Text messaging is one of the highest-engagement channels in Aesthetix CRM, but it only works when your contacts have consented to hear from you and can easily stop marketing messages without losing important touchpoints like appointment reminders. This article covers the marketing-operations side of SMS consent: how opt-in and opt-out work, how to honor STOP requests, how to build a smarter marketing-only opt-out, the restricted terms and prescription-drug rules that keep your texts deliverable, and the international sending rules you need to know.
This is the day-to-day operational view. For the legal and regulatory background — TCPA, express written consent requirements, and record-keeping obligations — see the Compliance collection, which covers the underlying rules in depth. This article focuses on how to put those rules into practice inside Aesthetix CRM.
Before you can text a contact for marketing purposes, they must opt in — that is, give consent to receive promotional messages. Opt-in is typically collected when a contact submits a form, checks a consent box at booking, replies to an initial message, or otherwise agrees to receive texts from your practice.
Every marketing SMS you send should make it easy for the contact to stop receiving messages. At a minimum, each message must include carrier-required opt-out language such as "Reply STOP to unsubscribe." This keeps your sending compliant and protects your number's reputation with carriers.
For the full legal requirements around what counts as valid consent and how long you must retain proof of it, refer to the Compliance collection.
When a contact replies STOP to an SMS, Aesthetix CRM automatically enables Do Not Disturb (DND) for all SMS on that contact. This is a carrier-level requirement — once STOP is received, the contact will no longer receive any texts, including appointment reminders and confirmations.
This all-or-nothing behavior is exactly what carrier compliance requires, but it can be a problem for marketing operations: a contact who only wanted to stop promotional texts ends up losing every transactional message too. To keep those important touchpoints, you can offer a separate marketing-only opt-out alongside the required STOP option.
Rather than relying solely on STOP (which triggers full DND), you can offer contacts a custom opt-out phrase in your marketing messages that routes them into a separate workflow. This tags the contact as opted out of marketing while keeping them active for appointment-related texts, and removes them only from marketing/promotional SMS workflows.
Include a custom opt-out phrase in your marketing messages that gives contacts a way to stop marketing texts without triggering the platform-level STOP that blocks all SMS.
Step 1: Add a custom opt-out line to every marketing SMS, for example:
"Reply MKTG STOP to opt out of promotional messages only."
This lets contacts leave your promotional list while still receiving appointment reminders and confirmations.
Important: You must still include "Reply STOP to unsubscribe" as required by carrier compliance. The custom phrase is an additional option you offer on top of that — never a replacement for it.
Before building the workflow, create the tag you'll use to filter contacts out of marketing sends.
Step 2: Go to Contacts in the left menu.
Step 3: Open any contact record and click + Add Tag.
Step 4: Type "Marketing Opt-Out" and save. This creates the tag in the system.
Step 5: Use this tag as an exclusion filter in all marketing workflows so tagged contacts are dropped from promotional sends.
This workflow fires when a contact replies with your custom keyword and tags them — without enabling full DND.
Step 6: Go to Automations → Workflows → + Create Workflow → Start from Scratch.
Step 7: Name it "SMS Marketing Opt-Out."
Step 8: Click + Add New Trigger and select Inbound SMS.
Step 9: Add a filter — Message contains → type MKTG STOP (or whatever phrase you chose).
Step 10: Click Save Trigger.
Step 11: Add an action — + Action → Add Tag → select Marketing Opt-Out.
Step 12: Add an action — + Action → Send SMS to send a confirmation message, for example:
"You've been removed from our promotional messages. You'll still receive appointment reminders and confirmations from us. Reply START if you'd like to re-subscribe."
Step 13: Publish and Save the workflow.
Wireless carriers actively filter messages containing prescription drug names to combat spam and protect consumers. To comply with carrier regulations and avoid message filtering or account suspension, the following prescription drug names and medical product terms cannot be used in bulk SMS messages. Messages containing these terms may be blocked, and repeated violations can result in your sending number being suspended or blacklisted.
Ozempic, Wegovy, Mounjaro, Semaglutide, Tirzepatide, Saxenda, Victoza, Trulicity, Rybelsus, Zepbound, Phentermine, Adipex, Qsymia, Contrave, Xenical, Orlistat, Lomaira, Bontril, Didrex, Tenuate, Plenity
Botox, Dysport, Xeomin, Jeuveau, Daxxify, Botulinum, Onabotulinumtoxin, Abobotulinumtoxin, Incobotulinumtoxin, Prabotulinumtoxin, Daxibotulinumtoxin
Juvederm, Restylane, Radiesse, Sculptra, Belotero, Versa, Revanesse, RHA Collection, Kysse, Voluma, Vollure, Volbella, Defyne, Refyne, Lyft, Contour, Silk, Galderma, Teoxane, Stylage
Kybella, Deoxycholic, Aqualyx, Lipodissolve
Latisse, Bimatoprost, Tretinoin, Retin-A, Hydroquinone, Kligman, Obagi, SkinMedica
Testosterone, Estrogen, Progesterone, Estradiol, Sermorelin, Ipamorelin, CJC-1295, BPC-157, Thymosin, PT-141, Melanotan, HGH, Human Growth Hormone, Somatropin, Kisspeptin, Gonadorelin, Tesamorelin
Ketamine, Spravato, Esketamine, Lidocaine, Benzocaine
NAD+, NAD, Glutathione, Myers Cocktail
Viagra, Cialis, Sildenafil, Tadalafil, Vardenafil, Levitra, Stendra, Avanafil, Trimix, Caverject
Finasteride, Propecia, Minoxidil, Rogaine, Dutasteride, Avodart, Spironolactone
Accutane, Isotretinoin, Metformin, Naltrexone, Prednisone, Cortisone, Triamcinolone, Kenalog
All bulk SMS messages must include opt-out language. Acceptable phrases include:
Reply STOP to unsubscribe
Text STOP to opt out
Msg STOP to unsubscribe
Send STOP to unsubscribe
Best Practice: Focus your SMS messages on appointment reminders, promotions for non-prescription services, and general practice updates. Save medication-specific communications for email or in-person consultations, where content restrictions are far less strict.
If your marketing sends reach contacts outside the U.S. and Canada, carrier and government regulations in the destination country can block delivery even when your message is otherwise compliant. The United Kingdom and Turkey both have active rules worth knowing before you text contacts there.
Since June 2023, UK mobile carriers block SMS sent to UK numbers from international long codes, meaning a standard U.S. sending number will not reliably reach UK contacts. UK carriers also now require any UK sending number to be registered with an approved Regulatory Compliance bundle before it can send.
Because Aesthetix CRM manages your Twilio account and number registrations on your behalf, you don't register numbers or submit compliance bundles yourself. If you plan to send marketing or appointment texts to UK-based contacts, contact Aesthetix support to request a UK-compliant sending number before you start that campaign.
Important: Sending from your regular U.S. number to a UK recipient is not a supported route and typically fails. This shows up as error code 21612 in your Inbox. Reach out to Aesthetix support rather than troubleshooting the number yourself.
Effective April 1, 2026, Turkey's telecom regulator (the BTK) blocks all international SMS containing a URL, hyperlink, or shortened link when sent to a Turkish number. This restriction covers every message type, not just marketing, so appointment reminders, confirmations, and one-time codes sent to Turkish contacts are affected too.
Unlike the UK's number registration, this one is on you to fix in your own templates and workflows:
Remove full URLs, shortened links (such as bit.ly-style links), and tracking links from any SMS template or workflow step that can reach a Turkish contact.
Check custom values or merge fields as well. A dynamic field that resolves to a link is treated the same as a link typed directly into the message.
Replace the link with a phone number or plain-text instructions where a link would normally go.
Messages blocked under this rule typically return error code 30007 in your Inbox, though that same code can appear for other filtering reasons too. See the SMS Error Codes Reference article in the Phone collection for full troubleshooting guidance on carrier-filtering errors.
If you operate a registered business entity in Turkey, a compliant path may be available that lets you keep sending links in SMS to Turkish contacts through a local, properly authorized messaging provider. This path requires formal local business registration and additional provider setup on the carrier side, so contact Aesthetix support if you have a Turkish business entity and need to keep links in your messages. Without a qualifying local entity, remove links from any SMS sent to Turkish contacts as described above.
What happens when a contact replies STOP?
Aesthetix CRM automatically enables Do Not Disturb for all SMS on that contact. This is a carrier-level requirement, and it stops every text — including appointment reminders — not just marketing messages. To let contacts opt out of marketing only, offer a custom opt-out phrase and workflow as described above.
Can I offer a marketing-only opt-out instead of STOP?
You can offer a custom marketing-only opt-out phrase (such as "MKTG STOP") in addition to STOP, but never instead of it. Carrier compliance requires that every message include a standard STOP option; the custom phrase is an extra convenience layered on top.
Why can't I use prescription drug names in bulk SMS?
Wireless carriers filter messages containing prescription drug names to combat spam and protect consumers. Messages with these terms may be blocked, and repeated violations can lead to your sending number being suspended or blacklisted. Move medication-specific messaging to email or in-person consultations.
Where do I find the legal requirements for consent?
Can I text marketing messages to contacts in the United Kingdom?
Yes, but you'll need a UK-registered sending number first. Contact Aesthetix support to set one up. Your standard U.S. number is not a supported route for UK sends and will typically fail with error 21612.
Can I include a link in an SMS sent to a contact in Turkey?
No, not as of April 1, 2026. Turkey blocks any international SMS containing a URL, shortened link, or tracking link, whether it's a marketing message or an appointment reminder. Remove links from any template or workflow that can reach a Turkish contact and use a phone number or plain-text instructions instead.
Can I use a URL shortener to get around the Turkey block?
No. Turkey's restriction covers shortened links the same as full URLs and tracking links, so shortening a link does not make it compliant.
Does the Turkey link restriction affect WhatsApp or email?
No. This restriction applies specifically to international SMS. WhatsApp, email, and other channels are not affected.
This article covers the operational side of opt-in and opt-out. For the legal and regulatory background — including TCPA, express written consent, and record-keeping obligations — see the Compliance collection.
