Merz Aesthetics is a global leader in aesthetics, a field known as "a beauty expert" to healthcare professionals and consumers alike. 

However, what is less well known is that Merz's leadership in aesthetics has been accompanied by a great deal of research and development (R&D) and scientific endeavor. 

For more than 100 years, Merz has been introducing innovative treatments in the fields of dermatology and neurology.

Korea Biomedical Review sat down with Merz's Chief Scientific Officer (CSO), Dr. Samantha Kerr, during her recent visit to Korea to learn more about Merz's R&D pipeline and expertise.

With a background in biochemistry and immunology and more than 20 years of experience in medical aesthetics at Allergan and TMC Pharma Services, Kerr is responsible for leading the Merz R&D team, setting scientific strategy and priorities, and overseeing and building the company's R&D pipeline.

Question: What is the purpose of your visit to Korea?

Answer: At Merz, we are continually looking for new ideas. Why I'm here today, this week, to speak to our customers. Our very founding person, Friedrich Merz, always asked the question, "What is needed?" So, we do the same now. And we speak to people in Korea and Taiwan and the rest of the world and ask them what they want. It's really important. 

Q: Why does Merz, an aesthetics company, value a scientific approach to medicine?

A: I think no matter what the discipline in medicine should be, I think you should always apply the most rigorous standards. It's really important that we hold ourselves to the standards of every other medical discipline to make sure our products are efficacious, safe, and top quality so that our customers feel confident using them when they use them on their patients. 

When we speak about makeup, nine out of 10 women prefer this lipstick, but that's very different from when we speak about our product. There are different levels. I see medical aesthetics with normal pharma. And the reason I say that about Merz Aesthetics is because we have the biologic drug, Xeomin. That's a true drug. That's what differentiates us from the cosmetic side of the area. 

Q: Science has been emphasized in the aesthetics industry recently. Why do you think this is?

A: When I started my journey as a scientist, it was very simple. The patients didn't really know what each different drug was. Only the doctors knew. Now, patients are so much more educated. They want to know not only what the drug is, and what it does, but also what the ingredients are.

I think that science and beauty are almost converging. Now people are making informed decisions. So, science will play a huge part in every single decision the consumers and the patients will make.

Q: Merz Aesthetics maintains such high standards for therapeutic effectiveness and safety that its major pipeline of botulinum toxin products, HA fillers, and Ulthera have all been cleared by the U.S. Food and Drug Administration (FDA). Is this what you are talking about?

A: We have to believe that we have products that we believe in and that they are safe, effective, and high quality. We commit to our customers to make sure we deliver the best products.

And that is essential for us both as scientists, but also as you know, commitment to our customers, and as Merz always wants to give the opportunity to make people look better, live better, and feel better.

Q: What is the direction of Merz's R&D? And how much is invested?

A: That's a good question. The main focus is to drive innovation to bring new products to the market.  That is the very heart of my team. On average, we invest about 10 to 15 percent of our revenue on an annual basis back into R&D, so that we continue to fuel the pipeline as we move forward.  We also invest a lot in early development, where we're looking for new formulations, new ways of delivering things.

Q: What are some of the most notable clinical trials underway?

A: We've just started a new platysma band project. We're looking forward to having that approved globally. We're looking at skin quality indications. But we have many, many ideas. My team has about 30 projects in the pipeline across all of our four main products, which are Xeomin, Radiesse, Belotero, and Ultherapy. So many, many more things to come. 

Q: In general, pharmaceuticals are all about effectiveness and safety, whereas in aesthetics, you have to consider beauty as well. What does this mean?

A: I mean, for every pharmaceutical product, whether it's for therapeutic use or aesthetic use, increasingly, it's about how the patient feels. So, for example, if we take a therapeutic indication like spasticity for which our neurotoxin is used, you will ask patients, “Do you still feel pain?” It's not just about whether you can move the arm, which is the efficacy, it's also whether you have pain.

In the aesthetic world, we ask patients, “How do you feel? What do you feel you look like? Do you feel satisfied? Do you feel more confident?” And that really is the goal of aesthetics -- to make everyone feel confident, to be their best selves.

And that is very different for all of us. But I think that's really important. So, we call it “patient-reported outcomes.” And increasingly, it is getting more important than what the physician thinks. It's how the patient feels, regardless of aesthetics or therapeutics. And I like that. 

Q: What new technologies or new approaches are you considering in aesthetic R&D?

A: Yes, the world of digitalization such as AI has just exploded. We try to use as much as we can in terms of automation. All the way from R&D to manufacturing where we try and do as much automation as possible, and to our packaging, we're looking at different ways of developing new formulations, we try to do as much automation as possible and make ourselves as environmentally friendly as possible. 

Technology comes into everything. It seems to be so fast now with AI coming in. 

So, my teams continually assess what is out there and bring it back in to try and incorporate that into our R&D programs. And we do a very good job of that. Keeping up with it can be tricky but we really enjoy it. 

Q: In the field of medicine, personalized treatment using big data has recently become a trend. In the case of aesthetics, it is basically a customized treatment based on the skills of the practitioner, but on the other hand, it is difficult to standardize. Does Merz have any plans to develop technologies or products to make this process easier or to target specific patient groups?

A: The aesthetic industry is almost leading the personalized medicine. When you take a medication, let’s say you're taking a tablet a day. When it comes to aesthetics, the patient walks into the clinic. And what I would say to my doctor versus someone else is completely different. They start the conversation with what worries you and what you want to improve. 

It's very personalized, and we like that. Now, for each of our indications we get approved, we do have guidance as to what dose you can use. So, we do provide that and we also provide injection paradigms. So, in our labels, we will say, you can inject this much product in these areas. And you will see diagrams or facial areas, for example. So, physicians should stick to those amounts of product and also the areas. 

You treat the patient so that the patient knows how they want to look, they know how they want to feel confident. And so, there is that variation.

But we do give as much guidance as we can to ensure some patient safety. 

Q: In Korea, Merz's botulinum toxin product Xeomin is particularly popular. There is also a high level of interest in botulinum toxin products. What is your advice for Korean consumers and healthcare providers?

A: There are a lot of botulinum toxins now on the market. And what we are seeing is that patients are starting treatment with botulinum toxins much earlier than they used to. And so, patients will be using botulinum toxins for many more years than they used to. Botulinum toxins are used for both therapeutic and aesthetic indications. So, someone could be receiving botulinum toxin type A, for a therapeutic indication from one doctor, and then an aesthetic indication from another doctor. So, the most important thing we need to take into consideration is, to ensure the patient will continue to have treatment success. By doing that, it's selecting the right type of toxin product for your patients. 

We would recommend that you use a pure toxin, which is a toxin that only has the part of the molecule that's required for the biological effect. There are many formulations out there with accessory proteins and non-relevant proteins. Because if you inject more proteins into the body, you are likely to develop resistance. So, customers and healthcare professionals need to consider what is the best product to treat their patients with. 

Q: What are your final comments to healthcare providers and consumers in Korea?

A: I would like to leave the comment that we at Merz are committed to them. We truly appreciate them. From an R&D point of view, I love the innovation and all the technology that Korea is driving. It's such a delight to be here. We will continue to push our pipeline to provide them with new products in the future. And those products will be of the highest quality standards -- both safe and effective and proven so that they have the confidence to use those products.