying. I don’t have a patient where I have to say, ‘We’ve done everything that we can do for you.’ You’re dealing with patients that are well, they’re not ill, they’re not sick. And it’s really just to make them look good and feel good about themselves.”

It may not sound like much, Suess said, but it can be incredibly gratifying to help people feel more confident about themselves. “That’s just more of where my heart lies, helping people build their self-esteem.”

“It may not sound like much,” Suess said, “but it can be incredibly gratifying to help people feel more confident about themselves.”

The fact that most procedures are elected by the patient is another quality that separates aesthetic nursing from most other specialties.

“If you’re a cardiac nurse and someone needs a triple bypass done, you just do it. Whereas in aesthetic nursing, it’s still medicine and you are making a professional treatment recommendation, you are essentially diagnosing and prescribing. However, the prescription is 100% optional.” As a result, these procedures are usually out-of-pocket and therefore incite conversations about costs, which may make some nurses uncomfortable. In other specialties, Suess said, you don’t tend to have those dollar and cents conversations.

Salary and job growth

The U.S. Bureau of Labor Statistics (BLS) does not compile salary data on specific nurse specialties. They do report, however, that the median annual salary for registered nurses is $81,220 according to their 2022 Occupational Employment Statistics.

Registered Nurses

National data

Median Salary: $81,220

Projected job growth: 5.6%

10th Percentile: $61,250

25th Percentile: $66,680

75th Percentile: $101,100

90th Percentile: $129,400

Projected job growth: 5.6%

State data

State Median Salary Bottom 10% Top 10%
Alabama $63,090 $48,820 $82,760
Alaska $102,260 $80,950 $127,280
Arizona $82,330 $66,040 $105,520
Arkansas $64,130 $37,630 $83,700
California $132,660 $84,700 $177,670
Colorado $82,430 $66,130 $107,260
Connecticut $95,210 $71,050 $119,600
Delaware $82,230 $64,100 $101,110
District of Columbia $98,970 $66,260 $135,260
Florida $77,710 $61,190 $100,060
Georgia $79,440 $60,400 $118,270
Hawaii $120,100 $76,640 $137,710
Idaho $77,940 $61,530 $100,440
Illinois $78,980 $62,180 $102,080
Indiana $73,290 $55,200 $95,600
Iowa $65,000 $56,330 $83,360
Kansas $66,460 $52,010 $93,120
Kentucky $75,800 $56,120 $98,540
Louisiana $73,180 $57,500 $95,540
Maine $77,340 $61,170 $100,910
Maryland $83,850 $64,680 $106,910
Massachusetts $98,520 $67,480 $154,160
Michigan $79,180 $64,270 $100,920
Minnesota $84,060 $65,500 $107,960
Mississippi $63,330 $49,980 $84,030
Missouri $71,460 $51,440 $94,340
Montana $76,550 $62,930 $98,970
Nebraska $74,990 $58,900 $93,230
Nevada $94,930 $74,200 $130,200
New Hampshire $80,550 $62,790 $104,270
New Jersey $98,090 $76,650 $118,150
New Mexico $81,990 $64,510 $106,300
New York $100,370 $64,840 $132,950
North Carolina $76,430 $59,580 $100,430
North Dakota $69,640 $60,780 $91,150
Ohio $76,810 $61,860 $98,380
Oklahoma $74,520 $53,560 $97,520
Oregon $106,680 $81,470 $131,210
Pennsylvania $78,740 $61,450 $101,450
Rhode Island $85,960 $65,260 $104,790
South Carolina $75,610 $52,620 $93,190
South Dakota $62,920 $51,240 $80,860
Tennessee $65,800 $51,270 $95,490
Texas $79,830 $61,950 $105,270
Utah $77,240 $61,850 $98,000
Vermont $77,230 $60,900 $101,570
Virginia $79,700 $61,970 $104,410
Washington $101,230 $77,460 $131,230
West Virginia $74,160 $47,640 $96,470
Wisconsin $79,750 $65,110 $100,820
Wyoming $77,730 $60,910 $102,010

Source: U.S. Bureau of Labor Statistics (BLS) 2022 median salary; projected job growth through 2032. Actual salaries vary depending on location, level of education, years of experience, work environment, and other factors. Salaries may differ even more for those who are self-employed or work part time.

The BLS also estimates that the employment of RNs will grow 5.6% through 2032, about as fast as average across all occupations. That being said, demand for nurses tends to be consistently high given a national nursing shortage that is expected to continue for the foreseeable future, according to the American Hospital Association.

According to Suess, aesthetic nursing is booming right now. “It is just such a small percentage of people that show an interest [in aesthetic nursing] versus who treats. I think it is something that is really growing and we’re going to get to a point where we don’t have enough providers.” Part of aesthetic nursing’s growth could be attributed to the fact that it’s become encompassed within wellness trends as of late.

Professional resources

Aesthetic nurses that want to learn more about the field can check out some of the following resources:

International Society of Plastic and Aesthetic Nurses (ISPAN) is a membership organization for plastic surgery and aesthetic nurses. They hold an annual conference for nurses and other healthcare professionals within the field. “Anybody who’s looking to get into this industry or is currently doing this, they really should be a member of ISPAN,” Suess said.

American Association of Aesthetic Medicine & Surgery (AAAMS) is another membership organization committed to advancing the field of aesthetic medicine and surgery. They offer numerous continuing education courses about aesthetic medicine.

Plastic Surgical Nursing Certification Board (PSNCB) is responsible for administering professional certifications for plastic surgery and aesthetic/cosmetic nurses. 

American Nursing Association (ANA) is a national organization for nurses with chapters in every state. Members get access to numerous exclusive benefits.

“The biggest thing is that you’re constantly learning and you’re constantly educating yourself.”

Suess said that aesthetic nursing is still a relatively young niche in medicine, which means there’s still a lot of room for new discoveries and industry leaders to emerge. ISPAN’s annual conference is one such platform that nurses can present their findings and perhaps even inform how the field develops.

Published: July 20, 2023

kendall upton

Written and reported by:

Kendall Upton

Staff Writer

With professional insight from:

Rebecca Suess, RN, BSN, CPSN, CANS

Member of the ISPAN Board of Directors