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Last Updated: Oct 16, 2026
The answer to how many med spas in the US is 42,622, according to the Orbital directory’s October 2026 count1. California, Texas and Florida hold a third of them. Per person, Arizona leads with 20.7 med spas per 100,000 residents, while DC, West Virginia, Alabama and Mississippi have the fewest.
Demand follows a different map. New York leads the country on beauty and skincare searches, and California leads on looksmaxxing searches. Yet neither state makes the top 10 for med spas per person. Below, we set the med spa count beside those search signals, state by state. That lets you judge how crowded a market is before you open or expand there.
Key takeaways
California (4,941), Texas (4,850) and Florida (4,749) hold a third of America’s 42,622 med spas.
Arizona has the most med spas per capita, with 20.7 per 100,000 residents.
Florida (20.2), Colorado (19.3) and Nevada (17.4) follow Arizona on med spas per person.
DC (5.8), West Virginia (5.8), Alabama (6.3) and Mississippi (6.4) have the fewest med spas per 100,000 residents.
New York is the most beauty-obsessed state, with 3,620 beauty and skincare searches per 100,000 people a month.
California leads the country with 748,340 monthly “looksmaxxing” searches.
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How many med spas are in the US?
There are 42,622 med spas in the US, according to the Orbital directory’s October 2026 count, and three states hold a third of them.
Those three are California, Texas and Florida. Behind them, New York ranks fourth with 2,537 med spas, followed by Arizona with 1,577 and Georgia with 1,4771. The top three states account for 14,540 locations between them, or 34% of the national total.
California (4,941), Texas (4,850) and Florida (4,749) hold a third of America’s 42,622 med spas
California (4,941), Texas (4,850) and Florida (4,749) hold a third of America’s 42,622 med spas1. They’re also the three most populous states, so the raw count tracks population more than appetite.
For a practice, that means the most competition per city and the most patients weighing one provider against another. For patients, it means wide choice. Size isn’t density, though. California’s 4,941 med spas work out to 12.6 per 100,000 residents, 13th in the country, while Texas sits eighth at 15.3.
Which states have the most med spas per capita?
Arizona has the most med spas per capita, with 20.7 per 100,000 residents, followed by Florida (20.2), Colorado (19.3) and Nevada (17.4).
Wyoming (17.0) and Utah (16.0) come next. That puts the Sun Belt and Mountain West at the top of the med spas per capita ranking. All six of the leading states sit in the South or West.
Arizona has the most med spas per capita (20.7 per 100k)
Arizona has the most med spas per capita (20.7 per 100k), then Florida 20.2, Colorado 19.3, Nevada 17.41,2. Mississippi (6.4), Alabama (6.3), West Virginia (5.8) and DC (5.8) have the fewest.
That spread changes what opening a med spa means. A practice in Arizona or Florida competes with roughly three times as many med spas per resident as one in Mississippi or West Virginia. Low-density states can point to underserved patients and room for a new opening, as long as local demand backs it up.
Before you weigh a new state, check how it regulates med spas. Supervision and ownership rules, including whether an RN can own a med spa, differ from state to state. Our guide to med spa laws by state covers each one. If Arizona is on your shortlist, our guide on how to open a med spa in Arizona explains who can legally own one.
The chart below puts the four densest states beside the four thinnest, with 43 states in between.
What are the most beauty-obsessed states?
New York is the most beauty-obsessed state, with 3,620 beauty and skincare searches per 100,000 people a month, ahead of Colorado and California.
Colorado ranks second with 3,482 searches per 100,000 people a month, and California third with 3,4543. Search interest shows where people are thinking about treatments, which is often a step ahead of where they book them.
New York is the most beauty-obsessed state
New York is the most beauty-obsessed state: 3,620 beauty/skincare searches per 100k/month; also #2 for Ozempic searches3,4. New Yorkers search for Ozempic 1,364 times a month per 100,000 people, second only to Connecticut.
New York’s supply doesn’t keep pace with that interest. The state has 2,537 med spas, fourth by count, yet only 12.7 per 100,000 residents1. That keeps New York out of the per-capita top four. Eleven states have more med spas per person than the state with the country’s highest beauty search interest.
If you’re deciding what to offer a search-heavy market like this, start with most common cosmetic procedures and the demand behind each. Ownership rules in New York depend on license type, as our guide to New York med spa ownership explains.
Which states search the most for looksmaxxing?
California searches the most for looksmaxxing, with 748,340 searches a month, and Massachusetts ranks second once searches are adjusted for population.
Colorado places third with 104,460 monthly searches, and Mississippi records the fewest at 29,7905. The search terms behind these looksmaxxing statistics include facial fillers, masseter Botox and buccal fat removal, alongside DIY trends like mewing.
California generates 748,340 monthly ‘looksmaxxing’ searches (#1)
California generates 748,340 monthly ‘looksmaxxing’ searches (#1); Massachusetts is #2 per capita with ‘bone smashing’ searches 104% above the national rate5.
Looksmaxxing is an online trend, popular with young people, of chasing appearance “upgrades” through methods that range from skincare to cosmetic procedures. Bone smashing is one of its riskiest corners. People apply mechanical pressure to their facial bones in the hope of reshaping them, which is a dangerous DIY technique.
For med spas, this is a new and younger audience. These patients need safe, supervised options and honest consultations that set realistic expectations. A clear no to an unsafe request, paired with a medically sound alternative, can earn a patient’s trust for years.
How do the states compare on med spas and beauty searches?
The table below sets med spas by state beside the search signals, so supply and demand sit in one view.
| State | Headline fact | Figure | Med spas per 100k | Source |
|---|---|---|---|---|
| California | Most med spas; #1 for looksmaxxing searches | 4,941 med spas; 748,340 searches/month | 12.6 | Orbital directory1; Tmrw5 |
| Texas | Second-most med spas | 4,850 med spas | 15.3 | Orbital directory1 |
| Florida | Third-most med spas; #2 per capita | 4,749 med spas | 20.2 | Orbital directory1; Census Bureau2 |
| Arizona | Most med spas per capita | 1,577 med spas | 20.7 | Orbital directory1; Census Bureau2 |
| Colorado | #3 per capita | 1,161 med spas | 19.3 | Orbital directory1; Census Bureau2 |
| Nevada | #4 per capita | 570 med spas | 17.4 | Orbital directory1; Census Bureau2 |
| New York | Most beauty-obsessed state | 3,620 searches per 100k/month | 12.7 | Ethos Aesthetics3 |
| Massachusetts | #2 per capita for looksmaxxing; bone smashing searches above national rate | 104% above | 13.1 | Tmrw5 |
| Mississippi | Among the fewest med spas per capita | 189 med spas | 6.4 | Orbital directory1; Census Bureau2 |
| Alabama | Among the fewest med spas per capita | 328 med spas | 6.3 | Orbital directory1; Census Bureau2 |
| West Virginia | Fewest med spas per capita (tie) | 102 med spas | 5.8 | Orbital directory1; Census Bureau2 |
| DC | Fewest med spas per capita (tie) | 40 med spas | 5.8 | Orbital directory1; Census Bureau2 |
Med spas per 100k is our analysis of Orbital directory counts1 against Census Bureau 2025 population estimates2 for every row.
Read across the rows and the supply-demand split shows up fast. New York and Massachusetts lead on demand signals, yet they rank 12th and 10th on med spas per person, at 12.7 and 13.1.
Colorado is the state where the two line up. It ranks second for beauty searches, third for looksmaxxing searches and third for med spa density. At the other end, Mississippi is low on both, with the fewest looksmaxxing searches and 6.4 med spas per 100,000 residents.
How Pabau helps med spas stand out in crowded markets
Here’s our read from the med spas we work with. In a dense state you compete on retention, and in a thin one you compete on reach.
In Arizona or Florida, a patient can book with another med spa in one tap, so the second visit decides your revenue. Pabau, the all-in-one practice management system we build for aesthetic practices, puts online booking, automated reminders, digital consent forms and patient records in one place.
Patients book themselves in at any hour, get a reminder before they forget, and sign their forms before they arrive. Your front desk spends less time on the phone, and patients find rebooking easier than switching.
In thinner markets, the same tools let a small team serve a wide area without extra front-desk staff. Every subscription includes every feature, and new practices get structured onboarding so the setup fits how they work. Our roundup of medical spa scheduling software compares booking tools side by side, and our medical spa software page shows the full platform.
Keep patients rebooking in crowded markets
Pabau’s online booking, automated reminders and digital consent forms make rebooking with you easier than trying the med spa down the street. Every subscription includes the full platform.
Conclusion
The 42,622 count tells you how crowded the field is, and the search data tells you where demand is heading. The two rarely line up. Arizona and Florida are packed per person, while New York and Massachusetts pair heavy search interest with mid-table density.
So choose your market on both numbers rather than the headline count. A dense state rewards the practice that keeps its patients, and a thin state rewards the one that reaches them first. Either way, the experience after the first booking is what brings people back.
Book a demo to see how Pabau helps your med spa hold on to patients in whichever market you choose.
Continue your research
Weighing a new state? Med spa laws by state covers ownership, licensing and supervision rules state by state.
Deciding what to offer? Most common cosmetic procedures shows which treatments patients book most.
Budgeting for an opening? How much it costs to open a med spa breaks the budget down line by line.
Frequently asked questions
How many med spas are in the US?
The Orbital directory counted 42,622 med spas in October 2026. California, Texas and Florida hold about a third of that total.
Which state has the most med spas?
California, with 4,941, ahead of Texas (4,850) and Florida (4,749). Per resident, though, California ranks only 13th, at 12.6 med spas per 100,000 people.
Which state has the most med spas per capita?
Arizona, with 20.7 med spas per 100,000 residents, followed by Florida at 20.2. Colorado and Nevada round out the top four for med spa density.
Which states have the fewest med spas?
West Virginia and DC have 5.8 per 100,000 residents, followed by Alabama at 6.3 and Mississippi at 6.4. In raw numbers, DC has the fewest, with 40.
What is the most beauty-obsessed state?
New York, with 3,620 beauty and skincare searches per 100,000 people a month (Ethos Aesthetics, 2023). Colorado and California rank second and third.
Which state searches the most for looksmaxxing?
California, with 748,340 monthly searches, and Massachusetts ranks second per capita (Tmrw, June 2026). Those looksmaxxing statistics put Mississippi last.
Sources
- Orbital. US med spa directory: 42,622 businesses. Count as of October 2026.
- US Census Bureau. State Population Totals and Components of Change: 2020-2025. Vintage 2025 estimates.
- Ethos Aesthetics. The Most Beauty-Obsessed States. Reported by Salon Today, November 15, 2023.
- Kaly. These Are the Top 10 States Searching for Ozempic. Reported by Salon Today, November 10, 2023.
- Tmrw. Expert Offers Safer Glow Up Advice As Data Shows Dangerous Looksmaxxing Trends Sweep U.S. Search volumes collected June 2026.
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