- Improvement of hydration, radiance, and firmness
- Prevention of wrinkles & skin ageing
- Boost collagen I expression, while showing minimal inflammatory response2 RADIANCE
CPD: Approaches for Managing GLP/GIP Side Effects
GLOW HYDRATION
Experience long-lasting skin rejuvenation.a, 1-4
for further information please scan QR code Discover the combined power of: Non-Crosslinked hyaluronic acid (HA) & Glycerol
References: a) The aesthetic effect after initial injection of the viscoelastic implant lasts up to 16 weeks for lateral canthal lines and up to 24 weeks for perioral rhytids.1
1) Instructions for use
2) Sulovsky M, Müller D, Prinz V, Moellhoff N, Cajkovsky M, Duschek N, Frank K. A prospective open-label, multicentre study evaluating a non-cross-linked hyaluronic acid based soft- tissue filler in the correction of lateral canthal and perioral lines. J Cosmet Dermatol. 2022 Jan;21(1):191-198. doi: 10.1111/jocd.14460. Epub 2021 Sep 24. PMID: 34559948 3) Succi, I. B., Da Silva, R. T. & Orofino-Costa, R. 2012. Rejuvenation of periorbital area: treatment with
Dermatol Surg, 38, 192-8. 4) Data on file The healthcare professional confirms having informed the consumer of a likely risk associated with the use of the
Contents • November 2025
08 News
The latest product and specialty news
19 News Special: GMC Under Scrutiny After Banned Doctors Cleared to Practice
Aesthetics investigates vetting procedures within the specialty following the discovery of banned doctors practicing in the NHS
CLINICAL PRACTICE
20 Where Innovation Meets Community in Medical Aesthetics
Unite with the aesthetics specialty at ACE 2026 to achieve clinical and business excellence
25 Special Feature: Restoring the Skin Barrier Using Regenerative Skincare
Practitioners share how regenerative science and microbiome formulations are reshaping skin health and outcomes
28 CPD: Multi-Modality Approaches for GLP/GIP Side Effects
Nurse prescriber Anna Baker discusses tissue changes with GLP/GIP therapies
35 Approaching Photodamage with Topical Treatments
Dr Clare Kiely explores the mechanisms of photodamage and effective topical treatments
38 Managing Melasma Topically
Nurse prescriber Khatra Paterson shares topical treatments to address melasma
41 A Regenerative Approach to Skin Laxity and Dehydration
Dr Keiron Lord presents insights into strategies to address skin ageing
45 mesoestetic®: Redefining Standards in Medical Aesthetics mesoestetic® leading the shift toward regenerative aesthetics
46 Addressing Perioral Concerns
Nurse prescriber Kelly Richards outlines a multi-modal approach to perioral rejuvenation
50 Aesthetica – A Trusted Supplier
Aesthetica Solutions provides reliable service, ethical values and a forward-thinking approach
51 Abstracts
A round-up and summary of the latest clinical studies
IN PRACTICE
52 Managing Spousal Business Partnerships
Yogeeta Bawa provides guidance on balancing personal and professional partnerships
55 Engaging with Leading Specialty Journalists
CCR hosted a press panel offering key insights for aesthetic practitioners
58 Exploring Hypnotherapy for Aesthetic Patients
Anna Lancaster discovers how hypnotherapy can enhance patient care
61 In Profile: Dr Derrick Phillips
Dr Derrick Phillips discusses his dermatology career and his work with the BSF
62 The Last Word: Botulinum Toxin Stigma
Dr Sally Rayment argues that stigma around botulinum toxin needs to be challenged
NEXT MONTH: EVOLUTION
• Dermoscopy in Aesthetics • Polynucleotides for Scarring • Anatomy Updates
News Special: GMC Under Scrutiny After Banned Doctors Cleared Page 19
Special Feature: Restoring the Skin Barrier Using Regenerative Skincare Page 25
Clinical Contributors
Anna Baker is an aesthetic nurse prescriber, trainer and qualified educator. She is a key opinion leader, and vice chair of the BAMAN Education & Training Committee and is currently undertaking an MSc in Clinical Dermatology.
Dr Clare Kiely is a consultant dermatologist and co-founder of The Skin Diary. She is an honorary lecturer in skin ageing and aesthetics at the University of Manchester. Dr Kiely is also chair of the Cosmetic Practice Standards Authority.
Dr Keiron Lord has a background as an NHS surgeon and an undergraduate degree in biochemistry and biomedical science, he specialises in evidence-based, preventative skin ageing solutions integrating regenerative and longevity-focused approaches.
Khatra Paterson is an experienced nurse, FGM survivor and advocate for women’s health. With more than 32 years in healthcare and through her respected medical aesthetics practice, she champions inclusive, compassionate care and ethical beauty.
Kelly Richards is an independent nurse prescriber who founded clinic SKIN AESTHETICS in Wrexham. Balancing her NHS role with further education and business development, she transitioned to full-time aesthetics in 2022.
As the year begins to wind down, it’s clear that 2025 has been another incredible year of growth, change and innovation across medical aesthetics. Following the energy of last month’s CCR, our conversations have continued, from treatment trends and patient safety, to the importance of staying connected as a community.
This month, we turn our focus to Topicals and Skin Rejuvenation – a fitting theme as we prepare to help patients restore and protect their skin through the colder months. Our Special Feature explores strategies for repairing the skin barrier, while this issue’s CPD article examines the role of topical ingredients in managing GLP-1 side effects, an increasingly relevant topic as more patients present with changes in skin. Don’t miss this month’s News Special, which investigates vetting procedures for doctors in the specialty following reports of barred practitioners working within the NHS. It’s a timely reminder of why governance and oversight remain at the heart of patient safety.
Clinical Advisory Board
We’ve also included a write-up of our Meet the Press panel from CCR, which sparked fantastic discussions about what journalists are really looking for, how practitioners can effectively work with the media and key insights into consumer beauty trends shaping the future of aesthetics.
Looking ahead, it’s time to mark your diaries for our next big event – the Aesthetics Conference & Exhibition (ACE), taking place on March 13-14, 2026. We’re thrilled to announce Allergan Aesthetics, an AbbVie company, as our Headline Sponsor, and we’ll soon be unveiling their exciting new agenda dedicated to fresh thinking and clinical innovation. And the celebrations don’t stop there! The Aesthetics Awards will take place on Saturday March 14, the perfect finale to two inspiring days at ACE. Entries have now closed, so a huge good luck to those that put themselves forward this year! Tickets are selling fast, so be sure to secure yours soon and join us in honouring the very best in our specialty.
Thank you for being part of the Aesthetics community and for continuing to share your expertise and experiences with us.
Leading figures from the medical aesthetic community have joined the Aesthetics Advisory Board to help steer the direction of our educational, clinical and business content
Sharon Bennett is the former chair of the British Association of Medical Aesthetic Nurses (BAMAN), UK lead of the BSI committee for aesthetic non-surgical standards and member of the Clinical Advisory Group for the JCCP. She is a trainer and a registered university mentor in cosmetic medical practice, and is finishing her MSc at Northumbria University. Bennett has won the Aesthetics Award for Nurse Practitioner of the Year and the Award for Outstanding Achievement.
Sharon Bennett, Clinical Lead
Mr Naveen Cavale has been a consultant plastic, reconstructive and aesthetic surgeon since 2009. He has his own private clinic and hospital, REAL, in London’s Battersea. Mr Cavale is the national secretary for the ISAPS, president of the Royal Society of Medicine, and vice-chair for the British Foundation for International Reconstructive Surgery.
Miss Elizabeth Hawkes is a consultant ophthalmologist and oculoplastic surgeon. She is the lead oculoplastic surgeon at the Cadogan Clinic, specialising in blepharoplasty and advanced facial aesthetics. Miss Hawkes is a full member of the BOPSS and the ESOPRS, and is an examiner and fellow of the Royal College of Ophthalmologists.
Mr Adrian Richards is a plastic and cosmetic surgeon with over 30 years’ experience. He is the clinical director of the aesthetic training provider Cosmetic Courses and surgeon at The Private Clinic. He is also a member of the British Association of Plastic and Reconstructive and Aesthetic Surgeons and the British Association of Aesthetic Plastic Surgeons.
Dr Mayoni Gooneratne (MBBS, BSc, MRCS, MBCAM, AFMCP) was an NHS surgeon before establishing The Clinic by Dr Mayoni and founding Human Health – an initiative combining lifestyle with traditional and functional medicine to provide a ‘cell-up’ regenerative approach to aesthetics. She is also the co-founder of The British College of Functional Medicine.
Jackie Partridge is an independent nurse prescriber. She is the clinical director and owner of Dermal Clinic in Edinburgh and a KOL for Galderma. She holds an MSc in Non-surgical Aesthetic Practice and a BSc in Dermatology. Partridge is a stakeholder group member with Scottish Government/HIS, Honorary BACN member and JCCP Fitness to Practice Nurse.
Dr Souphi Samizadeh is a dental surgeon with a Master’s degree in Aesthetic Medicine and a PGCert in Clinical Education. She is the founder of the Great British Academy of Medicine and Revivify London Clinic. Dr Samizadeh is a Visiting Teaching Fellow at University College London and King’s College London.
If you are interested in contributing to the journal, get in touch...
Email: editorial@aestheticsjournal.com
Dr Sophie Shotter is the founder & medical director of Illuminate Skin Clinic in Kent and Harley Street, London. Her passion is for natural treatments delivered with utmost attention to safety. She works closely with Allergan as part of their UK and International Faculty.
Dr Anjali Mahto is one of the UK’s leading consultant dermatologists. She is a Fellow of the Royal College of Physicians, member of the Royal Society of Medicine and a spokesperson for The British Skin Foundation. In 2023 Dr Mahto opened Self London, a dermatology and lifestyle clinic aimed at managing skin conditions holistically.
Dr Stefanie Williams is a dermatologist with a special interest in adult acne, rosacea and aesthetic medicine. She is the founder and medical director of multi-award winning EUDELO Dermatology & Skin Wellbeing in London, and creator of Delo Rx skincare. She is the author of three books and has published more than 100 scientific articles, book chapters and abstracts.
ARTICLE PDFs AND REPRO
Material may not be reproduced in any form without the publisher’s written permission. For PDF file support please email, contact@aestheticsjournal.com
Kicking off the week with gratitude after an unforgettable CCR 2025, where I spoke on government regulation proposals alongside Andrew Rankin and Amy Bird.
#Event
Allergan Aesthetics
@allerganaesthetics
#Launch Sarha Courtnay
@sarhacourtnay
So honoured to be part of the team launching EXOMIND – thank you to BTL Aesthetics for including us, and congratulations on your well-deserved award for Most Impactful Launch!
Allergan Aesthetics brought together journalists, influencers and tastemakers for an evening dedicated to HA injectable fillers.
#Education
@drsepi
Dr Sepi Shahidi
A whirlwind 24 hours in Geneva with Teoxane –an incredible day spent learning, sharing insights and connecting with fellow experts in the field.
#Masterclass
Dr Xavier G. MD
@drxavierg.md
Galderma GAIN Summit 2025 was an incredible event. I absolutely loved everything about it!
Regulation
Scottish Parliament announces new Bill to regulate non-surgical procedures
The Non-Surgical Procedures and Functions of Medical Reviewers Bill has been introduced to the Scottish Parliament. According to the Scottish Parliament, the Bill was introduced to ensure that non-surgical procedures are safe, hygienic and properly regulated. It was also created on the basis that such procedures could cause physical or psychological harm to children and young people.
Part 1 of the Bill would make it illegal to provide certain treatments to anyone under the age of 18. The legislation targets procedures that pierce or penetrate the skin, are not part of the health service, are not provided by healthcare providers or by regulated healthcare professionals (HCPs) to treat illness, and are not covered by a licensing scheme under the Civic Government (Scotland) Act 1982. That Act gives local authorities the power to licence and regulate a wide range of public activities. HCPs includes those registered with the General Medical Council (GMC), General Dental Council (GDC), General Optical Council (GOC), General Osteopathic Council (GOsC), General Chiropractic Council (GCC), General Pharmaceutical Council (GPhC), Nursing and Midwifery Council (NMC) or Health and Care Professions Council (HCPC).
The Bill makes it an offence for a person to provide a non-surgical procedure to another person outside of permitted premises, including any premises of an independent hospital or clinic that is registered with Healthcare Improvement Scotland (HIS). The Bill also grants HIS additional appropriate enforcement and inspection powers to regulate non-surgical procedures as well as grant enforcement powers to authorised persons.
Where offences are committed by organisations, the Bill makes it possible to hold responsible individuals within those organisations personally accountable, if consent, connivance or neglect played a role in the offence.
Procedures undertaken for, or on behalf of, the NHS or by another HCP for the prevention, diagnosis or treatment of an illness are excluded from the Bill. The Bill also gives the Scottish Government the power to introduce further restrictions and requirements for these types of procedures in the future. This could include specifying who may provide them, the training or qualifications required and how the regulations are enforced.
Independent nurse prescriber and Aesthetics Clinical Advisory Board Member Jackie Partridge commented, “I am delighted that we’re taking another step towards keeping the public safe. The proposals that have been published today indicate that the Scottish Government has listened to our concerns, and we very much welcome HIS having additional appropriate enforcement and inspection powers. The proposals still need to go through parliament but the foundations have now been set.”
Clare Haughey, Convener of the Health, Social Care and Sport Committee, said, “Our Committee is aware that the use and administering of non-surgical procedures for cosmetic purposes has grown hugely in popularity over the last few years. But we are also aware of concerns that there may be risks when those providing treatments aren’t suitably trained to do so. This Bill proposes to strengthen the regulation of who can receive and administer these treatments, and where these can be carried out.”
ACE announces Allergan Aesthetics as Headline Sponsor
Allergan Aesthetics, an AbbVie company, is returning as Headline Sponsor for the second year in a row at the Aesthetics Conference & Exhibition (ACE) 2026. The company will be taking over the Main Auditorium and hosting unmissable educational sessions.
Djamshid Ghavami, general manager of Allergan Aesthetics UK&I, commented, “We will be sharing our unique Signature approach and bringing our award-winning portfolio of products to the event, alongside presentations and stand talks from our expert faculty who will be sharing their wealth of knowledge in injectable treatments. We will be exploring innovation with our Platysma Prominence indication, alongside going beneath the surface on skin hydration. On our stand we will be exploring detail on Juvéderm, a versatile portfolio of hyaluronic acid fillers, alongside HArmonyCa, with on stand talks deep diving into trends and suggestions on how to improve the patient-physician consultation.”
VAT Compliance
New framework for VAT after landmark case victory
Illuminate Skin Clinic, founded by aesthetic practitioner and member of the Aesthetics Clinical Advisory Board Dr Sophie Shotter, has won a legal appeal at the Upper Tribunal (UT) regarding how VAT applies to aesthetic treatments.
The landmark case centred on whether certain procedures, such as botulinum toxin, dermal fillers and fat reduction treatments, can be classified as exempt “medical care” for VAT purposes when performed by qualified healthcare professionals (HCP).
Barristers’ chambers, Monckton Chambers who represented the appellant in this case, has reported that the UT ruling on October 13 overturned an earlier decision by the First-tier Tribunal (FTT). The UT found that the FTT had applied an overly narrow legal testing in assessing whether the clinic’s treatments served a therapeutic purpose and lowered the threshold for how practitioners should document diagnosis or therapeutic purpose. In its decision, the UT stated, “This appeal concerns an important and difficult point. If a registered medical practitioner provides a treatment or intervention that has an aesthetic purpose or effect, under what circumstances might this supply fall within the exemption from VAT for medical care. We understand that this is a lead case with a number of cases stayed pending its outcome.”
The ruling now provides a clear framework to help other aesthetic practitioners navigate VAT compliance. It confirms that a treatment may be exempt from VAT if it is administered by a registered HCP, follows a multifactorial assessment, is supported by sufficiently evidenced clinical judgment and its principal purpose is determined to be therapeutic.
The case has been remitted to the FTT for reconsideration in line with the UT’s guidance, with His Majesty’s Revenue and Customs (HMRC) having 30 days to apply for permission to appeal the decision.
Vital Statistics
A survey of 2,004 respondents found that 41% of people using weight-loss injections sourced them without a prescription (GP Nutrition, 2025)
In the UK, 6.5 million men experience male-pattern baldness, and an estimated 100,000 people are living with alopecia (Alopecia UK, 2025)
Over the last 12 months, Google searches for ‘salmon sperm facials’ have risen by 67% (Google Keyword Planner, 2025)
Among 2,157 women aged 18-75, 55% mentioned ingredients matter more than the brand when purchasing skincare (Teoxane, 2025)
Out of 2,000 people in the UK, only 1 in 5 began caring for their skin in their 30s or later, yet half believe they should have started as teenagers (Genaura, 2025)
Patients with psoriasis had a 56% higher risk of developing age-related macular degeneration (Treichel A, et al. 2025)
Events diary
8th November 2025
IAAFA Conference
22nd November 2025
Interface Expo
29th-31st January 2026
IMCAS World Congress
13th-14th March 2026
Aesthetics Conference & Exhibition (ACE)
14th March 2026
The Aesthetics Awards
IN THE MEDIA
Mr Daniel Ezra discusses eye surgery with HELLO!
Oculoplastic surgeon Mr Daniel Ezra was featured on HELLO! Magazine’s Aesthetics Guide panel, where he shared insights into the evolving trends within ophthalmic surgery. Mr Ezra explained that many patients now pursue procedures to manage how others perceive their appearance, rather than for reasons of vanity. He recalled a past patient whose under-eye bags gave colleagues the impression they were struggling to keep up at work, while others with overhanging skin or brow drooping appeared unintentionally angry or sad. Mr Ezra explained, “People aren’t saying they want to look younger, they just want to look refreshed and less tired.”
Calls for age restrictions on skincare products
The dangers of promoting harsh skincare ingredients to teenagers was highlighted on ITV News 13-year-old Ava experienced skin issues after following skincare advice on social media, which the Cosmetic Toiletry and Perfumery Association Limited (CTPA) has reportedly expressed concern over. Consultant dermatologist Dr Emma Wedgeworth said, “Products like retinols and AHAs are not suitable for teenage skin. Getting into a simple routine of cleansing and moisturising the skin can be helpful to balance the microbiome, and to help with the excess oil production that very commonly happens around that sort of age.”
Research
Teoxane releases findings on skin quality
Aesthetic manufacturer Teoxane has unveiled new research analysing skin quality. Conducted by independent European data collector Norstat on behalf of Teoxane, the research surveyed 2,157 women aged between 18-75 in the UK. Almost half of the women surveyed shared that they regularly suffer from stress (47%), and 43% reported getting enough sleep and feeling refreshed the next day. According to Teoxane, adequate sleep supports cell turnover, boosts collagen production and blood flow, all of which contribute to an improved skin tone.
The report also outlined that 41% of women were using skincare containing hyaluronic acid, meanwhile 73% chose skincare products or treatments for long-term skin benefits and 55% chose skincare or treatments for immediate results.
Jordan Sheals, medical education and marketing director at Teoxane UK, commented, “The results of this report, combined with insights from our network of experienced healthcare professionals, has reinforced that skin quality is becoming a top priority for patients. Utilising this kind of consumer data unlocks deeper insights into the complex, multifactorial nature of skin quality and what that means for individuals across the board.”
Transition
IBSA Derma UK&I announced as new distributor for Profhilo
Pharmaceutical company IBSA Derma UK&I, a subsidiary of global pharmaceutical company IBSA, has announced that it will assume responsibility for the distribution of injectables Aliaxin, Profhilo and Viscoderm.
The transition marks the conclusion of a decade-long partnership with distributor HA-Derma, which managed the distribution of Aliaxin, Profhilo and Viscoderm for the past 10 years. HA-Derma confirms that all services will continue until December 31, 2025.
From January 1, 2026, IBSA Derma UK&I shares it will oversee the production of ultrapure hyaluronic acid using its patented NAHYCO technology, while also maintaining and expanding hologram-based product verification and managing logistics and distribution across the UK and Ireland.
Alex Stuart, head of IBSA Derma UK&I, commented, “Taking the reins in the UK and Ireland marks a pivotal milestone for IBSA Derma. The successful growth of Profhilo under HA-Derma has set apart injectable bioremodelling. With Aliaxin, Profhilo Structura and Viscoderm poised to reach new audiences, we’re excited to launch IBSA Derma UK&I and deepen our partnership with practitioners.”
Preventative Campaign
BCAM unveils campaign to promote patient safety
The British College of Aesthetic Medicine (BCAM) has launched a nationwide campaign ‘Vet It Before You Get It’.
According to the organisation, the campaign includes a toxin and dermal filler safety guide to help patients recognise legitimate products, as well as a safety focused questionnaire featuring a six-step checklist designed for clinics ahead of booking a consultation. The new campaign follows the release of BCAM’s annual review, which revealed 3,002 complications were treated by BCAM doctors in 2024, with 67% caused by non-medical practitioners. The questions featured include whether the clinic is registered with a regulatory body, what the practitioner’s qualifications are, what product will be used and what safety and emergency protocols the clinic has in place.
President of BCAM and aesthetic practitioner Dr Sophie Shotter commented, “Whilst we still don’t have the rules in place, it is important that the public do all they can to safeguard themselves from individuals who are carrying out these procedures. BCAM members and I support this campaign and hope members of the public take action to support their safety.”
Fraudulency
BBC investigation reveals patient safety risks in toxin prescribing
A BBC undercover investigation has found nurses and pharmacists putting patients at risk by supplying botulinum toxin without required face-to-face consultations.
In June, the Nursing and Midwifery Council (NMC) updated its position on the remote prescribing of prescription-only medication (POMs). It confirmed that independent nurse and midwife prescribers are required to conduct a face-to-face consultation before prescribing POMs for non-surgical cosmetic procedures.
In Christchurch, Dorset, an undercover researcher posing as a beautician sought a prescription for botulinum toxin. Senior nurse prescriber Sally Jackson issued the prescription for £30, despite professional rules requiring an in-person consultation and a duty of care. The prescription details were exchanged via WhatsApp. According to the BBC, Jackson also offered to prescribe additional vials under another patient’s name, enabling the undercover researcher to keep stock for patients without valid prescriptions – behaviour amounting to fraud. Jackson has ignored repeated requests for comment. When approached in person, she said only, “I am not interested.”
This year, 41 cases of botulism were reported between June and August, starting in County Durham and Darlington, and spreading to the East of England and East Midlands. The outbreak was linked to counterfeit botulinum toxin, and resulted in serious illness, prompting a crackdown by the Medicines and Healthcare products Regulatory Agency (MHRA) and warnings from the UK Health Security Agency (UKHSA).
Professor David Sines, chair of the Joint Council for Cosmetic Practitioners (JCCP), commented, “These checks are in place to prevent complications such as swelling, drooping and other adverse reactions, and to ensure patients receive safe, appropriate care. Urgent action is needed to restore confidence and ensure the public can access safe, regulated care.”
Regulatory Collaboration
MHRA collaborates with ASA and GPhC on advertising guidance
The Medicines and Healthcare products Regulatory Agency (MHRA), working alongside the Advertising Standards Authority (ASA) and the General Pharmaceutical Council (GPhC), has released an updated Enforcement Notice to clarify the regulations on advertising prescription-only medicines (POMs) used in weight management treatments.
According to the guidance, advertisers should refrain from using language that refers to POMs, such as terms like “weight-loss injection,” “obesity treatment jab” or “GLP-1.” They should also avoid imagery that consumers are likely to interpret as representing a prescription medicine, as well as advertisements for general weight-loss products or services that direct consumers to other ads, such as website landing pages, which promote POMs.
According to the MHRA, this year has seen more than 25 businesses having had action taken against them for the promoting of POM for weight loss.
A spokesperson from the MHRA commented, “The updated Enforcement Notice reiterates and clarifies existing rules that prevent the promotion of prescription-only weight-loss medicines to the public. We have been – and continue to be – clear that we take the illegal advertising of prescription-only weight-loss medicines to the public very seriously and we work tirelessly to crack down on those breaking the rules and putting people’s health at risk.”
BAMAN UPDATES
A round-up of the latest news and events from the British Association of Medical Aesthetic Nurses
REGIONAL AND LOCAL MEETINGS RECAP
As the year draws to a close, we’re carrying the momentum from our 2025 Autumn Aesthetic Conference straight into our second round of regional and local meetings in October and November.
From Cambridge to Cheshire, Newcastle to North Wales, members come together for CPD-events, peer-review days, coffee mornings and beyond, for honest conversations that remind us, we’re not doing this alone. These meetings aren’t just a date in the diary, they’re where connection happens, members share what’s working, what’s not and how we keep pushing forward together.
A huge thank you to our regional leaders for making this happen and to members who joined a meeting and got involved.
ADVOCACY AT NATIONAL LEVEL
The last few weeks also saw important progress at a national level. Several BAMAN members were invited to the House of Parliament and the All Party Parliamentary Group (APPG) on beauty and wellbeing, contributing to conversations around safety, standards and regulation in medical aesthetic practice.
A special mention to nurse prescriber’s Barbara Pointon and Nicky Robinson for raising concerns with their local MPs. It’s a strong reminder that local advocacy matters and that every professional voice makes a difference.
CELEBRATING
WHAT MATTERS
Now all eyes are on the BAMAN Awards. The votes are in, the finalists are announced and we’re looking forward to celebrating the people who’ve gone above and beyond this year. Members can join us for a glitz and glam filled evening in London. With stunning views of St Paul’s Cathedral as well as seasonal canapés, flowing drinks and live entertainment, we take a moment to celebrate our peers, show support and help recognise the nurses who are raising standards and leading by example.
We’re proud to be an open, supportive space for all nurses. We can’t wait to see you all there.
Djamshid Ghavami, general manager at Allergan Aesthetics, gives an insight into what you can expect at ACE 2026
What will Allergan be doing at ACE 2026?
We are very excited to be the Headline Sponsor at ACE 2026 for the second year in a row. We will be sharing our unique signature approach and bringing our award-winning portfolio of products to the event, alongside presentations and stand talks.
We will be exploring innovation with our platysma prominence indication, alongside going beneath the surface on skin hydration – following the successful launch of SKINVIVE.
On our stand we will be exploring detail on Juvéderm, a versatile portfolio of hyaluronic acid fillers, alongside HArmonyCa, with on stand talks deep diving into trends and suggestions on how to improve the patient-physician consultation.
What kind of content can delegates expect?
Within the symposium we will be discussing our approach to utilising the strength of our portfolio with SKIN360, with case studies and panel discussions allowing for audience questions and interaction, presented by our expert AMI Faculty.
What developments in injectable science are you most excited to share at ACE 2026?
Our new indication for platysma prominence is a significant milestone for BOTOX and is very exciting and will be a core focus of the live symposium.
Dr Nestor Demosthenous, a member of the Allergan Medical Institute Faculty, said, “This allows us to effectively treat a new concern non-surgically, which patients have been wanting for years, backed by strong scientific evidence and MHRA approval. This has the potential to benefit patients psychologically as it addresses an area which has been of great concern for patients.”
Register for ACE 2026 using the QR code
Event Anniversary
IAAFA conference returns
The International Academy of Advanced Facial Aesthetics (IAAFA) annual conference and exhibition is back for its 20th anniversary on November 8.
Hosted at De Vere Beaumont Estate in Windsor, the event aims to provide guests with live Q&A sessions, real case presentations alongside the latest techniques, treatments and technologies.
The key speakers expected at the conference include the president of IAAFA Professor Bob Khanna, aesthetic practitioners Dr Aamer Khan, Dr Alexandra Day, Dr Anjuli Patel, Dr Nina Bal, Dr Ranj Rai and nurse prescriber Áine Larkin. Lorna Bowes, CEO of AestheticSource, will also be at the event alongside holistic coach Ariella Indigo and consultant ophthalmic and oculoplastic surgeon Mr Raman Malhotra.
In the evening, IAAFA will host a charity ball supporting the Rainbow Trust Children’s Charity, a charity dedicated to supporting families who have children with life-threatening or terminal illnesses.
Professor Khanna commented, “The IAAFA 20th Anniversary Annual Conference, Awards and Charity Ball promises to be our biggest and best event yet featuring a world-class lineup of speakers, cutting-edge content and an exclusive exhibition of innovative aesthetic companies. Don’t miss this opportunity to elevate your skills, network with specialty leaders and be part of shaping the future of facial aesthetics.”
Reform
CQC opens consultation on new proposals
England’s independent regulator for health and social care service, the Care Quality Commission (CQC), has officially launched its autumn public consultation and confirmed developing sector specific frameworks.
The consultation is part of the CQC’s efforts to address the concerns raised in external reviews by chair of the NHS Dr Penny Dash and the CQC chair Professor Sir Mike Richards, in 2024, as well as the Care Provider Alliance.
The proposed changes are focused on two key areas. The first involves developing new frameworks and guidance for assessing providers, including reintroducing rating characteristics, replacing quality statements with assessment questions, creating sector-specific frameworks and simplifying the content of framework. The second area focuses on enhancing how the CQC assesses and rates providers, which may include changes to NHS trust ratings and making judgements at the key question level.
The healthcare regulator shared that the consultation will be open for responses via an online form until December 11.
Allergan Aesthetics debuts Skinvive
Pharmaceutical company Allergan Aesthetics, an AbbVie company, has officially launched Skinvive by Juvéderm.
The company hosted a press event to introduce the injectable to media and specialty guests.
Skinvive is a hyaluronic acid injectable designed to deliver deep hydration in the skin for up to nine months and improvements in skin texture on the face and neck for up to six months after a single treatment. The product is suitable for all Fitzpatrick Skin Types I–VI and is administered using microdroplet injections, designed to restore glow and radiance with minimal downtime, the company explains.
The event featured a panel of television presenter Cat Deeley, podcaster Josh Smith and aesthetic practitioners Dr Sophie Shotter, Dr Glyn Estebanez and Dr Ewoma Ukeleghe, who discussed the role of hydration in skin health and the benefits of the new treatment.
On the new launch, Dr Estebanez said, “Skinvive takes the hydrating benefits of hyaluronic acid beyond the skin’s surface to deliver deep hydration that transforms the skin from within.”
Djamshid Ghavami, general manager of Allergan Aesthetics UK&I, added, “Skinvive is the latest addition to our growing portfolio of products in the skin quality category and through our investment in research and development, we’ll continue to bring innovations to patients and health care practitioners. The new era for healthy-looking skin starts with Skinvive, changing the skin quality category for good.”
R&D Report
Aesthetics joins exclusive mesoestetic HQ event
Aesthetic manufacturer mesoestetic invited practitioners to its headquarters in Barcelona, Spain, on October 14.
The company hosted 13 aesthetic practitioners for an educational event focusing on innovation, scientific development and the newly launched mesofiller nexha injectable range.
The day commenced with a welcome from mesoestetic UK commercial director, Steven Schofield, who provided an overview of the company’s portfolio, including skincare, devices and injectables. This was followed by chief executive officer of mesoestetic Pharma Group Carles Font, who guided delegates on a tour of the company’s headquarters. The visit provided insight into the entire manufacturing and production process – from formulation to final packaging – including a tour of the quality control room, preparation areas and the ‘cold room’ where raw materials are stored.
Following the tour, Lizzie Calvert, marketing manager for mesoestetic UK, delivered a presentation examining current trends influencing the aesthetic specialty. Drawing on data from consulting company Rare:, Calvert explored developments in regenerative medicine, alongside strategies for patient retention and acquisition. The session promoted open discussion, with practitioners exchanging insights and best practices for enhancing patient loyalty and sustainable clinic growth.
Training Platform
The Academy of Medical Aesthetics launches as new training platform
The Academy of Medical Aesthetics has been introduced as a professional training platform.
Founded by nurse prescriber Rebecca Welstead-Green and aesthetic practitioner Dr Xavier Goodarzian, this initiative is designed to support practitioners in bridging the gap between clinical expertise and the operational demands of running an aesthetics clinic.
According to the co-founders, the Academy follows a structured, step-by-step programme aimed at developing confident clinic leaders. It begins with a focus on professional mindset, before moving into practical, business-focused modules such as consultation skills, skin science, patient communication, branding and online presence, and business foundations. The programme concludes with advanced clinical techniques.
Welstead-Green commented, “We kept seeing brilliant medical professionals struggle with confidence, pricing and visibility – not because they lacked skill, but because no one was teaching the business side of aesthetics. The Academy is about closing that gap, building confidence and helping practitioners grow successful clinics from the inside out.”
Next, Wendy Rogers, training manager at mesoestetic UK, introduced the PATH concept – designed to optimise patient care through profundity, action, time and homecare. The model aims to guide practitioners in tailoring individual treatment journeys by considering consultation insights, achievable timelines, budgets and homecare solutions to enhance clinical outcomes.
After lunch, Dr Alfredo Martínez, head of the biotechnology unit at headquarters, delivered a presentation outlining the scientific principles of the mesofiller nexha range. Dr Martínez explained that the formulation combines cross-linked hyaluronic acid with succinic acid, designed to provide both corrective and biostimulatory benefits. Schofield revealed that a second generation of the injectable line is in development, encouraging delegates to look out for future updates.
The event concluded with mesoestetic UK’s first live demonstration, performed by mesoestetic medical advisor Dr Andrea Miralbell. The session showcased the mesofiller nexha volume treating the nasolabial folds and mesofiller nexha lips for perioral rejuvenation, followed by mesotherapy incorporating vitamins, amino acids and peptides aimed at revitalising the skin.
The evening entailed a fine dining experience at Restaurante Feroz, providing attendees with the opportunity to reflect on a day centred around education, innovation and professional collaboration with the mesoestetic team.
Schofield commented, “We love to bring our practitioners to our headquarters here in Barcelona. It gives us the space to show them how we develop from concept, and manufacture our products to the highest pharmaceutical standard. It was also a great opportunity to discuss the upcoming product pipeline and to provide a detailed explanation of the new nexha range of dermal fillers, highlighting how they differ from standard hyaluronic acid fillers.”
International Symposium
Aesthetic Dialogue returns to Prague this November
Aesthetic Dialogue 2025 is scheduled to take place at Prague Castle in the Czech Republic from November 15-16.
Now in its third year, the symposium is a programme focused on full-face treatment strategies across different age groups, with particular emphasis on safety, anatomy and innovation.
The two-day event will include live demonstrations, such as cadaveric anatomy correlation and ultrasound assessment, aimed at providing a practical educational experience centred on precision and safety.
The symposium will host a diverse international faculty, including Dr Lee Walker, Dr Roshan Ravindran, Dr Steven Harris, Dr Monika Kavková, Dr Jani van Loghem, Dr Sonja Sattler, Dr Lim Ting Song and Dr Kyuho Yi, among others. Panel discussions will bring together specialists to examine current trends and future directions in medical aesthetics.
A new ‘Innovation Stage’ will provide a platform for emerging technologies, product updates and scientific developments presented by participating partners. The event’s venue has expanded to three halls within Prague Castle to accommodate a larger number of attendees. Topics on the agenda include toxins, fillers, biostimulation, regenerative medicine, exosomes and related areas of interest.
Dr Kavková, co-founder and scientific board director at Aesthetic Dialogue, said, “The Aesthetic Dialogue Symposium 2025 reveals where we stand in medical aesthetics today and how we elevate quality of life. Discover the newest approaches and get answers to what, why, when and where – all guided by the world’s most influential specialists. A perfect blend of theory, clinical practice and anatomy for a truly comprehensive experience.”
Laser
Lynton Lasers releases new laser
Aesthetic device company Lynton Lasers has launched its distribution of the RedTouch PRO, following its initial unveiling at the Clinical Cosmetic Regenerative Congress (CCR) 2025. Developed by manufacturing company DEKA, the new device is designed for the treatment of ageing, skin laxity, uneven tone and photodamage. Lynton Lasers explains that the new laser operates at a 675 nm wavelength which stimulates collagen types I, III and IV. The company also shares that RedTouch PRO has a photobiomodulation effect with the aim to enhance fibroblast activity, extracellular matrix (ECM) regeneration and dermal thickness through selective thermal stimulation of collagen.
Dr Jon Exley, managing director of Lynton Lasers, commented, “RedTouch PRO is a genuine category innovation, it opens up a whole new treatment modality based on exclusive collagen targeting at a wavelength that no other laser system can match. We’re excited to partner with DEKA on this UK-first launch and look forward to supporting our partners with training, education and clinical success.”
Device Launch
Dermalux unveils new device for acne
Medical device company Dermalux has launched the Dermalux Tri-Wave MD.
The company shares that the new medical device features clinically proven LED phototherapy, offering a non-invasive, drug-free alternative to antibiotics and isotretinoin.
Using the three most validated wavelengths, blue (415 nm), red (633 nm) and near infrared (830 nm), Dermalux Tri-Wave MD targets acne at multiple levels. The blue light eliminates acne-causing bacteria, the red light stimulates collagen and calms inflammation, while near infrared supports wound healing and reduces scarring. The system treats both facial and body acne efficiently, delivering up to 240 j/cm² in a single session.
Consultant dermatologist Dr Justine Hextall, who worked on the protocol with a medical advisory board, explains, “LED phototherapy works synergistically with topical treatments to reduce inflammation, repair the skin barrier, and control acne without compromising the gut microbiome or causing systemic side effects.”
Dr Hextall has reported significant improvements within two to four weeks for both teen and adult acne patients, with maintenance sessions sustaining long-term skin health. By addressing hormonal and inflammatory triggers holistically, Dermalux Tri-Wave MD phototherapy offers practitioners a safe, versatile and clinically validated alternative which reduces the need for antibiotics while promoting overall skin resilience.
This content was written and sponsored by Dermalux.
Regulatory Enforcement
Greater Manchester reminds clinics of legal duties
Tameside Metropolitan Borough Council (TMBC) has issued letters to non-medics reminding them of the legal requirements when administering non-surgical cosmetic treatments
The letters outlined that prescription only medications (POMs), such as botulinum toxin, can only be legally prescribed by a healthcare professional following a face-to-face consultation and must be dispensed by a registered pharmacy. TMBC also reminded businesses of the legal requirements surrounding weight-loss injections, the advertising rules on POMs and age restrictions which prohibit the administration of botulinum toxin on under 18s.
A spokesperson from TMBC said, “Other local authorities in Greater Manchester have served prohibition notices on unsafe practices in pop up non-cosmetic business activity due to a lack of information on venues and safety procedures. Compliance is being monitored by local and national intelligence from Environmental Health, Trading Standards, media, primary care professionals such as pharmacists where they are concerned with the volumes of lidocaine being prescribed.”
Injectable
Nordberg Medical hosts launch event for JULÄINE
Aesthetic manufacturer Nordberg Medical invited press and practitioners to the launch event of JULÄINE, a next generation poly-L-lactic acid-based (PLLA) dermal bio-activator.
The event featured sessions by Nordberg Medical CEO Dr Jack Yu, as well as aesthetic practitioners Dr Benji Dhillon and Dr Sabika Karim. Aesthetic practitioner Dr Wassim Taktouk was also present and spoke on the unique features and benefits of JULÄINE.
Hannah Nolan, general manager at Nordberg Medical UK&I, commented, “Through a thoughtfully curated programme of insightful presentations and expert-led sessions, attendees gained a deeper understanding of not just JULÄINE, but the wider topic of regenerative aesthetics. Our speaker line up came from across Europe to share their knowledge with our guests, and we hope the day set the bar for the level of education our customers can expect from Nordberg Medical.”
Safety Standards
Tweak platform debuts to enhance patient safety
Aesthetic practitioner Dr Kat Bennett has released Tweak with the aim to help raise safety standards within the aesthetic specialty.
According to Dr Bennett, the free app brings NHS-style transparency and accountability to cosmetic treatments, giving patients greater confidence and control. Dr Bennett further explains that tweak allows patients to log treatments and product details, connect with medically trained practitioners, access reliable jargon-free information and keep records safe, confidential and secure.
She commented, “There’s currently no centralised way for patients to track what’s been injected into their faces – or by whom. We created Tweak to put the power back into patients’ hands. This app isn’t about scaring people away from aesthetics. It’s about raising standards, empowering patients to make informed choices and ensuring they can find practitioners they can genuinely trust.”
Conference Report
ICAM presents its inaugural conference
The Irish College of Aesthetic Medicine (ICAM) hosted its first annual conference in Dublin, Ireland.
According to the college, the event convened aesthetic practitioners with the objective of delivering evidence-based learning. Aesthetic product company RELIFE and pharmaceutical company Evolus served as the headline sponsors of ICAM 2025. The programme was organised across two stages. Stage one featured sessions on Body Dysmorphic Disorder (BDD) screening, the use of poly-L-lactic acid (PLLA) for the neck and periorbital injectables, with presentations delivered by aesthetic practitioners Dr Vincent Wong and Dr Kam Lally.
Stage two included contributions from specialty partners, with BTL Aesthetics addressing wellness and longevity, Sinclair focusing on the integration of aesthetic treatments and Allergan Aesthetics, an AbbVie company, presenting on achieving natural-looking harmony. Sessions were supported by aesthetic practitioners Dr Ahrooran Sivakumar and Dr Ruaa Elbeltaji.
Dr Sean Fitzpatrick, aesthetic practitioner, president and co-founder of ICAM, commented, “ICAM’s motto is salus (safety), educatio (education) and reformatio (reform). Our commitment to raising the standards of medical aesthetics in Ireland is reflected in our inaugural conference, providing a key launchpad for our mission.”
Aesthetics’ festive gift guide
Discover the latest gift set collections for this year’s festive season.
AlumierMD’s HydraGlow Gift Sets
Skincare brand AlumierMD has unveiled its limited-edition HydraGlow Gift sets for the festive season. The HydraGlow Skin Icons set includes EverActive C&E + Peptide serum, rich in vitamins C and E, and Ultimate Boost Serum for firming and radiance. The HydraGlow Energising set features Aqua Infusion Mask, MicroDerm Polish and Eye Rescue Pads to hydrate, exfoliate and refresh tired skin.
iS Clinical’s Radiance Collection
Skincare brand iS Clinical has launched its Radiance Collection, trade-only set featuring the brand’s most sought-after formulas, according to the company. The collection includes products containing extremozymes, hyaluronic acid, copper tripeptide, glycolic and salicylic acids, botanical extracts and peptides. It features iS Clinical’s Reparative Moisture Emulsion, Cleansing Complex, Active Peel System, Active Serum and Youth Eye Cream, all designed for revitalised, radiant skin.
IMAGE Skincare’s festive sets
The Gold Standard gift set from IMAGE Skincare includes ORMEDIC Balancing Facial Cleanser, a gel that aims to remove impurities; ILUMA Intense Brightening Serum, designed to even skin tone and reduce pigmentation; and VITAL C Hydrating Repair Crème aimed at targeting dehydrated skin. Additionally, the Opulent Radiance 50 is a collection developed to hydrate, plump and protect the skin. It includes the VITAL C Hydrating Facial Cleanser, VITAL C Hydrating Anti-Aging Serum and DAILY PREVENTION Ultra-Defense Moisturiser SPF 50.
Dermalogica’s Holiday
2025 Collection
Dermalogica’s annual advent calendar features a selection of limited-edition skincare sets designed to support professional and at-home routines. It includes 24 skincare items, including three full-size products and 15 deluxe minis such as the Daily Microfoliant, BioLumin-C Serum and Daily Glycolic Cleanser.
Masterclass Report
Aesthetics attends GAIN summit
Pharmaceutical company Galderma hosted the GAIN Summit London 2025.
Held at the Hilton London Bankside, the programme featured sessions and live demonstrations on regenerative medicine, highlighting use of Sculptra and Restylane.
The event featured dermatologist Dr Sabrina Fabi discussing how medication-driven weight loss impacts facial appearance and ageing, and aesthetic practitioner Dr Catherine Denning on business growth, emphasising that improving patient care, not numbers, drives a thriving practice. The programme included a full-face rejuvenation demonstration by Dr Fabi and aesthetic practitioner Dr Yusra Al-Mukhtar, followed by a live slimming lift with Dr Al-Mukhtar and plastic surgeon Mr Luiz Avelar.
Wojciech Konczalik, head of marketing at Galderma UK&I, commented, “The GAIN Summit 2025 was a landmark moment for regenerative aesthetics in the UK and Ireland. Bringing together approximately 200 healthcare professionals, we explored the latest evidence-based approaches to skin quality, and insights shared by global specialists added exceptional depth to the conversation.”
Laser Device
Sciton introduces new resurfacing laser
Aesthetic device company Sciton has launched a resurfacing laser called HALO TRIBRID.
The company has revealed that the new device integrates Sciton’s top three laser treatments, the HALO, MOXI and Erbium Resurfacing, into a single handpiece. Sciton shares that as the wavelengths work alone and synergistically, providers can address texture, pigment and deep dermal renewal in a single session.
Robb Brindley, executive vice president of sales and marketing at Sciton, commented, “Our Sciton family is proud to introduce the most disruptive skin resurfacing laser that the aesthetic specialty has ever seen. With HALO TRIBRID, we’ve set a new standard for resurfacing, one device with the power of three that reaches every layer of the skin, addresses the broadest range of concerns in a single session, and does it all on Sciton’s multi-module JOULEX platform.”
Pharmaceutical company Sinclair has announced that Ellansé is now part of training provider Harley Academy’s new education framework.
As the manufacturer of Ellansé, Sinclair shares that the inclusion of Ellansé marks the first biostimulator to be featured in Harley Academy’s Global Evidence Matrix (GEM), a digital education framework providing evidence-based guidance to support safe and effective biostimulatory treatments.
According to Sinclair, Ellansé is a collagen-stimulating dermal filler composed of polycaprolactone (PCL) microspheres suspended in a carboxymethyl cellulose (CMC) gel carrier, which delivers both immediate volumisation and long-term collagen stimulation.
Dr Tristan Mehta, founder and CEO at Harley Academy, said, “Biostimulatory injectables represent the next generation of aesthetic treatments, offering patients both immediate and long-term improvements through collagen stimulation. By incorporating Ellansé into GEM, we are equipping Harley Academy students and app subscribers with clear, evidence-based guidance to deliver these treatments safely and effectively, regardless of experience level.”
SPF Launch
Teoxane unveils new SPF product
Aesthetic manufacturer Teoxane has released the Urban Shield SPF30. According to the company, the SPF protects against UV radiation, blue light, pollution and oxidative stress. Formulated with Teoxane’s Resilient Hyaluronic Acid (RHA), it also includes an antipollution active to help shield the skin, a peptide antioxidant aiming to protect skin cells from UVA-induced oxidative damage, and UV filters to prevent photoageing, Teoxane shares.
Additionally, the launch is supported by study results from Teoxane, which reported that among 22 participants, 91% noted improved skin hydration and a suitable tone match, with most describing the texture as easy to apply and providing a natural finish.
Jordan Sheals, medical education and marketing director at Teoxane UK, commented, “We’re thrilled to introduce Urban Shield SPF30 to the Teoxane Dermocosmetics range, a product that reflects our constant drive to innovate and evolve. Our goal is to offer a collection that not only stands strong on its own but also works synergistically with our injectable treatments and we’re delighted to be bringing this latest addition to the skincare lineup to the UK.”
Surgical Conference
BAAPS hosts annual conference
The British Association of Aesthetic Plastic Surgeons (BAAPS) held its 2025 annual conference ‘Redefining Aesthetics’ at King’s Place, London.
Welcoming 500 delegates and 32 exhibitors, the two-day event showcased the formal partnership between BAAPS and the Indian Association of Aesthetic Plastic Surgeons (IAAPS), aiming to strengthen international collaboration within the field of aesthetic surgery.
The conference opened with presidential addresses from BAAPS president and consultant plastic surgeon Ms Nora Nugent, alongside IAAPS president and plastic surgeon Mr Sandeep Sharma. The programme featured sessions on body contouring, facial rejuvenation and fat grafting, with guest speakers including plastic surgeons Mr Alexis Verpaele, Mr Marc Mani and Mr Steven Cohen.
Reflecting on the two-day conference, Ms Nugent commented, “The BAAPS 2025 conference showcased the latest advances in aesthetic facial, breast and body surgery demonstrating the innovative future of our specialty. BAAPS extends its gratitude to all delegates and faculty members for contributing to an immensely valuable and successful conference, which reinforced the association’s commitment to advancing standards in aesthetic plastic surgery.”
Event Agenda
Interface Expo enters its fourth year
Interface Expo marks its comeback to London’s Queen Elizabeth II Centre for its fourth edition on November 22.
The event is set to feature speakers including independent nurse prescriber Julie Scott, consultant ophthalmologist and oculoplastic surgeon Miss Elizabeth Hawkes, consultant dermatologist Dr Nicola Kefalas and aesthetic practitioners Dr Sophie Shotter and Dr Priya Verma.
The programme aims to address injectables and regenerative treatments in clinical practice, with a live injection demonstration, led by founder of Interface Expo and oral and maxillofacial surgeon Mr James Olding, headlining the programme.
Sponsors include pharmaceutical company Allergan Aesthetics, an AbbVie company, aesthetic device company BTL Aesthetics and skincare company SkinCeuticals.
Mr Olding commented, “The 2025 edition of Interface Expo is going to be even bigger and better with more speakers, attendees, specialty partners and opportunities for growth and networking than ever before. This is a world-class lineup of speakers who will be delivering the latest evidence-based approaches to treatments in medical aesthetics.”
Exhibition
RAMCE 2025 marks its return
The Regenerative Aesthetics and Medicine Conference & Exhibition (RAMCE) is set to take place at London’s Pullman Hotel on November 8. The programme spans four key themes – injectables, topicals, combination approaches and longevity. Featured speakers include aesthetic practitioners Dr Mayoni Gooneratne, Dr Lee Walker and Dr Kate Goldie, alongside plastic surgeon Mr George Christopoulos.
Sessions will examine emerging regenerative techniques, cellular science and patient longevity, concluding with a panel debate on the future of the field.
Content director of RAMCE Chloé Gronow commented, “RAMCE 2025 brings science, safety and substance together in a single day. It’s an event where practitioners can truly deepen their understanding of regenerative aesthetics and its practical role in modern patient care.”
News in Brief
The Children’s Burns Trust marks its 25 year anniversary
Charity organisation Children’s Burns Trust has celebrated 25 years and launched its new campaign. According to the organisation, it has provided emergency grants, family rehabilitation weekends and nationwide prevention campaigns to educate the public on the causes of burns in children and how to respond in the event of an accident. Marking this milestone, the Trust has also unveiled a new fundraising campaign to secure the future of its work.
Dermalogica debuts digital community hub
Skincare company Dermalogica has launched the Dermalogica PRO Community. According to the company, the platform is designed to connect professionals across the UK and Ireland, offering peer-to-peer advice, specialist-led discussions and a supportive space for career growth. Cirsten Hannken, general manager at Dermalogica, said, “Our ambition for the community platform is to create the most connected professional skincare network in the specialty. Here, education, innovation and peer-to-peer support come together to elevate our profession.”
Cosmetic Courses launches Ultrasound Masterclass Aesthetics training provider Cosmetic Courses is holding an Ultrasound Masterclass from November 21-23. The three-day event will cover a range of topics, including the fundamental principles of ultrasound imaging, opportunities for practical experience using live and inanimate models, and how AI can support anatomical diagnosis skills. The course will be led by plastic surgeons Mr Ali Arnaout, Mr Adrian Richards and Ms Noor Elbanna, as well as radiology specialist registrar Dr Natasha Aghtarafi and nurse practitioner Melanie Collins.
Laboratoires FILLMED UK announces new regional manager
Medical aesthetics company Laboratoires FILLMED UK has appointed Becky Hayward as the new regional manager for East Anglia and the North. The company shares that Hayward has more than 15 years of experience spanning both clinical and commercial roles. Scott Julian, Laboratoires FILLMED business unit director UK&I, commented, “With 13 years of dedicated service at Allergan Aesthetics, Hayward brings exceptional specialty knowledge, leadership and a proven track record of driving market growth.”
Not only Exosomes… but Secretomes1
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Stimulates fibroblasts to repair skin damage, boosting collagen production and improving skin elasticity.3
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Reduces oxidative stress and improves the appearance of scars, dull and hyperpigmented skin.
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Manufactured by Dermoaroma Italy. Exclusively distributed in the UK by DermaFocus. Purasomes products are not medical devices and are not intended to be injected. Please refer to the IFU for face, scalp and body.
References 1. J.Chenau et al., Secretome: Definitions and biomedical interest 2. Han, G. et al., 2022. The Potential of Bovine Colostrum-Derived Exosomes to Repair Aged and Damaged Skin Cells. 3. Privitera, A. et al., 2024. Nutri Complex 150+: A New and Effective Approach to Facial Rejuvenation. 4. Ferruggia, G. et al., 2024. Effectiveness of a Novel Compound Hair & Scalp Complex on Hair Follicle Regeneration.
GMC Under Scrutiny After Banned Doctors Cleared to Practice
Aesthetics investigates vetting procedures within the specialty
An investigation by The Times has identified 22 doctors working in the National Health Service (NHS) who were previously banned from practicing abroad. The Independent reported the doctors had faced restrictions or disciplines overseas for allegations affecting patient safety, which included sexual harassment, stalking charges and an incident involving sexual relations between a doctor and a patient.1 However, this information was not recorded on their General Medical Council (GMC) licences, and they were allowed to operate in the NHS.1 It is reported that 26 cases are now being reviewed by the GMC, and of these, 25 may have worked in the UK previously –although they do not currently hold a licence to practice. While the investigation focused on those practicing within the NHS, the findings raise alarms for the aesthetics specialty, as the GMC remains the regulatory body that oversees doctors who work within aesthetics.2 In the UK, all doctors must be registered with the GMC, hold a valid licence to practise and meet the expected standards set out in the GMC’s Good Medical Practice to work in the UK.3
As the aesthetics specialty remains largely unregulated, with no mandatory licensing requirements unless the treatment involves a surgical procedure or is carried out by a HCP in a regulated setting, there is a variation in practitioner qualifications.4,5 Therefore, patients are being increasingly encouraged to check the GMC as a marker for professional credibility and safety when choosing a practitioner.6 Aesthetic businesses, clinics and professional organisations within the aesthetics sector also rely on the GMC as part of their vetting process, ensuring that applicants hold a valid, unrestricted licence to practise and have no conditions, warnings, or active investigations listed on their record.
Regulatory response
In response to the findings of the investigation, a spokesperson for the GMC said, “We take our role protecting patients extremely seriously. We always actively seek information from overseas regulators when doctors who have been working abroad apply to register with us. Doctors wishing to gain registration should be under no illusion about their duty and responsibility to tell us anything that might affect their ability to practise safely in the UK –our professional guidance makes this very clear.”
The regulatory body added that it will continue to review each case “carefully and thoroughly,” and where doctors are registered with it, decide what action it might need to take. The GMC assured Aesthetics that it routinely receives information from overseas regulators including by way of the Physician Information Exchange, which has been developed by the International Association of Medical Regulatory Authorities (IAMRA). The GMC also shares information proactively with regulators overseas, including in the EU, where it has taken action against doctors registered with it.
Calls for greater oversight from the GMC
Since the disclosure, there has been calls by the specialty for a stronger oversight and greater intervention by the GMC. Ashton Collins, founder and director of aesthetic practitioner register Save Face, commented, “We are deeply concerned by the allegations reported in The Times regarding doctors facing professional restrictions overseas being able to practice unhindered in the UK. It is paramount that patient safety is not compromised and that robust checks are in place to ensure the public receives care from practitioners who meet the relevant standards of professional competence and ethical conduct.”
Secretary of State for Health and Social Care, Wes Streeting, has called for urgent clarification from the GMC regarding its processes for vetting international doctors seeking to work in the UK. Streeting commented, “The public rightly expects that any doctor practising in this country meets the highest standards of professional conduct, and these horrific allegations represent a serious failure in our medical regulatory systems that I will not tolerate.”
Ensuring robust vetting standards
Aesthetic practitioner Dr Aggie Zatonska, who runs a clinic in Surrey and has employed multiple doctors highlights that aesthetic businesses have a major responsibility to conduct their own due diligence. She says the investigations findings are of “Serious concern and emphasises the importance of robust vetting to protect patient safety.”
According to Dr Zatonska, while GMC registration is essential, it is not the only factor that should be assessed. In her clinic, all practitioners go through a rigorous recruitment process, that includes disclosure and barring service checks (DBS), professional references, proof of appraisals and revalidation, as well as British College of Aesthetic Medicine (BCAM) membership for all practitioners joining the team.
Membership to organisations like BCAM can provide an added layer of protection, offering guidance on standards and regulation in the aesthetics sector. International doctors applying for BCAM membership go through a rigorous process which includes registration with their countries equivalent regulatory body, three years of general professional experience and 12 months working in the aesthetic specialty. Candidates also must provide references, enhanced DBS certification and proof of all aesthetic qualifications and training, as well as proof of identity and address. Beyond paperwork, Dr Zatonska evaluates communication skills and bedside manner during recruitment, as she believes these are equally important for patient safety and trust. As an international practitioner herself, Dr Zatonska relayed that when she began practicing in the UK in 2011, she had to provide extensive documentation from her country of training. These included certificates and qualifications from medical colleges, hospitals or training institutions, confirming her specialty; a CGS; and written statements of conduct signed by the head of the department and her former educational supervisor.
An ongoing investigation
While the investigation is ongoing, the GMC has shared that it has added an alert to the records of each doctor who has been questioned, to ensure they are not granted erasure from the register, and to prevent any licence restoration without full GMC investigation of concerns raised. Dr Zatonska concludes, “Building and maintaining public trust starts with openness and accountability. Transparency should be a daily practice. Trust grows when people see consistent care, professionalism and a genuine commitment to doing what’s right every single day.”
Where Innovation Meets Community in Medical Aesthetics
Unite with the aesthetics specialty at ACE 2026 to achieve clinical and business excellence
In a specialty that thrives on collaboration and shared knowledge, coming together as a community has never been more important. Following the success of The Clinical Cosmetic Regenerative Congress (CCR) this September, it’s time to look ahead to the next major event in the aesthetics calendar – the Aesthetics Conference & Exhibition (ACE) 2026, returning to the Business Design Centre, London, on March 13 and 14.
ACE brings together thousands of practitioners, brands and key opinion leaders (KOLs) for two full days of clinical and business learning, innovation and networking. With six CPD-certified theatres, more than 100 speakers and a vibrant exhibition floor hosting 80+ leading companies, ACE 2026 is set to deliver its most ambitious programme yet.
Whether you’re an experienced injector or new to the specialty, ACE is your opportunity to enhance your knowledge, refine your techniques and strengthen your professional connections.
Headline Sponsor: Allergan Aesthetics, an AbbVie Company
Returning as Headline Sponsor, Allergan Aesthetics, an AbbVie Company, will once again deliver two days of world-class injectable education in the Main Auditorium. Attendees can look forward to evidence-based sessions from some of the most respected experts in the field. Through in-depth case analysis, advanced full-face approaches and anatomy-led techniques, Allergan Aesthetics’ sessions will empower delegates to refine their practice and deliver balanced, natural results for every patient.
Read more on p.12.
Learn, innovate and elevate your practice
ACE 2026 combines clinical excellence with business insight, giving both clinicians and clinic owners access to a wide variety of educational experiences across six specialist theatres.
Cutting
Edge Theatre (NEW for 2026)
Debuting at ACE 2026, the Cutting Edge Theatre will spotlight pioneering research, new treatment concepts and the next generation of aesthetic science. From the latest devices to digital tools and innovative skin therapies, this is the place to discover what’s next in the specialty.
Aesthetics Mastery Theatre
Get closer to the action in the Aesthetics Mastery Theatre, where live demonstrations and technical tutorials will showcase advanced injecting and device techniques. This theatre focuses on precision, artistry and achieving exceptional patient results.
In Practice Theatre
Perfect for clinic owners and managers, the In Practice Theatre delivers commercial advice on marketing, finance, leadership and compliance. Hear from award-winning practitioners and business consultants sharing the strategies that drive sustainable growth.
For those newer to the specialty or looking to get into the field, this stage will host the Getting Started in Aesthetics agenda, which will provide an introduction on how to kickstart your aesthetics journey.
Outside the theatre is the In Practice Zone, where you can find all the products, services and solution providers to help upskill your clinic.
The Innovation Forum
The go-to stage for new ideas, product launches and cutting-edge advancements. This fast-paced theatre offers an exclusive look at the future of aesthetics, featuring technologies and techniques set to transform clinical outcomes.
Association Theatre
In partnership with leading specialty bodies, the Association Theatre will address crucial topics such as patient safety, training, ethics and regulation, supporting practitioners to uphold the highest professional standards. This will be located in the Platinum Hall, which is your go-to for all the Platinum Sponsors of the show leading in clinical education.
Explore the exhibition
Located across two levels of the Business Design Centre, the ACE exhibition floor is home to more than 80 aesthetics brands presenting the latest injectables, devices, skincare and business solutions.
Delegates can meet face-to-face with top suppliers, experience live product demonstrations and gain insight into the technologies shaping medical aesthetics today. Expect returning favourites alongside innovative new exhibitors launching products and services for the first time at ACE.
The Platinum Hall will also return, bringing together premium aesthetics companies and Platinum Sponsors in one space. Located above the main exhibition floor, it offers direct access to the Main Auditorium, Aesthetics Mastery Theatre and exclusive VIP lounge, creating an immersive education and exhibition experience.
Connect with your community
ACE is more than just a learning experience – it’s where the aesthetics community comes together. Across the show floor and networking zones, delegates can share experiences, exchange ideas and build meaningful professional relationships.
Networking highlights include:
· The official ACE Networking Drinks – open to all attendees.
· In Practice Zone Networking Drinks – open to all attendees connect with business experts and peers.
· VIP Lounges and sponsor-hosted receptions – exclusive, invite-only events with leading brands.
These moments offer the perfect opportunity to unwind after a day of education and make connections that last long after the event closes.
Celebrate excellence at The Aesthetics Awards
After two inspiring days at ACE, the weekend culminates in a night of glamour and recognition at The Aesthetics Awards 2026, taking place on Saturday March 14 at the prestigious Hilton Park Lane, London.
Now in its 14th year, the Awards honour the practitioners, clinics and companies leading the way in medical aesthetics. Join colleagues and friends for an unforgettable evening of
celebration, entertainment and networking as the Winners are crowned.
Early Bird tickets are available now –purchase before December 31 to secure your discounted rate and guarantee your seat at the most anticipated event of the year.
New in 2026: select your seating when you purchase – first come, first served. Secure a prime spot by booking early!
Why attend ACE 2026?
· Free-to-attend, CPD-certified clinical and business education across six theatres
· 100+ world-class speakers and live injectable demonstrations
· 80+ exhibiting brands showcasing the latest products and innovations
· Exclusive networking opportunities across both days
· The Aesthetics Awards 2026 – celebrating excellence in the specialty
Secure your place
Whether you’re looking to advance your clinical skills, expand your business or simply reconnect with your peers, ACE 2026 will inspire you to elevate your practice and shape the future of aesthetics.
AbbVie has part-sponsored this event, including provision of a stand and/or a speaker programme/medical symposium. AbbVie has had no influence over the content or topics covered in other parts of the agenda.
GO BEYOND WITH ADVANCED PERFORMANCE
Relfydess™ provides a natural, revitalised look that patients are satisfied with and would recommend1-5
~90% were satisfied after 1 month and satisfaction remained high through 6 months*2,3
Up to 98%
would return for treatment and recommend Relfydess™ after 1 month, with up to 90% agreeing through 6 months†4,5 71% preferred Relfydess™ compared to previous neuromodulators they’d been treated with after 1 month‡6
Relfydess™ is indicated for the temporary improvement in the appearance of moderate-tosevere glabellar lines (GLs) at maximum frown and moderate-to-severe lateral canthal lines (LCLs) at maximum smile alone or in combination, in adult patients under 65 years, when the severity of these lines has an important psychological impact on the patient
* Based on the Facial Lines Treatment Satisfaction Questionnaire (FLTSQ) completed by all ITT patients treated with Relfydess in the READY-1 and -2 studies. 94% (GLs, n=218) and 87% (LCLs, n=226) of patients at Month 1 and 77% (GLs, n=210) and 71% (LCLs, n=223) at Month 6 were satisfied or very satisfied with their treatment.2,3
† Based on the FLTSQ completed by all ITT patients treated with Relfydess in the READY-1 and -2 studies. 98% (GLs, n=218) and 93% (LCLs, n=226) of patients at Month 1 and 90% (GLs, n=210) and 86% (LCLs, n=223) at Month 6 agreed or strongly agreed with the statement ‘I would have this treatment done again’. 98% (GLs) and 93% (LCLs) of patients at Month 1 and 90% (GLs) and 88% (LCLs) at Month 6 agreed or strongly agreed with the statement ‘I would recommend this treatment to others’.4,5
‡ Based on the Subject Treatment Questionnaire completed by all ITT patients treated with Relfydess in the RELAX study (n=99). Patients agreed or strongly agreed with the statement ‘I prefer to be treated with this study product than with other neuromodulators I received in previous treatments’.6
References: 1.Galderma. Relfydess Summary of Product Characteristics. July 2024. 2. Galderma Laboratories. MA-47072. Clinical Study Report for Protocol 43QM1602: READY-1. Fort Worth, TX: 2021. 3. Galderma Laboratories. MA-47073. Clinical Study Report for Protocol 43QM1901: READY-2. Fort Worth, TX: 2021. 4. Galderma Laboratories. MA-47073. Clinical Study Report for Protocol 43QM1901: READY-2. Tables 14.2.12.4 and 14.2.13.2. Fort Worth, TX: 2021. 5. Galderma Laboratories. MA-47072. Clinical Study Report for Protocol 43QM1602: READY-1. Tables 14.02.11.04 and 14.02.12.02. Fort Worth, TX: 2021. 6. Galderma Laboratories. MA-59692. Clinical Study Report for Protocol 43QM2106: RELAX. Fort Worth, TX: 2023.
This medicinal product is subject to additional monitoring. This will allow quick identification of new safety information. Healthcare professionals are asked to report any suspected adverse reactions.
SAY HI
to
NUCEIVA® is indicated for the temporary improvement in the appearance of moderate to severe vertical lines between the eyebrows seen at maximum frown (glabellar lines), when the severity of the above facial lines has an important psychological impact in adults below 65 years of age.1
Restoring the Skin Barrier Using Regenerative Skincare
Practitioners share how regenerative science and microbiome-focused formulations are reshaping approaches to skin health and treatment outcomes
Healthy skin has become one of the most sought-after aesthetic outcomes of the past decade. A generation of patients increasingly recognise that glowing, resilient complexions are built not only on injectables or energy-based devices, but on the integrity of the skin barrier itself.1 From viral “skin cycling” routines to the popularity of barrier-supportive products, conversations around the microbiome and regeneration have moved firmly into the mainstream.
Dermatological studies indicate that up to 70% of individuals now report some degree of sensitivity – a sign that barrier impairment is widespread.2-4 With external stressors such as pollution, UV exposure and over-exfoliation, combined with internal factors like hormonal shifts and stress, the epidermis is under more strain than ever.2-4
For practitioners, this shift has major implications. Barrier function underpins every aesthetic procedure, influencing comfort, recovery and long-term treatment success. In this feature, aesthetic practitioners Dr Xavier Goodarzian, Dr Becky Rollett and skin scientist Trevor Steyn explore what compromises the barrier, how regenerative science can restore it and why microbiome health may be the next revolution in aesthetic skincare.
Understanding barrier impairment
Dr Goodarzian describes the barrier as the foundation of all skin health. “When it’s compromised, everything else becomes secondary,” he says. He highlights common causes such as over-exfoliation, excessive use of active ingredients and aesthetic overtreatment without sufficient recovery periods. He adds that other contributors include harsh cleansers and incorrect pH formulations that strip natural lipids, UV damage and pollution that accelerate inflammation and age-related hormonal decline, particularly reduced oestrogen and thyroid function, which lower sebum and ceramide synthesis. “Clinically, patients present with dryness, flaking, tightness, redness, stinging or burning sensations and an overall dull or rough texture,” he notes. “In severe cases, even water or gentle products can trigger discomfort – a classic sign that the barrier has lost integrity,” he adds. Steyn echoes the prevalence of this concern from a microbiological perspective. “If the statistics are correct, people with a compromised skin barrier make up the bulk of your patient base,”2-4
he says. “Much the same as in the gut, the skin’s barrier function is primarily dependent on the microbiome.”
He explains that the loss of key microbial species through overuse of antibiotics, preservatives and harsh surfactants has weakened the skin’s natural defences.4 “It’s time for a shift to a more sensible approach that gets barrier function back on track to optimise skin health,” he says.
Dr Rollett adds that other medications such as isotretinoin, topical steroids or chemotherapy agents may break the skin barrier – sometimes temporary, but some having lasting effects. She also notes that sometimes there can be barrier disruption from in-clinic procedures such as lasers, microneedling or chemical peels. “It is essential that the correct products are used, pre-skin prep and patient education are all key to these working as best they can with as little downtime and disruption to the skin’s flora as possible,” she adds.
“Regenerative skincare plays a critical role in restoring lipid balance (ceramides, cholesterol, fatty acids), reinforcing the stratum corneum, encouraging cellular turnover and reducing inflammation and oxidative stress effects”
Dr Becky Rollett
Assessing the barrier
All professionals emphasise the importance of a thorough consultation and visual assessment before any intervention.
Dr Goodarzian says that he starts by reviewing the patient’s current skincare, aesthetic treatments, diet and lifestyle. “Overuse of exfoliants, retinoids or peels is often the first clue,” he says. He examines surface texture, hydration, erythema and oil balance, looking for signs of transepidermal water loss (TEWL), adding, “If available, I may use skin analysis imaging such as VISIA, Aura or OBSERV, or hydration and TEWL devices like a Corneometer or Tewameter for a quantitative assessment, but in most cases, an experienced eye and patient history are sufficient.”
Dr Rollett advises the use of diagnostic tools such as a skin scanner. “I use the ALMA IQ skin scanner to assess any redness – this means pigmentation, dryness, photodamage, rhytides, among others,” she says.
Steyn adds that lifestyle clues are equally revealing. “As well as antibiotic use, practitioners should look at environmental habits,
such as long, hot showers or the use of soap on the body, both of which can strip the acid mantle. You can visually check for redness, dryness or uneven skin texture and do a tactile test like the cheek pinch technique to estimate elasticity and hydration,” he says.
“New techniques now allow reasonable shelf-life on products that contain live bacteria at reasonable cfu/ml, so we can also supplement the skin microbiome with live biotherapeutics”
Trevor Steyn
From repair to regeneration
Once damage is identified, the focus turns from replenishment to renewal. Dr Rollett explains, “Regenerative skincare focuses on supporting skin renewal, cellular communication, collagen banking and barrier rebuilding. It plays a critical role in restoring lipid balance (ceramides, cholesterol, fatty acids), reinforcing the stratum corneum, encouraging cellular turnover and reducing inflammation and oxidative stress effects.”5
Dr Goodarzian distinguishes traditional repair, which simply replaces lipids and moisture, from regenerative formulas that “signal repair and renewal through bioactive ingredients such as growth factors, peptides, exosomes and stem-cell derived factors.” These stimulate the extracellular matrix (ECM) and improve cell communication.5 “In my clinic, I often describe it to patients as ‘helping the skin remember how to heal.’ By using regenerative products post procedure or during recovery phases, we significantly reduce inflammation, downtime and the risk of post-treatment sensitivity,” he explains.
Ingredients and innovations for barrier recovery
Dr Goodarzian favours formulations that combine lipid replenishment, hydration and regenerative stimulation. “I look for barrier lipids such as ceramides, cholesterol and linoleic acid to rebuild the lipid matrix and restore integrity; humectants such as glycerine, urea, hyaluronic acid and pyrrolidone carboxylic acid to retain moisture and improve elasticity.” He adds that he also employs regenerative peptides and growth factors such as copper peptides, and EGF or FGF analogues to stimulate repair and ECM production; antioxidants such as vitamin C, resveratrol and green tea polyphenols to neutralise oxidative stress; as well as soothing agents such as panthenol, niacinamide, centella asiatica and allantoin to calm inflammation and reduce sensitivity.
“Niacinamide deserves special mention,” he adds. “It supports ceramide synthesis, improves barrier function and reduces redness, making it ideal during recovery.”6
When it comes to supporting barrier recovery, Dr Rollett finds a combination of targeted ingredients and advanced technologies
to be most effective. She says, “Lipids are my personal favourite, my personal choice is Triple Lipid 242 Cream by SkinCeuticals, which contains ceramides (NP, AP, EOP), cholesterol and free fatty acids, but other products are available. These help to restore and strengthen the skin’s natural barrier.” She adds that she also relies on soothing and anti-inflammatory agents such as vitamin B5, as well as niacinamide and RGN6, to calm and protect the skin. “Regenerative actives, including signalling peptides like pro-collagen and exosomes following laser or microneedling treatments, further support repair and renewal,”7 she says. Steyn highlights advances in biotech as transformative for the microbiome field. “There have been amazing advances in biotech over the last couple of decades,” he explains. “It has become possible to sequence the skin microbiome reliably and relatively cheaply. As an example, we have been using shotgun metagenomic sequencing as a diagnostic tool.”8
Although currently more common among affluent patients, he predicts this will become mainstream as costs fall. “It’s still a little pricey and not easily accessible for all – priced at around £190 – but those on higher incomes are more than happy to use this to get to the underlying cause of their skin troubles.”
He also points to the rise of live biotherapeutics and novel fatty acids. “New techniques now allow reasonable shelf-life on products that contain live bacteria at reasonable cfu/ml, so we can also supplement the skin microbiome with live biotherapeutics,” he says, adding, “The work on short-chain fatty acids has also translated from the gut to skin and other fatty acids that are unique to human sebum, like sapienic acid, have made their entrance as a new technique to shift the microbiome.”9
Creating sustainable regimens
For patients with a compromised barrier, all interviewees advocate simplicity and patience.
Dr Goodarzian follows a phased, structured plan:
Step 1 – reset (two to four weeks): Strip back everything. Patients use only a gentle pH-balanced cleanser, a ceramide-rich moisturiser and a soothing barrier serum. No exfoliants, retinoids or acids.
Step 2 – regenerate: Once comfort and hydration improve, introduce regenerative actives such as peptides, growth factors or exosomes to accelerate repair and restore radiance.
Step 3 – maintain and protect: Introduce antioxidant protection and daily SPF50. Retinoids or exfoliants can be reintroduced slowly once tolerance is re-established.
He summarises this as a “less is more” philosophy that helps patients “rebuild trust in their skin and achieve sustainable, long-term health rather than quick cosmetic fixes.”
Figure 1: Patient before and eight weeks after treatment using MOXI laser and SkinCeuticals Advanced RGN-6 cream. Images courtesy of Dr Becky Rollett.
Steyn’s approach aligns closely. “In general – patients should do less, but better,” he says. “The days of harsh double-cleansing routines are numbered – we’re now recommending lukewarm water to cleanse in the morning.”
He emphasises nourishing the microbiome rather than stripping it.
“The main food source for the skin’s microbes is sebum. Humans produce eclectic sebum at high metabolic cost in order to feed coevolved microbes that perform key functions on skin.10 Products need to match the nutrient profile of sebum as closely as possible, which is a lot easier to say than to do,” he explains.
For Dr Rollett, the first step is also to simplify the routine, stripping it back to the essentials – a cleanser, moisturiser and SPF. “It’s also important to eliminate known irritants, so I avoid alcohol-based products, exfoliating acids or strong actives,” she says.
She adds that cleansing should be gentle, using pH-balanced, non-stripping and non-foaming products. “I recommend ceramide-rich moisturisers, resting the skin and avoiding makeup where possible, as some products can be drying or clog pores. SPF is crucial – it’s non-negotiable for melasma and rosacea pathways, otherwise patients won’t get the full benefit of their treatments, both in time and financially. I’m really frank about this step.”
Once the barrier shows improvement, usually within two to four weeks, Dr Rollett gradually reintroduces actives step by step and schedules more frequent reviews during this stage. “Listening to the patient is vital – if something isn’t working, it may need more time or if it’s making things worse, we assess why. Sometimes transient dryness occurs with reintroducing a retinol, or the product may simply be too strong for their skin type and adjustments need to be made accordingly,” she says.
Synergy with aesthetic treatments
All practitioners note that regenerative skincare enhances procedural outcomes and reduces downtime when used strategically around in-clinic treatments.
Dr Goodarzian explains, “The key is timing and synergy. Regenerative skincare enhances results when used strategically before and after procedures.”
“For microneedling or radiofrequency microneedling, I apply exosome or growth factor serums immediately post procedure to boost healing and collagen synthesis,” he says. “For chemical peels, I precondition the skin with a barrier-repair routine for two to four weeks and use soothing, regenerative creams post-peel to accelerate recovery.”
He applies similar principles to laser and injectable treatments, combining antioxidants, peptides and regenerative factors to reduce inflammation and improve resilience. “Practitioners should always prioritise skin health before intensifying procedures,” he advises. “Regenerative skincare acts as both a preparatory and recovery tool, ensuring safer, more predictable results.”
“Regenerative skincare acts as both a preparatory and recovery tool, ensuring safer, more predictable results”
Dr Xavier Goodarzian
Steyn agrees that many treatments affect the microbiome and that practitioners must support its recovery. “Many aesthetic treatments impact the microbiome, and it is essential that steps are taken to aid its recovery and restore full barrier function as quickly as possible,” he says. “There has been research recently showing that live probiotics can improve results and reduce risk in microneedling and laser treatments, for example.”11,12
Managing expectations and long-term outcomes
Barrier restoration is a gradual process that demands consistency and education, stresses Steyn. “It has generally taken years for the patient to break down the skin barrier with antibiotics, preservatives, pollutants and other lifestyle factors. It’s unreasonable to think that it can be instantly restored,” he says. “The microbiome will need to be rebuilt and remodelled with curated nutrients and allowed to thrive by removing synthetic pollutants. Patients should expect recovery to take at least a month, and DNA sequencing studies have shown that the process can take up to four months.”13
Dr Goodarzian notes that proper patient education is everything. “I explain that barrier repair is a process, not a quick fix – most patients see noticeable comfort and hydration improvement within two to three weeks, but full restoration can take six to eight weeks depending on damage.” He reminds patients that “visible radiance, even tone, and smoother texture are the natural outcomes of barrier health, not the goal itself,” noting that compliance improves dramatically once patients understand this.
Dr Rollett says she provides tangible evidence of progress to her patients through before-and-after photos and skin scans, highlighting areas that may require further treatment. “I am completely transparent about the limits of topical results and make it clear when in-clinic or even surgical interventions may be necessary,” she says.
Key takeaways
The science of the skin barrier has evolved from a discussion of moisture and lipids to one of regeneration and ecology. By uniting regenerative actives with microbiome-supportive formulations, practitioners can help patients move beyond temporary repair toward true restoration of skin function.
As all interviewees emphasise, the future of skincare lies in helping the skin – and its living ecosystem – remember how to heal itself.
Figure 2: Patient before and after eight weeks of the Esse Skincare Clarifying Range. Images courtesy of Trevor Steyn.
Multi-Modality Approaches for Managing GLP/GIP Side Effects
Aesthetic nurse prescriber Anna Baker discusses multi-modality approaches to addressing tissue changes with glucagon-like peptide-1 agonists and glucose-dependent insulinotropic polypeptide therapies
Current literature suggests that medical aesthetic practitioners are noticing an increase in demand from patients seeking treatments to counteract accelerated skin ageing associated with glucagon-like peptide-1 receptor agonists (GLP-1RA), as well as glucose-dependent insulinotropic polypeptide (GIP) therapies.1 The distinct and detrimental changes in tissue quality – most notably on the face, but also reported on the body – appear to arise from a number of factors.2 These include a loss of dermal and subcutaneous white adipose tissue coupled with altered proliferation and differentiation of adipose-derived stem cells (ADSCs).3
Consequently, this impacts the production of a variety of hormonal and metabolic factors, which can compromise skin barrier integrity, as well as potential reduced muscle mass, and negatively impacting and accelerating the overall symptoms of ageing.4
This article will consider the mode of action of GLP-1RA/GIP therapies and propose several regenerative topical ingredients and treatment modalities that can counteract these specific tissue changes.
These suggested treatment options are not intended to be exhaustive or exclusive, but a collective of some of the most popular approaches suited to these indications and concerns.
Background of GLP-1s
There has been a huge surge of interest surrounding the use of GLP-1 agonists.5 Historically, in 1906, clinical researchers identified that an extract from the intestine may hold potential to lower blood glucose levels, however this discovery was overshadowed by the discovery of insulin in 1921.6
In 1908 it had become established and understood how the extract contained GLP-1, essentially a hormone cleaved as a product of glucagon, which is produced by intestinal mucosa and the pancreas, in response to an increase in blood glucose levels. This incretin effect was demonstrated in 1987 when scientists administered GLP-1 into 18 fasted research volunteers, whereby it was observed that insulin levels rose and glucose levels fell, with an effect that was heightened following ingestion of a glucose sample.5
While GLP-1 receptor agonists were originally developed to treat type 2 diabetes they are now increasingly used for weight loss, especially in people living with obesity. Despite an abundance of evidence about the effectiveness and safety of GLP-1 receptor agonists for weight loss, network meta-analyses are inconsistent in their quality and scope, and this is a fast-moving field.7
GLP-1 receptor agonists are associated with significant contraindications, precautions, as well as adverse reactions.7 These therapies are contraindicated in patients with a history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2.7 These therapies are associated with severe warnings, including
the risk of thyroid tumours, pancreatitis, hypersensitivity reactions, acute kidney injury, complications related to diabetic retinopathy and acute gallbladder pathologies. Reported adverse reactions have also included nausea, vomiting, appetite suppression, diarrhoea, constipation and abdominal pain.7
Bakuchiol
has potent antioxidant properties, anti-inflammatory benefits, as well as improved epidermal regeneration, which serve well to correct many GLP-1 skin changes
Mechanisms of action
GLP-1 is an incretin hormone produced by enterocrine L cells localised in the duodenum.8 Incretins are hormones, which are primarily secreted by the L cells of the small intestine and colon in response to oral consumption, in particular, glucose.9 There are two key incretins, specifically, GLP-1RA and GIP, both of which are rapidly degraded by the enzyme dipeptidyl peptidase 4.1
GLP-1RA/GIP therapies have transformed the landscape of metabolic treatment for diabetes and obesity.1 Incretin effects of these treatments help to regulate blood glucose levels, encourage satiety and facilitate, often considerable, weight loss.
GLP-1RA therapies enhance glucose-dependent insulin secretion, suppressing glucagon secretion and delay gastric emptying.10 These are key benefits for controlling blood sugar levels in patients with diabetes, yet also serve multiple medical purposes, such as reducing cardiovascular risks.10 GLP-1 has also been shown
to possess anti-inflammatory effects on pancreatic islets and adipose tissue.11
GLP-1RAs are gaining importance with expanding research in neurodegenerative disorders, potential reno-protective actions, as well as asthma and psoriasis.12 GLP-1 is expressed in a diverse range of immune cells, which facilitates significant immunomodulatory effects. Recent data indicates that GLP-1RAs have immunoregulating effects and can reduce systemic inflammation and systemic ageing.13
Cutaneous changes and implications
Both GLP-1 and GLP-1RAs bind with a transmembrane GLP-1 receptor, coupled with G-protein which activates the adenylic cyclase and increases cAMP levels.4 GLP-1Rs are widely located across many tissues, including the skin. Concerns have been reported relating to the potential of GLP-1RAs to trigger muscle atrophy in addition to their proven efficacy in reducing weight.3 These treatments target GLP-1 receptors throughout muscle tissue, but cannot distinguish between fat mass and fat-free mass reduction, which may contribute to the overall facial and widespread skin changes seen on individuals receiving treatment.3
In addition, GLP-1RAs target GLP-1 receptors in white adipose tissue (a significant component of human body weight – 10/20% of total weight in lean adults).3 White adipose tissue plays important roles in contributing to skin health through metabolic and paracrine activities. GLP-1RAs have been shown to inhibit the in vitro proliferation and adipogenic differentiation of ADSCs within a few days of exposure, whilst enhancing production of adiponectin, increasing the fatty acid oxidation in adipose tissue.3
In light of the frequently reported and observed rapid acceleration in loss of tissue density and increased laxity, a frequent concern report by patients is the fragility of skin, as well as loss of volume, particularly fat depletion.3 A combined approach, initially with a topical regimen that is then paired with a modality is beneficial in improving skin quality by priming fragile and skin thin beforehand.
Topical corrective approaches
Topical skincare approaches should be considered as a key component underpinning the patient journey in correcting skin changes with GLP-1 therapies, either for standalone benefits or to supplement a combination plan of treatment, and to support maintenance in counteracting future tissue changes with sustained GLP-1 therapy.10
Peptides
Topical peptides are an established class of ingredients utilised widely across formulations for their diverse, regenerative and specific cell signalling mechanisms.14 These intuitive biological cues have consistently demonstrated broad and wide-ranging physiological effects, which include; antioxidant, antiageing, moisturising, collagen stimulating and wound healing properties, which characteristically support their application in counteracting the unique tissue changes noted with GLP-1 therapy.15 Peptides are short chains of two to 50 amino acids linked together by peptide bonds.15 These intelligent signalling molecules are ideally placed to correct many of the age-related skin changes seen with GLP-1RA/ GIP injections. Peptides can be categorised according to their function, and can be considered by these:
· Anti-microbial peptides: Gently defend the skin against microorganisms by disrupting their cell membranes.15
· Enzyme inhibitor peptides: Inhibit the action of enzymes that break down collagen, to support a strong scaffold within the skin.16
· Neurotransmitter inhibitor peptides: Restrict the release of neurotransmitters that allow muscle contraction and therefore
soften the appearance of lines and wrinkles.15
· Carrier peptides: Deliver trace elements to the skin, which are key factors for components for wound healing and a variety of key enzymatic processes.16
· Signal peptides: Trigger collagen and elastin regeneration, as well as keratinocyte and epidermal proliferation.15
Topical skincare approaches should be considered as a key component underpinning the patient journey in correcting skin changes with GLP-1 therapies
Patent pending XOSM
A proprietary, patent-pending technology which amplifies the antioxidant effects of ectoin, vitamin C and astaxanthin-rich micro-algae. The mechanism of action within tissue allows for the delivery and penetration of proven antioxidants, as well as augmenting overall efficacy. This technology reduces pro-inflammatory cytokine secretion as well as reducing MMP-9 levels that can contribute to collagen decline. This synergy protects the skin against oxidative stress and neutralises free radicals with enhanced skin barrier integrity and reduced transepidermal water loss (TEWL), which are ideal benefits for dehydrated and deflated skin.17,18
L-Ornithine amino acid (ornithine)
Ornithine has been proven to increase fatty tissue volume through three key mechanisms:19
1. The activation of adipogenesis (transformation of pre-adipocytes in to adipocytes).
2. The activation of lipogenesis (fatty acids synthesis).
3. The inhibition of lipolysis (breakdown of lipids into free fatty acids).
These mechanisms are highly effective at restoring tissue density seen through (GLP-1RA/GIP) injections and are critical to addressing these unique tissue changes.19
Bakuchiol
Bakuchiol is a botanical and an established alternative to retinol, effectively mimicking many of its benefits, including boosting collagen production, specifically types I, III & IV.20 These benefits lead to increased skin firmness, as well as improvements in skin tone and texture. A study found that bakuchiol effectively delivers a broad range of antiageing effects, including potent antioxidant properties, anti-inflammatory benefits, the expression of key extracellular matrix (ECM) components and improved epidermal regeneration.21 These effects serve well to correct many GLP-1 skin changes such as collagen depletion, as well as loss of elasticity and hydration.22,23
HA Silanol
This type of hyaluronic acid (HA) is combined with silicium for enhanced hydration and firmness, with data to support renewed HA synthesis, along with increased collagen production to improve the compactness of the skin. This ingredient is an effective choice to restore hydration and contribute to overall firmness.24
Plant collagen fragment
This extract (glycerine, water, pentylene glycol, nictoiana benthamiana hexapeptide-40, sh-polypeptide-47) is a biomimetic fragment of human type I collagen, which is proven to tighten and firm the skin by boosting collagen and increasing alpha 2 beta 1 integrin, resulting in a stronger, firmer skin.25 In addition, this complex effectively regenerates procollagen I and supports collagen-fibroblasts binding site reinforcement, which are key benefits in addressing skin laxity and thinning associated with GLP-1 skin changes.26
Treatment modalities
Medical aesthetic practitioners are increasingly exploring treatment modalities in response to correcting the accelerated facial ageing and altered skin health noted in GLP-1 patients.3
Radiofrequency
Radiofrequency (RF) is a type of non-ionising radiation within the frequency range of 30 KHz and 300 GHz, which is located in the low-energy remit of the electromagnetic spectrum.27 RF is a form of alternating electric current, and is used in aesthetic and medical energy-based devices, creating electric fields between two electrodes which function within a limited range of the RF spectrum.27 The charge at the skin’s surface switches from positive to negative, driving interactions between charged molecules and ions, which cause the polar molecules to vibrate at approximately six million times per second.28
RF energy may potentially be delivered through different tissues, which can include, skin, fat and muscle as the technology has multiple indications.27 One of the most common applications of RF is for the treatment of skin laxity through decreasing the distention of the loose connective tissue through collagen denaturation.28 Targeted application of RF thermal energy causes denaturation of the triple helix (collagen helical structure of polypeptide chains), which initiates tissue retraction to activate neocollagenesis, stimulating production of collagen types I and III.27 RF has been identified as an effective non-invasive regenerative treatment option to counteract GLP-1 skin changes, specifically skin laxity and collagen depletion.3
Microneedling
Microneedling is an established and proven treatment for the face and body that can effectively treat a variety of antiageing concerns. This popular form of collagen induction, stimulates regenerative processes, and as a result, structural collagen fibres are renewed, and elastin is strengthened.29 Microneedling can improve a range of concerns on the face and body including certain types of scarring (acneic), textural roughness, enlarged pores, fine or deep lines and hyperpigmentation. It can be combined with many other procedures, including topicals, injectables, chemical peels and energy- based modalities. It is an effective delivery method for appropriately indicated glide serums, which can amplify treatment outcomes.29 Whilst a variety of devices are available, the principles and mechanisms of treatment remain the same.
Skin boosters
The demand and breadth of medical aesthetic injectable treatments designed to address a plethora of skin quality concerns has grown exponentially in recent years.30 Consequently, a
wide scope of medical injectable technologies are increasingly available, which are designed to manage a wide variety of senescent changes in skin quality on the face, neck and body by targeting laxity and improving skin firmness through a variety of mechanisms. 31
This is a specialised and emerging area of medicine, reinforcing the importance of clinicians remaining abreast of new publications and key findings pertaining to these novel prescribed therapies
Polynucleotides
Polynucleotides (PN-HPT) are an effective regenerative treatment with proven efficacy in promoting free radical scavenging, increasing collagen synthesis, improving hydration, as well as increasing the viability and number of fibroblasts.32 This regenerative treatment is a popular option to deliver natural and lasting results with a wide range of benefits, which also include reducing redness and inflammation, and is often utilised to prime and condition the skin ahead of other modalities including topicals, injectables, chemical peels, microneedling, as well as energy-based modalities to enhance treatment response and reduce treatment downtime.33
Bioremodelling
Bioremodelling is a process which triggers a regenerative cascade through the three main layers of the skin. This novel technology, utilising a patented hybrid, stabilised, injectable, HA technology addresses signs of poor skin quality and areas of laxity.34 The injectable treatment utilises a patented thermal stabilisation which is based on stable hybrid cooperative complexes of high-and low-molecular-weight HA (H-HA and L-HA), without the addition of chemical agents.35 This is formulated in high concentrations of 64mg in a 2ml syringe for the face and neck, and 96mg in a 3ml syringe for areas on the body. An initial course of two to three treatments, at a one-month interval, elicits regenerative benefits to improve elasticity, hydrate, tighten and firm the skin, which effectively alleviates seasonal dryness and dullness.36
Mesotherapy
Mesotherapy is an effective method to restore optimal HA hydration levels in the skin of the face, neck and body. Mesotherapy can be considered as a form of biorevitalisation as it not only improves the moisture levels in the superficial layers of the skin, but can improve skin brightness and signs of
photodamage.37 Biorevitalising complexes typically combine a linear (non-stabilised) HA with a specific combination of amino acids, vitamins and minerals.38 Some formulations may be premixed and ready to use and one of the principal benefits of mesotherapy is that the HA carrier effectively hydrates the extracellular matrix, allowing the additional ingredients to stimulate key ECM proteins through stimulating fibroblasts, which are critical benefits for skin undergoing GLP-1 changes.38
Biostimulatory fillers
One of the most striking and consistently reported effects of GLP-1 associated weight loss is a significant reduction in facial fat, most notably in the subcutaneous layers. This is a distinctly different concern and physical presentation to loss of elasticity (laxity), and can be effectively addressed by replenishing deep fat compartments and providing structural support.1 Specifically, biostimulatory dermal fillers, such as calcium hydroxylapatite (CaHA), and poly-L-lactic acid (PLLA), provide additional collagen stimulation benefits to support GLP-1 volume depletion.1
LED
Light emitting-diode (LED) phototherapy treats a wide variety of skin concerns on the face, neck and body, across skin types. 39 LED phototherapy refers to the use of low-level light energy at defined wavelengths to elicit a range of cellular and regenerative benefits.40 The mechanisms of action are based on the same principles as photosynthesis, known as photobiomodulation, which means that light is absorbed by target cells to activate specific biological functions. 39 In addition, there are multiple reported pathways by which clinical benefit is achieved.41 LED positively impacts cellular metabolism by triggering intracellular photobiochemical reactions, which include increased ATP, modulation of reactive oxygen species, stimulation of angiogenesis and increased blood flow among others.42
LED is a particularly effective treatment for GLP-1 depleted tissue with a compromised barrier and loss of collagen and elasticity owing to its high tolerability and non-invasive benefits. In contrast to traumatic ablative (e.g. laser resurfacing), and non-ablative (e.g. intense pulsed light) modalities, which induce secondary tissue repair by causing controlled damage, LED phototherapy is atraumatic and bypasses the initial destructive step by triggering regenerative processes within the skin.43
Wavelengths of most benefit to skins affected by GLP-1 tissue changes are red light and near-infrared (NIR). Red light (633 nm) is proven to stimulate collagen and elastin synthesis, as well as skin tone, texture and reduces the appearance of fine lines.44 Red light can penetrate at 8-10mm in the mid-dermis, and recharges ATP which enhances and restores optimal cell function and accelerates cell renewal. In addition, it helps to reduce hyperpigmentation, increase skin hydration and stimulate blood circulation.40
NIR (830 nm) provides advanced skin rejuvenation benefits by specifically modulating inflammation and accelerating healing, and is suited to even the most sensitive skins.45 NIR is outside of the visible light spectrum and is invisible to the naked eye, but can penetrate to the subcutaneous layer at between 20-100mm. 39
An emerging area of medicine
Clinicians practising medical aesthetics are expected to observe a continued rise in patients with a variety of cutaneous concerns arising from the use of GLP-1 therapies on the face, neck and body, owing to the sustained popularity of this treatment.
The symptoms described, topical ingredients and corrective modalities are suggestive, not exhaustive, and can be used interchangeably with amplified combined outcomes, often
prolonging results. Patients may manifest a varied range of symptoms ranging from volume loss, through to skin laxity, which often overlap in their presentation, reinforcing a holistic and structured assessment to plan the most appropriate treatment(s). This is a specialised and emerging area of medicine, reinforcing the importance of clinicians remaining abreast of new publications and key findings pertaining to these novel prescribed therapies, and aligning their practices accordingly-specifically with implications pertaining to skin health.
Questions
Test your knowledge!
Complete the multiple-choice questions and email memberships@aestheticsjournal.com to receive your CPD certificate!
1. Which of these severe medical cautions are associated with GLP-1 therapy?
2. What is GLP-1 an abbreviated term for?
3. White adipose tissue constitutes how much % of total weight in lean adults?
Possible answers
a. Risk of thyroid tumours
b. Acute gallbladder pathologies
c. Pancreatitis
d. Acute kidney injury
a. Glucagon-like peptide-1 agonist
b. Glycated-like peptide-1 antagonist
c. Glycagon-like peptide-1 antagonist
d. Glucose-like peptide-1 agonist
a. 10-20%
b. 20-30%
c. 30-40%
d. 10-30%
a. Restrict the release of neurotransmitters that allow muscle contraction and therefore soften the appearance of lines and wrinkles.
4. What is the correct function of enzyme inhibitor peptides?
5. L-Ornithine amino acid (ornithine) primary function is:
b. Inhibit the action of enzymes that break down collagen, to support a strong scaffold within the skin
c. Deliver trace elements to the skin, which are key factors for components for wound healing and a variety of key enzymatic processes
d. Trigger collagen and elastin regeneration, as well as keratinocyte and epidermal proliferation
a. The activation of adipogenesis (transformation of pre-adipocytes in to adipocytes)
b. The activation of lipogenesis (fatty acids synthesis)
c. The inhibition of lipolysis (breakdown of lipids into free fatty acids)
d. All of the above functions
Answers: (A,B,C,D),A,A,B,D
Anna Baker is an aesthetic nurse prescriber, trainer and qualified educator. She is a key opinion leader, and vice chair of the BAMAN Education & Training Committee and is currently undertaking an MSc in Clinical Dermatology. Qual: BN, RGN, INP, PGCert, PGDip
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Addressing Photodamage with Topical Treatments
Consultant dermatologist Dr Clare Kiely explores the mechanisms of photodamage and effective topical treatments
With an ageing population, caring for our skin health has never been so important. Photoageing is responsible for many of the cosmetic complaints among patients, including pigmentation, wrinkles, skin laxity and solar elastosis.¹ To understand how to effectively treat photodamaged skin, we first need to look at what’s happening at a cellular level.
This article examines the impact of chronic sun exposure on extrinsic ageing and outlines topical strategies to protect and repair skin – helping it last the pace, which is the key to ageing well.
What is photodamage
Photodamage, also called photoageing, refers to the changes in skin that result from cumulative ultraviolet (UV) exposure (from sunlight or tanning devices). This build-up of UV radiation over time damages DNA and disrupts key cellular functions.²
In the short term, it appears as sunburn, with redness, tenderness and peeling. These symptoms reflect DNA injury in keratinocytes, many of which undergo programmed cell death, forming what are known as “sunburn cells.”³
The long-term effects are more complex. UV generates reactive oxygen species (ROS), unstable molecules that damage proteins, lipids and DNA. Over time, telomeres shorten, DNA mutations accumulate, mitochondria become less efficient and structural proteins such as collagen and fibrillin break down. Inflammation persists, keeping the skin in a constant state of low-level stress.² ⁴ This chronic damage accelerates the visible signs of ageing and increases the risk of precancerous lesions such as actinic keratoses, as well as melanoma and non-melanoma skin cancers.⁵
Photoageing is responsible for many of the cosmetic complaints among patients, including pigmentation, wrinkles, skin laxity and solar elastosis
Intrinsic vs. extrinsic ageing
Skin ages through two processes: intrinsic and extrinsic ageing. Intrinsic ageing is the natural, inevitable process that comes with the privilege of living longer. It is largely genetically programmed and driven by changes such as telomere shortening and mitochondrial decline.²
Extrinsic ageing is shaped by environment and lifestyle. Chronic UV exposure is the biggest factor, responsible for around 80% of visible skin ageing.⁶ Smoking, pollution, poor nutrition and stress also play a role. While intrinsic ageing cannot be avoided, extrinsic ageing – particularly UV-driven damage – is largely preventable.¹
Cellular mechanisms of damage
When skin is exposed to the sun, UVA and UVB trigger a cascade of harmful events:
· DNA damage: UVB creates direct DNA lesions such as cyclobutane pyrimidine dimers (CPDs), while UVA generates ROS that indirectly harm DNA.⁷
· Telomere shortening: Telomeres, the protective caps at the ends of chromosomes, are especially vulnerable to UV, leading to reduced genomic stability and cellular senescence.⁸
· Cellular senescence: Senescent or ‘zombie’ cells stop dividing but release inflammatory signals that disrupt surrounding tissue.
· Mitochondrial dysfunction: UV and ROS impair mitochondria, reducing adenosine triphosphate (ATP) production and creating more ROS.
Matrix metalloproteinases (MMPs): These enzymes, activated by UV signalling, break down collagen and fibrillin, weakening the skin’s structure.⁹
Together, these processes combine, resulting in the hallmarks of photoageing: wrinkles, pigmentation, thinning skin, solar elastosis, fragility and ultimately, an increased risk of cancer.
Evidence-based topical treatments
Despite the complexity of photodamage, several interventions have strong evidence behind them.
Sunscreen
Broad-spectrum sunscreen is the foundation of photoprotection. By blocking UVA and UVB, sunscreen prevents CPD formation, reduces ROS and protects dermal proteins.² Regular use slows photoageing and reduces the risk of actinic keratoses and skin cancer.¹⁰ ¹¹ Advances such as encapsulated filters improve stability and ensure more consistent protection.¹² Encapsulated UV filters are sunscreen ingredients enclosed within microscopic bubbles that physically separate them from the skin and other formulation components. That means greater photostability, reduced skin irritation and more consistent UV protection over time.
DNA repair enzymes
DNA repair enzymes add a new dimension to sun protection because they don’t just prevent UV damage – they actively repair it once it has occurred. If photoageing is driven largely by DNA injury, enhancing repair capacity directly reduces photodamage.²
This was proven in a landmark randomised trial by Dan Yarosh and colleagues, published in The Lancet.¹³ 30 patients with xeroderma pigmentosum, who are at extreme risk of UV-induced lesions, applied liposome-encapsulated T4 endonuclease V. Results showed a significant reduction in new actinic keratoses compared with placebo. This study was the first to demonstrate that supplementing DNA repair can have real clinical impact. DNA repair enzymes are now found in some cosmetic products on the market, but the delivery system is key.
The most studied enzymes in modern formulations are photolyase, which uses visible light to repair CPDs through photoreactivation and endonucleases, which support the skin’s innate nucleotide excision repair (NER) pathway. Combined with sunscreens, they shift photoprotection from passive blocking to active repair at the DNA level. Benchmark formulations such as Photozyme DNA Youth Recovery Serum, Neova DNA Total Repair and The Skin Diary’s Age Defence with Photo Shield DNA Repair highlight the use of DNA-repair enzymes in dermatological skincare. These examples, amongst others, underscore the specialty’s growing commitment to molecular repair science.
Retinoids and peptides
For repairing existing structural damage, retinoids remain the gold standard. A pivotal New England Journal of Medicine trial in 1993, showed that topical tretinoin restored collagen formation in photodamaged skin in 30 patients.¹⁴ Retinoids stimulate type I collagen, increase fibrillin-rich microfibrils, normalise keratinocyte turnover and remodel the extracellular matrix (ECM).¹⁵
The main limitation is tolerability. Irritation, peeling and redness are common, especially at higher strengths. More recent work in 2022, such as Mellody et al. demonstrated that 0.3% retinol achieved comparable epidermal thickening and fibrillin deposition to 1% retinol but with significantly fewer adverse effects with biopsies in five patients and clinical follow up in 218 patients.¹⁶ Encapsulation technologies are also improving tolerability by stabilising retinoids and delivering them more gradually.
Peptides provide a useful complement, acting as signalling molecules that stimulate collagen and elastin production. Collagen-optimising peptides enhance dermal repair and work synergistically with retinoids to restore ECM integrity while maintaining tolerability.¹⁷
Other actives
A range of other topical ingredients play a significant role in supporting skin exposed to chronic UV stress. Vitamin C remains one of the most studied, functioning both as a potent antioxidant and as an essential cofactor for collagen synthesis. Topical ascorbic acid has been shown to upregulate collagen types I and III mRNA expression and increase dermal matrix stability.¹⁸
Niacinamide has demonstrated wide-ranging benefits, from strengthening epidermal barrier function to reducing pigmentation through inhibition of melanosome transfer and downregulating inflammatory cytokines. In human studies, topical nicotinamide also prevented UV-induced immunosuppression and improved epidermal repair.¹⁹
Polyphenols, such as green tea catechins and berry-derived anthocyanidins, add further photoprotective value via ROS scavenging, modulation of inflammatory signalling (including NF-κB and MAPK pathways) and inhibition of MMPs, thereby reducing collagen breakdown.²⁰ ²¹
More recently, novel antioxidants such as acetyl zingerone and astaxanthin have attracted attention for their dual role in stabilising other actives and enhancing cellular DNA repair mechanisms. Acetyl zingerone acts as a multifunctional antioxidant capable of quenching singlet oxygen and repairing oxidative degradation products of UV filters, while astaxanthin, a carotenoid derived from microalgae, supports mitochondrial protection and photodamage prevention.²² ²³
Critically, advances in encapsulation and stabilisation technologies have addressed the historical limitations of these molecules, markedly improving their bioavailability, dermal penetration and tolerability – enabling more consistent clinical outcomes.²⁴
Pre- and post-procedure skincare plays a critical role in optimising treatment outcomes and minimising recovery time. Preparing the skin with evidence-based active ingredients enhances epidermal and dermal function, improves barrier integrity, and creates a more favourable environment for regeneration.²⁵
Preconditioning the skin has been shown to improve ECM turnover, increase fibroblast responsiveness and reduce baseline inflammation – factors that directly influence how well the skin responds to procedures.²⁵ ²⁶ Furthermore, initiating active topical therapy before controlled skin injury has demonstrated superior outcomes in wound healing, scar formation, and overall tissue recovery compared to starting treatment only post procedure.²⁶
Clinical trials have also shown that using targeted serums before and after procedures such as fractional CO2 laser can significantly improve hydration, reduce transepidermal water loss and enhance patient comfort and skin quality during the recovery phase.²⁷
These findings reinforce the importance of viewing skincare not as an optional add-on, but as a therapeutic adjunct that supports both procedural efficacy and long-term skin health.
Integrating prevention and repair
When it comes to photodamage, prevention should always be the priority. Daily use of broad-spectrum sunscreen remains the cornerstone of care. DNA repair enzymes add the ability to reverse damage once it has occurred, while retinoids and peptides remain central to repairing established structural change. Other antioxidants and barrier-supporting actives play a supportive role, with modern encapsulation technologies enhancing their effectiveness.
In an ageing population, strategies that protect DNA and restore dermal architecture deliver not only cosmetic benefits but also long-term health gains. By combining prevention with repair, clinicians can help patients maintain healthier, more resilient skin capable of ageing well.
Dr Clare Kiely is a consultant dermatologist and co-founder of The Skin Diary. She has completed fellowships in dermato-oncology and Mohs surgery at St John’s Institute of Dermatology and is honorary lecturer in skin ageing and aesthetics at the University of Manchester. Dr Kiely is also chair of the Cosmetic Practice Standards Authority.
Qual: MBBChBAO(Hons), MRCPI MSc
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Managing Melasma Topically
Nurse prescriber Khatra Paterson shares a topical treatment regimen to address melasma concerns
Melasma is a skin condition characterised by brown or sometimes grey-blue flat macules and patches of discolouration of the skin. The cause is thought to be due to melanocytes, the cells that produce melanin, producing excessive amounts of the pigment, darkening the affected areas.1
Melasma typically affects facial areas; the cheeks, forehead, nose, upper lip and chin.2 The condition can have a profound effect on patients’ self-esteem.3
Causes of melasma
The epidermis contains cells called melanocytes, located in the basal layer, which are responsible for producing all the melanin found in the epidermis. They synthesise melanin within vesicles called melanosomes, which are then transported along finger-like melanocyte dendrites and transferred into surrounding keratinocytes. Approximately 36 keratinocytes surround each melanocyte; it is the presence of the melanin-containing melanosomes in keratinocytes that causes the visible pigmentation of the skin.4 In response to sunlight, hormonal stimulation, heat and inflammation in the skin, melanocytes can be stimulated to overproduce melanin, which hyperpigments the surrounding keratinocytes, creating darker areas of the skin and, as a result, melasma.1,4
Pregnant women have increased levels of the hormones oestrogen and progesterone which are thought to contribute to the overproduction of melanin, and therefore the presence of melasma.1,4,5 The darker colour usually fades after pregnancy, although it has been reported that it can persist in up to 30% of cases for up to 10 years.4 The contraceptive pill or hormone replacement therapy can sometimes cause melasma for similar reasons.5
Treatment options
Hydroquinone 4% cream is a prescription-only topical depigmenting agent commonly used to treat melasma and post-inflammatory hyperpigmentation (PIH). It inhibits tyrosinase activity and melanin production, degrades melanosomes, and studies have reported that it can cause the necrosis of melanocytes.5 In systematic reviews of melasma treatments, hydroquinone, either as monotherapy or combined with a retinoid and a corticosteroid, is the most studied
depigmenting agent and remains the most effective treatment modality.6,7
Hydroquinone cannot be used as a cosmetic ingredient in the EU or the UK. Its use was banned in the EU in 2001 (before this, its use had been possible up to a concentration of 2%). The FDA in the US has also prohibited its use in over-the-counter products. Similarly, this had been allowed at levels up to 2%. This eventually came into effect in 2020, with the FDA reporting serious side effects, including rashes, facial swelling and permanent skin discolouration (ochronosis).8,9
Consequently, hydroquinone products in the UK, EU and US are only available as medicinal products prescribed by a healthcare provider.9
Other topical ingredients and skincare
The list below is a non-exhaustive summary of those that can be found in topical formulations used either as alternatives to hydroquinone when its use is contraindicated or unavailable, or as an adjuvant to complement its use, and where appropriate, to help provide maintenance therapy after hydroquinone use has been stopped.
Retinoids: Improve dyspigmentation by inhibiting tyrosinase, reducing melanin transfer and increasing cell turnover.10,11
Niacinamide: Is believed to decrease melanin by downgrading melanosome transfer to keratinocytes in the epidermis.11
Kojic acid: Derived as a natural fungal metabolite, it is a cosmetic ingredient that is limited to a maximum concentration of 1%. Its primary action is to inhibit tyrosinase, thereby reducing melanin production.10
N-Acetylglucosamine: Has been shown to reduce melanin synthesis in vitro and in a double blind, randomised split-face clinical test to reduce facial hyperpigmentation. The effect was greater when combined with niacinamide.12
Azelaic acid: A tyrosinase inhibitor with antioxidant effects. Clinical studies of azelaic acid 20% have shown it to be effective, but with no significant difference when compared to Hydroquinone 4% Cream.6,7,11
Vitamin C (ascorbic acid): Topical vitamin C antioxidant that has a chelating action binding copper, an enzymatic cofactor in melanogenesis. It inhibits tyrosinase and the production pathway of melanin.6,11
Tranexamic acid: Its effect on pigmentation
is believed to be due to its ability to inhibit plasminogen activator (PA) and interfere with the plasmin pathway, thereby reducing melanogenesis.6,11,13
Cysteamine: Derived from the amino acid L-cysteine, it has intrinsic antioxidant properties. When compared to a placebo, cysteamine 5% cream achieved significantly better improvement in melasma after two months.6,11
Arbutin: Its mode of action is thought to relate to its antioxidant and tyrosinase inhibition. The EU scientific committee on consumer safety stated that α-arbutin was considered safe up to a maximum concentration in face creams, 0.5% in body creams and β-arbutin was considered safe in face creams up to a maximum of 7%.14
Sunscreens: The use of high factor broad-spectrum sunscreens is mandatory in the management of melasma.6,7,11
Oral therapy and supplements
Oral therapies and supplements have emerged as potential treatments for melasma or as adjuncts to improve outcomes.6
Oral tranexamic acid
Oral tranexamic acid is a prescription-only anti-fibrinolytic medicine. It prevents the conversion of plasminogen to plasmin by inhibiting the plasminogen activator enzyme. Superior results are observed in patient groups that use a combination of oral tranexamic acid and hydroquinone-based topical therapies. Although there was often a relapse after treatment was stopped.6 It should be remembered that the use of oral tranexamic acid for melasma is outside of its licensed indications.6,7
Polypodium leucotomos extract
Polypodium leucotomos extract offers antioxidant protection against UVB, UVA, visible light and infrared-A.15-17 In a RDBPC, oral Fernblock supplement was assessed as an adjuvant to Hydroquinone 4% and sunscreen SPF 50+ melasma treatment in 40 Fitzpatrick skin type III and IV over 12 weeks. The Fernblock group showed lower MASI scores than the Hydroquinone 4%, sunscreen, and placebo group from four weeks. This difference continued to reach significance after eight weeks and at 12 weeks. Suggesting a faster response in the Fernblock-treated group.3
Procyanidin
Procyanidin (extracted from maritime pine bark) has been shown to have antioxidant and anti-inflammatory properties. Oral supplement of procyanidin 24mg, with vitamins A, C and E twice a day, plus sunscreen in an RDBPC study involving a total of 6,897 participants showed
Hydroquinone
improvements in MASI in both groups, with a higher improvement in the treatment group.6
Aesthetic treatments
Chemical peels are regularly used in skin rejuvenation and hyperpigmentation treatments. Their use in studies on melasma lacks consistency in objective assessment tools and design. They are often used as adjuvant or concomitant therapy, and their known potential adverse event risks include irritation, and PIH. Therefore, the use of peels is generally considered as a second line treatment and used with caution in skin of colour.6,7 Peels might have glycolic acid, salicylic acid or trichloroacetic acid.6,11
Laser- and light-based devices have yielded mixed results in treatment. Non ablative lasers are preferred for the treatment of melasma due to their tendency to create less thermal damage and a lower PIH risk, They are generally considered as a third-line treatment for melasma, and only with extreme caution in skin of colour.6,18
Considerations
For patients with lighter skin tones, particularly Caucasian skin with Fitzpatrick types I and II, the risk of PIH is lower due to associated melanin activity than those with darker skin tones.19,20 In these patients, we have greater flexibility when considering topical agents that may cause some irritation and erythema, as well as more invasive treatments, such as medium and deep chemical peels or laser treatments, which can disrupt the barrier, induce inflammation or introduce heat into the skin and potentially stimulate melanocyte activity. However, if considering more invasive treatments, it is best to combine them with topical therapies to minimise the risk of a hyperpigmentation response and the mandatory use of very high factor full-spectrum sunscreen that protects against UVB, UVA and visible light.21
Case study
Patient assessment
A 45-year-old Caucasian female patient, with Fitzpatrick skin phototype II, presented with severe hyperpigmentation diagnosed as melasma. Her pigmentation was predominantly concentrated along the sides of her face, neck, ears and forehead. Having dealt with this condition for more than two decades, she was initially diagnosed by her GP as having sun damage. However, her pigmentation gradually worsened over the years, increasing both in depth and surface area, suggesting that her condition was either misdiagnosed or exacerbated by other contributing factors.
During her initial consultation, the patient underwent an in-depth skin analysis with the Observ520x skin scanner, which
confirmed the presence of melasma with a high pigmentation density. The scanner also revealed that her skin exhibited some sensitivity, likely a result of prolonged use of a variety of skincare products over the years.
Treatment plan
The patient was treated with a daily oral dietary supplement and topical dermatological cosmetic skincare product regimen, the ALLSKIN|MED Pigment Control Plan, to be used morning and night. The patient was directed to follow this plan daily, replacing her complex and non-beneficial skincare routine with a straightforward regime. This was used as a stand-alone treatment for the first 21 days of the case study.
The ALLSKIN|MED Pigment Control Plan consists of:
· ALLSKIN|MED Pigment Oral
Capsules: A supplement capsule containing 240mg of standardised Polypodium leuctomos extract (Fernblock), L-Cysteine (glutathione precursor), Punica granatum extract (pomegranate extract), niacinamide. These were taken twice a day, morning and night.
· ALLSKIN|MED Pigment Control
Results
We observed a visible reduction in the hyperpigmented areas' uniformity and intensity (darkness) at day 14 and 30. When the patient returned to the clinic 66 days after starting treatment, she had a significant reduction in the area, uniformity and intensity of the melasma and her skin sensitivity had also improved.
The patient’s skin was a lot glossier, tighter and firmer, and there was a difference in texture too. Unlike her first visit, the patient came to the clinic that day with no makeup on, and said she had discontinued the use of heavy makeup; her confidence was palpable, and she oozed happiness with the transformation achieved.
Serum: A serum containing ingredients that include Kojic acid, niacinamide, N-Acetyl Glucosamine, a patented retinoid combination of retinol and hydroxypinacolone retinoate (Retinsphere Technology) and salicylic acid. Used twice a day, morning and night.
· Heliocare 360 Pigment Solution Fluid:
A broad spectrum UVB SPF50+, UVA PA++++ with Visible Light and infrared-A protection provided by Fernblock+ and enhanced with additional ingredients including niacinamide, ellagic acid and iron oxide pigments. Used every day in the morning and reapplied throughout the day as required.
After 21 days, hydroquinone 4% cream was initiated alongside the regime, using once a day at night to treat the patient’s deeper pigmentation. The patient used this for 60 days, after which its use was tapered off and ceased over a four-week period.
Using the Observ520x skin scanner to provide visual analysis, the patient was assessed on day one, which provided the baseline assessment. Progress was then monitored at follow up clinic visits on day 14, day 30 and day 66.
An effective approach
Given melasma’s chronic and recurrent nature and its psychological impact on patients, effective non-invasive approaches should be the cornerstone of treatment. The case study’s treatment plan using a simple daily regime of a topical dermatological skincare formulation designed for hyperpigmentation, an oral antioxidant supplement with evidence of complimentary efficacy in treating melasma and full-spectrum photoprotection, alongside a defined period of hydroquinone 4% cream treatment, provided a well-tolerated, scientifically backed and accessible way to help support the management of the patient's pigmentation.
Khatra Paterson is an experienced nurse, FGM survivor and advocate for women’s health. With more than 32 years in healthcare and through her respected medical aesthetics practice, she champions inclusive, compassionate care and ethical beauty.
Qual: BSc, BA
Figure 1: Day one and 14 using the ALLSKIN|MED Pigment Control Plan
A Regenerative Approach to Skin Laxity and Dehydration
Dr Keiron Lord shares insights into innovative strategies to address skin ageing
Skin laxity and dehydration are among the most common age-related aesthetic concerns encountered in clinical practice. Other frequently reported concerns include fine lines and wrinkles, uneven pigmentation, enlarged pores, dullness, loss of facial volume and textural irregularities. These manifestations not only reflect intrinsic ageing but are also amplified by extrinsic factors such as ultraviolet (UV) exposure, pollution and lifestyle.1
These conditions significantly affect skin texture, radiance and perceived age, often manifesting as dullness, fine lines, loss of elasticity and a general decline in skin quality.2 While traditionally associated with middle-aged and older adults, early-onset skin laxity is increasingly reported among younger individuals, particularly those exposed to environmental stressors, photodamage or poor lifestyle habits.3 From the patient’s perspective, these signs of skin ageing often contribute to self-perceived loss of vitality, confidence and wellbeing, which are key motivators for seeking aesthetic intervention. This article explores the science behind regenerative treatments for skin laxity and dehydration, outlining how emerging approaches can enhance outcomes and address the underlying biological causes of skin ageing.
Causes and pathophysiology of ageing skin
Skin ageing is a multifactorial process driven by intrinsic and extrinsic mechanisms. Intrinsic ageing is largely genetically programmed and characterised by hormonal shifts, metabolic decline and reduced cellular turnover.4 Extrinsic ageing, on the other hand, is caused by environmental and behavioural stressors such as UV radiation, pollution, poor nutrition, alcohol and smoking.5 These influences accelerate the breakdown of collagen and elastin, impair fibroblast function, and increase the formation of reactive oxygen species (ROS), leading to oxidative stress and mitochondrial dysfunction.5 As a result, the skin becomes thinner, drier and less elastic, with impaired barrier function and increased transepidermal water loss (TEWL).6
Current treatment options and limitations
Several non-surgical interventions are available for managing skin laxity and dehydration. These include:
Topical cosmeceuticals
Topical agents are commonly used as a first-line intervention to manage early signs of ageing. These include moisturisers, antioxidants (e.g. vitamins C and E), retinoids and peptides. Moisturisers enhance hydration and improve skin barrier function, while retinoids stimulate epidermal turnover and collagen production, contributing to improved skin texture and firmness.7 Antioxidants neutralise free radicals and reduce oxidative stress, helping to protect against photodamage.1 Despite their benefits, topicals often suffer from limited penetration into deeper skin layers, which restricts their efficacy in addressing moderate to severe skin laxity and dehydration.8
Microneedling
Microneedling is a minimally invasive procedure that uses fine needles to create controlled dermal injury, stimulating a wound healing response and collagen induction. It improves skin texture, elasticity and can enhance the penetration of topically applied bioactives.9 It is often used in both preventative and corrective aesthetic protocols, especially in younger patients or in combination with other modalities.
Energy-based devices
Radiofrequency (RF), high-intensity focused ultrasound (HIFU) and fractional lasers are examples of energy-based devices used to tighten the skin and remodel collagen. These treatments apply thermal or mechanical energy to the dermis, triggering fibroblast activity and extracellular matrix (ECM) remodelling.10 RF and ultrasound deliver heat to deeper layers of the skin, improving firmness and elasticity, while lasers resurface the epidermis and promote collagen neosynthesis. However, these devices may not significantly restore hydration or reverse oxidative damage.11
Injectable treatments
Injectables are widely used to address facial ageing through volumisation, hydration and biostimulation. Hyaluronic acid (HA) fillers are primarily used to restore lost volume and structural support by binding water and integrating into the ECM.1
Alongside these, HA-based skin boosters, sometimes referred to as non-volumising dermal hydrators, have become a mainstay in aesthetic practice for improving skin hydration, texture and elasticity without altering facial contours. They are often administered via microinjections into the superficial to mid-dermis, and are especially useful for treating delicate areas such as the periorbital, perioral and neck regions.12
These traditional skin boosters rely on the hydrophilic nature of HA to increase water content in the skin, thereby improving turgor and reducing fine lines. Repeated treatments over time have been shown to support dermal architecture by increasing collagen density and improving fibroblast activity.13
Biostimulatory injectables such as poly-L-lactic acid (PLLA) and calcium hydroxylapatite (CaHA) offer a different mechanism by stimulating neocollagenesis and dermal thickening over time. These agents trigger a controlled inflammatory response that activates fibroblasts and remodels the ECM, producing gradual, natural-looking improvements in skin texture and firmness.14
These injectables are frequently selected based on the patient’s individual ageing profile, skin quality and aesthetic goals. They are also commonly used in combination protocols with energy-based devices or cosmeceuticals to enhance global skin rejuvenation outcomes.
While each category offers unique benefits, hydration, collagen stimulation or skin tightening, limitations persist. Topicals often have poor dermal penetration and require prolonged use.6 Energy-based devices can induce collagen remodelling but may not fully restore hydration or target deep dermal structures.8
Dermal fillers and skin boosters improve plumpness, but typically act through mechanical or volumising effects, lacking broader regenerative or antioxidant action.1 Biostimulatory injectables, such as PLLA and CaHA, offer longer-lasting collagen stimulation but have come under scrutiny due to potential complications during subsequent facial surgery. These agents may leave behind granulomas or stimulate fibrotic responses that can obscure
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anatomical planes and complicate surgical dissection, particularly in facelift procedures or reconstructive surgery. Consequently, some plastic surgeons advise caution or recommend a washout period before surgical interventions.15
Emerging treatments
Recent advances in regenerative aesthetics have led to the development of skin boosters that go beyond hydration and volume restoration by actively engaging biological repair pathways. These next-generation skin boosters integrate dual-weight HA with longevity-focused bioactives such as nicotinamide adenine dinucleotide (NAD+), resveratrol, mannitol and biomimetic peptides, targeting the root mechanisms of skin ageing.16
Central to this innovation is the activation of Sirtuin 1 (SIRT1), a cellular regulator associated with mitochondrial function, genomic stability and oxidative stress modulation.17 NAD+ is a vital coenzyme in energy metabolism and DNA repair, while resveratrol acts as a polyphenolic SIRT1 activator with established antioxidant and anti-inflammatory properties. Mannitol, a sugar alcohol, stabilises HA and scavenges ROS, contributing to improved injection comfort and product longevity. Biomimetic peptides, modelled after endogenous signalling molecules, promote fibroblast activation and collagen synthesis, particularly types I and III, essential for dermal structure and elasticity.18
There are several formulations that can achieve this. One formulation that exemplifies this multi-targeted approach is Longevha (Caromed), a regenerative injectable that integrates dual molecular weight HA for deep and superficial hydration with NAD+ and resveratrol to activate SIRT1. Longevha may be administered via microneedling or (off-label) via intradermal injection, allowing for adaptable treatment protocols tailored to patient age, degree of laxity and depth of correction.19
Several other emerging formulations align mechanistically or compositionally with Longevha but differ in delivery route, clinical maturity or regulatory status. For example, the StyleFox NAD+ or Resveratrol Antioxidant Skin Booster is a topical product that combines NAD+, resveratrol, HA and peptides, mirroring Longevha’s key bioactive ingredients.20 However, as a topical formulation, its depth of penetration and ability to influence dermal fibroblast activity is inherently limited by epidermal barrier constraints. Moreover, topical delivery of NAD+ remains technically challenging due to molecular instability and limited skin absorption, reducing its potential to sustain biological activity in vivo.21
In a compelling in vitro study, Kang et al. investigated exogenous NAD+ supplementation in human fibroblasts, augmented by quercetin and enoxolone to inhibit CD38 and thus sustain intracellular NAD+ levels. The authors observed that the NAD+ boost improved sirtuin activation, mitochondrial function, and autophagy; additionally, it mitigated UV-induced senescence and oxidative damage. These results lend mechanistic support to the concept that NAD+ (or NAD+-enhancing formulations) can positively influence cellular resilience in ageing skin, offering biological rationale for their incorporation into skin booster strategies.22
Clinical considerations and integration into practice
In a prospective randomised trial (N=20), patients receiving a SIRT1-activating skin booster formulation reported measurable improvements in hydration, elasticity and overall skin quality, with the greatest effects observed following intradermal injection.23 This delivery route offers greater precision by enabling clinicians to control the exact depth, volume and anatomical placement of actives within the dermis. Compared to microneedling, which relies on passive diffusion through microchannels, injection allows for direct deposition into the superficial or mid-dermis, where fibroblasts, vasculature and ECM activity are most concentrated. This contributes
to enhanced bioavailability and potentially longer-lasting results.15 Patient selection is critical to ensuring safety and efficacy. Ideal candidates include individuals with early to moderate signs of skin ageing, particularly those with dehydration, fine lines or early skin laxity, who seek biologically active treatments rather than volumisation alone. Patients with realistic expectations, intact barrier function and a commitment to maintenance protocols are most likely to benefit. Contraindications include active skin infections or inflammation, recent isotretinoin use, autoimmune disease, known hypersensitivity to HA or formulation components and a history of hypertrophic scarring or keloids.24
Pre-treatment preparation includes detailed medical history, skin assessment and discontinuation of retinoids or harsh actives approximately three to seven days prior. Gentle cleansing and topical anaesthetic or cooling measures may be used to improve comfort. Technique typically involves a microdroplet injection pattern using a fine needle or microcannula, targeting the superficial to mid-dermis depending on skin thickness and treatment area. Most protocols recommend an initial course of two to three sessions spaced three to four weeks apart, with maintenance treatments every six to 12 months, a regimen in line with other skin booster approaches.19
Downtime is minimal, with common post-procedural effects including mild erythema, swelling or bruising resolving within 24-72 hours. Rare adverse events include nodule formation, hypersensitivity or vascular compromise, mitigated by proper injection technique, anatomical knowledge and adherence to aseptic protocols.24
Aftercare includes avoiding intense heat, exercise and active skincare for 24-48 hours, along with elevation and gentle skin handling to optimise outcomes. Patients should be informed of signs of potential complications and provided with follow-up contact details.25
When used as part of a multimodality plan, SIRT1-activating boosters can serve as a foundation for improved dermal health, hydration and mitochondrial function. Their regenerative effects may enhance outcomes when layered with complementary treatments such as RF microneedling, platelet-rich plasma (PRP) or polynucleotides.22
Thoughtful sequencing, for example, priming with a skin booster before introducing collagen-stimulating modalities, may yield synergistic clinical benefits while supporting long-term tissue quality.
Regeneration in aesthetics
Skin laxity and dehydration remain core concerns in medical aesthetics, with increasing patient demand for regenerative, long-term solutions over superficial correction. The introduction of skin boosters formulated with SIRT1 activators, including NAD+ and resveratrol, represents a promising advancement in aesthetic dermatology.
As medical aesthetics continues its shift toward outcomes rooted in health span and tissue integrity, SIRT1 activation offers a scientifically grounded, biologically intelligent strategy for skin rejuvenation.
Disclosure: Dr Keiron Lord is a key opinion leader and trainer for Caromed
Dr Keiron Lord is a regenerative aesthetics and longevity doctor, founder of Dr Lord Group and clinical assistant professor. With a background as an NHS surgeon and an undergraduate degree in biochemistry and biomedical science, he specialises in evidence-based, preventative skin ageing solutions integrating regenerative and longevity-focused approaches.
Qual: BMBS BSc (Hons), PGDip
mesoestetic: Redefining Standards in Medical Aesthetics
mesoestetic® leading the shift toward regenerative aesthetics
Medical aesthetics is undergoing a profound and rapid transformation. With increasing demand for non-invasive treatments and more natural, regenerative outcomes, patients and practitioners alike are seeking solutions that go beyond surface-level correction.
In response to this shift, mesoestetic® has launched mesofiller® nexha, a new range of next-generation injectables that merge immediate correction with prolonged skin regeneration. The rise of biostimulators and the growing acceptance of regenerative aesthetics have driven the need for solutions that not only fill but also work from within the tissues.
Christina Murray-Twinn, clinic owner at Christina Louise Aesthetics, shares, “Natural, long-lasting results are at the forefront of my clinic. Being able to offer my clients a dermal filler that not only restores volume but also enhances skin quality has truly excited them, and they’ve all been so impressed with their results.”
Image
mesofiller® nexha: a revolution in injectable science
mesofiller® nexha offers correction and biostimulation with succinic acid. At the core of this innovation is the Dual Release™ Technology, which enables progressive delivery of actives for up to seven months.1
The advanced formula features:
· Cross-linked hyaluronic acid – delivers volume restoration and a lifting effect.2
· Succinic acid – acts as a potent biostimulator with antioxidant and regenerative properties.3
The new nexha range are the first fillers in the world to combine cross-linked hyaluronic acid with succinic acid. This unique combination represents a new horizon in medical aesthetics what mesoestetic® defines as neostimulation: a synergistic approach that delivers both tissue volumisation and cutaneous biostimulation, improving skin quality from within.
Wendy Rogers, head of training at mesoestetic UK, comments, “Traditional fillers provide instant correction, mesofiller® nexha enhances tissue regeneration due to the incorporation of active ingredients, improving aesthetic results. It’s advanced formula with hyaluronic acid and succinic acid provide increased patient satisfaction outcomes.”
mesoestetic® celebrates 40 years of innovation in medical aesthetics
This year marks a significant milestone for mesoestetic® as the global pharmaceutical laboratory celebrates 40 years at the forefront of medical aesthetics and skincare. Founded in 1985 by pharmacist Joan Carles Font in Barcelona, the company has grown to become a world leader in the development and manufacturing of advanced aesthetic and cosmetic solutions. Today, mesoestetic® products are available in more than 110 countries, trusted by clinics and practitioners around the globe.
A brand built on science, research and innovation
Since its inception, mesoestetic® has remained committed to scientific rigour, continuous research and strategic collaboration with hospitals, universities and pioneering professionals in the field. A unique hallmark of the company is its reinvestment of 40% of
annual profits into research, development and innovation, ensuring the brand remains at the cutting edge of aesthetic science. Pharmaceutical-grade standards are applied across the entire product portfolio including cosmetics and injectables, with rigorous monitoring at every production stage. In 2025 alone, mesoestetic® has introduced eight new products across homecare and in-clinic treatments –ranging from antioxidants to injectables – each designed with both clinicians and patients in mind.
A 360º approach to skincare mesoestetic® offers more than just injectables, with a portfolio of over 300 products, the brand provides comprehensive skincare solutions designed to treat a wide range of concerns from ageing, hyperpigmentation and anti-blemish to sensitive skin, hair care, photoprotection and more.
The brand supports practitioners through the PATH framework: profundity, action, time and homecare, a strategic approach to patient management.
· Profundity: In-depth understanding of patient concerns through consultation.
· Time: Setting realistic expectations and treatment timelines.
· Homecare: Reinforcing results with tailored home-use products.
This advertorial was written and supplied by
For clinics interested in offering mesoestetic® solutions, contact the team at: contact@mesoestetic.co.uk mesoestetic® UK and Ireland is the official partner for the region and is the only authorised channel where professionals can buy aesthetic and medical products. When you buy from mesoestetic® UK you are guaranteed authentic, safe products, as well as ongoing support and training from our expert team.
1: mesofiller® nexha volume and mesofiller® nexha lips
Energy-based devices
Addressing Perioral Concerns
Independent nurse prescriber Kelly
Richards outlines a multi-modal approach to perioral rejuvenation
The perioral region undergoes progressive ageing due to intrinsic (chronological ageing) and extrinsic (environmental, mechanical stress) factors. These changes lead to dermal thinning, loss of ligamentous support and decreased collagen synthesis, contributing to fine lines, volume depletion and loss of definition.
This article presents a case study exploring a multi-modal approach to perioral rejuvenation, employing biostimulatory injectable treatments at varying depths to address volume depletion, tissue quality and hydration.
Perioral ageing
Facial ageing is a complex, multifactorial process driven by both intrinsic and extrinsic mechanisms. Intrinsic ageing, or chronological ageing, is genetically predetermined and results in progressive atrophy of the dermis due to reduced fibroblast activity, decreased collagen synthesis and diminished elastin integrity.2 This leads to thinning of the skin, loss of structural support and increased fragility. Alongside this, skeletal resorption and redistribution of facial fat pads contribute to volume loss and altered facial contours. Meanwhile, extrinsic ageing is primarily influenced by environmental and lifestyle factors, including smoking, pollution, ultraviolet (UV) radiation and mechanical stress.4 UV-induced photoageing accelerates dermal collagen degradation, resulting in reduced skin elasticity, deep wrinkling and pigmentation changes. In addition to all of the above, hormonal changes, particularly the decline in oestrogen levels in postmenopausal women, contribute to reduced skin thickness
and hydration. These factors combined lead to facial ageing, necessitating targeted interventions for prevention and treatment.5
Treatment options
Several approaches can be considered for addressing perioral ageing. Some of the most common methods include hyaluronic acid (HA) fillers, biostimulatory injectables, microneedling with platelet-rich plasma (PRP) and energy-based devices. Each modality targets different aspects of the ageing process and may be selected based on patient goals, skin characteristics and clinical findings.
Hyaluronic acid
HA dermal fillers restore lost volume and smooth perioral rhytides. HA fillers have been shown to improve hydration and elasticity by integrating with dermal tissues, though their primary mechanism is volumisation rather than collagen stimulation.6
Microneedling
Microneedling combined with PRP stimulates dermal collagen and elastin production, as it has been demonstrated that PRP enhances wound healing and improves fine lines by increasing fibroblast proliferation and extracellular matrix remodelling.7 One literature review of multiple studies between 2000 and 2020 found that there were largely positive treatment outcomes in this area, however there was a need for a standardised approach when it came to treatment and preparation methods.8
Radiofrequency (RF) and fractional laser resurfacing are non-invasive alternatives for collagen remodelling and skin tightening. RF has been shown to induce controlled thermal injury, leading to neocollagenesis. One study of 62 patients demonstrated a reduction in facial skin laxity and wrinkles, however more research on diverse skin types was needed.9 Fractional lasers have also been shown to target both superficial and deep dermal layers, improving skin texture and reducing fine lines.10
Polynucleotides
Polynucleotide-based injectables are an emerging treatment to enhance fibroblast activity and improve skin elasticity. Research has suggested that polynucleotides promote dermal regeneration by increasing cellular turnover and hydration.11 One systematic search of nine studies and 219 patients found promising outcomes in reducing wrinkles, improving skin texture and enhancing elasticity, however there was limited consensus for optimal use.12
Skin boosters
Skin boosters are a good option for enhancing hydration and collagen synthesis rather than simply replacing lost volume. Almost all skin boosters are based on the molecule HA and some are poly-component, containing amino acids, antioxidants, vitamins and minerals, to name a few. These can be particularly beneficial for enhancing skin hydration, reducing wrinkles and fine lines and improving overall skin texture.13 One study of 64 female subjects aged 38-60 years found a statistically significant reduction on average skin roughness and wrinkles in the nasolabial folds.14
A combination approach
A multi-modal approach combining injectables, energy-based devices and medical-grade skincare is considered for optimal perioral rejuvenation. Evidence suggests that combination therapy yields superior outcomes compared to monotherapy by targeting multiple ageing mechanisms simultaneously.15
Case study
Patient concerns and assessment
A 61-year-old patient initially presented with concerns about fine lines around the mouth that significantly affected her confidence, particularly when applying lipstick. She described feeling self-conscious, tired and aged. Medical history showed she was an ex-smoker, Fitzpatrick skin type II, was taking no current medications, had no previous aesthetic treatments and no established skincare routine.
On assessment, it was found that she had:
· Fine perioral rhytides, particularly vertical lines due to repetitive muscle movement and loss of dermal elasticity
Structural weakening of key ligamentous attachments, contributing to mid-face descent and nasolabial fold deepening
· Volume loss in the vermillion border, leading to reduced lip definition and increased perioral shadows
· Dehydration and reduced collagen synthesis, exacerbating skin crepiness and loss of elasticity
During the consultation, multiple treatment modalities were evaluated to address perioral fine lines, skin laxity and volume loss.
Treatment plan
Following clinical assessment and ultrasound-guided tissue evaluation, a layered biostimulation approach was chosen to address these concerns holistically. While HA fillers would usually be considered as a first-line treatment, in this case, they were opted against as the patient specifically requested to avoid dermal fillers due to fears of looking overfilled. The rationale for choosing a variety of skin boosters was that as an ex-smoker, the patient’s skin exhibited diminished collagen production.
A comprehensive approach was employed to ensure sustained improvement and complement in-clinic treatments. The treatment followed a structured, multi-phase protocol designed to deliver progressive, natural skin rejuvenation.
Three Jalupro skin booster formulations were used at different tissue depths to target specific structural and superficial concerns:16-18
1. Jalupro Super Hydro – administered into the deep dermis and ligamentous support points. This formulation combines polynucleotides with HA to support fibroblast activity, improve deep hydration and promote dermal matrix regeneration. Its primary effect is structural support and tissue quality improvement, rather than volumisation.
2. Jalupro Classic – injected into the papillary and superficial reticular dermis. This amino acid–based formulation focuses on superficial fine lines and skin texture, enhancing collagen synthesis in the upper layers of the skin.
3. Jalupro HMW – used in areas prone to subtle volume loss, such as the vermilion border. Combining high molecular weight HA with amino acids, it provides gentle volumisation, hydration and fibroblast stimulation, supporting both contour and tissue quality. Treatments were delivered over multiple sessions, spaced two to six weeks apart, with maintenance recommended as part of ongoing skin health management.
To support these treatments, supplements were taken throughout the treatment period. The supplements also contained amino acids that help to stimulate collagen production internally, complementing
Skin boosters are a good option for enhancing hydration and collagen synthesis rather than simply replacing lost volume
in-clinic treatments.19 The patient also used antioxidant skincare to support collagen turnover and dermal recovery.
Results and patient outcomes
The patient tolerated the treatment well, experiencing only mild, transient injection-site reactions such as erythema and swelling, which resolved within 48 hours. Post-procedure care included topical hydration using sheet masks. Given the patient’s history of smoking, potential compromised collagen turnover was a concern. To mitigate this, additional supportive therapies were recommended, including oral collagen precursors and antioxidant-rich skincare throughout the entirety of the treatment course.
The patient experienced a gradual improvement in perioral skin texture and elasticity, with reduced appearance of fine rhytides and subtle enhancement of lip definition. Key observed changes included a strengthening of perioral ligamentous structures, leading to a subtle lifting effect; a reduction of fine lines and improved skin elasticity; hydration enhancement at multiple tissue levels; and a restoration of lip contour with soft, natural volume (Figure 1). The patient reported significantly improved confidence and satisfaction with her appearance following treatment.
The outcomes in this single case suggest that a structured, multi-layered biostimulation approach may be effective for addressing perioral ageing, particularly in patients seeking gradual, natural-appearing results. Further studies with larger patient cohorts would be beneficial to validate these findings and assess long-term efficacy.
Treating the perioral area
This case study demonstrates the importance of a targeted, multi-layered approach in addressing perioral ageing. By strategically combining different molecular weight biostimulants, treatment outcomes were optimised across structural, superficial and volumetric levels. Patient consultation and preference are essential in treatment planning, particularly when dermal fillers are avoided. Choosing modalities that align with clinical findings and patient goals supports gradual, sustainable improvements.
Qual: INP
Kelly Richards is an independent nurse prescriber who founded clinic SKIN AESTHETICS in Wrexham. Balancing her NHS role with further education and business development, she transitioned to full-time aesthetics in 2022.
Figure 1: 62-year-old patient before and five months after treatment using three Jalupro skin boosters for perioral concerns
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M-BOC-UKI-0658
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Prescribing Information
Date of Preparation: July 2025
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Scan the QR code to get in touch with one of our Aesthetic Account Managers
Adverse events should be reported. Reporting forms and information for United Kingdom can be found at https://yellowcard.mhra.gov.uk/. Reporting forms and information for Republic of Ireland can be found at https://www.hpra.ie/homepage/about-us/reportan-issue. Adverse events should also be reported to Merz Aesthetics UK Ltd by emailing UKdrugsafety@merz.com or calling +44 (0) 333 200 4143.
Aesthetica – A Trusted Supplier
Aesthetica Solutions supports UK cosmetic clinics with reliable service, ethical values, and a forward-thinking approach
Aesthetica Solutions is a lead supplier to the UKs foremost cosmetic clinics. Being customer friendly is a value at its core and the team is always looking for ways to improve the customer experience.
The complimentary InstaScript platform is an industry innovation that is hugely appreciated by our clients. This bespoke online prescription generation platform lets practitioners and prescribers create and generate prescriptions online, streamlining their administration and helping to save them significant time. Aesthetica Solutions knows that inventory management is an operational challenge for their clients and is keen to provide a service that helps. Being able to generate digital prescriptions quickly and easily, means practitioners can buy in cosmetic injectables, skincare products and medical supplies when they need them and not risk products exceeding their shelf lives. This reduces wastage and operational costs. With our speedy next working day delivery service, it also means that you can order more regularly as your clients book their appointments after consultations.
Super secure ordering
InstaScript uses a comprehensive and robust process to ensure a prescriber’s identity is securely verified. An additional SMS verification system is used for extra security when a prescriber signs off any prescription online. Once generated, it’s possible to print a copy of the prescription to keep for practice records. It will always be securely stored within InstaScript and you can access it whenever you need it.
How can your practice benefit from InstaScript?
Save time: Digitising your prescribing means you’ll save time on paper-based administration. This frees up time for other work, staying abreast of industry trends and dealing with clients.
Enhance security: Having an electronic system with SMS sign off and audit trails, means you can relax knowing regulatory compliance is taken care of.
Improve record-keeping: In addition to the reassurance of compliance, an electronic audit trail also means there’s better record keeping.
Reduce risk of error: An electronic system is less likely to lead to errors that may result from interpreting handwritten prescriptions. It’s free: All Aesthetica Solutions customers can register for the Instascript service for free.
New feature added – ‘Prescriber hub’
Aesthetica Solutions recognise the challenges the industry is facing with face-to-face consultation and prescriptions.
As part of a constant drive towards innovation, Aesthetica Solutions has added a new function which allows non prescribing practitioners and local prescribers to contact each other to arrange face to face consultations with patients. How it works
For prescribers:
If you would like to offer your prescription services to local practitioners or clinics in your area, you can ‘opt in’ using your InstaScript account. Additionally, you can leave further information about your service, such as your availability, the number of patients you need to see at a time, and any other information which you feel as appropriate.
For practitioners:
To find a local prescriber, please go to ‘access InstaScript’ within your account, click ‘find prescribers near you’ button. You can then do a search for local prescribers within your area. A list of all prescribers that have opt in to use the service near you will come up. You can then select the ones that you wish to contact and send them your email address and phone number, then they will get in touch.
Looking for a local prescriber?
Register with out Prescriber Hub at www.aestheticasolutions.co.uk/register
This advertorial was written and supplied by Aesthetica Solutions. Please visit aestheticcasolutions.co.uk to find out more about InstaScript.
A summary of the latest clinical studies
Title: Energy Based Options for Male Facial Rejuvenation
In recent years, the advancements of minimally invasive, energy based facial treatments have been followed by an increase in male patient demand. This article presents a review of current energy based devices for male facial rejuvenation, aiming to inform clinicians on evidence-based treatment options. A search of the scientific literature from inception to June 2025 was conducted using the PubMed database. Articles were included if they discussed energy-based options for male facial rejuvenation. Seventy articles were screened and 23 met the inclusion criteria. Eighteen energy based options used for male facial rejuvenation were reported in included articles. This review provides an overview of the wide array of energy-based devices available for male facial rejuvenation. The literature suggests that these technologies can be effectively and safely used to tighten skin, improve contouring whilst reducing adiposity, enhance skin quality and tone, and manage cosmetic vascular lesions.
Title: Efficacy and Safety of Topical Dapsone in Dermatology: A Scoping Review of Clinical Studies
Authors: Bahareh Abtahi-Naeini, et al
Published: Journal of Cosmetic Dermatology, October 2025
Keywords: Dapsone, Dermatology, Topical Dapsone (4,4’-Diamino diphenyl sulfone) has been utilized in managing a wide variety of mucocutaneous conditions, usually as a systemic product. Topical dapsone is commercially available as 5% and 7.5% gel and is FDA-approved for acne vulgaris. Topical dapsone might benefit localized disease, immunosuppressed individuals, and those who avoid exposure to systemic therapies. Following PRISMA guidelines, a comprehensive literature search was conducted across PubMed, Web of Science, and Scopus databases for published papers up to April 2025. Then, eligible studies are included, and we summarize the findings of different clinical studies concerning the use, efficacy, and side effects of topical dapsone in various mucocutaneous conditions, excluding acne vulgaris. Finally, 56 articles were selected based on the eligibility criteria. We summarized and categorized them into two general entities, including applications of the topical dapsone and side effects of the topical dapsone. The first entity has six subheadings consisting of acne vulgaris and acneiform eruptions, Rosacea, neutrophilic dermatosis, vesiculobullous diseases, vasculitis, and others. In conclusion, topical dapsone appears to have therapeutic advantages in several mucocutaneous conditions, especially in minimal, localized, and chronic eruptions.
Title: Five-Year Trends in Facial Thread-Lift Practice: A Nationwide Cross-Sectional Analysis of 106,639 Cases by Age Group and Thread Material
Authors: Kohki Okumura, et al
Published: Aesthetic Plastic Surgery, October 2025
In this retrospective cross-sectional study, we analyzed 106,639 patients from 105 clinics across Japan affiliated with the Tokyo Chuo Beauty Clinic. Data on thread material (PDO or PCL), age, gender, and thread count were analyzed using two-way analysis of variance, multivariable linear regression, interaction modeling, and time-series analysis. PDO was used in 57.2% of cases, predominantly in younger patients (20s-30s), whereas PCL was more common in older patients. The mean thread count was significantly higher in the PDO group than in the PCL group (10.52 vs. 6.57, p < 0.001). We observed a significant interaction between thread material and age group. Over the 5-year period, the PDO usage rate and mean thread count gradually increased. Gender-based differences in material selection were generally minimal; however, statistically significant disparities were noted in patients in their 20s and 30s, with females more likely than males to receive PDO threads in both age groups. Thread material selection and procedural intensity in facial thread-lifts are associated with patient age and are increasingly individualized and strategy-driven. We provide the first large-scale, evidence-based insight into this evolving practice.
Title: Prospective Clinical Evaluation of Cross-Linked Hyaluronic Acid Dermal Filler (30 mg) for Facial Rejuvenation
Authors: Debraj Shome, et al
Published: Plastic and Reconstructive Surgery, October 2025
This is a prospective, single-arm clinical study that evaluates the safety and effectiveness of cross-linked sodium hyaluronate injection in patients undergoing treatment for facial wrinkles and lip enhancement. The safety and effectiveness were evaluated through physical examinations, wrinkle severity ratings, full face global aesthetic assessments, cheekbone augmentation, nasolabial fold severity, and lip enhancement evaluations. The study cohort included 122 participants, 41 men and 81 women, predominantly with Fitzpatrick skin types 3 (59%) and 4 (41%). Physical examinations revealed a significant reduction in facial wrinkles, with 81.14% (left side) and 84.42% (right side) of patients showing no wrinkles after 1 year. Full face aesthetic improvements were noted, with 36.88% of patients being “very much improved.” Cheekbone augmentation showed no wrinkles in 55.74% of patients (left side) and 72.13% (right side) at 1 year. Nasolabial fold severity decreased most significantly between 6 months and 1 year. The novel cross-linked hyaluronic acid dermal filler is safe and effective for enhancing lips, augmenting cheekbones, and improving nasolabial folds across various skin types. Significant improvements were observed in wrinkle severity, overall facial aesthetics, and specific enhancement areas.
Managing Spousal Business Partnerships
Managing director Yogeeta Bawa provides guidance on balancing personal and professional partnerships
Imagine waking each day beside not only your life partner, but also your business partner. Across the UK, many couples in the aesthetics specialty are blending personal and professional lives, and finding it both rewarding and challenging. Some divide responsibilities between clinical and managerial roles, while others work side by side in practice. Often, one partner brings corporate acumen while the other contributes clinical expertise honed within the NHS. Together, they combine these complementary skills to build thriving businesses that unite personal commitment with professional ambition, strengthening both their partnership and their success. Despite challenges such as maintaining work-life balance, establishing boundaries and managing stress spillover, many couples report experiencing both success and fulfilment in their joint ventures.
Common challenges faced by couples in business
Working with your partner can be highly rewarding, but it also comes with unique challenges that can impact both your relationship and your business.
1. Decision-making conflicts: Different approaches to making decisions and misaligned expectations can create power struggles and slow down business progress.
2. Communication breakdowns: Ineffective communication can lead to misunderstanding, frustration and unnecessary conflict.
3. Overlapping roles: Without clearly defined responsibilities, partners may unintentionally interfere with each other’s work, reducing efficiency.
4. Work-life balance struggles: Blurred boundaries between personal and professional life can make it challenging to disconnect and maintain a healthy relationship.
Key considerations
Working alongside a partner requires careful planning and awareness of both professional and personal dynamics. The following considerations can help couples establish a balanced and effective working relationship.
Compatibility and communication
Understanding each other’s strengths and weaknesses is key to effective collaboration. A detail-oriented partner paired with a strategic thinker can create a balanced dynamic, whereas partners with identical traits may struggle – two detail-focused individuals can get lost in minutiae, while two big-picture thinkers may overlook key essentials. In my experience, similar traits work best when partners have distinct clinic roles rather than overlapping ones.
A strong partnership thrives on balance. This looks like shared power, mutual alignment on things like risk tolerance, professional disagreements and the ability to switch off at home. After a busy day in clinic, it helps to unwind with a movie, a walk and maybe a nice dessert after dinner. Personality traits, decision-making styles and expectations around control should be discussed upfront to ensure complementary working styles.
Utilising shared tools, such as task lists, project management platforms (e.g. Slack, MS Teams, Trello) or even a live Google Sheet, can maintain transparency. Open discussions of expectations, periodic role adjustments and structured meetings, similar to those held with other team members, help ensure responsibilities remain well-balanced. For instance, one dedicated session might focus exclusively on introducing a new marketing strategy for the clinic.
Defining roles and responsibilities
Clearly defined responsibilities help prevent overlap and reduce the risk of conflict. Roles should align with each partner’s strengths and interests.
Managing operations can involve supporting the team, approving stock and ensuring rotas and schedules are adhered to for smooth clinic functioning. Documenting responsibilities in a business plan or partnership agreement, along with standard operating procedures for recurring tasks
– such as opening and closing protocols, bookings, payments, stock and cleaning rotas – provides clarity and consistency. Six-month check-ins help review roles, adjust responsibilities and resolve issues to stay aligned with evolving needs. Urgent matters can be addressed in dedicated meetings as they arise. Quarterly check-ins work well if time permits, but in busy environments, six months offers a practical, effective rhythm.
Setting boundaries
Blurring the lines between work and home life can increase stress, making clear boundaries essential. Couples should agree on specific times when work talk is off-limits, such as during meals, in the evenings or after the children’s bedtime. For example, establishing a “no work talk after 8:30pm” rule can help maintain a healthy balance.
Scheduling structured meetings during clinic hours, with a clear agenda and a shared document, keeps discussions focused and actions accountable. Creating a dedicated workspace, whether a clinic room or a separate office, also helps maintain mental clarity and minimises distractions. Alternatively, co-working spaces or a local coffee shop can serve as a dedicated workspace.
Clear boundaries help ensure they are respected and remain adaptable over time. Taking time away from the clinic for planning or reflection can provide valuable perspective. These practices not only reduce stress and burnout but also strengthen mutual support, personal wellbeing and productivity, enabling couples to nurture both their relationship and business effectively.
Financial considerations
Merging personal and business finances requires discipline, transparency and clear planning. One advantage of working with a partner is a shared understanding of your financial position, but open, structured discussions are essential.
Before investing, assess treatment demand, survey patients and evaluate return on investment (ROI), affordability and marketing strategy. Balance short-term cash flow with long-term growth to maintain a financially healthy business – ask yourself where you want to be and what team you need. Schedule financial reviews when you’re both focused, and seek advice from accountants or business mentors for objective insight.
Establish a budget separating business and personal expenses, integrate accounting software with your customer relationship management (CRM) system and hold monthly finance meetings using a live profit and loss (P&L) document. Regular key
performance indicator (KPI) reviews and ongoing check-ins help maintain clarity and accountability. Allocate profits strategically – for example, setting aside funds for reinvestment, savings or tax obligations. Discuss legal and tax implications, company structure, salaries and dividends openly, and plan for long-term goals, including exit and contingency strategies. These strategies are particularly effective when thinking about retirement, new roles or the next steps after the clinic.
Navigating these challenges
By understanding common pitfalls and proactively implementing strategies, couples can maintain both a healthy business and a strong personal relationship.
Decision-making conflicts
In most workplaces, professionalism, composure and respect ensure effective decision-making. When working with a partner, however, boundaries are often less defined. This can make decisions easier through mutual understanding but can also intensify frustrations, as partners may challenge each other more directly. Agreeing on a clear process for resolving conflicts helps prevent escalation. For example, taking a short break to cool off before returning to discuss the issue calmly. Setting an agenda, focusing on facts and defining objectives, such as agreeing on a specific outcome, can keep conversations productive. Avoid blaming language and use constructive communication to maintain respect. Meeting in a neutral setting outside of work or home can also provide a more balanced space for resolution.
Balancing personal and professional life
Maintaining a healthy work-life balance is essential when professional and personal lives overlap. Scheduling regular date nights or short getaways helps couples reconnect without business pressures. Even simple moments – like sharing dinner or watching a movie together – can provide valuable time to switch off from work. If personal stress spills into work, take a brief break – go for a walk, grab a coffee or exercise – to reset your mind. Practice compassion and patience with each other; small gestures, like a hug or acknowledging when one of you is having a tough day, can go a long way. These simple habits help preserve your relationship, support emotional wellbeing and allow the business to function smoothly.
Disagreements are inevitable in partnerships, but managing emotions at work is key. Taking five to 10 minutes to reset, saying, “We’ve disagreed today, but let’s talk after work,” can help maintain
professionalism. Remember, your team and patients look to you for leadership and composure throughout the day.
Prioritising self-care
Prioritising physical, mental and emotional wellbeing is essential for sustaining both your business and relationship. Scheduling regular exercise, meditation or relaxation – individually and together – helps manage stress and maintain energy.
Using a shared calendar, such as Google or Outlook, ensures visibility of each other’s commitments and helps avoid scheduling conflicts. Block out time in advance for breaks, holidays or personal reset days to prevent burnout and maintain clinic efficiency.
Most importantly, give yourselves permission to step away when needed. Taking time to rest and recharge is not a setback – it supports long-term productivity and strengthens both partners’ capacity to perform well at work and nurture their relationship.
Seeking external support
External guidance can be invaluable for couple-run businesses. Joining professional networks, attending specialty events or engaging with local business groups offers fresh insights and peer support. An objective mentor or business coach can also provide tailored advice and perspective.
Peers are a powerful resource – connecting outside the clinic to share ideas and discuss challenges encourages learning and collaboration. Leveraging these networks helps couples navigate obstacles more effectively, strengthen professional skills and foster sustainable long-term growth.
Celebrating successes
It’s easy to overlook achievements amid daily responsibilities. Taking the time to celebrate milestones – whether a successful product launch, a patient win or the completion of a major project – can strengthen both morale and the relationship. Celebrations can be as simple as sharing coffee together, or as special as a weekend getaway, but acknowledging accomplishments ensures motivation and positivity remain high.
Advantages of running a business as a couple
For many, the advantages of working alongside a partner outweigh the challenges, which explains why couple-led businesses are increasingly common. Research indicates that family firms led by married couples tend to outperform those with other leadership arrangements.1 Additional studies show that couples in business together remain together up to
five times longer than the national average. Among 1,000 participants, 79% reported a stronger relationship and 78% noted that the traits for business success mirror those of a solid personal partnership.2
One of the greatest advantages is a shared vision and purpose, grounded in common values such as integrity, service and making a positive impact. Couples who align on principles, whether a commitment to patient care, innovation or sustainability, can harness their combined passion to elevate standards, introduce new technologies and enhance patient outcomes. This unified sense of purpose fosters resilience and serves as a powerful driving force for both their business and shared life goals.
Another strength lies in trust and understanding. Relying on a partner to oversee finances while the other focuses on clinical delivery, for instance, allows each individual to work in their area of expertise. This division of labour enables the business to operate efficiently and confidently. Couples benefit from flexibility and adaptability. When challenges arise, one partner can support the other to maintain business continuity. A clear staffing structure, delegation and professionalism help sustain operations, support the team and keep the workplace comfortable and respectful.
Steps towards success
Working with your partner in business can be both rewarding and challenging. The unique dynamic of personal and professional relationships can streamline decision-making and foster a deep understanding. However, it also requires careful management of boundaries, effective communication and conflict resolution strategies to ensure both the business and the relationship thrive.
By prioritising mutual respect and maintaining a healthy work-life balance, partners can successfully navigate the complexities of working together and achieve their shared goals.
Yogeeta Bawa is the co-founder of Time Clinic, and has a background in strategic planning and financial management. Bawa recently launched The Invisible Partner mentoring programme, aiming to empower practitioners and strengthen business leadership.
Qual: BA Hons Business
NEXT COURSE 23RD NOVEMBER 25
Learn with the Primary Care Obesity Society
The Primary Care Obesity Society (PCOS) provides the complete framework for healthcare professionals and aesthetic practitioners to launch an effective, healthcentred, weight-management service
Training covers every aspect of care from patient selection and informed consent to medication protocols, side-effect management, and remote monitoring aligned fully with NICE guidance and fully evidence based
The course lead is led by Dr Alun Davies, a physician involved in developing the UK licences for weight-management medicines and contributing directly to the NICE appraisal process Dr Davies is also founder of Wales’ first HIW approved fully virtual weight-loss clinic, and Programme Director of the MSc in Weight Management at the University of South Wales and brings extensive pharmaceutical and clinical experience
Add weight management to your portfolio
Through this combination of regulatory insight and frontline clinical experience, PCOS empowers practitioners to transform unmet demand into safe, evidence-based care and sustainable business growth
Whether you are new to weight management or already treating patients living with overweight and obesity, you can benefit from the Primary Care Obesity Society Courses
This comprehensive training will refine your practice, update your clinical knowledge, and give you the practical tools to deliver outstanding patient outcomes and a profitable business addition
By upskilling now, aesthetic prescribers can lead the next wave of medically responsible, results-driven weight care
Face-to-Face course : Usual venue: RCGP 30 Euston Square, London
A National Health Emergency
Obesity has become one of the most pressing health challenges facing the United Kingdom According to the Office for Health Improvement and Disparities (2025), 26 5% of adults in England are living with obesity, and 64 5% are either overweight or obese These figures, mirrored across the devolved nations, represent millions of individuals at increased risk of diabetes, cardiovascular disease, and premature mortality Despite decades of public health campaigns, the prevalence continues to rise creating a silent but escalating crisis for the NHS
(OHID Obesity Profile – May 2025)
Recent guidance from the National Institute for Health and Care Excellence (NICE) has introduced a paradigm shift in obesity treatment For the first time, NICE has approved modern, once-weekly injectable therapies for chronic weight management provided they are used within structured, multidisciplinary programmes that include diet, exercise, and behavioural support
Two landmark technology appraisals TA875 (2023) and TA1026 (2024) recommend these new agents under specific criteria, offering a transformative option for patients struggling with excess weight. NICE’s broader Guideline NG246 (2025) further embeds obesity management into long-term clinical care pathways However, while the science has advanced rapidly, the capacity to deliver these treatments has not
The capacity gap: why the NHS cannot meet demand
NICE and NHS England estimate that around 3 4 million adults in the UK could meet eligibility criteria for these new treatments. If every eligible patient sought care today, it would require nearly one in five GP appointments and far exceed existing dietetic and specialist-clinic capacity Consequently, NICE has endorsed a phased national rollout a process expected to take up to 12 years to reach all who qualify
This imbalance between clinical innovation and service readiness presents an urgent question: who will meet the immediate need?
(House of Commons Library, “Weight Loss Medicines in England,” April 2025)
Next face-to-face Course dates
23 November 2025 rd 6 December 2025 th 11 January 2026 th
Engaging with Leading Specialty Journalists
The Clinical Cosmetic Regenerative Congress (CCR) 2025 hosted a Meet the Press panel, offering key insights and practical advice for aesthetic practitioners
Held on September 26 at Excel London, the panel brought together three leading voices within the aesthetics media landscape. Alice Hart-Davis, aesthetic and beauty journalist and founder of The Tweakments Guide, a platform designed to educate consumers and connect them with qualified practitioners, opened the discussion. She was joined by Victoria Woodhall, beauty and wellness journalist and editorial director of Get The Gloss and its practitioner directory, The Gloss Book. Completing the line-up was Francesca Ogiermann-White, founder of The Beauty Triangle and Health and Beauty editor-at-large at Tatler
The panel discussion explored emerging trends gaining traction in the media, the responsibilities of journalists and common misconceptions within medical aesthetics, while offering guidance to practitioners on how to build effective relationships with the press.
Gaining traction in the media
Opening the discussion, Hart-Davis explored the types of medical aesthetics reports that tend to gain the most traction in the media. She observed that while certain audiences are undeniably drawn to sensational or extreme narratives with exaggerated headlines such as, “I’ve got 20 years of filler stuck in my face,” these stories don’t appeal to everyone.
Hart-Davis explained that journalists often feel compelled to report on such pieces, not necessarily out of enthusiasm, but because they cater to what a portion of the public clicks on and demands.
“Such stories captivate readers through their mix of shock, fear and a sense of schadenfreude – observing people who have sought to enhance their appearance and feeling that they got what they deserved,” she said, adding that this dynamic reflects audience appetite more than journalistic preference.
Hart-Davis added that articles showcasing successful facial or body transformations also generate significant interest, as readers are drawn to visible improvement and may consider similar treatments for themselves. She further highlighted practical, list-style features – such as 50 of the best doctors, nurses or surgeons – remain popular, and are often kept for future reference or aspirational purposes.
Continuing the discussion, Woodhall reflected on evolving patient attitudes and emerging trends in language and lifestyle. She observed the term ‘antiageing’ is becoming less resonant, with patients increasingly engaging with the concept of longevity, which “approaches ageing from the inside out and promotes a more holistic perspective.” Expanding on this, she noted that patients are drawn to treatments and narratives that focus on improved energy, vitality and overall health rather than purely aesthetic outcomes.
Drawing on the idea of longevity and the link between internal health and appearance, Woodhall highlighted the growing interest in brain health. She noted that patients across all age groups are seeking preventative measures to support cognitive function and lower dementia risk. She also pointed out the increasing popularity of content centred on muscle mass, often referred to as “the organ of longevity” due to its metabolic activity. Woodhall emphasised, “Patients are becoming more aware of the importance of sleep, exercise – particularly weight-bearing activity – and mental engagement through activities such as puzzles.” She explained that together, these support the goal of remaining “sharper and stronger for longer.”
Building on this, Ogiermann-White observed that patients are actively sharing and discussing new and emerging trends, including GLP-1 medications, biohacking therapies and hormonal and intimate health. She concluded that, regardless of the platform, whether in print, at events or across social media, it remains essential for content to be relevant, evidence-informed and aligned with patient needs.
Through her international venture, The Beauty Triangle, Ogiermann-White was also able to offer insight into emerging global trends and highlight what practitioners should monitor closely. She first observed a rising patient interest in facelifts, noting, “There is a new awareness that a more advanced, somewhat assertive technique can often achieve the most natural and harmonious results.” She went on to discuss the growing momentum around regenerative treatments across medicine, emphasising that both internationally and in the UK, patients and consumers are increasingly attuned to these innovations.
Building relationships with journalists
Next, the press panelists were asked what advice they would offer practitioners for engaging with journalists effectively.
Exploring the foundations of journalist-practitioner relationships, Hart-Davis advised that building relationships starts with a warm introduction. “If you can be introduced by a mutual contact, whether a colleague, PR professional or brand, you’re far more likely to get noticed than if you appear as a stranger in their inbox,” she explained.
Hart-Davis added that silence shouldn’t be taken personally, as journalists often face overflowing inboxes, suggesting, “Follow up politely if you don’t hear back.” She recommended briefly outlining your credentials, linking to your social media or website and including a mobile number for quick contact. “If digital outreach fails,” Hart-Davis concluded, “find them at events – sometimes a friendly hello in person works best.”
Referencing her directory, The Gloss Book, Woodhall encouraged practitioners to engage with platforms of this kind, whose role is to educate patients about specialty practitioners while providing practitioners with a professional profile. She emphasised the importance of defining a personal brand, advising, “If you’re looking to establish yourself, ask what your unique selling point (USP) is – what is your story? It doesn’t need to be private, but sharing personal elements can help patients connect with you. This might include your passions or interests that others can relate to. Consider what you want to be known for, start there and see what kind of community you attract.”
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Woodhall also recommended collaboration among practitioners, noting, “Find a partner or buddy to work with. Share content on social media, tag and repost each other, support one another and do live Instagram sessions together. These connections can make a significant difference in building engagement and visibility.”
Ogiermann-White highlighted the value of authenticity, stating, “Practitioners should always be themselves, authenticity is key and something we’re always looking for as journalists. The field is vast, and many practitioners offer similar products, treatments and packages. What truly sets a practitioner apart, their USP, is their personality.”
Public perspectives and journalistic responsibilities
The panel next turned to discuss public perceptions of aesthetics and the responsibility journalists hold in shaping them.
Hart-Davis reflected on how the field of aesthetics has evolved over time, noting, “The subject of medical aesthetics is now widely regarded as a legitimate topic of discussion across various outlets, including mainstream news channels – a notable shift from previous decades.” She added, “20 years ago, coverage of aesthetics was largely limited to light features, or ‘Our brave reporter tries this treatment’ stories. Today, journalism bears a substantial responsibility to report on medical aesthetics accurately and without sensationalism.”
Expanding on this point, she observed, “In many editors’ minds, sensationalism and aesthetics often go hand in hand, as any article that is too straightforward is considered dull.” Hart-Davis added, “Journalism’s influence in this field is minimal compared to the power of social media in shaping how people view medical aesthetics.”
Woodhall reflected on when she first entered the field, outlining that aesthetic treatment options were largely limited to dermal fillers, botulinum toxin and “stringent blue peels,” and the results often publicised were unsatisfactory. She explained that many women of her generation recall the overly obvious aesthetic procedures of that time, such as ‘wind-tunnel’ facelifts and unnaturally plumped cheeks, that shaped early perceptions of cosmetic work. This historical context, she explained, underscores the importance of educating not only younger audiences but also older generations who may still associate aesthetics with outdated negative stereotypes – discouraging them from seeking treatment.
Another role for journalists, as highlighted by Woodhall, is not only to showcase skilled practitioners but also to support patients to make informed choices based on the results they hope to achieve. She emphasised that successful treatment is ultimately determined by patient satisfaction – when individuals feel the outcome aligns with their personal goals and sense of self. It is important for practitioners to recognise this perspective, as media coverage often reflects the patient’s viewpoint, and reinforces the idea that outcomes should be measured by how well they meet each individual’s expectations and sense of self.
Ogiermann-White underscored the vital importance of publishing and sharing accurate information, as she stated, “We have a duty to provide factual yet impartial advice and knowledge to the public. If there is ever a need to proceed on the side of caution, it is our responsibility to carry out proper due diligence.”
For practitioners, this serves as a useful reminder that journalists are expected to question and verify information to ensure fairness, accuracy and transparency. As Ogiermann-White explained, “Rather than quoting directly from a press release, it’s essential to challenge practitioners or brands to ensure that the information shared is honest and authentic for those considering or consuming it.” With that in mind, practitioners should be prepared to provide clear, evidence-based responses and ensure
that their communications uphold the same integrity expected of the media. “In that aspect,” she concluded, “we carry as much responsibility as the practitioners themselves.”
Common misconceptions or narratives
Opening the next discussion around inaccurate perceptions, Hart-Davis responded succinctly, “There are endless misconceptions!” She went on to highlight some of the most common myths, noting, “One of my favourites is the idea that you can always tell when someone has had something done.”
She continued, “Other narratives include the belief that fillers migrate, as it’s thought they inevitably move from where they are placed. There is also the notion that once you start with tweakments, you can never stop. People often laugh nervously when I ask them why they think this – do they imagine the ‘toxin police’ will arrive to check whether they’ve booked their next appointment?”
Adding to the discussion, Woodhall highlighted further common misunderstandings, particularly among first-time patients. She highlighted, “Many believe toxin and dermal filler are the same, while others assume botulinum toxin is inherently harmful, perhaps influenced by the word ‘toxic’ echoing its name.”
Woodhall suggested that practitioners can help address these misunderstandings clearly through social media presence, emphasising the value of sharing clear, factual information to support patients considering treatments for the first time.
Supporting these points, Ogiermann-White observed, “Many people believe that aesthetic treatments are always unnatural and easily detectable.” She elaborated, “We find ourselves countering these narratives until we are blue in the face, yet they persist and they simply aren’t true. I always emphasise that it’s not the product or the treatment itself, but the hands administering it that determine the outcome.”
Expanding on this theme, Ogiermann-White spoke about subtlety in aesthetics, explaining, “Treatments can be discreet and virtually undetectable when administered expertly, or overly obvious if not. This perception remains a significant barrier for patients considering these procedures. It’s unfortunate, because when done sensitively and judiciously, aesthetic treatments can be transformative, both functionally and psychologically.”
She concluded by reiterating the importance of “continuing to challenge misconceptions and helping patients understand the potential benefits.” For practitioners, this involves taking an active role in shaping accurate conversations around aesthetic treatments – not only through social media, but also by engaging with reputable journalists, contributing specialist commentary and providing transparent, evidence-based information for publication.
Media engagement in clinical practice
The panel highlighted that although practitioners and journalists serve different roles, they share a common goal; ensuring accurate and responsible communication within the aesthetics field. In many cases, the two work in close proximity, each contributing their expertise from a different perspective.
Gaining an understanding of specialist journalists’ viewpoint can help enhance your professional profile, while building strong relationships with them can create opportunities both within and beyond the clinical setting.
Exploring Hypnotherapy for Aesthetic Patients
Clinical
hypnotherapist Anna
Lancaster uncovers how hypnotherapy can enhance patient care in aesthetic practice
As a medical aesthetic practitioner, your work extends far beyond the skin. While procedures and outcomes may be physical, the patient’s psychological readiness, self-image and emotional wellbeing often play a significant role in their treatment journey. Conferences and professional networks, such as the British College of Aesthetic Medicine (BCAM) and Aesthetics Conference & Exhibition (ACE), have seen increased discussion around emotional readiness and wellbeing as key factors in patient outcomes. This shift mirrors a wider movement in medicine, recognising that mindset and stress levels can directly influence recovery, satisfaction and adherence to post-procedure care.
Increasingly, mind-body practices are being explored as adjunctive tools to support better outcomes, both in clinical results and patient satisfaction. In fact, recent data shows that 26.3% of adults in the UK (from a nationally representative sample of 7,630 respondents) use some form of complementary or holistic therapy, and the UK alternative medicine market is forecast to grow by nearly 15% annually over the coming decade – reflecting growing demand for integrative, wellbeing-focused care.1,2
Clinical hypnotherapy, a form of therapy that uses focused attention and guided suggestion to alter subconscious patterns, is gaining traction as a complementary modality in aesthetics. 3,4 From helping patients overcome needle phobia to supporting those with distorted body image or anxiety around appearance, hypnotherapy presents a valuable, yet underexplored resource.
Understanding hypnotherapy
Hypnotherapy is not what most people expect. It does not involve losing control, being unconscious or “clucking like a chicken.” Instead, it is a therapeutic technique that induces a natural trance-like state – much like the absorption one experiences when engrossed in a film or a book. This is typically achieved through guided relaxation, focused breathing and verbal suggestion designed to narrow the patient’s attention and quieten analytical thought. The practitioner may use gentle counting, imagery or progressive muscle relaxation to help the patient enter a calm, receptive state where the subconscious mind becomes more responsive to positive suggestion.
Studies using fMRI scans have shown changes in brain activity under hypnosis that reflect a decrease in self-consciousness and an increased focus on internal experience.5-7
This altered state allows patients to access underlying beliefs and habitual emotional responses – often the root of anxiety, self-esteem issues or distorted body image. By identifying and reframing these subconscious patterns, hypnotherapy can create long-lasting changes in perception and behaviour.
Why subconscious programming matters
In aesthetics, a patient’s beliefs about themselves and their appearance often shape not just their reasons for seeking treatment but also how satisfied they feel with the outcome. These beliefs, many of which are formed in early life or shaped by culture, media or past experiences, act as internal scripts that play out in behaviour and perception.
For example, a patient who subconsciously believes “I’m not good enough” or “I will never look beautiful” may continue to feel insecure even after an objectively successful procedure. These deep-rooted beliefs create a lens through which they experience results – and can lead to ongoing dissatisfaction or a cycle of repeat treatments in search of emotional relief.
Hypnotherapy works by accessing these subconscious beliefs and updating them. Just as the body responds to treatment, the mind can respond to suggestion, allowing patients to build new mental associations such as “I am worthy,” or “I can feel confident in who I am.” In doing so, hypnotherapy helps create congruence between internal belief systems and external appearance, leading to a more integrated and lasting sense of satisfaction.
Aesthetic challenges hypnotherapy can support
The following are four common psychological or emotional challenges where hypnotherapy can offer valuable support as part of a wider patient care strategy. The number of sessions depends on the individual and complexity of concerns. For instance, two to four sessions for specific issues (e.g. needle phobia) and six to eight for deeper emotional patterns (e.g. low self-esteem). Sessions are typically held weekly to support integration and reinforcement.8,9
Needle phobia and procedural anxiety
One of the most practical uses of hypnotherapy in medical aesthetics is in helping patients manage needle phobia or procedural anxiety. According to a review by Nir et al. which analysed multiple studies on the prevalence and impact of needle phobia, up to 20% of adults experience some degree of this condition – leading to treatment avoidance, increased cortisol levels and a heightened pain response.10
Hypnotherapy can be used to desensitise patients by leading them to a calm, safe space, then reprogramming their response to the trigger (e.g. the sight of a needle). Unlike traditional desensitisation, the hypnotic state bypasses resistance from the conscious mind, making change quicker and more lasting.
Exemplar
In a typical session, the hypnotherapist first guides the patient into a relaxed, focused state, then explores the subconscious root of the fear – often a past experience that created an association between needles and danger or loss of control. Once identified, this memory is reframed through positive suggestion and calm imagery, allowing the patient to process it safely and form a new, neutral or even confident response. The session may end with visualisation of a successful procedure, embedding the new calm reaction at a subconscious level.
Low confidence and self-esteem
A large proportion of aesthetic patients are motivated not solely by appearance, but by the desire to feel better in themselves. Even patients who achieve excellent clinical outcomes sometimes
feel dissatisfied, due to ingrained subconscious beliefs about their worth or desirability.
Hypnotherapy can help identify and reframe these internal narratives. Whether rooted in childhood messaging, social comparison or previous rejection, the hypnotic process can access the subconscious mind – where self-esteem beliefs are stored – and plant healthier, more empowering ones.
While research within aesthetic settings is still emerging, several studies demonstrate hypnotherapy’s effectiveness in improving self-esteem and confidence across medical and psychological contexts. For example, a hypnotic ego-strengthening procedure improved self-esteem and reduced depressive symptoms in adults,11 while hypnotic induction increased self-esteem scores in adolescents.12 A randomised controlled trial combining hypnosis with cognitive behavioural therapy (CBT) found greater improvements in body image and self-esteem among participants with obesity compared to CBT alone.13
Body image distortion and appearance-related anxiety
While aesthetic procedures can enhance confidence, some patients present with underlying body dissatisfaction that no physical treatment alone can resolve. Hypnotherapy can help patients move from self-criticism to self-compassion, gently shifting the lens through which they view themselves. It is not a substitute for psychiatric care, but for those with subclinical appearance concerns or cosmetic-related anxiety, hypnotherapy offers a non-invasive tool to promote healthier body perception.
It is crucial that aesthetic practitioners screen for body dysmorphic disorder (BDD) and refer such cases to medical professionals.14 Hypnotherapy is not recommended for patients with severe mental health conditions unless part of an integrated care plan under supervision.
Stress-related skin conditions and healing
Chronic stress has well-documented effects on the skin – from delayed wound healing to exacerbated conditions like acne or rosacea.15 Hypnotherapy promotes relaxation and parasympathetic dominance, reducing stress hormones and promoting better outcomes post procedure. Research in psychodermatology also supports the use of hypnosis in managing skin conditions with a psychological component.16 In his 2000 systematic review published in the Archives of Dermatology, Dr Philip Shenefelt examined multiple case studies and clinical reports, though specific patient numbers varied across the conditions studied. Dr Shenefelt documented clinical improvements in patients with stress-exacerbated dermatological conditions such as eczema, psoriasis and warts following hypnotherapy.17 In aesthetics, using hypnotherapy as a pre-treatment tool may improve the patient’s healing response and satisfaction.
Ethical considerations and referral pathways
Recognising when to refer a patient for hypnotherapy begins with identifying psychological or behavioural cues that suggest deeper emotional patterns may be influencing treatment expectations or satisfaction. Referral is appropriate when a patient displays persistent low self-esteem, heightened anxiety about appearance, or expresses beliefs such as, “I’ll only feel good once I fix this flaw,” despite otherwise realistic goals. These are indicators that subconscious self-worth issues may be present and that hypnotherapy could help reframe internal beliefs before or alongside treatment.
Mind-body practices are being explored as adjunctive tools to support better outcomes, both in clinical results and patient satisfaction.
When choosing a hypnotherapist to refer to, it is essential they are registered with recognised bodies such as the National Hypnotherapy Society (HS) UK, the General Hypnotherapy Register (GHR) or an equivalent.18 Ask about their training, experience with relevant cases and whether they follow ethical and data protection standards. This includes adhering to professional codes of conduct, maintaining patient confidentiality, obtaining informed consent for any therapeutic work and complying with UK General Data Protection Regulation (GDPR) and Data Protection Act (2018) regulations. Qualified hypnotherapists should also have appropriate insurance and clinical supervision to ensure accountability and best practice.19 Practitioners should screen for BDD using validated tools, such as the Dysmorphic Concern Questionnaire (DCQ), or refer directly to a GP or mental health professional when red flags arise – for example, when concerns seem disproportionate to physical findings or when multiple procedures are sought without satisfaction.
Hypnotherapy is suitable only for subclinical cases, where emotional factors such as low confidence, mild appearance anxiety or stress around treatment are present, but insight and perspective remain intact.
Integrating mind and body in aesthetic practice
As aesthetics embraces the wellness space, recognising the mind-body connection is vital. Hypnotherapy offers an evidence-based, non-invasive option to address anxiety, needle phobia, confidence and body image challenges. Integrated thoughtfully into an aesthetic clinic’s referral network, it reflects a holistic, forward-thinking approach that can enhance outcomes, build trust, improve retention and ultimately create more fulfilled patients.
Anna Lancaster is a clinical hypnotherapist, rapid transformational therapy (RTT) practitioner and member of the General Hypnotherapy Register (GHR). Lancaster works with aesthetic and wellness clinics, including Lisa Franklin Clinic Privé and W-Wellness, helping patients enhance emotional wellbeing and optimise aesthetic outcomes through mind–body alignment.
Qual: Cl.Hyp, GQHP
“Watching patients flourish made me appreciate how dermatology can change lives”
Dr Derrick Phillips shares his passion for dermatology and his role as spokesperson for the British Skin Foundation
Dr Derrick Phillips was born in the UK, but spent much of his childhood in Cape Coast, Ghana, surrounded by a family of lawyers and doctors. From an early age he was encouraged by his parents to pursue a career in law or medicine, following in his family’s footsteps. Being naturally drawn to physics, biology and chemistry at school, medicine quickly became the obvious choice for Dr Phillips. A notable familial influence for him was his aunt, who was the first female gynaecology consultant in Ghana.
Dr Phillips completed his medical degree from University College London Medical School in 2011, graduating with double merit and achieving First-class Honours in Medical Physics and Bioengineering. He later completed his medical training in London and New South Wales before training as a specialist dermatologist in Liverpool.
The transition from medicine to dermatology, as Dr Phillips describes it, was “pure serendipity.” Upon graduating from medical school, like many young doctors, he was unsure about his next step. After gaining practical experience in neurosurgery at Singapore’s National University Hospital, and later at the National Hospital for Neurology and Neurosurgery in London, he realised that a career in neurosurgery was not for him. “While I have great admiration for the skill and dedication required to become a neurosurgeon, the level of morbidity and mortality was something I struggled with,” he says.
highlighted the importance of sun protection and advanced skincare for Dr Phillips.
This commitment to skin health now underpins a large proportion of Dr Phillips work, as spokesperson for the British Skin Foundation (BSF). He explains, “What I really admire about the BSF is that their work goes beyond raising awareness of skin disease, they also actively promote healthy habits and positive lifestyle choices amongst young people.” Dr Phillips notes that BSF works in tandem with dermatologists, both in funding research, but also in raising public awareness of both skin conditions and promoting healthy skin behaviours. In September, Dr Phillips was featured on the BSF’s Skin Unfiltered podcast discussing acne, acne scarring and skin positivity within the filtered world of social media.
Dr Phillips frequently encounters misconceptions around skincare in his practice, especially relating to acne. A common misunderstanding he observes is the belief that acne only affects teenagers and is caused by poor habits such as bad diet or poor hygiene. In reality acne is a complex skin condition that is influenced by genetics, hormones, the microbiome and environmental factors.
At this stage in his life, Dr Phillips described himself as a “lost soul in medicine,” uncertain whether he wanted to stay in the discipline or leave altogether. The decision to leave neurosurgery unexpectedly diverted him towards dermatology – a blessing in disguise that set him on a new path that he remains passionate about today. He shares, “I had never really considered dermatology before and had minimal exposure to it, but I just instantly fell in love. I was drawn to the profound impact you can have as a dermatologist. I vividly remember seeing patients with severe psoriasis start biologic treatments and witnessing their transformation, not just in their skin, but in their confidence and outlook. Watching patients flourish as their condition improved made me appreciate how deeply dermatology can change lives.”
After deciding to specialise in dermatology, Dr Phillips did not dive into the field straight away – instead he moved to Australia. “I knew my destination, so I thought I would take the scenic route and pick up some life experience on the way,” he explains.
While working as a general medic, he found himself unintentionally immersed in a wide range of dermatological cases. He notes, “Queensland has the highest incidence of skin cancer worldwide, and I also witnessed a lot of advanced skin ageing.” This experience
“These misconceptions often stem from content seen on social media,” explains Dr Phillips. “Social media is a double-edged sword, while it provides access to expert medical knowledge from reputable sources, it also gives a platform to voices that spread misinformation purely for views,” he adds. Outside of his work with the BSF, Dr Phillips is a consultant dermatologist at OneWelbeck where he manages general skin concerns including acne and rosacea and has an interest in skin rejuvenation. He is a fellow of the Royal College of Physicians and a former recipient of the British Association of Dermatologists’ Green Prize, awarded for his contributions to sustainability in dermatological surgery. He has been acted as principal investigator for multiple clinical trials, including the SAFA study, which investigated the safety and efficacy of spironolactone in hormonal acne. In addition to his clinical research, Dr Phillips is published in several high impact journals, sits on the Aesthetics Reviewing Panel, and regularly provides expert commentary across newspapers, magazines, television and radio.
Looking ahead, Dr Phillips is excited about the technological advances in dermatology. He concludes, “In the past five years, we’ve seen the introduction of lasers that specifically target the sebaceous glands for acne, alongside a broader expansion of laser technologies for treating acne scarring. The pace of scientific progress in this field is truly exciting!”
Do you have a mantra you stick to?
Work hard, play hard!
What is the best career advice you have received?
Stay true and honest to yourself and every failure is a lesson. What is your favourite holiday destination?
Marrakesh in April – I would highly recommend.
Dr Derrick Phillips
Changing the Narrative Around Botulinum Toxin
Dr Sally Rayment argues that stigma around botulinum toxin needs to be challenged to ensure equitable access
Botulinum toxin has revolutionised both aesthetic and medical practices. Nonetheless, it remains entangled in a web of negative societal perceptions around gender norms, media narratives and cultural perceptions of ageing which can serve as a barrier to individuals considering both aesthetic and therapeutic applications. Frequently associated with superficiality or inauthenticity, toxin use, particularly among women, is judged harshly, despite growing evidence of its positive impact on psychological and physical wellbeing.1
I argue that understanding and addressing this stigma is essential to ensuring equitable access to botulinum toxin treatments – not only for aesthetic reasons, but also for therapeutic indications.
Origins of toxin stigma
Authenticity and shame
A key criticism of toxin is that it undermines ‘authenticity’. Critics suggest that users are concealing their true selves or attempting to deceive others by altering their appearance.2 These claims ignore the spectrum of motivations behind toxin use – from boosting self-confidence to addressing medical concerns – but shame is hard to shake. Secrecy around getting botulinum toxin injections, when it does occur, can reinforce this shame further.
Media representation and stereotyping
The media plays a central role in shaping public attitudes toward cosmetic treatments. Sensationalist portrayals – especially ‘botched’ tabloid stories – have contributed to a narrative of artificiality, exaggeration and emotional numbness. These depictions have overshadowed more accurate portrayals of subtle, well-administered results.
Misinformation
Despite botulinum toxin being MHRA-approved and supported by extensive research, myths around its dangers and side effects persist.3 An example of this is that people can think that botulinum toxin is toxic and unsafe. Many patients remain unaware of its broader clinical applications, such as in the treatment of chronic migraines, hyperhidrosis or bruxism.3
The impact of stigma
The consequences of stigma extend beyond public opinion, with psychological, emotional and behavioural implications. Individuals may internalise judgement, leading to reduced self-esteem, social withdrawal or heightened anxiety. Concealing toxin use can lead to stress and feelings of inauthenticity, while negative societal perceptions may amplify pre-existing mental health issues, particularly around self-image. I believe stigma can also deter individuals from seeking potentially life-enhancing or medically necessary interventions altogether.4
Reframing the narrative
In my view, by reframing botulinum toxin as a medically validated and multi-purpose treatment, we can challenge the view of it as merely a vanity-driven choice. Promoting accurate, accessible information about botulinum toxin’s cosmetic and medical uses can help correct misconceptions and reduce fear.
Although toxin is a prescription-only medicine and cannot be promoted to the public directly, this does not mean education is off limits. The Advertising Standards Authority (ASA) allows content that is educational or informational, provided it is not promotional, does not make claims of availability, and does not directly or indirectly encourage use of the product. In other words, practitioners can discuss botulinum toxin in a factual, objective and balanced way – including its risks, uses, stigma, history – but must avoid any wording that could be interpreted as enticement, implicit advertising, or product promotion.5
I believe practitioners and clinics can ethically raise awareness by explaining how dynamic lines form through repeated muscle movement, and how treatments that relax these muscles can soften their appearance, using neutral, non-branded language.
Sharing peer-reviewed studies and clinical insights about neuromodulators, while avoiding reference to specific products, also helps position the treatment in a scientific and credible way. In my opinion, myth-busting is particularly important – addressing common misconceptions such as the ‘frozen face’ stereotype, while
stressing the importance of qualified practitioners, safe injection techniques and proper consultation.
Healthcare professional advocacy
Medical professionals should also foster open conversations with patients, emphasising toxin’s clinical applications and addressing concerns with empathy.6
Finding a way to talk about the therapeutic advantages when indicated for an individual, without eliciting the immediate barrier patients can put up, is key. Lead with function, not the name – instead of jumping in with a word such as “Botox”, start by describing the medical mechanism or symptom relief. For example, “There is a treatment we use to relax overactive muscles,” or “one option that has helped many people in your situation is an injectable medicine.” Once they are engaged, you can then clarify that it is indeed botulinum toxin – the same substance used cosmetically but here for a clinical purpose.
I believe practitioners should use empathetic framing to position the treatment as part of a holistic care plan, not a quick fix. For example, “I know that this symptom has been affecting your quality of life – there is a treatment that might offer you real relief,” or “this is not about changing the way that you look, but about helping your body function more comfortably.” Share its history – explain that the history of toxin use stemmed from its medical origins.
Patient reviews and testimonials, such as anonymised stories of those treated for jaw tension, can also build trust and show that others like them have benefitted.
Increasing
tolerance and openness
By addressing stigma through education, transparency and advocacy, we can support a culture where individuals feel free to make informed, confident choices about their appearance and health. This education should always remain ethical and regulatory-compliant, ensuring that discussions about prescription-only medicines like botulinum toxin are grounded in facts, patient safety and informed consent.
Dr Sally Rayment is a medically trained facial aesthetic practitioner and restorative dentist based in Haywards Heath, West Sussex. She qualified at Guy’s, King’s and St Thomas’ Hospital in 2004 and holds a Master’s degree in Prosthodontic Dentistry from King’s College London.
Qual: BDS, MClinDent FRP
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Explore the products at ACE 2026:
*AbbVie has part sponsored this event, this includes provision of a stand and a speaker program. AbbVie has had no influence over the content/topics covered in other parts of the agenda.
REASONS TO CHOOSE BOCOUTURE
• Results seen as early as 7 days, lasting up to 4 months in upper facial lines1
• A well characterised safety profile1
• Convenient – no refrigeration needed prior to reconstitution1
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Merz Aesthetics Exchange (MAX) is a promotional website developed and funded by Merz Aesthetics UK & Ireland.
Scan the QR code to access BOCOUTURE UK and Ireland Prescribing Information
Adverse events should be reported. Reporting forms and information for United Kingdom can be found at https://yellowcard.mhra.gov.uk/. Reporting forms and information for Republic of Ireland can be found at https://www.hpra.ie/homepage/ about-us/report-an-issue. Adverse events should also be reported to Merz Aesthetics UK Ltd by emailing UKdrugsafety@merz.com or calling +44 (0) 333 200 4143.
1.BOCOUTURE Summary of Product Characteristics. Merz Pharmaceuticals GmbH: https://www.medicines.org.uk/emc/product/600/smpc (Last accessed September 2025).
