Alexa Nicholls Costa, NP (SAR ’10): Revamping the Dermatology Industry

Before launching LexRx in 2015, Alexa Nicholls Costa, NP (SAR ’10) studied health sciences at Sargent College earned Master of Science in Nursing from Regis College. Now, she and her co-founder are combining their expertise and strong branding to grow their boutique dermatology practice. 

INNOVATE@BU: Tell us a little about your venture, LexRx:

ALEXA NICHOLLS: LexRx is a boutique dermatology practice and lifestyle brand, with an educational platform and sister venture, Inject With Lex.

In your opinion, what does it mean to be innovative?

To be innovative, one must be able to recognize a flaw or problem, fiercely develop a solution(s), welcome feedback and criticisms, and execute in their space or market better than anyone ever has before them. One must be willing to challenge the herd mentality and previously established comfort levels, in order to say, ‘just because everyone else is doing something in a certain way does not mean that we should do it that way too’. You have to be willing to work smarter and harder, never settling for anything less than excellence in your field.

Tell us your story. How did it it all start? 

I have always been passionate in the fields of art and science. Growing up, I was always really good at art, however, I was also a very big science nerd. At Boston University, I studied PreMedicine/Health Science at Sargent College; following graduation from BU, I was accepted into the Plastic Surgery Research Lab at Massachusetts General Hospital, where I worked as a member of the Division Chief’s research team. It was during my time in research that I developed an even greater love for the field of plastic surgery.

Following my time in the lab, I attended graduate school at Regis College in Weston, Massachusetts; I was accepted into the Direct-Entry Nurse Practitioner program. During my time at Regis, I was fortunate to be welcomed back to the Plastic Surgery department at Massachusetts General Hospital for my NP clinical training. It was during my training that I found my true passion in the injectables market. However—I recognized a problem— injectables are offered in many different types of setting—hospitals, private practice, med-spas, concierge practice, salons, groupons, and beyond—but why would anyone want to go to a “jack-ofall-trades” for their injections? Wouldn’t they prefer to go to an expert? Someone who is exclusive to the injectables market? Thus, began the beta phase development of LexRx.

I convinced one of my best friends and fellow NPs from graduate school, Alexandra Rogers, to become my business partner–together we traveled to NYC to become formally certified in neurotoxins and dermal fillers. We started out very small and basic—we launched in 2015 as “TheLexNPs”—a name that we thought was totally fabulous, yet we spent so much of our time explaining what the name meant (#embarrassing). We had very simple (and in hindsight terrible) branding. We pooled together a few hundred dollars to purchase our first vial of BOTOX Cosmetic, and we hit the road via a concierge practice model.

For our first year, this approach was very savvy—we did not have the dreaded financial burden of a business loan or commercial rent.

However, the busier we got, the more we realized we needed a physical location to setup shop.

Year two, we quickly realized we needed to tighten our marketing approach, and trial the Boston market. It was around this time that I became familiar with the BU Buzz Lab (now Innovate@BU). I setup a meeting with Professor Ian Mashiter, and I gave him my best “TheLexNPs Pitch”—I have to admit, I was pleasantly surprised by Professor Mashiter’s enthusiasm around our little botox business. A few days after our meeting, Professor Mashiter paired me with BU MBA Alumni, Ani Collum—by far, the fiercest business woman I have ever met.

My meeting with Professor Mashiter single-handedly helped propel LexRx into the thriving practice it is today.

Ani has been able to mentor, consult and advise Alex and I through the many obstacles businesses face in the start-up phase. She helped us create a one-of-a-kind brand identity through a carefully calculated, business rebranding process. With the help of another BU Alumni, Kelley Wade (CFA Alumni), LexRx came to life; we partnered with Kelley and her full-service, graphic design firm—Pinkergreen—in order to create a visual stamp for LexRx. Kelley remains the Creative Director for LexRx, and is an integral part of our team. Kelley has been able to bring our ideas to life, and revolutionized the way we market injectables.

After launching in 2015 via a concierge model, we grew busy enough to trial a Boston-based headquarters on Newbury Street in 2016. During our nine months on Newbury Street, we operated in a shared medical space amongst other clinicians—a financially conservative decision fit for a “proof of concept” location.

Encouraged by a full schedule and growing client base, we began the hunt for a branded space to call our own. In June 2017, LexRx became the first boutique medical practice to open a flagship location on historic Charles Street in Beacon Hill. LexRx has quickly immersed itself within an admirable collection of businesses, boutiques, culture and history. We are members of the Beacon Hill Civic Association, the Beacon Hill Business Association, and the Beacon Hill Women’s Forum.

Our LexRx team of BU Terriers continues to grow—in 2017 we welcomed a Boston University intern, Sophia LeBeau (COM ’18), to the LexRx Beacon Hill team!

In an experience found only at LexRx, clients are able to select their desired services utilizing the trademarked ‘LexRx LineUp’ – a first of its kind illustrative menu-style offering of injectable treatments. The innovative LexRx Lineup includes realistic facial illustrations to help clients self identify with needs and the recommended offerings as well as transparent pricing for all services, eliminating any potentially awkward checkout post-treatment.

The response? LexRx has become the “go-to” practice for Boston’s growing Millennial and “selfie” demographic, Generation X, and Baby Boomers; their client base features some of Beantown’s finest socialites, TV personalities, athletes, and key influencers. Some of the most successful businesses are those are focused, diligent, and masters of their craft—the motivating drive behind the LexRx philosophy. LexRx’s operates via a lean business model—an approach that has proven successful across many markets and industries. By disrupting industry norms and staying true to its core values, 100% founder-owned LexRx has remained cash-flow positive since their launch in 2015, allowing the business to grow without the burden of business loans.

With plans for growth and expansion, and a passion for remaining true to our educational core, we have been determined to differentiate ourselves in a saturated market; in January 2018, LexRx launched a sister company—Inject With Lex—which offers didactic, hands-on, advisory and consulting services for clinicians. Inject With Lex will also play a vital role in growing the LexRx team here in Boston and beyond.

What has been the biggest challenge or obstacle you had to overcome? How did you do it? What did you learn from the experience?

I was advised early on in our venture that “you don’t know what you don’t know”—and this advice has been a constant reminder to remain open to help and guidance. Given our strong foundations in medicine, Alex and I quickly recognized that while this was important to help create a “medical practice”, it was vital that we surround ourselves with experts in other industries—marketing, PR, finance, etc.—in order to help us execute our vision. While it is humbling to realize “you don’t know what you don’t know,” I am incredibly grateful for all that I have learned from our team of multidisciplinary experts.


Is there one (or two) major accomplishments you’re most proud of? What’s your next big goal?

Two major accomplishments I am most proud of thus far include the launch of our Beacon Hill flagship LexRx location, and winning “Best of Boston” for the Boston A-List in 2017. These two accomplishments help support our passion, dedication, and belief in LexRx. For 2018 and beyond, I hope to continue to scale LexRx and grow our team.

What advice would you give to someone starting their own innovation journey right now?

There are many things I would share with someone starting their own innovation journey. For starters, you have to be honest with yourself and understand fully that this will be a 24/7 job.

No matter what challenges and criticisms you face, have to believe in yourself and your vision, in order to create your own narrative.

Surround yourself with positive people and commit to a strong support system. Don’t be afraid to reach out to fellow innovators and entrepreneurs for advice—even if their industries differ, they likely will have faced many of the same challenges and emotions as you.

Be prepared for the nay-sayers, the haters and the copy-cats—usually all the same people. The process of innovation and disruption will inherently ruffle feathers in your industry and beyond. Once your concept is proven, these same people will then try to copy your vision. You must be willing to continue to out-innovate and execute better than anyone else. I know I speak on behalf of all fellow BU Terriers when I say, don’t hesitate to reach out—we are always here to help one another out!

Follow LexRx on Instagram

More Innovation, More Inspiration