Making it Personal: The Focus of Multifactorial Skin Care

Editor's note: The purpose of this column is to tap first-hand into a clinician's experience with the consumer, including chief complaints and treatments, to asses common concerns for women today in an effort to formulate better cosmetic products for those issues.

Skin care personalization is an increasingly strong trend, so as I carry out consultations at my skin care clinic, I approach clients with a holistic view that takes into consideration a multitude of factors. These include: age and gender, skin type and concerns, history of tanning and outdoor exposure, health and medication, hormonal status, diet and lifestyle, and the client’s stress and support network, as well as their skin care beliefs and routines.

Skin Concerns and Needs

My clients express a broad spectrum of skin concerns and needs, and working with individuals in a clinical capacity, in addition to academic lecturing on appearance and well-being, has taught me that we are our harshest critics. Women give greater importance to appearance due to cultural norms; their appearance relates to the perception of belonging to a social group and peer comparison.

Unilever’s 2013 Dove Real Beauty Sketches campaign supported this view,1 stating that “only 4% of women around the world consider themselves beautiful.” It is also my experience that British women find it difficult to refer to themselves as “beautiful;” they might prefer to say they seek to “look good for their age,” an understatement that might be culturally more acceptable in Britain than in France or America.

Research into the perception of age and attractiveness confirms that certain concerns matter more.2, 3 For example, most of my post-menopausal clients often feel they are “becoming invisible” on a daily basis. Also, those affected by adult acne experience negative comments and feelings of rejection and shame.

My clinical practice includes clients ranging in age from 20 years to 75 years. Treatments involve anti-acne solutions for those in their twenties and thirties, and anti-aging recommendations for those ages 45 and older. In fact, the two biggest concerns my clients report are acne, 28%; and frown lines, 26%; followed by sagging and fine lines in the eye region. Interestingly, research7 confirms that “ideal” media images affect women most negatively at times of greater self-monitoring, which coincides with the hormonal changes accompanying puberty and menopause.

Analytical Approach vs. Empathy

Presenting the visible self as attractive to others holds high value in Western society, and flawless skin is one of the most universally desired human features. Our hardwired preferences for young and healthy-looking skin have created cultural norms, particularly for women, and being unhappy with one’s appearance spurs a vicious cycle of stress and worsening of skin conditions.

Concerns about personal appearance are increasingly common. Anxious people perceive a discrepancy between their appearance and societal standards of “what they should look like.” In relation, prior to treatment, 87% of my clients reported the appearance of their facial skin made them feel unattractive and self-conscious. After treatment, they felt satisfied due to the effects from the products used, changes in their skin condition, the psychological focus on them and the experience of caring for themselves, or a combination of these factors.

As noted, I approach skin care as a multifactorial process that involves personalized skin care products, facial massage and application techniques, gentle facial exercise, and restorative processes including relaxation, diet and sleep. During these treatments, a key aspect I include as part of each client’s education is to encourage them to look at their own face without scrutiny, and experience their natural aging process without judgment. While looking at and experiencing others’ faces and feelings instills a sense of empathy, in turn altering how they feel about their own appearance, dissolving their own critique often presents a challenge.

Quality of Life and Support in Well-being

When people first meet, their faces play a role in informing others of how to perceive the people behind them. With older consumers, it is up to the skin care industry to provide tools that help them embrace and enhance changes from aging. With acne, although it is often perceived as neither life-threatening nor physically debilitating, its adverse social, psychological and emotional effects are not trivial.4 So, it is no surprise that social impairment does not correlate with objective clinical assessment, but rather with the subjective judgment of the person affected.

The Cosmetic, Toiletry and Perfumery Association has worked with experts to explore this role of appearance in self-image and self-esteem,5 and online educational resources, particularly videos, are becoming popular. I find, however, that the connections and support of a local, expert-led peer group can have the biggest impact in transforming an individual’s quality of life.

Profound and palpable changes in the way individuals feel about themselves after applying skin care and makeup have been reported in populations more vulnerable than my acne and aging-affected clients. Cancer sufferers, for example, attending life-changing workshops such as those organized by the Look Good Feel Better charity, have praised not feeling isolated, regaining control and making the best of their appearance as invaluable in helping them cope with life.6

Putting it All in Perspective

The Society of Cosmetics Scientists (UK) maintains that, “Self-esteem is the biggest driver of economic performance.”8 In support of individual well-being, it is the role of skin care professionals, the inspirational media—journalists, brand owners and celebrities that signed the Positive Beauty Manifesto,9 as well as the cosmetic industry—to help consumers feel good about themselves. The individual perceptions of consumers’ “beauty” are often complex and delicate; and affected by an interplay of product efficacy and changes in skin condition as well as psychological focus on the self and the experience of caring for themselves. A personalized and multifaceted approach to skin care delivers the desired results.


All websites accessed Apr 16, 2015.

  7. JT Newton and G Minhas, Exposure to 'ideal' facial images reduces facial satisfaction: An experimental study, Community Dent Oral Epidemiol 33(6) 410-8 (2005)


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