Do you tip at a med spa? The etiquette guide

Tipping at a med spa is one of the most-asked questions in online aesthetic communities — and one of the most inconsistent answers. Here's a clear framework.

The core distinction: esthetician services vs. medical services

Tipping norms at a med spa depend entirely on who is performing your service.

Services performed by estheticians (tips expected):
HydraFacial
Basic or specialty facials
Dermaplaning
Waxing
Lash services
Brow tinting/shaping
LED therapy
Lymphatic drainage massage

These follow standard spa tipping conventions — 15–20% of the service cost is typical and expected.

Services performed by medical providers (tips generally not appropriate):
Botox or Dysport injections (performed by MD, NP, PA, or RN)
Dermal filler
RF microneedling (Morpheus8, etc.)
Chemical peels (medical-grade, performed by a provider)
Laser treatments
Kybella, CoolSculpting, Emsculpt
IV therapy

The standard medical profession norm applies: you don't tip your doctor, and the same logic applies to NPs, PAs, and RNs performing medical procedures. Medical professionals are compensated through their professional fee — tipping can feel awkward for them and creates an imbalance in the clinical relationship.

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The gray areas

RN performing Botox at a spa-style practice: If the setting feels very spa-like and the nurse has a direct relationship with you, some patients tip. Most nurses are comfortable with it but don't expect it. When in doubt, you will not offend a medical provider by not tipping.

Esthetician performing a medical-grade chemical peel: If the peel is performed by a licensed esthetician (not a nurse or PA), tipping follows esthetician norms.

Package or membership clients: Many patients on membership programs or multi-session packages tip at the beginning or end of a series rather than every session. This is fine — acknowledging a good relationship without tipping every visit.

Someone who has done exceptional work or been particularly kind: A personal thank-you note, a referral, or leaving a detailed positive review is often more meaningful to a medical professional than cash. These have real career impact.

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What to tip estheticians

| Service cost | Standard tip (15–20%) |
|---|---|
| $75 HydraFacial | $11–$15 |
| $150 facial | $22–$30 |
| $200 specialty facial | $30–$40 |
| $100 dermaplaning | $15–$20 |

Tip on the service price before any discounts or membership pricing if possible — the esthetician's income shouldn't reflect your negotiated rate.

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What about gift cards and packages?

If you're using a gift card or prepaid package, tipping from a separate payment on the service is standard. Tipping on top of the package value is appropriate for esthetician services.

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How to handle the awkwardness

If you're unsure whether to tip and feel awkward about it:
"Is it appropriate to tip here?" is a perfectly acceptable question at checkout
Front desk staff are familiar with the question and can tell you the practice's norms
Leaving a tip on the receipt is fine; handing cash is also fine
Not tipping at all for medical provider services is always appropriate

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The review as an alternative to tipping

For medical providers (injectors, laser techs, nurses) who have done excellent work:
A detailed Google or RealSelf review with specific feedback is extremely valuable
Refers a friend — the most powerful acknowledgment
A personal note or message directly to the provider

These forms of appreciation translate into real business impact and are often more meaningful to a professional than cash.

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Quick reference

| Who performs it | Tip? | How much |
|---|---|---|
| Esthetician — any service | Yes | 15–20% |
| RN/NP/PA — injectable | Not expected | N/A |
| MD — any treatment | Not expected | N/A |
| Laser technician — cosmetic | Optional | 10–15% if spa context |
| Massage therapist at med spa | Yes | 15–20% |

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