The emerging paradigm of aesthetic dermatology encompasses a wide range of therapies and solutions that have allowed physicians to increase their treatment portfolios. Today’s dermatologists and aesthetic practitoners have the ability to refine and customize skincare protocols for a wide array of concerns, which is perfect for today’s patients who come from all generations.
The social media effect
Social media has changed the way patients incorporate aesthetic dermatology into their daily lives. As social networks continue to grow, people are using it to build their personal and professional brands and feel that their image contributes to success.
Shino Bay Aguilera, DO, a board certified dermatologist and dermatologic surgeon at Shino Bay Cosmetic Dermatology in Fort Lauderdale, Fla., agrees that social media is changing patient expectations, and suggests using caution. “I think social media, and especially Instagram, has become a gateway for cosmetic procedures, mainly for the younger generations. This can be a blessing and a nightmare since the younger generation tend to be more insecure, impressionable and like to follow trends.”
Needs by generation
Sonia Badreshia, MD, a board certified dermatologist at Elite MD spa in Danville, Calif., is seeing trends in the industry that are specific to each generation. “Young generations are looking for contouring, cheekbones, fuller lips and nonsurgical rhinoplasty, whereas older patients want help with filling in lines and wrinkles or to lift their skin.”
To keep up with each generation’s unique needs, physicians use an expansive armamentarium of treatments for skin rejuvenation and aesthetic procedures. Today, a practitioner can work with patients in the office using specialized therapies such as resurfacing, injectables and microneedling, and expand to at-home care, allowing the patient to continue their skincare regimen after they leave the office.
Joel L. Cohen, MD, director of AboutSkin Dermatology and DermSurgery in Greenwood Village, Colo., sees the home treatment trend in his office and uses it as an opportunity to meet patient demand. As he explains, “In my opinion, baby boomers are more likely to focus on topical retinoids as well as antioxidants. And some of the younger age groups are looking for newer categories of products, like peptides and growth factors, and even newer ingredients like Bakuchiol.”
With each generation comes unique needs, which can be treated using multiple aesthetic therapies and procedures.
Generational differences call for attention to lifestyle when forming individualized treatment options. “In general, younger patients are more inclined to less down-time treatments, like non-ablative fractional lasers, but they also have less lines and wrinkles than older patients, who are more inclined to take several days or a week off for fractional ablative and full-field ablative resurfacing,” Dr. Cohen indicated.
Baby Boomers – Ages 55 to 75
Baby boomers are surprisingly health conscious when it comes to skincare. According to Dr. Aguilera, they are looking for products with natural ingredients that lift and tighten. He feels the most beneficial treatments include, “a great vitamin C antioxidant moisturizer in the morning plus sun protection, and a prescription retinoic acid at night. Glycolic acid and refining creams should be limited to short-term use as this may contribute to further thinning of the skin.”
Dr. Badreshia incorporates a blend of skincare treatments to help her mature patients, and feels the most beneficial are those that target sun damage as well as lifting. She finds that laser resurfacing and other procedures along with skincare products that include SPF, retinol and peptides to be most beneficial.
Alison Heinrich, owner and CEO of AKTIV Skincare Solutions, sees trends in medispas that are specific to baby boomers. “Baby boomers don’t have time to play around. They need to focus on years of free radical damage,” she stated. “Once skin is balanced with home care therapies, then address the skin with a TCA Chemical peel. Let the skin heal from the peel and follow up with your injectable service.” Her favorite? “Botox! No bruises, no fuss, basically painless and gives you a refreshed renewed appearance in minutes.”
As leaders in professional chemical peel treatments, PCA SKIN® (Scottsdale, Ariz.) recently launched their new MD Peel (CCI3), as well as improved Sensi and Ultra Peels (all formulated with trichloroacetic and lactic acids). With the inclusion of new anti- oxidants, these improved formulations are more stable, ensuring efficacy and results with no downtime. The company’s versatile chemical peel and skincare portfolio ensures physicians can offer a wide range of treatments in office, along with complementary daily care products for continued results.
Mature skin is subject to malnutrition, while sun damage is a major cause for undesired skin changes. One company has brought a new concept to skincare. U.SK Under Skin (Brazil), a premium skincare brand backed by science from over 100 studies, specializes in medical grade, physician-dispensed cosmeceuticals. Their focus is on creating luxurious products using a concept they call science behind the beauty. Each of their anti-aging and revitalizing products are developed with guidance from the world’s most renowned dermatologists, using science and technology that restores aging skin. Featuring the highest-performing and up-to-date active ingredients, the line of anti-aging products promote cell renewal and defense, repair environmental damage, provide UVA and UVB protection and anti-inflammatory effects.
Gen X – Ages 40 to 54
Taylor Benson, the education support manager at AKTIV Skincare, believes Gen X patients have a unique requirement. “I feel Gen X is still learning,” she elaborated. “They are in a limbo of listening to advice passed on from their mothers and grandmothers, while also getting new information from their daughter or even television. I see this age group favoring lasers and some more advanced technologies, while still really enjoying the steps of a skincare routine.”
Dr. Aguilera says this generation is in the “pre-juvenation” stage and are generally looking to fill lines and folds. “This generation starts to show telltale signs of aging.
During this decade the skin gets dry, rough texture and appears dull. Brown pigmentation increases in number and size causing the skin to look aged and blemished. Using antioxidants in the morning with a sunblock is very important as well as using a retinoic acid with a rich moisturizer at night. If my patient has brown spots, I recommend short contact cysteamine which allows effective bleaching of the skin with a low incidence of irritation. Exfoliating once a week is also advisable to help maintain the skin luster and smooth texture.”
According to Ms. Heinrich, this is the age where cell renewal processes slow down, and the skin is just beginning to show signs of aging. “I have found Gen X to be emotional about their aging process. This emotion leads to a more long-term treatment plan. They are patient and willing to wait for their results and willing to spend the necessary money on home care to keep the results. Gen X is at the age where their skin is starting to lose tight- ness and plumpness which microneedling can assist with.”
She adds that a quick fix treatment will also benefit this age group. “I love how a microderm with a 20%-30% AHA peel quickly gives the skin a boost to speed up cell production and instantly delivers a glowing complexion, more even skin tone, rhytid reduction and texture repair.”
Millennials – Ages 23 to 39
In Dr. Badreshia’s experience, this demographic of patients prefers a trending service that offers a unique experience. “Millennials request fillers, Botox, acne treatment, HydraFacials and take-home skincare. They are looking for the prevention of lines and wrinkles as well as protection from sun damage, and they love to do fillers and Botox for a contoured look and face shaping.”
Ms. Heinrich agreed, “The HydraFacial is popular in this age range since the service offers results with custom solutions.” But her favorite treatment for millennials is Dermaplaning. “Dermaplaning quickly removes unwanted hair and corneocytes. The skin will glow for weeks, makeup goes on smoother and superficial wrinkles are reduced,” she expressed.
As aesthetic technologies become more innovative and versatile, procedures that treat middle and younger generations continue to increase. Dr. Cohen uses this to the patient’s benefit, taking an evidence-based approach to developing a treatment plan tailored to each individual patient. He says his favorite for millennials is microneedling, and he also uses technologies like Ultherapy to tighten skin from the inside out.
Ms. Benson has a specific protocol that she sees as very successful. “One of my favorite services for millennials is microneedling/microchanneling infused with a stem cell growth serum. It is like magic for skin that is just beginning to show signs of aging. It is one of the most transformative treatments that has a long-term impact on how the skin is generating cell turnover and responding to aging.”
The scars left by acne can have devastating effects to the patient. The Icon aesthetic system from Cynosure (Westford, Mass.) offers IPL and laser therapies for acne scar (and surgical scar) treatment, as well as fractional skin resurfacing and melasma, making it a perfect option for the Millennial demographic. Using innovative laser technology, fractional skin resurfacing can help break down scar tissue and rejuvenate the skin, resulting in a smoother more even complexion. Icon also features Skintel, a live melanin reader that enables the user to choose streamlined treatment settings to ensure safe and efficient results.
Gen Z – Ages 7 to 22
The youngest generation often become patients for skin problems that include acne or rosacea. While treatment is milder for these patients, Dr. Aguilera sees this as an opportunity to build a relationship. “The GLOWBIOTICS line (Phoenix, Ariz.) is one of our favorites to teach our younger clients how to take care of their skin.” He explained that while the patient is young, maintenance as well as preventative measures are important. “The 20-year-old patient should use a mild exfoliating cleanser and an antioxidant oil free moisturizer cream or serum is recommended. Sun protection is a must.”
Ms. Benson agreed, “Gen Z’s age group would greatly benefit with simply introducing a skincare routine for maintenance, including but not limited to, SPF and an occasional facial to address any areas of concern.”
This generation is more influenced by social media and concerned with how they look on camera. “Younger generations want aesthetic treatments because of what they see celebrities using on social media,” Dr. Badreshia pointed out. Since acne is more common in Gen Z, she sees acne control high on their list of concerns. “Acne facials are important with Gen Z due to a high population with acne. They desire less breakouts and smoother skin so they can be less self-conscious in their everyday life.”
When it comes to overall skincare, Gen Z enjoys sharing their love of the current trend in botanicals. According to Ms. Heinrich, “Gen Z is new to the game and entered during a botanical loving season in skincare. Gen Z finds themselves with little money, but a lot of passion. This leads to purchases of mini-facial treatments that they have YouTubed, Instagrammed, etc.” Her favorite for this young group is the ultrasonic facial, “a 30-minute treatment completely clears pores and provides a bright glowing complexion.”
Communication with patients is important, and Dr. Badreshia shared these tips: “Young patients want a quick fix and no downtime, with very specific expectations.
Ensure they have realistic expectations, and are not anticipating to look like “filtered selfies.” Review side effects in detail so they understand there is risk, and that it is not like going to a Botox bar; these are true, actual medical treatments.”
Skincare doesn’t stop at the office door
“We should always be considering the basics of skincare,” Dr. Cohen emphasized. “Use a retinoid product at night to help minimize collagen-breakdown and help turn-on pathways that produce more skin structural support, consider an anti-oxidant or growth factor product during the day, layered under your sunscreen.”
Sending skincare treatments home greatly benefits patients as the doctor can continue to offer guidance. Dr. Aguilera explained, “I believe in rotating the skincare regimen. For example, I recommend they practice gentle exfoliation for a month with ingredients like Mandelic, AHA or Glycolic acids, then switch back to their regular routine to help prevent the skin from getting lazy.”
With summer coming, Dr. Cohen had one last tip to share with us. “I wish I could convince ALL generations to embrace effective sun protection – a sunscreen with either zinc oxide or titanium dioxide and reapplication at a minimum of every two hours.”