Improving economy impacts cosmetic dermatology demands

Key Points

As third-party payer reimbursements for medical dermatological care decreased, many dermatologists started growing their cosmetic dermatology practices.

Dermatologists who spoke to On Call report varying amounts of a slowdown in their practices during the economic downturn, but all report at least some increase in their cosmetic patient load in the past few months.

Melissa Lazarus, M.D., has been practicing in Miami Beach, Fla., for five years.

"I'm lucky I held on to my general dermatology when the economy was bad, because that kept us going. It wasn't that people dropped cosmetics completely, but they did it less frequently. Instead of coming in for Botox every three months, they spread it out as long as they could - returning every four or five months. Instead of doing two syringes of fillers, they would get by on one. We also didn't get a lot of new patients coming in," she says.

"Now a lot of people are coming back to their regular schedule, and two syringes, and I've had more new people interested," she says.

Cosmetic still booming

In practice for 39 years, Margaret Waisman, M.D., has offices in Houston and Aspen, Colo. She says she has had different experiences in her offices.

"In Houston, I'm lucky enough to be in an area not hard hit by the recession. Patients may be stretching out the time line between injections a bit, but not much, and we still have plenty of new people who are interested. I don't think that would be the same in much of the Midwest," Dr. Waisman says.

Even where the recession took hold, she says her cosmetic practice actually experienced an increase.

"I have unemployed patients in Colorado, because no matter what they tell you, the economy hasn't been good around Aspen," she says. "So I think a lot of people are doing it because they are job-hunting and want to look younger; they know they need to look younger, and that's sad."

Feeling the hit

Adam C. Esser, M.D., has a Mohs surgery and cosmetic dermatology practice at Kaiser Permanente, Panorama City, Calif. He is in a working-class, ethnically diverse neighborhood.

"We definitely saw a slowdown here when the economy went downhill, but it wasn't as severe as we anticipated," he says. "Patients were doing fewer procedures, but they were still coming in. Where before we might inject lips and nasolabial folds, people started choosing between the two.

"Patients are starting to get more aggressive again. They feel better about their situation. Still, it's an incredibly high unemployment rate here, but the people who can afford procedures are starting to do them again," he says.