State Regulatory Issues

State Legislative Alerts - Go to NCEA Archives

Political Representation

 

When the NCEA is alerted of an regulatory issue or concern by member or a state licensing board, the NCEA proactively works with the state or concerned parties to a positive resolution for the industry to protect your right to practice.

 

For example, use of the term “Chemical Peeling” has caused concern within medical boards and the medical community, that  Esthetician licensees are practicing medicine without proper training. NCEA had previously issued a National Standard that encourages estheticians to use the term “Chemical Exfoliation” as we do not affect living tissue.

 

Had the NCEA not become involved, the right to practice chemical exfoliation may have been removed from the estheticians’ scope of practice in several states.


Advocacy Position #1 – Esthetician Job Tasks/Hours

It is NCEA's position that an esthetician upon completion of a 600 hour program should be able to perform and/or know the following job tasks: 

1. Disinfection and Infection Control
2. Human Physiology and Anatomy
3. Skin Histology
4. Skin Diseases and Disorders
5. Hair and its Growth Cycle
6. Basic Chemistry
7. Cosmetic Ingredients
8. Factors that Affect the Skin
9. Skin Analysis and Procedures related to Consultation, Documentation, and Treatment
10.    Cleansing Procedures
11.    Towel Steaming Procedures
12.    Exfoliation Methods
13.    Safe and Proper Methods o f Extractions
14.    Massage Movements and their Effects
15.    Contraindications for Massage
16.    Masks
17.    Electricity and Use of Electrical Equipment
18.    Methods of Hair Removal
19.    Color Theory and Makeup Application
20.    Advanced Sciences
21.    Scope of Practice/Regulatory Rules

 

And, upon completion of 1200 hour program (in addition to the above) the esthetician should be able to perform and/or know: 

1. Skin Sciences                   
     A. Skin Histology
•    Wound Healing
•    Wounding the Skin (Chemical Peels, Dermabrasion)
•    Phases/Stages of Wound Healing
•    Scar Reduction (Silicone Patch)
•    Contraindications
     B. Anatomy & Physiology
     C. Dermatological Disorders and Terminology
     D. Health and Lifestyle
     E. Skin Conditions
     F. Classification Systems (Fitzpatrick, Glougau)
•    Treatment
     G. Ingredient Technology
2. Professional Skin Treatments for Face and Body
     A. Exfoliation

•    Microdermabrasion
•    Blading
•    Chemical Exfoliation
     B. Laser Light
     C. LED
     D. Ultrasound
     E. Ultrasonic
     F. Microcurrent
     G. Body Treatment
     H. Cellulite Treatment
•    Non-Invasive Form of Cellulite Treatments, Mechanical Cellulite Machines
     I. Manual and Mechanical Lymphatic Drainage
     J. Electrical Muscle Stimulation
     K. Water Treatments

3. Hair Removal or Permanent Hair Reduction*
     A. Laser Light Therapy

4. Medical Professional Interaction
     A. Pre and Post Op Care, Modalities to Enhance Outcome
     B. Medically Treated Conditions
     C. Prescription Drugs/Over-the-Counter (OTCs)
     D. Medical Terminology
     E. Definitions of professionals and associations (trade shows and trade publications)
     F. Additional Safety Considerations for Advanced Modalities
     G. Cosmetic Procedures
•    Surgical Procedures
•    Non Surgical Procedures
    Fillers and Nerve Blockers, legal use, differences

5. Business Management and Operations
     A. Sales and Marketing
•    Marketing
•    Retailing
•    Industry Relations
•    Franchising
•    Business
•    Menu Development

B. Operations
•    Business Software
•    Record-keeping
•    Policies and Procedures Manual
•    Facility Layout
•    Equipment Purchasing (Leasing), Classification and Where to Learn
•    Product Purchasing
•    Research and Resourcing
•    Human Resources

C. Compliance and Safety
•    State Regulations/Scope of Practice•    OSHA
            BloodBorne Pathogen Act
            Hazard Communications Standard
•    HIPPA
•    CDC
•    FDA
•    Protective Care, Client Consult and Consent

•    Liability
•    Insurance
•    Emergency Response/Action Plan
•    Risk Management
•    Emergency First Responder/First Aid
•    CPR/AED
  6. Other Advanced Modalities*

* Basic Theoretical Knowledge

Rationale:
It is our position that all states should raise their esthetician licensing requirements to meet NCEA’s Esthetician Job Tasks for a total of 1200 hours. Standardizing national educational requirements for esthetician licensees ensures that an esthetician trained in Idaho, is receiving the same education as an esthetician being trained in California.  Thereby, increasing the esthetician’s employability; further demonstrating standardized knowledge and comprehension of what industry is requiring of estheticians entering the work force.

Action:
We ask that your state utilize these industry-driven esthetician job tasks so that graduating estheticians entering the workforce can meet the demands of today’s employers by having obtained the highest equally accessible education.

Advocacy Position #2 – Tiered Licensing

NCEA does not support two-tiered esthetician licensing. Rather, the intent was to raise the educational standards to 1200 hours to meet industry-driven job tasks. A tiered system may make sense legislatively, however, consumer protection is compromised. A consumer now just understands the use of the licensing term “Esthetician.”  A consumer most definitely does NOT know to ask the esthetician if they have a basic or advanced esthetician license prior to consenting to a procedure.

Prospective esthetician students entering the workforce want to be productive, employable, and able to competently perform all tasks required of them. Earning the complete 1200 hours of training can also lead to higher pay, increased self-confidence and demonstrates professionalism.

Rationale:
In Utah–a two-tiered state, the Utah School Association stated that over 90% of prospective students are opting to attend esthetician school for the full 1200-hour program and NOT just complete the 600-hour program.

Action:
Therefore, we urge you to include a 3-year Sunrise Review and/or a systematic review of the necessity of a 2-tier license.  NCEA wants to ensure that the purpose of the statute/regulation is to protect the health, safety, of the consumer and is also meeting skill sets needed to expand the licensee’s opportunities for advancement.

Advocacy Position #3 - Endorsement of the NCEA Certified Professional Credential

Action:
If an applicant is applying for Advanced Esthetician licensure by reciprocity or endorsement in your state,
"...a licensed esthetician who has attained the NCEA Certified credential shall be recognized."
 
 
Rationale:
NCEA Certified is the professional status awarded to a skin care professional that has met the competency standards as set-forth by NCEA's 1200 Hour Esthetician Job Task Analysis. It represents the highest skin care credential available in the United States and adherence to the code of ethics of the profession. NCEA Certified professionals must re-certify in three years and obtain 12 units of COA-Approved Continuing Education, maintain liability insurance, First Aid/CPR/AED certifications and be a NCEA member in good standing.

Advocacy Position #4 - Separation of Skin Care from the Cosmetology Scope of Practice 

It is NCEA's position that skin care should be independent from the cosmetology scope of practice and license.
 
Rationale:
Due to the advances in technique, product and equipment, the NCEA recognizes the importance of protecting consumers and estheticians. Skin Care Curriculum requirements should be adopted from the NCEA's 600 and 1200 Esthetician Job Task Analysis. The current cosmetology license that allows licensees to practice skin care includes a maximum of 250 hours of actual skin care training and in some states, as low as 40 hours.
Currently there are over 25 states that are still allowing cosmetologists to perform all skin care services regardless of training/curriculum that lead to licensure.
 
Action:
Remove skin care services from the cosmetology license to ensure consumer protection and safety.

Advocacy Position #5 - Continuing Education and the Commission on Accreditation 

It is the position of the NCEA that:  

It is NCEA’s position that all states that regulate esthetician licensees should mandate a minimum of 12 hours of Continuing Education credits (CEUs)–before an esthetician can renew their license.  

 Action
Promulgate rules or regulations that require a minimum of 12 continuing education units of COA or other agency-approved skin care education. In addition, recognize the NCEA Commission on Accreditation (COA) as a resource to facilitate and supervise compliance of continuing education activities for your licensees.

Rationale
The NCEA position above was voted and passed prior to the launching of the NCEA Certification program. In May of 2007 when the certification program became a reality, it was mandated that 12 continuing education units would be part of the recertification process. In the 5-year NCEA Certification plan, the Commission on Accreditation would be created to assist the recertifying of candidates as well as assist state boards with the process as well prior to relicensure.