Recommending Skincare

By Victoria Hiscock / 11 May 2019

Clinical educator Victoria Hiscock addresses the challenges of skincare retailing and how practitioners can change their mentality around recommending products.

Clinical modalities can offer outstanding outcomes towards skin health and rejuvenation,1,2 but if patients use non-active skincare in-between visits to your practice, will they ever truly reach their full aesthetic potential? Corrective adjunctive skincare containing retinoids, acids and antioxidants for use at home can contribute significantly to long-term patient outcomes.3,4,5

A dentist wouldn’t advise their patients to avoid brushing in-between biannual check-ups any more than a personal trainer would advise their clients to eat fast food in-between workouts. As skincare professionals, I believe we must be advising our patients to use medical-grade skincare to maintain and gain upon the results we are achieving in-clinic. However, I am regularly hearing that medical professionals find the process of selling skincare awkward, uncomfortable and sometimes even intimidating.

Doctors, nurses and dentists leaving the NHS often report to me that they find it difficult to ask for money in the private sector of medical aesthetics, especially in exchange for skincare. Fear of losing patient trust and professional credibility are among the reasons given, as are ideas that skincare is rather ‘fluffy’. In my experience, common objections to recommending skincare to patients include, “My patients don’t want to be sold to, they just want their toxins” or, “I like my patients so I find it hard to suddenly try and sell to them.”

This article explores how to change your mindset around selling to help your patients achieve their skin goals and to help you build your business potential.

Your patients want skincare

Research indicates that while the global facial injectables market size is valued at USD £6.5 billion,6 skincare sales generated as much as $121 billion.7 Beauty e-commerce generated about $3.8 billion in sales in the US in the past year and in a survey conducted by AT Keary, 28% of 502 shoppers actively researched information online and carried that knowledge with them to stores where it is used to make more informed purchases.8

This shows that patients are seeking advice, so don’t you want to help them? Not only do these figures represent wide-spread desire and need for effective skincare, but also lost opportunities to your business if you are not stocking skincare or optimising your skincare sales. Alongside this, healthcare professionals have a duty of care. It is estimated that there are 15,400 new cases of melanoma in the UK each year,9 and in 2019 there will be around 96,480 new cases in the US;10 so we need to be promoting daily application of broad-spectrum UVA and UVB sunscreen as a bare minimum. I find that although patients want skincare, they don’t want to be sold to because they feel like they’ve heard it all before. Consumerism is saturated with skincare companies claiming to be ‘antiageing’, ‘clinically proven’ or ‘backed by science’ and many patients are under the impression that they have tried everything, and none of it works. They have no reason to believe that we, or the skincare we are recommending, are any different. This can make patients a little defensive and the consultation process a little challenging.

For this very reason, it is no longer powerful enough to simply promote a skincare product as ‘antiageing’ or ‘scientifically backed’ and hope we get ‘lucky’ with a sale. We must sympathise with our patients’ frustration in not seeing the results they were promised and offer them in-depth information about the differences between well marketed high-street skincare and medical-grade topical solutions, which include differing percentages of active ingredients, molecule size, pH and the inclusion of delivery systems, to name but a few.

In the muddled mindfield of information available, it’s our duty to offer patients correct, and more importantly, personalised skincare education. By 2024, the global skincare market is estimated to be worth US $180 billion.8 To avoid the majority of that money being spent on non-active skincare offering nothing more than a pleasant experience, rather than medical-grade topical solutions provided via licensed skin and healthcare professionals, we must act together to give our patients the education they deserve. Let us not be salespeople, but a united information service for the public. Forget sales, get used to educating.

How to ‘educate’ rather than ‘sell’

Firstly, it is vital that you know the value of what you are selling or recommending to your patients and are able to explain it thoroughly, in layman’s terms. You can’t teach what you don’t know intimately, so start learning. Anatomy of healthy skin and the pathology behind common skin conditions such as acne, hyperpigmentation and rosacea should be at the forefront of your mind. There are bountiful books and courses available to deepen your knowledge on cosmetic dermatology if it’s not currently your area of expertise.11,12

If you are already working in partnership with a skincare company, start revising the products and the mechanism of action of their hero ingredients or contact the company for additional education. If you are still looking for the perfect brand for your business, start researching companies and scrutinising their formulas. In either scenario, pick molecules that spark your interest and search Google scholar, NCBI and PubMed for credible clinical studies backing up their efficacy. Through this method of research, you will build knowledge in your products and a portfolio that you believe in and, more importantly, see the value in.

The consultation

Following a structured consultation will keep you on track and guide you through asking the right questions for personalised and effective skincare recommendations in a timely fashion. Don’t enter your consultation with only the pressure to remember all the clinical knowledge and convince your patient to believe your claims. Take in a list of questions, textbooks and medical illustrations, clinical evidence and before and afters. Let the science do the talking for you. You can break down your consultation into three parts: interested investigation, generous education, and comprehensive recommendations.

Part 1: Interested investigation

To avoid feeling like a used car salesperson pushing something our patient doesn’t want or need, we must care about their desires and offer solutions they are willing and excited to incorporate into their daily lives. Ask your patients as many questions as you can about their complaints, current routine and lifestyle. This will help you suggest the right products specifically for them. Try and ask three questions for every answer you get until you feel you have gathered adequate information for your assessment (see Table 1 for examples). Not only will this allow you to identify potential causes of skin conditions, it will help you build a picture of what products they like and have time to use. This, in the short-term, allows them to feel heard, and in the long-term ensures patient compliance.

Part 2: Generous education

This education includes general anatomy of healthy skin and the pathology of their skin condition. Educate your patient about the appearance of the visible presentations that they may see on their skin; these might include pustules, hyperpigmentation, redness and telangiectasias. Then talk them through skin physiology; this might mean talking about the sebaceous gland, melanocytes or the demodex mite; again use layman’s terms. At this point, general lifestyle tips are a useful way to help your patients get results. You might talk about cleaning makeup brushes regularly to remove bacteria, staying out of the sun to avoid pigmentation getting worse, or reducing flushing by avoiding hot to cold environments. There are certain ingredients that target these conditions universally, meaning you can offer unbiased information about ingredients like salicylic acid,13 arbutin14 or vitamin C15 without trying to sell a single product.

Once the patient understands what is happening to their skin and what ingredients they need to look out for and avoid, you can then ask them, “Would you like me to talk you through the products I would recommend which contain the correct percentages of these ingredients?” The patient then has the power to say yes, or no. If they say no, don’t take it personally, you have empowered them with the knowledge and any decision they make for their skin moving forward will be an educated one. A comment such as, “I understand, but know that I will be happy to explain this to you if you change your mind in the future,” is a great way to leave the door open.

Part 3: Comprehensive recommendations

If they say yes, you have full permission to move onto part three, during which you can explain individual products in detail, comfortable with the knowledge the patient WANTS the information. At this point, it is important that you are completely selfless with your knowledge. The choice is theirs, not yours. Recommending just one or two products to not seem pushy will only give your patient the option to buy one or two products. Instead, give patients the ability to choose a full programme, rather than potentially limiting their results. A patient using powerful antioxidant15 and broad-spectrum sun protection16 in the morning and regenerative retinol17 and acids18 in the evening is more likely to see results than their peer only using a cleanser and one serum.

Give the full extent of your recommendation, informing your patient that although a streamlined, budget-focused option is always available, the full programme will yield quicker, measurable results. Explain the cost and its breakdown thoroughly, including initial payment, length of use, and subsequent monthly, weekly and even daily cost. Sometimes a full programme of medical-grade skincare can work out at just £3 per day, so this is a good way to make it viable for the patient.

Don’t talk yourself out of a sale

Every patient has a different skin type, condition, income, willingness to spend and desperation to see change. Stop grouping your patients into one bundle and thinking, ‘they never buy’ and ‘my patient doesn’t want homecare’ and treat each patient like a true individual by taking the time to get to know their history with skincare. You don’t know that your patient isn’t already spending £300+ on a serum, or why they might be spending £2.99 on a supermarket cream. In my experience, patients’ lack of education is guiding their spend, and often they are not making well-educated decisions that optimise their skin health, or will complement the results of in-clinic treatments. Give patients as much information as you can, then let them make an informed, empowered and well-educated decision for themselves.

References

1 Landau M. Chemical Peels. Clinics in Dermatology 2008;26(2):200-208.

2 Laser treatment of photodamaged skin: Rostan EF: Facial Plast Surg.2005 May;21(2):99-109.

3 Kafi R, et al., Improvement of naturally aged skin with vitamin A (retinol). Archives of Dermatology, May 2007;143(5):606-12.

4 Telang PS, Vitamin C in dermatology. Indian Dermatol Online J 2013 Apr-Jun;4(2):143-6.

5 Devasagayam TPA, Tilak JC et al., Free radicals and antioxidants in human health: current status and future prospects..= Journal of Association of Physicians of India 2004;52:794–804.

6 Grand View Research, Facial Injectables Market Analysis By Product (Collagen, Hyaluronic Acid, Botulinum Toxin Type A, Calcium Hydroxylapatite, Polymer Fillers), By Application (Aesthetics, Therapeutics), By Region, And Segment Forecasts, 2018 – 2025. Published 2017. <https://www.grandviewresearch.com/industry-analysis/facial-injectables-industry>

7 Statista, Size of the Global Skin Care Market from 2012 to 2024. <https://www.statista.com/ statistics/254612/global-skin-care-market-size/>

8 ATKearney, Beauty And The E-Commerce Beast 2017. <https://www.atkearney.com/ communications-media-technology/beauty-and-the-e-commerce-beast>

9 Cancer Research UK, 2015, <https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/melanoma-skin-cancer#heading-Zero>

10 American Cancer Society. “Cancer Facts and Figures 2018”. Atlanta: American Cancer Society; 2019.

11 M. G. Rubin, N. Y. SchüRer, L. G. Wiest, U. Gout, Illustrated Guide To Chemical Peels, 2014.

12 Leslie Baumann, Cosmetic Dermatology, second edition, 2009.

13 Tasleem Arif, Salicylic acid as a peeling agent: a comprehensive review, Clin Cosmet Investig Dermatol. 2015; 8: 455–461

14 Rashmi Sarkar,Pooja Arora,1andK Vijay Garg, Cosmeceuticals for Hyperpigmentation: What is Available?, J Cutan Aesthet Surg. 2013 Jan-Mar; 6(1): 4–11

15 Rock CL, Jacob RA, Bowen PE, Update on biological characteristics of the antioxidant micronutrient, Vitamin C, Vitamin E and the carotenoids, J Am Diet Assoc. 1996;96:693–702.

16 Reena Rai,Sekar C Shanmuga,andCR Srinivas, Update on Photoprotection. Indian J Dermatol. 2012 Sep-Oct; 57(5): 335–342.

17 Mukherjee S, Date A et al. Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Clin Interv Aging December 2006;1(4)327-48.

18 Smith WP.J, Epidermal and dermal effects of topical lactic acid, Am Acad Dermatol.1996 Sep;35(3 Pt 1):388-9 

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