Every med spa keyword list starts with the treatment that pays the rent. For most practices that's Botox, and in our example market, Miami, "botox" and "botox close to me" each draw about 2,900 searches a month. It's the obvious first keyword.
It's also, for most med spas, a keyword Google won't sell you. This chapter builds the keyword list from the ground up, starting with that rule, because it shapes the whole account.
The Biggest Line on the Menu Is the Hardest Word to Buy
Google treats prescription drug names as restricted terms. Since its policy update took effect on October 29, 2025, advertisers targeting the US can use those names in ad text and on landing pages without any special approval. Bidding on them as keywords is different: that requires certification from Google.
Several of the names on a med spa menu are on Google's prescription drug list. We checked the list term by term:
- On the list: Botox, Dysport and Xeomin, the neurotoxins, and semaglutide, Ozempic, Wegovy, tirzepatide, Mounjaro and Zepbound, the weight-loss drugs.
- Not on the list: Juvederm, Restylane, Radiesse and Sculptra, which are fillers regulated as medical devices, not prescription drugs, and Kybella.
Google calls the list non-exhaustive, so a name missing from it isn't a guarantee. Kybella is a prescription injection even though it isn't listed, and newer neurotoxins such as Jeuveau and Daxxify don't appear either. We'd treat all three as restricted until Google says otherwise.
So the ad itself can say "Botox." The treatment page can say it as often as it needs to. What most med spas can't do is put "botox near me" in the keyword list and bid on it.
No Certification Box Fits an In-Person Med Spa
The next question is always the same: how do we get certified? For an in-person med spa, there doesn't appear to be a way.
Google describes the certification for businesses such as online pharmacies, telemedicine providers and drug makers, and telemedicine in the US also requires accreditation from LegitScript. The application asks which category you are, and Google is blunt about it: "Do not apply for a category that does not match your business model." A med spa that injects clients in person isn't an online pharmacy, a telemedicine company or a manufacturer.
Our reading is that an in-person med spa can't keyword-target Botox or the GLP-1 drug names. Google doesn't say that in one sentence, so check your own account's policy manager before you build anything around it. The one real exception is a med spa that runs a certified telehealth weight-loss program, and Chapter 14 covers that route and its rules.
You'll also run into the opposite claim online: that med spas can't mention Botox in ads at all. That was closer to true before late 2025. It isn't what Google's policy says now.
Start Where Your Competitors Already Did the Research
With the rule in hand, build the list the way we build every one: from what's already working in your market.
First, see who shows up. Google's Ad Preview and Diagnosis tool shows the ads for a search in your location without counting as a real search. Never click a competitor's ad to look; you're spending their budget and muddying your own data.
Then take the websites of the practices that advertise and feed them into Keyword Planner, one at a time, with the location set to your market. Keyword Planner reads each site and returns the searches it thinks the site is relevant to, with monthly volumes and bid estimates. In the example market, twelve competitor sites and one extra run on treatment names returned 25,320 keywords. Run your own site through it too. What comes back shows which treatments Google already connects to your practice, and which ones it doesn't.
Two cautions when reading the results. The top-of-page bid estimates are based on broad matching, so treat them as a range give or take about 30%. And close variants share one number: "laser hair removal" and "laser hair reduction" both show 4,400 because Google counts them together. Never add them up.
Seeded Runs Miss Whole Treatments. Fill the Gaps by Hand.
Keyword Planner only returns what it can connect to the sites you give it, and that leaves holes. In the example market, the twelve competitor-seeded runs came back strong on the treatments those sites wrote the most about and thin on others.
The fix is one more run, seeded with treatment names instead of a website. We gave Keyword Planner 21 of them, from Botox and lip filler to Morpheus8, CoolSculpting, IV therapy and PRP, set to the same market. That single run added 12,425 keywords and filled clusters the site runs had barely touched.
Do the same with your own menu. List every treatment you actually sell, including the ones your website barely mentions, and run them as seeds. A treatment you offer but never wrote a page about is invisible to a site-seeded run, and it's often the one a competitor is quietly winning.
Filler, Laser and Device Names Are Fair Game
Much of a med spa menu has no drug-name problem at all. In the example market:
- Sculptra, 2,900 searches a month
- HydraFacial, 1,900
- Morpheus8, 1,600
- Juvederm, 720
- Laser hair removal, 4,400, and microneedling, 4,400
These can be bid on like any other service (Kybella, at 720 a month, is the exception to handle carefully, as above), on their own or with "near me" and your city. For a med spa with a strong filler, laser or skin line, this is where most of the early budget can go without any certification question.
The Neurotoxin Line Has Few Searches Without the Drug Name. Weight Loss Has Plenty.
Here's the uncomfortable part, and it's worth being straight about.
For neurotoxins, clients mostly search by the drug name. Without it, the example market's volume thins out fast. The largest by far is "lip flip," the quick neurotoxin treatment that turns the upper lip slightly out, at 880 a month. After that, the numbers drop to almost nothing: "neurotoxin" 210, "forehead lines" 50, "anti wrinkle injections" 50. Next to 2,900 for "botox," that's a small slice.
That changes the job for the neurotoxin line. The keywords you can buy bring fewer visitors, so the treatment page, the ad text naming Botox, and your own brand campaign carry more of the weight. Clients who already know your name and search for you are the neurotoxin line's best source.
It also changes how you judge the line. A Botox campaign built on "lip flip" and a handful of area searches will never look as big as a laser campaign, and it shouldn't be measured against one. Judge it on bookings per dollar, and remember what Chapter 3 showed: a neurotoxin client can return every three months. A small line that books steady first visits can be worth more over a year than a big one that books one-time treatments.
Weight loss is the opposite. Clients search the problem and the program, not just the drug:
- "Weight loss injections," 1,600 a month
- "Weight loss clinic," 590
- "Glp 1 weight loss," 480
- "Weight loss shots," 480
- "Medical weight loss near me," 390
Bid estimates on these run as high as about $39 a click, a sign of how many advertisers want them. The weight-loss line can be built on real, searchable phrases without a single drug name in the keyword list.
The Word "Spa" Pulls In Massage Seekers, and Other Searches to Block
A competitor-seeded list comes back full of searches you'll never want. In the example market's 25,320 keywords, the biggest groups to block were:
- Massage, day spa and hotel spa searches, about 760 of them, led by "massage near me" at 90,500 a month. The word "spa" in your name and pages pulls these in.
- Urgent care and walk-in clinic searches, about 850, returned by one competitor that runs urgent care alongside IV therapy.
- Surgical procedures, about 900, from sites attached to plastic surgery practices. Junk for a non-surgical med spa.
- Competitor names, about 560.
- At-home devices, medical skin conditions, online and coupon drug buying, jobs and training courses, smaller groups but steady.
Competitor names deserve a word. They'll come back from this research, and in far larger numbers once broad match starts in Chapter 7. They go on the negative list. Going after a rival's name on purpose is another matter entirely, one that needs its own campaign and its own budget. Most med spas are better off never starting it.
"Cheap" and "free" searches get cut too, with one exception worth keeping: a real booking search like "free botox consultation." Negative keywords are never a finished list. They're checked daily once broader matching starts.
Build Tight Ad Groups in a Sheet, Then Load Them
The list goes into a Google Sheet before it goes into Google Ads. Each line of the sheet holds a single search, with the campaign and ad group it belongs to beside it. Formulas generate the exact, phrase and broad versions of each keyword automatically, so you never type brackets by hand. Then Google Ads Editor loads the whole sheet at once.
Keep ad groups small and tight: about five or six keywords that all mean the same thing, as Chapter 4 explained, each pointing to its own treatment page. Put searches for your spa's name and your injectors' names in a separate brand campaign, so they don't flatter the numbers of the treatment campaigns.
Next: Treatment Plus Near Me Is Where the Account Starts
A long, clean keyword list is the raw material. The next decision is which of those keywords go live first, and how tightly they're matched. Chapter 6 builds the first campaign around the searches most likely to book: a treatment plus "near me" or your city.
Every chapter of the rollout is linked from the Google Ads for Med Spas guide home. If you skipped ahead, Chapter 2 explains why a treatment name, rather than "med spa," sits at the top of each ad group.
In the med spa accounts we build under our Google Ads management, this research, and the drug-name rule behind it, is done before a single keyword goes live.
