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KEOGH REVIEW

WE ANALYSE THE OUTCOME OF THE LONG-AWAITED REPORT INTO THE AESTHETICS MARKET

SKIN CANCER TEARS OF A FROWN

AND SUN DAMAGE SPECIAL

THE AESTHETIC AWARDS 2013-14, 7 DECEMBER 2013, SAVE THE DATE

COSMETIC NEWS THE UK’S LEADING TRADE TITLE FOR MEDICAL AESTHETIC PROFESSIONALS

AESTHETICS AND THE DAMAGING EFFECTS OF THE SUN

CAN BOTULINUM TOXIN REALLY CURE DEPRESSION?

ALSO IN THE MAY ISSUE OF COSMETIC NEWS... SKIN ALLERGIES

SOCIAL MEDIA AND DEFAMATION

‘PAIN FREE’ HAIR REMOVAL


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Editor’s Letter Welcome to the May issue of Cosmetic News. The wait is finally over! After months of speculation and debate about the future of the aesthetics industry, the Keogh review has at last reported its findings. The industry has been waiting with baited breath to see what the outcome of the report would be, hoping that this may signal a wind of change in our unregulated sector. While many of the report’s suggestions for a way forward will be embraced by the industry there are others, such as a call for dermal fillers to be prescription only medicines, that will divide opinion. For our full analyses of the findings turn to pages 10-11. Also in this issue… Sun damage is by far the biggest cause of skin ageing and, with skin cancer also on the rise, dealing with the effects of too much sun is something aesthetic practitioners dedicate a lot of time to. As part of this month’s special feature (p14-20), we will be examining the issues surrounding skin cancer as well as the best treatments for sun damage and why sun protection is so key. We will also be taking a look at the latest clinical data, which shows how botulinum toxin can cure depression (22-23) and talking about the dos and don’ts of aesthetic advertising (44-46).

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Also don’t forget to turn to pages 40-43 to find out everything you need to know about entering the Aesthetic Awards 2013-2014.

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Contents INDUSTRY INSIDER 4 EDITOR’S CHOICE

Vicky Eldridge on the Arosha Express Slimming Programme 6 INDUSTRY NEWS

We round up the latest industry news 10 NEWS SPECIAL REPORT

We report on the outcome of the long-awaited Keogh Review

34 PRODUCT FOCUS

How the Asclepion NeXT diode laser from Carleton offers hair removal for all skin types 36 TREATMENT SPOTLIGHT

We report on the latest innovation from Alma Lasers – the Soprano ICE 38 PRODUCT NEWS

We round up the latest product news IN BUSINESS

12 AWMC

Find out what happened when Cosmetic News visited the Anti-Ageing Medicine World Congress in Monaco

40 AESTHETIC AWARDS

Everything you need to know about entering The Aesthetic Awards 2013-14

[SKIN CANCER AND SUN DAMAGE SPECIAL]

14 SKIN CANCER

We look at the rise in skin cancer and the role aesthetic clinics have to play 16 SUN DAMAGE

We examine the different types of sun damage related pigmentation 17 ADVERTORIAL

Find out how SkinCeuticals’ wide range of products can be used to prevent and correct sun damage 18 Q&A

We chat to leading skin cancer expert Mr Paul Banwell about sun protection

Editor’s choice

AROSHA EXPRESS SLIMMING PROGRAMME The summer seems to have been a long time coming this year but, as the warmer weather finally starts to make an appearance, my thoughts have turned to getting in shape for my summer wardrbobe!

Carlton Beauty & Spa Ltd has recently launched a series of new treatments within its Arosha Express Slimming Programme and I was offered a chance to try them out. The programnme uses pre-packed treatments with disposables bandages which are impregnated with a variety of ingredients to aid cellulite reduction, water retention, toning and moisturising, enabling you to create a bespoke solution for each client. Like many women cellulite is one of my biggest bug bears so Aqua Drain, which tackles one of the main issues of cellulite, water retention, was a good choice for me. The programme uses Aqua Drain to clear toxins and drain the lymphatic system before cellulite is treated. This is always used for the first treatment and includes Dead Sea Salts rich in calcium, potassium, magnesium, iodine and brome to treat water retention and promote tone in the tissues. Natural Moisturising Factor is also included to bring the tissues pH to their natural value, whilst promoting tissue and cell regeneration. This gives the skin a compact, uniform appearance as well as producing new collagen and elastin which helps to reduce the signs of ageing. The treatment drains and moisturises without heating the skin.

20 PRODUCT FOCUS

We find out why Heliocare has become the sun care range of choice for so many aesthetic practitioners CLINICAL PRACTICE 22 BOTULINUM TOXIN

Dr Patrick Treacy looks at the current data on whether botulinum toxin can cure depression 24 VIEW ON

Mike Murphy gives his View On laser and light based ‘pain free’ hair removal 26 DERMATOLOGY

We publish the results of a report by La Roche-Posay and Allergy UK into the disturbing impact of skin allergy and sensitivity in the UK

44 ADVERTISING

Lorna Jackson, editor of The Consulting Room™, gives you a few tips on advertising in aesthetics, an understanding of the rules and how to avoid common mistakes when promoting your clinic 48 BEST PRACTICE

Dawn Piper from Initial Medical Services on the new health and safety guidelines to reduce needlestick injuries being introduced this month 50 BUSINESS FOCUS

PRODUCT REVIEWS

Antonia Mariconda explores the darker side of social networking

30 TRIED AND TESTED

52 A DAY IN THE LIFE OF…

Slim-Cel 3 also focuses on cellulite and water retention. It uses caffeine to stimulate and detoxify, escina for its anti-inflammatory and draining properties and guarana as an anti-oxidant. The treatment promotes circulation, slimming, draining and moisturising. Cel-Term 4 is a warming treatment designed to have a slimming effect by burning fat. It is ideal for overweight clients with adipose cellulite. The treatment features caffeine, centella asiatica to improve tissue elasticity and fucus vesiculosus, which removes waste and stimulates fat metaboslim. The pre-prepared and disposable bandages used in the treatments are highly hygienic and offer a fast and effective twist on traditional body wraps. The Starter Kit contains two packets of Aqua Drain, two of Slim-Cel 3 and four of Cel-Term 4, corresponding to 8 treatments. In addition, the Starter Kit includes two dry brushes, one for in-clinic and one for home use. A course of eight sessions is recommended, twice a week, with each session lasting between 45 minutes to one hour. In addition, the wraps can be successfully combined with electrotherapy treatments to further enhance client results. I have just started my course and am looking forward to getting my body summer ready! CONTACT THE COSMETIC NEWS TEAM ON 01268 754 897

We find out why Dr Ariel Haus uses Syneron Candela’s systems as his treatments of choice

Antonia Mariconda finds out what a typical Day in the Life has in store for Dr Daniel Sister

Charlotte Body Publisher | charlotte@creativemedialtd.co.uk

32 INNOVATIONS

56 TRAINING NEWS AND DATES FOR THE DIARY

Peter Johnson Art Director | peter.johnson@creativemedialtd.co.uk

We find out about the body-jet® water-jet assisted liposuction (WAL) procedure

The latest dates for your diary

Vicky Eldridge Editor | M: 07940 083 677 | vicky@creativemedialtd.co.uk Sophie Belcher Events/Production | sophie@creativemedialtd.co.uk Sean Rice Senior Designer | sean.rice@creativemedialtd.co.uk DISCLAIMER

The editor and the publishers do not necessarily agree with the views expressed by contributors and advertisers nor do they accept responsibility for any errors in the transmission of the subject matter in this publication. In all matters the editor’s decision is final.


Belotero® now approved by the FDA • One of only 3 HA approved by the FDA currently promoted in the US • Optimal integration1 for superior evenness2 • Minimal local for sustained patient satisfaction4

voted as The Best by our customers in 2011 and 2012

Call Merz Aesthetics Customer Services now to find out more or place your orders: Tel: +44(0) 333 200 4140 Fax: +44(0) 208 236 3526 Email: customerservices@merz.com 1 Histological examination of human skin (eyelid dermis layer). Courtesy Dr. J. Reinmüller, Wiesbaden, Germany 2 Prager W, Steinkraus V. A prospective, rater-blind, randomized comparison of the effectiveness and tolerability of Belotero Basic versus Restylane for correction of nasolabial folds. Eur J Dermatol 2010;20 (6):748-52. 3 Taufig A, et al. A new strategy to detect intradermal reactions after injection of resorbable dermal fillers. J Ästhetische Chirurgie 2009; 2: 29-36 4 Reinmüller J et al. Poster presented at the 21 World Congress of Dermatology, Buenos Aires, Argentina, Sept 30 – Oct 5, 2007. Thereafter published as a supplement to Dermatology News: Kammerer S. Dermatology News 2007; 11: 2-3.

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SAVE THE DATE FOR THE AESTHETIC AWARDS 2013-14 - DECEMBER 7, 2013

SYNERON CANDELA

MERZ AESTHETICS

Syneron Candela sponsor Cosmetic News Expo and Aesthetic Awards

Lucy Dowling joins Merz Aesthetics

Cosmetic News is delighted to confirm that Syneron Candela will be sponsoring both The Aesthetic Awards and the Cosmetic News Expo, London. The awards will take place on December 7, 2013 while the Expo will be held on March 8-9, 2014. Syneron Candela is a global brand leader in technology innovation with a clear and focused strategy, driving the need for treatments to consumers and ensuring the footfall to your business is higher. Its treatments such as Motif painless laser hair removal, Velashape, sublime, sublative and GentleLasers have now become everyday terms used in the industry globally.

COSMETIC NEWS

Cosmetic News welcomes back Hollie Dunwell Cosmetic News has welcomed Hollie Dunwell back to its team. With two years previous experience on the title Hollie is well placed to re-join the team in the role of sales manager. She said, “I am really excited to be back at Cosmetic News. I am passionate about this industry so am really looking forward to starting my new role on the industry’s leading business to business magazine.”

G

Merz Aesthetics has announced the appointment of Lucy Dowling as its new Brand Manager. Lucy has a wealth of experience in both the aesthetics industry and broader marketing, having worked as a marketer since 2007 for both distributor and clinics, and understanding the nuance of communication from both perspectives. Lucy has worked as Marketing and Merchandise Manager, Purchasing Manager and Product Manager in various industries and holds an MA in Marketing. Fiona Sibeijn, Marketing Director of Merz Aesthetics, UK & Ireland comments, “Lucy comes to us with a very high level of commercial awareness and industry knowledge, she came to us by personal recommendation of two leading industry gurus and is excited about the prospect of working with Merz Aesthetics to help us drive a powerful message, we are very proud to welcome Lucy to the team.”

MYA / COURTHOUSE CLINICS

MYA and Courthouse Clinics join forces Leading cosmetic surgery provider MYA and award winning Courthouse Clinics have joined forces to become the UK’s foremost provider of surgical and non-surgical cosmetic treatments. Courthouse Clinics @ MYA will be launched at MYA’s flagship Fenchurch Street clinic and will provide patients with a full range of cosmetic services performed by doctors and top cosmetic surgeons, using only market leading products and equipment including the launch of the new Soprano Ice pain free laser hair removal. The partnership consolidates the experience and expertise of the founding fathers of surgical and non-surgical cosmetic treatments; Dr Patrick Bowler Medical Director of Courthouse Clinics and MYA Chairman and founder John Ryan. Dr Patrick Bowler says, “Courthouse Clinics are the UK’s foremost doctor led non-surgical cosmetic provider and MYA has some of the most experienced and skilled surgeons in the world. The partnership allows us to provide a safer and even higher standard of service at a time when pressure is mounting for more regulation and accountability in order to protect the public.” John Ryan MYA’s Chairman says, “Since MYA was founded seven years ago it has been one of the most vibrant and dynamic cosmetic surgery companies in the UK. From small beginnings it has outpaced most of its competitors and it’s now highly regarded as one of the top providers in the country. Recently MYA have joined forces with Courthouse Clinics, one of the most reputable companies in the non-surgical field. This has allowed a wide offering in an ever expanding market and gives patients the assurance that they are receiving a safe and extremely high quality service.”

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References: 1. Raspaldo H. J Cosmetic and Laser Therapy, 2008;10:134–142. 2. Fischer TC. Poster presented at EMAA, 1–3 October 2009, Paris. 3. Allergan Data on File (DoF), 2011. 4. Allergan Data on File (DoF) Marketing overview, 2011. Instructions and directions for use of JUvéDeRm® vOLUmA® with Lidocaine are available on request. Lidocaine does not affect the intrinsic performances of JuvéDERM® vOLuMA® and its safety profile, therefore, JuvéDERM® vOLuMA® data is representative of JuvéDERM® vOLuMA® with Lidocaine3

Date of Preparation: January 2013 UK/0008/2013a

INDUSTRY NEWS


aesthetic awards 2012-13, triple win for aBc lasers EquipmEnt Brand of thE YEar Aesthetic Medical Treatment System

Contact us on: Tel: 0845 1707788 info@a-b-c-uk.com, www.abclasers.co.uk © 2013 Alma Lasers, Ltd. All rights reserved. Alma Lasers Ltd., its logos and Soprano, are trademarks or registered trademarks of Alma Lasers, Ltd. Product specifications are subject to change without notice.

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trEatmEnt of thE YEar (BodY) soprano pain free hair removal (aBc lasers)

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SAVE THE DATE FOR THE AESTHETIC AWARDS 2013-14 - DECEMBER 7, 2013 AMBICARE HEALTH - HEALTHXCHANGE

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PEELING

ANTI-

CLEANSING

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Award winning teams join forces to bring you award winning products and services

Ambicare Health has joined forces with HealthXchange in the UK to promote the award winning Lustre Pure Light. The combination of Lustre Pure Light and Obagi skin care offers acne sufferers a clinically proven solution to acne that can be performed at home. This provides new hope to patients who have exhausted treatment options through conventional routes like the NHS. Ambicare Health Sales and Marketing Director, Gary Conroy says, “We are really looking forward to working in collaboration with HealthXchange to bring our customers the best products and latest technology available. The partnership offers patients suffering from acne a positive selection of products, unavailable on the NHS, to finally help them begin their journey to clear skin.” Karen Hill, Managing Director at Pharma-e Limited / HealthXchange says, “We are excited to be involved with Ambicare and Lustre Pure Light, this innovative use of technology appealed to us from the outset as it is simple but effective and matched our ethos of only providing quality products that deliver results.”

TONING

THE COSMEDIC COACH RESULTS

Cosmedic Coach Antonia publishes e-book

DRIVEN TREATMENTS

LATEST TECHNOLOGY

NATURAL PROCESS

Beauty writer and Cosmetic News contributor Antonia Mariconda has released a free e-book entitled The Hot 100. The 76 page book features 100 personally tried, tested and revised products. Antonia who is known as The Cosmedic Coach and has over 20,000 Twitter followers is constantly asked for her opinion on beauty products and treatments. She says, “I think the e-book is a fun, visually led, creative way of answering those questions that I am asked on a daily basis”. The book is available free by instant request from her website and has received great feedback from the 2,120 copies e-mailed to readers since it’s launch. Antonia adds, ‘It was fun writing my own e-book as I normally write these on behalf of clinics, aesthetic professionals and surgeons, an e-book is such a fantastic marketing avenue for your brand, expertise or service, and can lead people to your business and website with very little effort”.

MOLE DETECT PRO

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A new smartphone app has been launched for the UK market that can detect warning signs of skin cancer and offer its users a remote professional diagnosis within 24 hours. Mole Detect Pro securely stores photos of moles and uses an advanced algorithm to grade the likelihood of a potential melanoma, based on the ‘ABCDE method’ of detection. If you visit a dermatologist, they will often mention this acronym and ask you to track symptoms at home. It stands for: Asymmetry (irregular shape), Border (ragged, notched or blurred), Colour (more than one in a single mole) Diameter (larger than 6mm), Evolution (changing size, shape or colour). The new app, which has attracted the interest of leading UK dermatologist Dr John Ashworth, has been developed by the same US scientists behind the award-winning ‘Eye Netra’ instant smartphone eye test. A beta version, known as Mole Detective, has been available in the US for two years and already helped its users - including many health professionals - detect melanoma. The team behind Mole Detect are now working on a version of the app that will be capable of scanning for ‘Ugly Ducking’ moles from videos that users upload straight from their smartphones. These moles, that tend to be different in appearance to others surrounding them, are treated as the most suspicious by dermatologists. Dr Ashworth commented: “The technology behind this app is pretty impressive and the net result is that a lot more people with a potential problem will end up going on to seek a professional diagnosis. Skin cancer is one of the most prevalent forms of cancer in the UK, and tragically it often affects young adults. Self-detection is critical and potentially lifesaving. This tool facilitates that assessment through technology and encourages dermatology appointments so that more cases of melanoma can be detected early. It’s a fantastic step forward for consumers and for health workers alike.”



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• ABC www.almalasers.com Lasers -Equipment brand of the year for 3 years running or visit: 2013 Alma Lasers, Ltd. All rights reserved. Alma Lasers • ©Ltd., SopranoCosmetic News Award winning Treatment of the year from its logos and Soprano, are trademarks or registered trademarks of Alma Lasers, 2011, 2012, 2013Ltd. Product specifications are subject to change without notice. © 2013 Alma Lasers, Ltd. All rights reserved. Alma Lasers Ltd., its logos and Soprano, are trademarks or registered trademarks of Alma Lasers, Ltd. Product specifications are subject to change without notice.

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1/7/13 8:43 PM


INDUSTRY NEWS SPECIAL THE KEOGH REVIEW

WIND OF CHANGE After months of speculation, Sir Bruce Keogh and his expert panel have finally published their report into the aesthetics market. Here we report on the potentially industry-changing findings from this longawaited and ground-breaking review and ask what the implications are now going to be for our sector

It has been the most hotly anticipated thing to happen in the aesthetics industry in years and now finally the Keogh review has published its findings and outlined its recommendations for the future of the aesthetics market. The 67-page document could potentially have huge implications for the way medical aesthetics is practiced in the UK. The independent review into cosmetic interventions was published on April 24 and sets out how it would like to see the sector better regulated, practitioners better trained and people having proper redress if things go wrong. The industry has been waiting with baited breath to see what the outcome of the report would be, hoping that this may signal a wind of change in our unregulated sector. While many of the report’s suggestions for a way forward will be embraced by the industry there are others, such as a call for dermal fillers to be prescription only medicines, that will divide opinion. The key elements the review group feels would contribute to a successful and safe industry include: • Making all dermal fillers prescription only • Ensuring all practitioners are properly qualified for all the procedures they offer. This needs to include all people from cosmetic surgeons offering breast enlargement through to people offering injectables such as dermal 10 www.cosmeticnewsuk.com

fillers or Botox® An ombudsman to oversee all private health care including cosmetic procedures to assist those who have been treated poorly.

The review, led by NHS Medical Director, Professor Sir Bruce Keogh, was commissioned by the Government following the PIP breast implant scandal, which exposed significant lapses in product quality, after care and record keeping. It also drew attention to widespread use of misleading advertising, inappropriate marketing and unsafe practices across the sector. It has been looking at how to protect patients and tackle unsafe practices in an industry believed to be worth £2.3 billion a year. It has also looked at the products used for surgical and non-surgical procedures, the people who administer them, the way they are advertised and the advice and support patients and consumers are given. The committee was determined that the production of dermal fillers should fall under the same controls as other implants as this will ensure that only those fillers that have passed vigorous appraisals of safety will be available, and only those with appropriate skill will be able to administer them.

The Independent Healthcare Advisory Services (IHAS) has long called for regulation surrounding dermal fillers to be reviewed and tightened in the best interests of patients and will be taking this agenda forward at a seminar in May at the House of Lords hosted by Chairman of www. TreatmentsYouCanTrust.org.uk Baroness Trish Morris of Bolton, OBE DL. Key findings from this seminar will be submitted to the Department of Health for consideration. Reference to regulating lasers however was notably absent from the review’s recommendations, despite the potentially negative permanent effects they can have when administered by unqualified providers. Other key recommendations are: • Surgical providers should provide a record of implants and operations to both the person undergoing a procedure and their GP • A registry should be established for breast implants and other devices. This should alert the authorities to any signs of concerns at an early stage, and will provide critical intelligence in the event of product failure or recall • Obtaining consent should not be dismissed as a casual irrelevance, so that providers are obliged to ensure that people are aware of the implications and risks of procedure and that they have adequate time to consider this information before proceeding with surgery; • An advertising code of conduct should be developed and compliance should be mandatory for all practitioners; and • Insurance products should be developed to protect patients in the event of product failure, or provider insolvency.


Review chairman Professor Sir Bruce Keogh said, “At the heart of this report is the person who chooses to have a cosmetic procedure. We have heard terrible reports about people who have trusted a cosmetic practitioner to help them but, when things have gone wrong, they have been left high and dry with no help. These people have not had the safety net that those using the NHS have. This needs to change. “We would like to see everyone who chooses to have any cosmetic procedure better protected. We would like to see people who carry out procedures trained to a high standard. We would like the public to feel confident they are going to be well looked after and, if things go wrong, that they will be supported. And ultimately, if someone needs to step in on the side of patients, we think there should be an ombudsman to do that. “This isn’t just about the past and present, this

is about protecting people for years to come. We very much hope that our report will lead to a safer environment for patients and this industry in the future.” The review has assessed the current rules in England for: • Products or devices used in cosmetic interventions, e.g. breast implants or dermal fillers • Practitioners of cosmetic interventions, be they health professionals or non-health professionals • Providers, be they large providers or small high-street beauty clinics • Procedure that range from surgical operations to non-surgical treatments • Insurance and indemnity requirements • Patient information and consent • The advertising and marketing of cosmetic interventions

“At the heart of this report is the person who chooses to have a cosmetic procedure...These people have not had the safety net that those using the NHS have. This needs to change. Sir Bruce Keogh

INDUSTRY REACTION “BCAM is both pleased and relieved that the Review has put forward recommendations which are both sensible and proportionate in relation to cosmetic treatments. BCAM has long advocated the regulation of the use of dermal fillers in view of the potentially very serious complications which can arise from their use and we are delighted at the proposal that these products should become prescription only medicines. We also welcome the committee’s recommendations regarding requirements for verifiable training in the field of aesthetic medicine which is the central focus of the College” Dr Samantha Gammell, President BCAM “The British College of Aesthetic Medicine welcomes the Keogh Report and commends the authors for producing a thorough and proportional document. We look forward to working with the Department of Health over the coming months helping to implement the reports suggestions for the good of the medical /surgical aesthetic industry and patient safety.” Dr Mike Comins. Board Member and past President of BACD (now BCAM) “The successful implementation of the recommendations on non-surgical procedures to ensure patient safety relies on two things. First, to end bad practice, the new qualification for cosmetic injectables must be underpinned by medical knowledge to ensure these medical treatments are administered safely. Second, it is important that these recommendations are executed swiftly to stop patients falling through the net.” Sally Taber, director of the IHAS and responsible for managing www.TreatmentsYouCanTrust.org.uk “I am very embracing of the report because far too long there have been too many unregulated procedures that reflect badly on the whole cosmetic industry. The entire review is about putting the patient at the heart of cosmetic treatments. Every patient has the right to be protected by legislation that makes them feel confident that they will be well looked after and safe.” Dr Patrick Bowler “Allergan is supportive of the review into cosmetic interventions by the Department of Health in order to put additional safeguards in place for patients interested in these procedures. Many of the proposed changes are in line with our philosophy and should be adopted by all manufacturers entering the aesthetic market segment, particularly those making medical devices intended for cosmetic use”. Anthony Sauerman, General Legal Counsel for Allergan EAME “We are pleased that the recommendations by the Committee so closely reflect our own views and initiatives over the last decade championing greater transparency for the benefit of patient safety.” Rajiv Grover, BAAPS President “The recommendations outlined in Sir Bruce Keogh’s independent review are a step in the right direction for better regulation and ensuring practitioners are properly qualified to treat patients for both surgical and non-surgical procedures.” Mr Dalvi Humzah, consultant plastic surgeon at Plastic & Dermatological Surgery (PDS) “I have been in the cosmetic surgery business since the 1970’s and this is a turning point. All credible parties need to work together to keep up momentum to turn the recommendations into reality.” John Ryan chairman of MYA “A review of the cosmetic surgery industry is long overdue. I especially welcome the recommendation to establish a national implant register, as well as ensuring all those providing cosmetic interventions are properly registered to do so.” Dr JJ de Gorter, Spire Healthcare’s Group Medical Director

A full copy of the report is available at https://www.gov.uk/government/organisations/department-of-health www.cosmeticnewsuk.com 11


INDUSTRY NEWS SPECIAL AMWC

A meeting o f minds

Vicky Eldridge reports on the annual Anti-Ageing Medicine World Congress (AMWC) in Monte Carlo, Monaco

I

first went to the Anti-Ageing Medicine World Congress (AMWC) in Monte Carlo back in 2005 and over the years have noticed how the meeting has evolved to reflect the fact that aesthetics is becoming a more integral and internationally recognised part of anti-ageing medicine. Back then aesthetics was only a very small part of the event with only a few sessions dedicated to it on the progamme and with the only exhibitors representing the field being European distributors of products like mesotherapy guns. The 2013 event however told a very different story with a comprehensive scientific programme featuring big names from the cosmetic medicine industry from across the globe and with leading manufacturers and suppliers from the field dominating the exhibition halls, which have now spread to over three floors. The three-day event, now in its 11th year, is attended by thousands of aesthetic practitioners keen to find out about the latest European advances and to enjoy a few days on the French Riviera. Held at the Grimaldi Forum, the AWMC, focuses on aesthetic dermatology and surgery, anti-ageing, preventative medicine and medi-spa. This year, the Cosmetic News team did a fly in, fly out, visit for one day of the show. As well as catching up with some familiar faces from the UK world of aesthetics including Dr Bob Khanna, Dr Tapan Patel, Dr Patrick Treacy, Dr Sam Robson, Dr Linda Eve, Dr Martin Kinsella, Mr Chris Inglefield and the BACN ladies including Emma Davies, Lou Sommereux and Sharon Bennett, it was a fantastic chance to meet up with some of the UK teams from the key manufacturers and suppliers who were all out there supporting their brands. Fresh from the launch of its re-branding, Galderma had a big presence at the event, with its market leading brands Restylane and Emervel. The newest

12 www.cosmeticnewsuk.com

addition to the Galderma anaesthetic portfolio is the FDA approved topical local anesthetic cream, Pliaglis. The self-occluding cream is indicated for use on intact skin in adults to provide local analgesia for superficial aesthetic procedures, such as dermal filler injection, pulsed dye laser therapy, facial laser resurfacing and laser-assisted tattoo removal. For Allergan the AWMC marked two new launches: JUVEDÉRM® VOLIFT® with Lidocaine and a collaboration with Medispa Laboratories to create a post-treatment care pack for use following JUVÉDERM® VOLBELLA® with Lidocaine. The lip-specific care package includes a lip balm from Medispa’s Mediceutic range of cosmeceutical products, which can be applied following treatment with JUVÉDERM® VOLBELLA® with Lidocaine as well as a mirror and make-up bag. JUVÉDERM® VOLIFT® with Lidocaine is designed for facial contouring and the treatment of deep skin depressions such as nasolabial folds. It provides a new tailored treatment option estimated to deliver smooth, long-lasting results for up to 15 months. “For me, JUVÉDERM® VOLIFT® with Lidocaine provides a versatile treatment option for patients who are looking for a discreet, natural look with minimal swelling and long-lasting results,” says Dr Mauricio De Maio, Consultant Plastic Surgeon. “The smooth and easy injection allows for excellent control when contouring the face, providing even distribution under the skin for a natural look and feel. It also provides

outstanding impact for facial animation and natural expression – I have had very positive feedback from my patients already!” Syneron Candela also had a strong presence at the show holding a series of symposiums throughout the event. The company has just launched its GentleLaser No shades Barred Campaign. The new consumer awareness campaign is designed to educate consumers that GentleLaser hair removal is clinically proven for all skin types and hair colour. The website www.gentlelaserhairremoval. co.uk will have a clinic locator as well as FAQs and information for patients and physicians. The subject of this year’s press conference was ‘Fat: Friend or Enemy’. The media briefing involved presentations by some of the conferences keynote speakers including one of the pioneers of fat grafting Dr Sydney Coleman. Dr Coleman presented case studies showing how fat can be used as an effective dermal filler. He also spoke about the effect that grafted fat has on rejuvenating skin as well as filling because of the abundance of stem cells contained within it, citing the latest clinical research in this area. Stem cells was one of the hot topics of the conference and we had an interesting chat with Mr Chris Inglefield who was just back from a conference on the subject in the States and was enthused by the developments in this field and their potential impact on the future of aesthetics. Other things to watch were the new RollerJet multi-needle disposable syringe which enables you to carry out dermal rollering at the same time as placing dermal fillers into the skin. Dr Tapan Patel will be trialing out the kit and has promised to report back to us on the results!


N E W F OR LI PS AN D PE R I - OR AL AR E A

The only HA dermal lip filler using Allergan’s proprietary VYCROSS ™ technology. Designed for minimal swelling and a smooth, natural look that lasts.

®

WITH LIDOCAINE

Allergan’s newest innovation is designed for the lips and peri-oral area. It combines the soft and visibly smooth consistency of the JUVÉDERM® range with less swelling and up to 12 months’ duration in the lips with just a single treatment.1 Ask your local Allergan Representative for more information about JUVÉDERM® VOLBELLA® with Lidocaine today. Reference: 1. Eccleston D, Murphy D. Clinical, Cosmetic and Investigational Dermatology 2012:5 1–6. Allergan, Marlow International, 1st Floor, The Parkway Marlow, Buckinghamshire SL7 1YL, UK | January 2013 UK/1296/2012


CLINICAL - SKIN CANCER

GROWING CONCERNS

We look at the rise in skin cancer and the role aesthetic clinics have to play

A

esthetic practitioners are at the front line when it comes to seeing patients with ageing and sun damaged skin, so sun advice, mole checking and skin cancer are issues no aesthetic clinic can afford to ignore. Skin cancer incidence is on the rise in the UK with more than 100,000 people being newly diagnosed every year and more worryingly melanoma is rising faster than any other type of deadly cancer. Cancer Research UK reported that in 2010, there were 12,800 cases of melanoma diagnosed in the UK, making it the fifth most common cancer. One in four out of five cases, skin cancer is a preventable disease, however, despite this, many people are still guilty of taking risks in the sun and avoiding sun protection in order to get a tan. Sun exposure is a cumulative process and each exposure adds to, and builds on, the previous one, exasperating the damage. This can, in the worst case scenario, develop into skin cancer. Most people associate having a tan with being healthy but what a large majority still don’t realise is that a tan means that the skin has been damaged and is only making more melanin in order to protect itself. A survey carried out last year during the British Association of Dermatologists and La RochePosay Mole & Sun Advice Roadshow last year found that the majority of people (70%) still think they look healthier with a suntan and 92% had experienced sunburn, many, multiple times. Sunbeds can also increase the risk of developing other skin cancers in later life. In 2011, The Sunbed (Regulation) Act in England and Wales was passed into law, which banned businesses from allowing under-18s to use sunbeds; Scotland passed a similar law in 2008.

Types of skin cancer Skin cancer comprises both melanocytic and non-melanocytic lesions. By far the most

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prevalent form of skin cancer is basal cell carcinoma (BCC), which is present in the basal layer of the skin, a sub-layer of the epidermis. This type of cancer almost never spreads or metastasises to other parts of the body and is rarely fatal however treatment should still be sought. BCC most often occurs in sun-exposed areas in fair skinned people over 40, especially the head and neck, and is more common in men. One often-seen type of BCC is known as a rodent ulcer but there are several different types that vary in appearance. The other main type of non-melanoma skin cancer, squamous cell carcinoma (SCC), also arises in the epidermis and appears most often in sun-affected areas of the body. However, unlike BCC, it has the potential to spread and so can be much more harmful if left untreated. The most serious cancer, melanoma, is a cancer of the cells that produce melanin, the pigment that gives our skin its colour. It is the fastest rising common cancer and causes more than 2,000 deaths in the UK each year. Most cases are still curable if detected early, but if diagnosis is delayed allowing the cancer to spread outside the skin then the chances of surviving are greatly reduced. Risk factors for developing a melanoma include a close family history of the disease and the presence of numerous (more than 50) moles, or the presence of multiple dysplastic (atypical) moles.

Looking for signs Premature ageing of the skin is a clear sign of sun damage, and changes in the pigmentation of the skin or moles could be signs of skin cancer. With early diagnosis being so vital when it comes to skin cancer, aesthetic practitioners are in a unique position to screen, diagnose and refer. It is also vital that you can recongise skin cancer so that you are not incorrectly treating cancerous pigmented lesions as purely cosmetic ones.

The British Association of Dermatologists has developed the ‘ABCD-Easy mole check guide’ to help identify possible problems with moles: • A is for asymmetry, meaning that the two halves of the area may differ in shape and not match • B is for border, which may be irregular and the outside edges of the mole may be blurred • C is for colour, which may be uneven and patchy, with different shades of black, brown and pink • D is for diameter as most melanomas, but not all, are at least 6 mm in diameter, but any change of size should be checked • E is for expert – if you’re in doubt, get it checked.

The SPF factor Cosmetic practitioners are in an excellent position to promote skin cancer awareness by educating patients about the importance of sun protection and the link between photo-ageing and skin cancer. Sun protection is an essential tool in the aesthetic practitioners’ armamentarium. Not only is encouraging your clients to look after their skin in the sun one of the best things you can do to help them prevent premature ageing but sun protection is also a key part of post procedure skin care following many aesthetic treatments. But there is a far more important reason for wearing sun protection than preventing lines, wrinkles and pigmented skin: skin cancer. The most effective way to protect the skin from the sun’s rays is to take preventative measures such as wearing sunscreen as part of an everyday routine. Even in the colder winter months you should advise your clients to wear a broadspectrum sun protection (with a Sun Protection Factor (SPF) of at least 15) every day to protect their skin from both UVA and UVB rays which can both cause damage to the skin.


Skin types and sun protection There are six different skin types, with each one requiring a different level of sun protection. Here’s our guide to identifying them...

TYPE

I

Type I skin types have pale skin, coupled with blonde or red hair and freckles. They may burn very easily and rarely tan. They are at most at risk of developing skin cancer, so need to take particular care in the sun, seek shade, wear a minimum SPF of 30 and reapply their sunscreen frequently.

TYPE

IV

Type IV’s have brown eyes and dark hair, with skin that tans easily and only burns with very lengthy sun exposure. They are at moderate risk of skin cancer, so need to wear plenty of sunscreen and take breaks from the sun.

TYPE

II

People with light hair, blue or brown eyes and very fair skin are Type II. Their skin usually burns but may gradually tan. They are at high risk of developing skin cancer, so should avoid sunbathing and opt for minimum SPF 20 when out in the sunshine.

TYPE

V

Type V’s have naturally brown skin, with brown eyes and dark hair. They burn only with excessive exposure to the sun and their skin darkens easily. They are at a lower risk of skin cancer but should still take care to apply SPF to reduce their risk of skin cancer and accelerated ageing.

TYPE

III

Type III’s will burn after long exposure to the sun but generally tan quite easily. They probably have light olive skin with dark hair and brown or green eyes. They are at significant risk of skin cancer, so need to wear an SPF 15 and avoid lengthy spells in the sun.

TYPE

VI

Type VI’s have black skin with dark brown eyes and black hair. They burn only with extreme exposure to the sun and are at low risk of skin cancer, but should wear sunscreen to protect themselves from the ageing effects of the sun.

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CLINICAL - SUN DAMAGE

DAMAGE CONTROL Sun damage is by far the biggest cause of premature ageing. Here we examine the different types of sun damage related pigmentation

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bnormal skin pigmentation occurs when there is excess in melanin production, which forms deposits in the skin and can be caused by a variety of factors including hormones, genetics, medication, the ageing process, skin diseases such as acne and injuries to the skin, but by far the biggest cause is sun damage. There are many different types of abnormal

skin pigmentation known by various different names including hyperpigmentation, age spots, brown spots, post-inflammatory hyperpigmentation, solar lentigines and melasma. Sun damage related pigmentation can affect people of all skin types and ages and aesthetic practitioners and dermatologists are at the front line when it comes to its prevention and treatment. Exposure to the sun can cause patches of

pigmentation to form on the skin and can worsen existing pigmentation abnormalities such as freckles or melasma, which have been caused by other factors. This happens because melanin absorbs the energy of the sun’s harmful ultraviolet rays in order to protect he skin from overexposure. As such pigmentation is most common on areas of the face and body that have prolonged exposure to the sun such as the face, arms, hands and décolletage.

Types of pigmentation Age spots/liver spots/suns spots/solar lentigines Age spots or ‘liver’ spots are a common form of hyperpigmentation caused by sun damage, and are referred to by medical professionals as solar lentigines. They are usually found on the hands and face or other areas frequently exposed to the sun and will most likely increase with age. Age spots can vary in colour from brown to grey and black. They can also be very small or quite large and often appear in groups or clusters. They are more common on people with fair skin who don’t have as much natural protection from the sun. The reason they are known as age spots is due to the fact that the melanin accumulating in your skin over the years as you age can make you more susceptible to them but these pigmentation marks are not exclusively caused by ageing. Although they are also sometimes known as liver spots this has nothing to do with liver or anything that is associated with the function of the liver.

Freckles Freckles are small brown spots that can appear anywhere on the face and body. Freckles are an inherited characteristic and are most common on fair skinned people. Millions of people around the world have freckles and are less likely to seek cosmetic treatment for them than those who have other forms of pigmentation as they are often regarded as ‘a mark of beauty’. However people with freckles can be more susceptible to other forms of skin pigmentation, such as such spots, when exposed to the sun and the prevalence of freckles also increases with sun exposure.

Post-Inflammatory Pigmentation Post-inflammatory pigmentation is caused when the skin has been damaged or undergone some form of trauma. It is commonly found in people have had acne but can also be caused by sunburn, surgery.

Treatment options

Melasma/chloasma Melasma is the formation of irregular pigmented patches and is commonly found on the sun-exposed face in the period during or after pregnancy or in women who are on the contraceptive pill. It is thought to be caused by increasing levels of both oestrogen and progesterone, which stimulate melanocytes resulting in increased production of the normal tanning protective chemical..

Although skin pigmentation is in most cases harmless, many people seek treatment for cosmetic reasons. Wearing a broadspectrum sunscreen is the most important factor in preventing skin pigmentation however there are a wide variety of treatments for pigmentation including: •

Melasma or chloasma spots are similar in appearance to age spots but are larger areas of darkened skin. The condition is also known as ‘pregnancy mask’ because of its prominence in pregnant women and because of its appearance as ‘mask like’ patches on the face. Melasma is usually found on the cheeks, temples and forehead but can also be found on the body. Melasma is aggravated by exposure to the sun.

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• • • • •

Topical skincare and prescription products such as hydroquinone, tretinoin and Retin-A Chemical Peels Fractional Laser Skin Resurfacing Laser/IPL Resurfacing Laser/IPL Rejuvenation for Vascular and Pigmented Legions Dermal Rollering


PROTECT AND C O R R E C T

ADVERTORIAL - SKINCEUTICALS

When it comes to preventing and correcting sun damage, one cosmeceutical brand has consistently led the way with its superior range of results driven products offering a double defense in the fight against sun damage

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s pioneers in the cosmeceutical skincare market, SkinCeuticals has always been at the forefront when it comes to product development and innovation. Founded in 1997 by renowned American dermatologist Dr Sheldon Pinnell, with the formulation of the original, stabilised topical vitamin C serum and the conception of the patented Duke Parameters, its cutting edge products have become hugely popular with skin savvy aesthetic clinics and clients alike. Preventing and correcting sun damage is one of the mainstays of aesthetic practice and with its brand philosophy being: ‘Prevent’, ‘Correct’ and ‘Protect’, no other brands meets this need more than SkinCeuticals. Backed by clinical studies the range offers everything the aesthetic practitioner needs to help prevent skin damage, protect healthy skin from UVA/B rays and correct the appearance of existing sun damage.

PREVENT

CORRECT

UV rays, infrared radiation, pollution, and lifestyle factors generate damaging free radicals that prematurely age skin. SkinCeuticals antioxidants neutralise these unstable molecules, acting as a second line of defense against photo-damage and accelerated skin ageing. In addition to preventing free radical damage, SkinCeuticals antioxidants have been proven to improve the appearance of fine lines, wrinkles, laxity, and hyperpigmentation by neutralising free radicals and stimulating collagen production. In addition to these benefits, SkinCeuticals’ superior antioxidant formulations all conform to the strict Duke Parameters founded by Dr Pinnell (Pure L-Ascorbic acid, between 10 and 20% strength and formulated at a strict acidic pH level) and have advanced clinical trials supporting the effectiveness of the formulations, which in turn both guarantees their stability, penetration, and efficacy.

HERO PRODUCTS INCLUDE: • C E F ER ULI C C E Ferulic® is a revolutionary antioxidant combination that delivers advanced protection against photoageing by neutralising free radicals, boosting collagen synthesis, and providing unmatched antioxidant protection.

• PHLO R ET I N CF This broad-spectrum treatment provides advanced environmental protection to help protect skin against the reactive molecules (including free radicals) that are known to cause damage to the skin. In addition to its superior antioxidant capabilities, it has also been proven to help correct existing damage in the skin.

CLINICAL STUDY: Title: A Topical Antioxidant Solution Containing Vitamins C and E with Ferulic Acid Protects Human Skin from Sunlight Damage and DNA Mutations Associated with Skin Cancer Authors: Murray, J.C.; Burch, J.A.; Iannacchione, M.A.; and Pinnell, S.R. Results: Topical C E Ferulic provided substantial protection for human skin against solar simulator-induced oxidative skin damage, including erythema, sunburn cell formation and DNA mutations related to skin cancer. Disclaimer: This article was produced in its entirety by Cosmetic News.

SkinCeuticals corrective products combine active ingredients and advanced technologies to help correct the appearance of fine lines, wrinkles, hyperpigmentation, imperfections, and more, restoring a healthier and more youthful looking appearance.

HERO PRODUCTS INCLUDE: • P I G M E N T R E G U L ATOR Tested to be as effective as the leading prescription product for treating hyperpigmentation, the award-winning Pigment Regulator helps to lighten and reduce the appearance of existing hyperpigmentation, improving overall skin tone, and protecting skin from future discolouration. When combined with a 40% glycolic in-clinic treatment, the Pigment Balancing Peel, clinical studies also demonstrated a 67% reduction in hyperpigmentation over 84 days.

CLINICAL STUDY: Title: Evaluation of a Kojic Acid, Emblica Fruit Extract, and Glycolic Acid Skin Lightener as Compared to 4% Hydroquinone Authors: Zoe Draelos, Margarita Yatskayer, Pragya Bhushan, Sreekumar Pillai, Christian Oresajo Results: This novel skin-lightening preparation is a safe and effective alternative to 4% hydroquinone for subjects with mild to moderate facial dyschromia.

PROTECT SkinCeuticals complete range of broad-spectrum sunscreens help protect skin from UVA rays, in addition to providing the SPF necessary to prevent sunburn and damage caused by UVB radiation. However, research suggests that alone SPF’s only protect skin from up to 55% of the damage from the sun, however when combined with a topical antioxidant, the skin is offered up to 96% protection. With an option suitable for every skin type, and lifestyle, a SkinCeuticals daily sunscreen provides effective protection from the effects of UV rays.

HERO PRODUCTS INCLUDE: • NEW MINERAL RADIANCE UV DEFENSE SPF 50 This weightless fluid, with 100% mineral filters, provides high broad-spectrum UV protection, whilst the colour infused formulation enhances skin’s natural tone and boosts overall radiance. The first tinted formulation from SkinCeuticals is suitable for even sensitive or post-procedure skin

SkinCeuticals products are available in both Retail and Professional sizes. For more information on SkinCeutcials visit www.skinceuticals.co.uk, follow us on Twitter at @SkinCeuticalsUK or contact SkinBrands on 05603 141 956 to place an order. www.cosmeticnewsuk.com 17


CLINICAL - Q+A

Q&A

Mr Paul Banwell is one of the UK’s leading plastic surgeons and world-wide authority on skin cancer. He has a specialist interest in skin cancer and is the Head of the Melanoma and Skin Cancer Unit (MASCU) at the Queen Victoria Hospital. We chat to him about sun protection…

Cosmetic News: Is there such thing as a safe tan?

ity, discolouration and pre cancerous conditions such as solar keratosis as well as skin cancer.

Paul Banwell: No! A tan is a sign of trauma to the skin and shows that the body is attempting to increase its own sun protection after the skin has been damaged by an overdose of ultraviolet radiation.

CN: What is an SPF rating? PB: The Sun Protection Factor (SPF) gives an indication of the length of time it will take for UVB rays to redden your skin when you use a sun protection product compared to if the skin had no SPF on it. This SPF number gives an idea of how long you can stay in the sun without burning. An example would be that if you usually burn in 10 minutes without sun screen and you’ve applied SPF 15, you should be protected for 150 minutes. Always make sure to choose a broad spectrum sun screen as this will also offer Ultraviolet (UVA) protection.

CN: How much sunscreen should people apply to get the advertised protection? PB: A lot more than you think! To get the maximum protection from your sunscreen, apply at least one large handful about 30 minutes before you go outside to allow it to sink in properly. Also re-apply after swimming, towelling dry or any vigorous activity that causes heavy perspiration.

CN: What is the difference between UVA and UVB rays? PB: UV is a form of radiation emitted from the sun, and it is invisible to the naked eye. It is usually divided into three groups, A, B & C. UVA is linked to cell ageing and long term skin damage and is implicated in some skin cancers, but thought not to be as harmful as UVB. UVB causes sunburn and direct damage to our cell’s DNA and is thought to cause most types of skin cancer. UVC does not penetrate our atmosphere much and is low risk. Whilst short term exposure to UV causes sunburn and tanning, long term leads to loss of skin elastic-

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skin and sun, they are more effective than chemical filters at blocking UVA and UVB. Zinc Oxide also has anti-inflammatory healing properties.

CN: What is the difference between Chemical and Physical (Mineral) Sunscreens? PB: There are two main types of sun cream – chemical and mineral (which may also be known as physical). The main difference is that chemical suncare products contain UV filtering ingredients that take time to be absorbed by the skin – hence people using the 20 minute rule before sun exposure. By contrast, mineral sunscreens contain inert UV protective ingredients such as zinc oxide and form a protective barrier on top of the skin, and these have an immediate effect. What is more, some people who suffer allergies or sensitivities to chemical UV filters find that mineral SPFs do not irritate their skin. Zinc is also anti-inflammatory and does not block pores. The downside of mineral SPFs is that they used to be very thick and white but newer preparations are more ‘cosmetically elegant’ and become transparent when applied – they are even available in spray format too.

CN: What are the key advantages and disadvantages of both types of sunscreen?

PB: • Advantages of Chemical Sunscreens: Good protection from both UVA and UVB rays (not all sunscreens offer this, so do check). The most popular UVA and UVB filters include benzophenone, avobezone, parsol and cinnamates. • Disadvantages: The chemical filters parsol and cinnamates may not be good for sensitive skins, but the main irritant - the UVB-filtering ingredient PABA (para-aminobenzoic acid) - has been phased out of most sunscreens. • Advantages of Mineral Sunscreens: Zinc Oxide or Titanium based sunscreens contain excellent physical protection (they are not absorbed). They are also less sensitising than chemical. Some argue that in creating a barrier between

• Disadvantages: Often thicker and more occlusive than chemical sunscreens. This has long been their biggest drawback, but the newer mineral sunscreens are much more refined and cosmetically elegant. CN: Can chemical sunscreen cause cancer? PB: Not to my knowledge although some ingredients in chemical sunscreens may be carcinogenic. PABA has been withdrawn but this is an irritant as opposed a carcinogenic.

CN: What is the UV Index? PB: The UV index measures the amount of UV reaching the earth around midday, and is a relative scale from where 1 is low and 10 is extreme. It gives a more objective measure than ‘time to burn’.

CN: What else should we know about sun protection? PB: It is possible that the increased use of sun creams may give people a false sense of security which may encourage people to go into the sun more and, as a result, cause an increase in the risk of developing skin cancers. Sunscreens only partially protect your skin; therefore using sun cream does not mean that you can sunbathe for long periods without harm. Australia leads the way in sun protection with its ‘THINK ZINC’! campaign. Zinc oxide found in mineral sunscreens provides the best sun protection but, when applied, its appearance is white (as commonly seen with professional cricketers). This is not very ‘cosmetically elegant’ so scientists have recently patented revolutionary technology to make zinc oxide become transparent, which is more acceptable to consumers. Niacinamide serum is another exciting breakthrough and is now available to patients in the UK. Research has shown it has significant anti-skin cancer properties, as well as reducing skin damage and areas of pigmentation.


YOU, REVEALED new

THE NEXT GENERATION IN SKIN BRIGHTENING LYTERA™ features a patented blend of ingredients that work to brighten and even skin tone by reducing the appearance of dark spots and hyperpigmentation

INTRODUCING

For more information visit www.skinmedica.com/LYTERA

© 2013 SkinMedica, Inc. All rights reserved.

a ll the br a nds you need a ll the br a nds you need SkinBrands.co.uk SkinBrands.co.uk info@skinbrands.co.uk info@skinbrands.co.uk

+ 44 5603 141 956 + 44 5603 141 956


CLINICAL - SKIN CANCER/SUN DAMAGE SPECIAL

R I S I N G We find out why Heliocare has become the sun care range of choice for so many aesthetic practitioners

S U N

filters with antioxidant protection, DNA protection and repair and, with its ability to protect the Langerhan’s Cells, it helps to prevent the immunosuppression caused by UV exposure. A key ingredient in every product in the Heliocare® range is the unique, patented and natural Fernblock Photoimmunoprotection Technology. Fernblock® is extracted from Polypodium leucotomos, a fern originating inn Central America. Originally an aquatic plant, it adapted to life on land, developing its own natural protective mechanisms against UV radiation and has been used for centuries in the treatment of dermatological conditions. Fernblock® has been proven in extensive scientific and clinical studies published in peer review dermatology and scientific journals around the world to be a powerful and natural, skin-specific anti-oxidant and skin-protector and enhancer helping in the fight against UV damage.

S

un or photo-damaged skin is characterised by fine lines and wrinkles, a lack of elasticity and tightness, areas of pigmentation, blemishes and a duller complexion. At its worst it can have areas affected by solar keratosis and skin cancers. This damage is caused by ultraviolet radiation (UV) in the forms of UVA and UVB. In order to effectively protect our skin from the dangers of UV radiation we must first be aware of what those dangers are and what they mean for the overall health of our skin and the cells within it. UVA and UVB play different roles with regard to tanning, burning and skin ageing. This is due to the fact that they differ in their biological activity and the depth to which they penetrate the skin. UVB is probably the form of UV radiation that most people are aware of; only penetrating the upper epidermal layer of the skin UVB is more prevalent on sunny days or during the summer months. It is the form of UV that is responsible for burning the skin and regular overexposure can lead to the skin having a thicker, ‘leathery’ appearance. UVA is long wavelength making up 95% of UV radiation; it penetrates into the deeper layers of the skin and accelerates ageing by triggering free radicals. UVA rays are present during all daylight hours and throughout the winter months meaning the use of a high factor; broad spectrum SPF is critical even when the sun is not shining. UVA also penetrates cloud and glass, so, even when we think we are safe inside, or sitting in the shade we should still be applying a topical UV protection product on a daily basis. The Heliocare® Advanced UV Protection range provides, high or very high UVA and UVB protection with great skin loving, moisturizing gel formulations. Much more than simply a sun protection product, Heliocare® combines advanced UVA and UVB mineral and non-mineral

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To ensure the full SPF of a sun protection product is achieved it is crucial that enough is applied to the skin in the first place. The recommended amount, and the amount used when testing product efficacy, is 2mg/cm2 body surface area, which, in laymans terms, equates to a “golf ball” size of product per body. Studies show however, that most people only apply 1/4 - 1/2 of this amount meaning that the amount of SPF protection they are getting is reduced. A study(1) conducted in 2003 found that a product with an SPF of 50 when applied in the recommended quantity will provide the expected level of protection. If however the amount of product applied is reduced to 1.5mg/cm2 the level of protection reduces to SPF 18.8, less than half the expected level. Sometimes it can be hard for practitioners to convince their clients to use a UV protection product every day; many patients simply forget or stop use when their treatments are over or when the sun stops shining. Enabling patients to incorporate advanced and effective, anti-ageing and UV protection into their daily skincare routine has never been easier with the introduction of the Heliocare® Advanced Foundation and Cover Up Range. The Heliocare® Advanced SPF50 Gelcream Colours are available in both Brown and Light skin colour tones, they provide the Heliocare® high levels of skinprotection and a great to use skin-feel, with a skin tone enhancing bronzer ideal for masking uneven areas of skin tone and blemishes. If it’s a slight shimmer you need then the Heliocare® Advanced SPF50 Hydragel Sun Touch provides the Heliocare® high level broad spectrum UV skinprotection with a great to use skin feel, a touch of extra moisture and shimmer to the skin giving it an all year round sun-touched look without the risk of damage. 1. Pinnell SR. Cutaneous photodamage, oxidative stress, and topical antioxidant protection. J Am Acad Dermatol 2003; 48:1-19


Announcing the New Highgate Private Hospital for 2013. The Highgate Private Hospital has invested £13 million in an extensive redevelopment and expansion project, allowing one of the UK’s largest private hospital for cosmetic surgery to provide full operating and theatre facilities including HDU, minor operating suites and 14 state-ofthe art consulting rooms as we understand that many smaller cosmetic groups and clinics struggle to provide these added services as part of your offering. We can find you a clinical solution. As part of our investment we are delighted to announce the launch of the new Highgate Cosmetic Clinic which will include Cosmetic Surgery, Weight Management, Vascular Surgery, Non-Surgical Clinic and now VASER 2.0 which features improved technology that is excellent for fat transfer procedures as well as improved body sculpting efficiency.

£13 million redevelopment and expansion project.

• Established over 25 years, we are renowned as one of London’s leading • • cosmetic surgery centres but also offer everything you would expect • from a private hospital including outpatient clinics and treatment in most medical specialties, diagnostic imaging, physiotherapy and more. • We pride ourselves on our high standards of nursing care, friendly atmosphere and exceptional customer service.

Consulting Rooms: 6 to15 Bedrooms: 28 to 43 (all en-suite) Operating Theatres: 3 to 4 Phase 1 - High Dependency Unit Phase 2 - State of the Art Diagnostics Suite including: MRI, CT, Ultrasound scanners and X-Ray

Offer your patients more with Vaser® Lipo at Highgate Private Hospital Call us today to see how Highgate Private Hospital can enhance your patient offering.

www.highgatehospital.co.uk | Contact us: 020 8341 4182 or email: lee.huggon@highgatehospital.co.uk Highgate Private Hospital is part of Aspen Healthcare Ltd


CLINICAL - BOTULINUM TOXIN

Tears of a frown We have all seen individuals whose mood has changed positively following BTX-A injection in the brow area. Now there is growing evidence that treatment of the glabellar area may actually be used to treat depression. Dr Patrick Treacy looks at the current data to support this theory.

Dr Patrick Treacy Dr Patrick Treacy is Medical Director of Ailesbury Clinics Ltd and Ailesbury Hair Clinics Ltd. He is Chairman of the Irish Association of Cosmetic Doctors and is Irish Regional Representative of the British Association of Cosmetic Doctors. Dr Treacy is a renowned international guest speaker and features regularly on Irish breakfast television (TV3), RTE and as an expert panelist with the BBC World Service. He had a series on Discovery Health and the Discovery Channel (New York) recently filmed a programme about his work. He is an active member of many international medical societies and is a Fellow of The Royal Society of Medicine.

Depression affects over 120 million people globally, making it one of the leading causes of disability in the world. Although there are various effective treatments, therapeutic response remains unsatisfactory and depression can develop as a chronic condition in a considerable proportion of patients. Negative emotions, such as anger, fear, and sadness are prevalent in depression and also are associated with hyperactivity of the corrugator and procerus muscles in the glabellar region of the face. In 1872, Charles Darwin recognised these features as a very specific expression of sadness and attributed them to the activity of so-called ‘grief muscles’ in the glabellar region. He also formulated a new theory called the ‘facial feedback hypothesis’, which implied a mutual interaction between emotions and facial muscle activity. More recently, Larsen et al. have shown experimental evidence that voluntary contraction of facial muscles can channel emotions, which are conversely expressed by activation of these muscles. Heckmann and others (1992) have published data suggesting that treatment of the glabellar

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region with botulinum toxin produces a change in facial expression from angry, sad, and fearful to happy and this can impact on emotional experience. Many therapists, including Sommer (2003) have shown that patients who have been treated in the glabellar area reported an increase in emotional wellbeing and reduced levels of fear and sadness beyond what would be expected from the cosmetic benefit alone. Hennenlotter (2009) went one stage further and showed that botulinum toxin treatment to the glabellar area stopped the activation of limbic brain regions normally seen during voluntary contraction of the corrugator and procerus muscles. This indicated that feedback from the facial musculature in this region in some way modulated the processing of emotions. Many other researchers have continued down this road with Havas (2010) noting that the processing time for sentences with negative affective connotation was prolonged in women after glabellar botulinum toxin treatment and Neal and Chartrand (2011) speculating that the treatment interfered with the ability to decode the facial expression of other people. This is where things were until recently with many authors suggesting that this capacity to counteract negative emotions could be put to some


clinical use during the treatment of depression. There were some papers; including preliminary data from an open case series with ten female patients in the Journal of Derm. Surgery by Finzi and Wasserman (2006) that postulated that botulinum toxin in the glabellar actually demonstrated a reduction in the symptoms of depression. However a footnote by editor Alastair Carruthers stated that the report must be considered anecdotal as there were no appropriate methods of control utilized. In addition, there were other methodological weaknesses including limited follow-up, lack of randomization, the absence of blind evaluation, and especially the small number of individuals included. It was considered by many that the method evaluating depression should have been more rigorous. I noted by letter at the time that patients’ self-report of depressive symptoms by administration of the BDI-II introduced a significant self-report bias. This is of more concern because of the potential for secondary cosmetic gain. While the BDI-II is an accepted method of evaluating an individual’s level of symptoms over time, self-report in isolation was not considered an acceptable method of diagnosing depression. It was concluded that in order to ensure that patients’ psychiatric symptoms are accurately classified; a thorough psychiatric interview must be conducted. More recently, two centers, the Psychiatric University Hospital of the University of Basel, Switzerland and the Medical School Hannover, Germany conducted a randomised, placebo-controlled, double-blind trial. The authors hypothesised that facial psychomotor features associated with depression are not just epiphenomena but integral components of the disorder and may be targeted in its therapy. To explore, if attenuation of these features may produce alleviation in the affective symptoms, they conducted a randomized controlled trial of botulinum toxin injection to the glabellar region as an adjunctive treatment of major depression. The study was investigator-initiated and was carried out independently of any commercial entity. Participants in the study were recruited from local psychiatric outpatient units and psychiatrists in private practice. In order to avoid attracting candidates who were primarily motivated by receiving this treatment for cosmetic reasons, botulinum toxin treatment,

botulinum toxin injection to the glabellar region may be an effective, safe, and sustainable intervention in the treatment of depression. The reason for this has not yet been fully evaluated but we must consider the concept that the facial musculature not only expresses, but also regulates, mood states. was not explicitly mentioned. Exclusion criteria included psychotic symptoms, suicidal tendency and clinical severity requiring immediate intervention. The same injection scheme was applied in the open case series (Finzl and Wasserman, 2006). At each study visit participants were assessed using the Hamilton Depression Rating Scale with Atypical Depression Supplement (SIGH-ADS), the Beck Depression Inventory (BDI) selfrating questionnaire and the Clinical Global Impressions Scale (CGI). To conceal cosmetic changes from psychometric raters, participants wore an opaque surgical cap, which covered glabella and forehead during the examinations. The study concluded for the first time that a single botulinum treatment of the glabellar region with could reduce the symptoms of major depression. This effect developed within few weeks and persisted until the end of the sixteenweek follow-up period. The effect sizes in the study were large and the response and remission rates were high. It is still unknown how botulinum toxin actually reduces depression and it is postulated that several mechanisms may actually be involved: Because of the clinical data relating to botulinum toxin treatment on emotional perception, it is assumed that reduced proprioceptive feedback from the paralyzed facial muscles is a relevant mechanism of mood improvement. It is reasonable to assume an aesthetic benefit as the major cause of mood improvement, because the authors did not include patients who were cosmetically concerned about their frown lines. There is a small possibility of

either placebo effect or central pharmacological botulinum toxin effects including possible pharmacodynamics or pharmacokinetic interactions with the concomitant antidepressant therapy. In summary, there is growing evidence that botulinum toxin injection to the glabellar region may be an effective, safe, and sustainable intervention in the treatment of depression. The reason for this has not yet been fully evaluated but we must consider the concept that the facial musculature not only expresses, but also regulates, mood states. Because of the long treatment intervals it may also be an economic treatment option and the safety and tolerability record of botulinum toxin injections to the glabellar region is excellent. Further studies are required, including focus on muscles in lower sections of the face. It is possible that treatment of the depressor angularis oris and the mentalis muscles, for example, may also have mood-elevating effects and may enhance the clinical effect of the glabellar injection of botulinum toxin. Modulation of mood states with botulinum toxin may also be effective in the treatment of other clinical conditions involving negative emotions, like anxiety disorders. There also have been recent studies investigating the possibility of botulinum toxin for bipolar disorder and post-traumatic stress disorder. PTSD. There is a certain irony to the fact that soldiers returning from combat zones at risk of chemical warfare been treated for PTSD may be now treated with botulinum toxin. Even to the uninitiated, it would appear to have turned the full circle.

REFERENCES Facing depression with botulinum toxin: a randomized controlled trial. Journal of psychiatric research May 2012 Wollmer MA, de Boer C, Kalak N, Beck J, Götz T, Schmidt T, Hodzic M

www.cosmeticnewsuk.com 23


CLINICAL - VIEW ON

N O PA I N – NO GAIN Mike Murphy gives his View On laser and light based ‘pain free’ hair removal

R

ecently I have seen more and more hair removal systems claiming to be ‘pain-free’, particularly the homebased units. This always makes me wince! It clearly shows that the manufacturers/ suppliers do not understand how light energy destroys hair follicles. The bottom line is – no pain, no gain! It’s as simple as that. If your patient does not feel something then nothing will happen. The reason for this is due to simple biology. The dermis contains paintemperature nerves which register temperatures up to around 45°C. Beyond that they send pain signals to the brain to indicate excessive temperatures.

The zone of good results

TOO HOT TEMPERATURE

UNDER COOKED

ZONE OF GOOD RESULTS!

OVER COOKED

TOO COLD TIME

The mechanism behind hair removal is the irreversible denaturation of the follicle germ cells. If hair germ cells are exposed to a temperature of 45°C they will need to maintain that temperature around for 288 seconds (just under 5 minutes) to ensure complete denaturation of the proteins within. Only then will the hair follicle die permanently. The relationship is quite simple - successful tissue reactions occur when the temperature and time combination is right. In practice this means the longer the pulselength the lower the temperature required. For a 1ms pulse you need to achieve a temp of approx. 81°C, and for a 50ms you need approx. 69°C, to achieve irreversible protein denaturation. (These calculations assume a constant heating over the duration of the pulselength.) The temperature achieved within the tissues is dependent on the energy density and wavelengths used.

I often refer to the ‘zone of good results’ (see figure). This is the zone where the correct combination of temperature and time occur and, hence, good results should always occur. As an example, think about boiling eggs. We all know that to boil the perfect egg you need to cook it at a suitable temperature for a sufficient time. Cooking tissue is exactly the same – we want to achieve the permanent denaturation of the target’s proteins, without damaging the surrounding tissues. However, the problem is that patients generally want a pain-free treatment. This can result in many patients not returning for subsequent treatments. The answer to this problem is proper skin cooling during the treatment. The best way to achieve this is by contact surface cooling using a sapphire tip. Sapphire is four times more conductive than quartz (which many IPL system use). Proper contact cooling will draw out heat from the dermis and epidermis much more efficiently than air cooling or cold gel alone. As long as the sapphire tip is sufficiently cold, I suggest around 5°C, then the pain can be successfully mitigated while still achieving good results. Post-treatment cooling is also a good idea. It helps to sooth the patient’s skin and reduces erythema and oedema. The bottom line is, if your patient does not feel something during treatment by laser/IPL then they will most likely not achieve the desired result. The existing hair may fall out but a new one will grow in, over time. The follicle will remain viable. Sorry, but it really is a case of – no pain, no gain!

Mike Murphy is a physicist/bioengineer who has been involved in medical laser research since 1986 and in the commercial sector since 1989. His original research group developed the scar-free removal of tattoos by Q-switched ruby laser in Canniesburn Hospital, Glasgow. He now runs training courses on IPL systems and aesthetic lasers and their applications. www.dermalase.co.uk

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CLINICAL - DERMATOLOGY/SKIN ALLERGY

SCRATCHING THE SURFACE We publish the results of a report by La Roche-Posay and Allergy UK into the disturbing impact of skin allergy and sensitivity in the UK

I

n the UK, skin problems are the most common reason for GP consultations1. The incidence of allergic diseases has trebled in the last 20 years and is predicted to affect 50% of the population by 20152,3. In children, atopic eczema is the greatest cause and many adults also suffer from allergic or sensitive skin conditions. The skin is the largest organ of the body, whose functions include temperature regulation and the multi-factorial impact of skin disorders on the lives of sufferers and their families is rarely understood by others. This survey, carried out by Allergy UK in March 2013 has revealed that 78% of sufferers experience problem skin conditions all year round with 71% feeling uncomfortable as a result of their condition. It also highlights the fact that the psycho-social impact of people’s skin conditions appears to have as great an effect as the physical. Disturbingly, 34% stated that their skin condition had such an impact on their lives, that it has prevented them from going out socially. Allergy is a disease of the immune system, which affects the airways, skin and gut, often in those with close relatives who have allergic conditions. In infants, eczema is often the beginning of The Allergic March, so named by the medical profession because one allergic condition follows another in predisposed children, so eczema is sometimes linked to food allergy in infants and young children who later develop asthma and allergic rhinitis or hayfever. 6

8

8

Atopic Eczema is characterised by a faulty skin barrier and factor within the skin, allowing moisture to leak out and infection to readily enter the skin, rather like a brick wall with inadequate mortar between the bricks, causing the wall to crumble. It is intensely irritating,

promoting scratching and skin damage, resulting in inflamed, cracked, weeping skin, causing constant discomfort and intractable irritation, known as the itch-scratch cycle. This leads to disturbed or lack of sleep for sufferers and parents, poor concentration at school, work or when driving. Individuals with severe eczema have damaged, scarred skin, poor self-image and together with constant lethargy, means many will not socialise. Sufferers often have eye symptoms as the eye conjunctiva is part of the body’s constant skin surface. Allergic conjunctivitis can be unbearable and frequently associated with allergic rhinitis. In the most severe cases allergic eye disease can cause permanent eye damage. Symptoms of atopic eczema may be triggered by house dust mite, pets, moulds, pollen, certain foods or drugs. Other allergic skin conditions are also characterised by irritation. Urticaria is raised red areas called weals and angiodema is swelling deep within the skin. Urticaria and angioedema can accompany an acute severe allergic reaction (anaphylaxis) but may be a chronic complex allergic condition that may last for weeks or even months, needing specialist diagnosis and care. The report also highlighted that other skin conditions, which although not allergy related, can cause real concerns for many people. Sensitive or intolerant skin can be even more of a challenge as there is no absolute medical way to quantify ‘sensitive skin’, even though it is well recognised by dermatologists. Certain chemicals, perfumes and alcohol such as those found in skin care or laundry products for example, can cause reactions, even the texture of fabric used in some clothing is enough to cause irritation and soreness. Extremely dry skin, rosacea, acne and even irritant dermatitis caused

All year round 78% Winter (December - February) 16% Summer (June - August) 8% Spring (March - May) 8% Autumn (September - November) 6%

ANNUAL REACTION RESULTS The survey showed that a staggering 78% of respondents were reacting all year round, indicating that they are likely to be sensitised to several different allergens such as house dust mite, pets, moulds and pollens as well as many things coming into contact with their skin such as metals, plants, toiletries etc. A significant proportion (16%) stated they are more affected in the winter (which is probably due to the effect of harsh weather and central heating which exacerbates sensitive skin conditions). 78

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by over use of certain products such as detergents, all have to be added to the list of things that a person with sensitive skin might need to avoid. Allergy UK receives many distressing enquiries for help from people with eczema and other allergic or sensitive skin conditions. It seems for many, it can often be a challenge to obtain the right support to help effectively manage their conditions. Despite this and experience in caring for sufferers for many years, reading some of the effects on the lives of those who completed our survey was incredibly distressing.

HIGHLIGHTS FROM THE SURVEY This survey which involved 942 participants, carried out by Allergy UK in March 2013, has revealed that 78% of respondents reported skin symptoms all year round. Of those that responded to the question on how their skin condition made them feel, nearly half (45%) felt unattractive; 42% were embarrassed by their condition and 33% felt it affected their confidence levels. As highlighted above, 34% stated that their skin condition had such an impact on their lives, that it has prevented them from going out socially. A weighty 62% said their condition affected their lives from going out socially and day to day activities. Other points of concern raised included, getting undressed in public (including swimming or using public changing rooms); relationships being affected due to embarrassment; holidays avoided and distressingly, 3% of people have stopped themselves from having children for fear of passing on their condition. The face was the area most affected, 77% said that this was their main concern as it is always visible to others. 46% of the people said that they suffer daily with their symptoms. The survey also revealed that of the 71% of people sought advice from their GP, 29% of those were fortunate to obtain a diagnosis on their first visit. Over half were referred to either an allergy specialist or dermatologist for further investigations. The most common form of test used to diagnose contact allergy is patch testing. However the survey also revealed that that many sufferers did not seek advice from a health care professional as they believed that there was nothing that could be done to improve their skin condition. Because there are so many factors to take into consideration with skin allergies and sensitivities, over 65% of sufferers rely on resourced information to help diagnose their conditions or seek support, using websites and the advice of forums and chat-rooms to obtain their information. Finally, the survey showed that over half of respondents have used skin care products, which are specifically adapted for sensitive and allergic skin.


and effective management of their skin disorder.

allergy and sensitivity

SKIN SENSITIVITY Over half of the respondents (61%) stated that their skin conditions are inconvenient, 42% said that it made them miserable, and 18% said that it takes over their life.

PHYSICAL SYMPOTOMS

Classic Allergy Symptons

Rosacea/Acne

Skin allergy and sensitivity can affect than one it area of your body. pondents (61%) stated that their skin conditions are inconvenient, 42%more said that made The revealed that 78% said that the d 18% said that it takes over their life. symptom that affected them the most Redness 63.2% omfortable, and as a result I often feel exhausted. It makes everydaywas things much itching. By looking at the graph Red Patches 54.8% a very low tolerance for stress.” MrthatP it is divided into three we can see Small pimples/bumps 47.0% areas, the first four symptoms could Spots/Acne 19.7% dition makes me feel unhappy to wake up in the morning and look in the mirror.” indicate rosacea or acne, symptoms Cracked skin 38.5% Ms T listed from cracked skin to wheezing Scaly skin 29.9% Eczema are classic allergy and the last three 50.5% horizons and undermined my confidence. I resent always having to take my condition Itching typical of atopic eczema. Atopic 78.0% ust because I want to live a ‘normal’ life.” Mr C Flaking 37.8% eczema (also called atopic dermatitis) Swelling inflammation 37.7% is a group of diseases involving

erstanding

Hives/Urticaria

37.2%

inflammation of the skin with intense

Atopic Eczema

Skin dryness 61.7% itching, dryness, blistering asked if they felt that other people understood their skin condition, only 12%reddening, of Sensitive eyes 53.8% and scaling and usually there is a es’. Rhinitis (runny nose)

44.4%

Wheezing Other (please specify)

6.2% 0

20

40

60

80

26%

62%

100%

genetic link within families to other allergic conditions such as asthma and allergic nasal and eye symptoms.

27.2%

76%

TREATMENTS - THE ROLE OF TRIAL AND ERROR: In addition to prescription

12% 64%

treatments, there is a strong need from sufferers (56%) for skin care products which have been specifically 50% adapted for those with allergic or owed the lack of understanding surrounding skin allergies and sensitivities. This sensitive skin. Of those using a face 33% y and their friends. 31% cream specifically adapted for allergic 21% and sensitive skin (68%), 33% had 15% 12% 11% received a recommendation from a 9% 8% GP, dermatologist or allergy specialist. 0% However, it is clear from the comments on the survey that many people had used ‘trial and error’ to find out what would best suit their skin. 30% said that they have used the internet as a source of information in making their product choice. All other responses

Holistic therapy (e.g. aromatherapy, acupuncture)

Beauty treatments (e.g. facials)

Special diet

Dietary supplements

Treatment to clean nasal passages (e.g. nose douche)

Treatment to treat inflamed nasal passages (e.g. steroid nasal spray)

Prescription oral treatments (e.g. anti-histamine)

Thermal spring water

Cosmetic products adapted for skin allergies/sensitivities

Prescription topical treatments (e.g. Emollient Creams/Steroid creams…)

55%

CONCLUSION The responses from those who completed this survey reflect the daily situation of the lives of many thousands of people who contact Allergy UK, as well as many more who live with allergic and sensitive skin. Many believe that there is little help available for them and often feel let down by not only the lack of knowledge about allergy generally, but also the difficulties they can face achieving an appropriate diagnosis and effective management of their skin disorder. The physical and psycho social impact of these conditions has never been underestimated but this survey shows the extent to which they can affect people and underlines the very real need for on-going support and advice for sufferers and those that care for them.

The physical and psycho social impact of these conditions has never been und shows the extent to which they can affect people and underlines the very real and advice for sufferers and those that care for them.

Dr Stefanie Williams, MD Dermatolog Dermatologist “Skin allergies and intolerances are an extrem Dr Stefanie days. Sufferers often report a significantly red Williams said, severely itchy skin can be truly debilitating. A influence many aspects “Skin allergies and of a patient’s life from clothing, skincare, make-up, furniture, foods intolerances are an and work. social life, hobbies, school extremely common As allergic skin problems often affect the face problem these with reduced confidence and self-esteem. Fo hard toSufferers see their small children suffer, have s days. their skin until it bleeds. often report a Unfortunately many allergy sufferers significantly reduced qualityfeel ofthat life there and is little help available and from the survey that for 1 in 3 people who sought advice from their GP, it took severely itchy skin can be truly debilitating. what was causing the problem. Patients with skin allergies should see a derma experienced doctor dealing with skin problems. Dermatologists can arrange sp Allergy skin problems influence many as patch testing and initiate effective treatment. We see many patients with sk aspects of a patient’s life from having to dermatology clinic and correct diagnosis is key in successfully managing these important aspect isclothing, identifying and avoidingmake-up, the causative allergic trigger. Apar avoid certain skincare, of emollients is also vital. furniture, foods and pets to restrictions in Intermittently, skin might need anti inflammatory social life, the hobbies, school and work. prescription treatment. treatment and support approach, the life of allergy sufferers can be improved problem is often chronic in nature".

“As allergic skin problems often affect the face, patients may also suffer with reduced confidence and self-esteem. “I wonder how different my life would be without thinking about my skin ev For parents, it is particularly hard to see their small children suffer, have sleepless nights and scratch their skin until it bleeds. Unfortunately many allergy sufferers feel that there is little help available and I was shocked to find out from the survey that for 1 in 3 people who sought advice from their GP, it took 5 or more visits to find out what was causing the problem. Patients with skin allergies should see a dermatologist, the most experienced doctor dealing with skin problems. “Dermatologists can arrange specialist allergy testing such as patch testing and initiate effective treatment. We see many patients with skin allergies in our dermatology clinic and correct diagnosis is key in successfully managing these conditions. The most important aspect is identifying and avoiding the causative allergic trigger. Apart from that, daily application of emollients is also vital. “Intermittently, the skin might need anti inflammatory prescription treatment. With a comprehensive treatment and support approach, the life of allergy sufferers can be improved significantly, although the problem is often chronic in nature”.

[REFERENCES] 1 Skin conditions are the commonest new reason people present to general practitioners in England and Wales J.K. Schofield, JK., Fleming,D., Grindlay,D., Williams,H. British Journal of Dermatology Vol 165; 5, 1044–50, Nov 2011 2 Allergy and Allergic Diseases, Volume 1. edited by A. Barry Kay, Allen P. Kaplan, Jean Bousquet, Patrick G. Holt. 2009. Blackwell Pub. 3 A Breath of Fresh Air – Press Release; European Federation of Asthma and Allergy Associations. Nov 2011

www.cosmeticnewsuk.com 27


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We find out why the Syneron Candela portfolio offers he treatments of choice for leading Brazillan dermatologist Dr Ariel Haus

Leading Brazilian Dermatologist Dr Ariel Haus’ passion for skin and creating a youthful, flawless canvas means that he is constantly seeking the very latest nonsurgical, high-tech technology to deliver his patients long-lasting results. As well as being a medical advisor to La Roche-Posay and a spokesperson for Restylane, which includes involvement in trials for new products, Dr Haus works closely with global aesthetic leaders Syneron Candela (whose founder is the creator of IPL), and is the first London based dermatologist to take on their new face and body treatments. Dr Haus, comments, “Syneron Candela is worthy of their reputation for quality, safety, innovation and results, and as a dermatologist it is crucial that I offer superlative forward thinking treatments that deliver what they promise. I only use technology that is backed with reputable studies and trials, is proven to be safe and crucially only offer treatments that have the proper FDA and CE approvals. I’ve been concerned at the new at-home treatments that often do not have these approvals and yet are in the hands of untrained consumers”. For sun damage Dr Haus favours the Elos Plus, a new multi-platform work station that harnesses the elōs™ technology which uses combined energies

to effectively and gently restore and rejuvenate the appearance of the skin. Its combination of optical energy and bi-polar radio frequency has provided a revolutionary treatment for the most in-demand aesthetic applications. For treatment of sun damage, the SRA application on Elos Plus provides photo-rejuvenation. SRA safely and comfortably fades the appearance of the skin imperfections causes by the sun and uneven skin tones causes by brown and red spots. Treatment of the pigmentation is done in stages. First the pigmentation lesion is preheated with IPL. Then the pre-heated melanin which has lower impedance attracts Radio Frequency for further heating. Melanin is broken into small particles called melanazones, and melanin containing cells called melanocytes, are destroyed. The Sublime application offers tightening and lifting results through the stimulation of collagen production whilst the Sublative Rejuvenation treatment on Elos Plus treats the lines, wrinkles and brown spots through targets Radio Frequency energy precisely directed at the skin in the form of a matrix. Healthy skin around the dots accelerate the healing process of the skin and post treatment, new collagen and healthy skin cells are produced.

Sublime Collagen Creator Treatment:

Sublative Scar Treatment:

Sublative Rejuven-eyes Treatment:

Motif Pain-Free Hair Removal:

What? Pain-less deep dermal treatment for skin lifting, tightening and sculpting Targets: Deep folds, crepey skin, sagging jowls, loose skin on the lower face, neck and abdomen Technology: Bi-polar radio-frequency and infrared light Results: Short and long term. Boosts new collagen growth to promote skin firmness and to provide a lift effect. No. Treatments: Three to five treatments spaced three to four weeks apart The ‘Ouch’ Factor: Low Down Time: Zero

Targets: Mild to moderate lines and wrinkles, uneven skin tone and texture, sagging brow line Technology: Bi-polar radio-frequency that offers fractional skin resurfacing Results: Decrease in fine lines and wrinkles, a smoother more uniform skin surface with increased elasticity and collagen No. Treatments: Three treatments spaced four to six weeks apart Length of Time to see Results: Results develop over a two-month period The ‘Ouch’ Factor: Mid-high Down Time: Five to seven days. Skin redness, puffiness and formation of tiny scabs that by day five to seven will have

Targets: Face or body Technology: Bi-polar radio-frequency that offers fractional skin resurfacing Results: Smoother, improved texture and skin uniformity No. Treatments: From three to five treatments spaced four to six weeks apart Length of Time to see Results: Results develop over a two-month period The ‘Ouch’ Factor: Mid Down Time: Up to one week

What? Safe, predictable, proven, pain-free laser hair removal harnessing the latest technology Targets: Underarms, bikini line, legs, chest, back, chin and upper lip Technology: Laser diode light and radio -frequency Results: Long term hair removal No. Treatments: An average of six treatments spaced six weeks apart Length of Time to see Results: Hair growth begins to minimize after first treatment The ‘Ouch’ Factor: Low to Zero Down Time: Possible skin redness for a day or two depending on skin sensitivity

Triniti Face and Body Veins and Pigmentation Treatments: What? A laser designed to treat visible leg veins and spider veins on the face. Also treats brown spots and pigmentation on the face, hands and chest Technology: IPL plus radio-frequency Results: The heat from the treatment collapses the vessel walls and the body reabsorbs the damaged vessel resulting in diminished veins and pigmentation

30 www.cosmeticnewsuk.com

No. Treatments: An average of three to five treatments spaced three to four weeks apart Length of Time to see Results: Results can begin to be seen after just one treatment The ‘Ouch’ Factor: Mid Down Time: Possible skin redness for a day or two


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Radio Frequency Tri-polar Radio Frequency is the most advanced technology available for skin-tightening ensuring excellent results without the discomfort associated with mono or bi – polar devices.

Mesotherapy Non-invasive mesotherapy ensures that the active ingredients are delivered where they are needed most without the need for needles.

LED Full canopy LED ensures both rapid treatment time and excellent results are achieved. Available wavelengths Red (640nm - 700nm), Blue (425nm - 470nm), Yellow (590nm) and Green (520 - 564nm) ensures effective treatment for anti-ageing, pigmentation, acne and detoxification.

3D-skintech peels and clinical skincare A compact range of medical grade peels and cosmeceutical skincare products complete the Skintech’s unique offering and enables you to both use as a “stand-alone” service or combine with equipment protocols.

IT’S ALL YOU WILL EVER NEED…

For more information or a demonstration please call 01788 550 440

www.3d-skintech.com www.3d-lipo.com


INNOVATIONS

THE WRITING’S ON THE WAL We find out about the body-jet® water-jet assisted liposuction (WAL) procedure

body-jet®

Hu

Liposuction has long been one of the most popular cosmetic surgery treatments and advances in techniques and technology have seen less invasive procedures with fewer associated risks and downtime become the gold standard over traditional methods. One such treatment is body-jet®. The body-jet® system was developed by human med® and is distributed in the UK by Sigmacon. Launched in 2004 the body-jet® is a waterjet based infiltration, irrigation and aspiration system for removing undesired subcutaneous fat deposits and ecrine glands. A fundamental new approach to perform liposculpting, perspiratory gland removal and surgical treatment of lipoedemas, the body-jet® is the only device approved for water-jet assisted liposuction (WAL). WAL can be performed under general anaesthesia, sedation or local anaesthesia. However, WAL is tailored for – and most commonly practised under – local anaesthesia. Many surgeons prefer a mobile patient during the procedure in order to improve results and to eliminate risks associated with general anaesthesia.The low drug and pain level makes WAL the predestined method to go local.

There are three stages to the treatment:

WAL uses tumescent fluid, but not the tumescent technique. Whereas other liposuction methods (SAL, PAL, UAL, LAL) are based on the same principle – more or less large volume of tumescent liquid is pumped into the body to prepare tissue for fat removal – body-jet® uses the flushing power of water. The concept is that a slightly pressurised, fan-shaped laminar jet of water is enough to release undesired fat cells from its connective tissues while more fibrous structures (such as nerves and vessels) are spared. This eliminates extensive exposure of TLA solution to the body as WAL utilises TLA solution just as carrier for local analgesic and vasoconstriction, making high volume infiltration of TLA to prepare fat fragmentation (the basic principle of present tumescence methods) not necessary.The body-jet® system uses a sterile applicator system with integrated pressure pump (disposable); infiltration cannulas (resterilisable) and irrigation and aspiration cannulas (resterilisable). It comes with a cannula cleaning set, three litre disposable suction bag and reusable canister for suction bags.

Convenience

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1. Infiltration for local anesthesia use 20-30% of normal volume 2. Irrigation and aspiration 3. Drying

Fat harvesting for breast augmentation

also time-saving for practitioners as no centrifuging is required – the fat is harvested with approx. 25% liquidity and there is no extra time needed for collecting/processing the fat as it is done during liposuction automatically. Another advantage is that the sterility of the harvested fat is easily maintained as the container does not need to be opened – the fat is extracted through incoming socket – and the fully autoclavable system means disposable costs are minimal. Dr Klaus Ueberreiter, a plastic surgeon from Berlin, Germany explains, “For breast augmentation, at the very least you need approximately 500 ccs of fat. Harvesting and grafting fat with the traditional method of small syringes takes approximately five or six hours, or even longer.” By using the body-jet®, Dr Ueberreiter has been able to perform breast augmentation in about one hour by harvesting fat as a byproduct of standard liposuction. By featuring a two-cannula system, the body-jet® can irrigate and aspirate simultaneously. “A water beam is directed straight into the fatty tissue. It more or less washes out the fat in an emulsified state,” Dr. Ueberreiter explained. “You have good quality adipose tissue containing small fat cells ready for transplantation, without needing to centrifuge.”

Fat harvesting for breast augmentation has been much talked about but techniques have often been lacking, resulting in inconsistent and unpredictable results. The body-jet® is proving to be a useful tool in this area. Its superior, clinically proven fat harvesting method means that the fat is exposed to less mechanical stress as it is flushed out, not dissected. The cells are therefore exposed to less local anesthetics due to reduced infiltration and immediate separation. This results in a better re-injectable material as the ‘islands of adipocytes’ are smaller. The procedure is

A special system with an additional filter function allows for the sterile collection of fat. Hence, fat can be reinjected into the body without further preparation. Over the past 18 months, Dr Ueberreiter has performed close to 50 breast augmentation procedures with the body-jet®. “This is a safe and reliable method, the results are excellent and patients are very satisfied”, he says. The system is now being used in the NHS for high volume breast reconstruction after mastectomy.

Benefits of the treatment are: Safety • •

Patient is less exposed to TLA, operation risk is minimised Less tissue trauma, haematomas and bruising

Effectivity • •

• •

Precise real-time contouring (you see what you’ll get) Low correction rate

Less pain, physical and emotional stress to the patient Shorter procedure and recovery time (walk-inwalk-out)

This results in a reduction of procedure risk; improvement of aesthetic results; promotion of liposuction business and superior harvesting method for fat transfer


ESSENTIAL EVERYDAY PROTECTION FOR YOUR SKIN

CLINICALLY ADVANCED UV PROTECTION RANGE

PROTECT YOUR SKIN FROM UV AND AGEING DAMAGE WITH THE CLINICALLY PROVEN HELIOCARE ®

WITH UNIQUE

• High or very high level UVA and UVB protection with great skin-loving-gel formulations • Clinically and scientifically proven skin-specific anti-oxidant activity and dermal protection • Clinically proven anti-ageing protection from within with the Heliocare Oral Capsule supplements For Product and Scientific Information please contact AesthetiCare Tel: 0800 0195 322 email: info@aestheticare.co.uk

®

heliocare.aestheticare.co.uk FOLLOW US ON TWITTER

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PRODUCT FOCUS

NeXT G E N E R AT I O N We find out how the Asclepion NeXT diode laser from Carleton offers hair removal for all skin types

O

nly a few years ago the only type of laser that was effective and safe for hair removal on darker skin types, Fitzpatrick types IV-VI (Mediterranean, Asian, African), was the long pulse Nd:YAG laser (1064nm). This laser wavelength is safer on darker skins than most others as it does not react with the higher levels of melanin pigment in the skin surface. There are some excellent “YAG” lasers in the market but treatments tend to be rather slow, painful and uncomfortable. The cheaper and popular intense pulsed light (IPL) systems can also be uncomfortable and more dangerous on darker skin types. The market for hair removal on darker skins is huge and a great opportunity for clinics and Salons to offer a treatment which gives good results, client satisfaction and a very profitable income! Recent technological developments have led to the rise of the diode laser for hair removal, which in most cases is safe on all skin types. As always there are good, average and poor diode lasers available today. There is only one system available at the moment, which

34 www.cosmeticnewsuk.com

actually combines two laser diode wavelengths (810nm and 940nm) when performing hair removal. This is the NeXT diode laser from Asclepion. The dual wavelengths offer the perfect combination to target both the hair follicles and the blood supply to them. This laser also treats acne and offers skin

type V-VI, 50% have been of skin type IV and the rest have been skin type I-III”. So In total 65% of our clients have darker skin types.

tightening and vascular treatments. The Viva Light Beauty and Laser Clinic in Enfield purchased the new Asclepion NeXT diode laser for hair removal from Carleton Medical last year. This German made laser has three operating modes including a special “SmoothPulse” mode which offers the fastest hair removal treatment in today’s market at 12 shots per second with the extra benefits of working on all skin types and being virtually pain free! Mrs Nazan Damani, owner of the Clinic; “Our clients for laser hair removal are a diverse mix of skin types with the majority being of Mediterranean (Turkish) or Asian heritage. We really needed a diode laser with no consumable costs to offer the best service to our clients. The combination of safe, effective and pain free treatments is proving very successful and client feedback has been very positive. Looking at our whole client base for laser hair removal after nearly one year, about 15% have been of skin

first session. Treatment 2 was in “professional” mode and treatments 3-5 have been in “SmoothPulse” mode. The client started to notice results after treatment two and continues to see great results. She has experienced no adverse reactions and has said that the treatments were virtually pain free and very comfortable. One perhaps two more treatments will be required to complete the course of treatments.

CASE STUDY Female 26 years old of skin type VI (Caribbean origin) treating full bikini. Up to now she has had 5 laser treatments. Initially we started with the NeXT diode laser in “basic” mode for the

IN SUMMARY Clinics now have a great choice of hair removal laser and light technologies. When looking to buy a system for your business ask yourself what your clients of ALL skin types would expect from you: great results and pain free pleasant treatments! From a business point of view The NeXT laser is a winner for Viva Light. The laser has a two-year warranty and the diode is guaranteed for a massive 15 million pulses! There are no on-going consumable charges such as flashlamps (IPL). Also, the purchase price was a lot lower than similar, high profile, but lower specification, diode lasers!


T h e

f i n e s T

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p o w e r

d i o d e

T e c h n o l o g y

Asclepion neXT DioDe:

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asclepion neXT

• The world’s fasTesT hair removal diode laser@12 hz • pain free smoothpulse Mode • fda cleared for all sKin Types including black, asian and tanned skin • huge 14x10mm spot size • 15 million shots per handpiece • portable, lightweight at just 35kg • dual wavelength 810/940nm for hair removal, acne, rejuvenation and Vascular treatments • industry leading 2 year warranty • precision german engineering with expert sales, training and support

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810/940nm diode laser

carleton Medical formerly known as

Supply Chain

Contact us on: 01633 838081 www.carletonmedical.co.uk sales@carletonmedical.co.uk


PRODUCT TREATMENT SPOTLIGHT

ICE MACHINE We find out about the latest innovation from Alma Lasers – the Soprano ICE

at the Cosmetic News Expo in February, is the Soprano ICE, which further raises the bar.

THE SOPRANOS Soprano is Alma Lasers’ flagship laser hair removal system based on the company’s patented Super Hair Removal (SHR) technology – a clinically proven method of effective and virtually pain free hair removal.

The Soprano brand has become synonymous with cutting edge technology in the field of laser hair removal. Since 2006 when Alma Lasers unveiled its clinically proven SHR hair removal technology, the Soprano has become the industry’s gold standard in laser hair removal. Pioneers of fast, efficient and ‘pain free’ treatments for all skin colours, the brand has constantly evolved to meet the needs and demands of the rapidly expanding aesthetics market. It’s latest innovation, which was launched to the UK market by ABC Lasers

Its In-Motion technology gradually heats the dermis to a temperature that effectively damages the hair follicle to prevent re-growth while not injuring surrounding tissue. SHR combines high average power, low fluence and a high (10Hz) repetition rate gradually increasing the temperature of the hair follicle. By not exposing the epidermis to single high energy pulses SHR does not cause trauma to skin with high melanin count and is FDA approved to treat all skin types. The system is also indicated to treat all hair types and most hair colours. In multiple clinical studies conducted by leading dermatologists, Soprano has been proven as safer, equally or more effective and resulting in considerably less pain than other laser hair removal technologies. It is the only technology that can be used all year round on all hair and skin types.

COOL AS ICE The Soprano ICE is the next generation addition to the Soprano family. Soprano ICE cools the skin to -3°C with an encircled sapphire tip, combined with an auxiliary cold water pump, preventing 36 www.cosmeticnewsuk.com

burns on the skin surface while maintaining heat within the dermis. This high fluency delivery system provides an even more comfortable and faster treatment with improved results for light coloured and thin hair and all skin types, including tanned skins making it a year round treatment. When you are running a busy clinic with lots of different pieces of equipment being use, having a laser hair removal system that is operator friendly and easy to store and move offers many advantages. The Soprano ICE has a lighter and improved ergonomic design – the system is 50% lighter than its sister product and has a new, intuitive user-interface. One of the major advantages and business opportunities offered by the system though is its new handpiece specifically designed for treating smaller, more challenging and hard to reach areas such as eyebrows, nostrils and ears. This means your clinic can take laser hair removal beyond legs, backs, bikini lines and armpits and meet the wider needs of your patients with a safe, effective and clinically proven solution.


Imaginative.

Innovative.

A dermatology company

like no other.

Suppliers of quality products to Irish and UK medical and surgical professionals

double Aesthetic AwArds 2011/12 winner best product innovation Gold - Pix’L Micro Canula (Q-Med) best newcomer Gold - Emervel (Galderma)

AU5234 Azzalure A4 ad_Layout 1 06/06/2011 14:06 Page 1

Azzalure® Abbreviated Prescribing Information Presentation: Botulinum toxin type A (Clostridium botulinum toxin A haemagglutinin complex) 10 Speywood units/0.05ml of reconstituted solution (powder for solution for injection). Indications: Temporary improvement in appearance of moderate to severe glabellar lines seen at frown, in adult patients under 65 years, when severity of these lines has an important psychological impact on the patient. Dosage & Administration: Botulinum toxin units are different depending on the medicinal products. Speywood units are specific to this preparation and are not interchangeable with other botulinum toxins. Reconstitute prior to injection. Intramuscular injections should be performed at right angles to the skin using a sterile 29-30 gauge needle. Recommended dose is 50 Speywood units (0.25 ml of reconstituted solution) divided equally into 5 injection sites,: 2 injections into each corrugator muscle and one into the procerus muscle near the nasofrontal angle. (See summary of product characteristics for full technique). Treatment interval should not be more frequent than every three months. Not recommended for use in individuals under 18 years of age. Contraindications: In individuals with hypersensitivity to botulinum toxin A or to any of the excipients. In the presence of infection at the proposed injection sites, myasthenia gravis, Eaton Lambert Syndrome or Amyotrophic lateral sclerosis. Special warnings and precautions for use: Use with caution in patients with a risk of, or clinical evidence of, marked defective neuro-muscular transmission, in the presence of inflammation at the proposed injection site(s) or when the targeted muscle shows excessive weakness or atrophy. Patients treated with therapeutic doses may experience exaggerated muscle weakness. Not recommended in patients with history of dysphagia, aspiration or with prolonged bleeding time. Seek immediate medical care if swallowing, speech or respiratory difficulties arise. Facial asymmetry, ptosis, excessive dermatochalasis, scarring and any alterations to facial anatomy, as a result of previous surgical interventions should be taken into consideration prior to injection. Injections at more frequent intervals/higher doses can increase the risk of antibody formation. Avoid administering different botulinum neurotoxins during the course of treatment with Azzalure. To be used for one single patient treatment only during a single session. Interactions: Concomitant treatment with aminoglycosides or other agents interfering with neuromuscular transmission (e.g. curare-like agents) may potentiate effect of botulinum toxin. Pregnancy & Lactation: Not to be used during pregnancy or lactation. Side Effects: Most frequently occurring related reactions are headache and injection site reactions. Generally treatment/injection technique related reactions occur within first week following injection and are transient and of mild to moderate severity and reversible. Very Common (≥ 1/10): Headache, Injection site reactions (e.g. erythema, oedema, irritation, rash, pruritus, paraesthesia, pain, discomfort, stinging and bruising). Common (≥ 1/100 to < 1/10): Facial paresis (predominantly describes brow paresis), Asthenopia, Ptosis, Eyelid oedema, Lacrimation increase, Dry eye, Muscle twitching (twitching of muscles around the eyes). Uncommon (≥ 1/1,000 to <1/100): Dizziness, Visual disturbances, Vision blurred, Diplopia, Pruritus, Rash, Hypersensitivity. Rare (≥ 1/10,000 to < 1/1,000): Eye movement disorder, Urticaria. Adverse effects resulting from distribution of the effects of the toxin to sites remote from the site of injection have been very rarely reported with botulinum toxin (excessive muscle weakness, dysphagia, aspiration pneumonia with fatal outcome in some cases). Packaging Quantities & Cost: UK 1 Vial Pack (1 x 125u) £64.00 (RRP), 2 Vial Pack (2 x 125u) £128.00 (RRP) IRE 2 Vial Pack (2 x 125u) €187.05 (RRP). Marketing Authorisation Number: PL 06958/0031 (UK), PA 1609/001/001(IRE). Legal Category: POM. Full Prescribing Information is Available From: Galderma (UK) Limited, Meridien House, 69-71 Clarendon Road, Watford, Herts. WD17 1DS, UK. Tel: +44 (0) 1923 208950 Fax: +44 (0) 1923 208998. Date of Revision: January 2011.

The passage of time

Quality service - Quality products

John Bannon Ltd supply quality products to the Irish and UK medical and surgical professions.

Innovative medical solutions that meet the needs of dermatology We patients and physicians: • P remier investor in dermatology research • S tate-of-the-art global research and development

Galderma (UK) Limited, Meridien House, 69-71 Clarendon Road, Watford, Herts, WD17 1DS. Tel: +44 (0)1923 208950 Fax: +44 (0)1923 208998. Copyright © 2011 Galderma (UK) Ltd. Date of preparation: March 2011

• F ocus on therapeutic, corrective and aesthetic innovations

The secret to reveal beauty are your one stop shop for all your aesthetic needs and requirements. Azzalure is a Botulinum Contact us now toAopen anuse.account and Toxin Type for aesthetic avail of our fantastic offers and discuss how we can help your business grow.

Adverse events should be reported. Reporting forms and information can be found at www.yellowcard.gov.uk. Adverse events should also be reported to Galderma (UK) Ltd.

Azzalure® is indicated for the temporary improvement in the appearance of moderate to severe glabellar lines seen at frown, in adult patients under 65 years, when the severity of these lines has an important psychological impact on the patient.

®

• Fast onset of action (median time to onset 2-3 days)1 • Long duration of action (up to 5 months)1

• High level of patient satisfaction (93% after 6 months, following one treatment session)2

References 1. Azzalure® Summary of Product Characteristics. 2. Ascher B et al. J Am Acad Dermatol 2004; 51: 223-33. Azzalure® is a registered trademark of Galderma.

an aesthetic choice

Date of preparation: February 2011 AZZ/510/0211

GEN/522/0311

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06/12/2011 10:38

VAT FREE to UK customers John Bannon; Service to Surgery tel; 00353(01) 6789766 e; info@johnbannon.ie, www.johnbannon.ie Follow us on:


PRODUCT NEWS I-LIPOXCELL

SILDERM

Chromogenex launch i-lipoXcell

New Study Shows Sunscreen Plus Anti-Ageing Cosmetic Celfix DNA™ Youth Recovery™ Facial Serum Provide Significant Benefits to the Skin

Chromogenex has introduced its third generation technology for the reduction of fat - i-LipoXcell. i-LipoXcell is FDA cleared for circumferential reduction and improvement in cellulite and incorporates four technologies for intelligent body fat analysis and measurement, laser diode fat reduction, IR Vacuum massage and radio-frequency skin tightening. i-LipoXcell is clinically proven, safe and treatment is comfortable, backed by leading physicians in worldwide multi-center studies. i-Lipo incorporates patented technology to instantly measure body fat and provide detailed analysis including Basal Metabolic rate, body fat percentage and records in a patient data base reduction in body fat and overall improvement in patient health. Results can be printed out to show the positive results of incorporating i-Lipo laser into a lifestyle changing programme. Dr. J.P.Laura, Newport Beach, CA said, “i-Lipo is a true practice builder. It really works.” Steve Shapiro MD co-director of Gardens Dermatology and associate professor, at the University of Miami added, “I have been in practice for 20 years and have seen many different new technologies. The i-Lipo has been a “wow” in terms of results and no risk with high benefit.” Chromogenex will be holding a launch for i-LipoXcell on June 24, 2013 at The Royal Society of Medicine from 6-8pm.

SKINCEUTICALS

SkinCeuticals launches new SPF SkinCeuticals has launched a new sun protection product - Mineral Radiance UV Defense SPF50. The product contains a universal tint which works on all skin colours. It adds radiance to the skin tone and diminishes any white colouring of the skin that mineral sunscreens can sometimes leave. It is also ideal post-procedure for those who do not want to wear any make up after a treatment, but need to protect their skin and want something to improve its tone. It contains 100% mineral filters and offers high broad-spectrum UV protection. It also contains no parabens and is suitable for sensitive skin.

38 www.cosmeticnewsuk.com

A new study has revealled that cosmetic enzymes can help delay future signs of ageing. The March 2013 edition of the Journal of Drugs and Dermatology published renowned US Dermatologist James Spencer, MD, on the effects of sunscreen plus SilDerm-Celfix DNA™ Youth Recovery™ Facial Serum. The study tested Celfix DNA™ on the arms of 19 patients, followed by a sunscreen twice a day for eight weeks. The results were groundbreaking, showing that Celfix DNA™ plus sunscreen are not only addressing damage caused by the sun, but also helping to delay future signs of ageing skin. “This research makes a strong argument for daily use of Celfix DNA™ and sunscreen for patients who want to delay the signs of ageing.” The results of the study showed the following reduction in biomarkers of skin ageing: • A decrease in pyrimidine dimers, in 18 out of 19 patients, for an average reduction of 53% • A decrease in p53 alteration, in 18 out of 19 patients, for an average reduction of 36% • A 73.7% reduction in the appearance of pigmentation (brown spots) and 63.2% in redness (erythema) as measured by a colorimeter device. When it comes to anti-agieng, according to Dr Spencer, “This research makes a strong argument for daily use of Celfix DNA™ and sunscreen for patients who want to delay the signs of aging.” An earlier clinical study on Photolyase, a key component of Celfix DNA™ Youth Recovery™ Facial Serum by renowned Italian dermatologist, Dr. Enzo Berardesca, MD, showed that sunscreen alone is not enough to protect your skin. Dr. Berardesca’s study tested the effects of applying an SPF alone versus SPF coupled with a naturally occurring enzyme, Photolyase, on the lower back. There was a major reduction in the appearance of the signs of ageing cause by ultraviolet radiation (measured by level of pyrimidine dimers) — almost as if skin was never exposed in the first place – when combining SPF with the enzyme vs. sunscreen alone. Celfix DNA™ Youth Recovery™ Facial Serum is a powerful, lightweight cosmetically elegant serum that helps fight future signs of ageing. It is the only product that features Celzyme Technology™. Celfix DNA™ contains Photolyase, endonuclease, and OGG1 enzymes that help address the signs of skin ageing. Celfix is also packed with antioxidants to defend against ageing free radicals, and hyaluronic acid to boost hydration. The light, non-greasy formula is ideal for all skin types, making it the perfect addition to anyone’s daily cosmetic routine.


3D-LIPO

BIOACTIVE BEAUTY

CAN Associates Limited Win 3D-lipo PR Account

New tinted SPF from HydroPeptide

CAN Associates Limited has won the PR account of 3D-lipo and will now be managing all press for the aesthetic machine and brand. 3D-lipo is one of the most advanced machines of its kind offering a powerful new dimension in non-surgical fat removal, treatment of cellulite and skin tightening for both face and body. The 3D brand is a culmination of 20 years’ worth of experience developing result driven devices for the beauty and aesthetic industry. Unlike other lipo offerings that utilize diode laser, the 3D-lipo technology, Cavitation + Cryolipolysis, physically destroys the fat cell. Managing director of CAN Associates Limited, Claire Powell, said, ‘The CAN PR team and I are absolutely thrilled to be working with 3D-lipo – this award-winning brand has seen many successes throughout 2012/2013 and we cannot wait to take them to new heights in the National media this year. It is an incredibly advanced machine in the health and beauty / aesthetic world and crucially is innovative and different to what’s already on the market – we cannot wait to get to work on the PR for this award winning brand.’ Managing Director of 3D-lipo, Roydon Cowley, continued, “After what has been an incredibly successful and award winning year for 3D-lipo I am delighted to announce our collaboration and partnership with CAN Associates Limited. The CAN PR team have been responsible for the success of many great brands and we are looking forward to seeing what fantastic results they can achieve for us. 2013 is set to be the biggest year yet for 3D-lipo so watch this space.”

BioActive Beauty has launched HydroPeptide SPF 30 Anti-Wrinkle Skin Enhancing UV Protection. Offering a broad spectrum protection from UVA/UVB rays and physical blockers Titanium Dioxide and Zinc Oxide, this revolutionary sunscreen contains Self Adjusting Spheres which blend perfectly to the color of your own skin tone– similarly to a tinted bronzer— enhancing your complexion and offering smooth, flawless coverage. Acai berry ,Green Tea, Medicinal Galanga and Aloe offer a rich blend of anti-inflammatories and powerful Antioxidant protection, shielding the skin from wrinkle forming free radicals. This sunscreen offers a lightweight feel and helps maintain a clearer complexion. SPF 30 also contains Calendula (wound healer), Cucumber (calming and Hydrating), and Chamomile (wound healer/calming) HydroPeptide® products are Paraben free. Phthalate free. Formulated for all skin types.

FLABÉLOS

Feeling FLABéLOS Anyone who attended the Cosmetic News Expo in February will have seen visitors testing out the FLABéLOS vibration plates on the Sasaki International stand. Now registered as a Class 2A Medical Device CE FLABéLOS is the only body vibration machine on the market to be registered for use by healthcare providers and patients. The FLABéLOS machine provides a whole body workout for fat burning and weight loss, in as little as 10 minutes. The alternating tilting movement of the platform works continuously through a sequence of vibration levels to tighten and tone key areas of the body including the stomach, thighs, arms and buttocks. FLABéLOS employs a ‘pivotal’ system that oscillates just like the action of a seesaw. This sends out a fast sequence of vibrations specifically designed to trigger and stimulate muscle walls. The vibrations induce over 10,000 muscle contractions. The more muscle a person has, the faster they burn calories. In a clinical study, FLABéLOS was trialled on people with Neuromuscular Conditions. The device showed a direct decrease in pain perception by the majority of the 98 candidates involved in the research. Additionally, a study presented at the European Congress on Obesity found that overweight or obese people who regularly used vibration technology in combination with a calorie restricted diet, were more successful at long-term weight loss and shedding the fat around their abdominal organs than those who combined dieting with a more conventional fitness routine.


EVENTS

THE AESTHETIC AWARDS 2013-14

OP ENI N G TI ME It’s finally here! The online entry form for the Aesthetic Awards 2013-2014 has now gone live – so here’s a run down of what you have to do to enter or nominate your favourite companies, people and brands

It may not be time to start dusting off your glad rags just yet, but it is time to start thinking about your entries and nominations for this year’s Aesthetic Awards. The Aesthetic Awards is the premier awards event for the aesthetics industry and will once again be celebrating the achievements of the practitioners, clinics, products and treatments that represent the gold standard in cosmetic medicine. Entering the awards is a fantastic chance to celebrate the successes and achievements of your business. Being a shortlisted finalist or winner in the awards is a fantastic marketing tool, enabling you to show your clients that you stand out from the crowd and have gone that extra mile. If you are proud of what you do or know someone you think deserves recognition then make sure you enter! Now in its third year, the glamorous Winter Wonderland themed event will take place on Saturday December 7, 2013, at a venue to be confirmed.

Online entry has now opened and will remain open until August 1, 2013. This gives you three months to make sure you get all your entries and nominations in so you can be a part of the industry’s only trade awards event. This year’s Awards will see a total of 31 awards categories including three new categories: Training Provider of the Year, Training Course of the Year and Hospital Group of the Year. The categories for the 2013-2014 Aesthetic Awards are…

AWARDS FOR MANUFACTURERS AND SUPPLIERS BEST PRODUCT INNOVATION Who is this award for? This award is designed to recognise the most innovative new products on the market. Products should have been launched into the UK market in 12 months before the 2013 awards entries opened (May 2012-2013). Who can enter/nominate? Manufacturers, suppliers and distributors can nominate/enter their own products in this category. Clinics and practitioners can also nominate their favourite products in this category. How will the winner be decided? The winning product in this category will be decided based on the number of votes it receives and feedback from the judges.

BEST NEWCOMER (PRODUCT OR TREATMENT) Who is this award for? This award is designed to recognise the newest products and treatments on the market. Products/treatments should have been launched into the UK market in the 12 months before the 2013 awards entries opened (May 2012 -May 2013). Who can enter/nominate? Manufacturers, suppliers and distributors can nominate/enter their own products/treatments in this category. Clinics and practitioners can also nominate their 40 www.cosmeticnewsuk.com

favourite products and treatments in this category. How will the winner be decided? The winning product/treatment in this category will be decided based on the number of votes it receives and feedback from the judges.

COSMECEUTICAL OF THE YEAR This award will go to the best cosmeceutical product range in the UK. This can be any professional use product range that is retailed in UK medical aesthetics clinics. Who can enter/nominate? Manufacturers, suppliers and distributors can nominate/enter their own product ranges in this category. Clinics and practitioners can also nominate their favourite cosmecuetical product ranges in this category. How will the winner be decided? The winning cosmeceutical product range in this category will be decided based on the number of votes it receives and feedback from the judges.

INJECTABLE PRODUCT OF THE YEAR This award will go to the manufacturer/UK distributor of the injectable product – this includes dermal fillers and botlulinum toxin - that is deemed to be the best available in the UK. Who can enter/nominate? Manufacturers/

distributors can nominate/enter their own injectable products in this category. Clinics and practitioners can also nominate their favourite injectable product in this category. How will the winner be decided? The winning injectable product in this category will be decided based on the number of votes it receives and feedback from the judges.

TREATMENT OF THE YEAR (FACE) This award will be given to the manufacturer/ supplier with the best medical aesthetic treatment for the face. This can be anything from peels to laser or dermal rollering. Who can enter/nominate? Manufacturers/ suppliers can nominate/enter their own facial treatments in this category. Clinics and practitioners can also nominate their favourite facial treatments in this category. How will the winner be decided? The winning facial treatment in this category will be decided based on the number of votes it receives and feedback from the judges.

TREATMENT OF THE YEAR (BODY) This award will be given to the manufacturer/ supplier with the best medical aesthetic


treatment for the body. This can be anything from peels to laser or dermal rollering. Who can enter/nominate? Manufacturers/ suppliers can nominate/enter their own body treatments in this category. Clinics and practitioners can also nominate their favourite body treatments in this category. How will the winner be decided? The winning body treatment in this category will be decided based on the number of votes it receives and feedback from the judges.

BEST SELLING RETAIL PRODUCT This award will be given to the manufacturer/ distributor of the best selling retail product that is currently sold in medical aesthetic clinics in he UK. Who can enter/nominate? Manufacturers/ distributors can nominate/enter their best selling products in this category. Individual products should be entered, separately, not as a range (for this enter Cosmeceutcial of the Year). Clinics and practitioners can also nominate the products that are the best sellers in their clinics. How will the winner be decided? The winning product in this category will be decided based on the number of votes it receives and feedback from the judges.

EQUIPMENT BRAND OF THE YEAR The winner of this award will be the manufacturer or UK distributor of what is deemed to be the best equipment brand available in the UK today. This award is not limited to lasers but any supplier of equipment used in the medical aesthetics environment. This award is for the brand as a whole. Individual products/treatments can be entered into other categories such as Treatment of the Year, Best Newcomer or Best Product Innovation. Who can enter/nominate? Manufacturers/ distributors can nominate/enter their equipment brands in this. Clinics and practitioners can also nominate the manufacturers/suppliers that they feel offer the best equipment to meet their needs. How will the winner be decided? The winning equipment brand in this category will be decided based on the number of votes it receives and feedback from the judges.

BEST WEIGHT LOSS/DIET PROGRAMME A new category introduced at the 2012/2013 awards, this award is designed to acknowledge the new and emerging area of in-clinic weight loss and diet programmes. Who can enter/nominate? Manufacturers/ distributors can nominate/enter their weight loss and diet programmes in this category. Clinics and practitioners can also nominate the weight loss/diet programme that they feel is most deserving of this award.

How will the winner be decided? The winning weight loss/diet programme in this category will be decided based on the number of votes it receives and feedback from the judges.

THE JANEĂ&#x2030; PARSONS AWARD FOR SALES REPRESENTATIVE OF THE YEAR Re-named in honor of Obagi territory manager JaneĂŠ Parsons who tragically died on the night of the 2012 Aesthetic Awards, this award designed to acknowledge the hard work and services provided by sales reps working for manufacturers and suppliers in the UK. Who can enter/nominate? If you are a sales rep working for a medical aesthetics company in the UK then you can enter yourself into this category. Anyone working for manufacturers/distributors in the UK can also nominate their colleagues for this award. Clinics and practitioners can also nominate the sales reps that they feel are most deserving of this award. How will the winner be decided? The winner in this category will be decided purely on the number of votes they receive from their colleagues and customers.

BEST CUSTOMER SERVICE BY A MANUFACTURER/SUPPLIER This award will be given to the UK manufacturer/supplier deemed to offer the best customer service as judged by their customers. Who can enter/nominate? UK manufacturers and suppliers who are proud of the customer service they offer can enter themselves into this category. Clinics and practitioners can also nominate the companies that they feel offer the best customer service and are most deserving of this award. How will the winner be decided? The winner in this category will be decided purely on the number of votes they receive from their customers.

BEST ADVERTISING CAMPAIGN BY A MANUFACTURER/SUPPLIER This award will be given to the manufacturer/ supplier with the most memorable and effective UK advertising campaign. Who can enter/nominate? UK manufacturers and suppliers/advertising agencies who have created ad campaigns in both the consumer and trade arenas can enter themselves into this category. Clinics and practitioners can also nominate the companies that they feel have created memorable advertising campaigns and are most deserving of this award. How will the winner be decided? The

winner in this category will be decided by a panel of judges with expertise in the areas of advertising and marketing.

DISTRIBUTOR OF THE YEAR This award is designed to acknowledge the important role played by UK distributors who bring new, international products and treatments into the UK market place. Who can enter/nominate? UK distributors of medical aesthetics products, devices and treatments can nominate/enter their company into this category. Clinics and practitioners can also nominate the distributor that they feel offers the best products/ treatments and service. How will the winner be decided? The winner in this category will be decided purely on the number of votes they receive from their customers.

NEW AWARD FOR 2013-14 TRAINING PROVIDER OF THE YEAR A new category for the 2013-14 awards, the Training Provider of the Year award is designed to acknowledge the best providers of medical aesthetics training in the UK. Who can enter/nominate? Any provider of medical aesthetics training in the UK can enter this award. Clinics and practitioners can also nominate the training providers that they feel offers the best level of training. . How will the winner be decided? As training is a somewhat controversial area, the winner in this category will be decided based on three factors: votes and feedback from people who have attend the courses; mystery shopping of the training course and judging.

NEW AWARD FOR 2013-14 TRAINING COURSE OF THE YEAR Another new category for the 2013-14 awards, the Training Course of the Year award is designed to acknowledge the best individual medical aesthetics training course in the UK. Who can enter/nominate? Any provider of medical aesthetics training in the UK can enter a specific course that they offer into this category. Clinics and practitioners can also nominate the training course that they feel is most deserving of this award. How will the winner be decided? As training is a somewhat controversial area, the winner in this category will be decided based on three factors: votes and feedback from people who have attend the courses; mystery shopping of the training course and judging. www.cosmeticnewsuk.com 41


EVENTS

THE AESTHETIC AWARDS 2013-14

AWARDS FOR CLINICS/PRACTITIONERS RISING STAR This award will be presented to an up and coming practitioner who may not have the longevity of some of their colleagues but who has made an impact in their field. Who can enter/nominate? You can enter yourself for this award or nominate someone else who you feel is a deserving winner. How will the winner be decided? The winning practitioner will be judged on the number of votes they receive from Cosmetic News readers as well as their peers, customers and industry representatives.

BEST NEW CLINIC This award will be presented to the best new clinic in the UK. Who can enter/nominate? Any new UK based clinic can enter into this category. You can also nominate any new clinic that you feel is a deserving winner. How will the winner be decided? Mystery shoppers will be sent to the clinics who have been shortlisted and their feedback as well as feedback from customers and the number of votes received will determine the winner.

BEST CLINIC CHAIN This award is designed to recognise clinics who have a chain of practices in the UK. Who can enter/nominate? Any UK based clinic chain can enter into this category. You can also nominate any clinic chain that you feel is a deserving winner. How will the winner be decided? Mystery shoppers will be sent to the clinics who have been shortlisted and their feedback as well as feedback from customers and the number of votes received will determine the winner.

BEST CLINIC (FOUR ROOMS OR MORE) This award will be presented to the best large clinic in the UK with four or more treatment rooms. Who can enter/nominate? Any UK based clinic with four or more treatment rooms can enter into this category. You can also nominate any clinic that you feel is a deserving winner. How will the winner be decided? Mystery shoppers will be sent to the clinics who have been shortlisted and their feedback as well as feedback from customers and the number of votes received will determine the winner.

BEST CLINIC (THREE ROOMS OR LESS) This award will be presented to the best small clinic in the UK with three or less treatment rooms. Who can enter/nominate? Any UK based clinic with three or less treatment rooms can enter into this category. You can also nominate any clinic that you feel is a deserving winner. How will the winner be decided? Mystery shoppers will be sent to the clinics who have been shortlisted and their feedback as well as feedback from customers and the number of votes received will determine the winner. 42 www.cosmeticnewsuk.com

NEW AWARD FOR 2013-14 Hospital Group of the Year A new award for 2013, this award is designed to recognize the hospital groups that work within the medical aesthetics arena offering surgical and non-surgical services. Who can enter/nominate? Any UK based hospital group offering medical aesthetics services can enter into this category. You can also nominate any hospital group that you feel is a deserving winner. How will the winner be decided? Mystery shoppers will be sent to the hospital groups who have been shortlisted and their feedback as well as feedback from customers and the number of votes received will determine the winner.

BEST MOBILE PRACTITIONER This award will recognise the achievements of solo practitioners who operate out of multiple locations. Who can enter/nominate? You can enter yourself for this award or nominate someone else who you feel is a deserving winner. How will the winner be decided? Mystery shoppers will be sent to the practitioners who have been shortlisted and their feedback as well as feedback from customers and the number of votes received will determine the winner.

AESTHETIC NURSE PRACTITIONER OF THE YEAR This award will go to the aesthetic nurse who has gone above and beyond in his/her field this year. Who can enter/nominate? You can enter yourself for this award or nominate someone else who you feel is a deserving winner. How will the winner be decided? The winner will be decided on votes from the readers of Cosmetic News, peers and clients of the practitioners shortlisted

AESTHETIC PRACTITIONER OF THE YEAR This award will go to the cosmetic doctor/ dermatologist who has gone above and beyond in his/her field this year. Who can enter/nominate? You can enter yourself for this award or nominate someone else who you feel is a deserving winner. How will the winner be decided? The winner will be decided on votes from the readers of Cosmetic News, peers and clients of the practitioners shortlisted.

BEST CLINIC CUSTOMER SERVICE This award will be given to the clinic in the UK with the best customer service as judged by ‘mystery shoppers’ and votes from customers. Who can enter/nominate? You can enter your own clinic for this award or nominate someone else’s clinic that you feel is a deserving winner.

How will the winner be decided? Mystery shoppers will be asked to rate the clinics on their customer service both on the telephone and in person. You can also get your customers to vote for you online.

BEST CLINIC WEBSITE The most easy to navigate and informative clinic websites will be awarded in this category. Who can enter/nominate? You can enter your own website for this award or nominate someone else’s website that you feel is a deserving winner. How will the winner be decided? Mystery shoppers will be asked to rate the websites on ease of use, information and style. A judging panel made up of web experts will also examine the short listed websites and give their feedback on which they think is best.

SPEAKER OF THE YEAR This award will be given to the person deemed to have given the best lecture at a UK conference or educational meeting between May 2012-May 2013. Who can enter/nominate? You can nominate yourself for this award or nominate someone who you have seen lecture that you feel deserves recognition. How will the winner be decided? The winner in this category will be decided purely based on the number of votes they receive from the industry.

CLINIC RECEPTIONIST OF THE YEAR This award will go the member of clinic front of house staff who has excelled in 2012. Who can enter/nominate? You can nominate yourself for this award or nominate a colleague/ friend that you feel deserves recognition for managing front of house. How will the winner be decided? The winner in this category will be decided based on a mixture of the number of votes they receive, mystery shopping and feedback from their customers.

ASSOCIATION OF THE YEAR This award will be presented to the association that has gone above and beyond in 2012. There will only be one winner in this category. Who can enter/nominate? Any professional body/industry association that represents medical aesthetics practitioners can enter this award. Practitioners can also nominate the associations that they feel are most deserving of this award. How will the winner be decided? The winner in this category will be decided purely on the number of votes they receive from the industry.

SPECIAL AWARDS SERVICES TO THE INDUSTRY This category will award an individual who has gone above and beyond in their services to the industry. Who can enter/nominate? You can nominate yourself for this award or nominate a colleague,


BEST UK AESTHETIC TRAINING PROVIDER as voted by our customers! friend, mentor or peer that you admire and feel deserves recognition for what they have done within the arena of medical aesthetics. How will the winner be decided? The winner in this category will be decided purely on the number of votes they receive from the industry. Each person can only vote once. Multiple votes under the same name or from the same email address will be discounted. Voting will open on August 1, 2013.

Award-Winning Medical Aesthetics Training

LIFETIME ACHIEVEMENT AWARD This award will recognise the achievements of an individual who has had a long and fruitful career in the aesthetics industry. Previous winners include David Hicks and Mr Chris Inglefield. Who can enter/nominate? You can nominate yourself for this award or nominate a colleague, friend, mentor or peer that you admire and feel deserves recognition for what they have done within the arena of medical aesthetics. How will the winner be decided? There is no short list for this category. One winner will be selected by the Aesthetic Awards panel from the names put forward during the nomination process.

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HOW TO ENTER

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Entering could not be simpler. Just go to www.cosmeticnewsuk.com and fill out our online entry form. You can enter as many categories as you like as well as nominating other people, products, companies and associations who you think are worthy winners. Please remember that only one form will be allowed per person/email address so filling out multiple forms for yourself or colleagues will not increase your chances of winning, only waste your time. All your entries/nominations can be done on the same form. It is recommended that you provide us with a statement of no more than 500 words on why you think you/your company or product or the person/product/company or clinic you have nominated should win as it helps us when creating the shortlists. We will ask for additional supporting material to aid judging once the shortlists have been complied. Once all the entries have been received and the short lists have been complied voting will be opened. The voting process will be between August 1 and October 1. Shortlisted clinics will also be mystery shopped during this time.

• A NOTE ON VOTING Each person can only vote once. Multiple votes under the same name or from the same email address will be discounted. Multiple voting from within the short listed finalist’s organizations will also be monitored. Voting is IP address monitored. Voting will open on August 1, 2013.

• A NOTE ON MYSTERY SHOPPING Please note that mystery shoppers will not be booking in for any surgical or invasive procedures. They are instructed to book in for a consultation and/or non-invasive treatment, where appropriate, and will be examining the clinic facilities; the telephone and in person customer service; the staff/practitioners; the range of treatments available and the consultation process. You are not obliged to give away any treatments although we do ask that the mystery shopper is able to try out a suitable treatment to enable them to get the full experience of your clinic. We also ask that you waive the cost of the consultation/treatment. The mystery shopper will present you with a voucher once they come to pay. If you do not agree to giving away a free consultation/treatment you will need to let us know as soon as the short lists come out. This will not effect your place in the final short list, however it may affect your score as the mystery shopper will not be able to mark you on certain areas. You will not be marked down in any way for refusing treatment following consultation if it is not appropriate for that patient.

This event is always a sell out so book now to make sure you don’t miss out! Tables cost £1,750. Individual tickets are £180. For more information visit www.cosmeticnewsuk.com or call our events team on 01268 754 897.

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Cosmetic News May 2013


IN BUSINESS ADVERTISING

ADVERTISING ANGST Lorna Jackson, Editor of The Consulting Room™ gives you a few tips on advertising in aesthetics, an understanding of the rules and how to avoid common mistakes when promoting your clinic

‘A LORNA JACKSON Lorna has been Editor of The Consulting Room™, the UK’s largest aesthetic information website, for 10 years. She has become an industry commentator on a number of different areas related to the aesthetic industry, collating and evaluating statistics and writing feature articles, blogs, newsletters and reports for The Consulting Room™ and various consumer and trade publications, including Aesthetic Medicine, Cosmetic News and Aesthetic Dentistry Today.

dvertising’... something of a dirty word in the aesthetic industry at the moment with various organisations seeking to outlaw advertising for all cosmetic interventions. There are those championing a fullon ban, and those advocating a more measured approach to avoid irresponsible advertising which trivialises the medical nature of treatment through time limited discount deals. Whatever your view, and the outcomes of Keogh, every business will advertise and more importantly is likely to ‘need’ to advertise in order to recruit new clients to their services. No matter which method of advertising you use to promote your cosmetic treatments, rules do apply and it’s important to know them, to try not to get caught by them and to realise that those policing it are not doing as effective a job as you might otherwise think! This article will focus on non-broadcast advertising mediums such as magazines, newspapers, billboards, posters, brochures, direct mail (including printed, email and SMS text messaging), as well as Internet based material such as web sites, blogs, social media (Facebook, Twitter etc) and banner or pay-perclick advertising.

44 www.cosmeticnewsuk.com

• THE POLICE In the UK, the British Code of Advertising, Sales Promotion and Direct Marketing (the Code) is the rule book for non-broadcast advertisements, sales promotions and direct marketing communications. The Committee of Advertising Practice (CAP) is the selfregulatory body that creates, revises and enforces the Code; and the Advertising Standards Authority (ASA) is the independent body set up by the advertising industry to police the rules laid down in it. The Medicines and Healthcare products Regulatory Agency (MHRA) also polices the advertising and promotion of licensed medicines through UK legislation, and has published guidance on the legal requirements for this in its Blue Guide. As well as setting out basic and general rules, the CAP Code also details specific rules applicable to the advertising of health & beauty products and cosmetic therapies. These state that references to the relief of symptoms or the superficial signs of ageing are acceptable if they can be substantiated; however, unqualified claims such as ‘cure’ and ‘rejuvenation’ are not generally acceptable. The general rules to follow are not to mislead, make unrealistic claims or claim anything which you cannot substantiate if required. This also applies to the use of before and after photos, which should


be genuine patients, with unadulterated images and be direct representations of a treatment being advertised. The ASA will reactively investigate complaints made about an advertisement and if your advert is judged to be in breach of the Code, then the likely request is that it must be withdrawn or amended.

• THE CODE Surgical, Non-Surgical, Minimally Invasive, Non-Invasive?

According to the CAP, if you offer BoNTA and other injected treatments in your clinic you may advertise using the term ‘cosmetic fillers’ or ‘injected fillers’, however, you may not name a BoNTA brand directly or describe the treatment in any way that would imply BoNTA. • COSMETIC INJECTABLES

Sensibly it would be misleading to claim that invasive surgery was a ‘minor procedure’, and one must also not imply unrealistic claims in relation to the complexity or duration of the operation, the pain experienced either during or after the operation, the length of the recovery time or the potential side-effects, as well as the outcomes achievable. But can something be described as nonsurgical? Well the simple answer is yes; if it is being used to distinguish between surgical and non-surgical procedures offered by a clinic, but treatments such as Laser Lipolysis for example, which is not, in itself, surgical cannot be described as ‘non-surgical’ or ‘non-invasive.

• YOUR CREDENTIALS Claims such as ‘a/the leading clinic’ are likely to be seen to refer to the clinic and not purely to the doctors/surgeons it uses. Therefore you should be able to demonstrate that the clinic has qualities, such as a proven track record, outstanding facilities and additional staff that would put it above most or all other clinics. The same goes for practitioners, be wary of terms such as ‘qualified’, ‘highly qualified’, ‘fully qualified’, ‘experienced’, ‘skilled’, ‘leading’, ‘foremost’, ‘specialist’, to name but a few, as all require demonstrable evidence which may be overlooked when writing your marketing copy! Another common pitfall would be linking oneself or ones business to renowned locations such as Harley Street; this is not acceptable unless you can show that you carry out consultations or treatments/procedures there.

Please note that for ease, I will use the terminology BoNTA to refer to all the botulinum toxin type A brands currently available in the UK, (Botox®, Vistabel®, Azzalure®, Dysport®, Bocouture® and Xeomin®). According to the CAP, if you offer BoNTA and other injected treatments in your clinic you may advertise using the term ‘cosmetic fillers’ or ‘injected fillers’, however, you may not name a BoNTA brand directly or describe the treatment in any way that would imply BoNTA. But, and this is where is gets silly! If BoNTA is the only one you offer, (i.e. you do not carry out dermal fillers as well) then you should not advertise ‘fillers’ because that would be an indirect promotion of a prescription only medicine, namely the BoNTA! But as above, if you also offer dermal fillers, you may advertise ‘fillers’. Thankfully, most clinics and practitioners would have both treatment options within their armament to offer clients so this small complexity is unlikely to trip most advertisers up. In respect of dermal filler products, irrespective of composition, you may refer to them as being capable of ‘temporarily reducing the appearance of fine lines and wrinkles’ but you should not suggest either that treatment can ‘cure’ or ‘rejuvenate skin’ or that ‘lines and wrinkles will be permanently eliminated’. Similarly, unqualified claims, such as ‘wrinkle reduction’, are likely to be unacceptable. BoNTA is a prescription only medicine which cannot be advertised to the public, so the promotion of BoNTA, whether direct or indirect is likely to breach both Code and MHRA (legislation) rules. Being ‘sneaky’ and thinking

that you’re not ‘really’ mentioning it won’t work either as an advert on the daily deal site Groupon proved which tried to claim that the advert related to a dermal filler treatment when the terminology used in the advert stated, “facial injection treatments on one, two or three areas” and “choice of crow’s feet, between the eyebrows and forehead area”. Needless to say the ASA did not buy that argument and deemed it to be indirect promotion of BoNTA. The MHRA has issued a document entitled, ‘Advertising of Medicines: Guidance for consumer websites offering medicinal treatment services’, which highlights its advice for those wishing to include information about POMs, such as BoNTA on their website. They request that there be no reference to named POMs on your home page, no hover text (tool tips), small print, hidden text or icons/logos naming a POM and that links from the home page may refer to conditions but not to the POM itself. Additionally, the website URL itself should not include the POM name, e.g. www. wesellbotox.com. However they are not interested in the meta tag information for a website, used to assist in Search Engine Optimisation (SEO) such as keywords, titles and descriptions as they are deemed to be not public facing, thus these elements may name a POM. As you will have noted, the MHRA is only interested in policing the home page of a website, which they put down to resource difficulties but this naive view leaves them wide open to not effectively policing non-compliant content on other pages within a site which have been SEOed to appear higher in Google™ rankings than the home page! Although, the MHRA are proactively checking sites on a region by region basis and writing to clinics about their website if it is deemed to be in breach.

www.cosmeticnewsuk.com 45


IN BUSINESS ADVERTISING

Clinics wishing to market their aesthetic services within current guidelines often complain that they are operating at a disadvantage to local competition that don’t. It is true though that the ASA takes a harder line than the MHRA on the advertising of BoNTA and will for example look at a website as a whole, but there may be limited exceptions for clinics offering consultations for treating specific conditions for which BoNTA brands may be used. In looking at a particular complaint against a clinic, the ASA considered that it was acceptable for a website to make balanced and factual references to BoNTA as a treatment option IF the advertisers emphasised the promotion of the consultation rather than any associated POM AND, during that consultation, a range of therapeutic options would be discussed; that consultation may or may not lead to the provision of BoNTA. But, if the context or content of claims in the advert go beyond balanced and factual references to BoNTA as one of several treatment options likely to be discussed during a consultation, the ASA is likely to consider the advert promotes the use of a POM to the public. You may therefore refer to a consultation for lines and wrinkles (or for hyperhidrosis/excessive sweating) on your website and include a price list with a range of treatments available but the price list should not include product claims or actively encourage viewers to choose a product based on the price.

• HAIR REMOVAL – PERMANENT OR NOT? Two phrases ‘permanent removal’ and ‘permanent reduction’ are often used when describing treatment options for hair removal. Electrolysis is the only one which can make the claim for permanent removal of hair, but it cannot make claims for being painless. With light based devices, the Code takes its lead from the US FDA who have given market clearance for some to claim ‘permanent hair reduction’ but not 46 www.cosmeticnewsuk.com

‘permanent hair removal’, thus this applies to ASA investigations. Additionally the efficacy of laser treatments can vary depending on a person’s skin type, as well as their hair colour, therefore it is important to avoid giving the impression that laser or IPL hair reduction will be effective or suitable for all. Similarly the ASA has upheld complaints against advertisers for failing to prove claims they made that their treatments were ‘painless’.

• LASERS AND LIGHT FOR SKIN TREATMENTS The ASA does not like unqualified claims such as ‘rejuvenation’, yet this is often the terminology used to describe treatments to improve the appearance of the skin using ablative and non-ablative laser and light treatments. They do however accept that skin can be ‘resurfaced’, but urge the use of phrases such as ‘temporarily rejuvenate the skin’s appearance’ when promoting laser treatments. Similarly Intense Pulsed Light (IPL) treatments are often marketed as ‘photo-rejuvenation’, so you could be asked to disclaim or delete the name if you use it to advertise your treatment. The claim that lasers can ‘reduce the superficial appearance of wrinkles’ is generally accepted, but claims that the treatment can ‘remove wrinkles or the signs of ageing’ are not. This was highlighted in a complaint where the phrase ‘remove fine facial lines and wrinkles permanently’ was used as a claim for CO2 laser resurfacing. Although the advertiser submitted evidence which showed that CO2 laser resurfacing could improve the appearance of static facial lines, the studies showed those

lines could return within a year, especially if the lines were caused by the movement of underlying muscles so ‘permanent’ removal could not be substantiated and was thus misleading.

• CONCLUSION It is very clear that although there are many guidelines laid down and enforced by the ASA, CAP and MHRA regarding appropriate advertising of cosmetic surgery, aesthetic treatments and prescription only medicines there are literally hundreds of examples of clinics currently breaking these rules. Most ‘offences’ are partly due to a lack of knowledge regarding the specific CAP guidelines, but many clinics flout the rules in the knowledge that policing of these guidelines is currently ineffective and with the simple hope that none of their ‘enemies’ will shop them to the regulators, which most frankly won’t for fear of ‘what goes around comes around’. Clinics wishing to market their aesthetic services within current guidelines often complain that they are operating at a disadvantage to local competition that don’t, and can be tempted to follow suit if they think they are losing customers. Representative industry bodies, such as doctor and nurse associations appear to do little to help reinforce appropriate advertising guidelines amongst membership, although recognition of that is occurring and some, such as BAAPS are quite out spoken on their views on advertising regulations and best practice. Regulatory bodies such as the MHRA are taking a more proactive stance, but openly admit to not having the resources to really investigate to any great depth, leading to many loopholes being wide open to their ‘policing’. Most regulation of advertising compliance is therefore reactive which, although makes examples of a few offenders, does little as a deterrent. Even if the Keogh report does provide recommendations in terms of advertising and clamps down on certain practices, there is still likely to be a question of whether it will have any teeth if it simply gets included in the current selfregulatory arrangements of the ASA which relies on reactive policing. ________________________________________ For those interested in a more in-depth overview of this subject, with an opportunity to discuss the complexities of it, please visit www.smartseminar. co.uk to book your place on the next event where Lorna will be presenting this subject to delegates.


dermamelan速 is a professional whitening treatment designed to eradicate or eradicate or attenuate cutaneous blemishes with melanic origin while it homogenizes skin tone and increases skin luminosity. dermamelan速 application inhibits the melanogenesis process paralysing melanin production for a long period of time in which corneum stratum desquamation and the action of macrophage cells drag melanin deposits.

www.mesoestetic.co.uk


IN BUSINESS BEST PRACTICE

THE SHARP END OF THE LAW

Dawn Piper from Initial Medical Services on the new health and safety guidelines to reduce needlestick injuries being introduced this month

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n the UK, a small but still troubling number of healthcare workers develop a potentially lifethreatening disease as a result of sharps injury. There are a number of existing and new laws which help to prevent this from happening and ensure any employer does their utmost to protect their staff, however something that has been missing so far has been an overarching framework to bring together all different health and safety requirements.

This is all about to change as of May 11 when the UK healthcare sector needs to bring into force the necessary measures to comply with the new Health & Safety (Sharps Instruments in Healthcare) Regulations 2013, translated into national law from the European sharps injuries directive, European Council Directive 2010/32/ EU, to overarch a number of existing health and safety laws and introduce further preventative requirements. Under the directive, healthcare facilities need to assess the risk of exposure to blood-borne infections from sharps injuries, identify how to eliminate this and where exposure cannot be eliminated, put into place extensive prevention methods. The new legislation also requires a framework for the occurrence of a sharps injury. The directive is supported by a local, national and European-wide reporting system and employers need to revise their reporting procedures with health and safety representatives. The health and safety law has always placed general responsibilities on the employer to provide their staff with a healthy working environment. However, this new EU Directive is putting further emphasis on prevention. In reality it would be difficult, if not impossible to remove all sharps so the next best thing is to assess the risk correctly, use devices which limit the risk of injury and dispose of all sharps in a safe manner. Quick and simple way to reduce the risk of needle-stick injuries is to use innovative solutions such as InSafe Safety syringes – a safety

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HEALTHCARE ORGANISATIONS CAN BE SUBJECT TO ENFORCEMENT ACTION IF THEY FAIL TO COMPLY WITH THE LEGAL REQUIREMENTS. system providing comprehensive protection for clinical staff from the beginning of the procedure through to the disposal of the needle. InSafe’s syringe and sharps box ensure that the contaminated needle is never exposed except during the actual injection. It feels and aspirates just like a traditional syringe so there will be no interruptions to the procedure when introducing the protective system. When the injection has been administered, the protective sleeve locks securely into place over the needle, protecting clinical staff and patients when not in use. The needle can then be safely disposed of using a sharps container. Specially developed sharps disposal bins are designed for such waste and comply with all EU and UK regulations and directives with companies such as us offering a dependable and safe collection service. It’s important to remember that when it comes to hazardous and infectious waste, such as syringes and other sharps the cradleto-grave rule applies. The producer of waste will always be held responsible for the safe and legal disposal of it, even after it has been passed onto the waste carrier collecting it. This is why it’s important to work with comprehensively trained sharps waste disposal experts who will safely and securely dispose of it and advise on the correct products which comply with both the UK and EU legislation. Health and safety law is criminal law and healthcare organisations can be subject to enforcement action if they fail to comply with the legal requirements. There is also always a threat of civil law action if an employee is injured due to insufficient practices and technologies being in place.


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IN BUSINESS BUSINESS FOCUS

Think before you Tweet She is the queen of Twitter and Facebook but here Antonia Mariconda explores the darker side of social networking

S

ocial media is an arena that I’m most familiar with, now firmly entrenched in my Twitter sphere I can safely vouch that I really have seen it all, the good, the bad and the ugly! None more so than the last 12 months where I have at first hand experienced the evil that lurks behind the hidden technological wilderness of the cyber world, not only have I experienced cyber bullying in the worst extreme, but I have become familiar with a term that until 12 months ago had never existed in my world: defamation. Cast a deeper glance over the aesthetic community on Twitter, Facebook and on social media forums and you’ll see examples of defamation run rife like wildfire. Rebekah Finch a defamation specialist from leading law firm Irwin Mitchell LLP explains, “Defamation involves the publication of words to third parties which lower the subject of the words in the estimation of right thinking members of society and generally, expose the complainant to hatred, ridicule or cause the complainant to be shunned or avoided. A mere insult is not enough to amount to defamation” There are two types of defamation that people are often confused about, there is libel and slander. Slander is a transient form such as talking, whereas libel involves the publication of remarks in a permanent form such as written or printed documents. This includes newspapers, magazines, e-mails and internet postings. Finch explains, “In the aesthetics and cosmetic surgery industry (as with any industry where a service is being provided to a consumer), defamation claims usually arise from disgruntled customers who may

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not be satisfied with the service or product they have received, not necessarily because the service or product provided was insufficient or unsatisfactory, but sometimes as a consequence of a change of heart. For example, a customer may undertake a treatment which changes their physical appearance but later decide that they do not like the changes they have undertook”. It seems from my research and observations that the

The growth and increased use of the internet has had a big impact on people’s reputation and private lives. This has led to a surge in the number of defamation and privacy cases relating to content published online. Consumers (particularly in the aesthetics and cosmetic surgery industry) rely on the feedback of others before choosing a professional to approach and social media platforms allow such feedback to be easily accessible.

The growth and increased use of the internet has had a big impact on people’s reputation and private lives. This has led to a surge in the number of defamation and privacy cases relating to content published online. practice is not just confined to a patient-professional scenario, it also occurs between colleagues. Finch concurs, “Defamation disputes also arise between professionals within the same industry. This is usually as a consequence of competition, when a professional makes false comments about a competitor, which damages their reputation, so as to try and put consumers off using the competitor for their own business advantage”

Consumers who have had a bad experience or are not happy with the service they have received have an inclination to share their experience with the world at large. Such feedback can often be exaggerated or misleading which leads to defamation disputes arising. The internet had also made it easier for people to conduct ‘campaigns’ of vilification”. Reputational issues are not just faced by celebrities and/or the rich and famous. Any individual, company, partnership, and some other organizations may bring proceedings and seek damages from those responsible. False statements made about business leaders, such as chief executives and senior executives or professionals can also create a significant reputational risk for their organizations and could affect future career prospects. I have myself experienced three forms of defamation in the following scenarios; firstly in the form of a badly written piece of editorial littered with spelling errors in a self published magazine on a small commercial website, secondly in the form of an attack website dedicated to the pure vitriol of my existence, and thirdly in the form of a fake Twitter account created to


disparage my work and profile. Legally all three examples had clearly crossed the boundary from an opinion to blatant defamation, and from an ethical stance the creators of the three examples (all by the same people I may hasten to add) were quite evidently indulging in the unsavoury activity of cyber bullying just for added measure. Finch states “Defamation and harassment claims often overlap, when there has been a ‘campaign’ of defamatory statements being published”. It seems that I am not alone; a verbal private survey that I conducted with 20 industry aesthetic professionals revealed that 3 in 5 professionals have experienced defamation in some form. “I get it all the time on the forums” said one cosmetic doctor who wished to remain anonymous, “what can I do?” he added, “You can’t control what people say!” “I’ve been in tears over it” revealed one public relations professional after a random unprovoked Twitter attack. Whilst I have developed a thick skin over the last twelve months, and let my reputation and professionalism ‘do the talking’, I confess that at times it has been difficult to stomach the pure vilification that targeted defamation (and in my case cyber bullying) has set out to achieve. Sometimes no matter how transparent your reputation is and how good your PR representative may be, you will need a bigger weapon to fight your battle, and that is the time when you need to call in the cavalry by way of legal expertise. The involvement of a solicitor can often result in a matter being resolved more quickly. Those responsible and/or website hosts tend to take a request to remove

content more seriously if they are asked to do so by a firm of solicitors as it demonstrates that the matter is being taken seriously. Finch concludes “It is important to take action quickly not only to try and limit any potential damage caused but also because if court proceedings are necessary, a claimant must also be able to demonstrate to the court that they have acted quickly to minimize any potential damage. In addition to this, there is a strict one-year limitation period for bringing a defamation claim. This timescale runs from the date of the publication and the court will only allow a claim to be brought outside this one year period in very exceptional circumstances”. With kind thanks to Rebekah Finch Defamation Solicitor at Irwin Mitchell LLP http://www.irwinmitchell.com

Antonia Mariconda also known as ‘The Cosmedic Coach’ is a health and beauty writer, and author of four books. She is quoted in national and consumer press such as the BBC, Top Santé, The Evening Standard, Daily Mail, and Metro, for her knowledge on beauty and aesthetics, and cosmetic surgery. Antonia also independently advises clients both from the UK and around the world on where and where not to shop safely for cosmetic surgery, beauty, aesthetic medicine, and anti-ageing treatments. Her client list includes A-list celebrities, Royalty and VIPs. Follow Antonia on Twitter @CosmedicCoach or join Antonia on Face book where you will be updated about events and happenings in the world of health and beauty. www.thecosmediccoach.com

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IN BUSINESS A DAY IN THE LIFE

The Vampire Diaries Antonia Mariconda finds out what a typical Day in the Life is like for Dr Daniel Sister

D

r Daniel Sister is a world-renowned cosmetic, anti-ageing and hormone specialist doctor, best known for his critical role in the development of Dracula Therapy in the UK as one of the first practitioners of the much-coveted treatment. Dr Sister is featured in national press and media on a frequent basis and was recently featured in Tatler as a ‘Top Doc’. Antonia Mariconda spends a day in the life of the ‘fangtastic’ expert. “I live in Holland Park, with my wife, Sara, and my Labrador Zac. Quite often my sons Alex and Jonathan visit us. 6:30am is the regular wake up call; I don’t rely on an alarm. My body clock functions quite well, I Just open the eyes and I am ready for the day. I have never been a “late

in the office. My first patient generally will arrive at 10am I will work solidly through a clinic for the whole day, and rarely break for lunch (I know that’s not good!). My day usually ends at around 6pm with my last patient. Work is varied and interesting and there is never a dull moment. I went into medical school in 1968 without really knowing what to expect, but thanks to great teachers I loved it and because I was always curious and there are so many new medical discoveries it keeps the interest alive if not growing. The best thing about my career is to be able to help, improve and give confidence back to a patient. Finding new treatments or protocols is also extremely interesting to me. I was always curious and loved discovering and

The best thing about my career is to be able to help, improve and give confidence back to a patient night” person but mornings were and are always easy, plus the dog would not have it any other way. Breakfast is continental so along the lines of bread, butter, jam, and a lot of coffee. I walk the dog for 45 minutes every morning in the park, who needs the gym when you have a pet to walk in the wonderful parks of London? I am not a gym fan but I still do boxing and martial arts once per week. My commute is a 25 minute walk from my home to the office. Even though my working day starts at home by checking e-mails in peace, by 9am I am

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I am totally convinced that SYNERGY is a key word in this industry, I am always looking into new treatments. I was lucky enough to introduce

into the UK nine new treatments over the past eight years, such as ELOS laser technology, Carboxytherapy, VIPeel, Rouge Peel, Aqualyx, M.E.L.T. 1, 2 and 3 and most notably PRP/Dracula special protocols. My motto is Safe, Efficient, and Innovative. I enjoy lecturing and training colleagues, from Oslo to Los Angeles, and from Lisbon to Switzerland and of course in the UK where I trained over 100 practitioners so far. I lectured at the last BODY Conference and will do so again at the FACE conference in London, This year I will be at the Marrakesh anti ageing conference and also at Oxford with the British College of Aesthetic Medicine. I also enjoy writing articles for industry publications. I admit there are still limitations in the arena of aesthetic medicine, personally I’d like to see more transparency, better training and for people to be more open-minded. I’m involved in an important new study on growth factors and skin with the London School of Medicine, so watch this space! When the working day is done I do what any bon viveur would do! I love to cook, to read and watch TV. The one luxury I could not live without I confess is cigars, but yes, I do know I shouldn’t! My final thought of the day? Life is too short; we have only one chance at it so let’s do as much as we can.”

Antonia Mariconda also known as ‘The Cosmedic Coach’ is a health and beauty writer, and author of four books. She is quoted in national and consumer press such as the BBC, Top Santé, The Evening Standard, Daily Mail, and Metro, for her knowledge on beauty and aesthetics, and cosmetic surgery. Antonia also independently advises clients both from the UK and around the world on where and where not to shop safely for cosmetic surgery, beauty, aesthetic medicine, and anti-ageing treatments. Her client list includes A-list celebrities, Royalty and VIPs. Follow Antonia on Twitter @ CosmedicCoach or join Antonia on Face book where you will be updated about events and happenings in the world of health and beauty. www.thecosmediccoach.com


Large scale exhibition featuring 120 companies International attendance including: Cosmetic Doctors and Nurses I Dermatologists I Surgeons I Clinics I Hospitals 14 days of CPD accredited content at a two day event 3 high level conferences: Non-Surgical I Cosmetic Surgery I Reconstructive Surgery The great live debate theatre Live demonstrations and workshops Networking reception

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2 1ST –2 3R D J UN E 2013 QEI I CO NFER EN C E C EN T RE , W E ST MI N STER , L O N DO N

FACE is the UK’s largest scientific and business congress for practitioners of all specialities, business owners, clinic managers and marketeers working in the facial aesthetics field. Whether you work as a sole practitioner or part of a large clinic team, FACE provides the best opportunity to learn about the latest treatments, procedures, scientific data, practical tips, and marketing and business strategies—all delivered by leading experts in their respective fields. FACE 2013 will build on its heritage as the scientific forum devoted to facial aesthetics by combining it with the largest dedicated medical aesthetics exhibition ever seen in the UK.

Injectables agenda This is the most comprehensive agenda devoted to facial injectables ever seen in the UK. A host of national and international lecturers, trainers and clinical triallists will feature, providing scientific updates and practical pearls to help you maximise results and minimise problems when using cosmetic injectables for total facial contouring. Different techniques, new treatment approaches and concepts will be explored alongside practical demonstrations. This year we are devoting a two hour session to examining the evidence for the use of platelet rich plasma—the “Vampire Facelift”—as a treatment

P L AT I N UM SPO N SO R S:

for facial rejuvenation. If you are passionate about cosmetic injectables then FACE 2013 is an essential entry in your professional diary. You won’t find a better industry focused event anywhere in the world this year. Equipment agenda The use of lasers, radiofrequency, ultrasound and other aesthetic equipment for facial rejuvenation has exploded over the last decade, providing new approaches to the treatment of skin lesions and skin ageing. This two day agenda allows delegates the opportunity to explore the latest equipment, protocols and treatment approaches to a wide range of different

FACE 2013 combines over 150 hours of world class lectures with the biggest medical aesthetic exhibition ever hosted in the UK

GOLD S P ON S ORS :

skin problems—all delivered by an international panel of experts. Aesthetic therapists forum The last 10 years have seen the role of beauty therapists, laser technicians and other non-medically qualified practitioners working in the aesthetics market rapidly evolve, enabling them to work alongside medical practitioners or expand their own skillset in salons or their own businesses. We’re excited to announce a new two day event tailored specifically to exploring advanced treatments that are performed by practitioners with different skill sets, interests and backgrounds. This is the first year

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THREE DAYS OF UNPARALLELED CHOICE INCLUDING: – Over 100 national and international speakers

– Three day facial cosmetic injectables agenda

– Two day facial aesthetic equipment agenda

– Two day aesthetic therapists forum

– Three day business and marketing agenda

FACE will run this event, so topics are not limited to just facial treatments. The agenda will also cover laser and IPL hair removal and non-surgical body contouring, including practical demonstration sessions. Many lectures will be delivered by therapists who have specialist expertise in their chosen fields, with the aim to share knowledge and stimulate debate amongst therapists working in this rapidly developing market.

essential. This three day event explores a wide range of topics related to the daily challenges of making decisions and creatively marketing an aesthetic business. This provides a unique opportunity for clinic managers, marketeers and aesthetic business owners to learn from experts, network and share ideas with peers and come away with practical solutions to maximise profitability.

Business agenda In an economic environment that will continue to be challenging for the foreseeable future, mastering the wide range of skillsets required to market and run a business profitably is

Skin forum This two day forum will focus predominantly on topical non-injectable and non-device approaches to preventing and treating signs and symptoms of ageing skin.

Cosmeceuticals are an important adjunctive approach to in-clinic treatments, both to enhance results and as a valuable, additional revenue source. A scientific approach to selecting products from the bewildering array of topical treatments available today will be explored, alongside practical tips to effectively and safely treat darker skin types. The Summer Ball This year, join us for The Aesthetic Industry Summer Ball in the heart of the City at the Brewery. A chance to relax and network, this event always proves extremely popular and is a highlight of the industry’s social calendar.

If you would like to register for FACE 2013, you can do so by visiting our website faceconference.com or by calling 020 7514 5989. If you would like to be kept up to date with the latest news and offers, please email info@face-ltd.com to register for our newsletter, or alternatively follow us on Twitter @face_ltd

– Skin forum: cosmeceuticals and anti-ageing

– Three days of exhibitor workshops

– The Aesthetic Industry Summer Ball


TRAINING NEWS

BACN ANNOUNCES DATES OF ANNUAL CONFERENCE The British Association of Cosmetic Nurses has announced the dates of its 2013 conference and exhibition. The event will take place on Friday October 4 and Saturday October 5 at the Renaissance Manchester City Centre. See next month’s Cosmetic News for full details.

LYNTON HOSTS BODY SHAPING WORKSHOPS Lynton is hosting a series of ‘Body Shaping – Technologies & Techniques’ educational workshop. The course will discuss some of the most common body concerns such as inch loss, cellulite reduction and skin tightening. Experienced technicians will focus on the science behind the different technologies that are used to treat these conditions, including radiofrequency and ultrasound cavitation. There will be an opportunity to watch some demonstrations and gain some handson experience with the latest body shaping technology. 

 One of the workshops will take place at the Gestalt Centre in central London on June 10 . Another will take place on Monday July 29 at
The Lynton Clinic in Cheadle.

AMWC EASTERN EUROPE TO TAKE PLACE IN MOSCOW NEXT MONTH The Anti-Ageing Medicine World Congress Eastern Europe will take place on June 14-15 at the World Trade Centre in Moscow, Russia. Among the speakers will be UK plastic surgeon Mr Dalvi Humzah who will be speaking about anatomy. Other speakers will include Dr Pierre Bouhanna from Paris and Dr Ralph Trueeb from Zurich, Switzerland who will be speaking about the latest treatments for alopecia and pioneering hair transplant techniques and Dr Pietro Palma, a plastic surgeon from Milan who will be lecturing on rhinoplasty.

DATES ANNOUNCED FOR EMAA 2013 The 9th European Masters in Aesthetics and Anti-Aging Medicine will be held on October 11-12, 2013 at the Palais des Congrès, Paris, France. Organised by EuroMediCom, and supported by the World Society of Interdisciplinary Anti-Ageing Medicine (WOSIAM), the EMAA was founded on a multidisciplinary approach to Global Ageing Management and attempts to unite two aspects of aging prevention and treatment, using aesthetics strategy (dermatology, surgery and aesthetic medicine) for the external appearance and applying anti-ageing medicine for internal wellbeing.

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DATES FOR THE DIARY

D AT E S F O R THE DIARY WE ROUND UP UPCOMING EVENTS, TRAINING COURSES AND MEETINGS

• MAY 7 NeoStrata Training, Wigmore Training, 23 Wigmore Street, London, www.aestheticsource.com 9 Solta Medical, Cocktail Reception and Workshop, London 11 Aesthetox Foundation Botox and Dermal Fillers, Birmingham, www.aesthetox.co.uk 11 Aesthetox Foundation Botox and Dermal Fillers Manchester, www.aesthetox.co.uk 12 Tear Trough Masterclass, Boston International Training Academy Ltd, Bayswater, London, 0207 727 1110, www.bostontrainingacademy.com 14 NeoStrata Training, Purple Aesthetics, 54 Spenser Avenue, Perton, Wolverhampton, www.aestheticsource.com 14 Obagi Workshop, Glasgow, www.healthxchange.com 14 Obagi Workshop, Glasgow, www.healthxchange.com 18 Revanesse Dermal Fillers, Bayswater, London, 0207 727 1110, www.boston-medical-group.co.uk 18 Advanced Botulinum Toxin: Lower Face, Neck, Under-arm Hyperhidrosis,Central London, www.innomedtraining.co.uk 19 Mesotherapy – Face, Body and Hair, Boston International Training Academy Ltd, Bayswater, London, 0207 727 1110, www.bostontrainingacademy.com 19 Advanced Dermal Fillers: Facial Contours, Lip Refinements, SkinHydration, Central London, www.innomedtraining.co.uk 22 CIBTAC ENDORSED Ultrasound for skin rejuvenation and wrinkle reduction, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 23 Infrared for weight loss and detoxification, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty. com, www.academyofadvancedbeauty.com 24 CIBTAC ENDORSED Diamond Microdermabrasion for Face and Body, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 25 Aesthetox Foundation Botox and Dermal Fillers London, www.aesthetox.co.uk 25 Advanced Non-Surgical Facelift, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 27 Advanced facial treatment (Combined Course), Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 28-29 CIBTAC ENDORSED Ultrasonic Lipo-Cavitation, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 30 Pressotherapy for lymphatic drainage and cellulite reduction, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@ academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 31 BioSlimming, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com

• JUNE

2 Tear Trough Masterclass Boston International Training Academy Ltd, Bayswater, London, 0207 727 1110, www.bostontrainingacademy.com 8 Masterclass Aesthetox Botox and Dermal Fillers, Birmingham, www.aesthetox.co.uk 12 Advanced facial treatment (Combined Course), Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www. academyofadvancedbeauty.com 13 CIBTAC ENDORSED Diamond Microdermabrasion for Face and Body,


Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 14 Obagi Workshop, London, www.healthxchange.com 15 BioSlimming, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 14 Infrared for weight loss and detoxification, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 15-16 Dermal Fillers and Botulinum Toxin Foundation Course, Boston International Training Academy Ltd, Bayswater, London, 0207 727 1110; www.bostontrainingacademy.com 17 CIBTAC ENDORSED Ultrasound for skin rejuvenation and wrinkle reduction, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 18 Pressotherapy for lymphatic drainage and cellulite reduction, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 19 Advanced Non-Surgical Facelift, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 20 CIBTAC ENDORSED Cosmetic thermotherapy and Cryotherapy, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 21 CIBTAC ENDORSED Cryotherapy Induced Lipolysis, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 22 Aesthetox Foundation Botox and Dermal Fillers Manchester, www.aesthetox.co.uk 23 Aesthetox Skin Health and Chemical Peels, Birmingham, www.aesthetox.co.uk 29 Botulinum Toxin in Facial Aesthetics: new users - includes all major brands, Central London, www.innomedtraining.co.uk 30 Dermal Fillers in Facial Aesthetics: new users to hyaluronic acid fillers, Central London, www.innomedtraining.co.uk 30 Advanced Botulinum Toxin, Boston International Training Academy Ltd, Bayswater, London, 0207 727 1110; www.bostontrainingacademy.com

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• JULY

1 CIBTAC ENDORSED Ultrasound for skin rejuvenation and wrinkle reduction, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@ academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 4 CIBTAC ENDORSED Diamond Microdermabrasion for Face and Body, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@ academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 5 Advanced facial treatment (Combined Course), Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 6 Aesthetox Foundation Botox and Dermal Fillers, Birmingham, www.aesthetox.co.uk 6 Botulinum Toxin in Facial Aesthetics: new users - includes all major brands, Greater Manchester, www.innomedtraining.co.uk 7 Dermal Fillers in Facial Aesthetics: new users to hyaluronic acid fillers, Greater Manchester, www.innomedtraining.co.uk 8 Pressotherapy for lymphatic drainage and cellulite reduction, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@ academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 9 Infrared for weight loss and detoxification, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com The Dates for the Diary section is now a paid for section of the magazine and is a chance for you to advertise your training courses to our readers both in the magazine and online. Advertisers will get free listings of any training courses as part of their campaign. Anyone else wishing to publish training courses can do so for £300 a year. For more details contact 01268 754 897

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Ellipse Contact: Jane Myerson T: 0208 741 1111 Intense Pulse Light (I2PL) & Laser T: 0208 741 1111 E: sales@ellipseipl.co.uk E: sales@ellipseipl.co.uk Systems E: ashaki@ellipseipl.co.uk W: www.ellipseipl.co.uk W: www.venusconceptuk.co.uk Contact:Services: Jane Myerson W: www.technicalsupport.ellipseipl.co.uk/ UK distributor of IPL & Laser Services: UK distributor of Venus AZTEC Services Services: Onsite service & repairs of T: 0208 741 1111 systems, IPL & Laser training courses Freeze and Swan Radio Frequency (RF) aesthetic systems. UK agent for Ellipse and technical support & Magnetic Pulse (MP) systems Contact: Anthony Zacharek IPL & Venus Radio Frequency systemsE: sales@ellipseipl.co.uk Service: Exclusive UK distributor for Viora W: www.ellipseipl.co.uk Lynton product range Intense Pulse Light (I PL) & Laser Systems TECHNICAL SUPPORT Services: UK distributor of IPL & Laser systems, IPL & delivering the promise Contact: Customer Services T: 07747 865600 Beautylight Technical Services Ltd Contact: Jane Myerson Laser training courses and technical support Venus Freeze T: 0845 6121545 Contact: Jane Myerson Contact: Ashaki Vidale T: 0208 741 1111 E: sales@aztecservices.uk.com Contact:T:Jane Myerson 0208 741 1111 E: info@lynton.co.uk T: 0208 741 1111 E: sales@ellipseipl.co.uk W: www.aztecservices.uk.com E: sales@ellipseipl.co.uk T: 0208 741 1111 W: www.lynton.co.uk E: ashaki@ellipseipl.co.uk W: www.ellipseipl.co.uk W: www.venusconceptuk.co.uk W: www.technicalsupport.ellipseipl.co.uk/ E: sales@ellipseipl.co.uk Services: UK distributor of IPL & Laser Services: UK distributor of Venus Services: Onsite service & repairs of systems, IPL & Laser training coursesW: www.venusconceptuk.co.uk Freeze and Swan Radio Frequency (RF) aesthetic systems. UK agent for Ellipse and technical support & Magnetic Pulse (MP) systems 2 Services: UK distributor of Venus Freeze and Swan IPL & Venus Radio Frequency systems Med-fx Intense Pulse Light (I PL) & Laser Systems TECHNICAL SUPPORT delivering the promise Radio Frequency (RF) & Magnetic Pulse (MP)2 systems Contact: Faye Price Services Ltd Contact: Jane Myerson Ellipse Beautylight TechnicalTechnical Support Jane Myerson T: 01376Contact: 532800 Contact:Technical Ashaki VidaleServices Ltd Bioptica Laser Aesthetics T: 0208 741 1111 Beautylight T: 0208 741 1111 E: sales@medfx.co.uk T: 0208 741 1111 Contact: Mike Regan E: sales@ellipseipl.co.uk Contact: Ashaki Vidale E: sales@ellipseipl.co.uk ashaki@ellipseipl.co.uk W: www.medfx.co.uk T: +44 (0)7917 573466 W: www.ellipseipl.co.uk T: 0208E:741 1111 W: www.venusconceptuk.co.uk W: www.technicalsupport.ellipseipl.co.uk/ E: mike.regan@bla-online.co.uk Services: UK distributor of IPL & Laser E: ashaki@ellipseipl.co.uk Services: UK distributor of Venus Services: Onsite service & repairs of systems, IPL & Laser training courses Freeze and Swan Radio Frequency (RF) W: www.bla-online.co.uk W: www.technicalsupport.ellipseipl.co.uk/ aesthetic systems. UK agent for Ellipse and technical support & Magnetic Pulse (MP) systems IPL Onsite & Venus Radio&Frequency Services: Core of Knowledge Training and Laser Services: service repairs of systems aesthetic systems. Zanco Models Protection Adviser (LPA) Services. UK agent for Ellipse IPL & Venus Radio Frequency systems Contacts: Mr Ricky Zanco T: 08453076191 E: info@zancomodels.co.uk Medical Aesthetic Group W: www.zancomodels.co.uk Contact: David Gower T: 02380 676733 Boston Medical Group LTD E: info@magroup.co.uk Contact: Iveta Vinklerova W: www.magroup.co.uk Energist Medical Group T: 0207 727 1110 Contact: Eddie Campbell-Adams E: info@boston-medical-group.co.uk T: 01792 798 768 W: www.boston-medical-group.co.uk E: info@energistgroup.com W: www.energistgroup.com Contact: Ashaki Vidale T: 0208 741 1111

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Bocouture® 50 Abbreviated Prescribing Information Please refer to the Summary of Product Characteristics (SmPC). Presentation 50 LD50 units of Botulinum toxin type A (150 kD), free from complexing proteins as a powder for solution for injection. Indications Temporary improvement in the appearance of moderate to severe vertical lines between the eyebrows seen at frown (glabellar frown lines) in adults under 65 years of age when the severity of these lines has an important psychological impact for the patient. Dosage and administration Unit doses recommended for Bocouture are not interchangeable with those for other preparations of Botulinum toxin. Reconstitute with 0.9% sodium chloride. Intramuscular injection (50 units/1.25 ml). Standard dosing is 20 units; 0.1 ml (4 units): 2 injections in each corrugator muscle and 1x procerus muscle. May be increased to up to 30 units. Not recommended for use in patients over 65 years or under 18 years. Injections near the levator palpebrae superioris and into the cranial portion of the orbicularis oculi should be avoided. Contraindications Hypersensitivity to Botulinum neurotoxin type A or to any of the excipients. Generalised disorders of muscle activity (e.g. myasthenia gravis, Lambert-Eaton syndrome). Presence of infection or inflammation at the proposed injection site. Special warnings and precautions Should not be injected into a blood vessel. Not recommended for patients with a history of dysphagia and aspiration. Adrenaline and other medical aids for treating anaphylaxis should be available. Caution in patients receiving anticoagulant therapy or taking other substances in anticoagulant doses. Caution in patients suffering from amyotrophic lateral sclerosis or other diseases which result in peripheral neuromuscular dysfunction. Too frequent or too high dosing of Botulinum toxin type A may increase the risk of antibodies forming. Should not be used during pregnancy unless clearly necessary. Interactions Concomitant use with aminoglycosides or spectinomycin requires special care. Peripheral muscle relaxants should be used with caution. 4-aminoquinolines may reduce the effect. Undesirable effects Usually observed within the first week after treatment. Localised muscle weakness, blepharoptosis, localised pain, tenderness, itching, swelling and/or haematoma can occur in conjunction with the injection. Temporary vasovagal reactions associated with pre-injection anxiety, such as syncope, circulatory problems, nausea or tinnitus, may occur. Frequency defined as follows: very common (≥ 1/10); common (≥ 1/100, < 1/10); uncommon (≥ 1/1000, < 1/100); rare

(≥ 1/10,000, < 1/1000); very rare (< 1/10,000). Infections and infestations; Uncommon: bronchitis, nasopharyngitis, influenza infection. Psychiatric disorders; Uncommon: depression, insomnia. Nervous system disorders; Common: headache; Uncommon: facial paresis (brow ptosis), vasovagal syncope, paraesthesia, dizziness. Eye disorders; Uncommon: eyelid oedema, eyelid ptosis, blurred vision, eye disorder, blepharitis, eye pain. Ear and Labyrinth disorders; Uncommon: tinnitus. Gastrointestinal disorders; Uncommon: nausea, dry mouth. Skin and subcutaneous tissue disorders; Uncommon: pruritus, skin nodule, photosensitivity, dry skin. Musculoskeletal and connective tissue disorders; Common: muscle disorders (elevation of eyebrow), sensation of heaviness; Uncommon: muscle twitching, muscle cramps. General disorders and administration site conditions; Uncommon: injection site reactions (bruising, pruritis), tenderness, Influenza like illness, fatigue (tiredness). General; In rare cases, localised allergic reactions; such as swelling, oedema, erythema, pruritus or rash, have been reported after treating vertical lines between the eyebrows (glabellar frown lines) and other indications. Overdose May result in pronounced neuromuscular paralysis distant from the injection site. Symptoms are not immediately apparent post-injection. Bocouture ® may only be used by physicians with suitable qualifications and proven experience in the application of Botulinum toxin. Legal Category POM. List Price 50 U/vial £72.00. Product Licence Number PL 29978/0002. Marketing Authorisation Holder Merz Pharmaceuticals GmbH, Eckenheimer Landstraße 100, 60318 Frankfurt/Main, Germany. Date of revision of text FEB 2012. Full prescribing information and further information is available from Merz Pharma UK Ltd., 260 Centennial Park, Elstree Hill South, Elstree, Hertfordshire WD6 3SR. Tel: +44 (0) 333 200 4143 Adverse events should be reported. Reporting forms and information can be found at yellowcard.mhra.gov.uk. Adverse events should also be reported to Merz Pharma UK Ltd at the address above or by email to medical.information@merz.com or on +44 (0) 333 200 4143.

1085/BOC/JUN/2012/JH

Date of preparation July 2012

Bocouture® is a registered trademark of Merz Pharma GmbH & Co, KGaA.


C

onfidence is Reliable1,2 Rewarding 3 Performance 4,5 BOTOX® is licensed for the treatment of moderate to severe glabellar lines Delivers long-lasting patient satisfaction, time after time 2,3 Has been used for over 20 years in over 26 million treatment sessions worldwide6 Is the world’s first and most studied botulinum toxin*7

Botox® (botulinum toxin type A) Abbreviated Prescribing Information Presentation: Botulinum toxin type A (from clostridium botulinum), 50 or 100 or 200 Allergan Units/vial. Indications: Temporary improvement in the appearance of moderate to severe vertical lines between the eyebrows seen at frown (glabellar lines), in adults <65 years, when the severity of these lines has an important psychological impact for the patient. Dosage and Administration: See Summary of Product Characteristics for full information. Do not inject into blood vessels. Doses of botulinum toxin are not interchangeable between products. Not recommended for patients <18 or >65 years. Use for one patient treatment only during a single session. Reconstitute vial with 1.25ml of 0.9% preservative free sodium chloride for injection (4U/0.1ml). The recommended injection volume per muscle site is 0.1ml (4U). Five injection sites: 2 in each corrugator muscle and 1 in the procerus muscle: total dose 20U. Contraindications: Known hypersensitivity to any constituent. Infection at proposed injection site(s). Warnings/Precautions: Relevant anatomy and changes due to prior surgical procedures must be understood prior to administration. Serious adverse events including fatal outcomes have been reported in patients who had received off-label injections directly into salivary glands, the oro-lingual-pharyngeal region, oesophagus and stomach. Do not exceed recommended dosages and frequency of administration. Adrenaline and other anti-anaphylactic measures should be available. Reports of side effects related to spread of toxin distant from injection site, sometimes resulting in death. Therapeutic doses may cause exaggerated muscle weakness. Caution in patients with underlying neurological disorder and history of dysphagia and aspiration. Patients should seek medical help if swallowing, speech or respiratory disorders arise. Clinical fluctuations may occur during repeated use. Too frequent or excessive dosing can lead to antibody formation and treatment resistance. The previously sedentary patient should resume activities gradually. Caution in the presence of inflammation at injection site(s) or when excessive weakness/atrophy is present in target muscle. Caution when used for treatment of patients with peripheral motor neuropathic disease. Use with extreme caution and close supervision in patients with defective neuromuscular transmission (myasthenia gravis, Eaton Lambert Syndrome). Contains human serum albumin. Procedure related injury could occur. Pneumothorax associated with injection procedure has been reported. Interactions: No interaction studies have been performed. No interactions of clinical significance have been reported. Theoretically, the effect may be potentiated by aminoglycoside antibiotics or other drugs that interfere with neuromuscular transmission. Effects of administering different botulinum toxin stereotypes simultaneously, or within several months of each other, is unknown and may cause exacerbation of excessive neuromuscular weakness. Pregnancy: BoTox® should not be used during pregnancy unless clearly necessary. Lactation: Use during lactation cannot be recommended. Adverse Effects: See Summary of Product Characteristics for full information on side effects. Based on controlled clinical trial data, the proportion of patients that would be expected to experience an adverse reaction after treatment is 23.5% (placebo: 19.2%). In general, reactions occur within the first few days following injection and are transient. Pain/

burning/stinging, oedema and/or bruising may be associated with the injection. Frequency By Indication: Defined as follows: Very Common (> 1/10); Common (>1/100 to <1/10); Uncommon (>1/1,000 to <1/100); Rare (>1/10,000 to <1/1,000); Very Rare (<1/10,000). Infections and infestations. Uncommon: Infection. Psychiatric disorders. Uncommon: Anxiety. Nervous system disorders. Common: Headache. Uncommon: Paresthesia, dizziness. Eye disorders. Common: Eyelid ptosis. Uncommon: Blepharitis, eye pain, visual disturbance. Gastrointestinal disorders. Uncommon: Nausea, oral dryness. Skin and subcutaneous tissue disorders. Common: Erythema, Uncommon: Skin tightness, oedema (face, eyelid, periorbital), photosensitivity reaction, pruritus, dry skin. Musculoskeletal and connective tissue disorders. Common: Localised muscle weakness, Uncommon: Muscle twitching. General disorders and administration site conditions. Common: Face pain, Uncommon: Flu syndrome, asthenia, fever. Adverse reactions possibly related to spread of toxin distant from injection site have been reported very rarely (exaggerated muscle weakness, dysphagia, constipation or aspiration pneumonia which can be fatal). Rare reports of adverse events involving the cardiovascular system, including arrhythmia and myocardial infarction, some with fatal outcomes. Rare reports of serious and/or immediate hypersensitivity (including anaphylaxis, serum sickness, urticaria, soft tissue oedema and dyspnoea) associated with BoTox use alone or in conjunction with other agents known to cause similar reaction. Very rare reports of angle closure glaucoma following treatment for blepharospasm. New onset or recurrent seizure occurred rarely in predisposed patients, however relationship to botulinum toxin has not been established. Needle related pain and/or anxiety may result in vasovagal response. NHS Price: 50 Units: £77.50, 100 Units: £138.20, 200 Units £276.40. Marketing Authorization Number: PL 00426/0074 Marketing Authorization Holder: Allergan Pharmaceuticals (Ireland) Ltd., Westport, Co. Mayo, Ireland. Legal Category: PoM. Date of preparation: December 2012.

Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard Adverse events should also be reported to Allergan Ltd. UK_Medinfo@allergan.com or 01628 494026. References: 1. De Almeida A et al. Dermatologic Surgery 2007;33:S37–43. 2. Carruthers A et al. J Clin Res, 2004;7:1–20. 3. Stotland MA et al. Plast Reconstr Surg, 2007;120:1386–1393. 4. Beer KR et al. J Drugs Dermatol, 2011;10(1) :39–44. 5. Lowe et al. Am Acad Dermatol, 2006;55:975-980. 6. Allergan data on file. BoTGL/001/SEP 2011 7. Allergan Data on File VIS/006/JUL2011. *Allergan botulinum toxin type A. Global figures. Launched in 1989 in the US. UK/0008/2013 Date of Preparation: January 2013


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