Med Spas

The 8,800 medical spas offer cosmetic medical procedures and traditional spa services under the supervision of licensed healthcare professionals. Operators provide a variety of aesthetic, minimally invasive, and non-invasive procedures that enhance physical appearance. Popular treatments include dermal fillers, neuromodulators/Botox, laser treatments, microdermabrasion, and chemical peels. Medical spas employ trained staff, such as registered nurses (RN), nurse practitioners (NP), physician assistants (PA), and aestheticians, to administer procedures.

Medical Complications

Medical procedures naturally come with some risk of complications, and those performed by nonphysician personnel in medical spas have elevated risks.

Government Regulation

Because medical spas are technically medical practices, operators are subject to regulatory oversight by state medical boards, which determine what constitutes a medical procedure, who can perform the procedure, the staffing ratio of physicians to non-physicians, and what qualifies as on-site/off-site supervision.

Sep 10, 2026 - Spas Face Staffing Challenges

• US med spas are benefiting from broader spa-industry growth, but labor and profitability pressures could temper expansion, according to a Spa Business report on ISPA data. ISPA’s study showed medi-spas represented 8% of all US spa locations in 2025, within an industry that generated a record $23.5 billion in revenue, up 4.2%. Spa visits rose 1.8% to 191 million, nearly matching pre-pandemic levels, supporting demand for aesthetic and wellness services. However, profitability weakened across non-hotel/resort spas, with 60% reporting profit margins above 10%, down from 67% in 2024. Staffing remained the industry’s biggest challenge, cited by one-third of respondents. For med spas, the outlook remains favorable, but growth will depend on recruiting skilled providers, managing payroll costs, and improving utilization through memberships, scheduling, and higher-value treatments.
• Weakening consumer confidence in August points to a more cautious outlook for US med spas, where many aesthetic treatments are elective and can be delayed. The University of Michigan Index of Consumer Sentiment fell 6.3% from July to 51.7 and was 11.2% below a year earlier, which could soften demand for higher-ticket procedures such as injectables, laser treatments and body contouring. Separately, The Conference Board Consumer Confidence Index slipped to 89.4 from 90.2 in July. Its Present Situation Index improved to 121.2, but the Expectations Index fell to 68.2 as consumers grew more pessimistic about jobs, incomes and business conditions. For med spas, weaker confidence may lengthen treatment cycles and increase demand for memberships, financing, promotions and lower-cost maintenance services.
• Zenoti's 2026 Beauty and Wellness Benchmark Report suggests a mixed but generally favorable outlook for US med spas, with technology and client engagement emerging as key growth drivers. While non-membership spas expanded rapidly in 2025, with center growth accelerating from 4% to 13% and same-store revenue rising from 2% to 3%, membership-based spas saw same-store revenue growth slow from 5% to 2% and existing client visits decline 2%. The report found that spas using Zenoti's AI Concierge achieved 3% to 4% sales growth, outperforming non-users by 1 to 2 percentage points, highlighting AI's potential to offset softer new client acquisition. Zenoti also found that guests rebooked multiple times canceled just 2% of appointments versus 23% after a first rebooking, underscoring the importance of retention strategies, digital engagement, and operational efficiency for sustaining revenue growth.
• The US medspa industry continued attracting strong investor interest in 2025 as steady consumer demand for injectables, laser treatments, skin rejuvenation, and non-surgical body contouring fueled ongoing consolidation activity, according to a recent American Med Spa Association report. Private equity-backed platforms remained highly active, particularly in large states such as Texas, Florida, and California, while more than 90% of medspas remained independently owned, leaving significant room for additional acquisitions. The report highlights that recurring revenue streams from memberships, subscription skincare, and repeat treatments are increasing the sector’s appeal to investors seeking predictable margins and loyal customer bases. At the same time, regulatory scrutiny surrounding provider supervision, compliance, and corporate ownership structures is becoming a larger consideration in transactions. For medspa operators, the environment presents opportunities for growth and higher valuations, particularly for multi-location businesses with strong operational systems, recurring revenue, and scalable infrastructure.

Industry size & Structure

The average medical spa operates out of a single location and generates almost $2 million annually, according to the American Med Spa Association. Single-location medical spas employ an average of eight workers and generate just over $121,000 annually. Multi-location operators employ an average of 16 workers at the primary facility.

• The medical spa industry consists of over 8,800 operators that employ 70,000 workers and generate about $15 billion, according to the American Med Spa Association.
• The medical spa industry is fragmented; over 80% of firms operate out of a single location. Multi-location operators average six locations.
• Two-thirds of medical spas have a single owner. Over 60% of medical spas have an owner who is not a physician.
• Large firms include Ideal Image and Laser Away.