Every aesthetician should be trained in the classic European facial. This facial consists of a cleanser, exfoliator, toner, extractions (if applicable), massage, mask, serum, eye cream, and moisturizer. Clients would receive this treatment because not only was the skin being taken care of, but the hands-on experience of the aesthetician performing the massage on the face was calming and soothing. It was the full package of skin therapy as well as the nurturing touch that kept the client returning for more facials.
Now, people consistently seem to be in a rush. Time is often being pressed by clients and pushing aestheticians into performing more clinical skin therapy instead of a more luxurious experience. Why would a client receive treatments in a six-month duration when that duration could be lessened by five months? Clients are willing to pay costs that give them quicker results.

AT-HOME TECHNOLOGY
Not too long ago, only the aestheticians had the tools to treat their clients’ skin and those tools were limited. That is no longer the case and because of the advancement of technology in the beauty and health industry, aestheticians are not as limited and clients have more access to treat themselves between treatments and maintain their professional results with at-home care. The development of lasers and other devices allows aestheticians to perform treatments that deliver great results and clients are proving to maintain those results at home with the consumer tools available to them.
At-home devices are becoming more and more available for clients to purchase. The manufacturing of these devices vary. Some at-home devices are of great quality while others can be considered subpar. The rotary brush, electrode, and galvanic implements are primitive in today's time. Years ago, clients did not have these kinds of tools in their homes while aestheticians had them dangling from their utility cart and ready to use on their client’s skin. Incorporating any one of these mentioned tools on the skin during a facial was a ‘wow’ factor to the client. Now, clients can ‘wow’ their skin every day because of technology's progression. Ambitious manufacturers have enabled a market of at-home devices.

The Rotary Brush
The rotary brush, once used by aestheticians to assist in the exfoliation process of the European facial, is a household device for the most skin-savvy consumers today. The traditional rotary brush had different speeds that could rotate and the bristles only rotated in one direction. The current consumer versions, such as the Clarisonic, are more advanced than the traditional rotary brush as there are different speeds for the rotation and different rotations of the bristles. The rotations are oscillating, meaning that they change rotation. The bristles on current models can move in one rotation and then change to move in another direction. This oscillation allows for greater exfoliation on the skin. The rotary brush that once dangled from the aesthetician’s utility cart is becoming obsolete because of the various consumer brands mimicking professional services.

The Opal
Clarisonic also made a device called the Opal, which is used for the eye. Aestheticians did not have a device they could use on the eye until the Opal. The eye is a very sensitive area to treat. It is the first area on the face that will age with fine lines and is also the most delicate part of skin on the face. Until the Opal was developed, the only kinds of treatments that aestheticians were able to use for the eye were eye pads. The Opal is able to push the infused serum deeper into the orbital bone region of the eye. This helps minimize fine lines around the eyes and is a great eye treatment upgrade in a facial.

Electrotherapy
Another device available to purchase for at-home use is the NuFace device, which has taken the place of galvanic implements. Galvanic implements are used to emit an electrical, galvanic current on the skin. This galvanic current contracts the muscles under the skin, creating a tightening and firming effect of the skin. The consumer versions are microcurrent, delivering the same effect. A gel is applied on the skin to help with the microcurrent process as the two-bulb, metal tool glides along the skin, stopping to hold points on certain placements of the face. There is an instant lifting effect on the skin that can immediately be felt and noticed following treatment. Many aestheticians have bought these at-home devices to use in their treatment room.
Galvanic tools that aestheticians had used to tighten and firm the face have been trumped by other consumer versions. A two-pronged microcurrent attachment for the eyes and a red-light attachment for the buildup of collagen on the skin and ridding inflammation on the skin have also been developed. The lymphatic massage and other massage techniques used to assist in providing therapy for the skin can be substituted with the NuFace.
There are at-home hair removal lasers that clients can purchase for their own use. Granted, some of these at-home treatment tools do not have the high nano measurement that professional lasers emit, but their frequency is enough to deliver a result. The consumer perceives that an aesthetician performing European facial is not needed as much because the exfoliation can be performed at home. An upgraded eye treatment can be done at home, as well as the firming of the underlying tissues of the skin. Clients are trying to save costs when purchasing at-home devices because they are able to treat their skin similarly to the aesthetician during European facial. These devices, once only available to an aesthetician, have gone mainstream to the masses and taken away the skilled work of a professional aesthetician.

MEDICAL SPAS
Due to the beauty industry's technological advancements, aestheticians have been forced to turn to medical spas. At a medical spa, an aesthetician is able to perform clinical facials. Clinical facials take away the feel-good sensations that come with European facial. The main focus of a clinical facial is to target the client's needs. A thorough analysis is performed on the skin and the concerns of the client are taken into complete consideration as the right treatment is chosen.
Medical spas are able to equip aestheticians with higher-grade percent solutions in products for facials. For example, European facial could have a mild chemical exfoliation of 11 percent glycolic acid used, whereas a clinical facial could use 30 percent or higher glycolic acid. The percentage of acids that an aesthetician can use on the skin increases at a medical spa, enabling more achievable results for the client. A majority of the cleansers, masks, and other products are clinically-based and can deliver effective results.
Although results are sometimes more effective, the downtime to healing on the skin after the treatment can take anywhere from a few days to a week. Some people do not like the downtime factor and will stay with the
European facial while others do not mind it. When working with the skin, there has to be entropy; it has to become disordered in order to gain results. The harsher the disorder on the skin, the more order the skin creates in reaction to bringing the skin back to its normalcy. Medical spas can often provide the reassurance needed to their clients that their beauty is intact.

Botox and Fillers
One way in which medical spas reassure their clients is with Botox and fillers. Botox helps to temporarily block neurons that send messages to the muscles to move. Fillers like Juvaderm or Restylane help plump up certain areas in the skin. Deep wrinkles or shallow skin can regain a smooth and fuller look with these fillers. It has become normal to incorporate a Botox treatment and/or filler treatment at a medical spa by a professional, such as a doctor or a registered nurse. Aestheticians are not allowed to perform this treatment unless they have been grandfathered in by the state in which they are licensed. Botox usually lasts up to three months and fillers can last anywhere from six to 10 months, depending on the metabolic rate in which the body breaks it down.
Botox and fillers are a great income resource to a medical spa because the body does eventually degrade the substances, causing the neurons to start sending messages to the muscles to contract and flush the fillers out of the system. The client will need to return to receive more injectables at a high cost. They become repeat clientele because they want to maintain the youthful appearance with no fine lines or sunken, sallow skin. This injectables-addicted clientele will often like their results and inquire about other services that can be provided to sustain their perceived fountain of youth.

Medical Equipment
Although aestheticians are unable to inject Botox and fillers, they are able to use different types of lasers and other equipment that will complement their clients’ treatments. Because chemical peels are medical-grade, aestheticians can choose to use lasers that test the limits of the skin. IPL rejuvenation and Fraxel laser treatments help penetrate into the layers of the skin, causing a resurfacing effect. These lasers help stimulate collagen and decrease fine lines and scarring. Depending on the frequency of the laser, these treatments can be done more than once. The price of IPL is usually cheaper than Fraxel because more treatments are needed with IPL. Fraxel laser treatments have a stronger emittance to the skin, which comes with a longer downtime period; it usually only needs to be done once to achieve the desired results.
Laser resurfacing treatments on the face have long-lasting results, unlike European facial where it takes time to achieve small results that need to be maintained by follow-up facials. Aestheticians who once thrived by only performing European facial might feel a struggle to keep clientele. Clients want to see immediate results. Because the advancement of facials and progression of technology has allowed clients to achieve quicker and longer-lasting results, the gratification time table is continuing to digress into shorter durations. The skill of the aesthetician is no longer the only driving force in the beauty industry; the science and education that the aesthetician has acquired to treat the skin is now equally as important.

Aestheticians have evolved and are still evolving to continuously keep up with the high demands of their clients. The once-loved and relaxing European facial is descending into the past. Clinical facials are transcending into an appetizer for clients. Facials give skin the right amount of satiation between laser treatments. Botox and fillers are often a' la carte and give clients leeway to choose from the appetizer's list of clinical facials or the main course, a laser resurfacing treatment. With the advancement of facials, only time will tell if aestheticians will be able to survive or if too much advancement will be the death of the once highly-respected profession.

Amra Lear is a licensed massage therapist and aesthetician. She has been working in the spa industry for 16 years, working for two of the most prestigious spas in the world. Her clientele consists of the stars, moguls, and people alike. She has been trained by Japanese shiatsu masters and the founders who pioneered such wonderful modalities such as ashiatsu, mother massage, and lulur. Skin is her ultimate passionate. She has dedicated the last six years to research and education of biochemistry to better understand the biochemical response to products used on the skin.