Changing your clinic to a face and body spa
BY TIM HAMILTON

Adding a wellness spa to your selection of services is one way to expand your practice. It is not difficult, it will enhance your image, and it creates great revenue.

A recent release from the International SPA Association’s (ISPA) industry study shows an exciting and profitable consumer trend:

• Currently an estimated 12,000 spas operate in the United States, a 25 percent increase from 2002.
• The largest category is day spas, numbering some 8,734, a 20 percent growth from 2002. Resort and hotel spas come in at a not-so-close second, with 1,662 spas.
• Revenues for the U.S. spa industry in 2003 were $11.1 billion, up from $10.7 billion in 2001.

Spa industry growth depends on the services offered and the results obtained. It is not merely a trivial enterprise that consists of cucumbers over the eyes and fingertips soaking in preparation for a manicure.

According to the International Medical Spa Association (IMSA), a medical spa is a facility that operates under the full-time, on-site supervision of a licensed healthcare professional, such as a chiropractor. Operating within the scope of practice of its staff, it may offer traditional, complementary or alternative health practices and treatments in a spa-like setting. Practitioners working within a medical spa are governed by their appropriate licensing board, if licensure is required.

You do not have to perform any of the spa procedures yourself; skin care specialists (estheticians) can manage this part of your clinic. In most states you can also use cosmetologists, and in some states no special training is required to perform skin care services.

Most skin care specialists dream about working in a facility that has an established database of clients and many will work on commission. This means you do not pay them unless they are making money for your clinic.

If your client population follows the curve of most of your colleagues, then you already have a target audience that coincides with that of the spa-attending audience. The majority are women between 25 and 55. The male population who receives spa services is growing rapidly and many spas already have a menu of services specifically for men.

The most popular procedures offered in medical spas include treatments noted by the American Academy of Facial and Plastic Surgeons:

• Microdermabrasion. This is a mild abrasion of areas on the face or other parts of the body that gently removes the outer layer of skin (stratum corneum). The results are rejuvenation of the skin, diminished fine lines and wrinkles and promotion of new cell growth at the germinal layer of the epidermis.

This process also stimulates reoxygenation at the dermal layer by increasing blood flow and has been documented to increase collagen, elastin and fibroblasts at the dermal layer. Typically, this procedure is done once every seven to 14 days in a series of five to 10 treatments, with the average cost per procedure at $100.

Equipment costs range from $5,000 to $10,000 for a micro-dermabrasion system, with operating costs under $10 per procedure for most systems on the market.

• Chemical peel. A chemical alternative to physical abrasion is similar to microdermabrasion in that it removes the outer layer of the epidermis, promotes new cell growth and is done in a series.

The intensity of treatment is amplified at each visit by applying more layers of the acids (glycolic, salicylic, latic or malic) or by increasing the treatment time. Customers are charged anywhere from $50 to $200 per procedure in a series of up to 10 treatments.

Investing in a line of cosmeceutical products to compliment your treatments can cost from $200 to $5,000, depending on the minimum order required by the manufacturer. Retail products for face and body can be a huge source of income in your new spa, as there is usually a 100-percent markup on these products.

• Botox® and fillers. These are the most popular, minimally invasive procedures in the industry. Most states still require that a medical doctor perform these procedures; however, some states allow a nurse practitioner. If you have a medical doctor associated with your practice, these procedures can be performed without a lot of startup expense. Your esthetician can market these services to your clientele and even screen candidates.

Typical charges for Botox® treatment range from $250 to $350 per site. Collagen (either bovine or human) and the newer synthetic fillers such as Radiesse™ (formerly known as Radiance™) or Restylane™ (hyaluronic acid-derived synthetics) vary in price. Bovine collagen injections are typically $350 to $450 per site. Synthetic collagen injections range from $450 to $550 per site but typically last twice as long as the nonsynthetic fillers.

• Permanent hair removal. A variety of new light- therapy treatments have emerged in the past several years that are labeled “pulsed light therapy.” Most people call this treatment IPL (intense pulsed light).

Less expensive to own and operate than most laser devices, they can still be quite expensive at $30,000 to $130,000. Many IPL devices have multiple hand pieces that use different wavelengths and frequencies to remove unwanted hair, vascular blemishes, acne and tattoos.

IPL devices are generally listed as FDA Class 2 equipment. The regulations on the use of this device vary from state to state. Some states allow the use of Class 2 devices without an MD’s supervision, while other states will not.

Do not be discouraged by the cost of the equipment — permanent hair removal is a great revenue source. Most clients have multiple treatments that average $429 per client, with a national total of $267 million spent for this treatment.

Wellness spa services provide a quick return on investment. Most expanding clinics begin with microdermabrasion and a cosmeceutical product line, since these do not require a physician’s supervision. A conservative investment would average $10,000 and enjoy a return on investment within the first several months. As your spa business grows, you can advertise and pre-sell other services even before you invest in them.

Our society in general is not aging gracefully. This aging population is willing to pay a lot for services that succeed in making them look and feel younger. Current statistics indicate that somebody turns 50 every eight seconds, and most of them are not happy about it!

Tim Hamilton has been involved in clinical medicine for more than 20 years. He has degrees in biology and human genetics and attended University of South Carolina School of Medicine. He owns Grace Medical Equipment, Inc. in Charleston, S.C., and teaches continuing education programs throughout the southeast. He can be reached through his Web site, www.gracemedicalequipment.com