Google Ads for skin clinics: 7 mistakes we see in almost every account

Most skin clinics lose money in Google Ads in the same seven places: brand keywords that make results look better than they are, a Performance Max campaign that mostly runs on your own name, bookings that aren't tracked, the wrong action counted as a conversion, switching to 'Maximise conversions' too early, no negative keywords, and ads that send people to the wrong page. We see this in almost every account we review. Below you'll find how to spot each mistake and what to do about it.

The good news: fixing most of these doesn't take a bigger budget. It comes down to settings, tracking and structure.

1. Brand keywords inflating your results

Someone who types in your clinic's name already knows you. They'd find you without an ad, or click your listing anyway. Yet we often see the clinic's own name sitting inside the treatment campaigns. The account then looks healthy, while a large share of conversions comes from people who were already clients or had already made up their mind.

Always split off a separate brand campaign and exclude your brand name from every other campaign. That way you see what Google Ads actually brings in new clients, campaign by campaign. A brand campaign is still useful: we regularly find competitors bidding on a clinic's name. With your own brand campaign, you stay at the top for your own name.

2. Performance Max that is really a brand campaign

Performance Max is the campaign type where Google decides where your ad appears: in search results, on YouTube, in Gmail and across other sites. That sounds appealing, but in one account we reviewed almost every conversion from this campaign came from searches for the clinic's own name. A success on paper, an expensive brand campaign in reality.

Use brand exclusions in Performance Max so the campaign has to find new people. Work with several asset groups, for example one per treatment, so you can see which message works. And only start once your tracking is in order, because the system can only learn from the conversions you feed it.

3. Bookings aren't being tracked

This is the biggest structural problem we come across. A client books through the booking system, sends a WhatsApp message or calls, and Google Ads sees none of it. In some cases we found no Google tag on the website at all. The account is then steering on incomplete data: weak campaigns look like they work, and the other way round.

Make sure you track at least these actions:

• A completed booking in your booking system, ideally through a thank-you page after booking.
• A submitted form for a free consultation or intake.
• Clicks on the call button and on WhatsApp.
• Clicks on the 'Book now' or 'Make an appointment' button.

Also connect Google Analytics 4 and Search Console, so you can see what happens beyond the ads.

4. Soft actions set as primary conversions

In Google Ads you choose for each conversion action whether it is primary or secondary. Bidding is optimised on primary actions; secondary ones only show up in your reports. We regularly see the most important action, such as a request for a free consultation, set as secondary, while a soft action like a click or a page visit counts as primary.

The result is that Google goes looking for people who click, not people who book. Make a booked appointment or consultation request your primary conversion. Calls and WhatsApp clicks can be primary if you genuinely treat them as enquiries; everything else goes to secondary.

5. Switching to 'Maximise conversions' too early

With 'Maximise conversions' you let Google set your bids based on past conversions. That only works when the system has enough conversions to learn from. On a small budget, or while tracking is still off, the algorithm has too few signals and is effectively bidding blind.

For a new or small account, start with 'Maximise clicks' with a maximum cost per click, or with manual bidding. Move to a conversion-based strategy once tracking is right and real enquiries come in regularly. After any change, give the system a few weeks to learn before you draw conclusions.

6. No negative keywords

By default, Google also shows your ad for searches that resemble your keyword. Without negatives you pay for clicks that will never turn into a booking. In one laser hair removal campaign, for example, we saw lots of clicks on searches about waxing. We also found other clinics' names and general terms that had nothing to do with the treatment.

Here's how to keep the account clean:

• Check the search terms report every week: which searches actually led to a click?
• Build an account-level negative keyword list with terms like 'jobs', 'training', 'DIY' and treatments you don't offer.
• Decide deliberately whether to advertise on competitors' names, rather than leaving it to chance.
• Use phrase or exact match for your most important keywords, so you keep control.

7. Ads that lead to the wrong page

Someone searching for a specific treatment who lands on your homepage has to keep looking, and often gives up. We also see clinics where every treatment sits on a single page, or where the ad promises a free consultation while the landing page barely follows through, especially on desktop.

Give every key treatment its own landing page with an explanation, reviews, a clear button for the free consultation and a direct way to book. Send people who want to book a treatment straight to that appointment type, not to a general overview. In your sitelinks, use words clients know, such as 'Free skin analysis' or 'Reviews', rather than device names.

Be extra careful with wording around injectables. In the Netherlands, Google doesn't allow ads for prescription medicines, and Dutch medicines law (the Geneesmiddelenwet) bans advertising them to the public. So advertise the consultation, the practitioner and the concern someone comes in with, not the brand name of a product. If in doubt, have your copy checked by a legal adviser.

Where to start

Tackle the mistakes in this order: tracking and conversions first (mistakes 3 and 4), then structure with a separate brand campaign and negatives (1, 2 and 6), then your landing pages (7), and only then your bidding strategy (5). Without reliable tracking you can't properly judge the rest.

Want someone to look at it with you? In the free Clinic Scan, Clinic Agency carries out a full analysis of your clinic across nine areas, including Google Ads. Thomas gives you a short call beforehand, then you go through the analysis and a tailored proposal in a 30-minute meeting. You're free to carry out the plan yourself.

Frequently asked questions

Should a skin clinic advertise on its own brand name?

Usually yes, but in a separate campaign. That protects your name from competitors bidding on it, while keeping brand conversions out of your treatment campaign results.

How do I know whether my bookings are tracked correctly?

Make a test booking yourself and check whether it shows up as a conversion in Google Ads within a day. Also look at your list of conversion actions to see which are primary and whether calls, WhatsApp and the booking system are included.

When does Performance Max make sense for a skin clinic?

When your tracking is in order, your brand name is excluded and you have good visuals for each treatment. Without that foundation, Performance Max often ends up reaching people who already know you.