On a medical search, a dermatology practice competes mostly with other dermatology practices, hospital systems and directories. On a cosmetic search, the field changes. Search for Botox, lip filler, a chemical peel or laser hair removal in almost any US city and the results fill with med spas, independent injectors, plastic surgery practices and booking apps. In our example market, those were the names that led the cosmetic results, and a med spa sat among the verified Search advertisers alongside the dermatology practices.
Most of those competitors can't do what a dermatology practice does, but many of them advertise as if they can, and they are often cheaper and faster to book. This last chapter covers how a dermatology practice competes with them on Google: which searches to leave alone, which to own, and how to use the one advantage a med spa can't copy, the board-certified dermatologist, without crossing the rules on how that claim is made.
It follows the drug-name rules in Chapter 14, which shape how every cosmetic ad in this chapter is written.
Ten Thousand Med Spas Now Want the Same Botox Patient
The med spa industry has grown quickly. According to the American Medical Association, "From 2010 to 2023, the number of medical spas nationwide grew nearly sixfold, from about 1,600 locations to more than 10,000." The same report cites an AMA issue brief finding that "70% of medical spas lack any affiliation with a physician practice," and a study showing that 36 states have no regulations or laws specific to medical spas.
For a dermatology practice's Google Ads account, that growth shows up in the cosmetic auctions. Each of those med spas is a potential bidder on "Botox near me," "lip filler" and "laser hair removal," and many run aggressive introductory offers because cosmetic treatments are most of what they sell. A dermatology practice that treats cosmetics as a side line is bidding against businesses for which it's the whole business.
The answer isn't to outspend them. It's to choose the searches where a dermatologist has an honest advantage and make that advantage obvious, in the ad and on the page.
"Med Spa Near Me" Is 110,000 Searches You Probably Shouldn't Chase
Google Keyword Planner shows about 110,000 US searches a month for "med spa near me" and about 135,000 for "med spa." Those are enormous numbers next to almost anything else in this guide, and the temptation to bid on them is real.
Look at who is searching. Someone who types "med spa near me" has already decided what kind of place they want. Many are comparing prices on a single treatment, looking for a membership or a package, or wanting the relaxed spa experience rather than a medical office. A dermatology practice can serve some of them, but it's bidding for a patient who asked for something else, at the same price a med spa pays for a patient who asked for exactly what it offers.
For most practices, the right move is to leave these searches alone and add "med spa" to the negative keyword lists from Chapter 5, so broad match in the Exploration campaign doesn't drift into them. The exception is a practice that genuinely runs a med spa, under that name, with its own pricing and booking. For that practice, a separate cosmetic campaign aimed at med spa searches can make sense, with its own budget and its own measure of success.
"Cosmetic Dermatologist" Is a Search a Med Spa Can't Honestly Win
Now look at the other side. Keyword Planner shows about 3,600 US searches a month for "cosmetic dermatologist" and about 4,400 for "cosmetic dermatologist near me."
These are smaller numbers, but they come from people who have already made the choice that matters most to a dermatology practice. They want a physician, and specifically a dermatologist, to handle their cosmetic treatment. A med spa can bid on those searches, but it can't honestly answer them, and a patient who clicks through to a med spa looking for a dermatologist is likely to leave.
Treat these searches the way Chapter 6 treated "dermatologist near me." Put them in the Isolation campaign, in exact match, with their own ad group and a landing page built for them. Add the variations patients use, such as "dermatologist for Botox" or "dermatologist for fillers," using the drug-name rules from Chapter 14 when deciding what can be a keyword and what belongs only on the page.
This is where a dermatology practice should spend first on cosmetics. The volume is modest, but the patients arrive already convinced of the one thing a med spa can't give them.
Say "Board-Certified Dermatologist" Only When It's Exactly True
The strongest claim a dermatology practice can make in a cosmetic ad is that a board-certified dermatologist is involved. It's also a claim with rules around it, and getting it wrong undoes the advantage.
In dermatology, board certification comes from the American Board of Dermatology or the American Osteopathic Board of Dermatology. The ABD describes its certified dermatologists as physicians, MDs or DOs, who have completed an accredited internship and at least three years of accredited dermatology residency and passed its exams. It also points out that "Being 'certified' is not the same as being 'licensed.'"
The American Academy of Dermatology's position on advertising lists, among the things a member's advertising should not do, stating or implying board certification unless the physician is certified by a recognized board. It also asks practices to clearly indicate the training and licensure of the team a patient is likely to see. Two practical rules follow.
Be exact about who. "Board-certified dermatologists" in a headline should mean the physicians who will actually be involved in the treatment being advertised. If injections are done by a physician assistant or nurse injector under a dermatologist's supervision, say so on the landing page. Patients respect the honesty, and it's what the AAD's guidance asks for.
Watch the near-miss phrases. The ABD states that board eligibility ends five years after residency, after which a dermatologist "may not claim to be 'board eligible.'" Some states go further. Texas, for example, deems language such as "board eligible" or "board qualified" misleading when it's "calculated to convey the same meaning as 'board certified.'" State rules differ, so check your own state medical board's advertising rules before any credential goes into an ad.
The Credential Goes in the Headline, the Proof on the Page
Once the claim is accurate, use it. In the cosmetic ad groups, the headlines from Chapter 8 should say plainly who does the work: "Board-Certified Dermatologists," "Injections by a Dermatologist," "Lasers by a Dermatologist." Each fits the 30-character limit. A med spa can't write those headlines, and a patient comparing three ads side by side notices.
Then make the landing page prove it. Name the dermatologists. List their boards, and FAAD where it applies, which the AAD describes as a sign that a dermatologist is board certified. Say who performs each treatment and who supervises. Some practices do this well. Forefront Dermatology, for example, states that "all of our cosmetic procedures are performed or supervised by a board-certified dermatologist who is specially trained in cosmetics," a simple line that answers the question a cautious patient is asking.
There's evidence behind the difference, too, which a practice can reflect honestly without attacking anyone. A 2025 study in the Journal of Cosmetic Dermatology surveyed laser providers by phone and found physician involvement in laser procedures at 60% of fellowship-trained laser dermatologists, 33% of plastic surgery practices and 9% of med spas. A landing page doesn't need to quote the study. It needs to make clear, in the practice's own words, that a physician is involved.
Keep the tone confident, not defensive. The ad's job is to make the dermatologist's advantage easy to see, not to warn patients away from med spas.
Med Spas Win on Price and Speed. Only One Is Worth Matching.
The same study found the other side of the comparison. The wait for a consultation was 23 days with the fellowship-trained laser dermatologists, 11 days at plastic surgery practices and 4 days at med spas. Consultation fees averaged $153, $78 and $30.
A dermatology practice rarely wins a price war with a med spa, and it shouldn't try. A lower price per unit attracts the patients least likely to value what a dermatologist offers, and it undercuts the value per patient that Chapter 3 used to set every bid in this guide.
Speed is a different matter, and it's often fixable. A patient who clicks a cosmetic ad and is offered an appointment three weeks away will often book the med spa that can see them on Thursday. Hold a few cosmetic consultation slots each week for new patients, make sure the front desk can offer them on the first call, and say on the landing page how soon a new patient can typically be seen. Closing even part of that gap turns the credential into a booked visit instead of a reason to wait.
What to Build First, and What to Leave for Last
That's the whole guide. Put together, the order looks like this.
Start with measurement. Count real new-patient bookings, split by funnel, before a single ad runs (Chapter 1). Separate the medical, skin cancer and cosmetic funnels, since each has its own patient and its own value (Chapter 2), and price every click by what a new patient is worth over a year (Chapter 3). Build a landing page for each condition and service (Chapter 4), and research keywords with the drug-name and product-search traps in mind (Chapter 5).
Launch with the Isolation campaign on the searches that book, such as "dermatologist near me," "skin check near me" and now "cosmetic dermatologist," alongside a brand campaign (Chapter 6). Bid by condition (Chapter 7), write the ads in patients' own words (Chapter 8), and fix the settings Google fills in for you, starting with location (Chapter 9).
Only once Search has months of real bookings behind it, add the campaigns that rely on Google's judgment: Performance Max split by funnel (Chapter 10), Demand Gen for skin checks people haven't searched for (Chapter 11), Local Services Ads as an optional test (Chapter 12), and AI Max last of all, with its block list in place (Chapter 13). Throughout, keep drug names and credentials within the rules (Chapter 14 and this chapter).
The Google Ads for Dermatologists guide home lists every chapter in that order. If you'd rather have it built and run for you, that's what our Google Ads management does for dermatology practices, in the same order, starting with the bookings.
