How Generation X Is Shaping Aesthetic Practice Strategies of the Future

As aesthetic dermatology continues to advance technologically and culturally, dermatologists are encountering notable generational shifts that influence patient behaviors, expectations, and decision-making. Understanding these trends is essential not only for patient engagement but also for effective practice management and marketing.

Generation X (Gen X), now a major cohort in aesthetic dermatology with an age range of approximately 45 to 60 years, brings a specific psychological and cultural framework to care. These patients tend to value clinical reputation, physician referrals, and natural results, and they frequently scrutinize their provider’s personal aesthetic before committing to procedures.

While Gen X patients do use social media, they are far less driven by it compared with Millennials and Generation Z (Gen Z). Instead, they rely heavily on word-of-mouth recommendations, primary care referrals, and physician credentials. Even online reviews carry less weight for Gen X, as these patients often interpret them with more skepticism, recognizing the potential for bias or bad-faith critiques. Whereas Millennials and Gen Z may rely too heavily on reviews, Gen X patients are typically very measured in their approach, often wanting to meet and evaluate their physician before proceeding with cosmetic treatments. They are also less trend-driven than younger patients, for whom social media visibility plays a significant role in how they select providers.

Gen Z and Millennials often value rejuvenation but may simultaneously engage in lifestyle choices—such as smoking or vaping—that counteract their cosmetic goals, whereas Gen X is more likely to support their aesthetic goals with healthy choices.

Additionally, loyalty patterns differ significantly. While Gen Z and Millennials are more transactional and price-sensitive, Gen X patients are more likely to remain with a provider long-term. I often tell patients, “You shouldn’t use discount coupons for your face because a pair of uncomfortable shoes can be returned, but poorly performed injections can have significant aesthetic consequences.” Fortunately, Gen X patients are more likely to heed that advice.

At my practice, we have adopted communication strategies and staff training to reflect these generational differences. For instance, before-and-after photography is universally important, but it is particularly so for Gen X patients, who may not immediately perceive subtle improvements without direct comparison.

Looking forward, technology adoption and the desire for cutting-edge procedures will only intensify as Gen X continues to age, though this demand spans across generations to certain degrees. From Gen Z patients interested in trending aesthetic procedures to octogenarians seeking needle-free hair restoration, the appetite for innovation is not age-restricted. Recently, an 87-year-old patient sought me out specifically because I offer a needle-free alternative to platelet-rich plasma (PRP) for hair loss—a reminder that being at the forefront of noninvasive technologies is essential for serving patients across the lifespan.

Clearly, generational dynamics play a critical role in shaping both the patient experience and the business of dermatology. By recognizing the differing values, trust factors, and behavioral patterns of Gen X as these patients continue to occupy a critical age group for aesthetic treatment, dermatologists can tailor communication, build loyalty, and ensure safe, effective care across age groups.