Alex Thiersch, CEO of the AmSpa, joins The Dr. Randi Show for a wide-ranging conversation about the legislation that nearly shook the med spa industry and the collaborative advocacy that stopped it in its tracks. Alex shares how AmSpa is stepping into its leadership role to unify the aesthetic community, push for national safety standards, and ensure medical spas remain both compliant and competitive across all 50 states.
From his fight against damaging regulations in Texas to launching industry-shaping initiatives like the upcoming Women in Aesthetics Leadership Conference and injector credentialing programs, Alex breaks down what’s coming next and why 2025 may be the most pivotal year yet for medical aesthetics.
Episode FAQ
What does The Dr. Randi Show episode with the CEO of the American Med Spa Association cover?
In this 2025 episode of The Dr. Randi Show, host Dr. Randi Boyette spoke with Alex Thiersch, CEO of AmSpa, the American Med Spa Association, and a self-described recovering lawyer. The conversation covered AmSpa’s role in the 2025 fight over proposed medical spa legislation in Texas, why the med spa industry needs consistent safety standards, AmSpa’s top initiatives for the rest of 2025 including a new injector credential and industry councils, the Women in Aesthetics Leadership Conference, and the Medical Spa Show. The episode closed with a CEO speed round. The answers below reflect Alex Thiersch’s personal views and experience and are not medical or legal advice.
What happened with the proposed 2025 Texas med spa legislation?
On The Dr. Randi Show, Alex Thiersch explained that legislation proposed in Texas followed the death of a woman who received an IV treatment at a med spa, which he called a terrible thing that should never have happened. In his view, the bill in its original form could have crippled the medical spa industry in Texas, and he noted that as Texas goes, a lot of other states go. He said AmSpa and many others in the industry testified, legislators listened, and the bill was changed to better reflect what needed to be done. Alex Thiersch described the outcome as a team effort and a wake-up call for the industry, and noted the issue was still ongoing at the time of recording. This reflects his personal perspective and is not legal advice.
Why is the medical spa industry so difficult to regulate?
Alex Thiersch told The Dr. Randi Show that most of the rules and regulations for medical aesthetics already exist, but the industry grew up partly in the shadows. He described an “underbelly” of the industry that operates without oversight, with little enforcement and no real standards to show who is doing things right. He said confusing, state-by-state laws combined with huge and growing patient demand, plus an influx of providers and money, caused the industry to get “over our skis a little bit.” Alex Thiersch believes the industry needs to get its own house in order, because otherwise regulators will do it for them, likely with results the industry will not like. This reflects his personal opinion and is not legal advice.
What are the American Med Spa Association’s top priorities for 2025?
Alex Thiersch said on The Dr. Randi Show that AmSpa’s overarching goal for 2025 is to bring the entire medical aesthetics industry together to act as one, with a unified voice. He stressed that patient safety has to come first, and that the industry must give the public, regulators, and state medical and nursing boards confidence that it can operate safely. He said the response from large med spa chains, pharmaceutical companies, and energy device makers, including at the Medical Spa Show, has been overwhelmingly positive. According to Alex Thiersch, the specific initiatives supporting that goal include a new injector credential and a set of industry councils. This reflects his personal perspective.
What is the AmSpa injector credential, and what does it test?
According to Alex Thiersch on The Dr. Randi Show, AmSpa is developing an injector credential with AIA, the Academy for Injection Anatomy, run by board-certified plastic surgeon Dr. Chris Surek, whom he called a world-famous anatomist who has written textbooks on facial anatomy. He said the curriculum teaches and tests whether someone can inject the face safely and handle complications and adverse effects, with the goal of preventing serious injuries such as occlusions or blindness. Alex Thiersch described it as a consistent minimum standard for safety rather than a mark of expert skill, which he said comes with experience. AmSpa planned to roll it out later in 2025 and hopes it becomes the accepted industry standard, though he acknowledged reaching agreement will be a long process. This reflects his personal perspective and is not medical advice.
What are the AmSpa industry councils, and how do they support national advocacy?
Alex Thiersch explained on The Dr. Randi Show that AmSpa is launching councils, which are membership levels designed to help set industry standards and support its national advocacy program. He described a medical spa council that brings together some of the largest med spa brands along with smaller brands, state chapters that send representatives to share what is happening in their states, and an industry council where companies weigh in on training and other needs. He noted that smaller med spas make up about 90% of the industry, and said that when pharma, energy device manufacturers, large chains, and small med spas work together, the industry is “unstoppable.” This reflects Alex Thiersch’s personal perspective.
What is the Women in Aesthetics Leadership Conference (WALC)?
On The Dr. Randi Show, Alex Thiersch described the Women in Aesthetics Leadership Conference, known as WALC, as a luxury retreat for women leaders in medical aesthetics, held in October 2025 at the Terranea resort in California. He credited the idea to his AmSpa team and said the previous edition, held two years earlier at the 1 Hotel in South Beach, Miami, featured Spanx founder Sara Blakely. He said the 2025 keynote speaker was Jamie Kern Lima, founder of IT Cosmetics, and that the event focuses on personal development, growth, and connection alongside some business training, with everything taken care of from the moment guests land. Alex Thiersch noted the event is not limited to women but is made for them, and directed listeners to the conference website to learn more.
Why is medical aesthetics considered a women-led industry?
Alex Thiersch said on The Dr. Randi Show that he knows of no other industry so thoroughly led by women as medical aesthetics. He cited a study AmSpa conducted that found roughly 70 to 75% of aesthetics businesses are owned by women, noted that many of the energy device companies serving med spas are also run by women, and said about 90% of med spa patients are women. In his view, women have created, built, and invested in many of the industry’s multimillion dollar brands, which is what inspired the Women in Aesthetics Leadership Conference. These figures reflect what Alex Thiersch shared on the episode.
What is the Medical Spa Show, and how can speakers apply to present?
Alex Thiersch described the Medical Spa Show on The Dr. Randi Show as AmSpa’s big annual event in Las Vegas, focused entirely on medical spas. He said speaker submissions for the next show had just opened and encouraged anyone who wants to present to apply through the Medical Spa Show website. He also urged everyone in medical aesthetics to stay engaged, whether through AmSpa or other organizations, because he sees bills like the one proposed in Texas as existential threats that could cripple what the industry can do. This reflects Alex Thiersch’s personal perspective.
What leadership lessons came out of the CEO speed round?
In the CEO speed round on The Dr. Randi Show, Alex Thiersch said he favors bold risk taking, data-driven decisions, and hiring for culture fit first. Asked whether his legacy would be to build a brand or build a culture, he said the two are not mutually exclusive, but culture has to come first and the brand follows from it. He also shared that he is a morning person who prefers early morning strategy sessions, finds delegation very difficult, and tends to go with the flow rather than time block. Outside of work, Alex Thiersch and his wife rescue and foster animals, have five dogs and three cats, and he encouraged listeners to consider fostering a dog.
