At Peachy, you get clinical wrinkle-prevention results, minus the doctor's office vibes.

By Sara Spruch-Feiner
October 08, 2020
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Credit: Peachy

In the not-so-distant past, Botox called to mind images of frozen faces, unable to emote. But Carolyn Treasure, M.D., and Eric Zhang, a former investment banker, aim to take a totally different approach with their new "studio," which focuses on preventative Botox. The duo, who initially met as students at the University of North Carolina at Chapel Hill, recently co-founded Peachy, a "wrinkle prevention studio" that opened its doors in June to crowds of New Yorkers who'd been deprived of their usual Botox fix for months (thanks to COVID-19), or, who had discovered unwelcome wrinkles as a result of staring at themselves on one too many Zoom calls.

At Peachy, injectables are just one part of a three-pronged, science-based formula for staving off wrinkles. There are the injectables themselves (which are planned and plotted by an algorithm), and then there are Peachy's branded prescription retinoids, and, finally, a host of SPF options (multiple textures = no excuses).

I went to Peachy's bright, and, unsurprisingly, peach-hued studio in Soho in early September, where I was greeted with the now-standard temperature check, hand sanitizer, and a giant ring light. I stood in front of the ring light as my face (mask on!) was photographed in both resting and furrowed positions. By the time I was in the treatment room with Dr. Treasure (mere moments later) these photos had already gone through Peachy's proprietary wrinkle analysis process. "Our technology uses a computerized method for determining a plan to prevent or treat wrinkles based on several key input variables unique to each client (which include the dynamic index, static index, and the desired amount of muscle movement, among others)," explains Dr. Treasure. To demystify these phrases a bit, static wrinkles refer to wrinkles that are always present, while dynamic wrinkles refer to wrinkles that are present only when moving muscles. (Related: I Tried Cosmetic Acupuncture to See What This Natural Anti-Aging Procedure Was All About)

Based on the analysis, a plan is made to inject Botox in one, two, or three of the FDA-approved locations for Botox — the frontalis (aka the forehead), the glabella (aka the space between your eyebrows), and the lateral canthal lines (aka crow's feet) — and then suggests locations and amounts for injectable wrinkle reducers. The algorithm-based assessment indicated that my static wrinkles are at a level one (out of five) while my dynamic wrinkles were at a level three — this made me a perfect candidate for Peachy's preventative strategy because most of my dynamic wrinkles have not yet settled into the static stage. Dr. Treasure noted that Peachy turns away on average one client a day, as not everyone is a great candidate for these treatments. "People are not good candidates for preventative Botox if they do not have dynamic lines, or they have a significant amount of static lines," she says.

My face showed up on an iPad marked with dots and numbers that showed where to inject the neuromodulator (a wrinkle-relaxing injection of botulinum toxin - commercially known as Botox Cosmetic, Dysport, Xeomin, or Jeuveau) in my frontalis and glabella, which Peachy recommends should be done simultaneously. I opted not to have my lateral canthals injected because I like my eyes to look like they're smiling when my mouth does, and I don't mind if that means they crinkle a bit! (Also, smizing has never been a more important skill.) At the bottom of the iPad screen, there's a setting to customize depending on the patient's desired capacity for muscle movement. The default (and Peachy's recommendation) is natural, but you can also choose 'minimal' or 'ample.' (Related: The Anti-Aging Benefits of Red Light Therapy)

Although Botox is now used as a generic phrase (i.e. Kleenex) I was actually injected with Xeomin. Though all neuromodulators will bring about the same results, Xeomin has "good data surrounding their purification process, which filters away almost all of the accessory proteins just so it's the purest form of the neuro isolator," explains Dr. Treasure. (Translation: it contains only a single ingredient, botulinum toxin A.) Peachy offers all four neuromodulators on the market — Botox, Juveau, Xeomin, and Dysport; you're matched with one depending on the wrinkle analysis and a discussion with the doctor. (BTW, did you know you can get Botox in your scalp to reduce sweating and prolong your blow-out?)

However, Dr. Treasure is quick to note that the Peachy algorithm doesn't solely determine the treatment so much as provide a starting point for the conversation a patient has with their provider. "Medicine is an art and science, and this application perfectly embodies that," she says.

Peachy was founded on the idea that preventative Botox is one of the best ways to prolong a wrinkle-free appearance. If you talk to Dr. Treasure about the start of the company, you'll hear about "the twin study." It was the study that convinced her to start getting preventative Botox five years ago. This was a study in which a researcher treated one identical twin with preventative Botox when she was 25 years old while the other twin did not receive any treatment at all. In summary, she explains: "The study followed them for 13 years and the images taken at age 38 illustrate what Botox does — subtle minimization of wrinkle burden (the number of wrinkles — both static and dynamic) that does not change your natural appearance. The twins in this study lived in the same area and the researchers controlled for as many variables as possible; they lived in the same neighborhood, used similar skin care products, and had similar levels of sun exposure," she explains. "This study demonstrated clinically what we had known mechanistically that Botox did."

Here's how preventative Botox works: Dynamic wrinkles become static wrinkles simply by moving the muscles in our faces. Over time, these repeated muscle contractions cause our skin to break down, resulting in static lines or permanent lines. Using Botox (or any other neuromodulator) before the static lines have taken residence can help prevent them from forming in the first place. (See: Why I Got Botox In My Twenties)

"Botox is a neuromodulator that inhibits the release of acetylcholine [a neurotransmitter] into a neuromuscular junction," says Dr. Treasure. "With less acetylcholine in the neuromuscular junction, the targeted muscles contract less fervently. This relative relaxation of the muscle is what prevents the dynamic to static wrinkle transition." Put a lot more simply, neuromodulators help prevent dynamic lines from becoming static lines.

The idea for Peachy started to take shape soon after Dr. Treasure graduated from Harvard Medical School and was about to begin at Harvard Business School. Her friends were asking for wrinkle-fighting advice, so she says, "I did a deep-dive into the literature and realized it centered around three tried-and-true methods: preventative Botox, prescription retinoids, and daily-use sunscreen." (See: How to Protect the Collagen In Your Skin)

When she actually went to get preventative Botox, the experience didn't match what she was looking for: "I felt pressured to consider other treatments that would change my natural appearance," she recalls. Around the same time, Zhang called clueless from the aisles of Sephora wondering what to do about lines on his forehead. A physician at the time, "I started giving him preventative Botox, he started using retinoids, and we realized there was a need in the marketplace that merges scientific rigor with accessibility," explains Dr. Treasure. And so, the concept for Peachy was born.

At Peachy, Botox always costs $375, so there are no surprises or increases in fees based on using more units. In fact, that price even covers touch-ups within two weeks of the initial treatment, because when it comes to injectables, any good doctor will tell you it's always better to start with less and then add more as needed — it can always be added, but it can't be taken away.

"Taking care of your skin is a lifelong journey; we never want our clients to feel pressured to get more Botox than they feel comfortable with," says Dr. Treasure, explaining that "to mirror this belief, there's a flat fee for all Botox treatments, ensuring no client's experience is hindered by monetary incentives." Generally speaking, to maintain the results of botox, patients go in every three to six months. (If you're not interested in that kind of upkeep, consider these non-invasive Botox alternatives.)

As for their other offerings, a retinoid consultation is $80 — you chat with a Peachy Provider who helps determine the appropriate strength for your skin. Peachy retinoids use additional ingredients not always found in OTC or prescription formulas — and the consultation is part of deciding which are the best fit. "The additional ingredients alongside the tretinoin are niacinamide, hyaluronic acid, and vitamin C, and they work to make our formula more nourishing, soothing and luxurious than others," says Dr. Treasure.

Peachy's SPFs will run you $30 to $40 and are all clean, cruelty-free formulas that only use physical filters (i.e., zinc oxide, titanium dioxide) instead of chemical sunscreens, which absorb UV radiation and convert it to negligible amounts of heat and can be absorbed into the bloodstream, putting their safety profile into question. They offer everything from a powder brush to a full body spray to a tinted face cream — so there's something for everyone.

Injectables, even if they're cheaper at Peachy than your average dermatologist office, aren't for everyone. The good news: SPF and retinol are tried-and-true — no needles required.