Where Wellness Meets Wealth: A Complete Guide to Starting a MedSpa in the U.S.
- D Wasake
- Aug 6
- 8 min read
MedSpa Business in the U.S.
A High-Margin Business Blending Health, Beauty & Lifestyle
About the Writer
Dickson Wasake has more than 20 years of experience, including with global accounting firms PwC, Baker Tilly, and Deloitte, and various roles such as a fractional CFO and advisor for clients. He is an ex-audit partner (Baker Tilly CI). Dickson is a UK CPA (FCCA)and a US CPA (IL), with experience working with clients of various sizes, ranging from start-ups to a $1.3 trillion listed company. He has travelled to 30+ countries, including Sub-Saharan Africa, the Bahamas, the UK, and Canada. He lives in IL, USA. Connect with him on LinkedIn or view his detailed resume/CV.
📍 Introduction: Where Botox Meets Business Brilliance
Let me be open and honest first, I have never done Botox. The smile you will see is genuine, and so will be the crease lines, and when I frown, you can see my frown lines rather than seeing an expressionless male mannequin. My eyebrows won’t seem like I am permanently surprised. Okay, I am being a bit harsh on this sector. It is not that bad, I just wanted to start dramatically, so let’s start again:
Imagine this: a serene, spa-like environment where clients willingly spend hundreds to thousands of dollars per visit—and come back every few months. No emergency calls. No late-night returns. Just steady, high-ticket, appointment-based revenue.
If you are lucky, on one of those serene days where they play “mood music” you just might bump into one of your celebrities and superstars who dreams of living forever or one who needs to continue looking young because American audiences (okay, global ones too) are obsessed with youth.
Welcome to the MedSpa business, one of the most resilient and profitable ventures in the $16 billion U.S. aesthetic medicine market (Statista). Whether it’s laser treatments, injectables like Botox and fillers, or skin rejuvenation, the market is booming. Aging populations, Zoom culture, and the rise of personal branding are all fueling demand.
Bonus Insight: Over 70% of MedSpa clients are repeat visitors (American Med Spa Association), with lifetime value often exceeding $5,000–$10,000 per client.
This high retention is driven by the nature of aesthetic treatments, which typically require regular maintenance every 3 to 4 months—such as Botox, fillers, and facials. Many MedSpas capitalize on this by offering bundled packages or membership models (e.g., $199/month for monthly treatments), which help smooth cash flow and boost loyalty.
Unlike one-time retail or healthcare visits, MedSpas operate in a hybrid space where clients are not only willing—but eager—to return. This repeatability makes client acquisition costs more justifiable and strengthens long-term profitability, provided the quality of service and client experience remains consistently high.
⚠️ Location Strategy Tip: MedSpas thrive in urban or suburban areas with high disposable income and aging populations. Popular regions include Florida, California, and Texas. College towns and up-and-coming metros with social media-savvy populations are also promising.
💬 What We Think About This Business
MedSpas combine the best of retail, healthcare, and hospitality. They’re ideal for medical professionals or strategic investors who can partner with licensed personnel. While regulations vary, the upside is clear: high margins, cash-based revenue, and loyal clientele.
🔍 Competitive Differentiation Tip: With rising competition, successful MedSpas often differentiate through specialization (e.g., male aesthetics, postnatal treatments), advanced technology (AI-powered skincare diagnostics), or holistic add-ons (e.g., IV therapy lounges, meditation pods). Branding, atmosphere, and practitioner consistency are crucial to stand out.
⚖ SWOT Analysis (Big Things to Know in the MedSpa Business)
Category | What It Means | Examples |
Strengths | High margins, recurring treatments | Botox, fillers, facials done every 3–4 months |
Weaknesses | Licensed staff required, regulation-heavy Staff turnover and injector burnout can impact consistency and reputation | Must comply with state medical board rules Must Offer incentives, profit-sharing, or clear career progression plans for injectors and estheticians |
Opportunities | Aging boomers, beauty-conscious Gen Z Expansion via franchising or acquisition of underperforming MedSpas | Men now make up 15–20% of MedSpa clients |
Threats | Poor quality control or malpractice risk Cybersecurity risks tied to HIPAA data breaches and social media missteps State-specific ownership or licensing restrictions may halt expansion plans
| Bad outcomes = lawsuits or social media backlash |
🧠 Key Things to Know Before You Start
✅ Requirements:
● Medical Director (usually MD, NP, or PA)
● Appropriate state licenses for each procedure
● Insurance: medical malpractice, general liability
● HIPAA compliance if patient data is collected
● Cybersecurity: Use HIPAA-compliant platforms (e.g., Paubox, MedChart) and consider cyber liability insurance.
● Patient Financing: Offer third-party financing tools like CareCredit or Cherry Financing to ease client payment for premium services.
⚠ Risks to Manage (Risk Management in the MedSpa business):
Risk | Control |
Improper procedures | Hire experienced, licensed practitioners |
Client dissatisfaction | Clear consent + before/after photos + follow-up process |
Legal/regulatory issues | Work with a healthcare attorney, stay updated per state law |
Inventory shrinkage | Use inventory management system (e.g., AestheticsPro) |
Cybersecurity breach | Use encrypted software + cyber insurance + regular IT audits |
Reputational damage | Monitor reviews (Google, Yelp), use online reputation tools like Birdeye or Podium |
🔐 Internal Controls (Systems to put in place for the MedSpa business)
Risk | Control |
Patient injury or side effects | Licensed, insured team + pre-procedure assessments |
Inventory misuse | Track vial numbers and procedure logs |
Revenue leakage | POS system integration with scheduling + accounting |
HIPAA non-compliance | Use encrypted, HIPAA-compliant software |
Typical Founder Concern: Unlicensed professional
Qn: Can I legally own the MedSpa if I’m not a licensed medical professional?
In the U.S., whether you can legally own a MedSpa as a non-medical professional depends on the state. Many states follow the Corporate Practice of Medicine (CPOM) doctrine, which prohibits non-licensed individuals from owning or controlling a medical practice. Since services like Botox and laser treatments are classified as medical procedures, ownership must often lie with a licensed provider.
However, non-clinicians can still be involved through a Management Services Organization (MSO) model. In this setup, the medical entity (owned by a licensed professional) handles treatments, while your MSO manages business functions like marketing, admin, and rent—charging a management fee in return.
👩⚕️ What the First Few Months Look Like
Month 1–3 Activities:
● Lease space and pass state inspections
● Hire or contract certified injectors and estheticians
● Build service menu: Botox, peels, microneedling, facials
● Launch soft-opening promotions and loyalty program
● Set up a reputation monitoring process using platforms like Podium to encourage 5-star reviews and flag negative ones early
● Onboard patient financing options (e.g CareCredit) and integrate them into the sales conversation during consultations
Typical Day:
● Consultations and consent
● Aesthetic treatments (20–45 min each)
● Follow-ups and retail skincare product upsells
● Client reminders, reviews, and email marketing
📈 Future Outlook (What’s ahead in the MedSpa Business)
● The industry is expected to grow over 10% annually through 2030 (Allied Market Research).
● Integrative wellness (IV therapy, hormone replacement) and AI-powered skincare recommendations are emerging trends.
● Sustainability-focused clients are seeking non-toxic skincare, cruelty-free brands, and low-waste packaging. Partnering with eco-conscious vendors or offering green treatment options may boost brand image and attract Gen Z/Millennial clientele.
🔭 Advanced Thinking Tips
Insights:
● Zenoti: MedSpas that offer bundled packages see 24–30% higher retention
● Forbes: Men’s skincare and wellness treatments are among the fastest-growing segments
● Bain: Emphasize customer lifetime value, not single service sales
● Offer memberships (e.g., $199/month includes 1 facial + discounts)
● Invest in client journey tech: pre-booking, testimonials, smart follow-up
● 💡 Consider tiered memberships (e.g., $99 Basic, $199 Premium, $299 VIP) to maximize upsells and cater to diverse budgets
● 🤝 Strategic partnerships with local gyms, dermatologists, or lifestyle brands can create referral loops
● 📦 Explore skincare product white-labeling or private-label lines to boost retail margins and brand loyalty
Bonus Insight: Buying Instead of Building
MedSpa businesses are often franchises, so consider this as a good option.
Franchises resell at 1.5–3× Seller Discretionary Earnings (SDE). Check corporate support, reviews, and royalty structure. Red flag: high churn or litigation. See BizBuySell’s franchise section.
Inachee Can Help: We can review franchise docs, revenue mix, and regional cannibalization risk.
Business Model and Revenue Streams for the MedSpa business
💵 Start-Up Cost Breakdown (Detailed)
Item | Est. Cost | Notes | Source |
Leasehold improvements | $30,000 | Buildout, plumbing, aesthetics | Contractor estimates |
Equipment (laser, injectors) | $49,000 | May vary widely based on focus | Candela, Cynosure |
Licensing & legal setup | $5,000 | Includes legal fees + insurance | Healthcare attorneys |
Software & POS system | $2,000 | AestheticsPro, Envision, Square | Vendor websites |
Marketing | $5,000 | Website, ads, soft launch promos | Local digital marketing firms |
Miscellaneous | 9,100 | 10% |
|
Startup Estimate: $100,100
🛠 Optional Add-Ons:
● Reputation Management Tools (e.g., Podium, Birdeye): $1,500–$2,500/year
● Financing Partner Setup (CareCredit, Cherry): Usually free to set up, with merchant fees on usage
💸 Revenue, Operating Costs & ROI (Annual Estimate)
Assumptions:
● Revenue: 50 clients/month at $400 average spend = $240,000/year
● Add cost of Botox/fillers/products (COGS), typically 25% of revenue
Item | Annual Cost | Notes |
Staffing | $62,400 | Injectors & estheticians (PT/FT) |
Product & Supplies (COGS) | $60,000 | Botox, fillers, selrums, consumables (25%) |
Rent & Utilities | $18,000 | Urban strip mall or boutique location |
Software + Licensing | $6,000 | EMR, HIPAA, POS, scheduling |
Insurance & Admin | $6,000 | Malpractice, legal, bookkeeping |
Marketing | $12,000 | 5% of revenue |
Total Annual Costs: $164,400Net Profit = $240,000 – $164,400 = $75,600
ROI = $75,600 ÷ 100,100 = ~76% (conservative)
📊 3-Year View (High Level)
In year 1 you operate with part time (P/T) staff but in year 2, you scale by moving to full time (F/T), add more equipment (lease) and add more rooms.
As you expand, consider additional costs for for ongoing training, staff incentives, and bonus pools to reduce turnover
🛠️ Recommended Software Stack
● AestheticsPro or Envision (EMR + scheduling)
● Square or Stripe (POS + payments)
● Hootsuite or Mailchimp (marketing automation)
● QuickBooks (bookkeeping & CPA-ready)
🌍 Global Outlook: Medical Spas Are Poised for Explosive Growth
● The global medspa market was valued at around $18.6 billion in 2023 and is projected to hit $49 billion by 2030, growing at a 15% CAGR from 2024–2030. (Grand view research)
● Another forecast estimates a rise from $16.5 billion (2023) to $45 billion by 2030, with a 13.4% CAGR. (GlobeNewswire)
●🌱 Green trends and clean beauty are gaining traction globally. MedSpas that emphasize non-toxic, vegan, or sustainable skincare solutions may tap into a more discerning global clientele—especially in the EU, Canada, and certain U.S. cities like Portland and Boulder.
🧾 Conclusion: A Business with Measured Potential
Life has a way of going full circle, as I age and the grey hairs threaten to take over, perhaps I will visit a MedSpa and do some laser hair blackening. Maybe not a tan, though, I am already naturally well tanned though.
That said and done, the MedSpa industry combines high-margin services with recurring, cash-based revenue, making it one of the most attractive opportunities in the health and lifestyle space.
Growing demand—driven by aging populations, wellness trends, and digital-first beauty standards—adds to its appeal. However, the business is not without challenges, including licensing requirements, regulatory complexity, and the need for skilled medical staff, particularly for non-clinicians.
🏁 Inachee Index Score: 72/100 – Tier B (Strong)
High ROI and growing demand, but requires upfront capital and licensed staff. Great for medical entrepreneurs or investor partnerships.
A strong brand, robust internal controls, and flexible financing or membership models can significantly increase client lifetime value and MedSpa resilience. However, success requires navigating state laws, ensuring data security, and retaining skilled professionals in a high-expectation industry.
What Is the Inachee Index?
The Inachee Index scores sectors using 8 weighted dimensions: ROI potential, startup accessibility, ease of entry, scalability, compliance, market resilience, future relevance, and execution simplicity. Each sector receives a score out of 100 and is assigned a tier (A–D).
How does this sector rank against all others in the US? Check out the US ranking list.
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