Millennials aren't new to dermatologists—they have been seeking treatment for eczema, acne, and other dermatoses of youth and adolescence for decades. But the teens and tweens have graduated college, joined the workforce, and are increasingly entering the self-pay aesthetics market.

As patient/consumers, Millennials may come to the practice with certain expectations and attitudes that differ from those of Baby Boomers and Gen-Xers. For example, Millennials may express interest in aesthetic services within the broader, popular trend of “wellness,” whereas some older generations just wanted to fight off the signs of aging.


With his focus on natural results, Dr. Bhanusali is careful to assess patients' aesthetic desires and their rationale. He's willing to turn away patients looking for dramatic changes, will steer patients away from requested interventions if he's not convinced they're a perfect fit, and focuses his energy on directing patients to subtle enhancements.

Regular maintenance and skin-directed interventions go a long way toward providing a rejuvenated, refreshed look. “Every once in a while, you just need to get your pores tightened a little bit, or have just a little bit more brightness to your face.” A device like Clear & Brilliant is ideal for such treatment.

“The patients who have a laundry list of different things they want done, like six, seven, eight things, I always stay a little bit more cautious and have more of a discussion as to why their interest in aesthetic interventions has recently developed,” Dr. Bhanusali says. He has seen patients seek drastic changes in their appearance after a break up or even the death of a loved one. “I try to make sure I distinguish between the types of procedures and the degree of change associated with them. Obviously, if I can, I make sure that they are really in to something, and it's not just a phase, or transient thought.”

When it comes to aesthetic services, most Millennials remain ideally suited to receive minimally invasive procedures. They may be candidates for fillers, neuromodulators, and/or certain energy-based procedures, depending on their specific aesthetic concerns.

“I think this trend of skin health has become kind of interesting,” observes New York City and Miami-based dermatologist Dhaval Bhanusali, MD. “For me, when I talk about some of the lasers we do, and using products like Retinol, it's more about skin health than it is cosmetic procedures.”

Looking Better

For patients in the their early to mid-30s the Clear & Brilliant is a great fit, Dr. Bhanusali says: “We do a ton of Clear & Brilliant procedures.”

When patients ask what treatment will be like, Dr. Bhanusali tells them, “You just look better. Your pores look better. You look fresher.”

Dr. Bhanusali focuses on natural looking results, providing patients a rejuvenated, refreshed look without drastic changes in their appearance. “Some people don't realize it, but you can just view yourself looking better. Not with changing anything. Not increasing or decreasing. Just having something for light skin maintenance,” he says. “That's almost as important as anything else, or maybe more important.”

Clear & Brilliant is Dr. Bhanusali's “favorite ‘refine and maintain laser.' While we do a lot of scar work and I generally use different options for it, Clear & Brilliant is my favorite for getting the final ‘pop' for my patients, perfecting the skin to get the ‘glow' that people love.”

Dr. Bhanusali likes to use Clear & Brilliant for all patients mid-40s and younger. “It's my first recommendation for anyone under 45, and the Permea handpiece has been one of my favorites for pigmentation,” he adds.

Courtesy Dhaval Bhanusali, MD

Before (top) and after (bottom) the patient underwent two Clear & Brilliant Permea treatments and fillers.


Though they may represent only about 10 percent of the aesthetic market, more and more men are seeking cosmetic treatments. For them, Clear & Brilliant may be appealing. “The number of men coming in has been increasing every year and now it has become commonplace for males to come in for treatment,” Dr. Bhanusali says. Men have the same skin concerns as women—large pores over the midface and pigmentation, he notes. “I think the minimal downtime with Clear & Brilliant is appealing,” Dr. Bhanusali says, noting that it would be harder for men to cover any post-laser evidence with makeup.

A Skincare Complement

Educating patients about the role of skincare and their multiple skincare options is a good way for an aesthetic physician to distinguish her/himself from other treatment providers and non-medical outlets.

Steven Dayan, MD believes patients want reliable education on skincare, and he is convinced core aesthetic physicians should be the ones supplying information to patients.

He also thinks that, since patients are going to purchase skincare somewhere, they might as well get it from their physicians. In addition to helping patients select appropriate formulations, the practice can also ensure that the products patients actually purchase and use are effective and safe.

“A lot of products out there might be adulterated or expired so we try to educate patients to be cautious about where they buy from or who they buy from,” Dr. Dayan says.

In many practices, skincare goes hand-in-hand with Clear & Brilliant treatment. The treatment is a sort of skin prep that readies the skin to absorb and synthesize topically applied ingredients.

“Clear & Brilliant is the procedure I do once I have my patients on a great skin regimen and needing that extra ‘oomph' for a big event or just everyday good skin health,” Dr. Bhanusali says.

“I think every laser has its own unique pros and cons and understanding where/when to use what can separate good results from great ones.”

Clear & Brilliant targets signs of photodamage, especially in its early manifestations. This includes uneven tone and skin “dullness.”

Patients see results immediately.

Early and notable improvement in the skin with Clear & Brilliant frequently sets the stage for future treatments, so that patients start to look forward to their regular visits. Many practices report that patient adherence with the program is high.

A rewards program from Solta doesn't hurt in terms of driving adherence, either.

No Downtime Results

Ultimately, the most attractive feature of Clear & Brilliant may be that it provides its benefits with no downtime. The skin remains intact, and that means patients can apply make-up immediately after the procedure. Other than a bit of flushing in some patients, there is no evidence the patient “had something done.”

This means treatment can be done for “freshening up” before social events. It also means the treatment may be attractive to patients who are new to aesthetics and not quite ready to plunge into injectables or more aggressive energy-based devices.

Broad Appeal

“The Clear & Brilliant is great for my NYC crowd: Minimal downtime, quick procedures, great for the jetset corporate life,” Dr. Bhanusali says.

In his Miami practice, he says, “Pigment is more of an issue due to sun exposure. We use the Fraxel laser, which has the same 1927nm wavelength handpiece as the Permea in the Clear & Brilliant and gives a similar effect.” He reveals he's adding a Clear & Brilliant to the Miami office soon.