America didn’t lose all its malls to the internet. It traded them in for Botox.

Walk into any strip center worth its rent in 2025 and you’ll find the same thing: a med spa where the shoe store was and an IV drip lounge where the electronics store used to be. 

Now there’s data to back up the rise of wellness facilities in underutilized properties. A 17-year analysis of med spa retail leasing across the country’s four largest markets shows this was a slow takeover of American retail real estate, beginning long before anyone had heard of Ozempic or red-light therapy — and it’s nowhere close to finished.

In 2008, med spas signed leases on just 50,261 square feet of retail space in Los Angeles, according to CoStar Group data obtained by The Post. That same year, the four markets combined — LA, New York City, South Florida and Chicago — accounted for roughly 143,000 square feet of new med spa leasing nationally, against a total US wellness leasing figure of just over 1 million square feet. The category was barely a blip.

By 2024, LA alone had hit 217,945 square feet in a single year, the highest single-market reading in the entire dataset and nearly double the city’s historical average. The four markets combined cleared 360,000 square feet. 

Brandon Svec, national director of US retail analytics for CoStar Group, said the numbers reflect something deeper than a passing trend. 

“A sign of success today is a youthful appearance and good health, whereas it was a luxury handbag or a private jet 10 years ago,” he told The Post. “Health and wellness has become the new status symbol.”

Svec points to the pandemic as a turning point. Americans emerged from lockdown more focused on how they looked and felt than perhaps any previous generation, and an industry was waiting to meet them. 

“We came out of the pandemic a little softer, probably, than we would have liked,” he said. “And now there’s just an overall wellness trend that has really gone mainstream.”

What followed was an explosion of offerings, from IV hydration lounges to testosterone replacement clinics. Many of these services were once available only at select boutique wellness destinations in LA or Manhattan. Now they anchor neighborhood strip centers from Phoenix to Pittsburgh.

Svec added, “You can almost think wellness has been commoditized now and brought to the masses.”

In the years immediately following the financial crisis, LA and New York dominated med spa expansion. Chicago, not traditionally associated with the wellness industrial complex, quietly became a powerhouse — hitting 108,186 square feet in 2019 alone, regularly outpacing Manhattan in total leasing activity. South Florida maintained a steady, if smaller, presence throughout.

Then COVID hit and the whole thing fell apart — briefly. LA cratered from 130,838 square feet in 2019 to 68,461 in 2020. Chicago went from its all-time high of 108,186 to 15,890.

The comeback was faster and more ferocious than anyone expected. By 2021 Americans were sprinting back to their aestheticians. Perhaps not of assistance: a year of looking at their own faces on Zoom, and not liking what they saw. 

Leasing roared back. By 2024 LA alone had hit 217,945 square feet in a single year, an all-time record for any city in the entire dataset, nearly double its own historical average. 

The pandemic didn’t kill the med spa. It created its best customer.

Service-oriented tenants leased just over 50% of total retail square footage in 2025, surpassing goods-based retailers for the first time in recorded history, according to CoStar. 

The wellness sector alone totaled $2.1 trillion in 2024, according to the Global Wellness Institute. And driving a significant chunk of that shift, tucked between nail salons and fitness studios in some of the country’s most coveted ZIP codes, is the American med spa.

For med spas specifically, Svec considers them among the fastest-growing categories within the broader personal care and wellness sector. 

“We’re not opening a ton of new nail and hair salons today,” he said. “What we are opening is a new form of wellness and a new form of personal care that quite frankly never existed to the mass consumer.”

Social media has been gasoline on the fire. In a world where personal appearance has become its own public brand, spending on the face and body carries a different cultural weight than it once did. 

Then came the weight loss drugs. Svec describes what he sees happening in the market as Americans trading Big Macs for barbells. 

Fitness center leasing jumped from 11% to 15% of all service leasing last year. Restaurant and bar leasing dropped from 19% to just over 16% in the same period.

“The biggest declining sector last year was food, and the biggest increasing sector last year from leasing was fitness,” Svec said. 

In other words, the same cultural moment that is emptying fast food drive-throughs is filling med spa waiting rooms. GLP-1 users lose the weight and then, as Planet Fitness chief development officer Chip Ohlsson explained, want somewhere to tone it up. The med spa is ready and waiting.

But the runway, Svec cautions, is narrowing. The commercial real estate market has tightened severely over the past five years, with roughly 25% less small-format retail space available today than in 2019. 

Rents on spaces under 5,000 square feet, the sweet spot for most med spas, have risen by more than 30% over the past decade. 

“It’s a combination of there just not being available to lease, and when you find that space, you better have high revenue assumptions for what you can do out of that location,” Svec said.

Geography is also starting to impose its own ceiling. Med spas perform best in pockets of affluence, and those pockets are finite. 

Svec notes that operators are increasingly moving into suburban strip centers and neighborhood retail, but almost exclusively in areas with household incomes well above $100,000. 

“It plays much better, is much more successful in pockets of affluence,” he said. “You’re seeing it spread across the affluent urban areas of nearly all major markets.”

Franchise money has accelerated much of the expansion, with a significant share of the $51 trillion in wealth created in the US since the pandemic finding its way into wellness franchise ownership. 

But that dynamic too has limits. 

“The runway is narrowing for the future possibility of how much leasing we could do,” Svec said, citing tighter space availability, competitive clustering and moderating franchise demand.

The 2025 data, which appears to show a sharp pullback across all four markets, may partly reflect the lag time built into CoStar’s lease tracking process. Some leases don’t get captured for 60 to 120 days or more after signing, meaning the full picture of 2025 activity will almost certainly look stronger than current figures suggest.