MedSpa Market Overview

FEBRUARY 2024

Understanding Medical Aesthetics

The field of Medical Aesthetics (or “MedSpa”) is dedicated to enhancing patients' cosmetic appearance using a variety of non-surgical methods. What differentiates MedSpas from conventional beauty services and spa treatments is the oversight of qualified medical professionals and licensed estheticians.

What Services Are Offered?

Fundamentally, the MedSpa industry is characterized by the availability of non-invasive cosmetic procedures.

  • Body contouring
  • Facials
  • Fillers
  • Laser treatments
  • Micro needling
  • Neuromodulators
  • Ultrasound therapy

In each specified category, a multitude of services are accessible for patient utilization, and these services are becoming increasingly prevalent.

Who Are The Providers?

Although pure-play MedSpa practices can administer these services independently, the industry gains added value from diverse medical professionals who integrate these core services into their existing practices.

  • Licensed physician (MD)
  • Nurse practitioners (NP) & physician assistants (PA)
  • Registered nurse (RN)
  • Licensed practical nurse (LPN)/licensed vocational nurse (LVN)
  • Aesthetician, cosmetologist and unlicensed personnel

What Are The Benefits?

MedSpas offer a wealth of cosmetic and mental health benefits. The most successful practices blend the confidence associated with high-level medical professionals with the convenience and wellness capabilities of a health spa.

  • Non-surgical anti-aging treatments
  • Access to innovative technology
  • Manage health conditions
  • Metabolic optimization
  • Improved self confidence
  • Long lasting results
  • Relaxation benefits

The MedSpa Market

The MedSpa market size reached $18 billion in 2023, with a projected CAGR of 18.7% through 2032. This expansion is fueled by robust consumer trends, highlighted by a heightened focus on wellness and cosmetic care.

Historical & Forecasted Global Market Size

cagr-graph

# of Procedures by Service
in U.S. (2022)

of Procedures by Service in U.S. (2022) img

The United States dominates the MedSpa market and continues to witness growth. The top four states with the highest concentration of MedSpa businesses are California (11.5%), New York (10.0%), Florida (8.8%) and Texas (7.6%).

Map Data Img
7,430

Registered MedSpas in the U.S. by the end of 2021.

8,841

Registered MedSpas in the U.S. by the end of 2022.

+19%

Sources: Expert Market Research, Statistica, Medica Depot, IBISWorld

Consumer Segments in U.S.
(2023)

Catalysts for Growth in the MedSpa Industry

Factors Fueling Growth

  • Surge in non-invasive cosmetic procedures.
  • Rising disposable incomes. With the rise in consumer incomes, there is an increasing willingness to spend more on aesthetics. Surveys indicate that 50% of consumers planned to invest more of their income on cosmetic treatments in 2020, a number that reached 73% in 2021.
  • Expanding target market (males, geriatric population).
  • Significant technological advancements. The MedSpa industry is reaping the benefits of extensive medical research and development, leading to more effective and enduring treatments.
  • Diverse range of medical professionals who can practice within the MedSpa industry.

The demand for non-surgical cosmetic treatments is rapidly increasing. With consumers placing greater emphasis on overall wellness and appearance, there is a growing need for the more affordable and safer procedures that are offered by MedSpa practices.

Growth Rate in Non-Invasive Cosmetic Procedures
(2018-2022)

3x

While the typical consumer remains predominantly female, the number of males seeking aesthetic treatments has tripled since 2000.

1.4B

The population of adults over 60 is growing and expected to reach 1.4 billion by 2030.

In contrast to traditional medical practices, MedSpas can be owned and operated by a variety of specialized medical professionals. This allows the industry to benefit from core doctors, such as plastic surgeons and dentists, incorporating MedSpa services into their primary business.

revenue-result
  • Dentists
  • In Home Nurses
  • Dermatologists
  • Plastic Surgeons
  • MedSpas

Sources: Mordor Intelligence, Data Bridge Market Research

Highly Acquisitive Operators

Ownership:

PCP-LOGO

Initial investment:

December 2019

Recent Acquisitions:

1 Sept 2022

bodify

2 Feb 2023

shinobay

3 Feb 2023

advance-skin

4 Feb 2023

doris

5 April 2023

faces

Ownership:

Independent

Initial investment:

October 2022

Recent Acquisitions:

1 Mar 2023

Destination logo

2 May 2023

glow

3 May 2023

theageless logo

4 Jul 2023

blush-logo

5 Jan 2023

h-medical-logo

Ownership:

PCP-LOGO

Initial investment:

April 2023

Recent Acquisitions:

1 Jan 2023

hte-logo

2 Jul 2023

refied

3 Aug 2023

barbarinr

4 Nov 2023

laser-logo

5 Dec 2023

w-logo

Ownership:

PCP-LOGO

Initial investment:

April 2022

Recent Acquisitions:

1 Jan 2023

ski

2 Mar 2023

sk-njectables

3 May 2023

kun

4 Jun 2023

gunesis

5 Aug 2023

advancelifeclinic

Investor Appetite & Activity

In the last five years, approximately $3.1 billion in private capital has been invested in the MedSpa industry. These investments are driven by substantial growth and enduring tailwinds, making the MedSpa sector an appealing investment.

North American M&A Volume

North American M&A Volume Img
8%

Just 8% of MedSpas are under private equity, franchise, or national chains, signaling a substantial opportunity for investors to consolidate the industry.

Tailwinds & Headwinds:
What is Impacting Investment?

Strong
Growth
Catalysts
Increased demand for core services, rising consumer incomes, an expanding target market, technological advancements, and a diverse range of service providers contributing to significant growth.
Highly
Fragmented
Market
MedSpa stands out as one of the few healthcare industries witnessing a faster influx of single-location operators than the consolidation of existing practices. In 2022, approximately 76% of the U.S. MedSpa space was dominated by single-location owners, presenting promising investment opportunities.
Resilient
Industry
The industry has proven to be resilient in times of economic downturn. During the 2008 financial crisis, as well as the COVID-19 pandemic, MedSpa took a hit, but recovered well in the following years.
Recurring
Nature
MedSpa practices tend to experience high rates of returning patients, and the procedures administered are largely recurring in nature leading to predictable cashflows.
Demand
Outpacing
Supply
While this issue has not manifested prominently, the current surge in demand could outpace the supply of qualified medical professionals. Despite the industry having a varied array of service providers, demand is on the rise. Any regulatory measures aimed at expanding the certifications needed to practice within the industry could pose challenges.

Sources: Modern Aesthetics, PitchBook, PR Newswire, BeautyMatter

Select MedSpa Platform Transactions

Date Target Acquirer Transaction Type
November 2023 Was acquired by Platform
October 2023 Was acquired by Platform
September 2023 Was acquired by Platform
July 2023 Was acquired by Platform
June 2023 Was acquired by Platform
May 2023 Was acquired by Platform
April 2023 Was acquired by Platform

Select MedSpa Add-On Transactions

Date Target Acquirer Transaction Type
January 2024 Was acquired by Add-On
January 2024 Was acquired by Add-On
January 2024 Was acquired by Add-On
December 2023 Was acquired by Add-On
December 2023 Was acquired by Add-On
November 2023 Was acquired by Add-On
November 2023 Was acquired by Add-On
October 2023 Was acquired by Add-On
August 2023 Was acquired by Add-On

Regulatory Impact on MedSpa

Rising consumer demand and heightened investor interest in the MedSpa industry has brought about various federal and state regulations, presenting complexities in structuring transactions and establishing new clinics.

Select Current Legislation

State CPOM Doctrines:

CPOM (Corporate Practice of Medicine) Doctrines differ by state, imposing restrictions or outright prohibitions on the ownership of medical practices or businesses by individuals without medical licenses.

Implications:

As many states classify core MedSpa services as medical practice, non-physician ownership is generally restricted. Investors must consider this when structuring transactions within the MedSpa industry.

FTC Act & HIPAA:

Physician and clinic advertising adhere to FTC Act regulations, with consumer information governed by HIPAA. In this visually and digitally focused industry, practitioners must carefully follow these guidelines to avoid penalties for deceptive acts or consumer rights.

$43,792

in fines per violation (FTC Act)

U.S. Stark Law & Anti-Kickback Statute:

The AKS and Stark Law bar medical providers from exchanging kickbacks for patient referrals under Medicaid/Medicare. Although most MedSpas operate on a cash basis, those providing treatments like neurotoxin injections for non-cosmetic conditions and participating in federal healthcare programs are subject to these regulations.

35

states have imposed their own variations (some extending to all cash transactions)

Select Pending/Proposed Legislation

Texas Bill HB 3567:

A proposed law in Texas aims to mandate the presence of an NP, PA, or MD on-site for all aesthetics businesses. Additionally, medical directors must be within 75 miles of the business they oversee, and the supervision limit for one MD over NPs and PAs is proposed to decrease from 7 to 5.

Michigan 2022-19 LR:

The proposed rules restrict estheticians from using blades, performing medical treatments like microdermabrasion and Botox injections, employing devices below the stratum corneum, diagnosing or treating medical conditions, and using lasers or ultrasounds.

Implications:

Estheticians cannot perform cosmetic medical procedures, unless acting as unlicensed medical assistants under a physician. This restriction would limit estheticians' independent service abilities, affecting the flexibility and efficiency of med spa operations.

California AB 1091:

The proposed regulation mandates a 90-day notice to the Attorney General (AG) before any health care transactions take effect. The AG reviews based on market competition, quality of care, and access to care, with the authority to approve, conditionally consent, or deny the underlying transaction.

Sources: McGuireWoods LLP, Telos Digital Marketing, Morgan Lewis, Lengea Law, American Med Spa Association, UC Law San Francisco

Regulatory Landscape in Major MedSpa Markets

While federal laws play a role in shaping the regulatory landscape of the MedSpa industry, the crux lies in the diverse regulations of individual states.

Regulatory Considerations in the Top 4 MedSpa Markets

Key Considerations California New York Florida Texas
Does the state have a Corporate Practice of Medicine doctrine? Yes Yes No Yes
Is continued education or advanced training required? Yes Yes Yes Yes
Can you charge commission on laser treatments or injectables? No No No Yes
Can you share profits if you’re not a licensed doctor? No No No No

Sources: Dental & Medical Counsel, Facemedical

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AMB Investment Banking Snapshot and Deal Team

AMB focuses on lower middle-market healthcare niches where consumerism and fragmentation meet to disrupt traditional healthcare channels. We typically advise companies with EBITDA of $5M to $20M and an average enterprise value of $100M, but will move up and down the spectrum. AMB’s research-oriented approach to business development has resulted in a vast network of strategic and financial sponsor relationships that yield industry leading intelligence and optimal outcomes for our clients.

Mikel Parker

Managing Director
843-501-2183 Direct
mikel.parker@ambadvisors.com

Ryan Loehr, CPA

Managing Director
843-405-1108 Direct
ryan.loehr@ambadvisors.com

Johnny Cross

Vice President
843-371-8596 Direct
johnny.cross@ambadvisors.com

Kevin Williams

Senior Associate
843-473-7981 Direct
kevin.williams@ambadvisors.com

Sully Hagood

Associate
843-576-4709 Direct
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Josh Hall

Analyst
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josh.hall@ambadvisors.com

Asha Hamaker

Analyst
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asha.hamaker@ambadvisors.com

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