For the past 21/2 years, Marlena Hall, a public relations and marketing professional, has visited Nancy Reagan (not the former first lady, but an aesthetician with about 200 clients) almost weekly.
"I was skeptical at first," said Ms. Hall, 26, who lives in Boca Raton, Fla. "But after a session, I know things are going to be better. I've a plan, I'm getting solid advice and I'm setting goals with someone who wants to help me."
Ms. Reagan isn't a therapist in the clinical sense. But for many of her patients seeking skin care help, that's exactly what she is.
"I prefer skin care coach," said Ms. Reagan, who has been in the business for 20 years, speaking from her spa in Delray Beach, Fla. "The majority of my work deals with women and self-esteem. That involves their face and their feelings."
Ms. Reagan's hourlong coaching sessions cost $50 to $250 (the first consultation is free), and might involve creating a strategy, setting goals, lifestyle reviewing, journal keeping, or the recommendation of topical products and treatments.
Getting professional advice on skin care outside the dermatologist's office is nothing new (just think of Clinique's famous "technicians," with their white lab coats), but lately the popular and expensive practice of life coaching has been making its way into the beauty industry.
Myskinprescription.com is a 2-month-old website with more than 100 clients, each seeking customized skin care help. Renee Rouleau, who owns two skin care spas in Dallas, developed the site for out-of-state clients who needed one-on-one care, education and counseling. Call it "face coaching."
"People are desperate for a personalized connection," Ms. Rouleau said. "This is a competitive industry dominated by products and procedures, and consumers are left to sort things out by themselves."
Thirty minutes of Skyping with Ms. Rouleau costs $250, and includes $100 worth of her own skin care products. She looks at clients' diets, edits the list of products in their medicine cabinet and discusses the right way to wear sunscreen. They are then placed into one of nine groups, such as dry/tired/aging (No. 7), and a given a daily treatment plan, followed up with regularly scheduled emails containing personalized skin tips and tricks.
Skin care coaches suggest that although many dermatologists and plastic surgeons have their own cosmetics lines, they may be too busy to talk patients through the nuts and bolts of maintenance.
"Dermatologists focus on immediate care and treating skin problems, usually by prescribing medications or professional treatments like lasers and fillers," Ms. Rouleau said. "They don't focus on the day-to-day home care required for long-term healthy skin."
Karin Roth, 35, an engineer in Cambridge, Mass., said that she spent years seeing dermatologists. She had her first Skype session with Ms. Rouleau last month and was pleased with the experience.
"I wanted what I couldn't get from my dermatologist," she said; that is, to be told when to exfoliate, when to do a peel, when she should be moisturizing and how certain products will affect her skin.
"No dermatologist would sit through that," she said.
Skin care companies are getting into the game as well. Skin Authority, a company in Carlsbad, Calif., employs 15 such coaches, all trained and licensed aestheticians, to answer questions.
"There's a coach for every form of self-improvement: exercising, eating, careers," said Celeste Hilling, the chief executive of Skin Authority. "Why wouldn't you have a virtual coach for your skin?"
Her service is not meant to be a replacement for a dermatologist, she said, "but very often your issue is resolved by the time you get the appointment with your doctor."
Dermatologists worry that patients might be turning to the wrong people for help.
"Some skin coaches have a lot of experience," said Diane Berson, a dermatologist in Manhattan. "But how do we know which ones do and which ones have just read a number of magazine articles? There's no governing board with respect to certification. And how do you define an aesthetician? Many just know how to do facials."
Dr. Berson also had health concerns.
"Skype has huge limitations as opposed to seeing someone's skin under a bright light with a magnifying glass," she said. "You might have rosacea or lupus, which presents with a redness of the cheeks."