Skincare Trends, Injections and the Globalization of Beauty: Dr. Pearlman Opens Up About the Past, Present and Future of Skincare

Dr. Pearlman

Like fashion, the skincare industry is subject to change, shift and countless trends. Whether it be the botox boom in the late 80s or the K-beauty mania of today, skincare is an evolving industry just like many others. Recently we spoke with beauty and skincare expert Dr. Jennifer Pearlman of the leading vitality clinic, Pearl Rejuvenation. In our educational one-on-one we covered a wide range of skin-centered topics from her own practice and services to the latest beauty trend that has everyone looking a little more, let’s just say, universal.
Renée Butts: Tell me a little about Pearl Rejuvenation. Why did you start it? What does it entail?

Dr. Pearlman: PearlMD was born out of this vision, beauty comes from within. We are probably the first generation that has access to the science, tools and technology to age proactively. Right from the beginning, I envisioned building a program and toolbox that delivered on two ends of the same coin of healthy, beautiful aging. The first side is the concept that health is so much more than the absence of disease. Our model of health — I call it a medical vitality clinic — picks up where sick care ends. Though we never replace the primary provider like a GP, for instance. We offer the very best of well-women care, ensuring that — at a high standard with advanced testing — we are optimizing women’s health cuddled with an integrative approach. This employs nutrition, naturopathy, homeopathy, looking at the gut to microbio and understanding her stress, sleep and lifestyle. I work with nutritionists, nurses, psychotherapists and life coaches to offer a wide range of services with a very personalized approach.

How has the skincare industry evolved since you started Pearl Rejuvenation?

Ten years ago, parabens, phthalates and sulfates were pervasive and because I had a background in health and hormones, I know that what you put on your skin is going to be widely absorbed. Hormone disruptive chemicals in our skincare were pervasive and in some cases, still are. The skincare products you got from a doctor were cosmeceuticals and not pharmaceuticals. There was a gap in effectiveness and safety which I set out to change. I worked with a pharmaceutical company ten years ago to create personalized medical-grade skincare. It has 18 products now, but of course no one uses all 18. We put you on a personalized program to target all common skin concerns to help protect your skin. For instance, the sun care industry has changed dramatically over the past ten years, where our sun care is a personalized sun treatment protocol. Today, it is more well known that these chemicals are harmful though they are still pervasive. We know our suncare must have UVA protection because that SPF rating doesn’t tell us enough nor is UVV protection enough to shield us from the aging effects of the sun, the cancer-causing effects of the sun and the effects that will ultimately pigment us. So that’s where having a little bit more of the UVA protection is important. So I do think there’s a lot more of that now but still, I look at the market and think there’s a lot lacking. Back then I had to really educate my patients on parabens and phthalates. Increasingly, my patients are much more informed and coming in looking for something that will target their specific needs without any of the aforementioned chemicals. Although the skincare and suncare industry hasn’t progressed as much as I would have hoped, consumers have.

As you mentioned, you have your own skincare line, PearlMDSkin CareRx, which is considered medical-grade skincare. What is medical-grade skincare and how does your product differ from other medical-grade options?

Medical-grade means that it’s a prescription based treatment. Let’s compare our line to a typical prescription you’d get from a regular doc. Let’s use Vitamin A, it’s the wonder drug for skin and the most commonly prescribed skin agent. The typical forms you would get — prescribed from a doctor — are going to be synthetic forms or retinoic acid or Vitamin A. This tends to be very traumatic and irritating to the skin which leads to a lot of surface problems. Redness, flaking, peeling. These lead to very low compliance. It hurts, it’s itchy, it’s flaking, it’s red. It’s a big payoff to get to the therapeutic benefits. The brilliance behind the pharmaceutical engineering in our line is that we are able to deliver equivalent effectiveness of the Vitamin A in a way that’s not traumatic or irritating to the skin. Depending on what you’re on with me, there may be a little bit of initial redness but it’s in no way comparable to what you’d experience with a prescription product. That’s one therapeutic benefit. In other areas, there just aren’t any options. With pigment — another common problem — there are not a lot of approved skincare products that contain bioactive agents to target it. Most specialists rely on compounding which isn’t very elegant. There will be grittiness in the products, they’re going to settle, the active ingredient won’t be evenly distributed. Sometimes there may even be a lot of irritation and by the end of the bottle, zero effectiveness. What we’ve done is, we have the combination of safe and effective depigmenting agents — natural cousins to hydroquinone — that we compound in a much more elegant way that provides better, more effective, more evenly distributed, less irritating, delivery of these active ingredients. We also have a range, whether it’s pads, serums, creams or office-based treatments, and we put a whole program together.

Now let’s talk lips. Lip enhancements have become quite popular, especially fillers. Is there a way women can achieve the plump look without injections or are all those beauty blogger hacks a waste of time?

I think we are seeing the emergence of a new kind of body dysmorphism. Thanks to various young celebrities, we are undergoing what I like to call liporexia. We had othorexia, anorexia and now liporexia. Liporexia is the fixation of volume in the lip. However, there is nothing you can do, naturally, to make your lips bigger. Save money, don’t buy all the plumbing tools or skin irritants that only swell the lips temporarily. However, I do want to change your thinking. Most people think lip treatments are all about volume, they are not. There are seven steps to the perfect lip. First, understanding enhancement and rejuvenation. When we look at the mouth, a part of it may be volume. Is the volume correct? Part of it is symmetry, are your lips inherently symmetrical? Proportion, internal proportion on the lip. There’s something called perfect proportion or the Golden Ratio. Leonardo da Vinci created it. It’s based on the five ratio that everything in nature, architecture and beauty is in accordance with this ratio. The ratio for the lip depends on the person. For people with fair skin, it’s 1/3 on top and ⅔ on the bottom. However, you look at Hollywood pictures and that’s not what you see. The darker the skin, the closer you get to the perfect 50/50 which looks perfectly appropriate on dark skin. A fair skin person with that proportion is going to look done. She wasn’t born that way. Now the beauty ideal is shifting towards 50/50, however, part of my job isn’t just to inject and fill but to educate my patients on what’s appropriate. If you’re fair skin, trying to maintain a ⅓ to ⅔ ratio is important. The other proportional issue is how are your lips in proportion to your face? For a woman will really full cheeks and a fuller forehead, having full lips would be proportioned. But someone who is really delicately featured, finer lips would be more well proportioned to her face. So external and internal proportions are important. Then there’s the structural aspects where I’ll come in and talk to women about the vermilion border, you want that to be nicely defined. You want the projection of the lip to be nice, you want the corners to be slightly upturned, you want the philtrums to be nicely defined, you want the pout to look nice. So when I talk about the seven steps to the perfect lip, it’s never just about volume. Although for many women, volume is a goal and obviously we’re using a gel and bioatmentive gels to achieve that result. We are introducing volume but to achieve much more than pumping up the lip. Most injectors, just do that. Just pump up the lip. They create tubular structures that in no way reflect the natural shape or structure of the lip. That’s why we see a lot of lips that look done.

Going into the new trend of everything getting bigger and bigger–

Not everything! Breast augmentation is the number one sought cosmetic surgery but standard size has gone from between a C and D cup to a B cup. Breasts are still popular but have gotten smaller. It’s all about the butt now and the lip. The body ideal shifted, it’s the globalization of beauty. Especially being Torontonian, we reflect this more than anywhere else in the world because we are the most multicultural city in the world. So the beauty ideal, because of globalization and the emergence of cultural beauty trends, has never been higher but it’s the intersection of beauty ideals from various cultures. We basically take the best of different cultures and intertwine them. You look at the emergence of a Kim Kardashian, she is the reflection of caucasian, Middle Eastern, African American. Multiple beauty ideals from different cultures. There’s so many different examples of this and it really does mean our beauty standard shifted and it has a lot to do with the globalization of beauty. Things haven’t only gotten bigger. Things have become more globalized and they’re different. But definitely lips and butts are bigger than ever.

Is there a downside to lip fillers? You spoke briefly about docs who purely increase volume. What are the cons, if any?

There are three different sets of problems. The first problem is a cosmetic problem, the patient doesn’t like the result. It’s not a medical problem but the patient isn’t happy. The second problem is a short term problem and those are a little more common. What I always say, remember fillers are a treatment typically delivered with a needle and with anything delivered with a needle, there’s a risk of a bruising or redness on the injection site. However, this is a short term problem. More serious problems, but rare problems with fillers, depending on the site and technique, would include damage to blood vessel, which are bruises but more serious. This damage jeopardizes blood supply to the skin and can increase the risk of an ulcer. That is a rare but possible complication. Another complication related to blood vessel damage would be, — again, rarely reported, never in my practice, only something many docs have only heard about — blindness. Hugely depending on the injection site. This is why informed consent is really important. Fillers are composed of hyaluronic acid, non animal-based stabilized hyaluronic acid or nash tech, a natural chemical. It exists throughout your skin. It’s in your eyes, joints, it’s like a sugar molecule that holds a thousand times its weight in water. It preserves the structure, hydration and elasticity of skin. When we lose it with age or sun damage, our volumes are going to deflate so we inject this natural gel and the gel comes in various hardness and lift. For the lip, I recommend softer product whereas in the cheek or jawline, where I do facial contouring, I’m using harder product which have more lift and shaping capacity. Product selection is very important and you need medical expertise to know what products to use as this level of expertise and injection placement are very important. Now, if the product is one of the options I described and not some of the other options out there, which are considered permanent fillers, then the other fantastic aspect of this is that it’s completely reversible. There’s no permanent problem because we have the opportunity to reverse it.

We talked a little bit about the globalization of beauty, it being one of the biggest beauty trends right now. What do you consider the biggest skincare trend?

I think the buzzwords in skin right now are the dewy look and the polished look. I have a whole protocol we’ve developed in our practice. Step one, always on trend is protect your skin. Really rigorous approach to sun protection. No matter your skin type, age, where you live or where you’re going, be diligent. You could be in a car on a cloudy day but you’re still getting UVA. Always on trend, sun protection and targeting concerns. Assuming one is doing those things, the next step is the dewy look or the polished look. To polish is to etch out surface regularities. We don’t want to see pores, we don’t want to see any crepiness. We offer that look with our Venus Viva technology which is safe for all skin types. This is non-laser skin resurfacing with less pain — virtually no pain — less downtime and really significant improvements in texture. To get the dewy look requires facial contouring. I’m one of the first docs in Canada who offers mesotherapy so I have a whole toolkit that I inject into the skin. It’s a skincare treatment injected into the skin with a meso gun. On the skin product side we have our Hydroglow which is a skin product I recommend putting on once the procedure is done. Polish, resurfacing and dewy look are the It thing right now.

In terms of taking care of the skin, K-beauty is all the rage right now. What is the major differences between Korean and North America skincare?

With K-beauty there are two things. On the skincare side, the Korean skincare industry is filled with innovative pioneers. If you go to the streets of Korea, you will see agents like pearl, egg etc, just really moving the needle very rapidly in terms of active ingredients. Perfect skin hasn’t always been the ideal here but complete sun protection has. They are experts in skin so they really have advanced options in skincare but the real thing that sets them apart from what we’re doing is, and this is just a difference is philosophy, Koreans tend to be more fad like. There’s more cohesiveness in what they’re seeking whereas here it’s more personalized. Not everyone wants the same thing here. There’s a lot of fads whether it’s hair styles or beauty trends, it’s a fad like culture there. The second thing is, the culture towards look alteration whereas here it’s more about enhancing not changing what you look like. So the ideals are a bit different. Changing the eye or jawline to alter their look is a little more on trend there and it’s just widespread acceptance and consumerism as well as highgrade medical cosmetic treatments.

Where do you see the future of skincare going?

I think we’re at the frontier and I think it’s all the things we’ve talked about. Personalized skincare, beauty from within and the idea of being able to deliver treatments that will have highgrade potency without the harmful ingredients. The last overall trend that isn’t widespread yet, is rejuvenative therapy because that is here and now. Whether it’s stem cells, POP’s or mesotherapy, those are all regenerative treatments. Personalization, beauty from within, medical-grade treatments without the harmful chemicals and rejuvenative therapies.