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the same improvements as those patients whom the

author treated in the early years of her career. With a desire to obtain healthy-looking skin, patients will often ask for a ‘clean’ face, with the removal of ear and nose hairs, brown spots, and blood vessels visible on the nose. On the contrary, men in the age range of 35–50 years

wish to erase all signs of fatigue, such as bags under the eyes, and a sad-looking or ill-looking face; they do not want their social life to be visible on the skin when at work, but wish to look ready and accessible. A more surprising phenomenon is the entry of the

20–35-year age range in the author’s practice. This patient group, who, years ago, would only come for treatment on very rare occasions, seem to have developed a strong interest in aesthetic medicine, so much so that their female relatives complain that they spend as much time in front of the mirror as them. When male patients come for a consultation, they are very well informed about the treatments they require,

such as those for acne scars treated with fractional C02 laser or radiofrequency. They are not only very aware of the effects of botulinum toxin and hyaluronic acid injections on wrinkles, and the prospects offered by techniques such as LED or radiofrequency for the enhancement of skin quality, but they are also ‘on top’ of

The aspiration to

look younger or more attractive

does not seem to be their first

motivation; most importantly, men want to please


Figure 1 Fillers in the periorbital area, with a very low risk of the Tyndall effect

subjects such as hair growth treatments and the range of methods for handling weight issues. It should be noted that techniques intended for female

patients cannot be used in male patients. Indeed, the two genders show a number of differences with regard to their motivations for treatment, their histologic and physiologic specificity, and their psychological characteristics for example.

Motivations for treatment The majority of men will begin their journey toward cosmetic treatments by exercising and taking a healthy diet1

. According to Fried2 , their motivation comes from a

combination of fear of age, and a desire for sexual intimacy, money, power and prestige, through which they can enhance their success. In practice, it should be noted that men want to erase any sign of fatigue and appear more competitive and dynamic. The aspiration to look younger or more attractive does not seem to be their first motivation; most importantly, men want to please themselves. Whenever possible, male patients generally prefer ‘one

shot’ treatments that do not require repetition: the main requirement is discretion. These gentlemen want to be presentable from the moment of leaving the clinic, and are often ready to cancel the entire process when the risk of bruising is high, for example. With regard to pain, men are well known to be more

sensitive than women, are less tolerant to discomfort, and do not have as strong a will to reach their goals. Men are also often less satisfied after a treatment compared with women. In the author’s experience, these gentlemen are more

fearful of pain, but seem to have the same pain threshold as the ‘weaker’ sex.

Histologic differences Epidermis In men, the epidermis is 10% thicker and the stratum corneum has a less efficient barrier function (sexual/ gonadal steroids have an impact on permeability)3

Furthermore, the hydrolipidic film is thicker and the pH lower (4.5 vs 5.3 for women)4

skin’s pH can influence the barrier function of the stratum corneum and the flora living on it5

20 ❚

more abundant and varied aerobic flora than women, hence the importance of beard and acne folliculitis6

. As November/December 2012 |

. . It is well known that the . Therefore, men have a

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