Male Aesthetics – Skin Therapy Letter
Male skin is thicker at all ages and the extent varies by anatomical region. Male skin tags also show increased activity and men have increased sebum and sweat production. There are significant differences in hair distribution because sexual hair growth is dependent on androgens.
Androgens convert small, straight, unpigmented hairs into thick, pigmented terminal hairs. Androgen dependent areas include the chin, upper lip, chest, breasts, abdomen, back, and front of the thighs.
Men have increased skeletal muscle mass, including facial memetic muscles. Men also have a highly vascularized face due to the vascular plexus that supports the beard hairs.The higher density of the facial vasculature can make men more prone to bruising with injectables, particularly on the lower face.
Anatomical variations between genders result in differences in aging. The aging male face is unique and needs to be approached and treated differently. Men have more severe facial wrinkles except in the perioral area. The loss of subcutaneous adipose tissue with age results in deeper expression lines in men due to thicker skin and more prominent facial musculature, as opposed to the superficial wrinkles that women tend to develop. The significant loss of volume makes men appear older than their age compared to women.
It is important that clinicians do not overlook behavioral differences, which must also be recognized when evaluating aesthetic male patients. Men are generally poor consumers of healthcare and dermatology services.
Men consistently underuse preventive health care services compared to women, regardless of income or ethnic origin, even when reproductive services are taken into account. With regards to their skin health, men are less likely to see a dermatologist, participate in a skin cancer screening, or do skin self-exams.
Aesthetic procedures in men
Injectable botulinum toxin type A and dermal fillers are the main drivers of any cosmetic dermatology practice. The injection technique varies in male patients due to differences in the patient’s anatomy and goals. Successful use of dermal fillers and botulinum toxin in men requires a balancing act between masculinizing and feminizing the face, as overuse of either of these can result in an unwanted cosmetic result.
These can be very helpful in male patients struggling with volume loss given their relative lack of subcutaneous fat. Volume replacement with dermal fillers carries the risk of feminization.
The midface augmentation must take into account the anatomy of the male cheek. Fillers should be injected laterally along the zygomatic arch, carefully avoiding too much volume in the anterior and medial cheeks. Unlike women, for whom lip augmentation is a primary use of fillers, the upper lip is generally avoided in men due to the risk of feminization.
Men may represent a small proportion of cosmetic patients, but they are a growing segment of the cosmetic industry. Men are an untapped patient population that could serve as an area for growth in aesthetic practices.
As the number of male patients seeking treatment increases, clinicians must take gender into account when evaluating and treating a cosmetic patient. It would also be incumbent on the medical community to broaden our understanding of the male face and its proper treatment with minimally invasive cosmetic procedures.