SkinHealth Systems Inc.

Good afternoon, ladies and gentlemen, and welcome to the Skin Health Systems Inc. second quarter 2026 earnings call. At this time, all lines are in listen-only mode. Following the presentation, we will conduct a question and answer session. If at any time during this call you require immediate assistance, please press star zero for the operator. This call is being recorded on Thursday, August 6, I would now like to turn the conference over to Noberto Aja, Investor Relations. Please go ahead.

Thank you, operator, and good afternoon, everyone. Thank you for joining us today to review Skin Health Systems' 2026 second quarter results. We released the results earlier this afternoon, which can be found on our corporate website at skinhealthsystems.com. Joining me on the call today is Skin Health Systems Chief Executive Officer, Pedro Malha, along with her Chief Financial Officer, Mike Monahan. Before we begin, I want to remind everyone of the company's safe harbor language. Management may make forward-looking statements, including guidance and underlying assumptions. Forward-looking statements are based on current expectations and beliefs and involve risks and uncertainties that could cause actual results to differ materially. Listeners are cautioned not to place undue reliance on any forward-looking statements. For further discussion of risks related to our business, please refer to the risk factors contained in the company's filings with the SEC. In addition, this call presents non-GAAP financial measures. A reconciliation of these non-GAAP financial measures to the most comparable GAAP measure is available in the earnings crest release. which was furnished to the SEC and available on our website. Following management's prepared remarks, we will open the call for a question and answer session. With that, I would now like to turn the call over to our CEO, Pedro Malha. Please go ahead, Pedro.

Good afternoon, everybody, and thank you for joining us to discuss our second quarter results. Let me start with a quarter at a high level. Overall, this was a mixed quarter. Revenue came in at approximately $72 million at a lower end of our guidance range. Equipment sales remain the biggest headwind as providers continue to take a cautious approach to capital investments. Consumables proven a bit more resilient, supported by the continuous growth of our installed-based although treatment activity remained below expectations. This overall revenue pressure was evident across both our domestic and international businesses, with international markets remaining a bit more challenging. At the same time, profitability for the quarter was significantly stronger than we expected. Adjusted EBITDA came in at $17 million, well above our guidance range and driven by strong gross margins and continued discipline in how we manage the business. In summary, we are not satisfied with our top-line performance, but the quarter reinforced an important point. Even in a more demanding commercial environment, we are building a stronger company with better margins, greater operating discipline, and a more resilient financial model. As importantly, nothing we saw this quarter change our strategic direction. If anything, it reinforced it. Let me spend a few minutes now on what we are seeing in the market, because it can provide an important context for both the quarter and the strategic choices we are making. The long-term demand for skin health remains healthy. What is changing is how that demand is being distributed. Consumers have more treatment options than ever before, and providers are making more selective capital investment decisions as they evaluate a broader range of technologies. We believe that that environment rewards companies with trusted brands, meaningful innovation, strong clinical evidence, and deep provider relationships. and those are the areas where our company is best positioned to compete and where we continue to focus our investments. As we said last quarter, market conditions are only a part of this story. Our responsibility is to execute better and that is exactly where our efforts are focused. We are strengthening our commercial capabilities, improving how we engage with customers, and becoming more effective at converting opportunities. Those are the things we can control and that is where our team is focused every day. We also continue to believe strongly in the long-term opportunity for this business. For more than 20 years, HydroFacial has built one of the most recognized and clinically validated brands in professional skin health. Today, we serve more than 36,000 providers worldwide, have a large and growing install base, and generate around 75% of our revenue from recurring consumables, which together build durable, competitive advantage. that position us to create long-term value. Last quarter, we discussed several of the investments we're making across the business, including consumable boosters and the next generation of the hydrofacial device. Today, I want to explain how this worked together to support our long-term strategy. Our strategy is built around three priorities. First, Strengthens and growing the core hydrafacial franchise. Second, increasing the value of every system already in the field. And third, leveraging our platform and provider relationships to expand into attractive adjacent categories. Together, these priorities are designed to accelerate sustainable growth by expanding our installed base, increasing treatment utilization, growing recurring revenue, and creating a more diversified business over time. Let me start with the first priority, strengthening and growing our core Hydrofacial franchise. A key part of strengthening the franchise is making the platform accessible to a broader range of providers. As we discussed in prior quarters, capital constraints remain one of the most significant barriers of adoption. So to address that, early this month, we introduced in the U.S. a new device rental program designed to lower the upfront investment by providers and make hydrofacial accessible to more practices. We believe this will expand our addressable market and support growth of our installed base. The financial accounting for the program is similar to our existing sales program, with the revenue for the sales being booked upfront upon shipment. Also, the program was built with a third-party financing partner who takes ownership of the devices and administers the program. Part of this strategy of strengthening and growing our core Hydrofacial franchise is also the investment We are making in the next generation of hydrofacial platform. As we discussed last quarter, this remains a multi-year development program targeting a 2028 launch. Our objective here with the next generation of the hydrofacial platform is to deliver a meaningful step forward in clinical outcomes, treatment experience, and provide a workflow while also creating a compelling reason for existing customers to upgrade and for new customers to choose Hydrofacial. Moving now into our second strategic priority, increasing the value of every system already in the field. Our installed base is one of our company's greatest competitive advantages. It gives us longstanding relationship with providers around the world and supports a highly recurring revenue model that few companies in our industry can match. As we discussed last quarter, improving utilization remains one of the largest and most immediate growth opportunities that we have. So our objective here is very clear, is to help providers perform more treatment, deliver better clinical outcomes and improve the value of every customer visit. and that is exactly what our investments in clinically validated boosters and treatment enhancements are designed to do. To support that strategy, our next clinically validated booster is expected to launch globally in the fourth quarter with additional launches planned throughout 2027. Finally, our third strategic priority. which is to use our platform and provider relationships that we've built over the past two decades and leverage those to expand into adjacent categories where providers and consumers are increasingly investing. This strategy is intended to diversify our portfolio, create additional growth engines, and to do so by building on capabilities we already have. The Skin Stylus Microneedling Device is a good example of that strategy in action. It gives us participation in one of the fastest growing categories in aesthetics and continues to perform well. And recently, we received the FDA clearance for the improvement in the appearance of periorbital wrinkles. And more importantly, it also demonstrates our ability to introduce clinically differentiated technology through the provider relationships we already established. Hydrosculp is another example. The reposition and relaunch of KeraViv extends our presence into the growing scalp and hair wellness category, while increasing the value of hydrofacial systems already in the field. Following its June relaunch, we are encouraged by how Hydroscope continues to gain traction. Also, as we discussed on our last call, we continue to make progress on our plans to introduce a new device to the U.S. market in 2027. This is not another hydrafacial device. and reflects our broader strategy of building a platform of clinically differentiated skin health solutions that leverages the provider relationships and commercial infrastructure we spent more than two decades building. So before I turn the call over to Mike, let me leave you with two observations here. First, we are not satisfied with our current performance. Despite our current business environment remaining challenging, improving execution is our responsibility and remains our highest priority. Secondly, we believe our company has exceptional assets and a clear path to using them more effectively. The rental program and the continued advancement of our next generation platform demonstrates that the strategy is moving from planning to execution. We know that there is still plenty of work to do, but we are in the process of building a stronger and more diversified company with multiple opportunities for long-term growth. And so with that, I'll turn the call over to Mike to review the financial results in more detail.

Thank you, Pedro. In the second quarter, total net sales were $72.1 million, down 7.8% versus the prior year. Delivery systems revenue was $18.3 million, down 18.4%, with 770 systems placed compared to 957 in the prior year. Consumables revenue was $53.9 million, down 3.5%, driven primarily by lower utilization and a tougher prior year comparison that included booster launches. Our active install base grew to 36,516 systems globally, up 3.8% year-over-year, and remains the foundation of our recurring revenue. Despite this continued top line pressure, adjusted EBITDA came in above our projections. This was primarily driven by adjusted gross margin expansion, disciplined cost management and timing of R&D investments and commercial initiatives. Sales performance by region is as follows. America's net sales were 49.9 million, down 4.2%. Consumable sales were down 1.4%. while delivery systems reflected the broader capital equipment pressure. EMEA net sales were 14.9 million, down 19%, driven by softness in both equipment and consumables. We've been actively addressing headwinds in the EMEA market. We had personnel shortages in the region along with a shift of timing in distributor orders, which we expect to improve in the second half of the year. APAC net sales were 7.3 million, down 5.4%. During the second quarter, we transitioned Australia and New Zealand back to a distributor model from a direct model. We now have the entire APAC region being served by a distributor model. We believe this approach better serves the region going forward. The 2026 financial impact of the Australia-New Zealand transition to a distributor model is a reduction of revenue of approximately $1 million. Gap gross margin was 68.4%, up from 62.8%. adjusted gross margin was 71.8% compared to 65.9% in the prior year, representing a 590 basis point improvement. The year-over-year improvement was primarily driven by three factors. First, lower cost of goods on equipment due to sell-through of trade-in units that pressured margins a year ago. Second, lower inventory-related charges and continued efficiency in operations as we realized the benefits of tightened inventory purchasing and Discipline Cost Management, and third, a favorable mixed shift towards consumables. GAAP operating expenses were $45.8 million down from $51.8 million, reflecting lower personnel costs and improved efficiencies. With total operating expense, selling and marketing was $21 million, G&A was $23.3 million, and R&D was $1.4 million. We expect R&D to step up in the second half of the year as our innovation initiatives ramp. On a gap basis, we generated income from operations of 3.6 million compared to a loss of 2.7 million in the prior year. Net loss was 2.7 million compared to net income of 19.7 million a year ago. The prior year figure included an 18.1 million net gain related to the exchange and repurchases of our 2026 notes. Adjusted EBITDA was $17 million, up from $13.9 million in the prior year, and above our guidance range of $11 to $13 million. The year-over-year increase in adjusted EBITDA was largely driven by operating expense savings from lower selling and marketing expenses and lower professional service fees in G&A. We ended the quarter with approximately $206 million in cash, cash equivalents, and restricted cash. This is approximately $1.5 million above our first quarter ending cash position. Our October 2026 convertible maturity is approximately $103 million. Based on our current cash position and our expected second half cash needs, we remain confident in our ability to address this maturity. We will continue to evaluate options based on our cash needs and market conditions. As of today, our current plan is to repay the October 2026 maturity with cash on hand at the end of the third quarter. We are lowering our revenue outlook to 280 to 290 million by reducing the top end of the previous guide, reflecting continued pressure on year-over-year device sales. We are raising our adjusted EBITDA outlook to 39 to 46 million from 35 to 45 million previously, reflecting the margin strength and cost discipline we delivered in the first half of the year. Our second half guidance reflects increased investment of 4 million in R&D and commercial initiatives versus the first half of the year. As a result, we are projecting our second half adjusted EBITDA to decline relative to the first half. For the third quarter, we expect revenue of 65 to 70 million and adjusted EBITDA of 5 to 7 million. Finally, I'd like to briefly address our NASDAQ listing. As we disclosed, we received notice from NASDAQ that our stock had traded below the dollar minimum bid price requirement for 30 days. As outlined in our preliminary proxy statement filed last Friday, we will be asking stockholders to approve a reverse stock split at a special meeting scheduled for September 22nd to remain compliant. The proxy provides a range of potential split ratios, and if approved, our board will determine the specific ratio within that range it believes is appropriate based on market conditions and other relevant factors at the time of implementation. For more information, please read the definitive proxy statement that we will file with the SEC. With that, I'll turn the call back to Pedro.

Thanks, Mike.

Let me close with one final thought. This quarter did not change our view of the business. The market remains demanding, and we know that we need to continue improving on execution. But at the same time, we are making tangible progress against the strategic priorities that we laid out. The rental program is underway. Hydrosculpt has been relaunched. Skin Stylist is taking good traction. The development of our next boosters and next generation hydrafacial platform continues to advance. and we continue to make progress on our plans to introduce a new device in the US in 2027. All of these are meaningful milestones and they reinforce our conviction that we are building a stronger, more diversified company with multiple drivers of future growth. Operator, you can now open the line for questions.

Thank you. Ladies and gentlemen, we will now begin the question and answer session. Should you have a question, please press the star followed by the one on your touchtone phone. You will hear a prompt that your hand has been raised. Should you wish to decline from the polling process, please press the star followed by the two. If you are using a speakerphone, please lift the handset before pressing any keys. One moment. Your first question comes from Oliver with TD Cohen. Please go ahead.

Hi, Pedro and Mike. Regarding what you're seeing with consumables being down relative to the active installed base, what's happening there with utilization and or the inventory on the installed base that you're noticing? And also, I think you had a tough compare there, too. Second question, on the convertible note due in October, What do you need for cash in terms of your base level of cash and also things we should know about working capital dynamics and needs there in terms of the cash flow? And finally, regarding the rental program, how do you manage for incrementality and not cannibalization and what's the thinking that goes through? It sounds like it's going to increase your TAM and there's a reason for people to buy and a different reason for people to rent. Thank you.

Thanks, Oliver. So I'll address the consumable dynamics, and then I'll go just right into the rental program, and then I'll let Mark address the convertible note, the cash, and the working capital question. So in terms of what we're seeing in consumer dynamics, I don't think that the consumer itself has fundamentally changed. continue to invest in skin health and they continue to believe in the long-term demand for non-invasive skin treatments. So that continues to be healthy. What has changed in our view is that consumers now have more choices than they ever did years ago. And they're basically spreading their aesthetic spending across a broader range of treatments. and also on the same line of thinking, providers have to now work harder to keep these patients engaged and these consumers engaged and these consumers coming back into their doors. So that's why we don't look at this as simply as a demand issue when it comes to consumer behavior, when it comes to our consumables, We see it actually as an opportunity to increase the productivity of every hydrofacial systems that we have in the field. And that is exactly why I discussed during my prepared remarks the second pillar of our strategy, which is basically focused on improving, increasing the utilization. We have the boosters. Hydroscope, all of that enhance the utilization. We also are working in better provider education and better protocols. And all of those, they basically, they come with one single objective, which is for these providers to perform more treatments and to be able to personalize those treatments and be able to create a better Thank you very much. Thank you. In terms of the rental program, you're talking now more about devices. As I explained, and if we look back, the rental program addresses one of our biggest barriers that we have seen in the last quarters, which is basically the upfront capital commitment from providers. And with this new program that we launched in the U.S., We are giving qualified U.S. providers another way to access Hydrofacial through a much more manageable payment structure and conditions. I'm not going to go through all the mechanics of the program right here, but the objective, and I'm sure it's pretty clear, the objective is simple. It's basically to remove a quite meaningful adoption barrier that we have been noticing in the past quarters. And when doing that, the expectation is to expand the install base. And we don't expect to cannibalize. We expect just to bring more providers into the fold, given that we're going to be lifting this barrier. So, Mike, do you want to address the capital questions?

Sure. Hi, Oliver. The midpoint of our forecast assumes that we'll end the year roughly with about $100 million in cash. That would exclude any kind of unforeseen items that we don't have in the model, but we feel pretty comfortable kind of with that level, and that gives us enough cushion in our view heading into 2027 to kind of manage the business and meet the working capital needs.

Thank you. Best regards.

All right, thank you. Your next question comes from Susan with Canaccord. Please go ahead.

Hi, thanks for taking my questions. I guess maybe I was just kind of first looking for some color just around the consumer behavior you're seeing out there with the consumables now down two quarters in a row. I guess are you seeing consumers maybe extend the timeframe between treatments or maybe foregoing a treatment? or is it more just that they're not trading up and adding consumables to their treatments that they're getting done? Thanks.

Sure. As I explained, yes, all of you both. There's definitely more choices for the consumables, for the consumers to come in, which is great, which means that the segment is healthy, continues to have innovation, and consumers continue to spend money in the categories. and that is all the levers that we need. We just need to position ourselves better to take advantage of that willingness to spend in aesthetics. All the things that I referred, all the initiatives, all the strategies that we are putting basically into place speak to that, right? The boosters, basically all the investment that we're doing in the boosters is there to increase the treatment frequency. the relaunch of Hydroscope is there to create additional recurring revenue from the same devices on the same practices. The relaunch of the skin stylus, basically we put that there and we're putting a lot of focus because we want to leverage the relationship into a fast category that we currently have, which is microneedling. So all of that is actually target to take advantage all of that healthy spend that we see happening.

Okay, great. And then maybe if you could just talk a little bit about just the competitive landscape that you're seeing out there. I think last quarter you mentioned that it was intensifying, I guess. Are you still seeing a pretty intense competitive landscape from other competitors out there? Thanks.

Sure, Susan. No different from what I said last quarter. Basically, indeed, the market has become more competitive, and some competitors are using pricing and other commercial incentives more aggressively. We have seen this throughout the year. Nothing new here, but our focus is rather on showing these providers where we can differentiate hydrafacial, where we can differentiate and so forth, and where the economics of our treatment come in and where we can create value to their practice. So short answer, no change from last quarter in what we discussed, but these are kind of the undercurrent dynamics that we have been noticing in the market. Okay, great. Thanks so much.

Good luck there. See you.

Thank you.

Your next question comes from JP with Roth Capital Partners. Please go ahead.

Great. Hi, guys. I appreciate you taking my questions. If I could maybe just start, you know, hoping that you could give us an update So I can speak a little bit. I'll touch on the new syndale.

in terms of innovation roadmap. And Mike, you can share some of these numbers just to round out the answer here. In terms of the NextGen Hydrofacial, as we've been discussing in the past quarters, this continues to be a program that has a 2028 launch target. And the objective and where the team has been working and moving forward is to bring to market a meaningful step of innovation in terms of clinical outcomes, of the overall experience, in terms of provider workflow and basically giving the existing providers that have Hydrofacial now a pretty compelling reason to upgrade or obviously bring new providers into the fold with a strong reason to choose Hydrofacial versus versus other procedures. It's a bit too early to discuss more details on specifically the features that we're working on or the economics behind it, and obviously we'll provide all the details as the program progresses, but we feel very encouraged by the development and the gait cycle of the process that we are currently doing. Mike, do you want to?

Sure. Hi, JP. Typically, we tell consumer and providers that the payback can be roughly around nine months. That obviously depends on how many treatments and the volume that you do. The more treatments that a provider is able to do, the faster the payback is. But generally, that's the... overall kind of number that we give.

Okay and then a follow-up Mike maybe more for you but you know on the last call I think we sort of talked about Q1 gross margin maybe kind of being the high for the year you know just curious you broke down a little bit of where the strength in 2Q is coming from but just if there's if there's any more detail there and then about how you kind of expect gross margin to run through the back half of the year it would be appreciate it. And really the question then is sort of the implication for EBITDA on the back half. You've done obviously such a great job of managing costs that the question really is sort of why is that stepping down? And is that baking in a little bit of conservatism?

Yeah. Thanks, JP. Overall, just to kind of speak to the midpoint of our guide. So the first half of the year, adjusted gross margin was 72% is what we did. The midpoint of our guide kind of assumes that there is a step down on adjusted gross margin into kind of the 68% range. And the real reason for that is a couple of things. One is we expect an increased mix of Thank you for joining us. We modeled in an increased percentage of Cindeo machines versus the first half of the year, and that's largely due to the rental program. To qualify for the rental program, it's only for Cindeo devices that we have, and they tend to have a higher cost of goods than some of our other devices. So overall, those are kind of the two big drivers kind of pressuring kind of margin. On the back half, again, just to speak to the midpoint, so the first half of the year, adjusted EBITDA was a little over 25 million. The midpoint of our guide would assume a little bit less than 17 million of adjusted EBITDA in the back half of the year. And that's going to be driven by three things, primarily. The first is the lower adjusted gross margin that we just kind of walked through, the key drivers of that. The second is there's timing of RMD and commercial marketing expenses that are more back-end weighted this year than they've been in the past. And so we have those moving into the back. And then the last piece of it is we have some general operating expenses that we had lower expenses than what I would call normal. A simple example is kind of our bad debt expense was running very, very low in the first half of the year. and we're projecting that to go back to more normalized levels in the back half of the year. So, you know, as you look at the overall kind of forecast towards the midpoint, it ends up being those two key factors, the higher operating expenses and lower adjusted gross margin.

Got it. Very helpful detail. Best of luck going forward, guys. Thank you.

Your next question comes from Cindy with Jefferies. Please go ahead.

Hi, thanks for taking our question. So when you think about the adjacent categories, how much of the opportunity comes from acquiring new customers versus increasing penetration within your existing provider base? And then I guess just also wondering if there's any further detail that you can share on the new device that's coming as well.

Thank you. So in terms of where we think we're going to get The biggest share actually is going to come from both. We have an incredible large install base. It's actually one of our biggest and most valuable assets that we have. And so any product that we relaunch or launch, it's definitely going to be primarily targeted into that extensive install base because that's an automatic channel that we have and an automatic lift that we can that we can explore. In terms of more details into this strategic partnership, so last quarter basically we discussed our intention to expand into an adjacent category. And the most important update that we are ready to give is that we are indeed progressing in that area. and the goal is to bring a device to market next year. And the objective for us as we've been working throughout this project is to basically broaden the set of solutions and the set of procedures that we can offer to this extensive provider network that I just mentioned, and again, leverage the infrastructure that we have. Right now, as we stand, we're not in the position to discuss the specifics of the technology itself, but definitely we will share more as we get closer to concluding this project.

Any follow-up questions?

All right, we're done. Your next question comes from Bruce with Stonex. Please go ahead.

Hi, thanks for taking my question. I wanted to ask a little bit more about the booster you plan to launch during the fourth quarter. Is it going to be targeted to any particular market segment?

So, for example, the medical or the aesthetic segment, and will it be out in time for the holidays?

Yeah, Bruce. So, the target date is Q4. It's going to be a clinically validated booster, which is going to be aligned with the new strategy that we're putting behind every single booster that we're going to put investment dollars behind from going forward. Everything is going according to plan, it's tracking. That is what we are comfortable to share right now. We are expecting the same level of performance and commercial behavior as we had with HydroLock as an example, which was, again, another booster that has good traction to it. This is just the beginning, and we will be launching more clinically-backed boosters next week as well, part of the booster development and innovation roadmap.

Okay, and then one follow-up.

In 2027, what do you anticipate in terms of the launch cadence? So it's going to be like one every six months, one big one for the year.

How are you thinking about that?

Two boosters, that's kind of the plan as we stand right now. Again, we are being very diligent and and I'll say good stewards of capital when it comes to boosters. We are going to only launch boosters that are clinically backed and can provide clinical outcomes.

Okay. That's it for me. Thank you.

Thank you. Your next question comes from Olivia with Rademan James. Please go ahead.

Hi. Good afternoon. This is Martin Metella on for Olivia. I just want to quickly touch on the rental program and sort of get an idea of what was the impetus of it. Was this sort of a request from potential existing providers? Is it something that other competitors are doing?

What we have been doing is looking at challenges in terms of being able to expand our device footprint. Thank you very much. definitely ease that barrier of entry and allow these providers to have and to operate the hydrofacial machine in their practice. So basically, we saw the problem and we stood up a model that addresses, and in our view, will substantially fix that problem.

Great. Thank you very much.

Thank you. Your next question comes from Naveen with BNP Parabas. Please go ahead.

Hi. Thanks for taking my question. My first one is we have seen the neurotoxin market improving sequentially this quarter. So do you expect some improvement in the aesthetics capital equipment environment to follow with a lag or is that too early?

So as I mentioned, that's a good question. As I mentioned in the beginning, we continue to see the market as a healthy category. Aesthetics continues to grow. People continue to dedicate some discretionary spending into aesthetics. And a lot of these categories are actually growing. Toxins is one of them. So we see this as an opportunity. What we are doing is catering and building strategies that can take advantage of that spend. And so all the strategies that I just discussed speak exactly to that objective.

Thank you. And maybe if you can discuss some early progress or examples on increasing the productivity of the hydrafacial install base.

Thank you. I'm sorry.

Can you just repeat your question? You just kind of broke up a little bit.

If you could discuss some early progress or examples on increasing the productivity of the hydrophacial install base.

Sure. So I can definitely start with commercial excellence. Again, this is an area that we keep that we keep investing in. That is one. The other is we are launching the boosters, speaking right into the utilization of the devices. That's another. And so, again, we are very focused on making more out of every single machine that is out there in the field.

Yeah, Naveen, I could add one thing I would just add. I think we can point to in terms of progress in Q2 was around skin stylists. So here was a product that we have that we began really focusing on the sales team, refocus their efforts in order to sell into the existing base. And while it's a small revenue stream for us, it grew nearly 50%. year over year in the second quarter when the sales and marketing team reshifted the focus there. So I just point that out, not that it has a material impact on the overall P&L in the second quarter, but it is an example of Salesforce execution and partnership in marketing where the team was really able to drive results.

Thank you. This is a helpful vote.

Thank you. Ladies and gentlemen, at this time there are no further questions and this concludes today's conference call. Thank you for participating. You may now disconnect.