My Med Spa Prompted Me to Tip. Should I?

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Should I Tip for Cosmetic Procedures?

Dear Beauty Editor,

I got Botox at a medi-spa, and they asked if I wanted to leave a tip. Doesn’t Botox count as a medical procedure? What are the tipping rules for getting injectables or other spa and beauty services?

Thanks for your help,


The only rule with tipping is … there are no rules. (We did a modern etiquette guide last year for that reason.) At least that’s what it feels like, especially now that some med-spas and retail shops have those checkout tablets with the software that prompts you to leave a tip for every transaction. But just because a screen makes a suggestion or an employee asks you what amount you want to tip, that doesn’t mean you have to pay anything extra.

Should I tip my injector?

Tipping your Botox injector is generally not a great idea. If you’re happy with the outcome of a procedure, like Botox at a medi-spa chain, you may feel inclined to tip, just as you would for a great haircut. But aesthetic medicine is still medicine, and, as a general guideline, you shouldn’t leave a tip. “Tipping could potentially undermine the professionalism and integrity of the medical profession,” explains Terri Ross, a medical-aesthetics consultant. In fact, in the United States, there are federal laws that are broadly written to deter medical practitioners from accepting gratuities. That’s not to say it’s illegal for you to tip someone for a medical treatment. Still, if they accept, they could be subject to prosecution by local authorities or disciplinary action from their medical or licensing board.

The thing is, this guideline gets tricky with some of the procedures offered at spas and salons these days. Is a laser facial a medical treatment? What about lip filler? Facial acupuncture? A chemical peel that requires numbing? One way to determine if your treatment is medical is to consider who administered it. If it was a physician, registered nurse practitioner, certified aesthetic nurse practitioner, physician’s assistant, or licensed acupuncturist, it’s safe to consider it a medical procedure. “My rule of thumb is no tipping at a medical office or med spa if it’s attached to a practice, and no tipping for med-spa owners or medical directors,” says patient advocate Michelle Garber, the founder of the plastic-surgery consultancy Nip Tuck Coach. “I will tip an aesthetician for a facial, but I would not typically tip the nurses at a med spa.” Bottom line: If you get a medical procedure, aesthetic or otherwise, and feel pressured to tip — or you think the service you’re getting has suffered because you don’t regularly tip — then you should go somewhere else for your treatments.

Do I tip my massage therapist? Or lash tech? Or microblader?

These rules don’t apply to all the other beauty treatments we get these days, including manicures, infrared facials, lymphatic massages, permanent makeup, haircuts, etc. “I think it’s customary to tip for facials, massages, haircuts, manicures, and pedicures,” says Garber. But if you got the service from the business owner, “you don’t have to tip unless you feel compelled for personal reasons.” And if you get services from someone who works alone, like a lash tech who rents studio space and works for herself, you should still tip because that person isn’t generally considered a business owner, in the sense that they’re not making a profit from services provided by other employees.

How much do I tip my hairdresser? Or manicurist? Or facialist?

In theory, tip amounts are at your discretion and can be adjusted slightly based on the quality of service. Still, in practice, most people who work in the beauty industry are paid hourly wages or salaries that reflect the expectation that customers and clients will tip 15 to 20 percent of the pre-tax cost of the service. If the fact that I’m suggesting an amount to tip seems contrary to the whole graciousness aspect of gratuity, then think of it this way: If tipping weren’t a thing, the price of your beauty services would probably be 20 percent higher.

Obviously, the numbers I’ve laid out above are just guidelines based on interviews with experts in the industry. There are no rules, and you can do what you please. For example, you may want to tip on the lower end of the 15 to 20 percent spectrum if your beauty provider works for themselves (like the lash tech example I gave). But those providers are still pricing their services to reflect an expectation that clients will tip them, and it’s common decency to add something extra.

You should also take your personal preferences into account. As someone who has worked in service and has a generally guilty conscience (no need to unpack that here!), I feel compelled to demonstrate my gratitude to all my service providers, if only for my peace of mind. The way I do that for people who work in the medical field is by giving them a gift around the holidays (it’s not against the law to drop off a snack tray at your doctor’s office or favorite med spa or send a gift card to your injector). But I do that because it makes me feel good, and ultimately you should do what feels right for you.

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My Med Spa Prompted Me to Tip. Should I?