Millions of wrinkles, billions of dollars

The face of middle age increasingly is smooth and wrinkle-free. More and more Americans are using an arsenal of cosmetic procedures - eyelid lifts, lasers and skin fillers - to turn back the clock. This is more than just a vanity play.

The $12 billion-a-year industry is big business for companies such as Medicis Pharmaceutical Corp., which has hitched its growth to selling skin products that make people look and feel younger.

Medicis sells the nation's most widely used "dermal filler," Restylane, and has two more anti-wrinkle products on the way.

While the Scottsdale-based maker of skin and acne products sees a lot more room for growth, so does its chief rival, Irvine, Calif.-based Allergan Inc., which makes Botox and recently launched Juvederm, a skin filler that competes with Restylane.

Both companies see dollars in demographics. Fewer than 1 million people now pay for these dermal filler injections that plump up wrinkles to help skin retain its youthful appearance, but more than 25 million American women age 30 and older earn enough money to afford such treatments.

They believe it's a matter of time - and perhaps wrinkles - before some of these women become paying customers. Treatments increasingly are popular with men, too.

Both companies are embarking on aggressive marketing campaigns that highlight their fountain-of-youth formulas. And part of that effort includes explaining why their product is better than the competition's.

"There are plenty of people out there who ought to be customers but don't know about these products," said Jonah Shacknai, chief executive officer at Medicis. "We think we know who they are and where they are. It's just a matter of telling a good story."

Wooing consumers
So far, Medicis has launched the more unconventional approach in this wrinkle war.

In addition to courting dermatologists and plastic surgeons at conferences in elite settings such as Vail, Colo., and Maui, Hawaii, the company is reaching out directly to consumers through advertising and "viral marketing."

Medicis hired a Hollywood producer to film its search for the "Hottest Mom in America," a casting call for mothers in six cities including New York, Miami and Los Angeles.

The company will pitch footage to network television stations with the goal of airing the search as a reality show. The idea: Expose primetime viewers to Restylane, which sponsored the search. Medicis has not yet announced any deal.

Medicis has pursued an even edgier approach on the Internet. The company distributed a Web video featuring a birthday party of a 50-year-old woman caught smooching her son's 20-something buddy sitting on a sofa. The video's kicker: Restylane Cosmetic Filler, Age Disgracefully.

Shacknai has said he doesn't know how these pitches will appeal to potential customers.

"We know our communications have to be extremely targeted," Shacknai said.

He quickly added, the Age Disgracefully Internet video "certainly doesn't represent what we will put on television. It's just another vehicle to reach people."

Battling Botox makers
Medicis wants creative advertising, in part, because it's squaring off against a much larger company.

Allergan, a pioneer in saline and silicone breast implants, skin products and obesity treatments, collected more than $3 billion in revenue last year compared with Medicis' annual revenue of about $350 million. And Allergan has the proven marketing chops: It's the company that made Botox a popular culture mainstay.

While Allergan has not revealed details of its marketing plan, company representatives say it likely will include a mix of print and television advertising.

"We've been able to establish Botox as a household name. We're trying to do the exact same thing with all our other product lines," said Robert Grant, president of Allergan Medical.

Grant added that Allergan's strategy would differ from Medicis'.

"Our approach would never be done that would be driven around salacious media," he said. "Partnering with the physician community is really the approach we want to go after."

Restylane vs. Juvederm
While Allergan boasts the upper hand in company size and revenues, it's playing catch-up in dermal filler sales.

In June 2006, the Food and Drug Administration approved the use of Juvederm, and the company said the product was widely available in January.

The company hatched last fall what it called the Juvederm experience trial, which entailed giving doctors samples to hand out to 10,000 patients. The catch: Patients had to be regular Restylane users.

Grant would not say how many customers switched to Juvederm based on the giveaway promotion, but he said it was a "good experience" that highlighted consumers' favorable opinions about Juvederm.

It's unclear how fast Juvederm has caught on. Allergan has yet to report sales of the skin filler publicly.

Medicis reported that Restylane sales increased 20 percent during the final three months of 2006, and the product remains the dominant filler product in the United States.

Shacknai emphasized that Juvederm must prove itself with customers.

"We are mindful that there is a direct competitor in the market. We respect the company," Shacknai told stock analysts last month. "But having said that, I think that is a product that really needs to prove itself with physicians."

Restylane received welcome news from a recent study led by the University of Michigan. In a paper published in the journal Archives of Dermatology, researchers reported that Restylane injections helped patients generate their own new, natural collagen.

The American Society for Aesthetic Plastic Surgery reported nearly 1.6 million procedures for dermal fillers last year. Patients typically need two to three procedures each year, depending on the extent and depth of facial creases and wrinkles.

Botox, a neurotoxin that relaxes muscles underneath wrinkles, remained the most popular anti-wrinkle procedure with nearly 3.2 million procedures last year.

Botox generally is injected to the forehead and upper face while dermal fillers Restylane and Juvederm, both hyaluronic acids, are used to smooth smile lines and lower facial wrinkles and even to fill lips.

Medicis expects to gain federal approval by the end of March to sell a more robust filler, Perlane, and the company next year plans to roll out Reloxin, a neurotoxin that is expected to compete with Botox.

Doctors still don't have a good handle on which product will win over consumers.

"It is still very early in testing," said Carl Mudd, chief executive officer of Dermacare, a Valley-based company that owns or franchises nearly 50 skin care clinics nationwide.

"Juvederm is purported to provide a smoother look, although, frankly, we have had issues with the lumpiness of Restylane."

Mudd believes the company will find enough customers who want to look young to ensure both products will sell well.

"I believe the whole market will grow," Mudd said. "Men and women want to look better. They want to look better without great risk or expense."

Erasing smile lines
Lori Zeller, 46, of Cave Creek, never thought she would pay for a cosmetic procedure. Because years of smoking left her lips wrinkled, she began to research products and skin care clinics.

"I was skeptical because I didn't know what to expect," Zeller said. "You see all those actresses in Hollywood who go to the extreme with their huge lips. I just wanted my wrinkles gone."

She visited a Dermacare clinic and paid about $500 for a doctor to inject her lips with Restylane. Four months later, she paid about $250 for a follow-up procedure, and she expects to return later this week to reduce her smile lines.

"It took the wrinkles off my lips and took years off me," Zeller said. "My husband really liked it, but I won't tell you what he said. That's for us."

Shacknai and Grant agree on this: The industry needs to build the trust of more customers like Zeller.

"Our challenge is to take the patients from the consideration stage to the doing stage," Grant said.

By Ken Alltucker.
Source: www.azcentral.com