Professionals should keep this in mind because the client is there for a facial, but they may be stressed or have a sinus infection and need aromatherapy. They could also have dry hair and skin and need a hydrating mask. The skin care professional will not know these things until they inquire and the client will not spend more money unless the professional asks for it. Therefore, it is important to converse with the client, listen to them, and then let them know which add-on services will enhance, customize, or add therapeutic value to their already booked treatment. 

Choosing the Right Add-Ons
Popular add-on options depend on the professional's personal ideals about wellness and their spa clientele. They should create an add-on theme based on the type of experience the professional wants their clients to have. For example, if luxury and pampering are valued at the spa, the professional should look at add-ons that include flower petals, chocolate, and honey. If being eco-friendly is important, clients may be more drawn to herbs, mineral salts, and seaweed as these ingredients tend to connect clients closer to the Earth.

The skin care professional should start by defining their own personal values for wellness and then thoroughly survey all of their clients on their interest in services that are not currently being offered. This collection of data will ensure that the professional has enough volume and interest to justify the added service and expense for add-ons. Lasers, for instance, have the potential to generate significant income, however, they are expensive to purchase and have a high operating cost. By no means should spas only add items that are cheap to provide; location and available space should also be taken into consideration. Waxing is very fast and inexpensive, but it would not be practical to convert an entire facial room into a waxing area as facials tend to be a higher-priced service. In this case, take a look at the spa's space and consider adding a waxing station in an underutilized area or pairing it with a makeup station in a well-lit location.

Pricing Add-Ons
When deciding on the price of an add-on, the professional will need to determine the cost of supplies and the percent of increase in cost to the client. Skin service costs are highly variable, but tend to be two to 10 percent for supplies and products used. For waxing, which runs on the lower end, a $15 eyebrow wax should cost the spa 30 cents. For more advanced facials and body treatments, a $120 service should cost around $12 in products.

The typical price of an add-on should be 10 to 20 percent of the cost of the original service. For example, if a basic facial is $75, the preferred add-ons would be between $7.50 and $15. If it were a larger body treatment at $150, preferred add-ons would range from $15 to $30. One of the biggest mistakes a spa can make is to price the add-ons too high; for example, a $75 facial should not have an add-on that is between $25 and $30. This pricing indicates a 30 to 40 percent increase, which is not an attractive markup. The entire purpose of add-ons is to expose the client to more menu and retail product options and provide customized and targeted results.

Professionals can increase the average total ticket sales as long as the cost of providing an add-on is kept low. The goal is to add revenue, not time and product cost.

Facial Add-On Options
When deciding on which add-on services to offer, use a head-to-toe approach.

Hair and Scalp Hydration
Hair and scalp treatments are not just for salons. Conditions such as hair loss, dandruff, and dry hair make the following add-on service extremely popular. Begin by slowly parting the client's hair in one-inch sections while applying an oil treatment to the roots. Apply a rich, hydrating cream to the hair that can be customized with ingredients that target the client's specific concerns. This treatment can be left on with a cap or warm towel for 20 minutes. This add-on is ideal as it provides maximum results with minimum effort from the therapist.

Eye Treatments
Eye treatments can target puffiness, dark circles, dehydration, and fine lines. Consider incorporating or adding a lymphatic massage to a facial or even full body massage. Stress and illness can decrease the ability of the lymphatic system to perform and create an accumulation of fluid, especially around the eyes. Because the lymph vessels are just below the skin's surface, moving fluid requires a very light touch. Lymphatic massage pressure can be compared to the weight of a teaspoon of water. It is much lighter and slower than a standard massage and many clients experience it as deeply relaxing. Targeting the eye area for an add-on can be marketed to both men and women and is perfect prior to any event that may require pictures, such as a wedding or formal occasion.

Eyebrow Upgrades
If a client is already getting their eyebrows shaped, consider offering eyelash and eyebrow tinting. Other upsells include eyebrow stencils, colors, and brushes. To get perfect eyebrows, the professional can use an eyebrow stencils with a small angle brush and eye shadow to fill in sparse hair. This technique creates a finished look; furthermore, the tools can be retailed to the client for daily use. This treatment may be considered a value service instead of an add-on as some professionals provide it to all eyebrow clients as their standard level of service.

Lip Treatments
Treat the lips with a gentle fruit enzyme, such as papain, to refine and exfoliate the lip area. This application can be followed with a rich hydrating mask and finished with a minty balm that could include a lip plumper if the client desires. The selection of the lip balm's fragrance is important as it is so close to the client's nose and can provide aromatherapy benefits. Consider selecting a signature fragrance for this treatment.

Facial Steaming
Facial steaming can be added to nearly any service. It can be used to reduce puffiness, clear sinuses, alleviate headaches, and soothe a sore throat or cough. Facial steaming provides immediate results with minimal effort and is the perfect service to pair with a hair and scalp treatment or body massage.

Body Add-On Options
Some massage add-ons include dry brushing, body scrubs, body wraps, hot and cold stone therapy, and target solutions for bruising or cellulite.

Dry Brushing
In dry brushing, the treatment begins on dry skin and uses gentle, long upward strokes that start at the feet and work towards the heart to improve circulation. The movement also goes from the hands toward the underarms. This treatment helps with lymphatic support, exfoliation, and increased energy and blood flow. The skin will have an immediate improvement in its appearance and will allow for better penetration of the body serums and oils used during a massage. Its use is even beneficial prior to an airbrush tanning session. Dry brushing is very invigorating and is recommend for morning or early afternoon appointments. It is not recommended before bedtime hours as it may be too energizing and might keep the client from having a restful sleep. Because of its energizing and detoxifying effect, dry brushing it is a popular option for the treatment of cellulite.

Cellulite Treatments
With cellulite being the bane of existence for many women, cellulite treatments are a very popular and obvious addition to any spa menu. Cellulite can look worse with poor circulation as the collagen separates and allow the fat to rise up to the surface of the skin. Using a combination of gentle dry brushing, slimming and toning formulas, and deep fascia massage, professionals can immediately improve the appearance of cellulite. Peptides, Co-Q10, and caffeine are popular ingredients used in toning formulas prior to a handheld pressure rolling and/or vacuuming device. Coffee grounds, green tea, olive oil, and seaweed are viable options to use in a slimming body wrap to finish the protocol.

Body Wraps
It is a common belief that a wet room is needed for body wraps and scrubs, but these treatments can be performed without a wet room and with a little creativity and minimal effort and cost. When starting out, shop around for emergency thermal blankets, which can be purchased at sports and outdoor stores for significantly less than the price of spa wholesalers, and plastic sheets for bed and floor protection, which can be a thin painters drop cloth or shower curtain purchased at a hardware or dollar store. The benefit of a body wrap is that after a dry brush, body scrub, or massage, the skin care professional can apply a customized mask, wrap the client, and then walk away for 20 minutes. Many clients opt for a 60-minute massage, however, research shows they would spend more time in a treatment if they could. Because it is extremely physically demanding for a massage therapist to perform a treatment longer than an hour, the addition of a body wrap allows the therapist a moment to rest, regroup, and get ready for their next appointment without feeling rushed or as though they are wasting time and money. A body wrap can be coupled with a hair treatment, facial steaming, or paraffin wax treatment.

Paraffin Dip
Paraffin wax therapy is one of the most effective methods of applying deep heat to relieve pain and stiffness. It has been shown to improve conditions such as osteoarthritis, rheumatoid arthritis, and fibromyalgia. Paraffin wax therapy can increase blood flow to relax muscles, decrease inflammation, lower fluid retention, and reduce joint stiffness. Cosmetic benefits are created because the paraffin wax has a very high heat capacity and, once applied, the heat surrounds the skin, opening the pores, increasing circulation, and moisturizing for healthier-looking, softer skin. Paraffin wax can also be scented and customized with soothing essential oils. 

Foot Baths and Body Splashes
Sometimes referred to as anointing the feet, a therapeutic foot bath can be performed prior to any treatment to increase the client's core body temperature and begin the relaxation process. To complete any treatment, a body splash is a fun add-on that the client can apply after their shower and before getting dressed.

Wellness Add-On Options
For medical spas, ancillary add-ons for wellness laboratory testing are booming. These services include allergy testing, micronutrient testing, anti-aging telomere length testing, and neurotransmitter testing. Some of these tests are performed with saliva and urine and do not require a blood venipuncture and many of the test kits are provided free of charge to the medical spa by the laboratories in the hopes that the client will purchase the vitamins or supplements recommended by the professional when they review their results.

Laser services are the gold standard in medical spas for add-ons and standalone treatments because they, along with IPL, treat a variety of skin issues including fine lines, skin laxity, broken capillaries, and hyperpigmentation. In some cases, when testing the market for lasers, there are laser rental companies that will bring equipment to the spa for a day. This option can generate income as they typically provide their own insurance and will take a set rate or percent of profit on the spa's laser day. As a result, the professional would not be losing money and would have time to build a laser clientele if they decide to purchase a laser at a later time.

Adding It All Together
Survey the spa's clients and location; define the theme, feel, and fragrance; and keep costs down until the spa's venture is viable. Be sure not to choose add-ons that have a gimmicky feel to make a quick dollar, but are actually therapeutic and beneficial to clients. Consider whether or not the treatment is adding a value service, an add-on performed in the same amount of time as the booked service, or an add-on that requires additional time. If the add-on requires additional time, the client may need a break to rehydrate, grab a snack, or use the restroom. In this case, the professional may want to schedule the session into two parts with a break in-between. For example, the client's feet can be soaking in a foot bath for 20 minutes while they are waiting on their appointment; they can have a short break before being dry brushed and having their face steamed. Afterwards, they can receive their massage and end the treatment with a hair cream mask and body wrap with firming and toning ingredients. After their shower, they may apply a body splash. Do not forget that the client is there to be pampered; listen to them and add-on what they want and need. If the professional does not offer the add-ons, the client will not get everything they need.

Erin Lucie, D.N.P., FNP-C is a Stillwater, Oklahoma native, where she obtained a Bachelor of Arts from Oklahoma State University and an aesthetics license. She also obtained a Bachelor of Science in Nursing from The University of Oklahoma Health Sciences Center in Tulsa. Her doctoral residency was obtained at The University of South Alabama, where she focused on the prevention and treatment of obesity, diabetes, and metabolic syndrome and used bio-identical hormone replacement therapy in the prevention of heart disease. Prior to her career in family practice, Lucie had 14 years of experience in the aesthetic industry.