5 Minutes with Dr Izolda Heydenrych: Weaving Art and Science 

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Join us for a fascinating conversation with Dr Izolda Heydenrych, a Cape Town-based dermatologist known for blending art and science in aesthetic and medical dermatology. Paola Chellew explores Dr Izolda’s career highlights, from her passion for teaching to her innovative approach to patient care. Learn how neuroaesthetics, natural beauty, and precise treatment techniques shape her philosophy in the ever-evolving world of dermatology. 

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Born and bred in Cape Town, Dr Izolda Heydenrych studied at Stellenbosch University, obtaining a BSc Hons in Nuclear Medicine (a speciality using radioactive tracers to assess bodily functions and to diagnose and treat disease), as well as a Diploma in Anaesthetics (SA College of Medicine). 

Now a dermatologist holding various positions in the dermatological community, Dr Izolda is the director and co-founder of the Cosmetic Dermatology Centre with Dr Ean Smit in Cape Town. She is an honorary consultant in the Division of Dermatology at the University of Stellenbosch, on the Faculty at UCL (MSc in Aesthetic Medicine) and Australasian College of Medicine (Triennial Registrars Programme), and also a director of the HeyEd Academy. 

What diverted your path from nuclear medicine to dermatology? 

Dr Izolda: I had a sincere longing for long-term patient relationships. 

Our diversity and demographics in South Africa are vast. In your practice, what are the most prevalent skin conditions that you treat? 

Dr Izolda: The most common is actinic damage in all its forms. This brings about skin changes as a result of excessive sun and ultraviolet light exposure. 

Do we have enough dermatologists in South Africa? 

Dr Izolda: Emphatically no! Our country desperately needs more university posts for specialisation.  

Although we’ve come a long way, there is a definite conservative view that aesthetic medicine is frivolous or unnecessary. How do you feel about this? 

Dr Izolda: The World Health Organization defines “health” as, “A state of complete physical, mental and social well-being and not merely absence of disease or infirmity.” 

Indeed, there is a huge and robust body of science proving that aesthetic injectable treatments are linked to true health benefits. 

Do you think that people are becoming more aware that obtaining healthy skin should come first – before other injectable procedures? 

Dr Izolda: Yes, I do believe this is increasingly true. 

Is the acne battle being won? 

Dr Izolda: Despite the availability of hugely exciting and effective new prescription medications, there remains a scarcity of knowledge among this huge group of patients and a percentage of non-dermatologist healthcare professionals, which requires greater education around this. Acne is a treatable disease, and we now have topicals that can prevent and reverse scarring. 

Is skin cancer on the rise, or do you find that people are more aware that their sunscreen is their most important beauty product? 

Dr Izolda: Unfortunately, skin cancer is most definitely on the rise. 

There are various skin types, like dry or oily, yet there is still very little time given to menopausal skin. As women are living longer, and therefore may be menopausal for more than half their lives, do you think there should be more education on the subject? 

Dr Izolda: There is good science around this topic, although increased patient and consumer education would be beneficial.  

Your thoughts on medical-grade skincare versus green and clean products? 

Dr Izolda: While “green and clean” constitutes a trendy catchphrase, it is often a misleading term. Medical-grade skincare comes with supportive, evidence-based science. 

Do we tend to over-exfoliate? 

Dr Izolda: Sadly, dermatologists are frequently faced with patients with tricky skin types, such as rosacea sufferers, who have unduly over-exfoliated, often in a desperate attempt to obtain good skin texture when nothing else seems to be working. Even with other skin issues, a guiding consultation regarding these lifelong skin conditions may be life-changing. 

Are we moving towards a more natural look, or do patients still ask for the works when it comes to botulinum toxin and fillers? 

Dr Izolda: Worldwide, there is a wide spectrum, which is essentially broken down into Hollywood vs The Rest. 

The “natural look” is a heavily punted term that actually requires extensive discussion among both the patient and treating healthcare professional. Perhaps a better endpoint would lie in seeking “subtle treatment”. 

Beauty as exuded by an individual is often described as a cube with three dimensions, denoting: 1 = Proportions, 2 = Confidence, and 3 = Naturalness.  

While confidence may increase after altering proportions, the naturalness curve cannot be transected beneath a certain point without unfortunate consequences. Naturalness is highest at birth and can only diminish with intervention, inherently making “natural treatment” a contradiction in terms. 

Tellingly, the observer’s brain constitutes a totally separate fourth dimension. Within less than a hundredth of a millisecond, factors such as the authenticity of muscle movement and expression are analysed before the final determination on beauty is made. And the human brain likes subtlety! 

The new field of neuroaesthetics is proving that the human brain’s perception of beauty is extremely malleable. Short exposures to very full or very small lips may cause visual adaptation to make them seem more acceptable. 

Perception drift follows when the brain’s global beauty processing is lost, and only local processing is retained. These individuals lose perspective of the total image and chase the treatment of one area after the other.  

At the recent World Medical Aesthetic Congress in Monaco, there was an entire session dedicated to “The Art of Subtle”. If only #theartofsubtle could start trending… 

What’s your favourite treatment (for yourself) that you would not want to do without? 

Dr Izolda: Fraxel thulium laser treatments for sun damage, as well as Ultherapy, which is a non-surgical ultrasound treatment that improves, lifts, and tightens loose skin and wrinkles. 

Do you prefer teaching or practising medicine? 

Dr Izolda: Teaching – sharing knowledge makes my heart sing! 

What is your most rewarding procedure to perform? 

Dr Izolda: It’s any procedure after which I witness improved quality of life. Treating patients with facial palsy is right up there. 

Music is a passion for you (holding three licentiates in solo piano). Is your love for music a separate hobby or is it interwoven into your career in some way? 

Dr Izolda: Music and art form integral parts of my medical presentations and life.  

Who has been your most significant mentor? 

Dr Izolda: I’ve been blessed with so many, but to name just two: Dr Koen de Boulle (dermatologist, Belgium) and Dr Mauricio de Maio (plastic surgeon, Brazil).

Can you share a moment that triggered an important career change for you? 

Dr Izolda: In 2010, just after opening the Cosmetic Dermatology Centre, I was faced with the career choice of pursuing either Moh’s surgery (microscopically controlled surgery used to treat both common and rare types of skin cancer) or aesthetic medicine. As a last-ditch attempt to seek clarity and structure, I attended the Aesthetic Medical and Anti-Aging World Congress in Monaco. 

There, I serendipitously landed in a session featuring Dr Arthur Swift who was presenting his “Mathematics of the Perfect Cheek” and “Seven Features of True Facial Beauty” for the first time. Mauricio de Maio also presented “The Eight Point Lift” for the first time. 

Both of these remarkable plastic surgeons subsequently became personal mentors and friends who dramatically impacted the course of my career! 

And a closing inspirational quote or motto? 

Dr Izolda: “The meaning of life is to find your gift. The purpose of life is to give it away.” – Pablo Picasso