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Botox Has an Online Beauty Magazine. The Ethics Are Murky.

Allergan’s digital beauty site, Spotlyte, raises questions about how increasingly popular but potentially dangerous medical aesthetics treatments should be covered, and by whom.
Allergen's new site Spotlyte offers articles and recommendations for cosmetic procedures | Source: Instagram @Spotlyte
  • Cheryl Wischhover

NEW YORK, United States — Spotlyte, an online beauty publication that launched last year, looks like any number of digital lifestyle sites. There are interviews with celebrity makeup artists and lists of the best oil cleansers. Readers may also notice an unusual number of stories about cosmetic procedures: features about how women hide injectable treatments from their spouses, and how to budget for the next trip to the doctor. Unlike in the pieces about cleansers and makeup, specific brands are never mentioned; instead of Botox, there are "injectable wrinkle reducers," and "injectable fillers" in place of Juvéderm.

That sometimes awkward language exists because Spotlyte is owned by Allergan, which makes both products and medical devices meant to smooth wrinkles and eliminate stubborn fat deposits. Under US regulations governing pharmaceutical advertising, Spotlyte can’t mention certain Allergan-owned products by name.

Allergan is injecting itself into the increasingly crowded world of magazines, websites and blogs focused on medical aesthetics — a field that covers everything from Botox to in-office procedures like dermaplaning, lasers, peels, liposuction and even plastic surgery. Mainstream publications like Elle now routinely discuss these procedures alongside makeup tips. New Beauty has published a quarterly aesthetics magazine since 2005, and RealSelf, a site where patients rate and review procedures, recently invested in a team of editors and writers.

Plenty of brands have tried their hand at publishing, from one-off articles tucked inside catalogues to magazines like Porter, a fashion publication put out by Net-a-Porter, and travel magazines from AirBnB and Away. Dollar Shave Club and L'Oreal are among the brands that operate websites filled with editorial content that goes far beyond advertising their products.

Brand-driven media can raise ethical questions, particularly when slickly packaged advertising mimics the look and voice of independently produced content. Spotlyte adds an additional layer of concerns because some of the procedures it’s advocating carry health risks and are irreversible.

What is most important is that the consumer gets to make the decision about whether she thinks the content is credible.

“What is most important is that the consumer gets to make the decision about whether she thinks the content is credible,” said Kathleen Culver, director of the University of Wisconsin-Madison’s Center for Journalism Ethics. “For her to decide it’s credible, she needs to know where it’s coming from.”

In the world of medical aesthetics, that’s getting harder to do. Allergan’s foray into publishing comes as cosmetic procedures have lost much of their stigma.

In 2015, Kylie Jenner came clean about receiving lip fillers, prompting reports of young patients looking to do the same. Dermatologists and plastic surgeons regularly take to Snapchat and Instagram to demonstrate Brazilian butt lifts, non-surgical nose jobs and Botox injections, gaining millions of followers — and new patients — in the process.

In the last two years, companies like Alchemy 43 and Ever/Body introduced a "Drybar of Botox" concept that makes it easier for customers to receive procedures like Botox and fillers. In 2018, 7.4 million botulinum toxin (the generic name for Botox) injections and 2.7 million filler injections were administered, according to the American Society for Plastic Surgeons.

"We're not putting things in these buckets anymore of 'that's aesthetic beauty and that's regular beauty,'" said Emily Dougherty, editor-in-chief of New Beauty since 2018 and the former beauty director at Elle. "What we turn to ... can be stuff that's in the doctor's office or things you buy at the drugstore."

New Beauty launched just three years after Botox was approved in the US for the temporary treatment of wrinkles. Dougherty has added touches like runway beauty stories and richer photography. She also added more of what she calls "beauty candy" into the mix — stories about skincare and makeup, next to in-depth articles about nose jobs and breast reconstruction, complete with information about risks and how to find reputable providers.

While there are ads for beauty products and pharmaceutical products sprinkled throughout the magazine, the majority of advertisers are doctors hawking their services and experience via sponsored profiles in the back half of each issue. An advisory board of plastic surgeons and dermatologists vet articles and ads for accuracy, said owner Adam Sandow.

“If you’re writing about lipstick and the magazine gives you bad advice, it’s not that big a deal,” he said. “If you’re on the internet reading about lipo and you’re getting bad advice, that’s a big deal.”

Ultimately, New Beauty's editorial arm functions the way most magazines do, with at least some divide between them and the business team.

"It's a more traditional approach to fashion and beauty editorial, and that separation, as thin as it may be, still exists," Aileen Gallagher, an associate professor in journalism at Syracuse University's Newhouse School, said of New Beauty.

This is not the case for Spotlyte, which Gallagher calls “brand journalism.”

Spotlyte is part of an Allergan digital initiative the company dubbed “Project Moonwalker,” which includes the newly-launched Regi, an app for booking treatments from massages to injectables.

The initiative comes at a time when Allergan is focused on recruiting more Millennials into trying Botox and other products. In a January earnings call, Allergan Chief Commercial Officer Bill Meury noted that Millennial users in aesthetics grew from 300,000 to over a million in the past five years, and are expected to overtake Gen X users in the next five.

Allergan, which was acquired by AbbVie in July for $63 billion, also faces competition for Botox from upstarts like Evolus' Jeuveau. Earlier this year, the company tapped a handful of beauty editors to run sponsored ads about Botox in their Instagram feeds.

An Allergan spokesperson said in an email: “Allergan does not view or treat Spotlyte as a marketing tool.”

Allergan, which sells products that are virtually synonymous with the procedures they represent, doesn’t need to flag specific brands to drive sales, said Nielsen Hobbs, an executive editor at Pink Sheet, a publication focusing on pharma policy and regulation.

“Botox is almost the Kleenex of wrinkle reduction at this point, but they’re avoiding [the name] so they can avoid the need to include a full disclosure of risk information,” he said. “Because of their market prominence, whatever business this site drums up and any increase in general sales in this category will benefit them even if the site doesn’t drive people to their products.”

When scrolling the site, “by Allergan” appears under the Spotlyte header. In the “About” section, there is a disclosure that the site is owned and operated by Allergan, and that it owns Coolsculpting (medical devices have different disclosure requirements from pharmaceuticals) and SkinMedica, an over-the-counter skin care brand. It discloses when doctors interviewed in stories are paid Allergan consultants. There are short risk disclosure statements that link to more detailed side effect profiles and information.

But if Allergan discloses on the site that it owns Botox and Juvéderm, or even generally that it produces any “injectable wrinkle reducers,” that information is well hidden. Occasionally a coupon offering $50 off any “Allergan Medical Aesthetic Portfolio” treatment pops up on-screen.

Pharmaceutical advertising is tightly regulated by the Federal Drug Administration and the Federal Trade Commission. Neither agency would comment on Spotlyte specifically; a spokesperson for the FDA said that in cases where direct product promotion doesn’t exist, “the assessment of whether and how FDA requirements apply is ultimately fact-specific.”

By the FDA’s definition, Spotlyte is likely classified as a “disease awareness site,” Hobbs said. The purpose of such sites is to share general information without talking about specific treatments by name.

RealSelf is attempting to find a middle ground between independent media and brand-sponsored publications. It launched in 2006 as a platform for people to review cosmetic procedures, post pictures, share experiences and find doctors. Its revenue comes from charging physicians to advertise on the site.

Audiences don't really understand the difference between what is supposed to be neutral reporting on a brand versus what's published by the brand.

In 2017, RealSelf raised $40 million, led by Elephant, a VC firm founded by Warby Parker's Andy Hunt. This January, RealSelf laid off 36 employees, blaming changes to Google's algorithm that led to a decrease in site traffic, according to Geekwire. In September, it had 2.65 million unique visitors down from over 4 million in April, according to SimilarWeb.

It is betting on editorial to bring traffic back. RealSelf has always had a blog, but it is now leaning into daily editorial coverage of all things medical aesthetics, even poaching its site editor and several writers from New Beauty. Founder Tom Seery said he hopes to engage consumers more actively on the site, and not only when they are researching a procedure.

“How can we enter into one of our community members’ lives in a more periodic, continuous basis? Editorial is key to that endeavour,” he said.

Eventually, the articles will include links to doctors in the reader’s area or links to read about real people’s experience with procedures. But Seery said advertising will remain separate from editorial.

“We partition our editors away from that bias and ask that when they do choose who to interview in a story, they’re not factoring in how much that doctor spends or our commercial relationship with them,” he said. “It would be a violation of our editorial integrity to do so.”

Ultimately, readers have to be able to trust the information they’re reading, something that is especially important when it involves medical procedures.

“It’s a very confusing time for consumers,” said Culver, the journalism ethics professor. “Audiences don’t really understand the difference between what is supposed to be neutral reporting on a brand versus what’s published by the brand.”

Editor’s Note: Cheryl Wischhover has written one story for New Beauty’s website, and several articles for Elle while Emily Dougherty was an editor there.

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