We audit 50+ med spa accounts every month. The same seven mistakes appear in 70% of accounts. Here's exactly what's draining your budget and how to fix it.

Sending All Traffic to Your Homepage

Your homepage is beautiful. It's not designed to convert Google Ads traffic. Someone searching "Botox near me" lands on your homepage and sees 10 different treatment options, a photo gallery, staff bios, and navigation. They bounce in 8 seconds. Build dedicated landing pages for each service category: one for Botox, one for fillers, one for laser. Each landing page has one goal: "Book Consultation." CTR improves 40%, conversion rate improves 50–60%, and your cost per lead drops by 25–35%.

Broad Match Keywords Without Negatives

Running "Botox" on broad match shows your ad for "how to remove Botox," "Botox side effects," "Botox gone wrong," and 50 other irrelevant searches. You're paying for traffic that will never book. Add 200+ negative keywords from day one. Negative keywords to use immediately: free, training, kit, courses, before and after (unless you're using that for remarketing), side effects, gone wrong, remove, eliminate, how to. Switch to exact match for surgical procedures.

No Call Tracking

Most med spa bookings happen by phone. If you're not tracking which ads and keywords drive phone calls, you're blind. You might think "Botox near me" is your best keyword, but maybe it's "lip filler appointment" that actually books more appointments. Set up Google Call Extensions and Conversions from calls. Every number on every ad needs to be tracked. Track minimum 15-second calls (filters out wrong numbers and hang-ups). Review call data weekly and adjust keywords accordingly.

Geographic Targeting Too Broad

Many med spas bid on 30+ mile radius targeting. Someone 25 miles away who books is likely a no-show. Your CPL looks cheap but actual show rate drops. Use 5–15 mile radius targeting depending on your market. You're more likely to get local patients who show up. Yes, you'll get fewer clicks, but higher conversion rate and better show rate. Net: cost per actual consultation (that shows up) drops 15–25%.

Ignoring Ad Copy Testing

Running the same ad copy for 6+ months. Ad fatigue is real. CTR drops gradually. Your CPCs creep up because Google sees declining engagement. Test new ad copy every 30 days. Create 2–3 RSA variants with different value propositions: "Results in 3 Days," "No Downtime," "See Results Week 1." Rotate them for 30 days. Kill the worst performer. Launch new variants. This alone improved client accounts by 18% CTR improvement.

Bad Landing Page Load Speed

Google penalizes slow pages. If your landing page takes 4+ seconds to load on mobile, your Quality Score drops. Quality Score impacts your CPC directly. Slow page = higher CPC = higher CPL. Speed test your landing pages at PageSpeed Insights. Aim for under 2 seconds on mobile. Optimize images, enable compression, use a CDN. A 1-second speed improvement can reduce your CPC by 10–15%. Mobile is 60% of med spa Google Ads traffic. Prioritize mobile speed.

Setting Up Smart Bidding Wrong

Agencies set up Target CPA bidding with unrealistic targets. If your actual CPL is $80 and they set Target CPA at $30, Google can't hit the target. The algorithm gives up. You get fewer conversions and overpay per lead. Set Target CPA at 2–2.5x your actual CPL initially. At 30+ conversions/month, tighten it to 1.5x CPL. Let the algorithm learn. If you have fewer than 20 conversions/month, use Maximize Conversions instead and let Google optimize for volume while you collect data.

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7 Med Spa Google Ads Mistakes That Burn Your Budget