COVID and Cosmetics: Supplying the (increased) Demand While Protecting a Space to Flourish

The novel coronavirus, SARS-CoV-2, has not only re-shaped how we navigate our day to day operations within dermatology, but it has also redefined how our patients navigate their new norms of life with daily routines. From staying in touch with family and friends, to working remotely, people have adopted varying video conferencing platforms like ‘Zoom’ and ‘Houseparty’. One thing in common, a deeper and more self-critical view of one’s facial appearance. Not only are our patient’s noticing their imperfections hyper-displayed now more than ever, we also have added societal pressure to improve our imperfections. Now filters like “touch up my appearance” on ‘Zoom’ or utilizing ‘Ring-Lights’ to hide blemishes have now become the norm. It is important to understand the new patient-perspective of aesthetics, what they want, how to set oneself apart as a cosmetic dermatology specialist, and how to make patients feel comfortable receiving these procedures amid a deadly pandemic.

I often hear from patients that they are tired of starring at their problem-areas on video calls and come in for cosmetic procedures to make themselves feel and look better. An article published in Facial Plastic Surgery & Aesthetic Medicine: Video Conferencing Impact on Facial Appearance: Looking Beyond the COVID-19 Pandemic, found that 55% of respondents had concerns related to their facial appearance. Of the respondents who had prior cosmetic procedures, 100% respondents had plans for continued treatment. Of the subjects who did not have prior facial cosmetic treatments, 40.6% planned to pursue treatments based on concerns from video conference appearance. The most common responses being neurotoxin and filler injections. This is very reflective of my own personal experience working with my patients through this pandemic. Now, with the added downtime at home, I have also found a higher demand for non-invasive laser treatments more than ever.

As patients view oneself from a video lens or putting images of oneself on social media, there is a psychology of one’s perspective of their appearance that needs to be addressed. People want to be accepted. The younger generation has placed a higher pressure on physical imperfections and the need to keep up with others; and perhaps this is why we have seen an uptake in the number of rhinoplasties being performed annually. We understand that due to “selfies” and the angle of the camera, the appearance of one’s nose may be perceived being up to 30% larger than in reality. These magnifications or simply being at home with more time to view oneself in the mirror amid this pandemic has created more opportunities for individuals to be more self-critical. Alternatively, patients are spending more time at home and less time doing other activities like traveling or eating out. With such changes to one’s routine, I have found more people are starting to look down the pipeline beyond this pandemic, in where they may be. While during it, they want to put their money from traveling into investing in oneself which in this case includes cosmetic treatments and a skincare regimen. Overall, I think everyone is putting a higher emphasis on maintenance of their appearance, not only improvements. Patient’s understand and see the effects age has on our skin, and more and more people want to continue to invest in their appearance. Working in dermatology, we are able to offer a compressive approach to skin and beauty. It is important to understand that there has been a positive shift over the past couple years for women and men alike, with a higher acceptance and desire for cosmetic procedures. This demand has not wavered through this pandemic, and I do not foresee it declining for those individuals whose budget can afford treatments.

Injectables like “Juvéderm®”, “Restylane®”, “Botox®”, and “Xeomin®” have now become common talk among the general public. As these have now been around for many years, patient’s comfort level has grown, and this includes for treatment-naïve individuals. Perhaps the patient wasn’t comfortable with a toxin being injected into their face, or putting a “non-natural” product into them; something has changed. I believe there has been a society change and more acceptance of treatments mirrored with a demand or expectation to hold beauty. This change can be seen across multiple generations and sexes. From a female painter in her mid-seventies who tells me the beauty of her face is her business card, to a young mother of three who wants to age gracefully; people know these treatments are available and seek them out. Interestingly, I have seen a higher acceptance of lip filler across all generations. To the extent of plumpness each person wants varies from patient to patient. Some women want the more modest “New England look” while others want the more dramatic “LA look”. It is important to understand our patients, and what they want. I have seen a large increase in male demand for cosmetics over the past two years. Men often seek quick non-invasive procedures which make things like dermal fillers, neurotoxins, and low downtime lasers a slam-dunk to offer men who often like to invest in themselves and have the disposable income available. I often find other dermatology specialist overlook and undervalue the male market. Just as cosmetics procedures have become more commonplace, so too is the market for men growing which can be a missed opportunity for continued customer business. The market has changed. We need to continue to keep up with it, or other non-dermatology injectors will take your place.

With a higher demand for cosmetic aesthetic procedures, we need to take the growing common talk of aesthetic procedures amongst patients and strongly represent dermatology. We are unique to others outside of dermatology when it comes to providing these services, and we need not to forget that. From medical procedures to laser therapies, we in dermatology are able to offer a comprehensive approach to aesthetics which is uncommon outside of our field. Cosmetics is very unique compared to medical dermatology where it is very much sales-based. We in medical dermatology are unique to have a constant flow of patients to be seen for an array of conditions. It is a missed opportunity if you are not taking advantage of a cosmetic consult and/or treatment during that medical visit; this is an important opportunity to help grow your cosmetic practice. If that be a cosmetic consultation during their medical visit which resulted in scheduling a procedure, or adding on the cosmetic treatment during the same visit, the demand is here and it is up to you to decide to provide it. Just as we have seen a higher acceptance and usage of injectables, so too are laser treatments becoming more common talk and accepted. Some patients simply just do not want fillers or neurotoxins, further opening the door to talk about alternative treatments like laser therapies. I have seen this acceptance particularly among individuals who prefer a more “natural” approach to aesthetics. No matter what the concern is, we in dermatology are unique to discuss and treat it within our field.

How seriously we take SARS-CoV-2 is abundantly clear to our patients, and that is reflected back on the patient in choosing to continue to follow up during this pandemic. I have had multiple patients tell me that they feel comfortable continuing to receive cosmetic treatments because of the precautions I set forth in my practice. The standards we set and uphold reflect back on our communities. We need to be aware of updates and guidelines from both local and state agencies. It is important to screen patients for signs and symptoms associated with Covid-19 before and during the time of appointment. Your practice should consider protocols in place regarding patients needing to quarantine if having had close contact with someone with Covid-19, and how your practice will respond to a patient who recently tested positive for Covid-19. The precautions we take, including PPE, and set forth as an example to our patients in turn mention this to other potential patients which drives our business. Each provider will need to ask themselves what they feel safe with, unless mandated to them in the workplace. Prior to Covid-19, I was one of the few providers I knew wearing a N95 when cauterizing malignancies or warts. Now with SARS-CoV-2, I think each provider needs to consider how best to protect oneself and your patients when performing cosmetic procedures. These may vary from wearing a N95 or face-shield, to having a protocols in place from the time of booking.

The year 2020 will forever be looked back upon in time. As we prepare for an unpredictable course forward amid the SARS-CoV-2 pandemic, it is important to take safety seriously. The measures and protocols we establish in our own practice of aesthetics is deeply reflected on the patient’s further comfort in follow up care. As we navigate through 2021, it is unforeseeable if there may be future mandated shut-downs, including aesthetics. How we work though this pandemic continues to unfold, but it is important that we set high standards that are reflected on our patients and our field. The demand for cosmetics continues to be growing, even amid a pandemic, but how we as a medical community respond to the patient’s concerns will continue to safely drive our industry forward.

Byline: Jeffrey Bonnaud, MHS, PA-C
Posted April 15, 2021

Video Conferencing Impact on Facial Appearance: Looking Beyond the COVID-19 Pandemic:
Facial Plastic Surgery & Aesthetic Medicine Volume 22, Number 4, 2020 ª American Academy of Facial Plastic and Reconstructive Surgery, Inc. DOI: 10.1089/fpsam.2020.0279
Published July 2020
Robert T. Cristel, MD,1,* Daniel Demesh, MD,1 and Steven H. Dayan, MD, FACS1–3