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The Current & Future State of the Medical Spa Business with Alex Thiersch

By: Hannah Celian | April 24th, 2024

The Current & Future State of the Medical Spa Business with Alex Thiersch Blog Feature

Live from the 2024 Medical Spa Show in Las Vegas, AmSpa founder and CEO Alex Thiersch shares fresh insights on the rapid growth of the industry and an exclusive preview of their upcoming State of the Industry Report. 

Twelve years ago, Alex’s work as an attorney helping a solo medical spa owner led him to establish AmSpa to offer essential guidance on compliance and safety for others within the industry. 

Since then, he and his team have introduced much needed resources for med spa owners including boot camps and courses for business, legal, and safety training.

With legislative work happening behind the scenes in every state to develop rules and regulations, often without the input of those in the medical aesthetics industry, Alex emphasizes the importance of staying organized and having a seat at the table as new laws are introduced.


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Alex Thiersch, Founder and CEO of AmSpa

While building his legal practice in business and employment law, Alex Thiersch identified a specific need for legal compliance education in the aesthetic market. He founded the American Med Spa Association (AmSpa). With over 3,000 members, AmSpa is one of the fastest growing and most sought-after resources in the aesthetic industry, and its website receives over 30,000 visits a month.

Learn more about the American Med Spa Association

Learn more about AmSpa’s medical aesthetic training courses


Tyler Terry, Director of Sales, MedSpa at Nextech


Announcer (00:06):
You are listening to the Aesthetically Speaking podcast presented by Nextech.

Tyler Terry (00:13):
Hey guys. Welcome back to the Aesthetically Speaking podcast. We are here today live at the Medical Spa Show 2024 at the Beautiful Wynn. We're actually here in the exhibit hall, and I'm here with an incredibly special guest, someone that I've known since I think about 2018, and someone that I actually really look up to, and it's been really cool to see his growth and his company's growth and just this entire organization. But we have Alex Thiersch, the founder and CEO of Amspa. Alex, welcome to the podcast.

Alex Thiersch (00:47):
Hey, what's up, what's up? It's great to be here. I appreciate what you said. Kudos to everything you guys have going for you too. This has been an amazing event and I appreciate you guys being here. This is awesome. I'm having so much fun. I'm a little bit on the struggle bus this morning, if we're going to be honest. We had a late night last night, but I'm all right. It was a great party. It was amazing.

Tyler Terry (01:08):
It seems like those parties get better every year.

Alex Thiersch (01:09):
I mean, we have to keep topping ourselves somehow. I'm not next term on what we're going to do. We're going to have to, I'm not sure. We'll figure it out. We'll figure it out, but it was a lot of fun. You know what I love about this industry, and I know having grown and been in it too, and at that party, which was at Excess nightclub, it's just the energy. Everyone is so pumped up and excited to be there, and it's got nothing to do necessarily even with us. It's just everybody being together and supporting one another, so that's really cool.

Tyler Terry (01:40):
I love that. I know. I feel like people are here to learn and to grow and have fun to network. I've actually told multiple people that this has become ever since probably three years ago, this has become my absolute can't miss show, my favorite show of the year. That's awesome. That's good to hear and try to tell everyone to go. And now people are starting to get that acronym of the MSS, right?

Alex Thiersch (02:00):
That's right.

Tyler Terry (02:00):
Yeah. Yeah, so I love the branding there. I love just everything you guys are doing, and it's crazy too to see even just the growth and the expansion of the exhibit hall. I think it's grown a lot this year, right?

Alex Thiersch (02:10):
Yeah. Even this year, it's about 40% bigger than last year.

Tyler Terry (02:14):

Alex Thiersch (02:15):
The booths are getting bigger too, so it's an interesting problem that we're having, which is that people love being here. They love coming, they want bigger space, they want more time, and at the same time, there's other companies we want to get in, so we'll see what happens, but at some point, we're going to have to expand again because we want to give everybody as much transparency and honesty as they can. So they come in there and all the brands are here. We want everyone to be here. I honestly came in here just, this is the first time I've been in the exhibit hall this year, and I'm like, where the hell am I? I don't even recognize it.

Tyler Terry (02:50):
Is this my meeting?

Alex Thiersch (02:50):
I know. It is, and last night, I'm telling you, I was out at the party and I look up and I had the big digital board, and it said MSS 24, and I was like, huh, is that ours? It seems like it's somebody else's. You know what I mean? It's pretty cool.

Tyler Terry (03:05):
Yeah, and I love the culture you built with your team. I think of Natalie and Meumi and everybody across the board.

Alex Thiersch (03:11):
They're awesome.

Tyler Terry (03:12):
Just the culture that you've built, I love, well, first off, let's go in and talk about that. What is it about that culture within your organization that you're really trying to tap into, and what are you looking for when you're expanding the team? I mean, you guys are growing fast.

Alex Thiersch (03:27):
Well, I wish I could take credit for all of those hires, but I did hire Kathy Christensen who hired most of those people.

Tyler Terry (03:36):
Yeah, she's amazing too. I should have said Kathy. She's incredible.

Alex Thiersch (03:38):
Although I did also bring Natalie on way back when because been, Natalie has been with us since the beginning. But for me, it's always, I instill this in my team, it's like we want good, talented people with a good attitude. You can't teach that niceness, right? They got to be nice. They have to care, be genuine. You guys at Nextech, everyone in this exhibit hall, you guys are as much a part of what we do as the attendees and the members. We'll go out and try to hire for. We'll have positions that are open in positions that are open right now, but oftentimes, I'm not sure how you do this, but we'll find somebody who doesn't necessarily fit a position that we have, but they're just, we can tell they're rockstars, and if you find a rockstar, you take it. It's like a first round draft pick. You can figure out where to put them.

Tyler Terry (04:27):
Yeah. Yeah. I don't know if it's in right field or if we're putting you a second base, but we're going to find a spot for you.

Alex Thiersch (04:32):
That's the approach I've taken. Like someone like Naomi, who, again, I wasn't directly involved in hiring them, but I know that is the approach we take. This is someone who comes in, oftentimes they'll come in and they'll be applying or looking for another job, and we're like, you know what? That's not exactly we think the best fit, but this would be awesome and we'd love to have you. Or one thing that we also do a lot of is allow people to grow. I want folks to know when they start at Amspa, they're not going to be stuck in their position if they want to do something else, if they want to become a speaker, if they want to do sales, if they want to do marketing, whatever it might be, whatever your talents are, I want you to grow into that position.

Tyler Terry (05:09):
Something that I thought was really cool that might Meumi, right? Yeah, that Meumi has shared with me was the fact that you guys actually encourage entrepreneurship, and she was telling me about her candle business, and I actually ordered some candles for my Airbnb, for my Airbnb guests, and they're incredible. Everybody loves them. That is so cool. I haven't heard of that before.

Alex Thiersch (05:29):
That's what she does creatively. I love it that if people have the entrepreneurial spirit, cuz to me, I mean, we're trying to build something. When you're trying to build something, I can't do it by myself, so as much vision as I can have, you have to have those other people who are thinking in that same way. And the truth is, people have different personalities and strengths. Some folks are going to be the creatives they want to create, they want to build, they want to have ideas. Other folks are going to be problem solvers. But when you find those people who are creative, they are entrepreneurial, they do want to build and create, they are valuable. And so someone like her, I said, Hey, look, I'm always telling, oh shit, you're going to end up selling your candles and you're going to leave Amspa because you're going to be a candle empire. But you know what if makes her happy and she wants to do that, then more power to her. But I think either way, it's going to be empowering for us to have somebody with that type of attitude.

Tyler Terry (06:26):
And even the way you guys incorporated that at Wok, the Women in Aesthetic Leadership Conference was amazing, again, under Kathy's leadership there, and that was awesome, what she's done. Awesome. But I want to rewind a little bit and just ask you a little bit about your background and then also how you started Amspa, why you started Amspa.

Alex Thiersch (06:44):
Well, I like to call myself a recovering lawyer, cuz I say that all the time. My background is in law. I've been a lawyer for almost 25 years. I never in a million years thought that I would be sitting here right now in this exhibit hall with our, I mean, honest to God, I thought I was going to be a lawyer my whole life. I'd be working at a firm, maybe become a partner, whatever that might be. I also knew I wanted to work for myself. I'm not really necessarily an entrepreneur. I have a lot of ideas, but I don't like people telling me what to do. And so I like to be able to do what I want to do. And so I started my own firm, and it was really just fortuitous, one of the first clients I had was a woman who, and this was 2008, 2009 or so, who was just killing it in this thing that she called a med spa.

I had never heard of it. I knew what Botox was, I knew, and she was killing it. And I was like, well, what is going on? What is this business? And I started learning about it. And the one thing that struck me was, number one, the passion and the care that these people had, the money and the success they were making, which is attractive, the way that it was being grown. And the big thing for me as a lawyer was they didn't know what the hell they were doing when it comes to the law. They really didn't.

Tyler Terry (07:59):
Like, I can help you.

Alex Thiersch (08:00):
I can help you. And so my original intent was not to build Amspa, it was to market my law firm. And we started by providing resources and summarizing the different laws in the different states and providing additional information, to help these folks be able to grow compliantly and safely. And I woke up one morning and we had members all over the place, and I'm like, huh, this might actually be something. And that's the best decision I ever made, now I don't have to practice the law, which is great.

Tyler Terry (08:28):
So now it's been 11 years?

Alex Thiersch (08:29):

Tyler Terry (08:29):
12 years, 12 years. Wow. It seems like it's always growing. You have the memberships. What are some of the things when somebody joins Ampspa and they become a member, what are some of the things that they get?

Alex Thiersch (08:42):
We're constantly trying to evolve and sharpen what our benefits are because that's the most important thing. Our goal is to help the industry, not just our individual med spa members and providers, but you guys as well. The industry. We want to help the industry. So our main thing is providing basic guidance on compliance and safety. That's kind of the one thing that we have done. That was our value proposition. Nobody else was doing that. It is kind of dumb luck that I was a lawyer. I came in at the exact time and there was confusion about what people could do, and we clarified some of that. That's the main thing. If you need information on what you can do in your particular state, what provider could do, what treatments, what type of supervision do you need, all those types of things, we have all of that information at your fingertips as well as all the protocols, all those things that you need, those legal tools, the compliance documents that you need, the consents, all those things are things that we provide. And then we have since expanded into doing business training. That was actually the other thing that really juiced Amspa was when we started doing our bootcamps, our med spa bootcamps, which nobody was doing. And I didn't know how to run a med spa, but I knew that people who did, and we just organized, Hey, teach doctors how to run a business.

Tyler Terry (09:59):
Quarterbacked it.

Alex Thiersch (10:00):
Basically, and they did it. And so that's the other thing that we do is business and legal training. And we, of course, we are getting some clinical and things like that.

Tyler Terry (10:06):
Yeah. And obviously this growth is only continuing to grow. And you guys have the Medical Spa State of the Industry report coming out, right?

Alex Thiersch (10:14):
Yeah. Couple weeks.

Tyler Terry (10:15):
Where we'll see a lot of those stats and the growth. Is there anything that you can share with us, a little piece of info about what you're seeing? Tease our listeners a little bit with some of that data that's coming out.

Alex Thiersch (10:25):
Yeah. We just got the results. Honestly. I've got all the data, which is really exciting. We're still looking at it and tweaking it and making sure that it's all presented. So I mean, the main thing is the industry is still growing, and it's growing like crazy. So 25, 30% year over year. I think we're now at 11,500 ish med spas nationwide, and we're adding several hundred a year. So that's the good thing. Whenever people say, Hey, I want to come into the business. This is the time the expansion is happening. The thing that was a little surprising was 2023 was we've been used to, especially post covid, just this massive influx of cash and growth. 23 was great for a lot of people. For other people it was a little bit plateaued. And so we've seen, because there's a 27% increase in the number of med spas, the per location revenue has flattened out a little bit, starting to spread out. And I think what's happening is that's the natural growth of the business. The good news is that what we're seeing is the number of treatments and providers needed to continue to service this market is overwhelming, and we don't have enough people to service the need. So that's one thing we're going to have to work on is how do we get more trained providers in.

Tyler Terry (11:45):
And we're talking, I mean, 20 to 30% growth year over year. That's 2000 plus med spas coming online. Right?

Alex Thiersch (11:52):

Tyler Terry (11:52):
Which serves bootcamp. And that's why that bootcamp is imperative. And I'd love for you to talk to us a little bit more about the Injector Academy training and what happens there. And I believe those are now paired with bootcamp.

Alex Thiersch (12:06):
So we actually acquired the Academy for Injection Anatomy, which is a clinical, it's not a clinical training, it's more of an anatomy training course. Dr. Chris Surek, who's a plastic surgeon, and anatomist,

Tyler Terry (12:18):
He's incredible.

Alex Thiersch (12:18):
He was born to teach anatomy. It's of the face, like that's what he does. And he has this incredible course where he spends a day teaching you all about the anatomy, all about complication management, and then you do a cadaver dissection. And instead of, oftentimes the way it was back in the day was everybody would gather around and the instructor would dissect, and then they would point stuff out. What he did was flip that on its head and said, okay, I'm going to give everybody in the course a chance to dissect their own cadaver, inject it, which is the only way you can really practice. Right?

Tyler Terry (12:54):

Alex Thiersch (12:54):
See where the vessels are. At the same time, he's teaching the anatomy, and I'm obviously not a provider, but I'll watch it. And it's fascinating because this is what we need as an industry. We need safe injectors, and in order to be safe, you have to know what the anatomy is, and he just knocks it out of the park. It's the coolest thing.

Tyler Terry (13:13):
So do you see all levels or people that are just starting off injecting as well as people that have been doing it for five to 10 years joining this?

Alex Thiersch (13:19):
We do. It's honestly not a beginner course. So we have seen people who have come in and they're just beginners, and they tend to be a bit overwhelmed because it helps to have a little bit of an understanding of how to do it. So we are getting into that, and we have the ability to do beginner courses, but if you want to know that you have a competent, safe injector, not teaching techniques necessarily how to, it's this person knows where the vessels are, how to avoid complications. That's what this is meant to be.

Tyler Terry (13:51):
Okay, that makes sense. That's great. And that's what the industry needs. We need that for compliance, for safety. It's always about what's best for the patient, of course, the practice. So let's talk about the future. We've talked about the last 12 years. What about the next 12 years? Where do you see this industry going? What are you most excited about?

Alex Thiersch (14:10):
Where would the industry be in 10 years? I mean, I have no idea because growing so fast, I think what I do know is that the treatments and the desire to look and feel better, more confident is not going to go away. So we don't necessarily know what the treatments will look like in 10 to 15 years, but we know there are going to be treatments and people are going to want them. When you look at the younger population, so under 30 or under 35, we have seen continually that population is growing more and more, and our data ref reflects us. They're the ones who are slowly creeping up and being the primary consumers of aesthetic medicine. So it's not just 40 to 50-year-old women, it's 25-year-old men as well as younger women who are taking this very, very seriously at the beginning. So when I think about it is I don't see any end to the growth.

I feel like the industry is probably going to look a little different, but there's a hundred thousand people employed right now by the med spots. It's a 20 billion industry in the United States. I think there's probably going to be a need for 10, 20,000 new injectors and providers in the next five years or less that are going to be coming into the industry. So there's going to be a need for training. There's going to be a need for some safety standards, so we can start kind of making sure that we're all growing in a safe, responsible way. The technology, I mean, with what you guys are doing and just with all the energy devices, this is going to change the game too. And who knows? When you start talking about weight loss and hormone replacement and all these new treatments that are coming, we're seeing definitely a blending of the wellness side and aesthetics where people are now embracing everything from your physical fitness, mental health, coupled with the aesthetic treatments, because it's not just how you look, it's how you feel, right. And it's all connected. So as was a long-winded answer to be, like I say, I have absolutely no idea.

Tyler Terry (16:18):
That was amazing. And honestly, I don't know if anybody could have articulated that just like you with your unique insights.

Alex Thiersch (16:23):
I've got a different perspective on it for sure. I mean, our goal, we believe very strongly we can have a membership that is 10,000 strong. And I think we need to get to that size because what we need to be able to do is have a voice in the changing legislative environment. Because what we're seeing is laws are being written, they're being changed. We as an industry haven't been as coalesced around one position. If you look at dermatologists, they're very, very organized. We need to be organized because these laws are being introduced, they're being passed, and we need to have a seat at the table.

Tyler Terry (17:00):
And speaking of that challenge, what are some other challenges you're seeing this year, 2024, that med spa owners are seeing in their practice or just things that you're hearing? I mean, you're in a lot of discussions, you're on a lot of these talks. What are you hearing?

Alex Thiersch (17:14):
There's really two. One is more practical, and the one is a little bit more, not theoretical, but it's not as easy to put your finger on, which is the regulatory legislative environment. I know people don't understand the amount of work that is being done right now behind the scenes in basically every state to develop rules and regulations for the medical aesthetics industry. And most of the time, the people that are making those rules don't know what they're doing. So that makes me nervous because it's happening. It's happening over the place, and it's not visible. It's happening kind of under the surface, which is why we need to get organized, because we need to be able to have a seat at that tip, because that is happening right now. We'll see, every week another bill is introduced that sometimes adversely impacts the whole industry. So that's the one thing that's happening.

Tyler Terry (18:07):
And these bills could be introduced by people that maybe don't even know what a laser treatment is, or maybe they'd never even been to a practice. Maybe their husband or wife has, but maybe they're not them.

Alex Thiersch (18:17):
I guarantee that their husband and wife hasn't even been. They don't.

Tyler Terry (18:19):
That's crazy.

Alex Thiersch (18:20):
It's a reactive process. So oftentimes it's driven by the new cycle, public relations. So if there's a bad outcome, and unfortunately there is, we are now seeing a very, very concerted effort on the part of national and local media to start looking into med spas and ask questions. And the questions they're asking aren't necessarily fair because they're saying, why are med spas unregulated? Why are they so dangerous? And that's just not the case. It's not 99% of the industry is safe as can be. But a good news story isn't about a successful Botox treatment. It's about a botched treatment, and that's when you get into it. And so the media is driving the bills. And so for instance, in Michigan, this is a rumor, I don't actually know this to be true, but there was a bill that was introduced that would severely curtail RNs ability to be a part of the industry just to inject even regardless of supervision.

But it happened because at least the word on the street is a state senator's wife had a drooped eyelid. It had a bad outcome from Botox, and within a week they had legislation percolating through the system that was way over reactive. Right? And so that's what happens. It's silly stuff like that where you have just one outcome that you don't anticipate, and you'll have a massive overreaction. And again, it's going to even itself out, but the only way that we can have an impact is if we know when that's happening, and they know that we have a voice and a seat at the table so we can provide our input and educate them as to what the actual, what we do. Cuz they don't know. These regulators don't know what nets spas do. They think we're like back alley nail salons doing Botox and after hours.

Tyler Terry (20:07):
Crazy. I mean, I think it's worth being a part of Amspa just for that alone, just to have a voice that's eyes and ears all day, because they're busy during the day. They get tired. The industry, everyone's working, everyone's hustling. And to have your organization actually keeping an eye out.

Alex Thiersch (20:25):
That's our focus now. That's got to be the next iteration. We've spent 10 years trying to corral the industry and let everyone know that it is an industry, it's its own separate industry, but now we've got to look for the future. And it's a bit terrifying sometimes. When I think of the people that are making decisions about the future of this industry and what their background is, they don't know shit. Pardon me.

Tyler Terry (20:54):
No. Hey, truth's the truth. Alright, so before we go and ask you a few more questions, first off, tell us a little bit more about things that you enjoy any given day. I know you're a huge Michael Jordan fan, right?

Alex Thiersch (21:06):

Tyler Terry (21:07):
But what do you like to do for fun?

Alex Thiersch (21:09):
Oh, yeah. I do spend a lot of time watching Michael Jordan videos on YouTube, although.

Tyler Terry (21:14):
See I'm a Kobe Bryant guy.

Alex Thiersch (21:15):
Well, I like Kobe Bryant too. A trigger for me is when people start telling me LeBron James is better than Jordan. I just can't. Can't do it. So my wife and I have, we rescue dogs and cats, and we rescue typically older dogs that have health problems. So we're kind of like a pet hospice in a way. So we've got these old dogs and we take care of 'em, and we don't have kids. So we pour all of our resources into rescuing these things. And then in the last years of their life, we just make sure they're comfortable. It's rewarding and tough at the same time.

Tyler Terry (21:49):
Wow, that's amazing. I love that. How long have you been doing that?

Alex Thiersch (21:53):
Well, and I have to give most of the credit to my wife on that. The nicest, most caring, she'll rescue anything, people, whatever. It's been probably really since we've gotten into it, maybe about eight years.

Tyler Terry (22:06):
Okay. Yeah. That's amazing. I love animals too. We just got our first dog, and actually, I have a 4-year-old and 2-year-old, and while I've been here, we got a goldfish, so.

Alex Thiersch (22:15):
Oh, all right. Yeah. They, goldfish need homes too.

Tyler Terry (22:18):
Exactly. Next thing, tell us a little bit more about your podcast, Medical Spa Insider. How long have you been doing that? I mean, I know I've been listening to it for quite a while, but tell us more.

Alex Thiersch (22:29):
God, we've been doing it for years. I don't even know how long.

Tyler Terry (22:34):
Before podcasts were cool.

Alex Thiersch (22:35):
I'm not sure. I don't even know when, our podcast is probably not that cool, to be honest. But it's what we wanted to do, and this was, I mean, it's been six, seven years. I mean, I wish I could do it more, to be honest. I enjoy these types of conversations. What we want to do is we want to talk to entrepreneurs, business owners in the med spa industry, but it doesn't have to be med spa owners. I mean, it is providers, it's industry, and just what makes the industry tick? What are the people like, right? One of the data points that we have is 70% of entrepreneurs in this business are women. And I don't know that there's another industry in the world that has that percentage of female owners, and it's not just the med spa owners. When you look at the heads of the big injectable companies, it's a female dominated industry, and it's really exciting to be able to talk to women about their journeys.

No industry like it when you have the ability to build your own brand. And a lot of these, not just women, but men too, are getting out of other areas of medicine because their exhausted, they don't want to deal with managed care. And so the podcast is a way for us to tap into those. I know there are tens of thousands of folks out there who are thinking about joining the industry who want to join the industry, and this is a way to give them something to listen, to, give them some idea of what to do.

Tyler Terry (23:56):
That's amazing. Well, it's awesome, Alex, I want to tell you, thank you so much. You've been phenomenal. Would love to have you back on in the future.

Alex Thiersch (24:03):
Anytime. I love it. I love it, anytime.

Tyler Terry (24:04):
But appreciate all that you do, and again, I've always looked up to you, and it's been really cool to see your growth as an entrepreneur and leading Amspa, so thank you so much.

Alex Thiersch (24:14):
I appreciate it. Yeah, we'll have to have you on our podcast, too. I think we get maybe 2000 listeners, though, so that's not like, it's all right. But yeah, I appreciate you having me. This is great. Thanks for coming.

Tyler Terry (24:24):
Yeah, of course. Thank you.

Announcer (24:27):
Thanks for listening to Aesthetically Speaking, the podcast where beauty meets business, presented by Nextech. Follow and subscribe on Apple, Spotify, YouTube, or wherever you like to listen to podcasts, links to the resources mentioned on this podcast or available in your show notes. For more information about Nextech, visit, or to learn more about TouchMD, go to Aesthetically Speaking is a production of The Axis,