The Dermatology Digest • August/September 2025 • The Confidence Factor and the Shifting Narrative About Aesthetic Treatments

Confidence is defined as the feeling of having little doubt about yourself and your abilities, and new survey data suggests this is what people are after when they pursue aesthetic treatments.1

Merz Aesthetics’ inaugural global study, “Pillars of Confidence: Global Insights on Aesthetics and Self-Affirmation,” looked at the link between confidence and aesthetics. The report surveyed 15,000 adults from 15 countries who have had aesthetic treatments in the past or are open to having one in the near future. Participating regions and countries included:

• Europe, the Middle East & Africa: France, Germany, Italy, Spain, the United Kingdom and the United Arab Emirates

The main takeaway? Aesthetic treatments go more than skin deep. Yes, these treatments, or “tweakments,” can both help enhance your appearance and help people feel empowered and confident in their own skin.

“My conversations with patients around aesthetic treatments are deep and often delve more into their motivations and goals for treatment, demonstrating that just looking better is not the be all, end all,” says Sheila Farhang, MD, a Dermatologist and Cosmetic and Skin Cancer Surgeon in Tucson, AZ, and Beverly Hills, CA. “The ‘Pillars of Confidence’ study is paving the way for more meaningful conversations between providers and patients, creating a deeper bond, increasing trust, and forging a new outlook on how we all approach aesthetics.”

In the U.S. specifically, 52% of respondents noted feeling somewhat or very confident when they look in the mirror, as do 49% of folks in Canada. Many people surveyed also appreciate and love their bodies, despite their imperfections. In addition, 62% of people polled said they seek aesthetic treatments to help their outward appearance reflect how they feel on the inside, which counters the belief that the decision to pursue aesthetic treatment is purely about vanity.

“What is so fascinating about the data is that it helps create a meaningful bridge between how people see themselves and interact with the world. One simple change can help someone put a little pep in their step and move forward in life with more enthusiasm. The way aesthetics can help fuel inner confidence is truly amazing,” Dr. Farhang explains.

But… what does confidence truly mean? North American survey respondents reported that aesthetic treatments help them feel refreshed (78%), more alive (60%), ready to embrace new experiences (56%) and improve their outlook on life in general (52%). Others reported feeling more cared for, fulfilled, energized, and powerful following an aesthetic treatment. What’s more, folks in North America also said that aesthetic procedures can impact how confident they feel in social situations (65%) and affect their openness to interacting with new people (52%). The findings were similar across the globe.

“These findings tell an important story, as self-perception often influences our interactions with others, self-assurance in professional settings, and personal relationships,” Dr. Farhang adds. “Patients in my ‘after’ photos smile a lot more, and their posture is more confident than in ‘before’ pictures as they are excited about what’s to come.”

In the field of psychology, identity discrepancy refers to a mismatch between how an individual perceives themself and how they believe others see them, and this all-toocommon phenomenon can easily erode self-confidence.2 “Aesthetic treatments, however, can realign identity and boost self-confidence,” Dr. Farhang explains.

“This survey shows that aesthetic treatments are one possible route to increased self-confidence, but this is not to say that it is necessarily right for everyone.”

Other seismic shifts in the cosmetic landscape include how people learn about aesthetic treatments. Social media and online sources have a notable influence on people surveyed in the U.S., the survey found.

“It’s important for healthcare professionals, including dermatologists, to provide evidence-based information on aesthetic treatments, including their benefits and risks, to help manage patient expectations, optimize outcomes, and minimize the risks dissatisfaction,” Dr. Farhang says.

There are many high-profile voices out there who espouse advice and promote beauty standards that may or may not be helpful or even attainable, and in some cases can even be harmful. “Our voices, from a healthcare provider perspective, are needed to cut through the noise and provide honest insights that will help prospective patients look and feel their best,” she adds

Once cloaked in secrecy and spoken about only in hushed tones just a few years ago, aesthetic treatments have officially come out of the shadows and are now a normal part of the beauty and self-care conversation, especially among younger generations. In fact, more than half (52%) of people in North America are very or somewhat comfortable discussing aesthetic treatments with others, according to the survey.

“More and more people feel comfortable talking about cosmetic procedures they have had, are planning to have, or would like to have,” says Dr. Farhang. “More than half of respondents to the survey reported seeking aesthetic treatments for regular beauty maintenance, which tells us these services have become a normal part of life for many.”

The online survey occurred between September 23, 2024, and October 8, 2024. Participants did not receive monetary compensation but did accumulate points to be redeemed for a variety of rewards. The study was conducted in adherence to the standards of ESOMAR and the International Chamber of Commerce/ESOMAR International Code on Market and Social Research. Qualifying participants have either had an aesthetic treatment or are open to having one. Participants were aged 21 to 75, and 75% were female.

How North American survey respondents reported that aesthetic treatments help them feel