Should You Tip at a Medical Spa?

Medical spa tipping
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Everyone knows that you should tip at a spa when you get services like massage or facials. A 15 to 20% tip is the norm at most spas, and many resort spas add the tip on as part of the service. 

But things aren't as clear-cut at the medical spa, a hybrid between a medical clinic and a day spa that operates under the supervision of medical doctor. Many of the services are costly. And no one ever tips doctors and nurses when they're getting their annual exam, or a prescription for bronchitis.

So should you tip at a medical spa? The old answer was "no." Now the answer is, "it depends." Before you decide, consider who is giving you the service–usually an esthetician–and the cost. If the service is very expensive, don't feel obligated to give 15%, but it's nice to give something to show your appreciation. 

An illustration of a woman getting a massage with info on how much to tip

The Changing Landscape of Medical Spas

That's because medical spas have changed a lot over the years. When they first appeared in the 1990s, they were primarily owned by doctors. The services they offered, like Botox and aggressive dermabrasion that left your skin red and bloody, were often delivered by the doctor himself. The price was quite high (because of the cost of the product, as with Botox) or the cost of buying or leasing the equipment. 

Medical spas didn't want to discourage clients by making them think there would be a $200 tip on that $1,000 treatment. The doctor owned his own business and was making the profit on the treatment, so tipping wasn't necessary. Plus, tipping interfered with the medical image they were cultivating. 

But things have changed. There are still doctors who own medical spas, but many have hired nurses for the services, such as Botox, Dysport and fillers, that require medical training and expertise. At the same time, entrepreneurs with no medical background have also opened medical spas, partnering with doctors who are "on the masthead" as "overseeing the clinic." 

Woman at the spa getting a facial
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Estheticians Are Delivering the Medical Spa Services

Most medical spas have expanded into the territory of the traditional spas, particularly facials, chemical peels, and microdermasion. They are delivered by estheticians who are paid by the hour–usually $15 to $20. While that's not a bad wage, they're definitely not in the 1%. In general, you should tip on facials the same way you would at a day spa.

Most of the other more traditional medical spa services, including laser hair removal, skin tightening, IPL, micro-needling, are delivered by estheticians. The treatments are expensive because of the cost of the machine. So even though it's costing you a lot, the esthetician aren't making any more money. 

So you don't need to offer a 20% tip on a $500 skin tightening session, but it's always appreciated if you offer them a tip–$20 or $30 would be most welcome, especially since most people don't tip anything. 

Plastic surgeon watching female patient with mirror
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You Don't Need to Tip The Doctor

What about treatments that are given by a medical professional, like a nurse, who doesn't own the business? A nurse's salary is higher than an esthetician–around $35 an hour–but it's always nice to show someone that you appreciate a job well done. And it builds the relationship. Again, it doesn't have to be a percentage of the bill, just a token of appreciation.

You don't need to tip is if the doctor who owns the business is giving you a treatment that requires his level of expertise, treatments like Cellulaze, body contouring and more aggressive, specialized laser treatments for skin conditions. You'll be paying a lot and the doctor will be making a lot, so you don't need to tip. What doctor needs an extra $20?

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