Every campaign you create in Google Ads arrives with a long list of settings already filled in. Most of them were chosen by Google to reach as many people as possible, which is a sensible goal for a company that sells clicks and a poor one for a dermatology practice that can only see patients who walk through its door.
This chapter goes through the settings that matter for a dermatology account before the first ad runs: where the ads show, who Google won't let them reach, and the handful of boxes Google checks on your behalf that are worth unchecking. None of it is glamorous. All of it decides whether the careful work in Chapter 8 reaches the right people.
Switch the Location Option to Presence Before Anything Else
When you choose a location for a campaign, Google offers two ways to interpret it. The default, which Google recommends, reaches people who are in your area and also people who have shown interest in your area, wherever they happen to be. The other option, called Presence, reaches only people who are in your area or regularly spend time there.
For a travel company, the default makes sense: someone in Minneapolis planning a winter trip south is a real customer for a beach hotel. For a dermatology practice, it mostly buys clicks from people who will never be your patients. A person three states away who searches "dermatologist" plus your city's name, perhaps for a relative or out of curiosity, can be shown your ad under the default setting. Every one of those clicks costs the same as a local one.
A skin check is a visit. A mole removal is a visit. Even most cosmetic treatments need the patient in the chair. Switch every campaign to Presence before it launches. It's one of the least exciting changes in this guide and one of the quickest to pay for itself.
Draw the Map From Patient ZIP Codes, and Give Mohs a Wider One
With Presence on, the next question is how big the area should be. The answer is in your patient records, not on a map with a compass.
Pull the ZIP codes of new patients from the past year. Most practices find their patients cluster in a handful of towns and neighborhoods, sometimes lopsided in one direction because of a highway, a river or where the competition sits. Target those areas, by radius or by listing the ZIP codes and towns directly, and you'll spend where patients actually come from. These are the same towns Chapter 6 used for the "dermatologist" plus town keywords.
The practical steps are simple. Export new-patient addresses from the practice management system, count them by ZIP code in a spreadsheet, and sort from most to fewest. Start the campaign with the ZIP codes that account for most of your new patients, and leave the long tail out at first. You can always widen the map once the account shows which outlying areas book, and it's much harder to explain wasted clicks from towns nobody drives in from.
Mohs surgery and other specialty services are different. A patient who already has a skin cancer diagnosis, often referred by another dermatologist or a primary care doctor, will usually travel much farther for the right surgeon than someone booking a routine skin check. If the practice offers Mohs, give that campaign its own, wider map. The same can apply to any service few practices nearby offer.
This is another reason each funnel gets its own campaign. Location is a campaign-level setting, so a skin check campaign and a Mohs campaign can only have different maps if they're separate.
Google Treats Eczema, Psoriasis and Injections as Health Topics
Google has a policy called health in personalized advertising, and much of dermatology falls under it. The policy names chronic health conditions, surgical procedures and injections among its sensitive topics.
What the policy limits is personalized targeting: reaching people based on their own browsing or your customer list. Remarketing to past site visitors, uploading patient lists for Customer Match, and building lookalike audiences from them aren't available for these topics. Broader audiences that Google builds itself, such as people in the market for a type of service, are still allowed in some campaign types.
Mapped onto a dermatology menu, the clearly sensitive topics include psoriasis, eczema, hidradenitis, rosacea and other chronic skin conditions, skin cancer and Mohs surgery, and injectables such as Botox and fillers. Acne treatment and mole removal are likely covered too, as physical health conditions and procedures. That mapping is our reading of the policy, not a list Google publishes, so treat anything medical as sensitive when planning audiences.
What the policy doesn't touch is the core of this guide: keyword targeting on Search. A patient who searches "psoriasis treatment" can still see your psoriasis ad. That's one more reason the account starts with Search and adds other campaign types later.
Naming a prescription drug in an ad or on a landing page puts it in its own sensitive category with the same kind of limits. Chapter 14 covers that in detail.
Cosmetic Ads Can't Reach Teenagers. Acne Ads Still Can.
Google also restricts certain ads from being shown to users it believes are under 18. The category that matters here is body modification. Google's policy lists "body-modification products or services such as cosmetic procedures," and states that "these restrictions apply to YouTube, Google Display, and Search ad campaigns."
In practice, cosmetic dermatology ads, such as Botox, fillers or laser treatments, won't reach teenage users. That's appropriate, and it rarely costs a practice anything.
Acne is a different case. Treating a teenager's acne is medical care, not a cosmetic procedure, and a parent or teen searching for acne help is exactly who a medical dermatology campaign is for. Our reading of the policy is that medical acne ads aren't restricted, but the risk comes from mixing: an acne ad that talks about "flawless skin" or bundles a cosmetic facial starts to look like the thing the policy restricts. Keep teen acne in the medical campaign, write it as medical care, and keep cosmetic offers in their own campaign.
AI Max, Search Partners and Three Other Boxes Google Checks for You
A handful of settings arrive switched on that a new dermatology account should switch off, at least for launch.
AI Max. According to Google's own setup instructions, AI Max comes switched on whenever you create a Search campaign. It widens the searches an ad can match and lets Google rewrite parts of the ad. That's the opposite of what the Isolation campaign is for. Switch it off in Isolation. Chapter 13 covers when, and how carefully, to switch it back on.
Search partners. These are sites outside Google Search that show your ads. They can bring in cheaper clicks, but also more low-quality and automated traffic. Leave them off at launch and test them later, once you know what a normal booking rate looks like.
The Display Network. Search campaigns can spill onto websites and apps as display ads. For a Search campaign, that's a different audience with a different intent. Turn it off.
Automatically created assets. Google can write extra headlines and descriptions from your website. For a medical practice, where every claim needs to be accurate and some words carry policy risk, write your own and switch this off.
Broad match in Isolation. Isolation is exact match only, by design. If the campaign offers to switch keywords to broad match, decline.
Two settings go the other way and should be on: auto-tagging, which passes click information from Google Ads to your analytics, and call reporting, which records calls from your ads as conversions in the way Chapter 1 set up. While you're in the settings, set ad rotation to favor the best-performing ads, and add a second language only if the practice truly sees patients in it.
Start the Budget Low for the First Two Weeks
One more setting deserves care on day one: the budget. Set each campaign's daily budget lower than you plan to run it long term for the first week or two. The goal of those first days isn't volume. It's reading the real prices in your market, the actual cost per click on each condition, how often each ad group shows at the top, and whether the first bookings arrive.
Once you've seen a week or two of real numbers, raise the budget on the campaigns that are booking patients at a cost that fits the ceilings from Chapter 3. Remember that Google can spend up to twice the daily budget on a busy day while keeping the month within about 30 times the daily figure, so a low start also limits the surprises while you learn.
Medical, Cosmetic and Your Practice's Name Each Get a Campaign
Put the settings together and the account structure follows from them.
A medical campaign carries skin checks, mole removal and the conditions you treat, on a map drawn from your patients' ZIP codes, with teen acne written as medical care.
A cosmetic campaign carries Botox, fillers and lasers, with its own budget, its own pages, and the teen restriction applied automatically.
A Mohs or specialty campaign, if the practice offers it, gets the wider map.
A brand campaign carries your practice's name and your dermatologists' names, as Chapter 6 described, so people searching for you by name always find you first.
Four campaigns sounds like more work than one. It's actually less, because each one has a single job, a single map and a single budget, and when something goes wrong you know exactly where to look. The Google settings that marketers often worry about, such as the campaign's marketing objective, make no difference to how these campaigns run. The ones in this chapter do.
Next: When Performance Max Is Ready for a Dermatology Account
Once the campaigns run on the right settings, the account starts building the one thing every later campaign type needs: a record of real bookings. Chapter 10 covers Performance Max, when a dermatology account is ready for it, and why it can't tell a Mohs patient from a filler patient unless you set it up to.
The Google Ads for Dermatologists guide home lists every chapter. Every new account under our Google Ads management goes through this settings review before the first ad runs.
