Picture three people typing into Google on the same evening. One has noticed a mole that looks darker than it used to and types "melanoma symptoms." One has had an itchy rash on her arms for two weeks and types "eczema treatment." One is looking in the mirror at the lines on his forehead and types "botox."
All three might end up in a dermatologist's chair. None of them is ready to book tonight. And each one is walking a different road to get there, with different questions, different costs and different competitors waiting along the way.
That is the second thing a dermatology practice has to get right in Google Ads, right after the tracking we set up in Chapter 1: knowing which searches are questions and which are appointments, and paying for the appointments first.
A Dermatology Practice Runs Three Funnels Through One Account
Most businesses have one path from curiosity to purchase. A dermatology practice usually has three, running side by side through the same ad account.
The medical path starts with a symptom: a rash, acne that won't clear, hair thinning, a scalp that flakes. These patients usually pay through insurance, and the first question many of them ask is whether you take their plan.
The skin cancer path starts with worry: a spot that changed, a family history, a friend's diagnosis. It moves fast once a patient is scared and slow when they aren't, and it ends in a screening, a biopsy or Mohs surgery.
The cosmetic path starts with a mirror: wrinkles, sun spots, unwanted hair. These patients pay cash, compare prices, and have more places to go than any other kind of dermatology patient, because med spas, injectors and plastic surgeons all want the same search.
Google Ads can serve all three. It just can't serve them with one campaign, one set of keywords and one message. Each path has its own stages, and the stages are where the planning starts.
Five Stages Stand Between "Itchy Rash" and "Dermatologist Near Me"
We use five stages of awareness to sort every search a practice might pay for. The names are borrowed from classic copywriting; the examples below are real words from dermatology patients, taken from the online forum threads and Google reviews we collected for this guide.
Unaware. The patient doesn't know there's anything to do. "I've honestly never heard of a yearly skin check by a dermatologist before this sub," one person wrote. Nobody at this stage is searching for you, so the marketing job is to create awareness.
Problem aware. Something is bothering them, but they haven't connected it to a treatment. "My moles look kind of funky." The job here is to drive interest: help them understand what they're looking at.
Solution aware. They know what they want done. "I want to start doing yearly checks." Now the job is to influence a decision toward your kind of care.
Service aware. They're choosing who. "Does anyone have a derm they'd recommend specifically for skin cancer screening?" This is where searches like "dermatologist near me" live, and the job is to compel action.
Most aware. They've chosen. "This will become my new Dermatologist for the future." These people search for your practice by name, and the only job left is to make sure you're the one who shows up.
The stages matter because a search at each one costs money in a different way. A click from a problem-aware patient buys you a reader. A click from a service-aware patient can buy you a booking.
Five Times More Atlanta Searches Ask What Skin Cancer Looks Like Than Ask for a Screening
Here is what the skin cancer path looks like in real search volume. These are monthly Google searches in the Atlanta market, from Google's Keyword Planner:
- "what does skin cancer look like": about 1,300
- "melanoma symptoms": about 880
- "skin cancer treatment": about 1,600
- "skin cancer screening": about 260
The two question searches together bring in more than eight times the traffic of the screening search. That can look like an opportunity. Mostly it's a trap for a new account. A person asking what skin cancer looks like wants pictures and reassurance. They'll get both, often from Google itself: in our September check of 20 Atlanta dermatology searches, Google showed an AI-generated answer at the top of six of them, mostly condition and cosmetic searches, and none on "dermatologist near me" or the screening searches.
The screening search is small, but the person behind it has already done the worrying and the reading. They want an appointment. That is the search a new account should pay for first, alongside the broader "dermatologist near me," which pulls about 22,200 searches a month in the same market.
None of this means the research searches are worthless. It means they belong later in the account's life, once Google has learned from enough real bookings to find the few researchers who are close to acting.
Med Spas Crowd the Cosmetic Searches Before a Dermatologist Appears
The cosmetic path is shorter in volume and much more crowded:
- "forehead wrinkles": about 260 a month
- "botox": about 3,600
- "botox cost": about 260
When we checked the organic results for Atlanta cosmetic searches such as Botox, lip filler, chemical peels and laser hair removal, the top spots went mostly to med spas, independent injectors, plastic surgery practices and directories, with dermatology practices mixed in rather than leading. A dermatologist advertising Botox is walking into a room that was full before they arrived. Chapter 15 covers how a board-certified dermatologist competes there.
The medical path looks different again:
- "itchy rash": about 260
- "eczema treatment": about 4,400
- "dermatologist for eczema": about 1,000
- "dermatologist near me": about 22,200
Notice where the volume sits. On the medical path, the biggest number is at the bottom, where people have already decided they need a dermatologist and are looking for one nearby. On the cosmetic path, the biggest number is a treatment name with no location attached, which suggests people still comparing their options.
Some Patients Want Two Dermatologists: One for Moles, One for Botox
One comment from an online skin care forum sums up why these paths need to stay separate in an ad account: "I'm finding I need two different derms. One that does the a la carte beauty stuff and one that does the medical mole check."
That patient isn't confused. They're describing two different purchases. The mole check is usually billed to insurance, happens once a year, and is judged on thoroughness. The "beauty stuff" is paid out of pocket, happens every few months, and is judged on results and price.
An ad that tries to speak to both ends up speaking to neither. "Medical and cosmetic dermatology, accepting new patients" tells the worried mole patient nothing about how thorough the exam is, and tells the Botox shopper nothing about price or results. When each path has its own campaign, each gets its own keywords, its own ads, its own landing page and its own budget, and you can see which one is paying for itself.
This is also why the tracking in Chapter 1 matters so much here. If a cosmetic booking and a skin cancer booking count as the same conversion, Google has no way to tell which path is working.
Give Each Stage One Google Campaign Type, Not All of Them at Once
Google has built a campaign type for almost every one of these stages. The mistake is launching all of them on day one.
At the bottom, where patients are service aware or most aware, the tool is Search. We start with what we call an Isolation campaign (our name for it): exact match keywords with manual bidding, limited to the searches we already know lead to bookings, such as "dermatologist near me," "skin cancer screening" and your city plus the condition. Next to it runs a brand campaign for the people searching your practice and your doctors by name.
One stage up, where patients are solution aware and searching treatments like "eczema treatment" or "mole removal," the tool is still Search, but broader. That is the Exploration campaign we build in Chapter 6, and it waits until the account has enough real bookings to learn from.
Higher still, Performance Max and Demand Gen reach people who are problem aware or haven't searched at all. Google describes Demand Gen as campaigns that "capture engagement and action across YouTube (including Shorts), Discover, Gmail, and the Google Display Network." That reach is real, and in dermatology it can do genuine good, such as reminding people that a yearly skin check exists. It is also the most expensive way to find a patient who is ready to book, and it belongs after the bottom of the funnel is working.
Start at the Bottom, Where Patients Have Already Decided to See Someone
Traditional marketing starts at the top of the funnel and hopes people trickle down. Google Ads works better in the opposite order.
A new account knows nothing. Google's automated bidding can't learn what a good patient looks like until it has seen some, and the fastest way to show it is to buy the searches where people book. Every booking from "dermatologist near me" or "skin cancer screening" teaches the account something true. Every click from "what does skin cancer look like" mostly teaches it what curious people look like.
So the order is: win the bottom, feed the account real bookings, then climb one stage at a time. The medical and skin cancer paths usually go first, because "dermatologist near me" and the screening searches are the clearest signs that someone wants an appointment. The cosmetic path joins when the practice has decided how it wants to compete with the med spas down the street.
The one exception is a practice with a budget large enough to fund every stage at once and the patience to wait for the upper stages to pay back. That is rare in private practice, and even then, the bottom still goes first.
Next: What a Dermatology Patient Is Worth Over a Whole Year
Knowing which searches to pay for leads straight to the next question: how much to pay. A skin check patient may come back every year, and a cosmetic patient may return every few months, so the first visit is rarely the whole story. Chapter 3 works out what a click is worth when you price it against the patient's full year.
The Google Ads for Dermatologists guide home lists every chapter in order. Every account under our Google Ads management is planned stage by stage this way before the first campaign goes live.
