They come in for all kinds of reasons. Because they have a skin disorder. Because their profession demands a youthful glow. Because they are curious. And sometimes just because their wives or girlfriends ordered them to do whatever was needed to stop the effects of Father Time. The men who come in are all ages, according to Dr. Terrence Keaney, who oversees W for Men, described as “the world’s first clinical practice” dedicated to skin treatments for men. It celebrated its launch Wednesday evening. The clinic is in the city’s business hub—14th and K streets, Northwest—convenient for lobbyists and lawyers, the media offices, the White House, and the Capitol. The clients come from all these places, and sports fields, too. The entrance, on the ground floor, is discreet—no mixing with the adjacent women’s clinic.
“The focus of the practice is to create an environment where men feel comfortable, as well as to treat all their dermatological needs,” says Keaney via a phone interview. “There are a lot of middle-aged men who are becoming increasingly conscious of their age and the demands of their profession, and younger people, and the newly single. We see the middle-aged group, 40- to 50-year-olds. That’s when we see a lot of patients. We do see a lot of 20- to 30-year-olds, too, who are being proactive, because patients who start earlier get better results; you can slow the damage before it begins.”
Keaney started formulating the idea for a men-only practice when he was working his way through the rigors of medical school. He got his undergraduate degree at Duke and his medical degree at the University of Virginia, then trained at the University of California in San Francisco; he completed dermatological training at the University of Miami. He did a fellowship with Dr. Tina Alster at her Washington clinic, which is where the two doctors have created the special men’s practice.
“I recognized during my medical school training that the study of aging invariably focused on the female and how to slow the aging process on the female face,” Keaney says. “I noticed from the beginning that whenever companies produce products or physicians talk about using lasers or injectibles, they talk about the female face. It makes sense, because that’s where the market was.” But he knew male skin was different, and he sensed an emerging market for men who wanted to deal with skin issues and look their best. “My theory was that if men were going to be spending time and money on clothes and were concerned about their appearance, they would be concerned about their face and their skin,” he said. He says it’s a growth market now, with many skin-care companies making products for men.
“Nobody has really targeted men. . . . They are difficult customers, [because they are] not as educated about all the options a dermatologist can offer. Not just Botox, but all the procedures available and the basic tenets of good skin care. The consultation tends to be longer with men, which is unusual, because men don’t usually talk as much as women.” Women, he says, know specifically what they want. Men don’t. Men can be embarrassed. “I’m really honest with them, as an ex-athlete, that I won’t over-feminize them or overdo them. We start conservatively.” Men are also less tolerant of extended downtime for recovery, so Keaney takes a “completely different approach.”
Men’s skin is thicker, with more oil glands and hair than female skin, and the aging process is different in the two genders. Women have more fat pads in their faces, and as time marches on the fat pads diminish and the skin begins to sag. Because men have less dense fat pads, the sagging process isn’t as apparent. But what’s unique to men’s faces is “deeper, more severe wrinkles,” according to Keaney, usually due to more exposure to sun and less skin care. The solution? Fillers to provide structural support, and laser resurfacing to help generate new collagen.
With men, “you have to be careful,” he says. “They don’t have that much volume to begin with. Too many dermatologists treat men as women. You can’t do that. You have to accentuate the masculine features.”
Keaney says that since he set up shop he’s been seeing about 100 patients a week, and almost half of them are in his men’s practice. We asked him for the top five reasons men come in to see him. Here’s his list:
• A general concern about skin health, whether it is acne or moles or any suspicious skin rash or growth. For example, melanoma. He says with melanoma men have twice the mortality rates of women.
• Concern about the aging process on the face or body. Procedures include Botox, laser treatments, fillers, dermabrasion, and peels. He focuses on “any part of your skin you may not like.”
• Underarm sweating. Men sweat more than women, and the area of greatest concern is the underarms. Keaney uses a microwave procedure, Mira Dry, that destroys the sweat glands and reduces underarm sweating by 80 to 90 percent. He says the sweat glands in the underarms represent a tiny percentage of the body’s healthy ways of coping with heat, but “the underarms are the only area that display psychological sweating”—from nervousness, for instance.
• Getting rid of any unwanted, resistant fat, the kind that hangs on regardless of diet or exercise. Keaney uses “cool sculpting,” a minimally invasive device that is particularly effective on the flanks, abdomen, and inner thighs. Keaney says liposuction is still the standard, but it is surgery and he considers the results “uneven.” Cool sculpting reduces fat by 20 to 30 percent.
• Hair loss. Keaney says to him this is “a big area of interest.” He performs “neo-graft hair transplantation,” which removes individual hairs from the back of the scalp and transplants them where they are needed. “There’s no big scar, and there’s a shorter recovery time.” He says this works best on 40- to 50-year-olds who are experiencing hair thinning. “This fills in, but we can’t re-create a 20-year-old’s hairline.”
Keaney won’t name names, but when we asked if he sees recognizable faces from Washington’s ranks of notables, he says, “Yes, we do. For some it’s a professional essential. They are out in the public eye, on TV, and they understand the benefits of these treatments because of the industries they are in.” To accommodate busy men, he opens at 8 AM most weekdays and at 7 AM on Wednesday and Friday. The office closes at 4 PM and is not open on Thursday. The offices are decorated with sports gear, the staff is all male, the waiting room is hidden from the check-in area, and there are three treatment rooms. The overall look is spare and masculine.
Last but not least, we talked about cost, because insurance covers only procedures that are considered medical. For example, acne treatment is covered, but removing acne scars is not covered because it’s considered cosmetic. Routine dermatological exams—skin checks, mole removal—are covered. But the cosmetic work—Botox, fillers, laser resurfacing—are not. The treatments can start from anywhere between $200 and $500 for Botox and climb up into the thousands for highly sophisticated procedures. No one ever promised the fountain of youth would be cheap.