How cosmetic and aesthetic clinics can use HIPAA compliant email securely

Cosmetic and aesthetic clinics provide a wide range of services, from injectables and skin resurfacing to laser treatments and surgical procedures, that require close communication between patients and providers. Email has become an essential tool in this process, enabling clinics to send appointment reminders, share treatment instructions, provide follow-up care, and even deliver targeted promotions.

However, like all healthcare providers, cosmetic and aesthetic clinics handle protected health information (PHI) and are therefore subject to the strict privacy and security requirements of the Health Insurance Portability and Accountability Act (HIPAA). Any email communication that involves PHI must comply with HIPAA regulations to ensure the security of patient data and maintain trust.

Why HIPAA compliance matters for cosmetic and aesthetic clinics

Many cosmetic and aesthetic providers assume that HIPAA doesn’t apply to them because their services are elective or not covered by insurance. This misconception is addressed in the article Are Medical Spas Subject to HIPAA Requirements? by Marti Law Group, which states, “The general misconception is that, since not all aesthetic procedures are considered the practice of medicine, and further, since treatment is elective and generally not covered by insurance, HIPAA is not a concern for medspa owners. Unfortunately, this is wholly inaccurate.” The article stresses that medical spas often qualify as "covered entities" under HIPAA because they collect and store patients’ health information electronically. This includes patient history, treatment notes, and photographs, all of which are considered protected health information (PHI) and must be handled in compliance with HIPAA regulations.

This is a dangerous misconception. HIPAA applies to any healthcare provider who electronically stores, processes, or transmits health information, regardless of whether the services are cosmetic or medically necessary.

As soon as your clinic handles PHI (e.g., patient names, treatment plans, before-and-after photos, payment information), you are legally required to comply with HIPAA. This includes communication channels like email, especially if you are:

• Sending appointment reminders
• Providing pre- and post-procedure instructions
• Sharing lab results or treatment outcomes
• Discussing treatment eligibility or contraindications
• Responding to patient inquiries
• Sending invoices or payment links

Even if a single email includes both a patient's name and the type of procedure they’re receiving, it qualifies as PHI and must be protected under HIPAA.

Read also: Who HIPAA does not apply to and why

Email scenarios in aesthetic clinics and HIPAA risks

To understand how HIPAA impacts daily email usage in aesthetic clinics, let’s look at a few common scenarios:

Scenario 1: Appointment reminders

Sending appointment reminders via email is convenient, but including too much detail, like procedure type or the provider’s name, can inadvertently reveal PHI. HIPAA requires that such messages be minimal in content unless the email is encrypted or the patient has consented.

Read also: How the minimum necessary standard protects patient privacy

Scenario 2: Pre- and post-treatment instructions

Patients may receive instructions before or after procedures (e.g., skincare routines or medication guidelines). If these emails reference the procedure or contain identifiable information, they must be encrypted and sent through secure channels.

Related: Using HIPAA compliant email to ensure effective patient communication

Scenario 3: Before-and-after photos

Sharing before-and-after images for consultations or follow-ups via email can easily violate HIPAA if the images contain identifiable features or metadata. Even if the patient is unrecognizable, consent and encryption are still essential.

Scenario 4: Promotional campaigns

Email marketing is popular among aesthetic clinics. In fact, as of 2017, approximately 37% of aesthetic clinics in the United States reported using email marketing as part of their promotional strategies. This statistic was highlighted in the “State of Aesthetic Healthcare Marketing" report, which surveyed various marketing practices within the industry. 

If the clinic is using email to send personalized emails to existing patients based on their treatment history, this can cross into PHI territory. General newsletters can be sent using standard marketing platforms, but any personalized or treatment-related promotions must use a secure, HIPAA compliant platform.

Best practices for secure, HIPAA compliant email use

Ensuring HIPAA compliant email in your aesthetic clinic doesn’t have to be complicated. Here are the best practices you can adopt to protect patient privacy and maintain regulatory compliance:

Use a HIPAA compliant email provider

Choose an email service provider that explicitly offers HIPAA compliance and is willing to sign a BAA. Examples include:

• Paubox
• Google Workspace (with HIPAA configuration and BAA)
• Microsoft 365 (with appropriate settings and BAA)

Ensure the provider supports encryption and other necessary safeguards.

Train your staff on HIPAA email rules

Email security isn’t just about technology, it’s also about people. Make sure all staff members understand:

• What constitutes PHI
• When and how to send secure emails
• How to recognize phishing attempts and suspicious attachments
• The consequences of HIPAA violations

Conduct regular training and refresher sessions to keep compliance top of mind.

See also: How staff training ensures HIPAA compliant email

Obtain patient consent

Before communicating with patients via email, especially for treatment information or promotional messages, get written consent. Let patients know the risks of email and document their preferences. Include this in your intake forms or consent paperwork.

Use encryption for all PHI-containing emails

As of 2025, encryption has been deemed a HIPAA requirement, not a recommendation. Therefore, clinics must encrypt any email that contains PHI, even if it seems harmless. It’s best to use automatic encryption so staff don’t have to remember to turn it on. 

Limit the use of PHI in email

Avoid including sensitive information in the email body or subject line unless absolutely necessary. Use general language like “your upcoming appointment” rather than specifying “your Botox appointment.”

Create and enforce an email use policy

Establish clear policies that define how email should be used in your clinic. Your policy should address:

• Approved email providers and devices
• Handling of PHI and attachments
• When to use secure email vs. the patient portal
• Who can send and receive emails on behalf of the clinic
• Have staff acknowledge and sign the policy as part of onboarding.

What you need to know about HIPAA compliant email marketing

Email marketing remains an effective way to attract and retain patients, especially in the cosmetic and aesthetic space. However, HIPAA imposes extra considerations when sending email campaigns.

Here’s how to stay compliant:

Use a HIPAA compliant marketing platform

Standard tools like Mailchimp may not be sufficient unless configured properly and covered by a BAA. Consider platforms, such as Paubox Marketing, that cater to healthcare marketing and are built with compliance in mind.

Segment patients appropriately

Avoid segmenting patients based on past procedures unless you have clear consent and are using a secure platform. General promotions (e.g., “20% off all facials this month”) are safer than targeted ones (e.g., “Your next laser session is due!”).

Don’t include PHI in email campaigns

Marketing emails should never include PHI, such as names, appointment dates, or treatment specifics, unless the message is encrypted and consented to.

The cost of non-compliance

HIPAA violations can be costly, both financially and reputationally. The Office for Civil Rights (OCR) can impose fines ranging from $141 to $710,146 per violation, with a maximum penalty of over $2 million per year for each violation category.

Even more damaging is the loss of patient trust, which is needed in an industry where personal image and privacy are at stake. Patients who feel their data is not secure may be reluctant to return, or worse, may file complaints.

FAQS

Is it safe to send treatment instructions via email?

It can be, as long as you’re using a HIPAA compliant email platform with encryption. Avoid including excessive PHI unless necessary, and always ensure the recipient’s email address is correct.

What should I do if I send an email to the wrong patient?

This may be considered a HIPAA breach. Document the incident, notify your compliance officer or legal team, and take immediate steps to mitigate harm. Depending on the severity, you may need to report it to the affected patient and the Department of Health and Human Services (HHS).