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Taken from Dazed & Confused, August 1999 issue

Beauty is bloodwork: the medicalisation of skincare

With ‘hormone healing’, wellness IVs and at-home saliva tests, the skincare industry has become more medicalised than ever

For the past few decades, the beauty industry has been selling us the dream that perfect skin is achieved through an extensive amount of topical products (hello ten-step skincare routines). Other health factors like diet came into the equation only as a way to treat acne concerns – how many of us have been told that too much sugar gives you pimples, for example? This surface-level approach to skincare kept our bathroom shelves full of products to “heal our skin barrier” or “eliminate wrinkles”, and our focus away from our internal health.

With the rise of increasingly extreme wellness practices and a renewed interest in gut health, however, we are witnessing the skincare industry becoming more and more medicalised. In this landscape, it’s becoming normal to mix your blood in with your moisturiser, to get bloodwork done for “hormonal healing”, to sit for hours with antioxidant wellness IVs in our arms, and take personalised at-home skincare saliva tests. Could it be that the skincare industry is becoming more holistic, or is this yet another way to complicate (and monetise) us just trying to exist in our skin suits?

In an episode of The Kardashians last year, Kendall Jenner revealed her “well-being room” while climbing into her own personal hyperbaric chamber, the Vitaeris 320, which retails at around $23,000. “[I have] this whole new room in my house that has all these crazy gadgets and gizmos,” she says. As Jenner and her friend and fellow model Hailey Bieber ordered vitamin IVs as a house call in Miami, the latest wellness message of the wealthy was clear: when it comes to staying young and beautiful, you have to obsessively invest in your health.

With celebrity medicalised “wellness” as the backdrop, new skincare brands are asking for blood or saliva tests before you even receive their products. Vanessa Hudgens and Madison Beer’s DNA-based skincare brand Know Beauty, launched in 2021, asks customers to submit a few mouth swabs of their saliva in order to create a “personalised Skin DNA Analysis profile based on your genetic data”. Biotech beauty brand Codex Labs has also just released a “Decode.MySkin Collection” with four kits including DNA testing, hormone testing, a skin microbiome test (launching in June), and a gut microbiome test. The result, the brand says, is a skincare routine that factors in personal health and wellness.

Allie Egan, CEO and founder of Veracity, which released one of the first skin-focused hormone tests on the market in 2020, says that the health and appearance of our skin is often the first touchpoint we have for our overall health. “By addressing the root causes of our skin concerns through shining a light on hormone health-based wellness, we can both look and feel better,” she says. “Knowing your hormones allows you to make the dietary and lifestyle changes required to rebalance your hormones and escape the cycle of only treating symptoms, so you can see long-term change.”

It’s true that, especially for women, the roles that hormones play in our health have been largely overlooked medically, with an estimated 80 per cent of women having a form of hormonal imbalance at some point in their lives. Issues like endometriosis and depression have historically gone undiagnosed, seen as a vague “hormone” issue for women in a male-focused medical establishment. However, taking this much-needed hormone testing and presenting it as something to improve your skin, yet again sells the narrative that women should aspire to health purely for aesthetic purposes. It could also push the message that skin issues like acne are a sign of poor diet or health (when genetics plays a large role).

Despite the hidden diet culture message that’s in most “healing your gut” videos on TikTok today, Emily Ocon, founder of Healthembody and graduate student at Columbia University, says that routine blood work (at least once yearly) is essential to know what effects your lifestyle choices are having on your body. “Just like you check your car’s oil to make sure the engine is running well, you need to do the same with blood work,” she says. “New research clearly indicates that an unhealthy gut microbiome also affects your skin through what is called the gut-skin axis, and the scientific community is just beginning to understand this.”

Considering the gut is where 70 per cent of our immune system lies, there’s no denying that gut health is important to overall health. However, as recently proven by before and after bloating videos on the internet, the beauty and wellness industry has a tendency to get people fixated. Soon, it won’t be enough just to have clear, healthy skin, you’ll also want to have the healthiest, smoothest, sexiest and most goop-ified gut possible. Meg Hagar, a registered dietitian and acne nutritionist, says she can see the trend leading to “unrealistic expectations and striving for unattainable results”. Despite this, Hagar tests all of her client’s hormones. “For people with a uterus specifically, it’s even beneficial to understand their menstrual cycles and how that impacts their skin,” she says. Again, the pursuit of holistic wellness isn’t an issue without the pursuit of physical “perfection”.

Women have been putting their blood, sweat, and tears into the pursuit of physical attraction for years. But as the frightening at-home microneedling trend on TikTok has proven, not every treatment that you’d get at your dermatologist’s office is meant for you to try in your bathroom mirror. With this in mind, Hagar believes that some of the more medicalised beauty brands signal a “true advancement” in the field, while other at-home medical beauty devices should be further investigated. After all, skincare has always been a medical field with highly trained dermatologists standing at the ready to address your skincare concerns.

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