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How I Started My Own Med Spa

One RN shares the highs and lows of starting her own med spa, as well as 6 key pieces of advice she has for other med spa entrepreneurs.

August 7, 2020

Variety of beauty treatments laying on a peach-colored table

As told to Lisa Fields by Eileen M. Fleer, RN, BSN, owner of ALC Medspa in Gurnee, Illinois

Newly divorced — and a medical spa owner — I kept going over the financial spreadsheets. What if I can’t pay myself a living wage? I had four kids to care for. What if I couldn’t pay rent or our health insurance bills? There were nights I couldn’t sleep, running the numbers over and over, thinking about what would happen if I had to shut everything down.

My love for small business started in 2004 when my (now ex-) husband and I bought a laser hair removal and microdermabrasion franchise. Laser hair removal was hot, and as a nurse performing the work, I was always busy. I brought in my business-savvy sister-in-law to help manage the business, and after a year or two, we were adding more aesthetic treatments like skin rejuvenation and intense pulsed light (IPL) photorejuvenation. Our business was growing!

Owning my own business was amazing. I had previously worked as an RN in the ER and ICU for a few years and then took 10 years off to raise our children. But with the med spa, I was going to work with a new passion. The money and the flexible schedule were exactly what I wanted. I was my own boss. Plus, providing aesthetic treatments came naturally to me and allowed me to use my nursing skills in a totally different way.

My husband was a doctor and his salary supported us, so I was able to put all my income directly back into the business. But then the divorce happened, and suddenly, without my husband’s salary to fall back on, owning a med spa was potentially terrifying. I was consumed by fear and anxiety and endured many sleepless nights considering all the worst-case scenarios.

My med spa is now 14 years old and a great success. We separated from the franchise in 2006, which allowed us to focus on providing more offerings. In fact, business has been so good, I’m about to open a new location!

Starting Out

To get started, we took out a loan for $120,000. The franchise was $40,000, and the equipment leases were $80,000. And because it was a franchise, my sister-in-law and I just followed the business plan, enthusiastically throwing ourselves into the work.

Our main goals were to find a good location, hire staff, and do everything legally. We rented a three-room suite on the second floor of a professional building. It was tiny and private, at a time when most people were still very secretive about getting aesthetic treatments. As soon as I walked in, I could imagine myself working there, and we both became excited about our plans coming to life. I did all the procedures at first, but we hired another nurse within the first year, and we were booked out for weeks in advance.

Med spas were largely unheard of when we opened in 2004, and the laws about who could perform certain treatments seemed ambiguous. The local business attorney I hired didn’t know about the med spa business, so I eventually sought out AmSpa — the American Med Spa Association — for guidance. I needed a professional liability insurance policy to cover my licensed providers, including nurses and aestheticians. On top of that, I also needed a business owner’s insurance policy for things like worker’s compensation, slips and falls, fire destruction, and equipment damage.

A New Beginning

We didn’t plan to separate from the franchise, but the company was bought out by another group that we didn’t want to be affiliated with. After some litigation, we were able to keep our name, our location, and all our equipment so we could break out on our own. All of a sudden, the world was our oyster! I didn’t have to answer to the franchise and do it their way anymore. We could now offer new products and services (like Botox and fillers), and my vision for this company came to life.

Part of the plan was always to have someone in a medical director position. Med spas must have a collaborating physician to purchase the medical equipment, prescription injections, and other things that are only available to doctors (although this may vary by state). For the first six years I ran the med spa, my then-husband assumed this role. But after the divorce, I had to hire a plastic surgeon, which was costly.

Where I Am Today

It’s been eight years since those sleepless-newly-divorced-spreadsheet-checking nights, and my med spa is thriving. In fact, those services we added post-franchise are now our top sellers. Botox, fillers, and medical-grade facials are what people are looking for today, and they no longer need plastic surgeons to perform them.

This hasn’t been the easiest road. There were huge lessons to learn along the way, especially when it came to my own time management. There have been times when I’ve felt spread so thin that I was having anxiety, feeling like I was letting everyone down. As the main injector, I was consistently booked solid and wasn’t able to focus on growing the business. I was only getting through the day-to-day.

A year ago, I stepped out of the treatment room altogether. Now, I have a staff of RNs, NPs, and aestheticians who perform the treatments so I can focus on the business. I even hired someone to do my social media, Google ads, and SEO for my website. I also use the eRelevance platform to market to my clients. Right now, my focuses are on the next spa I’m opening and going to more of my kids’ sporting events.

While I feel more like a businesswoman than a nurse at times, my nursing background is always with me. Truly caring for our patients is at the core of my office culture. It impacts who I hire and how I treat everyone who walks through my door.

The Best Lesson I’ve Learned

You have to follow your passion and open a med spa for the right reasons. Don’t go into it for the money. It’s not easy work. As a business owner, it’s a 24/7 responsibility.

I’ve had to ask friends to stay at my house to take care of my kids when I was working late nights. I’ve also missed my kids’ performances and sporting events because loyal customers needed me. You really have to love what you’re doing, so you can love your business through the good and the bad.

My 6 Pieces of Advice for Other Med Spa Entrepreneurs

Here are the six most important pieces of advice I can give other entrepreneurs who are looking to open their own med spas.

  1. If you’re starting out, focus on the injectables and facial services, which don’t require expensive equipment. Laser hair removal and CoolSculpting equipment are nice to have, but the equipment is expensive and takes longer to profit on the investment if you’re just starting out. If I were starting out today with Botox and fillers instead of pricey laser equipment, I could probably get by with a $10,000 loan.
  2. Don’t get overwhelmed by the idea of writing a business plan. There are easy templates online. All you have to do is fill in what your dream is for the next five years. You don’t even have to stick with what you write down because this industry changes so quickly. But it’s good to get your vision onto paper.
  3. Take the time to do your homework. Figure out what your rent will be, how many people you’ll hire, what services you’ll offer, insurance rates, and whether you’ll need to buy equipment. Then, sit down and do the math. There will also be startup fees to consider, such as legal advice and store renovations, that are one-time expenses. The legal fees to get you established can be significant, but it’s something you just can’t skimp on.
  4. If you need help with your business plan or need legal counsel, check out AmSpa’s services. Their attorneys really understand the nuances of this specialized field, so I feel comfortable with their guidance and support.
  5. Before you hire anyone, make sure you’re like-minded as far as mission and culture go. How do they take care of people? What are they interested in doing? Does the person emulate the way we do things? You can teach people skills, but you can’t teach them culture and passion.
  6. When you’re looking for equipment for your med spa, think about getting POS software to help with scheduling and managing client relationships. There are several systems available. Booker is the one we use. We did a free trial and really liked it; it was easy to integrate into our database, so we signed on. It does check-ins and check-outs, and it lets us run credit cards. I use it for all my reporting, as well as for sending promotional emails to customers. Millennium is another POS system I’ve heard that people use a lot, too.

Image courtesy of iStock.com/fortyforks


The views expressed in this article are those of the author and do not necessarily reflect those of Berxi™ or Berkshire Hathaway Specialty Insurance Company. This article (subject to change without notice) is for informational purposes only, and does not constitute professional advice.

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