AI Max is the setting Google most wants you to turn on, and in a new Search campaign it's already on. Chapter 9 switched it off for launch. This chapter is about when a dermatology account is ready to switch it back on, and what to block first.
The short version is that AI Max lets Google do three things you have been doing by hand throughout this guide: choose which searches to show up for, write parts of the ad, and pick which page of your website the click lands on. For many businesses that's a reasonable trade once the account is mature. For a dermatology practice, there's a specific hazard. Most practice websites describe treatments Google won't let you advertise, and AI Max reads the whole website.
The Local Services Ads in Chapter 12 handed Google the targeting in exchange for a price per lead. AI Max hands Google the targeting and the words, inside your own Search campaign.
AI Max Turns a Search Campaign Loose on Your Whole Website
AI Max isn't a separate campaign type. It's a set of features added to a Search campaign, and Google describes three of them.
Search term matching lets the campaign show ads on searches beyond your keywords, based on what Google judges relevant. It must be on at the campaign level before it can be used in individual ad groups.
Text customization lets Google generate headlines and descriptions using, in its words, "content from your domain, landing pages, existing ads, keywords in your ad group and assets." In other words, the ad text is no longer only what you wrote in Chapter 8.
Final URL expansion lets Google send a click to a different page on your site from the one you chose, whenever it predicts that page will perform better.
Each of these takes a decision away from the practice. Search term matching goes further than even the broad match Exploration campaign from Chapter 6. Text customization can write claims you never wrote. And final URL expansion can land a patient searching for eczema help on whatever page Google picks, including pages you would never have chosen for an ad.
Exploration Has to Prove Itself Before AI Max Gets a Turn
In the rollout this guide follows, AI Max comes at the very end. It never touches the Isolation campaign, which exists to keep exact control over the searches that matter most. It only belongs, if at all, on top of an Exploration campaign that has already been running for months and booking real patients.
The reason is the same one behind every later chapter. AI Max learns from your conversions. If the account's conversion tracking still counts portal clicks or page views, AI Max will learn to find more of those. If Exploration hasn't yet shown which broad searches turn into bookings, AI Max has no good examples to follow.
By the time it's switched on, the account should have months of bookings the front desk can confirm, a negative keyword list refined week by week since Chapter 5, and landing pages for each condition from Chapter 4. AI Max doesn't replace any of that. It works on top of it, and it works only as well as what's underneath.
Google Bans PRP Ads. AI Max Can Still Write Them.
Here is the hazard specific to dermatology. Google's policy on experimental treatments doesn't allow the promotion of cell and gene therapies, and it names examples directly: "Stem cell therapy," "Cellular (non-stem) therapy," and "Platelet rich plasma, also referred to as PRP therapies." The US exception applies only to "FDA licensed or approved cell or gene therapies" advertised by the company that holds the license. Exosome treatments aren't named, but the FDA has stated that "There are currently no FDA-approved exosome products," and they fall close to the policy's "similar forms of regenerative medicine."
Many dermatology practices offer PRP for hair loss, PRP microneedling or a so-called vampire facial, and many have a page on their website describing it. That's allowed on the website. It isn't allowed in an ad.
A campaign you wrote yourself never mentions PRP because you never wrote it in. A campaign with AI Max is different. Text customization reads your landing pages and can write a headline about PRP hair restoration. Final URL expansion can decide your PRP page is the best destination for a hair loss search. Search term matching can put your ad in front of someone searching "PRP near me." Any of these can get ads disapproved and, repeated often enough, draw a closer look at the whole account.
The fix is to block these terms before AI Max ever runs, which the next two sections cover. Chapter 14 covers the full rules on PRP, stem cells and prescription drug names.
Twenty-Five Words a Dermatology Practice Blocks First
AI Max comes with controls, and Google calls the most important ones text guidelines. According to Google, you can set "up to 25 term exclusions and 40 messaging restrictions per campaign" for Search and Performance Max. Term exclusions are words or phrases Google must not use in the text it writes. Messaging restrictions are plain-language instructions about tone and content.
Twenty-five terms sounds like plenty until you start writing the list. For a dermatology practice, these belong near the top:
- Banned treatments: PRP, platelet, stem cell, exosome, vampire.
- Guarantee language: guaranteed, guarantee, cure, permanent, painless, risk-free. Google's own rules require a clear refund policy if you guarantee results, and the American Academy of Dermatology's position on advertising specifically warns against any guarantee "that satisfaction or a cure will result."
- Drug names: the prescription and injectable brand names from your service pages, since naming a drug puts the ad in a sensitive category with its own limits, as Chapter 14 explains.
- Comparative claims: best, top-rated, number one, unless you can back them up.
Term exclusions only control the text Google writes. They don't stop search term matching from showing your ad on a PRP search, so add PRP, platelet, stem cell, exosome and vampire facial to the campaign's negative keywords as well.
Then use the messaging restrictions to say what term lists can't. Useful examples for a dermatology account include: don't describe any skin condition as dangerous or frightening; don't promise specific results or timelines; don't mention prices; don't refer to any treatment the ad group isn't about.
One caution comes straight from Google's help pages: "Term exclusions can't prevent assets with prices from being generated." Adding "{{BODY}}quot; to the list won't keep a price out of a headline. If prices must stay out, use a messaging restriction such as "Don't generate assets with prices."
Keep It Away From the Pages You Can't Advertise
Blocking words handles the ad text. Blocking pages handles where the click goes.
Final URL expansion can be steered with URL exclusions, which Google describes as a campaign level control, and URL inclusions, which work at the ad group level. Exclude every page that shouldn't receive ad traffic. For a dermatology site that usually means the PRP, stem cell and exosome pages, the patient portal and online bill pay, careers pages, blog posts with graphic skin cancer photos, and any page that mainly talks about prices or financing.
Then think about which pages you want. If the medical campaign should only ever land on condition pages, use URL inclusions in each ad group to keep it there. An eczema ad group that can only send clicks to the eczema page is much safer than one that can pick any page on the site.
AI Max also includes brand controls. Brand exclusions apply at the campaign level and brand inclusions at the campaign or ad group level. Exclude the practice name and each dermatologist's name here too. Searches for them already belong to the brand campaign, and an AI Max campaign that collects them will look far better than it is.
Split the Campaign in Half and Count Bookings, Not Clicks
The safest way to switch on AI Max is not to switch it on everywhere. Google offers AI Max experiments for exactly this. According to Google, it's a one-click test that "splits your current campaign 50/50," so half the traffic runs with AI Max and half without.
Run the experiment on the Exploration campaign, never on Isolation, and give it several weeks. Then judge it the way this guide judges everything: by bookings the front desk can confirm, split into medical and cosmetic. AI Max will almost always win on clicks and usually on reported conversions, because it reaches more searches. The question is whether it books more real new patients at a cost that fits the ceilings from Chapter 3.
If it does, keep it on Exploration and keep reading what it does. If it only adds clicks and conversions that never turn into patients, end the experiment. There's no penalty for deciding AI Max isn't right for your account yet.
Read the Headlines It Wrote Before Patients Do
Once AI Max is running, someone has to read what it's doing, every week, especially in the first month.
Google's AI Max reporting shows the search terms it matched, the text it generated (marked "Google AI" in the asset report) and the landing pages it chose, including the ones final URL expansion picked. Check three things. First, the search terms: are they real patient searches, or has it wandered into product searches, research questions or other cities? Add negatives as you did in Chapter 5. Second, the text: has it written anything you wouldn't sign off on, such as a promise, a drug name or a treatment you don't offer? Add it to the term exclusions. Third, the landing pages: is it sending clicks to pages you would never have chosen?
If the ad text keeps drifting despite the guidelines, switch off text customization and keep the other two features. The settings can be used separately, and many medical practices find that search term matching is worth keeping while text generation isn't.
A dermatology practice is legally and professionally responsible for every claim in its ads, whoever wrote them. Reading the machine's work isn't a formality. It's the job.
Next: Botox, Drug Names and the Certification Wall
This chapter treated drug names and PRP as words to keep out of ads that Google writes for you. Chapter 14 covers the full rules for dermatology's most tangled advertising question: when Botox and other prescription drug names can appear in an ad, why bidding on them as keywords needs a certification, and how to advertise injectables without naming the drug.
The Google Ads for Dermatologists guide home lists every chapter. Under our Google Ads management, AI Max is tested only as a split experiment, with the block list in place before the first impression.
