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Sarah Higgins, DNP, APRN, WHNP-BC, is a board-certified nurse practitioner who has specialized in aesthetic dermatology for nearly a decade with an emphasis on expanding clinical practice and patient safety. She earned her bachelor’s degree in nursing from the University of Pittsburgh and her master’s degree from the University of Cincinnati, followed by a doctorate in nursing from Grand Canyon University. Sarah has served as an Expert Practice Consultant for Aesthetic Treatments for the California Board of Registered Nurses and is currently a member of the American Nurses Association (ANA) and the American Association of Nurse Practitioners (AANP).
Hello Sarah! Can you tell us a little about your background?
I grew up in the suburbs of Dayton, Ohio, and had a fairly traditional Midwestern upbringing. I loved sports and started running and joined the swim team in elementary school. I also played on the field hockey team in middle school and at the end of high school was added to the sports achievement wall after earning nine varsity letters. The social aspect of being on an athletic team was appealing to me, but I wasn’t set on a specific career path that involved that passion.
The medical field was in my blood as I have many relatives who are nurses and doctors, but when it came time to choose a college, I decided to go to business school at Ohio University. I ended up observing a friend’s mother in the emergency room of a local hospital and immediately decided to change my major in college to nursing. Ohio University didn’t have a nursing program, so I had to switch quickly: I’m sure my parents thought I was crazy making the switch right before graduation, but I ended up at the University of Pittsburgh to start an undergraduate nursing program in 2003!
What originally drew you to a career in aesthetics?
My nursing career began at Magee Women’s Hospital in Pittsburgh, PA in a high risk prenatal and postpartum unit. I was drawn to this area of nursing because I loved being able to build relationships with my patients who were ultimately healthy but ended up in the hospital with a pregnancy complication. After several years in Pittsburgh, I took a nursing appointment in Los Angeles in 2011, right around the time that aesthetic dermatology treatments were becoming more mainstream and less taboo. Having been in Los Angeles for several years (ground zero for esthetics) and learning more about esthetics career opportunities for nurses and nurse practitioners, I decided to make the leap from women’s health to esthetics. The fact that I could work with healthy patients and build a patient-provider relationship was really exciting for me.
What’s the best esthetics career advice you’ve received?
It’s okay to say no to a patient if you don’t believe a procedure is in their best interest, and it’s imperative to end the patient-provider relationship with patients who are unreasonable, unrealistic, or overly demanding.
Which demographic of aesthetic patients do you think is the most desirable? Has it always been this way? Is this a shift?
I believe the most desirable patient demographics have shifted from the over 50 age group to those in their early to mid 30s. These patients are just beginning to notice subtle aging changes and achieve great results with aesthetic treatments. This demographic is often established in their careers and has a great network of friends and colleagues in the same age group. Patients in their early 30s also have a unique experience with brand loyalty when it comes to where they spend their money, as they are the first generation to have such a wide array of technology and social media at their fingertips. So, there’s a lot of long-term potential for patients when we focus on and leverage that patient demographic in terms of loyalty as well as the need for aesthetic treatments over a long period of time.
Telehealth exploded during the pandemic. Is it here to stay?
Absolutely. Healthcare as a whole is seeing a huge shift towards telehealth, and if esthetics providers don’t get on board, they will be left behind in the next few years. We live in a time where with a few clicks we can have anything we want delivered to our doorstep in less than 24 hours. Any healthcare sector that can offer patients immediate answers through telehealth is sure to experience exponential growth in the next few years.
What is the biggest myth in the beauty industry?
The idea that only doctors can provide safe, high-quality aesthetic treatment. The unbiased data simply does not support this notion. I have listened to so many anecdotal podcasts and read countless unsubstantiated articles where doctors claim that only treatments performed by board certified plastic surgeons and dermatologists are safe. Meanwhile, in their own practices, treatments are administered by teams of allied health professionals, including RNs, NPs, and PAs. We can all agree that it is imperative that aesthetic procedures be performed by educated, highly qualified and competent health professionals and it is also time to recognize that the unwarranted exclusivity of degrees is undermining the integrity of the industry.
I need to push a little on that front. Why do you think some aesthetic physicians may be threatened by aesthetic allied health professionals?
It’s a myth that there aren’t enough aesthetic patients to go around, and what I think some doctors fail to recognize is the incredible benefit that allied health providers can bring to a business. Let’s summarize some simple numbers: If a doctor can see 20 patients a day and works with a nurse who can also see 20 patients a day, the number of patients coming into that office has already doubled, which of course improves finances, but more importantly, the appointment of this nurse casts a large net, potentially improving the practice’s diversity and patient demographics in the long run.
What can the beauty industry do to increase diversity and inclusion?
This seems like such a simple answer, but honestly, those in leadership positions need to be proactive about hiring. Clinicians and managers should be open to the inclusion of staff from different ethnic, religious and cultural backgrounds. I’ve walked into aesthetic offices (and non-aesthetic offices for that matter) where every employee looks the same. The future is diverse, and the sooner this fact is acknowledged, the better off we will all be.
Why do we see new aesthetic products fail to take off?
It seems to me that many new aesthetic procedures and products fall into the “fad” category. When a company launches a new treatment without proper market research, without evidence-based practice, and without the support of legitimate practices, well, by the time it hits the market, patients have already moved on to the next new trend.
Moving forward, what can we do to promote integrity, fairness, and transparency in aesthetics?
All healthcare professionals must make collaboration a top priority and stop petulantly neglecting other aesthetic providers. No one has ever accomplished anything by complaining, so clinicians who grumble about others’ academic degrees lose credibility, create confusion for patients, and undermine the field of esthetics. Working closely as a team and emphasizing collaboration is a time-honored tradition in healthcare that helps to enhance the integrity of the industry.
If you weren’t an esthetician, what would you do for a living?
I would be a stockbroker because I’m a geek and I love finance and numbers!
What’s the funniest mistake you’ve made in your aesthetic career?
Agreeing to treat boyfriend’s mother. Long after we broke up, she continued to visit me for her Botox cosmetic treatments and it was always an awkward situation when she came for her appointment!
Funny? That sounds awful! So what’s your favorite aesthetic treatment to get in person?
This is such a difficult question because each treatment provides such unique benefits. But I have to say, I love neuromodulators. If I had to give up everything else in the aesthetic space, neuromodulators are the only thing I would keep.
What advice do you have for someone outside the industry who wants to get into esthetics but doesn’t know where to start?
Work with a company that takes the time and resources to train their employees in depth on aesthetic procedures. If a nurse is working in a new part of the hospital, she will have mentors and resources to ensure competence in treating that particular group of patients. The same standard should be maintained in the aesthetic industry. You want to enter the field of aesthetics somewhere that has a longstanding reputation for proper training and providing safe procedures.
What changes would you like to see in the beauty industry?
The aesthetic industry is one area of medicine where I see healthcare providers badmouthing their colleagues on public social media platforms. One area in particular would be adverse reactions to filler treatments that go viral. Any competent aesthetic health care provider understands that filler treatments are associated with well-known risks, including vascular occlusion, just as any medical procedure is associated with certain risks of adverse events. In the comments on these posts, I can’t tell you how many times I’ve seen posts saying this won’t happen if you go to someone reputable, or it happens when nurses inject fillers. I find it unprofessional to comment on a social media post where you know nothing about the patient’s or provider’s background, especially knowing that an adverse event can happen to anyone who gets a filler. The important thing is to know how to manage the patient when these rare things happen, and often this information is not shared in viral social media posts.
What does your aesthetic legacy look like?
I hope my esthetic legacy is known for raising the bar for patient safety in esthetics. While serving as an expert practice consultant for the California Board of Registered Nurses, I saw too many adverse patient reactions and situations where nurses were putting their patients at risk and risking their professional licenses. I earned my Doctor of Nursing Practice degree by completing a study on the application of safe laser treatment to reduce side effects. My goal is to continue patient safety research and education and make it widely known and practiced in the aesthetic space.
As an expert in the aesthetic industry with a powerful position, people look to you as a leader. If you could inspire a movement in our industry, what would it be?
It would be to focus on becoming an expert in the basics before moving on to advanced practice techniques. I think it’s a common theme in our industry that trends emerge driven by social media, and it’s easy to lose sight of the fact that the aesthetic procedures that have been around the longest still provide some of the most effective and life changing results. It’s easy to get distracted by shiny new things, but we can’t lose sight of the value of well-designed and researched aesthetic procedures.
Name three individuals who represent the future of our industry and maybe they will be the subject of future interviews!
Cynthia Lazaro, DO, Chelsea Natty, RN; LaserAway.
Sarah, thank you for all this insightful insight! How can readers get more aesthetic expert information from you?
Find me on Instagram at @shiggs32!
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