A follow-up to "Start Here: Resources for Nurse Practitioners in Aesthetic and Dermatology Practice"

Disclosure: This post contains affiliate links. If you click through and make a purchase, I may earn a small commission at no additional cost to you. I only recommend resources I genuinely believe will help you build a successful practice.

The Pattern No One Talks About

Here's what I see over and over again: An NP decides to pursue cosmetics. They invest in training, sometimes thousands of dollars (averaging $100,000 per year). They start injecting. And then... silence.

Not because they've failed. But because they're struggling. Alone.

They don't know who to ask. They're not sure if what they're experiencing is normal. They second-guess every clinical decision. They feel stuck between what they learned in training and what they're seeing in practice. They're watching others on social media who seem to have it all figured out, and they're wondering what they're doing wrong.

This is one of the most common, and most damaging patterns in our profession.

Practicing in silos. Suffering in silence.

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It's not a personal failing. It's a systemic one. Nursing culture has long normalized isolation. We're trained to be strong, self-sufficient, and resilient. We're rarely taught how to ask for help, or even that it's acceptable to need it. And when we move into aesthetics, a field with no standardized pathway and no built-in peer structure, that isolation intensifies.

You're not just learning a new specialty. You're building a business, navigating legalities, managing patient expectations, and trying to establish credibility, often without a single colleague who understands what you're facing.

If this sounds familiar, I want you to know: you are not alone. And more importantly, you don't have to stay in that place.

The Myth That Cosmetics Will Cure Your Burnout

Let's address something directly: Aesthetics is not a solution to burnout.

I've spoken with multiple NPs who entered cosmetics hoping to escape the exhaustion, the patient loads, the systemic dysfunction of their previous roles. They imagined shorter hours, better pay, more autonomy, and less stress.

And some of those things can be true, eventually. But not automatically. And not without a foundation.

What often happens instead is this: the burnout follows them. Because burnout isn't just about the specialty. It's about how you practiced within it. It's about boundaries, systems, self-knowledge, and support. If you didn't have those structures in your previous role, you won't magically develop them in aesthetics. You'll just bring the same patterns into a new environment, and now you're also learning new skills, managing new risks, and possibly running a business on top of it.

Cosmetics is a demanding specialty. The stakes are high. The learning curve is steep. The market is competitive. And if you enter it burned out, under-resourced, or underprepared, you will struggle.

This isn't meant to discourage you. It's meant to prepare you.

Before you invest your time and money, invest in yourself. Rest. Reflect. Build the habits and systems that will sustain you, not just in cosmetics, but in any path you choose.

Know Your History Before You Invest

Here's a truth that will save you thousands of dollars and years of frustration: You need to understand where you're coming from before you can decide where you're going.

That means knowing your history, not just as a clinician, but as a nurse.

The nursing profession was not built with cosmetics in mind. It wasn't built with entrepreneurship in mind. And for much of its history, it wasn't built with diversity in mind either.

When you enter aesthetics, you're stepping into a field that sits at the intersection of dermatology, business, marketing, regulation, and patient psychology. None of those areas are covered comprehensively in any nursing program. Most NP programs don't even teach basic business principles, let alone how to price services, negotiate contracts, or build a brand.

This is why I wrote The State of Nursing Education: Pathways, Purpose, and the Future of Cosmetic & Dermatology Practice 2025. It's the first white paper of its kind that examines the full landscape of nursing education, from ADN to PhD, and identifies exactly where the gaps exist for nurses entering dermatology and aesthetics. It covers the lack of standardized training, the absence of skin of color in most curricula, and the structural barriers that keep nurse practitioners underprepared for specialty and entrepreneurial practice.

If you haven't read it yet, start there. Before you pay for another course. Before you sign up for another training. Before you launch anything.

You need to understand the system you came through, its strengths and its failures, so you can build intelligently on top of it.

Exposure Is Everything

One of the best decisions you can make before committing to cosmetics is to get exposed to as many specialties, settings, and industries as possible.

I know that sounds counterintuitive. You've already decided you want aesthetics, why would you spend time in other areas?

Here's why: Exposure gives you perspective. It shows you what you like and what you don't. It teaches you how different systems work, how different providers communicate, how different businesses operate, and how different patient populations behave. It helps you see patterns you wouldn't otherwise notice. And most importantly, it gives you a foundation of experience that will differentiate you in a crowded market.

The NPs who thrive in aesthetics are not the ones who jumped in fastest. They're the ones who came in with breadth. They worked in primary care and learned how to manage complex patients. They worked in urgent care and learned how to think on their feet. They worked in oncology and learned how to have hard conversations. They worked in wound care and learned how skin heals. They worked in corporate settings and learned how to navigate systems.

All of that experience, every rotation, every job, every challenge, becomes part of your clinical lens. It informs how you assess, how you communicate, how you problem-solve, and how you lead.and

And it doesn't stop at clinical exposure. Get exposure to business. Shadow entrepreneurs. Read about marketing, finance, operations. Talk to people in industries outside of healthcare, tech, hospitality, retail, and see how they think about customer experience, branding, and scale.

Because if you want to build something in this industry, you're not just a clinician. You're a founder. And founders solve problems at every level, not just at the treatment chair.

Make an Informed Decision

Cosmetics may be exactly where you're meant to be. Or it may not. The goal isn't to talk you out of it, it's to make sure you're walking in with clarity.

Ask yourself:

• Have I addressed my burnout, or am I hoping a new specialty will fix it?

• Do I understand the gaps in my nursing education and how I'll fill them?

• Have I been exposed to enough clinical settings and industries to know this is the right fit?

• Do I have a support system, peers, mentors, community, or am I trying to figure this out alone?

• Am I entering cosmetics because I want to build something, or because I'm running from something?

These are hard questions. But they're worth answering before you invest.

The Reality of Aesthetic and Dermatology Education

Traditional nursing programs do not include cosmetic or aesthetic training. It's not part of pre-licensure curricula, and it's not embedded into standardized advanced practice competencies. A few schools have begun experimenting with optional add-on offerings, like Boston College's partnership with LexRx, but these are obtained after licensure and certification. They're a "nice to have," not a "need to have," and their quality varies widely.

This means there is no standardized educational pathway for nurses entering aesthetics or dermatology. Every injector's foundation depends entirely on where they trained, who taught them, and what opportunities they happened to access. The system wasn't built for cosmetic practice, which means the burden of competency falls directly on the individual nurse, not the curriculum.

And that brings us to the deeper truth: Your degree opens the door, but your self-discipline determines your expertise.

No matter the school you attended, how expensive your training was, or how experienced your mentor might be, none of those factors can replace the day-to-day discipline required to master dermatology, aesthetics, and entrepreneurship. Nursing education offers the fundamentals, science, safety, ethics, and clinical judgment, but it cannot (and was never designed to) teach you everything you need as an injector, trainer, or business owner. Specialty finesse, pattern recognition in dermatology, advanced anatomy, complication management, and business acumen all come from disciplined self-study and ongoing continuing education.

Mentorship helps, but a mentor cannot be your entire curriculum. Even the best preceptor cannot guarantee complete dermatology depth, comprehensive injectable training, or the business systems required to run a sustainable practice. A mentor is a supplement. Your discipline is the curriculum.

In aesthetics and dermatology, your competence is shaped by your habits: reading new studies, reviewing complication cases, practicing under supervision, evaluating your outcomes, investing in quality courses, and seeking knowledge long after graduation. This field evolves too quickly, and the stakes are too high, to depend on any single person or program to teach you everything.

Whether you are the injector, the educator, or the business owner, discipline is the equalizer. It's what turns safe injectors into great ones, and great injectors into clinical leaders and entrepreneurs. The most successful NPs in aesthetics are not those who had the "best" school or the "right" mentor, they are the ones who made learning a lifelong responsibility.

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Why These Books Matter

Most of the experienced cosmetic NPs I've consulted with who went directly into cosmetics reported the same thing: they wished they had learned medical dermatology before they started.

I agree. Having a medical dermatology foundation is as important as having an internal medicine foundation. There are between 3,000 to 4,000 diagnoses in dermatology; physician's residency is 3 years. You likely will never see all those dermatoses, but knowing the most common ones is a realistic goal. The timeframe in which you will learn them depends on how much time you have to devote to learning and what you decide to focus on in your practice. Dermatology fellowship and training programs for NPs vary from self-paced to as long as 2 years.

The books below were written by MDs, NPs, and PAs with over 20 years of experience. They represent the resources I recommend to Founding Members of the Alliance of Cosmetic Nurse Practitioners, like Dr. Jasmine Waller Landrum, DNP, Founder of Phoenix Aesthetics + Wellness in Richmond, Virginia, who are serious about building a practice grounded in evidence-based care, clinical excellence, and skin of color expertise. In fact, Jasmine is counting down to her opening at the time this article is being published (Nov 2025)!

To avoid getting overwhelmed, I recommend starting with treating mild to moderate cases and referring out for complex cases until your clinical skills and confidence grow. I've reviewed businesses on my YouTube channel (Kimberly Madison DNP) that have achieved great success by focusing their business model on 1-2 problems or desires, see Peachy (Botox and prevention), LexRx (injectables), and Peach and Lily (creating a destination), which makes marketing easier and reduces your sense of overwhelm. It also speeds up the time you can master your cosmetic niche.

Simply put, you don't have to start doing everything. Let your business grow with you, prove that you can master one thing, and build trust as well as your visibility in your community.

The Reading List

Start Here: The State of Nursing Education White Paper The State of Nursing Education: Pathways, Purpose, and the Future of Cosmetic & Dermatology Practice 2025

Before you dive into clinical texts, understand where you're coming from. The foundation of our practice is nursing,nand this white paper examines the current landscape of nursing education across ADN, BSN, MSN, DNP, and PhD pathways, specifically highlighting the widening knowledge gap in cosmetic and dermatology nursing. It breaks down how each pathway prepares (or fails to prepare) nurses for dermatology and aesthetics, the lack of standardized education and clinical training, and the historical exclusion of skin of color in dermatology curricula. It also outlines a new framework for dermatology nursing education centered on equity, evidence-based practice, and entrepreneurial pathways.

Download from the Mahogany Dermatology Nursing Bookstore >>> HERE <<<

1. Dermatology for Advanced Practice Clinicians: A Comprehensive Guide to Diagnosis and Treatment (2nd ed.) Bobonich, M. A., Nolen, M. E., Honaker, J., & DiRuggiero, D. (2021). Wolters Kluwer Health.

This is your medical dermatology foundation. Written specifically for NPs and PAs, it covers diagnosis and treatment across the breadth of dermatology. Before you inject, you need to know skin. This book helps you build that base.

Purchase here.

2. Taylor and Kelly's Dermatology for Skin of Color (2nd ed.) Taylor, S. C., Kelly, A. P., Lim, H. W., & Serrano, A. M. A. (2016). McGraw-Hill Medical.

This is the gold standard reference for dermatology in skin of color. If you want to understand how conditions present differently across skin tones, and why that matters for diagnosis, treatment, and outcomes, this is the definitive text. It fills a critical gap left by traditional dermatology training.

Purchase here.

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3. Aesthetic Procedures: Nurse Practitioner's Guide to Cosmetic Dermatology (2nd ed.) Haney, B. (2024). Springer Nature.

Written by an NP for NPs, this guide walks you through the clinical and practical aspects of aesthetic procedures. It's one of the few resources that speaks directly to our scope and our practice realities.

Purchase here.

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4. Procedures in Cosmetic Dermatology: Cosmetic Procedures in Skin of Color Alexis, A. F., Dover, J. S., & Alam, M. (2024). Elsevier.

This is the procedural guide for treating patients with skin of color. It addresses the specific considerations, complications, and techniques required when working with diverse skin types, information that's often missing from standard cosmetic training. If you're serious about serving diverse patient populations, this book belongs on your shelf.

Purchase here.

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5. Nursing Aesthetics: An Introductory Guide for Nurse Practitioners & Entrepreneurs Madison, K. (2024).

I wrote this book because I couldn't find a resource that addressed the intersection of clinical education, skin of color care, business acumen, and entrepreneurship for nurse practitioners entering aesthetics. The existing books are excellent for clinical procedures and medical dermatology, but none of them teach you how to build an NP-led practice, price your services, market to your ideal patient, or think like a founder.

This book fills that gap. It's for the NP who wants to understand not just how to treat, but how to build something of their own.

We can do both: improve patient outcomes and build businesses that solve problems.

Available in paperback or ebook on Amazon, Barnes & Noble, or wherever books are sold.

Purchase here.

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Where to Start

If you're feeling overwhelmed, here's my recommendation:

Begin with The State of Nursing Education white paper to understand the landscape and gaps in our educational system, because the foundation of our practice is nursing. Then move to Dermatology for Advanced Practice Clinicians to build your medical dermatology foundation. Follow that with Taylor and Kelly's Dermatology for Skin of Color to deepen your understanding of how conditions present across diverse skin tones. Add Aesthetic Procedures: Nurse Practitioner's Guide for procedural training, and Cosmetic Procedures in Skin of Color for comprehensive education.

And when you're ready to think like a business owner, not just a clinician, pick up Nursing Aesthetics: An Introductory Guide for Nurse Practitioners and Entrepreneurs - written for employers and employees. Take advantage of our BLACK FRIDAY DISCOUNT HERE.

Having a good resource handy and a plan in place for contacting your medical director will position you to deliver the safest care. As you know, there is a lot to learn about business as well, which is why we've been hosting both business and dermatology workshops each week in the Alliance. The business workshops are as important as the clinical ones once you start investing money in your practice and are spending more than you're bringing in. Members receive Standard Operating Procedures and Staff Training Guides per workshop.

Realistically, you can only sustain that for so long. We're trying to help you avoid going into debt and having to close your business in the first 2-3 years, which is why our major focus is helping you learn the art of sales. Something you'll get better at over time, just like our nursing practice.

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You Don't Have to Do This Alone

The most successful NPs in aesthetics are not the ones with the best training or the most followers. They're the ones who stopped suffering in silence.

They found community. They asked questions. They admitted what they didn't know. They built relationships with peers who understood the challenges and could help them navigate.

That's what we're building in the Alliance of Cosmetic Nurse Practitioners™. Not just a resource library, but a space where you can be honest, get real answers, and grow alongside people who are on the same path.

If you're ready to stop practicing in isolation, your seat is waiting.

Continue Your Learning

For Alliance Members: Check out the ACNP Podcast, where we've started learning about the biology and foundations of ethnic hair (member-exclusive content). And if you're working through Alliance resources, start with the oldest workshops first and work your way to the newest ones.

Ready to join a community of NPs building legally sound, ethically grounded, and financially fulfilling practices while identifying new revenue streams so they can make more money without seeing more patients? Learn more about the Alliance of Cosmetic Nurse Practitioners™.

This article is a follow-up to "Start Here: Resources for Nurse Practitioners in Aesthetic and Dermatology Practice."

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About the Author

Dr. Kimberly Madison, DNP, AGPCNP-BC, WCC, is a Board-Certified, Doctorally-prepared Nurse Practitioner, educator, and author dedicated to advancing dermatology nursing education and research with an emphasis on skin of color. As the founder of Mahogany Dermatology Nursing | Education | Research™ and the Alliance of Cosmetic Nurse Practitioners™, she expands access to dermatology research, business acumen, and innovation while also leading professional groups and mentoring clinicians. Through her engaging and informative social media content and peer-reviewed research, Dr. Madison empowers nurses and healthcare professionals to excel in dermatology and improve patient care.

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