Consulting Room Magazine | Volume 7: Issue 2 | April - June 2024 by Consultingroom

CONSULTING ROOM | VOLUME 7: ISSUE 2 | APRIL - JUNE 2024

INTEGRATING WELLNESS How to tap into the wellness trend

SKIN AND MEDITATION The stress-skin link

CPD Cortisol and weight gain

MOLE REMOVAL An expert guide

IN THIS ISSUE: WELLNESS SPECIAL

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EDITOR’S NOTE

WELCOME TO THE WELLNESS SPECIAL ISSUE OF THE CONSULTING ROOM MAGAZINE FOR SPRING 2024 Adobe/ckybe

Welcome to the Spring 2024 issue of the Consulting Room magazine. For this issue, we are focusing on wellness. I have been interested in wellness for over a decade in my personal life, but I have rarely had a chance to write about it through my work in aesthetics until recently. Aesthetic clinics are increasingly recognising the importance of a holistic approach that integrates treatments with lifestyle and wellness advice. As the wellness industry explodes in terms of growth globally, this trend doesn’t look like it’s going to slow down any time soon. Where once there was a clear divide between treatments, services and products considered to be under the category of ‘wellness’ and those that were labelled as ‘aesthetics’, the boundaries between the two are fading away, and I, for one, couldn’t be more excited about exploring the opportunities this brings. As part of our wellness special, we look at how you can integrate wellness into your practice (p19-21), visit the incredible 6-star longevity and aesthetics clinic that recently opened in London – Galen – (p23-24), look at the link between cortisol and weight gain as part of our CPD article (p25-28), examine the benefits of meditation on the skin (p29-30) and look at the importance of sleep (p33-36). Also, in this issue, we look at approaches to managing scarring (pages 45-46 and 53-54), delve into complications management (p41-43) and explore the topic of mole removal (p61-62). We also examine the importance of well-trained front-of-house staff (p71-72) and look at why cash flow is key (p73-74). We hope you enjoy this issue and, as always, welcome your feedback on what you’d like to read about in future.

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CONTENTS Adobe/ Front Cover/Rido Adobe/Ольга Лукьяненко/VadimGuzhva/Axel Bueckert/Lategan/Avirut S/New Africa

25 THE CORTISOL CONNECTION

Piroska Cavell explores the link between wellness and aesthetics and the role of cortisol in weight gain.

71 LEADING FROM THE FRONT Gilly Dickons from Aesthetic Response on the value of welltrained front-of-house staff.

WELLNESS IN AESTHETICS

SKIN-MIND CONNECTION

THE FAULT IN OUR SCARS

Vicky Eldridge and Hamilton Fraser discuss how to integrate wellness and a holistic approach into your aesthetic practice.

Certified meditation teacher and skin expert Victoria Hiscock explores how mindfulness and meditation can impact the skin.

Study provides significant insights into scars and body image from the perspective of children and young people.

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03 - 06 CONTENTS 07 - 14 NEWS 15 - 16 EVENTS

17 - 38 WELLNESS SPECIAL 39 - 50 CLINICAL

51 - 58 TECHNOLOGY 59 - 68 SKIN

69 - 82 BUSINESS

83 - 85 TRAINING

ARE YOUR PATIENTS GETTING ENOUGH SLEEP? Could not getting enough sleep be impacting the way your patients look and feel?

PUBLISHED BY The UK’s largest and longest running aesthetic industry information website and business portal. Consultingroom.com Ltd E: admin@consultingroom.com © Copyright 2018-2022 Consulting Room Material may not be republished or reproduced in any form which removes attribution to Consulting Room, without the publisher's written permission. Press clippings can be obtained from the Editor. The publishers accept no responsibility for the information transmitted by contributors or advertisers through publication in the Consulting Room magazine. Inclusion of advertisements does not imply endorsement of the products or services advertised. The Editor's decision is final in all matters. Published by Consultingroom.com Ltd, registered as a limited company in England; No. 4617405.

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Please be aware that some articles included in this magazine are certified for Continuing Professional Development (CPD) and may make a contribution to your personal CPD requirements.

To download a CPD Reflective Learning Form, produced in association with the British Association of Cosmetic Nurses (BACN) & the British College of Aesthetic Medicine (BCAM), please use the QR code or visit bit.ly/CR-CPD in your web browser.

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EDITORIAL BOARD Consulting Room has a long history of working with key figures within the global medical aesthetic community, many of whom are advisers on our website. We are honoured to welcome many of them, and others, to the Editorial Board of our quarterly magazine. Without their wealth of knowledge and expertise in this diverse sector, we would not be able to provide the levels of educational content on clinical, nutritional and business topics that you will find within this magazine.

Dr David Eccleston 20 years in Medical Aesthetics and a Private GP. Clinical Director at MediZen. Local Country Ambassador for Allergan and lead investigator in many clinical trials.

Dr Patrick Treacy Founded the Ailesbury Clinic based in Dublin. Named Top Aesthetic Practitioner in the World (2019) and Top Aesthetic Medical Aesthetic Practitioner (Irl) 2023.

Dr Uliana Gout Educator & Speaker. British College of Aesthetic Medicine Former President & Int. Peeling Society Board. Founded London Aesthetic Medicine Clinic & LAM Academy.

Emma Davies NIP Save Face Clinical Director. Nurse specialising in cosmetic medicine since 1998. Co-founder and pastChair of the British Association of Cosmetic Nurses.

Dr Niro Sivathasan Sydney-based aesthetic and restorative surgeon with international registrations. Senior trainer for pharma in Australia. Director of Harley Academy.

Ron Myers Business Coach, Director of Aesthetic Business Partners LLP, former Director of HydraFacial UK and Co-Founder of The Consulting Room Group.

Martyn Roe

Veronica Donnelly VAT partner at Azets. She has been a VAT adviser for 30 years, and heads up the Specialist Aesthetic accounting team for the firm.

Pam Underdown Business coach, trainer and mentor working exclusively with aesthetic professionals through her business Aesthetic Business Transformations.

Mike Regan Certificated Laser Protection Adviser and Chair of the Association of Laser Safety Professionals. Actively involved in laser safety and CEN standards.

Prof Mark Whiteley Consultant Venous Surgeon & Founder of The Whiteley Clinic. Internationally recognised expert in venous disease and endovenous surgery.

Madi Myers Biological Science graduate with a Masters (ANutr) in Human Nutrition from University of Aberdeen; an Association for Nutrition accredited course.

Mr Greg Williams Hair Transplant Surgeon at the Farjo Hair Institute with a special interest in the regulation of Hair Restoration Surgery in the UK.

Dr Tristan Mehta Medical doctor and entrepreneur. CEO & Founder of Harley Academy, founded to combat the lack of standardised medical training in aesthetic medicine.

Julia Kendrick Member of Chartered Institute of PR. Awardwinning business strategy & comms expert. Founder of Kendrick PR & E.L.I.T.E Reputation Programme™

A Specialist Business Consultant and Co-Founder of The Consulting Room Group. Martyn is the co-founder of Aesthetic Medical Partnership (AMP).

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CONTRIBUTORS

DR RAQUEL AMADO Dr Amado has 15 years of experience as a dentist. She is a Level 7 qualified aesthetic practitioner, senior clinical trainer for Harley Academy, opinion leader for Neauvia and international speaker for Alumier MD. Her expertise lies in a holistic approach to fullface rejuvenation.

PIROSKA CAVELL Piroska has an MSC in Cosmetic Medicine with an interest in tackling facial disfigurement due to injury, illness or surgery with the combination of treatment modalities. She also holds qualifications in obesity and weight management, prescribing and hormone health.

DR ASKARI TOWNSEND Throughout the years, Dr Askari used and struggled with six different major practice management systems. In 2019, he founded Collums software platform. Collums is user-centric software that offers the fastest digital note-recording system for injectable practitioners.

VICKY ELDRIDGE

ALAN ADAMS An award-winning profit coach and bestselling author, Alan has published a series of books all firmly focused on helping businesses achieve the ultimate sustainable growth. He has been recognised by Global 100 as Best Business Consulting and Services Firm 2023.

VICTORIA HISCOCK Victoria has been teaching medical-grade skincare for almost two decades. She is a certified Meditation Teacher and qualified Mental Health Advocate. Her expertise, in the mind-skin connection, and the impact of stress on the skin have been featured in the likes of Women’s Health and Esquire.

Vicky is an award-winning journalist and editor who has specialised in aesthetics for almost 20 years. She is founding editor of Aesthetic Medicine and edited five supplements for The Times. In 2015, she won a Safety in Beauty Award for supporting standards within the industry.

DR BELA HORVATH In 2005 Dr Horvath established the MelanomaMobil clinic based on a unique methodology that compares each and every mole of the patients resulting in the most accurate mole screening service available. MelanomaMobil has completed over 100.000+ screenings.

GARY CONROY

DR AHMED Dr Ahmed El Houssieny is the medical director of Bank Medispa in Hale, Cheshire. He holds a particular interest in training and is an Honorary Lecturer at the University of Chester and is a regular speaker at conferences. He has also had his papers published in various aesthetic journals.

Gary is the founder and CEO of 5 Squirrels, which helps skincare professionals launch their own brand skincare products. Gary is also a consultant to the Society Of Cosmetic Scientists, which promotes education and research to advance the science of cosmetics.

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WHAT’S TRENDING

BAAPS REPORTS 16% DECREASE IN COSMETIC SURGERY

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BAAPS annual audit reveals decline in procedures amid the economic downturn and an increase in complications from overseas procedures The British Association of Aesthetic Plastic Surgeons (The BAAPS) – the UK’s only organisation solely dedicated to advancing safety, innovation, and excellence in cosmetic surgery – has released its annual audit. According to the new figures, 25,972 surgical procedures took place in 2023, a 16% fall from 2022. Women had 93% of all cosmetic procedures in 2023. The five most popular procedures for women were breast augmentation (down 26%), breast reduction (down 17%), abdominoplasty, also

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known as the tummy tuck (down 19%) blepharoplasty, eyelid surgery (up 1%) and liposuction (down 17%). Face and neck Lift surgery increased in popularity to 6th place in 2023. Men had 7% of all cosmetic surgery procedures, a 20% drop from 2022. The five most popular procedures among men were rhinoplasty (down 1%), blepharoplasty, eyelid surgery (down 9%), chest reduction (down 29%), liposuction (down 36%), and otoplasty, ear correction (down 22%).

President of BAAPS, Mr Marc Pacifico said, “In 2022, we witnessed the most substantial yearly increase in procedures since the audit’s inception in 2004. While we anticipated a decline to offset the surge in post-pandemic pent-up demand and the prevailing recessionary environment, it’s noteworthy that certain procedures, such as breast and body surgeries, experienced a significant double-digit decrease. Conversely, facial procedures, including facelifts, brow lifts, and blepharoplasty, remained largely stable or exhibited only minor declines. “This trend appears consistent with the increasing number of individuals opting to travel abroad, particularly to destinations such as Turkey, in search of cheaper options for popular surgical procedures like liposuction and breast augmentation. However, this choice comes with significant consequences,

not only for the individuals undergoing surgery overseas but also for the NHS, which often bears the burden of correcting complications upon patients’ return to the UK.” Vice President Ms Nora Nugent remarked, “We’re observing a trend where individuals travelling abroad for surgery tend to be younger, with a median age of 39, indicating that financial considerations influence their choice to opt for cheaper surgical options. Typically, these surgeries pertain to breast or body enhancements, aligning with the priorities of a younger demographic. Conversely, procedures such as face, neck, and eyelifts are more common among individuals aged 50 and above, who likely possess greater financial flexibility and are less swayed by discounted offers.”

The top 10 surgical procedures for women in 2023 (24,150 total. A fall of 16% from 2022): 1. Breast augmentation: 4,918 – down 26% from last year 2. Breast reduction: 4,399 – down 17% 3. Abdominoplasty: 2,641 – down 19% 4. Blepharoplasty (eyelid surgery): 2,461 – up 1% (Increased to 4th place in 2023 from 5th place in 2022) 5. Liposuction: 2,211 – down 17% (Dropped to 5th place in 2023 from 4th place in 2022) 6. Face/neck lift: 1,631 – down 1% (Increased to 6th place in 2023 from 7th place in 2022) 7. Rhinoplasty: 1,565 – down 15% (Dropped to 7th place in 2023 from 6th place in 2022) 8. Fat transfer: 1,259 – down 16% 9. Breast implants removal 845 – down 15% 10. Labiaplasty 680 – down 25%

The top surgical procedures for men in 2023 (1,822 total. A fall of 20% from 2022): 1. Rhinoplasty: 385 – down 1% from last year 2. Blepharoplasty (eyelid surgery): 308 – down 9% (Increased to 2nd place in 2023 from 3rd place in 2022) 3. Breast reduction: 242 – down 29% (Dropped to 3rd place in 2023 from 2nd place in 2022) 4. Liposuction: 214 – down 36% 5. Otoplasty (ear correction): 196 – down 22% 6. Abdominoplasty: 189 – up 10% 7. Face/neck lift: 111 – down 16% 8. Fat transfer 71 – down 26% 9. Brow lifts 59 – down 31% 10. Lower body lift 24 – down 20% (Increased to 10th place in 2023 from 11th place in 2022)

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NEWS Non-melanoma skin cancer deaths will overtake melanoma deaths, according to latest research Non-melanoma skin cancer (NMSC) deaths are on track to overtake melanoma deaths in England and Scotland for the first time, according to recent research. During Sun Awareness Week (May 6-12), the British Association of Dermatologists urged the public to learn the signs of NMSC, which is the most common type of cancer in the UK. There are two types of NMSCs, basal cell carcinoma and cutaneous squamous cell carcinoma. It is estimated that there are around 250,000 new cases every year, with basal cell carcinoma making up around 180,000 of these cases. While less common than basal cell carcinoma, cutaneous squamous cell carcinoma is more deadly. Most NMSCs have a high survival rate in comparison to melanoma; however, recently published research suggests that the number of NMSC deaths will overtake melanoma deaths in years to come through the sheer number of people they affect. Dermatology researchers looked at data from six countries with more than 1,000 skin cancer deaths annually and high-quality mortality data, including England and Scotland. In all these countries, deaths from melanoma reduced or remained static between 2010 and 2019 due to advances in melanoma care. In the same period, NMSC deaths increased. Dr Chris Bower, clinical vice-president of the British Association of Dermatologists, said: “A shift in how we view non-melanoma skin cancer is long overdue. While non-melanoma skin cancer does have a high survival rate, it is becoming so common that the number of people it kills each year is beginning to overtake more deadly cancers, including melanoma. We estimate that there are around a quarter of a million cases a year in the UK compared to under 17,000 melanoma cases. While awareness of melanoma skin cancer is still very important, we would urge people to educate themselves on the signs of non-melanoma skin cancer as well. “Like melanoma, non-melanoma skin cancers are often caused by excessive sun exposure. They are particularly common among older people, and the increase in cases that we have seen in recent years is in part due to the ageing population in the UK.” Dr Zoe Venables, dermatology consultant and clinical lead at the National Disease Registration Service, who led the research, said: “Huge leaps, particularly in the form of immunotherapies, have been made in how we treat melanoma skin cancer in the last decade. This research provides analysis of deaths from both melanoma and non-melanoma skin cancers in England, and we hope our findings will support future research and result in greater awareness of non-melanoma skin cancers to improve prevention and early detection.”

Two-thirds of TikTok influencers are making skincare mistakes Booking software Fresha has identified the most common skincare mistakes made by TikTok creators across 100 of the most-viewed videos tagged #GRWM (get ready with me) and #skincareroutine. The most common issue across skincare routines was pulling on the skin too harshly when applying products, with 60% of creators found guilty of this. The second-most prevalent skincare mistake was skipping essential steps or not using products in the correct order, with more than half (54%) of creators caught doing so. The product most of these creators skipped was toner, while almost as many missed cleanser. Rounding out the top three most common skincare mistakes is not applying products to the chest or neck alongside the face, with just as many (54%) influencers skipping this. Concerningly, more than one in five influencers (22%) didn’t apply sunscreen or SPF after their morning skincare routine, leaving their skin vulnerable to sun damage. Other common mistakes spotted across the skincare routines were putting unclean fingers into product jars, with over a third (36%) of creators doing this, and 30% of videos saw creators wash their face using either too hot or too cold water. As well as looking at TikTok uploads from creators, the analysis also looked at which mistakes are made in celebrity makeup and skincare routines on YouTube – and it turns out that not even celebs with dermatologists and artists to advise them are getting things right. Even more celebrities – 80% – pull on their skin when applying the product, while half (50%) don’t apply sunscreen/SPF after their skincare routine. Adobe/InsideCreativeHouse/muse studio

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NEWS Bolton named as UK city most interested in weight loss medications Bolton has come out on top of a new poll looking at interest in weight loss medications across the UK. The research looked at the Google search volume of weight loss medication-related terms, such as ‘best weight loss medication”, as well as weight loss medications, such as Ozempic, Wegovy and Saxenda. Interest in weight loss medications has soared globally over the past couple of years, with almost half (45%) of adults living in the US expressing interest in prescription weight-loss drugs, according to research by KFF. This pattern has been emphasised by the recent Ozempic trend, in which many celebrities and social media influences have promoted use of the drug. This has led to a huge surge in interest, and Ozempic was found to be the most searched-for weight loss drug in every area across the UK. Simple Online Pharmacy decided to investigate which UK areas would most likely be interested in newly available weight loss medication. Using Google Keyword Planner, they looked at the average number of monthly searches for weight loss medication-related terms, such as ‘weight loss medication cost’ and ‘weight loss drugs’, alongside names of various weight loss medications. The total number of searches was compared to local population sizes in UK towns and cities to find the areas most interested in the use of weight loss medications. The area found to be the most interested in weight loss medications was Bolton, with 2,159 monthly searches per 100,000 people for weight loss drugs and related terms. Overall, Bolton had a monthly search volume of 3,051. In second was Croydon, which generated an average of 1,706 monthly searches per 100,000 people. Ranking third was Doncaster, which had a monthly average of 1,620 searches per 100,000 people. On the other end of the spectrum, Oxford was identified as the UK area least interested in the use of weight loss medication, with just 270 monthly searches per 100,000 people.

BAAPS launches campaign to address qualifications The British Association of Aesthetic Plastic Surgeons (BAAPS) has launched the “Discover the Distinction Safety Campaign” to address the ongoing issues surrounding the qualifications and credentials of practitioners in the field. It says a significant challenge facing patients is the misleading titles used by some practitioners without proper qualifications, such as ‘cosmetic doctor’ or ‘cosmetic surgeon’. These titles expose unaware patients to potential risks associated with invasive procedures and unfavourable outcomes. It says there’s also a misconception that practitioners operating from renowned locations like Harley Street automatically possess superior skills and qualifications. President of BAAPS, Marc Pacifico, emphasises the importance of discernment when choosing a surgeon, explaining, “Many people mistakenly believe that a Harley Street address automatically validates a doctor’s credentials; this assumption is not accurate because anyone can rent rooms in Harley Street. The geographical location of the practice has no impact on the surgery’s outcome or the skill of the practitioner. Always do your due diligence: make sure your surgeon is a member of their appropriate governing body. For a surgeon this should be The Royal College of Surgeons and that they are a member of BAAPS.” To assist patients in making informed decisions, BAAPS recommends evaluating three key criteria before proceeding with cosmetic surgery: • Is the surgeon listed on the GMC specialist register and affiliated with FRCS (Fellow of the Royal College of Cosmetic Surgeons) or an equivalent professional body? • Are they a member of BAAPS (British Association of Aesthetic Plastic Surgeons) or BAPRAS (The British Association of Plastic, Reconstructive and Aesthetic Surgeons)? • Is the clinic or facility Care Quality Commission (CQC) registered? BAAPS also encourages patients to utilise their database of Specialist Plastic Surgeons who are all qualified to carry out aesthetic plastic surgery procedures through the Royal College of Surgeons. Adobe/Wild Awake/Paul

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NEWS Dr Munir Somji develops protocol for Ozempic-related hair loss

NEWS IN BRIEF STORIES

Leading hair surgeon, Dr Munir Somji has recently noticed a surge in clients struggling with hair loss as a result of using the increasingly popular weight-loss drug, Ozempic. This is due to the drug disrupting the body’s natural hormone balance, redirecting resources away from hair follicles and leading them to a state of rest. Dr Somji has developed a protocol to improve this type of shock shedding with CALECIM® Professional Advanced Hair System. The treatment has clinically validated results that see a 24% increase in the growth of hair follicle cells and a 30x reduction in inflammatory signals within the hair follicle (a leading contributor to hair cell follicle death). It has been clinically proven that stem cell-derived growth factors are able to re-invigorate dormant and sluggish hair follicles such as those seen while taking Ozempic.

More than half of Brits get sunburnt accidentally A survey conducted by the British Skin Foundation (BSF) has found that 51% of Brits have accidentally sunburned themselves, underscoring the need for increased awareness and education on sun safety measures. Dr Anjali Mahto, a consultant dermatologist and BSF spokesperson, commented, “Sunburn is an acute inflammatory reaction resulting from over-exposure to ultraviolet radiation. It causes direct DNA damage, leading to inflammation and the death of skin cells. Sunburn during childhood or adolescence can double the risk of developing melanoma, the most serious type of skin cancer, in later life.” The survey also revealed that 41% of respondents would appreciate reminders about skin protection during the summer months. To address this, the BSF has launched the ‘More, More, More’ sun safety campaign, aimed at encouraging the public to adopt three key protective measures: wearing more protective clothing, using more sunscreen, and seeking more shade. Despite the apparent willingness to adopt sun safety measures, a quarter of those surveyed admitted to forgetting about them and needing regular reminders. The BSF’s campaign aims to provide the necessary nudge for the British public to prioritise their skin health. The survey also highlighted confusion over sunscreen usage, with nearly 24% saying they find sunscreen labels confusing and 18% saying they don’t understand how SPF ratings work. In addition, 13% didn’t understand UVA and UVB, and 20% didn’t know which type of sunscreen to use. 16% were unsure how often to apply or reapply sunscreen, and the same number didn’t understand the difference between chemical and mineral sunscreens.

Hamilton Fraser and Menopause in Aesthetics announce partnership Leading insurance provider Hamilton Fraser and specialist event organiser Menopause in Aesthetics (MiA) have announced a new partnership. The key focus of the partnership will be on the profile-raising industry events run by both companies: Hamilton Fraser’s seventh annual Aesthetic Business Conference (ABC), which takes place on Tuesday, 8 October 2024, at the Royal College of Physicians, London and Menopause in Aesthetics’ flagship event, which will be held on Friday, February 7, 2025, at The Grand Connaught Rooms, London.

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BAAPS announces honorary council representatives for Ireland Scotland and Wales The British Association of Aesthetic Plastic Surgeons (BAAPS) has announced the appointment of Ms Éilís Fitzgerald as honorary BAAPS Council representative for Ireland, Mr Alastair Lowrie as honorary council representative for Scotland and Professor Iain Whitaker as honorary council representative for Wales. The appointments underscore BAAPS’ commitment to excellence and innovation in the field of aesthetic plastic surgery. Mr Naveen Cavale launches the Real Clinic Podcast Surgeon and founder of Real Clinic, Mr Naveen Cavale has launched a new podcast. Sponsored by 42 South Films, the Real Clinic Podcast offers a peek behind the curtains of the surgery industry, delving into the intricacies of setting up a clinic and featuring conversations with industry specialists. In the first episode, Mr Cavale speaks with Francesca Ogiermann-White, founder of The Beauty Triangle and the Health & Beauty Editor-at-Large for Tatler. You can listen on Spotify, or watch it on Youtube. Transform Healthcare unveils transformation plan Transform Healthcare has announced the appointment of Dr Sayani Sainudeen as chief executive, alongside the unveiling of a comprehensive 10-point transformation plan. The plan marks a significant milestone in the company’s journey towards redefining the standards of healthcare delivery in the UK. DermaFocus to host regenerative medicine event in Manchester The first Northern-based Regenerative Medicine Summit focusing on polynucleotides and exosomes will take place at the Manchester Hilton Hotel in Deansgate on July 19. Led by DermaFocus Academy, the agenda will feature talks from leading regenerative experts, including Professor Maurizio Cavallini, who has steered extensive research into PLINEST polynucleotides and developed effective protocols to deliver optimum results. Adobe/Siam/jivimages

JCCP announces new approved education and training provider

NEWS IN BRIEF STORIES

The Joint Council for Cosmetic Practitioners (JCCP) has announced that formal approval has been awarded to the Skin Appeal Training Academy (SATA) Liverpool as a new Approved Education and Training Provider for the delivery of the OTHM Level 7 Diploma in Clinical Aesthetic Injectable Therapies. SATA has now been added to the JCCP’s Register of Approved Qualifications and can display the JCCP charter marks in accordance with the JCCP protocol for the use of the same. Neil Pybis, director at SATA Training Academy, said: “We are proud, after much hard work, to gain JCCP approval for our OTHM Level 7 Diploma and in particular to have become the first nurse-led level 7 post-graduate clinical aesthetic education provider in England on the JCCP register. We are passionate about standards in aesthetics education and practice and look forward to welcoming present and future aesthetic practitioners onto our programme”.

Brits spent record amount on healthcare in 2023 The latest consumer spending figures from the Office for National Statistics (ONS) reveal UK households spent a record £32.3bn on health products and services in 2023, 8.3%. Last year, patients spent £8.6bn on pharmaceutical products such as medicines, vaccines and vitamins. They also spent £4.2bn on consultations with doctors and specialists and £4bn on dentists and hygienists. One of the most significant amounts of household expenditure was £10bn on in-patient hospital services, including medical care, meals and accommodation charges. Dr Avinash Hari Narayanan, clinical lead at London Medical Laboratory, says, “It is great that Brits are now spending more on preventative healthcare measures, such as vitamins, acupuncturists and elective finger-prick blood tests and vaccinations. However, it is concerning that a growing amount of our household spending is going on health issues that the NHS is increasingly unable to fund.”

Caroline Larissey steps down from JCCP Caroline Larissey has stepped down from the Joint Council for Cosmetic Practitioners (JCCP). Larissey’s involvement with the JCCP was originally through a previous work role at The Hair and Beauty Industry Authority (Habia) as head of quality and standards, which led to her being invited to be a trustee in a personal capacity as recognition of her contribution and commitment to raising standards in non-surgical cosmetics. She said, “During my tenure at the JCCP, I had the privilege of supporting its creation and serving as a trustee. The UK hair and beauty sector is vibrant and dynamic, empowering individuals, promoting self-expression, and contributing to overall well-being and self-care. With a substantial £4.6 billion contribution to the UK economy, the sector plays a vital role in driving footfall to high streets, supporting jobs, and fuelling growth nationwide. As I step down from this role, I am excited to focus my efforts on championing the voice of the National Hair & Beauty Federation (NHBF) and the wider beauty sector.” The NHBF remains dedicated to supporting its Members and the sector in navigating the implementation of the Health and Social Care Act and any resulting licensing scheme. David Sines, chair of the JCCP, expressed his gratitude for Caroline’s invaluable contributions, highlighting her support, patience, and perseverance during challenging times. He wishes her the very best in her future endeavours and reaffirms the JCCP’s respect and commitment to supporting the sector. Adobe/deagreez/Brian Jackson

Evolus expands team in the UK and Ireland Evolus has announced the appointment of two new roles that will support the growth of the UK and Irish business. Julia Hart joins as medical affairs clinician, providing medical support to UK customers and Dallas Waltham joins as UK sales programme coordinator, responsible for managing and coordinating sales processes, events and much more. Aesthetic Associates welcomes new business development executive Aesthetic Associates has welcomed Harriet Rider as its new a new business development executive. Aesthetic Associates is an outsourcing agency that offers a range of services, from business strategy and sales to design, copywriting and social media. By tailoring who clients work with on which areas of their projects, Aesthetic Associates get results that are optimised and effective. Lynton opens new training facility in London Lynton has announced the opening of its new training site in the Edition Clinic in Wimbledon. The first training courses on offer at the London facility are the Level 4 VTCT Diploma in Hair Reduction and Skin Rejuvenation using Laser and IPL. Lynton’s training programmes are designed for those looking to enter the aesthetic industry as well as experienced practitioners. The company’s qualifications are widely recognised and respected across the industry. Intradermology skincare partners with GetHarley Intradermology has partnered with GetHarley to make it easy and efficient for practitioners to sell the new skincare line without investing in clinic stock. The range, which is only available to healthcare professionals, can now be delivered straight to patients’ homes following the creation of a skincare regime on the GetHarley platform. “I am very much looking forward to the collaboration to launch the rest of the Intradermology range via the GetHarley platform and service,” said founder and chief executive of Circa Skin Ltd, Claire Williams.

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EVENTS Wigmore Presents, Royal College of Physicians, London Wigmore Presents returned to the Royal College of Physicians, Marylebone, on April 20-21, bringing together a stellar lineup of national and international experts in aesthetics. The event featured a comprehensive agenda, offering the latest educational insights and exploring emerging trends in the industry. The opening speaker was Dr Anna Hemming, who questioned the industry’s current practices with her talk, “Are we using a Ferrari to deliver bread? Are we ignoring new technologies?” Another key highlight included Spoilt for Choice? The Nuances of Available Toxins with Dr Simon Ravichandran, Dr David Eccleston, Prof Syed Haq, Dr Tapan Patel, and Dr Abs Settipalli discussing the variety of available neurotoxins and the subtle differences that can impact treatment outcomes. In the evening, attendees enjoyed a VIP event at The Refinery, where they were transported back to the 80s with live music providing a perfect opportunity for networking and relaxation.

BACN Spring Symposium, The King’s Fund, London The British Association of Cosmetic Nurses (BACN) proudly hosted its most successful Spring Symposium yet at The King’s Fund on April 19. This year’s event marked the third consecutive year of the Spring Symposium, bringing together over 150 medical aesthetics nurses for a day dedicated to learning, networking, and professional development. As a cornerstone event for the BACN, the Spring Symposium has become a favourite among our members, particularly those seeking to exchange specialised knowledge. “The 2024 Symposium featured an impressive line-up of topics presented by our esteemed speakers, whose invaluable contributions were instrumental in the success of this event. The agenda was filled with insightful talks and discussions led by esteemed doctors and nurses specialising in medical aesthetics”, said BACN chair Sharon Bennett.

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Aesthetic Medicine London, Olympia London Aesthetic Medicine London returned to Olympia London on May 10-11, 2024, bringing 3,146 visitors and some of the industry’s biggest brands together. Celebrating its 10-year anniversary, the show featured exhibitors from across the industry, who were on hand to demonstrate the latest products and help delegates discover emerging trends. There were also eight education streams featuring industry-leading experts. The programmes included CPD-accredited injectables masterclasses, business seminars, the skin and body agenda, a live demo theatre and aesthetic symposiums. Professor Ali Ghanem also curated the Regenerative Medicine Conference, and the British Association of Hair Restoration Society (BAHRS) returned for its annual conference. Aesthetic Medicine London 2025 will take place at Olympia London on May 9-10, 2025.

Aesthetic Medicine Awards, The Royal Lancaster London The 2024 Aesthetic Medicine Awards hosted the best of the sector to celebrate its successes, recognising businesses and practitioners who help to raise the standards of the UK aesthetics market. The event was held at the Royal Lancaster Hotel, London, on Friday, May 10. Hosted by drag queen Baga Chipz, the event also featured speeches from Aesthetic Medicine managing director Mark Moloney and editor Anna Dobbie. Attendees enjoyed a delicious three-course meal before celebrating the winners. 2024 winners included: •

Aesthetic Clinic of the Year – London – The Cadogan Clinic

•

Aesthetic Clinic of the Year - South East – Perfect Skin Solutions

•

Aesthetic Clinic of the Year - South West and Wales – Pure Perfection Clinic

•

Aesthetic Clinic of the Year – North of England and Midlands – Dr Yusra Clinic

•

Aesthetic Clinic of the Year - Scotland and Northern Ireland – EstEthics Wellness Clinic

•

Aesthetic Clinic Team of the Year – Thames Skin Clinic

•

Aesthetic Nurse Practitioner of the Year – Julie Scott RGN NIP, Facial Aesthetics Ltd

•

Aesthetic Practitioner of the Year – Doctor – Dr Patrick Treacy, Ailesbury Clinic

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Aesthetic Practitioner of the Year – Dentist – Dr Yusra Al-Mukhtar, Dr Yusra Clinic

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Aesthetic Practitioner of the Year - Surgeon – Mr Kian Tan, Dr Kian Plastic Surgery

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Hair Restoration Clinic/Practitioner of the Year – Dr Edward Ball, The Maitland Clinic

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Aesthetic Therapist of the Year – Sarah Kennedy, Infinity Aesthetics by Sarah Kennedy

•

Best Social Media by a Clinic or Practitioner – Dr Ifeoma Ejikeme, Adonia Medical Clinic

•

Aesthetic Clinic of the Year – The Cadogan Clinic

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WELLNESS SPECIAL

In this section: Integrating wellness into your practice Clinic profile CPD: Cortisol and weight Skin and meditation Sleep Personalised approaches

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WELLNESS SPECIAL

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WELLNESS IN AESTHETICS Vicky Eldridge and Hamilton Fraser discuss how to integrate wellness and a holistic approach into your aesthetic practice One of the things that makes aesthetic medicine such an attractive sector to work in is its rapid growth and evolution, which presents clinics with new and exciting opportunities for their businesses. We are currently witnessing a big shift of this kind that is heralding a new frontier in aesthetics as wellness takes centre stage. There used to be a clear divide between wellness and aesthetics. On one side, there were indulgent spa treatments, holistic treatments, and relaxation rituals, while on the other, there were more invasive procedures like cosmetic surgery and injectables. But now, the boundaries between the two are fading away. Aesthetic clinics are increasingly recognising the importance of a holistic approach that integrates treatments with lifestyle and wellness advice, as reported in Hamilton Fraser’s ‘Emerging aesthetic trends and technologies in 2024’ article.

What is wellness? Wellness, in its broadest sense, encompasses any product or service that benefits physical and mental health, including health, fitness, appearance, sleep, nutrition, and mindfulness.

What is driving the trend for wellness? Since the Covid-19 pandemic, there has been a shift in consumer demand that emphasises holistic well-being and self-care at all levels. According to recent research by the Global Wellness Institute, the wellness market has experienced remarkable annual growth since 2020, surging 27% to reach $5.6 trillion (£4.42 trillion). It is predicted to reach $7.4 trillion (£5,85 trillion) in 2025, on its march toward $8.5 trillion (£6.71 trillion) in 2027. GWI projects that four wellness sectors (personal care and beauty; healthy eating, nutrition and weight loss; physical activity; and wellness tourism) will exceed $1 trillion in market size by 2024. Mental wellness is also predicted to grow by 12.8% annually. Three sectors will exceed half a trillion

dollars in 2024: wellness real estate, traditional and complementary medicine, and public health, prevention, and personalised medicine. Healthy eating, nutrition and weight loss will leapfrog beauty to become the largest wellness market by 2025. This surge is driven by a shift towards preventative rather than illness-driven medicine, highlighting the growing importance of holistic health practices. This has led to the fusion of aesthetics and wellness, creating an exciting opportunity that holds immense potential for both practitioners and patients alike.

The benefits of incorporating wellness into aesthetic practices Incorporating wellness into aesthetic practices has varied benefits. Beyond meeting consumer demand and increasing customer satisfaction, it opens up new revenue streams and has the potential to enhance treatment outcomes. Advantages of adding wellness to your practice: • Meeting consumer demand and increasing customer satisfaction by providing an enhanced patient experience • New source of revenue – you may attract new patients to the clinic who are nervous about aesthetic treatments • Increase your own sense of well-being and that of your team • Enhance the outcome of your treatments by offering a 360-degree approach

Ways clinics are integrating wellness into their aesthetic practices Beauty is now an inside-out experience, and consumers are increasingly craving experiences that transform not only their physical appearance but also their mental and emotional well-being. By embracing a 360-degree approach to aesthetics, practitioners can foster a sense of wellbeing within their clinics and communities, empowering patients to look and feel their best.

We are even seeing a shift in the industry vocabulary with terms such as “self-care”, “well-being”, “mindfulness”, “agelessness”, “longevity”, “skin health”, and “ageing well”, replacing “anti-ageing” Clinics can integrate wellness into their practices in a number of ways: 1. Clinic environments One way aesthetic practices are embracing this market shift is in the clinic environment itself. Modern clinics are reimagining the traditional clinical space, infusing elements of luxury and serenity typically associated with spas. From calming waiting areas to soothing music and aromatherapy, these environments aim to provide a holistic, relaxing experience that promotes a sense of peace and calm. Moreover, the integration of wellness into aesthetic practices extends beyond the treatment room, encompassing the entire patient experience. Thoughtfully curated amenities such as aromatherapy, soothing music, and mindfulness spaces further enhance the overall experience. 2. Mindful beauty The Galderma NEXT report claimed mindfulness is being evidenced in the market in three ways: • The ‘no make-up’ look – patients are looking to aesthetics for a healthy and radiant appearance, seeking treatments which improve skin quality. There’s also been a shift away from obvious-looking results towards a more natural look • Naturally in sync – artificial products and treatments are out as consumers look to naturally occurring ingredients like hyaluronic acid and treatments like platelet-rich plasma facials. Biostimulators are also seeing increased search volumes • Free from – there are more plantbased ingredients in treatments as consumers seek to align their beauty choices with their ethical beliefs

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WELLNESS SPECIAL Hamilton Fraser’s annual survey showed that the majority of practitioners had turned patients away, with only 13% saying they had never turned a patient away. Encouragingly, 91.5% said they were routinely looking out for patients displaying any mental health problems, in particular, body dysmorphia.

Your mental health matters too Healthcare practitioners traditionally don’t make time for themselves. They are often more focused on others. Research carried out by Safety in Beauty in 2022 showed eight in 10 clinic owners have experienced ‘Beauty Business Burnout’, with seven out of 10 professionals running a business in beauty or aesthetics also admitting to being overwhelmed.

3. Wellness-focused treatments and services To address the rising demand for holistic well-being, aesthetic clinics are diversifying their services to include wellness-focused treatments and services. This approach considers the whole person—their health, lifestyle, and overall well-being—and seeks to provide treatments that enhance not just physical appearance but also the overall quality of life. This paradigm shift reflects a deeper understanding of beauty as a component of overall health and wellness. This may include menopause services, nutrition and weight management, which aim to enhance not only physical appearance but also health and vitality. Traditional aesthetic procedures are also being complemented by integrative approaches that prioritise holistic health. Procedures such as facial acupuncture, which not only targets signs of ageing but also stimulates the body’s natural healing mechanisms, exemplify this holistic approach. Similarly, noninvasive body contouring techniques are being paired with lifestyle interventions such as personalised fitness plans and dietary guidance to achieve optimal results. Stress management, breath work and meditation may be used as an adjunct to treatments for those with stressed skin. Dr Priyanka Chadha, Director of Acquisition Aesthetics, says, “I suspect there’s going to be a move away from what we see now as individual, isolated treatments, and a move towards a holistic approach with wellness and a combination of devices and products and injectables, combining that with mental health and wellbeing.”

It’s important, therefore, to make time for your own well-being practices. Dr Manav Bawa, Time Clinic, says, “Taking time for your own mental health is really important. We see patients, we run our clinics, we’ve got the business side of things, we may be teaching or talking at conferences, so there’s a lot of prep that goes into that. Plus, there’s family life and children and all of the other commitments that we may have. It’s really important to take 10-20 minutes a day if you can just meditate or do something that you enjoy doing. I’m trying to do that, and it’s always tricky trying to find the balance of life. But it’s something that I’m searching for.” Dr Priyanka Chadha, Acquisition Aesthetics, says, “I too burn out and have done so more in the last two years. The recovery of that is difficult. People generally stop what’s caused the burnout and reset. I find that if I stop, because I am not practised at stopping work, I get more agitated and more upset, so I tend to take half a day or a couple of hours and sleep. I am always a bit more burnt out when I am tired. So I try to sleep and get on top of it. I don’t work well under extreme pressure, so I tend to never get myself into that situation. Other than dealing with burnout, I try to avoid burnout, overwhelm, and anxiety by planning things in advance.” The integration of wellness into aesthetic medicine represents a new frontier in aesthetics. As consumers increasingly prioritise holistic well-being, aesthetic clinics have an opportunity for professional growth and differentiation. By diversifying your service offerings and adopting a more holistic approach, you can attract a broader clientele, enhance the overall patient experience and contribute to better treatment outcomes and overall satisfaction.

Patient mental health and wellbeing Mental health also plays a central role in this paradigm shift, with practitioners increasingly attuned to their patients’ psychological well-being. Statistics reveal a significant correlation between mental health and aesthetic procedures, suggesting that of adults who suffer from depression and anxiety, 42% would be more likely than the average adult to consider a procedure in the next year. However, it’s essential for practitioners to ethically assess and support patients, even if it means declining treatment in cases where mental health concerns are prevalent. Shutterstock/Shark9208888

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Reception staffing solutions, keeping you in the conversation

Since 2011 Aesthetic Response have provided unique, tailored and bespoke business support to many of the UK’s leading and award winning clinics and practitioners. At times when there aren’t enough hours in the day, we offer pro-active and accommodating staffing solutions, all with a human touch and highly-efficient processes and protocols, so you can focus on your talent and expertise as a medical aesthetic practitioner. Empowering Practitioners to build a thriving aesthetic business

Elevate skills, efficiently & effectively Online Training Course

Our dedication, attention to detail, and extensive industry insight, coupled with our commitment to meaningful dialogue and efficient service, enable practitioners to attain the success and recognition as a trusted ambassador of safe, ethical, and effective aesthetic practice.

We have launched our Aesthetic Front of House Training course, designed to elevate the standards of customer service in the industry. The content of the course has been tailored to allow receptionists to access content at their own pace and review whenever and wherever they are.

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• Virtual clinic receptionists • Appointment booking • Deposits & payments • Lead management • Great customer service • Affordable clinic support T: 0191 720 3000 E: clientservices@aestheticresponse.co.uk www.aestheticresponse.co.uk

• Interactive online learning • Industry expert tuition • Comprehensive curriculum • Flexible & accessible program • Modules & downloads • Affordable training solution Join Aesthetic Response for excellence in medical aesthetics. Use the QR Code to book your discovery call.

WELLNESS SPECIAL

GREEK PHILOSOPHY

Vicky Eldridge visits London’s luxury 6-star wellness and aesthetics clinic – Galen From the minute you walk through the door of the Galen Clinic, you know you are somewhere special. So much time and attention to detail has gone into creating the luxury 6-star space in the heart of central London, and much like its concept, it’s not all aesthetic. Founded by Greek power couple Dr Andreas Androulakakis MD consultant plastic surgeon, cosmetic and reconstructive and Popi Makri (clinic and creative director), it is led by a team of specialist doctors, creating a new benchmark in progressive wellbeing, with the aim to preserve vitality, age-proofing the skin, body, and mind to elevate health and happiness. Galen is where your biological potential is supercharged with unrivalled expertise, longevity, and holistic health solutions. Galen is a modern, holistic clinic drawing on Galenic philosophies by focusing on balance within the body’s systems, using comprehensive diagnostic approaches and offering individualised treatment plans that include lifestyle changes through

integrating various therapeutic modalities to treat the whole person rather than just the disease or the aesthetic concern.

The Galen ethos Galen is inspired by Claudius Galenus, one of the most prominent Ancient Greek physicians, surgeons, and philosophers in the Roman Empire. His timeless philosophies and approaches to medicine and healing centred around maintaining equilibrium, were foundational for many centuries in both Eastern and Western medical traditions. These Galenic philosophies perfectly represent this modern, all-encompassing London clinic and the services they provide, which are intrinsically connected to the founder’s heritage, status and medical principles of precision and excellence. Galen exists at the axis of scientific innovation and the human experience, with natural results and progressive methodology at its core; it is the perfect marriage of results-driven, scientific, and holistic medical treatments paired

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with a feeling of luxury, exclusivity, and indulgence.

Clinic design Located on Queen Anne Street, Marylebone, the Georgian building has been transformed after a four-year restoration project over five floors, working with internationally renowned Athensbased interior designer Sissy Feida and London-based architect firm Corstorphine & Wright. All spaces, including Dr’s offices, examination rooms, operating theatre, common areas, and custom-made structures were designed to bring excellence while firmly remaining focused on the required functionality of this stateof-the-art clinic. The goal was to create a unique experience, a place where internal beauty is a significant part of the external surroundings. The breathtaking crystal chandelier has a

staggering 125-foot drop and echoes the brand’s core, offering silent luxury, comfort, calmness, and trust in an environment that values internal beauty as a significant part of the external surroundings. One of the other many standout features of The Galen Clinic is the luxurious operating theatre located in the basement. The founder, Dr Androulakakis’s vision and brief for the operating theatre were clear: to be calm and bright with blue skies above, ensuring the patient journey remains at the 6-star level of this state-of-the-art clinic.

Dr A As a world-recognised consultant plastic surgeon, Dr Androulakakis (affectionately known as Dr A) has over 30 years of specialist experience and performed thousands of successful operations. In 2014, he also became director of the medical aesthetic department of the worldrenowned Palace Merano Medical Spa. Dr Androulakakis offers a wide range of surgical and non-surgical procedures. His most recognised treatments include Fat Trilogy Facial Rejuvenation, a signature treatment at Galen created by Dr A. It involves transferring fat and regenerating factors in high concentration to achieve optimum facial rejuvenation. Dr A’s clientele also comes far and wide for his aesthetic breast surgery. From breast augmentation with the latest technology implants to breast reduction, his breast uplift without implants remains his trademark. Breast reshaping with minimal scars coupled with the ‘natural look’ is consistently accomplished. Mr Theo Nanidis, BSc (Hons), MBBS, MPhil, FRCS(Plast), a world-renowned expert in breast reconstruction and aesthetic breast and body procedures, is also an extremely important asset to this team.

Functional medicine Holistic medicine views the body as an intricate, interconnected system, much like Galen’s understanding of the body’scomplexity; treatments are designed to support the body’s natural healing processes rather than just address symptoms or aesthetic issues. Dr Nathan Curran, GP and functional medicine practitioner BMedSci, MBChB,

DipOH, AFMCP, DipNutrMed, is one of the world’s best anti-ageing doctors. Through Galen Clinic, he offers comprehensive advice, tests and treatment suggestions to help in the prevention of disease, age management, quality of life, weight control and hormonal balance and the specialised evolution of longevity. Functional medicine treatments will include NAD+ Therapy, which improves cognitive function and activates enzymes, which promotes brain function, healthy ageing, and improved metabolism, as well as Glutathione Push IV Drip, a powerful antioxidant delivered directly into the bloodstream to detoxify and support overall wellness. Other treatments include Biological Age Analysis, which pinpoints ageing from a biological standpoint, using epigenetics to tell you how old you really are, and Mitovit Intermittent Hypoxic training, which prepares the body at a cellular level for stress defence in anticipation of surgical or aesthetic treatment. The clinic also offers nutrigenomic testing as well as mindfulness and meditation workshops to help patients manage stress, improve mental clarity, and enhance overall well-being.

Sports medicine and orthopaedics Mr George Tselentakis, consultant orthopaedic surgeon FRCS (Tr& Orth), PHD. The orthopaedic team offers consultation for all orthopaedic aetiologies, surgery, and conservative treatments, including autologous injections of PRP and stem cells, which help with joint pain management and regeneration where needed.

Skin clinic and non-surgical aesthetics Dr Catherine Borysiewicz is a consultant dermatologist specialising in inflammatory skin diseases, including eczema, acne, psoriasis, sun damage and skin cancers, which includes skin surveillance strategies and the early detection of skin cancer using mole mapping, acne and acne scarring management. Non-surgical treatments will also include Morpheus 8 micro-needling with radiofrequency to improve skin texture and radiance, neuromodulators, Sofwave skin tightening, and advanced muscle shaping and sculpting using TruSculpt technology.

The Galen clinic will also offer only the top Gold and Blue Diamond range of products, exclusively available in The Omorovicza Institutes, and Galen Ultra HydraFacial with an Omorovicza booster healing serum. At the heart of every Omorovicza product is the patented, bio-fermented active ingredient, Healing Concentrate™. The Healing Concentrate™ has been clinically proven to significantly improve skin hydration, elasticity, and firmness, delivering the unique benefits of the Budapest mineral-rich (hydro)geology. This multi-disciplinary clinic has built the Galenic philosophy of balance within the body’s systems, using comprehensive diagnostic approaches, offering individualised treatment plans that include lifestyle changes and integrating various therapeutic modalities to treat the whole person rather than just the disease or the aesthetic concern. To sum up Dr A says, “Our vision for Galen was very clear; we wanted to redefine beauty and aesthetic intervention as a combination of science-engineered healthcare, physical transformation, and emotional well-being by harnessing the power of an unrivalled assembly of experts and specialists. Luxury and comfort combined with medical excellence, with natural results being paramount to the patient experience. In particular, for me was the brief for the operating theatre; to be calm and bright with blue skies above, ensuring the patient journey stays at the 6-star level as with all other Galen treatments and procedures.” Photography credit: Ben Sage Photography

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TRENDS SPECIAL

THE CORTISOL CONNECTION Piroska Cavell explores the link between wellness and aesthetics and the role of cortisol in weight gain. Wellbeing is a term we are now hearing and seeing promoted more and more widely in the health, aesthetics, and fitness industries.1 But what does it mean? Wellbeing is a multidimensional concept covering a multitude of social sciences, including psychology and health.2 While wellbeing is prominent in popular culture now, it has been a concern of many civilisations dating back to the ancient Greeks. There are numerous models of wellbeing, and with the increase in popularity of positive psychology3, there is a multitude of ‘wellbeing’ books, tutorials, podcasts and social media platforms encouraging us to look after our health and wellbeing, putting it at the forefront of everything we do. This is now moving into an era of increased interest in longevity and a form of medicine known as functional medicine4 with a focus on improving all areas of our health in order not just to live longer but to live in the best possible health as we age.

Changing concepts of ageing It used to be widely accepted that as we age, we will gain weight, find it hard to lose weight, develop heart disease, high blood pressure, high cholesterol, diabetes, lose muscle mass and strength, develop weak bones and potentially the most worrying of all, experience cognitive decline. But the good news is, with all the new evidence emerging, we now know that the previously accepted ‘ailments of old age’ are

not inevitable and are actually preventable. We do not have to look forward to living our older years consuming a cocktail of medications to keep us existing.

Ageing and hormones A great example of our newfound understanding relating to ageing is hormones. Hormones are an area that has exploded, particularly in women’s health. We now know that these hormones affect every area of your body5 and that the reduction in oestrogen that occurs with menopause, in particular, reduces women’s protection from heart disease, reduces libido, and slows collagen production, causing not just the skin on their face but also the tissues of the vagina to lose elasticity. This decline in hormones reduces muscle tone and bone protection. It also affects cognitive function, leading to increased anxiety, depression, and unopposed cortisol, the stress hormone, to increase. We also now know that testosterone is not just responsible for your sex drive but is related to your ability to experience all types of pleasure as well as keeping your mood level and motivation high and allowing you to continue to improve your strength and regulate your weight. Now, with careful hormone replacement therapy, we can protect patients from some of the effects of ageing on their hormones.

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WELLNESS SPECIAL Cortisol and weight gain Cortisol is an inflammatory hormone.6 An excess of cortisol promotes the storage of fat around the organs and on the abdomen, raising inflammation in the body, which can trigger diabetes, heart disease, stroke, and cognitive disruption. Patients with abdominal obesity often have elevated cortisol levels. Furthermore, stress and glucocorticoids control both food intake and energy expenditure. In particular, glucocorticoids are known to increase the consumption of foods enriched in fat and sugar.7-8 We can regulate high cortisol levels by adding magnesium to our bodies.9 When you are under continued high levels of stress, magnesium, an essential mineral for your body, is leaked out. Magnesium is essential for stabilising your blood pressure, nerve function and blood sugars. It also makes protein, bone, and DNA. The most effective way to replace it is not with oral supplements but through the skin. You can bathe in magnesium flakes; you can also use sprays and gels. We can also manage high cortisol by sweating it out to release it with regular exercise. We can also manage cortisol by journalling and writing out our negative thoughts. This is the mind-body connection, which is at the core of well-being.

The mind-body connection and its role in weight management The best example of the mind-body connection is the rapid rise in heart rate

and blood pressure when we are scared by something. Our emotional feeling – fear – triggers this physical reaction. The power of the mind over the body has now been widely researched and evidenced. In 1992, Yue and Cole conducted an experiment involving volunteers imagining exercising a muscle, not physically moving the muscle. The volunteers achieved a 22% increase in muscle mass from brain power alone.10 Another famous experiment was by Langer in 1981, ‘The Counter Clockwise Study’11 then repeated for TV in 2010 for the BBC “The Young Ones”. The experiment took older people into an environment that replicated their lives from their much younger days, including décor and clothing. They had to live as they did then; no walking aids or concessions were made for their chronological age during the experiment. They all emerged in shockingly better health mentally and physically; one went in using a wheelchair and left using just a cane. They were significantly stronger, fitter, healthier and happier than when they went in. This mind-body connection is evident, particularly in weight loss and weight management. Many overweight people are stressed, unhappy, and anxious. Weight gain becomes part of a cycle as they unwittingly eat to feel better, very often consuming high-fat, high-sugar, high-carb, ultra-processed, energy-dense food. They unknowingly chase a dopamine hit to help them feel better. This is known as comfort eating.12

Dopamine is a ‘feel good’ hormone released when food that is very sugary or easily converted to sugar in the body is eaten.13 But, to get the same ‘feel good’ factor as you do from the first time you eat it, you need to increase the quantity to get the same ‘hit’. This develops ‘cravings’, which can lead to bingeing. Cravings can become a relentless drive to eat, but emotions, not hunger, trigger this. A big part of successful weight management and weight loss is exploring, identifying and managing these emotions. Significant weight loss can be achieved with a focus purely on food intake and exercise, but this is not sustainable, which is why so many experience a lifetime of dieting trapped in the diet cycle. The process of being aware of being overweight, then deciding to act, maybe delaying it for a while, then exploring different methods to lose weight. Finally, when the decision is made to take action, it is usually focused on a target, which is based on a number on a scale. Significant weight loss is often achieved. And the goal is reached. But because the mindset and emotional drivers have not been considered people will return to their former habits, regain the original weight and more. This then causes a multitude of negative emotions, self-loathing, depression, and anxiety. Then eventually the pattern is repeated. Willpower alone is not enough. Successful sustainable weight loss is only possible when we work on the mind together with the body and this is when people can become free of the diet cycle

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and a lifetime of continuously thinking about food and ricocheting from self-love to self-loathing repeatedly. Connecting your physical and emotional health is sleep. We have known for centuries that sleep is essential for maintaining both your emotional and physical health and consequently your wellbeing. However, we now know that the brain is cleansed every night by what is called the glymphatic system. This is an extremely exciting discovery. The brain is essentially deep cleaned every night, washing out all neuro toxic waste products from itself. This ensures the brain can function at its full potential regulating all your body systems including both physical and emotional. It is widely acknowledged that lack of sleep

can affect your mood, your concentration your judgement, making you depressed, anxious but we now know that lack of sleep prevents this process leading to a build-up of toxins in the brain causing a myriad of physical and emotional issues. It takes around seven hours every night to complete this process and it is most effective when you sleep on your side. Your body is an amazing machine and is designed to work at its optimum, and we will continue to strive to do so no matter how we treat it. With these new advances often termed bio hacking we can now with the right help unlock the secrets to maintaining our health and wellbeing from within. Allowing us to work with our bodies using our amazing resources to live longer, happier, fitter lives.

The Cortisol Connection Article CONSULTINGROOM.COM (001376) June 2024

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at: https://doi.org/10.1016/j.neuropsychologia.2003.11.018

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WELLNESS SPECIAL CERTIFIED MEDITATION TEACHER AND GLOBAL SKIN EXPERT VICTORIA HISCOCK EXPLORES HOW MINDFULNESS AND MEDITATION CAN IMPACT THE SKIN My anxiety-ridden, acne-adorned 18-yearold self was SO desperate. If you had told her a decade on, I’d have both under control and after two decades, I’d be the calmest, most confident and clearskinned version of myself ever – and that meditation played a huge part in that – she wouldn’t have believed you. Dismissing the idea that anxiety and acne are intrinsically linked and declaring the notion that your intangible thoughts can somehow “leave your mind out into the universe and magically return to impact your physical body” ridiculous; she was on the hunt for a fix-all pill or ointment. As I approach my 40th birthday next year, meditation is part of my daily self-care and skin-care practice, and I can honestly say my skin is the best it’s ever been (minus some lingering acne scars, which I’ve grown an affection for). My nervous system is so regulated; not only do I have anxiety under wraps, but on occasion I think I might be dangerously close to inner peace. I had no idea how closely linked the mind and skin are, how my ongoing anxiety was a direct cause of my acne and just how much control we all have over our mental, physical and aesthetic wellbeing. So, how are the skin and mind connected? How does meditation impact the physical body, and can positive thinking really clear skin? Let’s explore…. It was my mum, Jane Hiscock, the author of the Beauty Therapy NVQs who convinced me to do a Diploma in Advanced Facial Technologies and Skin Siences at 18 when acne and anxiety were stealing my confidence and self-esteem. It was there I learnt about the pathology of acne and the skincare ingredients that support the skin for an outside in approach. Fast forward two decades and my job as Global Medical Communications Manager for AlumierMD includes curating content about the link between well-being and skin health because the medical aesthetics industry at large is paying attention to holistic health. Wellness is a trend going nowhere. Psychodermatology is on the rise, and the direct link between stress chemistry produced by the adrenal

glands (hello, cortisol and adrenaline) and inflammation is gaining traction. We now know that thoughts don’t go “out” into the universe. They are internalised by a limbic system that can’t always tell if our stressful thoughts are our imagination or reality. A perception of danger by the brain can trigger the release of a ‘helpful’ dump of hormones to get us through it regardless of its physical threat (sabretooth or looming deadline, it doesn’t matter). These hormones cause inflammation in our body that can cause and exasperate disease and inflammatory conditions, including Acne and Rosacea. Mindful aesthetics Luckily, the conversation about mindset is changing in the aesthetic arena. ‘Mindful aesthetics’ is leading the way and neurocosmetics are taking centre stage, right next to regenerative medicine. Aesthetics is no longer a skin-deep conversation; we’re talking about longevity, hormone health and stress management. As well-being and healthcare professionals, we have a wealth of knowledge to help patients build their unique tool kit that can improve well-being, reduce stress and target skin health from the inside out, too. Everyone’s stressbusting tool kit will be different. For some, busting stress is a kickboxing class or a run. For others, it’s a bubble bath or time in nature. For me, it’s meditation. What is meditation really? A spiritual, eastern practice adopted by free-loving hippies in the sixties, it could be easy to dismiss meditation as a physical wellbeing tool. However, Psycho-NeuroEndocrine-Immunology (P.N.E.I.) is a scientific field of study that investigates the link between thoughts (psycho), the brain (neuro), hormones (endocrine), and the immune system and is proving the correlations of mental health and physical health. Mindfulness-based apps such as Headspace are paving the way for a less spiritual and more practical approach to calming the mind and warming the Western world to this untapped resource of wellbeing. Phycologists, neurologists and neuroscientists alike are now promoting the neurological benefits of mediation

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including strengthening areas of your brain responsible for memory, learning, attention and productivity. The practice can also help calm down your sympathetic nervous system, the branch of the central nervous system that triggers fight or flight mode when it perceives a threat. Regularly telling the brain that the body is safe can nudge the nervous system away from fight and flight and towards rest and digest mode through the parasympathetic nervous system. In this mode, not only is damaging inflammation kept at bay, but absorption of nutrients, an increase in cellular energy and regenerative healing all take place. Meditation is a very powerful tool that can literally save and make a life like it has mine. If you haven’t tried or recommended mediation yet, don’t worry. You aren’t required to put on a white robe, light incense and say Om over again (although you can, it’s surprisingly relaxing). You

THE SKIN-MIND CONNECTION Adobe/Lategan

don’t even have to sit still or be quiet if that doesn’t suit you. Any kind of meditative state which pulls your mind away from the remunerations of yesterday and the unknown of tomorrow will do the trick. Mindful colouring, walking meditation and any creative activity that takes you away from time will work just fine. Sufi meditation includes dancing, vagus nerve toning meditations can include singing and you can even meditate while doing your skincare routine mindfully. The general idea is that you pay attention to yourself and your body in the now. Paying focus to the breath is a great way to

start. Next, you might try and observe your thoughts without attaching to them. You can also move your attention around your body, consciously relaxing each body part, a practice known as Yoga Nidra. You might be surprised at just how quickly you can feel the physical and mental relaxation washing over you. The most powerful thing about meditation is that it is available to everyone, it’s free and no fancy equipment is needed. It might just be the most accessible and inclusive wellbeing practice out there. It’s now proven to boost mental and physical wellbeing as well as immunity. it can also have a positive

impact on skin health and self-esteem. As medical professionals, you have the credibility to give this incredible practice the substantiation it deserves, and I implore you to try it if you haven’t and recommend it to patients as part of their skin-care and well-being practice. It could be the missing component of your current treatment plans to round out your holistic approach and unlock better, longer-lasting results for a range of inflammatory-based skin conditions. And remember, they say that if you don’t have time to meditate for five minutes a day, you should meditate for 10 minutes a day.

If you would like to meditate with Victoria or recommend her to your patients, she has a portfolio of meditations, including a relaxing skincare sleep story and skin-positive affirmations, on both Insight Timer, a meditation app and YouTube. https://insighttimer.com/VictoriaJaneh and https://www.youtube.com/@victoria_janeh www.consultingroom.com | 30

WELLNESS NEWS Byonik® announces introduction of a blue laser handpiece Byonik® has introduced the Blue Laser handpiece. Underpinned by scientific evidence, the handpiece offers clinics an opportunity to strengthen their in-clinic treatment possibilities and further enhance patients’ results by taking the Byonik® capabilities to the next level. The complementary Blue handpiece simultaneously emits Near-Infrared 808m light wavelength and 450m blue light. The Blue LLLT specifically targets and has clinically proven benefits for effectively restoring the health of damaged and blemished skin. The inclusion of this treatment option and scientific rationale is focused on increased skin pH value, dysbiosis and barrier damage, hyperpigmentation, oxidative stress, impurities, dehydration and skin degeneration. Those with an existing Byonik® are able to upgrade.

ProLon releases two new supplements ProLon has launched two new supplements to enhance overall well-being and gut health. distributed by SkinBrands, the ProLon brand is driven by a philosophy centred on longevity and healthy ageing. The new supplements are entirely vegan and designed to support patient health. The L-Biome supplement is enriched with live, friendly bacteria that aid in fatty acid production, reinforce the gut barrier’s integrity, and promote a healthy microbiome. The L-Pill combines four natural ingredients to boost energy, maintain brain and cardiovascular health, provide cellular protection, and support healthy ageing.

Quiet Blue functional fragrance brand launches Quiet Blue is a functional fragrance wellbeing brand that uses clinical aromatherapy blends for its purposeful candles, reed diffusers, and artisanal soaps. These products are designed to support clinic owners and practitioners in providing holistic care for patients. With an industry shift to longevity and patient care, prioritising client wellness has never been more important. Quiet Blue’s range of scents targets the symptoms of stress and anxiety with a carefully crafted blend of natural ingredients. These ingredients are chosen for their calming and soothing properties, aiming to provide relief in times of emotional turbulence. What sets Quiet Blue apart is its commitment to non-toxic ingredients, utilising sustainable soy wax and luxury wooden wicks, and avoiding hormone disruptors. This ensures a safe and healthy environment for individuals seeking solace and relaxation in their clinics and practices.

Novomins introduces Cranberry and D-Mannose Gummies Novomins, the UK’s and EU’s first B-Corp-certified gummy vitamin company, has introduced new Cranberry and D-Mannose Gummies designed to support women’s urinary health. Cranberry and D-Mannose are well-known for their ability to prevent harmful bacteria from adhering to the bladder and urinary tract lining, aiding in their elimination during urination, and supporting the treatment and prevention of UTIs. These gummies provide a concentrated dose of these key ingredients, making them more effective than simply drinking cranberry juice. Additionally, the gummies are gluten-free, dairy-free, and halalcertified, ensuring inclusivity and comfort for all patients.

31 | Consulting Room | Q2 2024

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Under the scientific supervision of the Aesthetic Multispecialty Society (AMS)

WELLNESS SPECIAL REGENERATIVE AESTHETICS SPECIAL

ARE YOUR PATIENTS GETTING ENOUGH SLEEP? Could not getting enough sleep be impacting the way your patients look and feel?

Sleep is as important for our bodies as breathing, eating, and drinking water, and disturbed sleep or lack of sleep can impact us both mentally and physically. Physically, not getting enough sleep can weaken our immune systems and make us prone to illness. Lack of sleep has also been shown to exasperate symptoms of depression and anxiety. But it can also significantly impact aesthetic outcomes. Quality sleep is fundamental not only for overall health but also for maintaining youthful, healthy skin and effectively managing weight. Here’s an in-depth look at the importance of sleep and how you can help your patients improve their sleep hygiene for better aesthetic results. Nuffield Health’s 2023 ‘Healthier Nation Index’ – a survey capturing data from 8,000 UK adults found that, on average, Brits are getting only 5.91 hours of sleep per night, a decrease from 6.11 hours in 2022 and 6.19 hours in 2021. Alarmingly, only 36% of respondents rated their sleep as ‘good,’ despite the average healthy adult needing between 7.5 and 8.5 hours of sleep per night, which equates to five sleep cycles. The survey also revealed notable differences in sleep patterns across age groups, with the 45-54 age bracket reporting the poorest sleep quality. Only 29% of individuals in this age group rate their sleep as ‘good,’ and they average just 5.72 hours of sleep per night. With many aesthetic patients being in this age group and also being impacted by menopause, talking to your patients about their sleep, or lack of it, could be key.

Sleep and skin Many patients visit aesthetic clinics to combat the signs of ageing, and a common request is to look “less tired.” While treatments can address these issues, the root cause is often a lack of adequate sleep.

Sleep deprivation negatively affects collagen production because cortisol, the stress hormone, remains elevated instead of decreasing at night. Elevated cortisol levels can break down collagen, resulting in increased fine lines and wrinkles. Additionally, growth hormone, which is crucial for collagen production, is released during deep sleep. Additionally, elevated cortisol levels can cause blood vessels to swell, leading to puffiness and dark circles under the eyes. Studies have shown that sleep deprivation can also impair the skin barrier, leading to increased transepidermal water loss (TEWL) and dehydration. Dehydrated skin is more prone to irritation, redness, and flakiness, affecting the overall appearance and health of the skin. Lack of sleep also impairs the immune system, exacerbating skin conditions like rashes and acne.

Weight management Sleep deprivation is linked to weight gain due to hormonal imbalances. Ghrelin, the hunger hormone, increases with lack of sleep, while leptin, the hormone that signals fullness, decreases. This imbalance leads to increased appetite and cravings for high-calorie foods. Furthermore, poor sleep lowers metabolic rate, making it harder to burn calories efficiently. Patients who struggle with weight management may find that improving their sleep quality can aid in achieving their weight loss goals.

Menopause and sleep Menopause brings hormonal changes that can severely impact sleep quality. Fluctuating levels of oestrogen and progesterone can cause night sweats, hot flashes, and insomnia. These disturbances not only affect overall health but also accelerate skin ageing and weight gain. Addressing these issues through proper sleep hygiene and hormonal management can significantly improve patients’ aesthetic

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outcomes.

Tips for better sleep 1. Limit electronic use before bed: Electronic devices, such as smartphones, tablets, and computers, emit a type of blue light that has been found to suppress melatonin production. Melatonin is a hormone that plays a crucial role in regulating sleep-wake cycles. When melatonin levels are suppressed, it becomes harder to fall asleep and maintain a restful night’s sleep. The impact of blue light on sleep is significant. Exposure to blue light in the evening tricks the brain into thinking it is still daytime, thereby delaying the onset of sleep and reducing overall sleep quality. This disruption can lead to a variety of issues, including difficulty falling asleep, fragmented sleep, and a reduction in the amount of REM sleep, which is essential for cognitive functions such as memory and mood regulation. In addition, numerous studies have shown that being exposed to blue light accelerates the ageing process and produces cutaneous hyperpigmentation. If patients are struggling with their sleep, advise them to turn off all electronic devices at least an hour before bed. This allows the body to begin producing melatonin naturally. Activities such as reading a book, taking a warm bath, or practising relaxation techniques are good alternatives to screen time. In addition, patients can use features like night mode or blue light filters on their devices if they need to use them in the evening. These features reduce the amount of blue light emitted, which can help mitigate some of the adverse effects on sleep. Encouraging patients to adopt these practices can lead to better sleep hygiene and overall health improvements.

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WELLNESS SPECIAL 2. Establish a consistent sleep schedule: Going to bed and waking up at the same time every day, including weekends, is one of the most effective ways to regulate the body’s internal clock, also known as the circadian rhythm. The circadian rhythm is a natural, internal process that regulates the sleep-wake cycle and repeats roughly every 24 hours. It responds to external cues like light and temperature, but maintaining a consistent schedule can reinforce and optimise its function. When you establish a regular sleep schedule, your body becomes accustomed to a routine, making it easier to fall asleep and wake up naturally. A consistent sleep schedule also supports the balance of hormones involved in sleep regulation. When sleep patterns are consistent, melatonin, the hormone that promotes sleep, and cortisol, the hormone that promotes alertness, follow a regular rhythm. Advise patients to choose a bedtime and wake time that allows for seven to nine hours of sleep and stick to it every day, even on weekends. Encourage them to develop a relaxing pre-sleep routine to signal to their body that it is time to wind down. As mentioned above, advise them to avoid exposure to light in the evening but make sure they get plenty of natural light during the day to help reinforce their body’s natural sleep-wake cycle. Try to spend time outside in natural daylight, especially in the morning. 3. Create a sleep-conducive environment: Creating an environment that is conducive to sleep is essential for achieving a restful and restorative night. The bedroom environment can significantly influence the quality of sleep, and making a few adjustments can lead to substantial improvements. A quiet, dark, and cool bedroom environment promotes better sleep. Noise can be a major disruptor of sleep. To ensure a quiet environment, consider using earplugs to help block out ambient noises, such as traffic, neighbours, or a snoring partner. White noise machines produce soothing sounds like rainfall, ocean waves, or soft music, which can mask disruptive noises and help people fall asleep more easily. Light exposure at night can interfere with

the production of melatonin, the sleep hormone, making it difficult to fall and stay asleep. To create a dark environment, you could use blackout curtains, which are designed to block out external light sources, such as streetlights or early morning sunlight. An eye mask can be particularly useful for those who cannot control light sources in their environment, such as travellers or shift workers. A cooler room temperature can help facilitate sleep by mimicking the body’s natural decrease in temperature during sleep onset. The ideal bedroom temperature for sleep is typically between 15-19 degrees Celsius. To maintain a cool environment you can advise sleeping with the window open, or using a fan or air conditioning to regulate the temperature in the bedroom, especially during warmer months. Patients can also opt for breathable, lightweight bedding materials to prevent overheating during the night, particularly during perimenopause. 4. Reduce alcohol intake: Advise patients to limit alcohol consumption, especially close to bedtime, to prevent sleep disruption. While alcohol might help some people fall asleep faster, it significantly disrupts sleep quality. Alcohol consumption leads to longer periods of deep sleep and shorter periods in the restorative REM stage. This imbalance results in non-refreshing sleep, causing fatigue and a cycle of poor sleep hygiene. Regular alcohol intake exacerbates these issues, leading to chronic sleep disturbances and subsequent aesthetic and health problems. Alcohol is also a diuretic, which means it increases urine production, leading to dehydration. Dehydration affects the skin by reducing its elasticity and plumpness, making fine lines and wrinkles more pronounced. Additionally, alcohol can cause inflammation, which may worsen skin conditions such as acne and rosacea. 5. Utilise the power of natural remedies Harnessing the power of natural remedies can be an effective way to promote relaxation and enhance sleep quality. Incorporating herbal teas and essential oils into a bedtime routine can create a calming environment conducive to restful sleep. Herbal teas have been used for centuries to aid relaxation and improve sleep. Certain herbs have natural sedative

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properties that can help ease the mind and prepare the body for sleep. Some of the most effective herbal teas include chamomile, lavender and valerian root. Advise patients to drink a cup of herbal tea about 30-60 minutes before bedtime. This allows time for the body to absorb the relaxing compounds and start to unwind. Suggest they choose a quiet, relaxing activity to pair with their tea, such as reading a book or practising gentle yoga, to enhance the calming effects. Certain essential oils are particularly beneficial for improving sleep quality, too.. Lavender oil is one of the most widely studied essential oils for sleep. Its calming scent has been shown to improve sleep quality by promoting relaxation and reducing anxiety. Recommend using an essential oil diffuser

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in the bedroom. This can fill the room with the soothing scent of their chosen essential oil, creating an environment that promotes relaxation and sleep. Suggest starting the diffuser about 30 minutes before going to bed to allow the scent to permeate the room. For added benefit, patients can apply diluted essential oils to their wrists, temples, or the soles of their feet before bed. 6. Meditate: Meditation is a powerful tool for reducing stress and calming the mind, making it an effective practice for improving sleep quality. Meditation helps to calm the mind by reducing cortisol. This reduction in stress can lead to a more relaxed state, which is conducive to falling asleep more easily. Regular meditation can also lead to improved sleep quality by increasing the duration of deep sleep and reducing the

time it takes to fall asleep. There are various types of meditation, but guided meditation can be particularly effective for beginners or those seeking specific sleep-related benefits. Guided meditation involves listening to an instructor who leads the practice, often focusing on relaxation and sleep preparation. Many apps and websites offer guided meditation sessions specifically designed for sleep. Popular apps include Headspace, Calm, and Insight Timer. These resources provide a variety of meditation practices to suit different preferences and needs. A common technique in meditation is to focus on breathing. Deep, slow breaths can help to relax the body and calm the mind. Instruct patients to breathe in deeply through the nose, hold for a few seconds, and then slowly exhale through the mouth.

The body scan meditation involves mentally scanning the body from head to toe, focusing on and relaxing each part. This practice can help release physical tension and prepare the body for sleep. Conclusion As aesthetic practitioners, integrating sleep hygiene advice into your consultations can enhance the effectiveness of your treatments. By educating your patients on the importance of sleep for their skin health and overall well-being, you can help them achieve better and longer-lasting aesthetic results. Remember, healthy sleep is the foundation of beauty and health. Make sleep a priority for both your patients and yourself, and observe the significant improvements in aesthetic outcomes and personal well-being.

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WELLNESS SPECIAL

PERSONALISED SKIN SOLUTIONS With personalisation being key to patients, the inclusion of a bespoke 360-degree approach to your treatment menu is the new standard The aesthetics industry has witnessed a noticeable shift powered by the burgeoning growth of personalised skincare and treatment solutions alike. This bespoke approach highlights a transformative impact, offering 360-degree intrinsic and extrinsically led modalities to optimise and enhance overall results, with the inclusion of innovative aesthetic treatments, bespoke topical skincare and systemic boosters which target the body’s vessel in its entirety. Customisation is here to stay, with patients requesting and expecting bespoke services in clinics. AI tools are growing in popularity as a means of assessing the skin under the surface. These diagnostic skin scanning devices provide us – and our patient – with a deeper level of information and understanding of their true skin type, displaying levels of sebum, bacteria, melanocyte activity, inflammation and signs of ageing. Knowledge is power; the more we understand our patients’ skin health, the better equipped we are to provide personalised solutions to correct unwanted skin damage. Our modern lifestyles have a continuing impact on our skin health and its overall performance, with intrinsic and extrinsic inflammatory factors contributing heavily to what is present on the surface of the skin. Providing personalised solution-based treatments offers a transformative paradigm shift in the aesthetics

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industry, utilising highly impactive and innovative technologies and holistic energy-based experiences supported alongside bespoke and prescriptive homecare regimens, thus skyrocketing patient results for long-term skin health and patient satisfaction. More traditional approaches to correcting skin damage are a one-size-fits-all approach; the treatment plan or modality selection is based on the primary visible concern only – acne, pigmentation, redness, scarring, lines and wrinkles, etc - which overlooks the complexity of the skin needs at a cellular level. These cellular degradations require an advanced approach, bio-hacking the cells to improve their biological behaviours to reverse and prevent skin damage. This regenerative approach relies on us identifying the underlying cause of why the skin has started to change, i.e. mitochondrial dysfunction, chronic inflammation, telomere attrition, gut dysbiosis, etc., which has ultimately led to what we see on the skin’s surface: visible inflammation and sensitivity, pigmentary discolouration, or signs of ageing such as lines, wrinkles and dehydration.

Once the cause has been assessed, utilising innovative solutions (such as the BYONIK® Pulse Triggered Laser) that tap directly into the skin cells themselves, replacing Adenosine Triphosphate energy depletion, preserving the DNA structures, and restoring the skin’s essential water levels, correcting the root cause of damage, allows the skin to heal itself from within and thus improves the skin’s visible appearance. Furthermore, the BYONIK®’s approach facilitates unrivalled personalisation through the use of a PTL (personal lifestyle trigger), utilising a medical-grade pulse oximeter which reads our patient’s own heart rate frequencies so that photonic laser energy is released at the precise moment our patient’s cells needs it. Personalised bio-hacking at a cellular level obtains an energising boost to the cells when they are most bio-receptive, alongside complete cellular detoxification through laser pulsing, creating an increased uptake of water (hyaluronic acid) and antioxidants within and around the cells – giving the skin exactly what it needs to truly age backwards! For a comprehensive approach to tackling skin concerns and rectifying skin health, a personalised homecare is a must to ensure all aspects of healthy skin can be restored. Products which support the skin’s living environment – the microbiome – and restore the essential lipid layer are becoming ever-important with modern influences of micro-inflammations created through skin dysbiosis and pollution-derived free radical irritation. Restoring a healthy skin barrier in the primary instance allows the integration of skin actives and more stimulating in-clinic procedures, with the knowledge that the skin has been fortified and therefore able to tolerate these treatment and products whilst maintaining its vital structure. When addressing our patients’ skin concerns, solutions are often provided topically, from the decolletage upwards. However, there is an increasing amount of evidence indicating that systemic solutions have a positive effect on our most external and largest organ – the skin. Providing a 360-degree approach, treating the body as an entire vessel, working on the intrinsic elements – specifically the lymphatic and circulatory systems, alongside supporting gut health, yields maximum physical and visible results for superior longevity, sustainability and overall well-being.

Our systemic health is impacted by dysregulation of hormones, chronic inflammation, and gut dysbiosis, exasperated by sluggish mobility of lymph and blood, which all play a vital role in overall well-being and skin health. Treatments (such as the SLIMYONIK® AIR Bodystyler) using tailored pressure therapy massage, tap-in to the parasympathetic nervous system, better-facilitating relaxation, repair, regeneration, and detoxification throughout the entire system. These pressure therapy programmes target the lymphatic system as its primary indication, improving full body immunity, detoxification, repair and the regulation of the endocrine system. Alongside the increased mobility of lymph, our circulatory system is boosted, increasing the transportation of nutrients to our skin and connective tissue. These pneumatic pressure massage devices also provide huge benefits to our gut, which has shown to have a direct positive impact on our skin. Imbalances of microbes in the gut – especially the small intestine - contribute to the resistance of inflammatory skin concerns, with bacterial overgrowths within the gut being directly linked to conditions such as Acne and Rosacea. By supporting our internal ecosystem, we promote a more effective relationship between the ‘skin-gut-axis’, thus reducing ‘leaky gut’, preventing nasty bacteria from infiltrating the bloodstream, and aiding in the removal of unwanted bacterial by-products, helping the gut and skin microbiota’s equilibrium to be rebalanced; with happy, healthy skin restored. This improved transportation of lymph and nutrients hugely benefits our patients’ who have been prescribed oral supplementation. Mobilising the lymphatics ensures our bodies can maximise the absorption of these digested nutrients, powering up their success and overall results. Ultimately, providing targeted, inclusive, personalised in-clinic treatments alongside bespoke, individualised at home topical products, provides our patients with ultimate satisfaction; consumer empowerment continues to promote the era of personalised treatment solutions, and integrating a 360-degree approach to your treatment menu is a must!

Images provided by author

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SMART COMBINATION THERAPY

...the SYNERGISTIC approach

ge-related anatomical changes are most effectively managed through the combination of science and technology. To achieve this goal, Neauvia research designed SMART COMBINATION THERAPY that combines different restorative therapies and grants clinically proven superior results.1,2 This has been possible thanks to the in-house portfolio of products FILLERS, ENERGY BASED DEVICES and COSMECEUTICALS - developed to work synergistically with each other and organically with the body.

1: Fillers

A REVOLUTION IN HA FILLER MARKET

Neauvia’s PEG-HA dermal fillers are based on a unique SMART CROSSLINKING TECHNOLOGY – SXT – which is an innovative and advanced technology that combines HYALURONIC ACID and PEG. PEG is a well-known polymer in the pharmaceutical market, due to its versatility and safety profile. 1, 2 Neauvia R&D designed monophasic and cohesive hydrogels with distinctive properties and gel consistencies, offering healthcare practitioners the appropriate tools to provide patients with made to measure results.

2: Devices

THE BEST RESULTS WITH MAXIMUM SAFETY

Neauvia provides a range of energy-based devices for the aesthetic, gynecological and surgical treatments. Neauvia devices are characterized by advanced electromedical engineering, ensuring maximum patient safety. They are based on specifically designed and integrated technology; they can be combined with Neauvia’s PEG-HA fillers and aesthetic cosmeceuticals. 1, 2

3: Aesthetic Cosmeceuticals THE PROMISE OF AMPLIFIED AESTHETIC RESULTS Based on advanced knowledge and research on active ingredients, Neauvia Aesthetic Cosmeceuticals offer professional and exclusive skincare range. High quality and scientifically based, they are suitable for skin preparation, post-treatment and home care, designed to work in synergy with aesthetic treatments.

RETHINKING MEDICAL AESTHETICS

DISCOVER HOW NEAUVIA SCT CAN BENEFIT YOUR BUSINESS TODAY

W: NEAUVIA.UK

E: INFO@NEAUVIA.UK T: 07570 621 895

1. Kubik et al., HA PEGylated Filler in Association with an Infrared Energy Device for the Treatment of Facial Skin Aging: 150 Day Follow-Up Data Report, Pharmaceuticals 2022, 15, 1355, DOI: 10.3390/ph15111355. 2. Kolczewski et al., Hyaluronic Acid and Radiofrequency in Patients with Urogenital Atrophy and Vaginal Laxity, Pharmaceuticals 2022, 15, 1571, DOI: 10.3390/ph15121571.

HAIR SPECIAL

CLINICAL SECTION In this section: Managing complications Scarring Abstracts Clinical news

Adobe/Axel Bueckert/artmim/Kalim

CLINICAL

IT’S COMPLICATED Dr Ahmed El Houssieny shares his insights on complications management The UK non-surgical aesthetics industry is projected to reach a market value of £3 billion in the next 12 months (Rare Consulting)1, with approximately 7.7 million people having received treatments in the past year. Furthermore, an estimated 13.9 million individuals are considering such treatments within the coming year. In addition, the most popular treatments performed by BCAM members in its most recent audit were toxin injections (96%) and hyaluronic acid (HA) dermal fillers (93%).2 This surge in popularity underscores the need for heightened awareness and management of potential complications associated with these procedures.

Expected side effects of HA dermal fillers HA dermal fillers are widely regarded as safe, with common expected side effects including mild discomfort, redness, swelling, bruising, and itchiness. These effects typically resolve within a few days post-treatment. However, understanding

and managing adverse events that extend beyond these expected outcomes is crucial for maintaining patient safety and satisfaction. Classification of adverse events Adverse events related to soft tissue fillers can be classified based on their time of onset.3-4 •

•

Immediate: Occurring at the time of injection, these include lumps, hematomas, infections, hypersensitivity type I, compromised muscle function, misplacement of filler, and paresthesia. Early: Emerging within several days post-treatment, such as nodules, infections, swelling, hypersensitivity type IV, and filler displacement. Delayed: Manifesting from weeks to years after the procedure, these can include chronic infections, late-onset nodules, and delayed hypersensitivity reactions.

Immediate complications tend to be things related to the injection. If you put a bolus in for example, you’re more likely to cause a lump, a bruise that’s well confined and

IMMEDIATE

becomes a hematoma. Vascular complications are among the most significant concerns immediately following dermal filler injections. These complications arise when the filler unintentionally enters a blood vessel or compresses it, leading to a range of potential issues from minor discomfort to severe tissue damage.

EARLY

DELAYED

• Injection-related reactions

• Lumps

• Nodules

• Infection

• Hematoma

• Infection

• Lumps

• Infection

• Swelling/cyclic swelling

• Hematoma

• Hypersensitivity type I

• Hypersensitivity type IV

• Vascular complications

• Compromised muscle function

• Displacement of filler

• Disproportionate pain

• Misplacement of filler

• Hypersensitivity type I

• Paresthesia

• Misplacement of filler

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Adobe/kalcutta

Types of vascular complications: • Intravascular injection: This occurs when the filler is inadvertently injected directly into a blood vessel. This can lead to vessel occlusion, which blocks blood flow and can result in tissue necrosis or even blindness if it affects vessels supplying the eye. • Vascular compression: This happens when the filler compresses a nearby blood vessel, impeding blood flow. This can cause ischemia and subsequent tissue damage due to reduced blood supply. Symptoms of vascular complications include: • Immediate pain: Often described as intense and unusual compared to typical injection discomfort. • Blanching: Whitening of the skin over the affected area, indicating compromised blood flow. • Mottled skin appearance: A lacelike, purplish pattern on the skin, known as livedo reticularis, suggesting reduced circulation. • Cold skin: The area may feel colder

•

than the surrounding tissue due to lack of blood flow. Delayed capillary refill: Slower return of colour to the skin after pressing it indicates poor blood supply.

Prevention strategies for VO: • Anatomical knowledge: Comprehensive understanding of facial anatomy to avoid major blood vessels. • Aspiration technique: Pulling back on the syringe plunger before injecting to check for blood return, which would indicate intravascular placement. • Low injection pressure: Using minimal pressure to reduce the risk of inadvertently forcing filler into a vessel. • Small bolus injections: Injecting small amounts at a time to minimise the risk and allow for better control. • Cannula use: Utilising a blunt-tipped cannula instead of a needle to reduce the likelihood of penetrating a blood vessel.

Management of vascular complications: • Immediate cessation: Stop injecting immediately if a complication is suspected. • Massage: Gentle massage of the area to disperse the filler and restore circulation. • Hyaluronidase injection: An enzyme used to dissolve hyaluronic acid-based fillers rapidly. • Warm compresses: To promote vasodilation and improve blood flow. • Anticoagulants: Consideration of medications to prevent clot formation in the occluded vessel. • Hyperbaric Oxygen Therapy: In severe cases, this can enhance tissue oxygenation and promote healing. In terms of early onset complications, patients may experience persistent swelling beyond three or four days. This may be an allergic reaction in which antihistamines have no role in swelling. If you are having persistent swelling, you may want to consider a short course of steroids: prednisolone 20 to 30 milligrams for four

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CLINICAL to five days. You do not need to taper that afterwards. You should be able to resolve this. Lumps can also become more apparent, and hematomas can fail to resolve. If this happens, you may consider treatments such as laser. They may help dissipate a hematoma infection. Another thing that can happen is if you’re a little bit deep when using a cannula on the chin or on the cheek, you can traumatise the muscle and impair muscle function. Your patient may come back and say, “I’m having difficulty talking. I’m not smiling properly.” This is just muscle trauma that will resolve. If you are unlucky and happen to touch a nerve with a cannula, you may likely get some paraesthesia that will resolve on its own as well.

Causes and types of infections Incidences of acute infection are rare (0.04-0.2%), although a lot will be underreported.5 They can stem from several factors, including poor disinfection at the time of injection, injecting through an infected sebaceous gland, reduced skin immunity, and bacteremia. Types of infections include cellulitis, which manifests as painful, hot, swollen red skin possibly accompanied by blisters and systemic symptoms like fever and malaise, and abscesses, characterised by painful, warm masses containing pus, potentially leading to systemic symptoms. •

Cellulitis: Typically presents within three to seven days as painful, hot, swollen red skin, possibly accompanied by blisters and systemic symptoms like fever and malaise. Treatment involves the use of oral antibiotics, such as Flucloxacillin

•

or Amoxicillin, with alternatives for penicillin-allergic patients. Abscesses: Developing seven to 14 days post-treatment, abscesses appear as painful, warm, fluctuant masses. Management may require oral or IV antibiotics and possibly surgical intervention for incision and drainage.

Strict aseptic techniques, comprehensive patient education, and meticulous aftercare are important to mitigate these risks. Ensuring needle channels are closed before applying makeup or touching the treated area is essential to prevent infections.

Effective treatment protocols Early detection and prompt management of complications are paramount. Patient education is also very important. Tell patients that if you do have a problem, it’s not enough to send a picture on social media. If you recommend they come in, they have to come in. It is important to understand that things like infection, vascular compromise, lumps, nodules etc can happen. But if they come in early, we may be able to intervene and deal with it. If they live far away and they’re not prepared to travel again; maybe that’s a reason not to treat them.

are going to be at higher risk, so avoid treatment. For cellulitis, oral antibiotics such as flucloxacillin or amoxicillin are recommended, with alternatives like clarithromycin for penicillin-allergic patients. Abscess treatment may require oral or IV antibiotics and, in some cases, incision and drainage. If it is an abscess, know where your regional oral maxillofacial unit is and get in touch to liaise with them. They have guidelines that they follow. If it’s a small abscess, just puncturing it with a needle is fine. But if it’s a larger one, you may need an incision and drainage. The patient may need oral/IV antibiotics.

Future directions in complications management I believe there is a need for improved patient risk management, the development of local and national guidelines, enhanced microbiology support, and the establishment of a central register for complications. These steps will foster better outcomes and safer practices within the industry.

Prophylactic measures and early detection are crucial for managing infections. One of the key things that I’ve learned is that bacteremia can be a serious problem with filler injections. So even if you are considering doing a treatment on someone who’s had recent dental procedures, you want to wait at least two weeks before or two weeks after seeing a hygienist. It also makes sense that if someone’s immunocompromised, i.e. they have had a recent vaccine, they

Adobe/kalcutta

References 1. https://www.rare.consulting/blog/how-the-uk-medical-aesthetics-market-is-evolving 2. https://bcam.ac.uk/media/news/37/bcam_2023_annual_clinical_review/#:~:text=Top%20treatments&text=The%20top%20 five%20treatments%20most,an%20increase%20of%205%25) 3. Funt D and Pavicic T. Clin Cosmet Investig Dermatol 2013;6:295–316 4. Signorini M, et al. Plast Reconstr Surg 2016;137(6):961–71 5. https://www.acquisitionaesthetics.co.uk/wp-content/uploads/2022/01/Acute-Infection.pdf

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Adobe/Axel Bueckert

CLINICAL

THE FAULT IN OUR SCARS

Study provides significant insights into scars and body image from the perspective of children and young people A groundbreaking study recently presented to the British Association of Plastic, Aesthetic and Reconstructive Surgeons (BAPRAS), conducted at Great Ormond Street Hospital, in collaboration with the University of Toronto’s Hospital for Sick Kids and University College London has provided significant insights into the assessment of scars from the perspective of children and young people, between eight and 18 years old. Led by Patricia Neves, a plastic surgeon and clinical fellow of plastic surgery with extensive expertise in scar management, the research aimed to determine the validity of SCAR-Q, a patient-reported measurement for scars, and its association with body image perceptions, especially in younger patients. The study, entitled Validating the SCAR-Q and Assessing the Relationship Between Body Image and the Experience of Scarring, coauthored by Ms Whitney Quong, Ms Edel Buitleir, Ms Gaynor Osman, Ms Brigitte Harrison, and supervised by consultant plastic surgeon Mr Neil Bulstrode, was presented at the recent BAPRAS Annual meeting.

The SCAR-Q questionnaire is a relatively established patient-reported outcome measurement designed to reflect patients’ opinions about the scarring process. Unlike traditional assessments that rely solely on clinician observations, SCAR-Q delves into the subjective experiences of individuals affected by scars, including appearance, psychosocial impact, and symptoms. Author Patricia Neves says: “The SCAR-Q questionnaire is of great value as it can be used both in research and clinical settings. In research it can help us try to discover a little more about psychological issues, such as the link between mental health and scarring. The study proved it to be a valid scale, and so we are now able to use it for other research studies. In clinical settings, it allows us to directly assess if our treatment is effective for patients.” The questionnaire was tested by providing patients with three questionnaires: the SCAR-Q, the BESAA (Body Esteem Scale for Adolescents and Adults), the VSS (Vancouver Scar Scale) and the POSAS (Patient and Observer Scar Assessment Scale). By providing patients with other validated

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questionnaires, researchers were able to test the validity of the SCAR-Q, finding it to be a valuable tool for understanding how patients feel about their scars. The questionnaire differs from others as it is entirely patientreported and does not incorporate a medical or surgical assessment of the scar. Additionally, SCAR-Q highlighted that patients with keloid scarring had significantly lower scores than people with other types of scarring. Keloid scars are a type of raised scar that occurs when the body produces an excess of collagen in response to an injury or wound. Unlike non-keloid scars, which may fade over time, keloid scars can continue to grow beyond the boundaries of the original wound and become larger than the surrounding skin. They are often firm, raised, and may appear shiny or lumpy. Keloid scars can be itchy, tender, or painful, and they can occur anywhere on the body. They are more common in people with darker skin tones and may develop after surgery, injury, acne, or even minor skin trauma.

Neves continues: “SCAR-Q is a crucial tool in scar management because it ensures that treatments are aligned with patients’ perspectives. A treatment may be deemed successful from a clinical standpoint, but if it doesn’t positively impact the patient’s life, then it falls short of its true objective.” Consultant plastic surgeon and BAPRAS president Mani Ragbir says: “This study is an exciting development in patient-centred scar management. It marks a significant step forward in understanding the experiences of people living with scars, particularly children and young people, providing valuable insights into body image perception and overall wellbeing. This allows us, as surgeons, to create a holistic treatment plan that not only considers a medical or surgical assessment, but that also incorporates patient experience.” The study involved 24 participants aged between eight to 18 years old, recruited from Great Ormond Street Hospital. Participants completed various questionnaires, including SCAR-Q, POSAS (Patient and Observer Scar Assessment Scale), and BESAA (Body-Esteem Scale for Adults and Adolescents), providing comprehensive insights into their scar experiences and body image perceptions.

Case Study: 17-year-old student Chloé, from London, developed keloid scarring following surgery. Her scars initially appeared unremarkable, but over time they became more pronounced and raised, affecting Chloé’s confidence. Chloé has Moroccan heritage, and while keloids have been documented in all major ethnic groups, they are more commonly seen in individuals of African, Asian, Hispanic, and Mediterranean descent. Individuals with dark skin form keloids 15 times more frequently than lighter-skinned counterparts, with keloid formation as high as 16% in black and Hispanic populations. Studies show that a slight female predominance is evident, but other factors could be at play, including ear piercing. Keloids can occur at any age, but are most common between the ages of 11 and 30. Chloé says: “My confidence took a hit as my scars became more visible. Their volume and dark purple/red colouring made me feel self-conscious, especially during the summer months when they are more visible. Always being asked about them is draining, making me uncomfortable as it makes me realise how noticeable they are. I am a pretty open and honest person but having others constantly ask and point out my medical scars, which I know is out of curiosity and not malicious intent, is hard work. I also don’t want to share my medical background.” Chloé has undergone injections and keloid treatments to reduce the appearance of her scars, but found the aftercare rigorous and tiring. Chloé scored poorly on the BESAA questionnaire, and was followed up with plastic surgeon Dr Patricia Neves, co-author of Validating the SCAR-Q and Assessing the Relationship Between Body Image and the Experience of Scarring. Chloé filled in the SCAR-Q questionnaire, self-reporting how she felt about her scars and how they impacted her overall wellbeing. Chloé says: “Participating in the SCAR-Q study was a turning point for me. The questions allowed me to authentically express my feelings about my scars. It’s important to talk about your scars, as it’s a way to subconsciously normalise them and get used to the fact that they will stay on your body forever, and thats okay. Self-confidence comes from within yourself, in accepting that the scars are there, finding beauty in them and the story they tell!”

Images provided by author

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CLINICAL

INTRALABIAL LIP COMPARTMENTS AND THEIR POTENTIAL CLINICAL RELEVANCE

Adobe/artmim

Cotofana, Sebastian; Hong, Wei-Jin; Horne, Julie; More Plastic and Reconstructive Surgery. 153(6):1293-1300, June 2024

BACKGROUND:

RESULTS:

Aesthetic soft-tissue filler injections for lip enhancement are popular and performed throughout the world. When injecting lips with a cannula, as the cannula is advanced, resistance is perceived in consistent locations, potentially indicating boundaries between intralabial compartments.

Independent of sex or race, six anterior and six posterior compartments in the upper and lower lip were identified, for a total of 24 lip compartments. Compartment boundaries were formed by vertically oriented septations that were found in consistent locations. The anterior compartments had volumes ranging from 0.30 to 0.39 cc; the posterior compartment volume ranged from 0.44 to 0.52 cc. The compartment volumes were larger centrally and decreased gradually toward the oral commissure.

OBJECTIVE: We aimed to investigate whether intralabial compartments exist and, if so, to describe their volumes, location, boundaries, and dimensions.

METHODS: This cadaveric study investigated a total of 20 human body donors (13 male, seven female) with a mean (SD) age at death of 61.9 years (23.9) and body mass index of 24.3 kg/m 2 (3.7). The investigated cohort included 11 White donors, eight Asian donors, and one Black donor. Dye injections simulating minimally invasive lip treatments were conducted.

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CONCLUSIONS: The volume and size of each of 24 compartments contribute to the overall appearance and shape of the lips. To achieve a natural lip shape preserving aesthetic outcome it may be preferable to administer the volumizing product using a compartmentrespecting injection approach.

Adobe/Kalim

THE ROLE, SAFETY, AND EFFICACY OF HYPERBARIC OXYGEN THERAPY IN AESTHETIC PRACTICE - AN EVIDENCE-BASED REVIEW Juanita Parnis MD, MRCS, FEBOPRAS, MSc, Anna Maria Fenech Magrin MD, MSc, Haidar Hassan DDS, FDSRCS, MSc, PhD Journal of Cosmetic Dermatology, Volume23, Issue6, June 2024, Pages 1940-1955

BACKGROUND: Hyperbaric oxygen therapy (HBOT) involves patients breathing 100% oxygen in a pressurised chamber above 1 atmosphere. Many centres are now promoting the use of HBOT for skin rejuvenation. However, the current indications for HBOT do not encompass aesthetic applications).

AIM: The aim of this evidence-based review was to assess the existing literature regarding the utilisation of HBOT in medical aesthetics and rejuvenation, evaluate its effectiveness and safety, and conduct a cost analysis.

MATERIALS AND METHODS: PubMed Interface, Cochrane Library, Google Scholar, and Embase searches were carried out. The Best Bets methodology was used, and the risk of bias was appraised using the Quality Assessment Tool for Quantitative Studies.

RESULTS AND MAIN FINDINGS: This review included a total of 17 human studies with a total of 766 participants. Three studies were classified as level II evidence, three studies were of level III evidence, and 11 were of level IV evidence. All the included studies were judged at high risk of bias. The most

relevant findings supported by level II evidence were that HBOT decreased the shedding rate post-FUE hair transplant (27.6 ± 2.6% vs. 69.1 ± 2.4%), but this did not affect the final outcome between HBOT (96.9 ± 0.5%) and the control (93.8 ± 0.6%). Moreover, level III evidence demonstrated that following HBOT, there was a significant increase in elastic fibre length (p ≤ 0.0001, effect size = 2.71) and a significant decrease in fibre fragmentation (p = 0.012). There was also a significant increase in collagen fibre density following HBOT (p = 0.0001, effect size = 1.10). However, there was no significant effect of antioxidant vitamins A, C, and E with HBOT. The inflammatory response significantly decreased after 7 days of HBOT with a decreased expression of IL-12p40, MIP-1β, and PDGF-BB and a higher expression of IL-1Ra. Moreover, HBOT was used prophylactically prior to abdominoplasty to decrease the risk of complications. In this study, complications were decreased from 32.6% (89 patients) to 8.4% (7 patients) with a p < 0.001, and in a multivariate analysis, preoperative HBOT was an independent protective factor against postoperative complications (p < 0.001).

CONCLUSIONS: There is conflicting evidence on how the method of action of HBOT can have a beneficiary effect in aesthetic and whether the treatment is justifiable. To our knowledge, this is the first comprehensive review discussing the available evidence regarding the use of HBOT in many aesthetic clinical scenarios, including preventive, medical, and surgical settings. However, randomised clinical trials with longer follow-up and better patient selection are needed to be able to generate a reliable conclusion.

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CLINICAL PRODUCT NEWS Aesthetic Medical Partnership takes over UKI distribution of Cellenis® Platelet Rich Plasma (PRP) Aesthetic Medical Partnership has taken over the distribution of Cellenis® Platelet Rich Plasma (PRP)in the UK and Ireland from Medira. The company will also spearhead the UK launch of Cellenis® PRP DermaFiller – a fully autologous regenerative volumiser – to the UK market in the coming months. Cellenis® Platelet Rich Plasma (PRP), made by ESTAR, is the number one PRP supplier in the US. It uses a medical-grade separation device designed to process 11 and 22ml blood. It utilises a specially designed and proprietary Separator Gel, which optimises its biological profile by virtually eliminating granulocytes from the PRP and eliminates undesired erythrocytes (red blood cells), which have been shown to significantly decrease fibroblast proliferation and augment apoptosis in vitro. In addition, Cellenis® PRP enables a high platelet concentration by allowing practitioners to control the final volume of PRP. Cellenis® PRP treatments improve skin texture and tone and restore skin moisture and glow. Cellenis® PRP is safe, effective, versatile, non-allergenic, and offers virtually no downtime or side effects.

DermaFocus launches exosomes range DermaFocus has launched Purasomes in the UK. The Purasomes range features three pioneering products that combine 20 billion exosomes in their purest form with 20 of the most potent growth factors to reset cellular activity, regenerating aged and damaged cells to significantly boost the quality of skin and hair. Manufactured by the innovative Italian research and development company Dermoaroma, each of the three products within the Purasomes range contains AMPLEX Plus – a patented technology that has been created using exosomes and growth factors from ethically sourced bovine colostrum. The products include: • • •

Purasomes NC150+ Skin Nutri Complex for tired and aged skin Purasomes SGC100+ Skin Glow Complex for dull, damaged and hyperpigmented skin Purasomes HSC50+ Hair & Scalp Complex for thin and damaged hair

Purasomes can effectively penetrate the skin through in-clinic microneedling as a standalone treatment or in combination with other aesthetic procedures. After a series of three to five Purasomes treatment sessions, patients can expect to see significant improvement of their skin and hair concerns, with results expected to last nine to 12 months. Continued treatment every six months is recommended to maintain enhancement.

Croma-Pharma launches countourel® absorbable PDO threads Croma-Pharma has announced the launch of countourel® absorbable PDO Threads, a simple, non-surgical method to lift, tighten and rejuvenate skin. The threads have superior tensile strength, according to the company, to enable maximum lifting capacity. Patented moulding technology guarantees stable and long-lasting cogs and anchoring features for a longer-lasting lifting effect. Individual blister packaging of thread decreases the inflow of moisture and risk of contamination and helps maintain stability after opening. An ergonomic hub and hub cap for a smooth treatment. Hub cap fixes the thread and avoids modifications or the removal of the thread during the procedure. “This new portfolio of PDO threads offers an extended shelf life, as well as superior tensile and fixation strength creating a versatile option for medical practitioners and their patients looking for an effective, non-surgical method to lift, tighten and rejuvenate skin both on the face and body”, said Vikki Baker head of marketing, UK/IRE/NL, Croma-Pharma UK.

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TECHNOLOGY & INNOVATION SECTION In this section: New technology for scar revision Clinic software Devices news

Images provided by author

TECHNOLOGY & INNOVATION

THE POTENTIAL OF NEW TECHNOLOGY FOR REVISION Scars, a universal consequence of injury and surgery, can often leave a lasting physical and emotional impact. While they represent the body’s remarkable healing power, raised, discoloured, or itchy scars can significantly affect a person’s selfesteem and quality of life. In the UK, over 20 million people are living with significant scarring, of which almost one quarter have said this caused significant emotional or physical problems1.

Unveiling the power of three: The Alma Hybrid™ Technological Advantage

Fortunately, advancements in technology are transforming the field of scar revision, offering practitioners exciting new tools to address these concerns. The journey towards optimal scar outcomes begins with understanding the different types:

•

• •

•

Atrophic scars: Indented scars commonly associated with acne. Hypertrophic scars: Raised scars confined to the original wound boundaries. Keloid scars: Raised scars extending beyond the boundaries, often itchy and painful.

Traditionally, scar revision options have been limited, with varying degrees of success. However, the Alma Hybrid™ laser has emerged as a potential game-changer, backed by promising new research. A groundbreaking study: The Alma Hybrid™ in action A recent publication, “Keloid and Hypertrophic Scars Treatment”, published in Plastic Surgery (2024)2, sheds light on the effectiveness of the Alma Hybrid. The study evaluated the Hybrid Proscan applicator on 61 patients with both keloid and hypertrophic scars. The results were impressive. Hypertrophic and keloid scar patients experienced significant reductions in their Vancouver Scar Scale (VSS) scores (62% ± 8% and 58% ± 7, respectively). This indicates a marked improvement in scar appearance2. Additionally, the study reported high patient satisfaction and minimal side effects2. These findings position Alma Hybrid™ as a first line of treatment for scarring and a valuable addition specialists armamentarium.

The Alma Hybrid™ stands out for its unique ability to combine three highly powerful, distinct yet complementary energy sources: •

•

CO2 laser: This ablative laser precisely removes surface irregularities while stimulating collagen production for improved texture. Erbium-Glass laser: This nonablative 1540nm laser works deep within the skin, promoting collagen synthesis without damaging the surface. Ultrasound technology: This innovative feature facilitates deeper penetration of the laser energy, allowing for more targeted and customised treatment.

This customisable synergy is what truly sets the Alma Hybrid™ apart. Alma’s patented HyGrid™ technology weaves these lasers into the ideal pattern. In the case of serious scarring, the two lasers can be stacked on top of each other, allowing the CO2 to reach much more profound depths for seriously transformative results. The HyGrid™ versatility allows practitioners to also adjust ablative-to-non-ablative ratios to: 1. Treat a range of the most complex scars (Keloid, Hypertrophic and Keloid) by precisely treating multiple skin layers with an ablative, thermal and coagulative effect at once. 2. Effectively balance results with recovery time for ultimate patient satisfaction. 3. Treat all skin tones, up to Fitzpatrick 6, with the correct preparation and aftercare. This level of precision and control is unmatched in any other CO2 device, redefining both scar revision and advanced rejuvenation. While clinical studies exemplify the Alma Hybrid’s ability to deliver positive clinical outcomes, Alma is partnering with select advanced practitioners in the UK to deliver incredible patient outcomes:

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Khatra Patterson, Nurse and Founder of KP Aesthetics: “For many patients, prominent facial scars can be emotionally devastating. The Alma Hybrid allows me to finally offer them real hope for improvement.” Dr Munir Somji, Founder and Clinical Director of Dr Medispa: “This technology is unlike anything else. The combination of CO2, Erbium-Glass, and ultrasound provides exceptional versatility for achieving the best possible outcomes, even for the most advanced scar types.”

UNDERSTANDING SCARS

Image provided by author

Partnering for Success: Why Alma Prioritises Practitioner Expertise At Alma, we understand that advanced technology thrives in the hands of skilled practitioners. That’s why we prioritise fostering strong partnerships with the most experienced professionals to unlock the full potential of the Alma Hybrid™. The corresponding training pathway reflects the device’s premium nature, designed to further elevate expertise with personalised one-on-one sessions, exclusive masterclasses led by Key Opinion Leaders, and intimate Alma Hybrid User Meetings for knowledge exchange.

Having just hosted the industry’s biggest education event, Alma Academy, in Barcelona, Alma is excited to connect new Alma Hybrid™ users with leading global scar experts at the upcoming Alma Academy Thailand in September. This exclusive opportunity fosters collaboration and best practice sharing, propelling Alma Hybrid™ users to the forefront of the advanced scar revision field. By embracing the Alma Hybrid, you can expand your treatment options and elevate your practice to deliver superior scar revision outcomes for your patients. Embrace the future of scar revision.

Contact Alma today to learn more about the Alma Hybrid. References: 1. The Scar Free Foudation commissioned a Censuswide poll of 1,000 UK respondents, September 2019. 28% said they had a scar [Accessed About Scarring — The Scar Free Foundation March, 2024] 2. Menashe, S., Heller, L. Keloid and Hypertrophic Scars Treatment. Aesth Plast Surg (2024).

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TECHNOLOGY CLINICAL & INNOVATION

CHOOSING CLINIC SOFTWARE Dr Askari Townsend explores how to choose the right software for your clinic In the nuanced world of aesthetics and healthcare, clinic software has become an indispensable tool for managing patient records and appointments, streamlining administrative tasks and every other aspect of running your business. With the myriad of options available, choosing the right software for your clinic can be a daunting task. However, it will be one of the most important decisions you will make and can have a huge impact on you, your patients and your business. You may not realise when you get it right, as software is often taken for granted, but getting it wrong will cause a huge amount of difficulty, time and money.

Make the right choice first time Switching software can be a time

consuming and disruptive process and so it’s important to do your research and make the right choice first time. Ask trusted colleagues about their experiences - this will be much more valuable than a short demonstration with a salesperson. Book demonstrations with more than one software and be prepared. Write down a list of processes that you use in your business and ensure that they can be accommodated (or that there are workarounds) and any other important questions. After your demo, ask (again) any important questions in detail by email so that you get responses in writing - don’t just rely on verbal answers that aren’t recorded. There is no perfect solution when it comes to clinic software, as each clinic has its

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unique set of requirements and challenges. Your goal should be to find the software that best fits your specific needs rather than the one that simply offers the most features or the lowest price.

Don’t just ask about price and features The most common first questions are “How much is it?” and “Do you have this feature?”. Whilst these are important questions, they are just the tip of the iceberg. Focusing solely on these aspects can lead to overlooking other critical factors that ensure the software aligns with your clinic’s needs and workflows. Many practitioners find themselves captivated by a particular feature or swayed by a lower price tag, only Image provided by author

to discover later that the software doesn’t fully support their day-to-day operations or long-term goals.

just rely on a yes or no from a salesperson. Remember to have important questions answered in writing.

Pricing

Training

With a large number of providers comes a wide range of prices. Especially when starting out, it is very tempting to go for the cheapest offer until you start growing. However, your data is the heart of your business and where much of the value of it lies. Moving this data to a new software provider is a big task and may well reduce its quality - you should plan to do this as few times as possible!

Regardless of how software literate you are, you will not know the details of how your new software works. If you have a small practice with no other staff and time on your hands, you may well be able to work your way through it.

The UK clinic software market is very cheap compared with the rest of the world, with mixed results. Good quality, secure & robust software with good support is not cheap, and, as with most things in life, you get what you pay for. In aesthetics, a single appointment could result in a sale worth hundreds, if not thousands, of pounds. A patient missing an appointment because a reminder failed to be sent or their appointment didn’t save correctly can be very costly for your business, both in terms of income and reputation. What might seem like a saving of £50 per month could, in fact, cost you much more.

Hidden charges There are several different ways to pay for software, the most obvious of which is a monthly or annual payment. But make sure you ask about other charges that you may not expect, such as fees to take bookings online that might be described as “deposits,” fees for extra features, or even for storing data such as photos or sending emails. It might be that one day, you decide to move providers. Check if you will be charged for this—some companies charge up to £450 + VAT to provide your data! Also, check if they will provide this on an agreed date and how long it will take. If it could take up to a week to send you your data, this will be a week when it will be difficult to run your business and potentially cost you thousands of pounds.

Features Depending on who you believe, 50 - 80% of software features are never or rarely used! The features that you think are must-haves might not be so important after all. If you know there are must-haves, ensure that they work in the way that you expect - don’t

Most software has help centres with articles or videos—make sure that you go through these. Using a complex piece of kit without reading the instructions is rarely the best way to get the most out of it. For larger and more complex businesses, seriously consider bespoke training if it is offered. Although it will usually be charged for, it is often an excellent investment and vital to ensure that not only do all staff know how to use the software but that the system is set up correctly in the first place. An incorrect or poor set-up may have implications on the user journeys and/ or financial data that will be vital for your accounting.

Support Even with the best training, there will be times when things go wrong, or you need advice on how to get the best from your software. When this happens, how long will it take to get an answer to your questions? Will they be answered by people who use and know the software well? Will they be conversing in their first language? Having slow or unhelpful support will really slow you and your business down, often when you need it the most. While we investigate what to look for in clinic software, it’s also important we identify what we don’t want in clinic software. A growing clinic does not want to deal with an unresponsive software provider. Technology fails sometimes, but trust is developed in knowing that if there are any technical issues, there is always someone to help me as quickly as possible.

Data security Most cloud software providers host their data via global giants like Amazon, Google, and Microsoft, which provide the highlevel security you would expect from large organisations such as banks and airlines. However, your software company is responsible for ensuring that the data sent

from your device to the cloud and back is encrypted. Ask colleagues about how robust the software is. Have they experienced data going missing or not being saved at all? This should never happen, but you might be surprised to hear that it does, even with very popular names. It’s worth noting that the easiest way your system could be compromised is via poor user security—clicking on suspicious email links or unsafe web pages that could install viruses that capture your login details. Ensure that you have good antivirus software on your devices and that passwords are changed regularly. Lastly, ask how often your data is backed up—if there were a catastrophic failure, how much data could be lost? The software that you use is one of the most important parts of your business and the custodian of all your sensitive data. Take your time in choosing what is right for you and go with a company that you trust, understands your business and will be there to support you as your business grows. Try not to be swayed by price and feature lists alone—think about ease of use, time saved, and responsive, helpful support. Speak to colleagues who use the software to get a better understanding of what it’s like to use it day to day and ask questions that might seem obvious, e.g. Does it work as it’s supposed to? Any problems might end up costing your business dearly. Be prepared to compromise—no software will perfectly match every requirement. Prioritise your needs and make compromises where necessary. Identify which features are non-negotiable and which you can wait for. Be prepared to adapt your processes if that is what is required to implement your new software. It may be that there are changes to your processes that will be more efficient now that you are using a different tool. Ultimately, ensure that you choose a provider who will be able to support you as your business grows or changes. If your current software is letting you down, speak to us about how we overcame our problems and can help you overcome yours.

Contact Collums to book a demo.

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TECHNOLOGY PRODUCT NEWS Lynton introduces Dynamix Introducing Dynamix, the newest innovation from Lynton, offering an extensive array of over 30 treatment options. Its modular design allows for easy configuration and customisation with any Lynton handpiece, catering to the specific needs of clinics. With Dynamix, clinics can scale up their offerings as they grow, eliminating the need to invest in additional devices. The user-friendly touchscreen interface ensures that practitioners of all levels can confidently deliver treatments. Dynamix seamlessly integrates multiple cutting-edge technologies, including IPL for hair removal (ReMove) and skin rejuvenation (ReBright), RF (ReModel), Q-Switched Nd (Remove Q), and Erbium YAG laser (ResurFACE), providing a comprehensive suite of aesthetic solutions within a single device.

Sciton adds BBL Heroic to range BBL Heroic is the latest innovation in pulsed-light technology from Sciton. This device incorporates a variety of advanced technologies to ensure optimal patient outcomes. A built-in motion sensor tracking function provides real-time, 3D spatial data about the handpiece’s position and orientation, enhancing treatment accuracy. Additionally, an automated pulse feature within the handpiece ensures consistent treatments across all skin surfaces. Intelligent Control (IC) orchestrates these components, allowing the machine to function seamlessly.

Alma unveils Hybrid Alma has introduced the new Alma Hybrid, a device set to revolutionise scar treatment and advanced skin rejuvenation. It combines a 70W CO2 laser with a 1570nm laser in one applicator to optimise ablation while minimising thermal damage to surrounding tissue. The device also features transepidermal ultrasound technology, which improves the delivery of topicals, enhancing results and reducing recovery time by enabling active ingredients to penetrate deeply into the skin. Alma’s Hygrid technology, integrated into the device, uses a single scanner to create the ideal laser pattern for each patient’s skin.

Heathxchange offers Observ 520x Healthxchange has launched a new skin analysis technology, the Observ 520x. Utilising visible light emitted by human skin cells, Observ identifies the distinctive colors and patterns that fluoresce under true UV light. The clarity of the Observ camera allows it to detect skin issues both at the epidermal level and deeper. This exclusive fluorescence technology reveals textural topography, pigmentation, microrelief, vascularity, volume loss, UV damage, and more, providing a comprehensive, multidimensional assessment of skin health.

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Hair removal, now even faster. INTRODUCING THE NEW

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SKIN SECTION In this section: Moles Mesotox Skin trends Skin news

Adobe/Pixel-Shot/Ольга Лукьяненко

Adobe/Pixel-Shot

SKIN

AN EXPERT GUIDE TO MOLE REMOVAL Dr Bela Horvath, dermatologist, cosmetic doctor, and founder of MelanomaMobil mole check franchise, shares safe practices and what to avoid The NHS no longer delivers “non-essential” mole treatments, meaning that the majority of mole removal procedures, or the removal of skin ‘lumps and bumps’ (e.g., warts, verrucae, and skin tags), can no longer be administered for free on the NHS. This means that private medical practices and aesthetic clinics are increasingly seeing patients come through the doors wanting procedures like mole removal.

a melanocytic origin, just like the dangerous melanoma skin cancer. So, when you think about ‘mole removal,’ make sure that the diagnosis is right. Whoever performs the mole removal should be able to diagnose it correctly first, which is not always easy or straightforward. I have seen cases when a melanoma was removed with an ablative laser and without histological verification. The next things the patient noticed were the metastases or the spreading tumour.

Mole removal is a very popular skin treatment. It can be life-saving, but it deserves a bit more contemplation. Whether you are offering mole removal at your clinic or referring patients elsewhere, it’s important to be educated about moles. Early detection is key, and aesthetic clinicians may be the first to notice changes in the skin if a patient comes in regularly for treatment and has any visible moles.

Conclusion: Mole removal should be performed or initially checked by a dermatologist first in a skin consultation.

1. “Mole removal” There is already a diagnosis in this term: mole. What is a mole? A mole or nevus has

2. Reason for mole removal There are multiple possible reasons for mole removal: an unsightly mole, an annoying lesion, frequent irritation, or a suspicion of a malignant transformation. These reasons weigh differently when we make pro-con mole removal decisions. For example, a small blemish on the chest that you don’t like is not a good enough reason to risk a keloid, which is overgrowing and

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disturbing scar tissue. A suspicious lesion at the same location has to be removed without hesitation. The chest is a highrisk area for abnormal healing (keloid formation).

3. Location of the Mole: Different parts of the body have different healing potentials. Generally, the face heals well and quickly, but it has a very high cosmetic significance. The worst healing potential on the body is the triangular area on the chest, with the highest chance of keloid formation. The back is an area where the skin is very thick due to the strong forces on the skin every time we bend forward, and it has to be considered when making decisions.

4. Photography before skin treatments Photography before any skin procedure is of the utmost importance. Taking pictures has a medico-legal requirement and shows that you care and are willing to learn from

your work. Taking pictures may help you notice any changes to the patient’s skin (and any moles) between treatments. They are also a valuable way of showcasing results to other patients with appropriate consent.

5. Mole removal method There are different methods for mole removal. The most suitable one should be selected based on different factors, such as the nature of the lesion, whether it is flat or elevated, the location, histology needed or not, etc. If the lesion is a mole and it is flat and looks asymmetrical, the method to use is excisional biopsy with a narrow safety margin followed by histology analysis. Shave biopsy can also be used to remove suspicious lesions. Ablative removal methods that destroy the lesion entirely, such as laser, cryotherapy, and electric cauterisation, should be used only carefully in expert hands who are experienced enough to distinguish a benign lesion from a potentially malignant one.

6. Safety margin Specific lesions require a safety margin when removed. When we remove moles, we typically leave a small free margin around the lesion, so there is nothing left back with the potential to regrow. When inadequately removed, moles may grow back, and they can look ugly and develop into pseudo-melanoma, which causes some headaches for clinicians and pathologists alike. With an ablative method (laser, cryo, cauterisation), the extent of the safety margin is unclear.

7. Histology analysis after mole removal In every case, histology analysis should be performed when there is the slightest suspicion about a skin lesion being malignant or the lesion’s nature is unclear. It will reveal the final diagnosis, and it can determine whether there is any further action needed or not.

8. The scar after mole removal There is a very simple rule here: any procedure that reaches the dermis (the second, thick layer of the skin) causes a scar. Procedures more superficial to this don’t leave a scar. So, small lesions such as viral warts, fibromas, and seborrheic keratoses can be removed without causing a permanent scar. If completely removed, any lesion extending into the dermis (most of the moles) leaves a permanent scar. Moles can be removed superficially with a shave biopsy, but in this case, it is most likely that there are remaining deeper cells with the potential to reappear.

9. Risks and complications During the consultation process, patients need to understand clearly the potential risks and complications of mole removal, such as infection, recurrence, unsatisfactory healing (keloid, hypertrophy, pigmentation), or unintended ablative removal of a malignant tumour without histology, including the possibility when no procedure is done.

10. Aftercare It depends on the location and size of the scar, but generally, a fresh scar needs support and protection. The dressing should be kept on for a few days without getting wet. Patients should avoid physical activity at this stage. After the removal of stitches (if applicable), a firm massage with cream or oil is recommended multiple times a day (the more, the better), followed by the application of a silicone liquid or tape. Scars need UV protection for 18 months post-procedure.

Conclusion Mole removal, while common, is not a decision to be taken lightly. It involves considerations regarding diagnosis, location, method, and aftercare, each with its own complexities. To ensure the best outcomes, it is crucial patients consult with a skilled dermatologist who can guide them through the process with expertise and care.

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SKIN

AESTHETIC TRENDS AND THE FUTURE OF SKINCARE Hamilton Fraser recently identified some emerging aesthetic trends and technologies shaping the market, including what the future holds for skincare. Here, they share their insights with us. Skincare has been a staple of aesthetic practice since the industry’s early days when glycolic acid was all the rage. Things have changed a lot since then, both in terms of the number of skincare brands available and the ingredients that are leading the way. However, one thing remains constant: the role of skincare in supporting and enhancing the procedures performed in the clinic. In Hamilton Fraser’s annual survey skincare was cited as the second most common service practitioners offer after injectables, with 56.9% saying they sell it. This is because skincare is not only a powerful tool for tackling age-related concerns but also for managing and treating skin conditions. Skincare can sometimes be overlooked in favour of new treatments, devices, and technologies, but the field has plenty of its own trends and innovations to get excited about.

natural renewal process, and peptides, which stimulate collagen production and improve skin elasticity, continuing to be popular. In terms of the ingredients being touted as the next big thing, Beauty Pie listed ectoin as the biggest skincare trend for the year ahead. Ectoin is an amino acid derivative used as a multi-functional skincare ingredient that offers a variety of benefits. It’s great for strengthening the skin barrier and also reducing water loss. Google searches have increased by 163% over the past six months, indicating that it’s an ingredient to watch in 2024. The second biggest trend for the year ahead was identified as ‘skin streaming,’ which advocates a slimline skincare routine to prevent damaging the skin barrier. Reverse skincare, bio retinol and hypochlorous acid also appeared in the top 10 biggest skincare trends for 2024.

Combining science and nature

Exosomes

The global skincare market is expected to generate sales of over $167 billion (£133bn) by 2030.

Exosomes are also making waves in the regenerative aesthetics field. Exosomes are an attractive prospect because they can instruct older cells to act like younger ones.

As consumers become increasingly discerning about what they put on their bodies, the demand for skincare products that blend scientific innovation with organic and natural components is on the rise. This trend reflects a growing preference for effective skincare that is also aligned with natural, sustainable practices. It also reflects the increasing demand for regenerative aesthetics, with potent ingredients like growth factors, which accelerate the skin’s

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Exosomes are nano-sized naturally-occurring ‘extracellular vesicles’ produced by almost every cell of living organisms. They act as messengers, ferrying signalling molecules like proteins and other genetic materials to tell cells how to behave. They can be sourced from humans, animals, and plants, but remember that cosmetic or off-label use of human biological products is illegal in Europe and the UK.

Exosomes can contain many different substances, including peptides, lipids, growth factors, vitamins and minerals, and DNA. They can speed up healing and repair after aesthetic treatments, improve cellular communication, and stimulate collagen, elastin, and HA. As no exosomes have been approved by the likes of the Food & Drug Association (FDA) or the MHRA, they are not allowed to be injected but can be applied topically or via microneedling.

Organic and environmentally conscious skincare In tandem with scientific breakthroughs, the future of skincare is also rooted in nature. Organic ingredients sourced from plants, fruits, and botanicals are gaining popularity for their efficacy and sustainability. One of the key drivers behind the rise of organic skincare is the growing awareness of environmental issues and the desire to reduce our carbon footprint. By choosing products made with organic ingredients, consumers can support eco-friendly practices while indulging in luxurious skincare experiences. Moreover, the shift towards natural skincare is about more than just what’s in the products but also what’s not. Many consumers are opting for clean formulations free from harmful chemicals, synthetic fragrances, and artificial preservatives. This move towards clean beauty reflects a broader cultural shift towards wellness and mindfulness, where self-care extends beyond skincare routines to encompass conscious choices that promote health and harmony.

Artificial intelligence (AI) According to Fortune Business Insights, artificial intelligence (AI) is also gaining traction in the beauty and personal care industry with the development of AI and IoT-based devices that offer personalised skin solutions. They predicted that the rise in techsavvy consumers exploring new devices will foster market growth. Hamilton Fraser also identified this trend, citing AI as playing a pivotal role in the future of aesthetic medicine. Personalisation and precision are key here, using algorithms to analyse a patient’s skin type, genetic factors, and lifestyle habits to recommend customised treatment plans and skincare.

SPF – the most powerful preventative tool And let’s not forget SPF. Prejuvenation has been cited as one of the key industry trends, and for young patients wanting to protect their skin from ageing, SPF is their most powerful daily skincare tool. Despite this, research commissioned by Skin Proud found that almost three-fifths (59%) of Gen Z individuals didn’t know that the sun causes skin damage. Moreover, 64% said they don’t wear daily SPF, with 26% saying the reason was they do not live in a sunny climate, so they thought they didn’t need it — a common assumption in the UK especially. SPF is also important in the fight against skin cancer. According to Cancer Research, more than 210,000 cases of nonmelanoma skin cancers are diagnosed annually in the UK, with cases expected to reach 400,000 annually by 2025. This means that one in four men and one in five women will be diagnosed with non-melanoma skin cancer. Sadly, most of these cases are preventable. In fact, 90% could be prevented by staying safe in the sun. However, research has recently emerged showing that the UK population is not adhering to SPF guidelines and is putting their skin health at risk, with just 22% applying SPF daily.In terms of SPF trends, researchers at Beauty Pie featured spray SPF, vitamin C sunscreen and ceramideboosted formulas in their top 10 biggest skincare trends. Searches for spray SPF had increased by 90% in the six months before the research was announced, as skincare fans sought a convenient way to spritz their sun protection on top of their makeup throughout the day. Vitamin C sunscreen searches were also shown to be up 53%, and ceramide sunscreen searches by 42% at the start of 2024.

To sum it up The future of skincare lies in merging science and nature. It’s about harnessing the power of cutting-edge ingredients and technology that deliver results and put prevention at the forefront at the same time as harnessing the wisdom of traditional botanicals and organic extracts and respecting the growing consumer consciousness when it comes to the environment.

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SKIN

MESOTOX Vicky Eldridge visits Dr Raquel Amado at her Kent clinic to try out microtoxin also known as mesotox I struggle with hormonal acne, and in my 40s, it has developed on my cheeks and forehead as well as on my chin, where it has predominantly been previously. I didn’t have acne as a teenager, so being 45 and working in aesthetics, having spotty skin for half of the month every month gets me down. Worst still, despite all my knowledge, I am a picker and have now created some scars on my cheeks as well as some hyperpigmentation.

Unlike traditional methods, where toxin is injected directly into the muscle, microtoxin is administered just below the skin’s surface.

In May, I had the Aesthetic Medicine London event and awards coming up, so I went to see Dr Raquel Amado at the Skin & Medical Cosmetics Clinic in West Malling, which is luckily within driving distance for me.

Dr Amado used the Wow device to administer my treatment. It took less than 30 minutes, and because I had local anaesthetic cream beforehand, I didn’t feel a thing.

After a thorough consultation and skin analysis, Dr Amado discussed the options she recommended for me. With my event coming up in a few days, we decided to start with microtoxin, also known as mesotox, as I would be able to see results within a few days. Perfect when I had a big event coming up. Microtoxin can help diminish pore size, reduce sebum, decrease redness, and improve fine lines, wrinkles and skin laxity. It involves using minute amounts of substances like botulinum toxin, which can be combined with a mesotherapy cocktail—in my case, Dr Amado used NCTF 135HA (Fillmed) and Nuceiva. I was excited to try this as I had heard it had a fast onset of action, exactly what I was looking for with this treatment. “The reason I like NCTF 135HA is because it has all the ingredients the skin needs to thrive”, says Dr Amado. “It has 60 different essential ingredients, including hyaluronic acid, glutathione, and vitamin C. This is also a product that has 45 years of clinical studies and science behind it. It is the gold standard of mesotherapy cocktails and that’s why I love it. I combine that with Nuceiva. I started using it I really loved the results from it. So it’s a combination of treatment that’s going to help with the skin texture and sebum and to create glass skin.”

“Microtoxin improves skin quality, but unlike other anti-wrinkle treatments, it doesn’t affect the muscles, allowing for freedom of movement and the ability to make facial expressions naturally”, explains Dr Amado.

“I use the WOW device for this treatment because I can control my depth amazingly, and it does multiple punctures at the same time, so it’s more comfortable for the patient,” explains Dr Amado. “ One of the key benefits of microtoxin is its ability to deliver very quick results. Unlike traditional injectables, where results may take days to become noticeable, microtoxin treatments yield visible improvements right after the procedure. Within a few days I noticed my skin was looking better. I had a glow; the redness had gone down, and my pores and acne had definitely reduced on my cheeks. The procedure also has minimal downtime; I didn’t experience any other than a shortlived bit of redness from the injections. The best thing was I was able to wear less makeup which was my goal. I would prefer not to wear any foundation, but because I am so spotty, I find myself desperately trying to cover it up, and then my skin feels cakey and clogged. I also know piling on the foundation is not going to help my skin in the long run, so it’s a double-edged sword. The pictures don’t really do it justice as I had slightly caught the sun in the month between these being taken, but I was really happy with the results. My skin was glowing and clear for the awards, and one of the best testaments is when people in the industry compliment your skin and ask

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what you have done, which happened to me on a couple of occasions. I am now going to have some exosome and polynucleotide treatment with Dr Amado, and she’d put me on a skin regime with AlumierMD, so we are working together to improve my skin. But I would definitely have mesotox again, especially if I had an event coming up and wanted a quick improvement and a healthy glow.

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BEST PRACTICES AND ADVANCING TECHNIQUES

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The 10th National Aesthetic Nursing Conference is back and better than ever! Join us to celebrate our 10th anniversary with leading industry specialists talks, discussions, demonstrations and more. Join us for our evening mixer after the conference with great food, drinks and entertainment. Let’s celebrate your hard work and best practices.

Organised by

SKIN PRODUCT NEWS ZO Skin Health launches Complexion Clarifying Serum ZO Skin Health has introduced Complexion Clarifying Serum to its range. The serum is designed to treat combination, oily and blemish-prone skin with its sebum-targeting ingredients. It minimises excess sebum production and reduces redness, according to ZO Skin. The product contains ZO sebum-targeting complex (rosa canina, eugenia uniflora leaf and syringa vulgaris extracts) to promote a healthy skin microbiome; water-soluble salicylic acid to decongest the skin; and ZO-RRS2 and ZPOLYTM plant stem cell and polysaccharide complexes to soothe visible redness. A six-week, third-party evaluation of 43 patients saw a 21% reduction in sebum and shine, a 12% reduction in visible pore size, and a 24% reduction in facial redness. ZO is distributed in the UK exclusively by Wigmore Medical.

Introducing Medik8 Total Moisture Daily Facial Cream Medik8 has introduced Total Moisture Daily Facial Cream. The lightweight, plumping, peptide-powered daily moisturiser has been expertly designed for optimum skin health, delivering clinically proven moisturisation with users citing +55% instant increase in skin hydration, and essential skin barrier support by boosting the skin barrier by +30% in just one hour. Prebiotic peptide maintains the natural balance of the skin’s microbiome, replenishing and boosting the skin barrier while multi-weight hyaluronic acid draws moisture into the skin to leave it hydrated, supple, and with a healthy-looking glow. Ceramides and lipids intensely replenish, nourish and visibly restore the complexion.

AestheticSource announce the launch of NEW skinbetter science® Trio-Luxe Moisture Treatment AestheticSource is delighted to announce the launch of NEW skinbetter science® Trio-Luxe Moisture Treatment. The product is formulated for moderate to severely dry skin, mature skin and skin that is compromised by age and environment. Emollient-rich with a velvety feel, skinbetter science® Trio-Luxe Moisture Treatment brings moisture and hydration - replenishing dull, dehydrated skin, leaving it looking renewed and feeling nourished. In addition, it provides support for healthier-looking skin with improved skin texture and reduction in the appearance of visible redness. Key ingredients include glycine, an amino acid that replenishes and hydrates the skin, niacinamide, a form of vitamin B3 that promotes skin hydration and healthy-looking skin and olea europaea (olive) fruit extract, a naturally derived antioxidant that helps to reduce the appearance of redness. It also contains a proprietary technology that uniquely addresses three critical elements of natural skin moisturization including Natural Moisturising Factors (NMF) which deliver hydration with water binding agents such as lactate, PCA & urea complex, amino acid replenishment and supporting of ‘water channels’ that transport water, urea and glycerol.

Obagi Medical unveils Rebalance Skin Barrier Recovery Cream Obagi Medical has extended its collection with a new launch. Obagi Rebalance Skin Barrier Recovery Cream works to rebuild the skin microbiome, replenish skin hydration, and repair the all-important skin barrier. The formula offers a multi-use, multi-tasking solution perfect for calming sensitive skin, posttreatment recovery, and boosting overall skin health. Barrierplex Technology™, an innovative, proprietary blend of postbiotics, ceramides, and green algae restores and rebalances the skin microbiome, as well as stimulating epidermal renewal. This is matched with soothing squalane that boosts hydration and niacinamide to reduce irritation for supremely glowing skin. This can achieve skin comfort and balance, which means the skin looks healthy.

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We’ve got you covered With over 25 years' experience, we are the leading provider of cosmetic insurance services and are proud to cover the most comprehensive range of cosmetic treatments in the industry Hamilton Fraser is a trading name of HFIS Ltd. HFIS Ltd is authorised and regulated by the Financial Conduct Authority. HFIS Ltd is registered in England CRegistration numberg 3B5Bf@c? >ith its registered oDce at 7th Floor Corn E`change, 55 Mark Lane, London EC3R 7NE.

Adobe/New Africa

BUSINESS SECTION In this section: Well-trained front-of-house Cash flow The Intradermology story Topicals round-up

Adobe/ARTFULLY-79/VadimGuzhva/Jacob Lund Photography

BUSINESS

LEADING FROM THE FRONT Adobe/VadimGuzhva

Gilly Dickons from Aesthetic Response on the value of well-trained front-of-house staff Let’s start with the old saying, ‘You only get one chance to make a great first impression!’ Although this may sound cliché, it’s still a simple truth – without a doubt, one of the most important factors that will affect your business growth and development is the first impression your business creates. Our sector continues to show good, solid year-on-year growth, with more clinics and practitioners wanting to take their share of the market. As this marketplace becomes more competitive, gaining and maintaining new clients becomes more challenging. Our natural response to driving the business is often to upgrade our website, contract SEO and lead generation support, create videos, put together special offers, and even do Facebook and Instagram lives – all in pursuit of new clients.

In this highly competitive sector, it’s no longer safe to assume that a new enquirer will book with you because you’re ‘good’ at the treatment. After all, if you’ve won an award or have a greatlooking website, you will have to work hard to engage potential new clients. Many new enquiries come from online searches, so the enquiry you’re responding to may be one of several the person has submitted. We’ve to consider how competitive this sector is – there’s every probability your clinic has a number of local competitors who are fiercely contending for new clients – it’s really important to make the most of every new enquiry – ensuring that your clinic secures new business opportunities.

The value of managing a new enquiry well lies in its potential to: Expand the clinic’s client base: Each enquiry represents someone looking for solutions to enhance their appearance, address a potential issue, and create confidence. By effectively engaging with each person making an enquiry, the clinic has the opportunity to attract new clients and expand its client base and success. Showcase expertise and quality: By responding to enquiries with professionalism, knowledge, and care, you can demonstrate the clinic’s expertise and commitment to delivering top-notch services. The positive impression created can instil trust in potential clients, influencing their decision-making process. Cultivate positive first impressions: We’ve already considered how important first impressions matter in aesthetics. Handling enquiries with promptness, efficiency, and warmth will leave a lasting positive impression on potential clients, setting the tone for the entire client-clinic relationship.

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Customer engagement: Engaging with enquiries presents opportunities to educate potential clients about various treatments, practitioner credentials, safety considerations, and the latest advancements in the aesthetics field. Educated and informed clients are more likely to make confident decisions. Brand Loyalty: Delivering exceptional service from responding to an enquiry, then throughout the consultation and treatment process and follow-up, creates a memorable experience for clients. Satisfied clients are more likely to become loyal, returning for additional treatments and, in turn, recommending the clinic to others. Measure marketing effectiveness: Tracking and analysing the source of enquiries ensures that the clinic can assess the effectiveness of marketing campaigns. A clear understanding of where new enquiries come from enables the clinic to optimise outreach strategies and allocate valuable resources more efficiently. New enquiries are the lifeblood of any aesthetic business. Each one that converts to a new client or patient for the clinic will generate valuable income for the business, so it’s critical to ensure your staff is able to respond efficiently and effectively, whether over the phone or online. Have you stopped to consider the impact your front-of-house staff are making on your growth, revenue, and client retention? The first point of contact for your business is where the first impact starts – is it time for you to review your approach to this area of your business? A great place to start is to put yourself in your client’s shoes, whether new clients or existing ones. Take a close look at your processes - running through what happens when they call, email, text, WhatsApp or social media message you. Look at the steps carefully to identify if there are any gaps.

initial response through to follow-up. If you don’t have a clear protocol for lead management, many of these enquiries will simply become lost leads. It’s harder to engage people who enquire online as there’s no opportunity to build a relationship in the same way as over the phone – wherever possible, your staff need to be trained to try to get the enquirer to speak with them over the phone – increasing your chance of converting them into a valuable new client.

In conclusion: If you take the time to review these areas, ensuring that you address any issues identified, you’re guaranteed to maximise your revenue – well-trained, knowledgeable staff will accelerate clinic growth. Whether you handle your practice calls yourself or employ part-time or full-time staff, it’s worth bearing in mind that you do not have to have all of your call handling provision in-house; outsourcing your enquiry handling to “virtual reception” providers who are highly knowledgeable and experienced in aesthetic practice can provide you with a very effective service to the benefit of your clients. With peace of mind that they’re in safe hands, you can prioritise your own valuable time to achieve other practice and personal goals in line with your business growth plans. To find out more visit www.aestheticresponse.co.uk or call 0191 720 3000.

The Phone: When contacting the clinic via phone, the caller should receive a response within a few rings from a knowledgeable person who can discuss their requirements and book an appointment there and there. The person responding to the call should have time to spend with a prospective new client who has a lot of questions. You need to have a well-trained receptionist who can answer questions as well as ensure that the caller feels like the most important person in the world at that moment in time. Callers should receive undivided attention and not be rushed off the phone – there’s nothing worse than the person handling the call coming across as distracted. Your receptionist needs to be able to secure the appointment booking – it’s up to you to ensure they have the necessary skills. Review your call-handling provision regularly. Retainably assess your call-to-appointment conversion and client retention statistics, ensuring that you’re making the most of all opportunities. If your staff are struggling in this area, invest in training for them. If you’re missing calls when either you or your staff are tied up, look at outsourcing appointment booking support - it’s important that you take action.

Online enquiries: Enquiries coming into the clinic via emails or social media channels need to be responded to in an efficient and effective way. Make sure you have a process in place for your staff to follow – from Adobe/VadimGuzhva

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BUSINESS EVENTS

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FLOW STATE Alan Adams on maintaining a steady and sufficient cash flow The simple act of not getting paid on time naturally impacts organisations of any shape, size and sector, but it can be most detrimental to SMEs. Recent stats reported by Natwest showed that two million of Britain’s small businesses fall victim to late payments, and 55% say that the number of these overdue invoices is only increasing. Not only does this mean that they’re spending valuable time and resources chasing these up, but it’s also diverting their attention from growing the business and striving for success. Aesthetic practitioners essentially provide a ‘service’ (in addition to offering add-on products) and so aren’t bound to the often crippling 30-day, 60-day, or even 90-day payment terms. However, they are impacted by another major problem: the volume, average spend, and regularity of

clients coming through the door aren’t predetermined. Alan S. Adams, Director of The Clinic Coach, understands that maintaining a steady and sufficient cash flow can be a mounting pressure for clinic owners. So, what can you do about it? Here, Alan shares the importance of bringing awareness to your cash flow and explains a simple-toimplement strategy to help overcome any shortfalls:

Understand Your Cash Flow “Owning a clinic is so much more than just providing a service that you’re passionate about and proud of, and that’s helping clients to achieve their own goals about how they want to look and feel. But, like all businesses (regardless of industry), it’s

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important that you’re rewarded for your time, expertise, and specialism – pay which exceeds what you could earn by working for someone else. Otherwise, what’s the point? “The great news is that there are thousands of tried-and-tested techniques that help businesses become (and remain) successful. “But first things first: you need to establish what commercial success looks like for you. Top-line, you must be able to easily cover your overheads and pay your staff a decent (and legal) wage. Plus, you must ensure there are reserves available to cover future investments, one-off purchases, and obligatory expenses, such as VAT (if applicable), tax, and other compliancebased costs.

Regular Retainers “Many businesses start each month at zero in terms of cash flow and then work incredibly hard for the remainder to increase this figure. But this is a huge risk. And in business, making provisions to reduce risks is vital in ensuring longevity, future success, and – ultimately - peace of mind. “Transferring your customers onto a retainer basis is well worth considering, allowing you to have more control over your cash flow. Meaning you’ll never start the month with zero again. “But how do you do this? One strategy that many of my clients have achieved enormous success with is the introduction of ‘VIP Clubs’. Not only can it help to ease financial pressures, but it can also provide added value to your most loyal clients too. Win: win.

Implementing the Idea

with. But aim for quality, not quantity – keeping it small and exclusive will ensure it retains its luxury VIP feel. “The impact? Based on 20 members, paying £150 per month would generate an instant £3,000 for your clinic before you’ve even opened your doors. Impressive, huh? “And you have the freedom and autonomy to tailor it to best suit your clinic’s ever-evolving needs and capabilities (and your clients). Also, you can try other initiatives within it, such as a pre-paid incentive, where the client pays for three months up-front and, in recognition, gets a month for free.

Launch the Club “Once you’ve scoped out how your ‘VIP Club’ will look and feel, and you’ve finalised the details and value of your offer, the next step is to spread the word.

“A great way to launch it could be at an event – invite your very best clients for drinks and nibbles before announcing your brand-new exclusive offer and its benefits. Not all of them will take it up there and then, but once you’ve gauged feedback, you can tailor the offer as you see fit. Or open it up further by inviting other potential VIP members to join (keeping it within the realms you previously established to ensure it remains truly exclusive).

“Having a secure and sufficient cash flow is always important – especially in the current climate. And introducing schemes and initiatives, such as VIP Clubs and exclusive memberships, will be a win for both you and your clients – not only in the added extras they’ll receive but also because you’ll be in a much better position to make decisions and investments that really matter to the future of your clinic and the services you’re able to offer.”

“Create an exclusive offer for your very best clients, whether it’s a ‘VIP Club’ or ‘Platinum’ membership - but a scheme where customers pay a monthly subscription to be a part of something really special and where they benefit from exclusive extras in comparison to your standard service offering. “Considered thought will need to be given to what you’re best incorporating as part of this, but it’s vital that you go above and beyond to ensure that customers can easily see the value. “For example, you might choose to charge £150 per month but, in turn, offer treatments with a retail value of £200, early access to the latest products and services, and other bonuses as you see fit. “Also, as with any business process, review the potential challenges prior to launching. Bear in mind that nobody likes to be tied into contracts, so to (again) reduce the risk, make sure it’s simple to cancel at any time they choose. (And then just make sure it’s too good that they’ll never want to). “The number of people in your club or membership will, of course, depend on how many individuals your clinic works

Adobe/creative soul

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HAMILTON FRASER PRESENTS THE AESTHETICS BUSINESS CONFERENCE 2024 BUSINESS

Bookings are now open for Hamilton Fraser’s Aesthetic Business Conference (ABC).

Taking place on Tuesday, 8 October 2024, at the iconic Royal College of Physicians, London, Hamilton Fraser presents the Aesthetics Business Conference (ABC), the dedicated business conference for aesthetic entrepreneurs seeking to establish an aesthetics business or take their existing venture to the next level. The Aesthetics Business Conference 2024, in association with Success in Aesthetic Business (SIAB) provides an invaluable opportunity for practitioners and clinic managers to learn and network with

some of the most influential names in the aesthetics business and network with likeminded people.

industry experts questions, get first-hand advice and chat with exhibitors showcasing a wide range of products and services.

This year, Hamilton Fraser has partnered with Menopause in Aesthetics (MIA) to cover safeguarding in aesthetics. The Aesthetics Business Conference are proud to present a unique take on how to be a successful aesthetics practitioner in 2024.

The Royal College of Physicians is an awardwinning conference centre overlooking Regent’s Park and provides food and refreshments throughout the day, including a hot buffet lunch and the RCP’s legendary cheeseboard. There will also be an exclusive champagne reception.

As well as earning over eight hours of CPD, delegates will be given learning materials to take away and have the opportunity to ask

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Tickets for the event are now live on Eventbrite and cost £115. The event runs from 9 am until 6.30 pm. Here’s what previous delegates have had to say: “I would recommend ABC to anyone in the industry. Most people forget the business side of aesthetics, and lots could benefit.” 2023 delegate “I was completely new and fresh to the industry and had no clue how to start and what to do. Attending ABC was the best decision I made for myself and my business, learning exactly what I needed to do to be successful.” 2022 delegate

Eddie Hooker, Founder and CEO of Hamilton Fraser, said: “The Aesthetics Business Conference 2024 will offer delegates business support, advice and expertise to arm them with the tools they need whether they are just starting out or are running an existing aesthetics business. We will be announcing speakers and topics for the agenda soon, so keep an eye out on our social media and the Hamilton Fraser website. Buying a ticket to ABC is an investment in the future of your business, and we look forward to welcoming you there.”

For more information and to secure your ticket, visit: www.hamiltonfraser.co.uk/aesthetics-business-conference

Adobe/Jacob Lund Photography

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BUSINESS

FROM KITCHEN TABLE TO CLINIC SHELVES The design, development and launch of a new skincare range, Intradermology Whether you work in aesthetic medicine or not, it is hard to ignore the importance of skincare. We are in a specialism characterised by innovation and the relentless pursuit of excellence. However, as an entrepreneur in this field, the journey from concept to marketready product is often fraught with challenges and triumphs alike. For me, this journey has been a remarkable learning curve, marked by a steadfast commitment to quality, efficacy, and placing our customers and their clients at the core of what we do. I have worked in dermatology, pharma, and aesthetics since 2008, but my first venture into the world of having my own skincare brand began with the idea of WOW facial. I wanted to create a system that helped practitioners build hyper-personalised facials with stages that complemented each other, supported by good training and exceptional service. WOW facial represented the culmination of years of experience in aesthetic medicine and spotting a gap in the market. During its design and development, I began to appreciate the complexities of creating a skincare range from scratch. The lessons learned from developing WOW facial meant lots of mistakes were made and rectified, giving me a strong foundation to start contemplating the development of our latest skincare brand, Intradermology. Initially, I aimed to design a WOW facial retail range, but I realised this would limit its reach. So, I began developing a brand name that captured my goal: high-quality skincare sold in professional clinics and salons that truly improved skin health. WOW facial started at my kitchen table in my flat in West London. When I finally registered as a limited company in February 2019, after I paid the registration fee, I had £9.80 left in my bank account, but I didn’t let that stop me. I spoke to my customers and asked them if they would like to pre-order products in return for lifelong preferential pricing, and surprisingly, I started generating enough income to pay my mortgage and start the development of my new products.

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Working with labs to make small quantities of products and samples that I had to label myself as I couldn’t afford to print huge quantities of packaging, having to learn how to label from YouTube tutorials. Early on, understanding labelling laws and registering products on the CPNP was just the beginning. When I look back to the very early days, I can’t believe how little I knew, but I just had a determination that I was doing the right thing and that I would learn along the way. I was positive I could make WOW facial a decent brand within aesthetics, and every day was a massive leap forward in my learning. I think if I had really understood how challenging it was going to be without the right expertise or financial backing, I wouldn’t have started, but I am so grateful that I did, and now the WOW brand looks very professional and very different to how it did in the early days. Intradermology has been 4.5 years in the making, starting with Russell Turner from RWT Creative to come up with a brand name. I wanted a name that reflected the changes I wanted the products to make within the skin. During a brainstorming session, I kept coming back to the word ‘intradermal’, and Russ suggested Intradermology. I knew immediately that we had our name. I sketched a rough logo, and Russ perfected it. Working with a designer is essential. Russ has an innate ability to take what is in my head and get it onto paper. The first product launched was Synergy 6 NX-GEN SPF. Developed with one of our existing labs, it is more than just an SPF. It includes a pollution filter, a blue light filter, and skin-loving ingredients like vitamin C, vitamin E, squalene, antioxidants, and peptides in a lightweight, wearable formulation. Working on this product and its packaging began after Christmas 2019, with the aim of launching it in March 2020. However, COVID-19 disrupted our plans. With clinics and labs closed, manufacturing was put on hold. This

gave the team and me time to work on training, marketing, and regulatory compliance. Once restrictions were lifted in July, we started manufacturing, and the first 1,000 bottles of Synergy 6 arrived. Our customers loved the product, and selling it to their clients during the lockdown helped sustain our business. Despite the success, the pandemic delayed the launch of the rest of the range. I continued developing the range, focusing on training presentations, marketing, legal contracts with labs, and ensuring compliance. Our operations director, Sarah Brown, insisted on pursuing ISO9001 certification to ensure we worked within a quality management framework. We started this journey and later realised we needed ISO13485 to manufacture the WOW fusion device as a class 2 medical device. We achieved this certification in September 2021. Post-COVID, innovations in active skincare ingredients, delivery mechanisms, and manufacturing processes prompted me to redesign and simplify the range. I stripped it back from 26 products to three washes, four serums, two moisturisers, threenight repair products, Synergy 6, and our eye serum. Working with my formulators, we ensured the products would be effective, user-friendly, and suitable for different skin types and conditions. The final step, I call the ‘slip and slide’, involved perfecting the texture and consistency of the products to ensure they felt good on the skin and that make-up sits well on top of the products, as this is of high importance to me. This can sometimes result in us making up to 4 versions of a product until I am happy. I enlist the team, friends and some customers to test the products and give me feedback so I can get a better overview of the products rather than just my opinion. With the new range finalised, we redesigned all the packaging, reflecting new ingredients, product names, and instructions for use. I decided on a rebrand, creating a new design and colour identity that encapsulated Intradermology’s essence. This lengthy process involved many design meetings and back-and-forth discussions. One of the biggest challenges I find in the entire process is naming the products, and there is one product that I am not happy with, but trying to land on the right name for it would have delayed things further, so for now, I am stuck with it. Ensuring market readiness required navigating regulatory compliance, handled by our in-house regulatory team. They worked on cosmetic safety assessments, PIFs, CPNP and OPSS registrations, stability testing, and designating the UK and EU responsible persons. Post-launch, we conduct post-marketing surveillance and manage complications through our quality management system. Reflecting on the journey from my kitchen table to the launch of Intradermology, I am grateful for the challenges and learnings that have made us stronger and more resilient as a business. The team at Circa Skin are dedicated to ensuring our business runs smoothly and supporting our customers with new products and great service, and I am so proud of them. I will not miss the hard work needed to bring Intradermology to market, but I enjoy the positive feedback from our customers and their clients and watching the brand grow. I look forward to seeing how the range progresses. To find out more about Circa Skin and our products, visit www.circaskin.com or email the team at info@circaskin.com.

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BUSINESS

JUNE 2024 TOPICALS ROUND-UP Adobe/ARTFULLY-79

In this monthly column, Gary Conroy, CEO of 5 Squirrels Ltd, will provide updates on the cosmetic topical landscape. He will focus on regulations, markets, new products, clinical breakthroughs, and scientific findings. The goal is to keep you and your patients informed about the latest developments in topicals, ensuring safety and enhancing treatment outcomes. Stay tuned for valuable insights and updates!

Since 2014, 5 Squirrels have helped skincare professionals to launch their own brand of skincare products and take back control of their business. They have developed an award-winning portfolio of product formulations containing highly concentrated active ingredients to improve the skin’s overall health and appearance. They offer a one-stop shop that makes the whole process simple so you can get on with what you do best - looking after your clients’ skin. If you would like more information about launching your own brand skincare with 5 Squirrels, they can be reached at info@5squirrels.com and www.5squirrels.com.

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The regulatory landscape has been relatively uneventful this quarter, perhaps owing to the significant overhaul of cosmetics regulations in the USA and Canada coming into effect at the end of 2023 and the impact it has had on many US brands’ infrastructure, the UK and EU continue to remain regulatory aligned, in part due to the Northern Ireland protocol and the extension of the CE mark reciprocal agreement. That said, there are some divergencies particularly around animal testing and the use of some ingredients. SPF seems to be under increasing scrutiny from regulators this year. Two common ingredients are already under investigation for safety concerns in the EU, while the USA, Canada, and Australia implement new regulatory pathways for SPFs to support consumer safety and truthful claims. Following a lacklustre 2023 for M&A activity in the cosmetics sector, probably due to high inflation, recession rumours, and interest rate hikes, the market picked up significantly in 2024 and is now forecast to be worth $580 billion by 2027, according to McKinsey. The growth in acquisitions from conglomerates and private equity companies is predicted to accelerate in 2024, and there have already been dozens of large deals so far this year. InCosmetics, the world’s largest exhibition for innovation and sustainability in skincare ingredients took place in Paris in April. Again, the focus this year was on new, safer SPF, more environmentally friendly ingredients, and ingredients to enhance mood and longevity as consumer demand requires feel-good as well as look products to meet their needs.

REGULATIONS Animal testing Defra, the UK Department for Environment, Food and Rural Affairs, has launched a consultation on UK Reach (Registration, Evaluation, Authorisation, and restriction of chemicals) to launch an alternative model to register chemicals in the UK following EU departure, the consultation impacts cosmetics in that, all chemicals previously registered in the EU will need to be re-registered in the UK and around increased protection against unnecessary animal testing. This comes soon after

the EU Court of Justice ruled last year to overrule a complete ban on animal testing in cosmetics. https://consult.defra.gov.uk/reach-policy/ atrm-consultation/ https://www.peta.org.uk/blog/reachsunscreen/ Titanium dioxide (nano) coatings and SPF The EU SCCS (Scientific Committee on Consumer Safety) has launched a draft opinion on the safety of new titanium dioxide (nano) coatings, which may impact some SPF products in the marketplace. Considering all the provided information, the SCCS is of the view that there are a number of uncertainties and data gaps that do not allow a conclusion on the safety of titanium dioxide (nano) coated with a combination of w/w 6% aluminium hydroxide, 18 14% sodium myristoyl sarcosinate and 10% dimethicone (Eclipse 70) - either on the basis of a similarity to the TiO2 nanomaterials previously assessed by the SCCS or on the basis of the additional information provided in the current submission. The provided information has not demonstrated a similarity of the titanium dioxide with the above-mentioned composite coating (Eclipse 70) to other TiO2 nanomaterials assessed in the previous SCCS Opinion (SCCS/1516/13 - Revision of 22 April 2014) in terms of physicochemical characteristics, stability of the coating, and the lack of dermal absorption of the nanoparticles. If these aspects cannot be addressed, additional data on physicochemical, toxicological and exposure aspects specifically relating to the nanomaterial under evaluation (Eclipse 70) will be needed to conclude the safety of its use in cosmetic products. In light of this opinion, clinic owners may want to assess any SPF they stock and its ingredients from a patient safety perspective. https://health.ec.europa.eu/document/ download/db310eb8-f2ee-47a6-b47adf52c692f97c_en?filename=sccs_o_289.pdf EU restricts three new chemicals The EU has restricted three new chemicals often found in cosmetics: cyclotetrasiloxane

(D4), cyclopentasiloxane (D5), and cyclohexasiloxane (D6), often referred to as silicones. These ingredients give cosmetics a smooth finish and feel good on the skin. However, they are highly volatile and may be considered CMR compounds (carcinogenic, mutagenic, or toxic for reproduction) https://eur-lex.europa.eu/legal-content/EN/ TXT/PDF/?uri=OJ:L_202401328 Plastic ban in wipes Defra has notified the World Health Organisation of a draft statutory instrument that will ban the use of plastics in cosmetic wipes in England, including sheet masks. The proposed date of adoption is September 2024, with a full ban from 2026. The ban does not impact the UK’s developed nations, which are responsible for their own legislation. https://www.ctpa.org.uk/news/draftregulations-for-wipes-containing-plastic-inengland-7711 Consultation on the UV filter ethylhexyl methoxycinnamate The SCCS has opened a consultation on the UV filter ethylhexyl methoxycinnamate (EHMC) relating to the consideration of it being a potential endocrine disruptor at concentrations over 10%. A final opinion is due later this year. https://health.ec.europa.eu/latest-updates/ sccs-request-scientific-opinion-ethylhexylmethoxycinnamate-ehmc-2024-03-04_en Restricting cosmetics for minors In the USA, lawmakers are considering restricting the use of certain cosmetics to minors. This comes after the controversy over the last year regarding Gen Alpha children’s demand to look and smell great with premium products and the emergence of the “Sephora Kids.” The proposed bill may ban the sale of skincare or cosmetic products that target ageing concerns. https://beautymatter.com/articles/ california-considers-restricting-youthaccess-to-retinol

BUSINESS MARKETS Estee Lauder acquires Deciem Estee Lauder has completed the acquisition of Deciem (The Ordinary) for $1.7 Billion. The Ordinary was founded by Brandon Truaxe in 2016 with a mission to democratise skincare, Estee Lauder became interested in the brand a year later and by 2019 it was generating $300 million in annual sales. https://www.elcompanies.com/en/newsand-media/newsroom/press-releas es/2024/06-03-2024-114511824 Claims against Amazon UK retailers have filed a £1bn damages claim against Amazon. The claim has been made by the retailers, including some skincare brand owners, for “illegally misusing their data” and “manipulating the Amazon Buy Box to benefit its own commercial operation and its overall revenues and profit” https://www.cosmeticsdesign-europe. com/Article/2024/06/07/uk-retailersfile-a-1bn-damages-landmark-claimagainst-amazon?utm_source=newsletter_ product&utm_medium=email&utm_ campaign=11-Jun-2024&cid=DM1140054& bid=427640964 Puig valued at $13.9bn

https://www.clariant.com/en/Corporate/ News/2023/10/Clariant-agrees-to-acquireLucas-Meyer-Cosmetics-a-leading-providerof-high-value-ingredients-for-th

week%2C%20L,its%20lab%20rather%20 than%20animals.

https://www.beautypackaging. com/contents/view_onlineexclusives/2024-02-16/the-biggestmergers-and-acquisitions-of-the-beautyindustry-in-2024/

Givaudan has launched Neuroglow, a new active that stimulates melanin in the skin. It also gives the skin a healthy glow, an uplifting mood, and positive emotions. The ingredient comes on the back of a new paradigm in skincare, which not only aims to improve skin appearance but also impacts wellbeing by stimulating feel-good factors like oxytocin and beta-endorphins.

SCIENTIFIC Fossil fuels A Danish start-up has raised $4.9m to create the world’s first fermentation platform that could replace fossil fuel material in cosmetics. The new technology could reduce carbon emissions from the extraction and processing of fossil fuels and improve safety due to microplastic production. https://www.cellugy.com/ Animal testing L’Oréal has launched new technology which is claimed to produce “bio-printed skin” which the company claims can improve safety and reduce animal testing https://www.cnbc.com/2024/05/30/lorealsays-its-working-on-a-form-of-bioprintedskin-that-can-feel.html#:~:text=At%20 the%20Viva%20Technology%20 conference%20in%20Paris%20last%20

Neuroglow

https://www.givaudan.com/fragrancebeauty/active-beauty/products/neuroglow Glycostop Beiersdorf has unveiled a new patented ingredient, Glycostop, which inhibits the effects sugar has on the skin through glycation. The company claims that the ingredient N-acetyl-L-hydroxyproline reduces advanced glycation endpoints by up to 68%, preserving collagen and elastin. https://www.beiersdorf.com/ newsroom/press-information/all-pressreleases/2024/04/22-pioneering-anti-aginginnovation-with-a-new-active-ingredienttargeting-sugar-induced-skin-aging.

Puig the family-owned cosmetics company estimated to be valued at $13.9bn who recently acquired Dr Barbara Sturn, have posted an IPO on the Spanish Stock Market at €24.50 per share, the largest Spanish listing for 10 years. The company also own Caroline Herrera and Charlotte Tilbury. The funds will be used to acquire new brands to add to their portfolio. https://www.puig.com/en/newsroom/ puig-begins-trading-on-the-spanish-stockexchanges-1/ Clariant acquiresLucas Meyer Clariant, the Swiss chemical company, has acquired Lucas Meyer, a Canadian cosmetics ingredients business, for $810M. The move increases Clariant’s exposure to active and functional cosmetics, making it a major player in the supply of raw materials to the topicals industry. Adobe/ARTFULLY-79

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2024

Autumn Aesthetic CONFERENCE Thursday 26th and Friday 27th September

Scan the QR code to secure your tickets now! Or visit www.bacn.org.uk/events to ﬁnd out more

BACN AUTUMN AESTHETIC CONFERENCE 2024

26th to 27th September 2024, at the Eastside Rooms, Birmingham The BACN will be showcasing the best in aesthetic nursing and providing expert lectures and demonstrations, as well as offering fantastic networking opportunities with medical professionals. For more information, please visit https://www.bacn.org.uk/events

THE CLINICAL COSMETIC REGENERATIVE (CCR) COGRESS

Thursday 10th October 2024, at the ExCeL London The Clinical Cosmetic Regenerative (CCR) Congress is dedicated to delivering evidencebased education and innovative products to shape the future of medical aesthetics. From injectables and devices to skincare and business. For more information, please visit https://www.ccrlondon.com/

THE AESTHETICS BUSINESS CONFERENCE 2024

Tuesday 8th October 2024, at the Royal College of Physicians, London Hamilton Fraser presents the Aesthetics Business Conference, the dedicated business conference for aesthetic entrepreneurs seeking to establish an aesthetics business or take their existing venture to the next level. In association with Success in Aesthetic Business (SIAB) ABC provides an opportunity for practitioners and clinic managers to learn and network with some of the most influential names in aesthetics. This year, they have partnered with Menopause in Aesthetics (MIA) to cover safeguarding in aesthetics. For more information, please visit https://www.ccrlondon.com/

IAAFA CONFERENCE 2024

24th November 2024, at the De Vere Beaumont Estate, Windsor Every year, IAAFA discusses the latest movements and innovations in the aesthetic industry. Their speakers and lectures are carefully selected and planned out to ensure that you stay up to date with the latest techniques and protocols, as well as gaining the most valuable amount of skills and knowledge possible during the conference, from top industry leaders. For more information, please visit https://www.iaafa.net/

DO YOU HAVE A TRAINING COURSE TO PROMOTE? www.cosmetictraining.co.uk can help you reach your key aesthetic audience. Advertise your training courses, seminars, webinars and other aesthetic events for only £95 + VAT.

Shutterstock/Montri

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Shutterstock/Africa Studio

TRAINING

TRAINING COURSES All the training course listed below and more can be found on www.cosmetictraining.co.uk

FOUNDATION IN WOMEN’S HEALTH Any time | Flexible online access This foundation e-learning course has been developed to give practitioners a basic understanding into women’s health, the role of hormones and current menopause diagnosis and management. This course gives an introduction to bioidentical hormone therapy using the proven “Marion Gluck Method” that will enable medical practitioners to offer a personalised approach to balancing hormones.

THE ART OF AESTHETIC CONSULTATION Any time | Flexible online access Learn how to turn consultations into profitable sales with ConsultingRoom.com’s CPD-certified therapist training. Converting consultations effectively can boost your clinics revenue and save marketing expenses. Empower your therapists and aestheticians to make your clinic more profitable by creating lasting customer relationships. Don’t miss out on potential earnings; invest in your staff now.

TREATMENT GROWTH MASTERY COURSE Anytime Online | Consulting Room Academy Want to convert more consultations into profitable sales? Teach your therapists and aestheticians how to convert more consultations into sales with our CPD-certificated therapist training. FREE for ConsultingRoom.com Members.

HORMONE THERAPIES INCLUDING BHRT Anytime Online | Roseway Labs These online courses teach you how sex hormones affect the female body, how imbalances manifest and how they can be treated with licensed medication, compounded medication (BHRT), supplements and dietary and lifestyle changes. All participants will receive an official CPD certification upon completion.

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