Cosmetic News Uk Sept 2011

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i n d u s try

www.cosmeticnewsuk.com

the uk’s only free of charge medical aesthetics trade magazine

Aesthetic the AwArds night for your industry

Awards 2011 c n

Something in the air

in AssociAtion with osmetic ews

p l At i n u m sponsor

Topical application of Oxygen

Hitting the spot Treating acne in the aesthetic practice

Fractional laser special We take a look at fractional laser systems

also inside this issue of cosmetic News H a n d r e j u v e n at i o n

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U lt h e r a p y

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Business case study

1 st december 2011 • sopwell h ouse • her tf or dshire: The Aesthetic Awards 2011, in assoc iat ion wit h Cosm et i c news

v oice

september

2011

Cosmetic news t h e

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Welcome to the September issue of Cosmetic News.

F

ractional laser skin resurfacing, both ablative and non-ablative, has gained popularity in recent years as it offers comparable results to conventional ablative laser skin resurfacing but with lower downtime. As part of this month’s Special Feature (p12-18) we will be looking at this treatment in more detail and examining some of the best fractional systems on the market. Also in this issue…

Leading skincare experts Mr Paul Banwell and Dr Sam Bunting tell you how to incorporate acne treatment into your aesthetics practice (p31-33), Dr Peter Pugliese examines the topical uses of oxygen (p20-24) and we take a look at the use of skin revitalisation products in hand rejuvenation (p35-36).

We also speak to Mark Grainger from the CHKS about his top tips for registering with Treatments You Can Trust (p46) and find out what a day in the life of Med-fx’s superintendent pharmacist, Peter Smith, is like (p44).

I hope you enjoy this month’s issue!

Aesthetic the AwArds night for your industry

Awards 2011 c n in AssociAtion with osmetic ews

p l At i n u m sponsor

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Cosmetic news C O

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September 04 EDITOR’S CHOICE Vicky Eldridge tries out the FULLfast™ slimming aid 06 INDUSTRY NEWS We round up the latest industry news 10 AESTHETIC AWARDS The latest on the Aesthetic Awards in Association with Cosmetic News, and how you can enter 1 2 - 1 8 S P E C I A L F E AT U R E – FRACTIONAL LASERS We take a look at fractional laser treatments and examine some of the best systems on the market

F U L L f a s t

T M

I have recently been on a bit of a weight loss mission and one of the hardest things I always find about dieting is curbing hunger. So when I was offered to try FULLfast™, a new slimming aid, the efficacy of which has just been proven by a study published in the International Journal of Obesity, I jumped at the chance.

Retailing at £23.95, FULLfast™ is an effective natural slimming aid that helps to increase feelings of fullness and satiety to help you eat less. The innovative food supplement comes in the form of a spray that is sprayed under the tongue (three sprays, five times a day). Already a hit in Italy and the USA, FULLfast’s botanical ingredients work on the hunger centre of the brain,

20 OXYGEN THERAPY Dr Peter Pugliese on the topical application of oxygen

helping to control the excessive feelings of hunger and irritability that come hand-

28 VIEW ON Two US plastic surgeons, Dr Andrew Campbell and Dr Matthew White, give their View On Ultherapy

but too often our battle against excessive hunger undermines our willpower and

31 ACNE Mr Paul Banwell and Dr Sam Bunting on treating acne in the aesthetic practice 3 5 T R E AT M E N T S P OT L I G H T Hand rejuvenation 38 PRODUCT FOCUS The Venus Freeze

in-hand with a diet.

Everyone knows that controlling hunger and cravings is essential to losing weight, impulsive snacking takes over. A study entitled ‘Satiety and amino-acid profile in overweight women after a new treatment using a natural plant extract sublingual spray formulation’ published in the International Journal of Obesity in September 2009 showed that the product may be safely used to treat the problem of appetite control in overweight women during a weight loss program.

FULLfast’s patent-pending formula contains selected botanical extracts of Griffonia, Guarana, Centella Asiatica, Taraxacum, Artichoke and Klamath Algae.

Griffonia extract is a natural source of the serotonin precursor 5-hydroxytryptophan.

Serotonin is one of the most important neurotransmitters of the central nervous system and regulates several physiological functions, such as the feeling of satiety and mood. Klamath Algae physiologically helps to improve mood. The mix of selected extracts contains Guarana, which helps to maintain an ideal body weight and

40 PRODUCT NEWS We round up the latest product news

Artichoke, Centella and Taraxacum to facilitate drainage of the excess of body fluids,

42 ABSTRACTS We round up the latest clinical studies

improving their success.

40 Q&A We chat to Med’fx’s superintendent pharmacist Peter Smith

this clientele.

46 BEST PRACTICE Mark Grainger from the CHKS gives his top tips for registering with Treatments You Can Trust 48 BUSINESS FOCUS We catch up with the winner of Blue Horizon’s ‘win a website’ competition Debbie Brady about setting up an aesthetic clinic on her own 5 2 D AT E S F O R T H E D I A RY Training course, conference and meeting dates 54 DIRECTORY Our guide to the manufacturers, suppliers and business services featured in this month’s issue

which are generally present in overweight people. This well-balanced composition enables FULLfast™ to help people stick more rigorously to low-calorie diets, Many patients coming into medical aesthetics clinics are trying to lose weight and improve the shape of their body so this is a handy little product for clinics to sell to

Meet the Cosmetic News team Charlotte Body Publisher 01268 754 897 charlotte@creativemedialtd.co.uk

Peter Johnson, Art Director 01268 754 897 peter.johnson@creativemedialtd.co.uk

Vicky Eldridge Editor 01268 754 897 M: 07940 083 677 vicky@creativemedialtd.co.uk

Loraine Winter Designer 01268 754 897 loraine@creativemedialtd.co.uk

Emilia Cops Associate Publisher 01268 754 897 emilia@creativemedialtd.co.uk

Shauna Peters Production Assistant 01268 754 897 shauna.peters@creativemedialtd.co.uk

Hollie-Jane Dunwell Account Manager 01268 754 897 hollie.jane@creativemedialtd.co.uk DISCLAIMER The editor and the publishers do not necessarily agree with the views expressed by contributors and advertisers nor do they accept responsibility for any errors in the transmission of the subject matter in this publication. In all matters the editor’s decision is final.

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News - Industry News

Sanofi Divests Dermik Dermatology Unit to Valeant Pharmaceuticals International Inc Sanofi has announced the strategic divestiture of its dermatology business, Der-

concentrate on its growth platforms. “Our strategy is based upon our growth

mik, to Valeant Pharmaceuticals International Inc for $425 million (US).

platforms and innovation,” declared Christopher A Viehbacher, chief executive of-

Valeant is a pharmaceutical company focused on the neurology and dermatol-

ficer of Sanofi. “This divestiture allows us to rationalise our portfolio and improve

ogy therapeutic areas, based in Ontario, Canada. Dermik’s portfolio includes

focus on our core businesses. Our manufacturing operations in Laval and our field

leading therapeutic and aesthetic dermatology brands such as BenzaClin® for the

operations teams will benefit from Valeant’s stronger presence in dermatology.”

treatment of acne, Carac® for the treatment of keratoses and Sculptra®, a facial injectable for the correction of facial wrinkles and folds.

“We are pleased to add another strong dermatology franchise to our growing operations in the US and Canada,” stated J Michael Pearson, chairman and chief

The scope of this transaction includes Dermik assets, which consist of an aesthetic

executive officer of Valeant. “Dermik’s assets, both in the medical and aesthetic

and therapeutic business in the United States and Canada, as well as an aesthetic

therapeutic areas, provide us with exciting opportunities to leverage our com-

business around the world with sales of US $206 million in 2010. Also included in

bined portfolios in our current markets as well as options to expand Valeant’s

the scope is Sanofi’s Laval, Canada site, which includes Dermik’s manufacturing

presence to other territories. Furthermore, the manufacturing facility will provide

facility. Sanofi’s Canadian affiliate, sanofi-aventis Canada, will maintain its opera-

increased capacity for our future growth initiatives in the US and Canada.”

tions in greater Montreal.

The closing of the transaction is subject to customary conditions, including clear-

Sanofi decided to divest its dermatology business with the intention to further

ance by certain antitrust authorities.

Dermapure launches Hop Clinic Essentials Dermapure Skincare Science has launched a new online store, Hop Clinic Essentials, in a bid to help its customers purchase everything they need from one place. Dermapure is the UK distributor of cosmeceuticals and mineral make-up, including DermQuest Skin Therapy, DermaMinerals and Youngblood. Hop Clinic Essentials will enable customers to buy retail products, professional products and clinic accessories at one time, saving time and postage cost. The service will offer high quality medical grade supplies from the simple essentials of gauze, cotton and applicators to more specialist ranges of professional brushes and Pure Rollers. All of the products are also discounted, so clinics will receive the best price on the stock they need. For more information visit www.hopclinicessentials.co.uk.

AZTEC Services is new exclusive UK distributor for Viora

BACN holds AGM this month

AZTEC Services is

The British Association of Cosmetic Nurses

Aston Triangle, Birmingham.

(BACN) will hold its annual conference and AGM

Tickets cost £110 for members or £220 for non-

in Birmingham this month.

members and include a dinner and entertainment

The event will take place on Friday September 16

on the evening of Friday 16. For more information

and Saturday September 17 at the Conference Aston,

visit www.cosmeticnurses.org.

now the exclusive

Inverurie Clinic Marks 5th Anniversary with £25,000 Investment

UK distributor for the Viora range of aesthetic/medical products.

Viora produce a high quality range of products including diamond tip microdermabrasion, mesotherapy, IPL

Anthony Zacharek

and RF systems for a range of treatments and applications.

AZTEC Services is run by Anthony Zacharek, who

6

Inverurie’s Grampian Cosmetic Clinic has

there were three

marked its fifth anniversary with news of a

of us working here

£25,000 investment in additional facilities,

and that number

staffing and refurbishment.

has now doubled

Grampian Cosmetic Clinic employs a specialist team

in a bid to meet the

of six, headed by former Inverurie GP, Dr James Beattie

growing demand

,and former Inverurie Health Centre practice manager

for what we do.

and nurse consultant, Doreen Restall.

The clinic has

Dr James Beattie with Doreen Restall (right) and Clinic Manager Sharon Hanton (left).

As well as re-branding, the cash injection has brought

established a strong

has been in the aesthetic market for many years and

additional treatments to the clinic including new

reputation for its professionalism and excellence and

also works as a consultant for Cynosure UK Ltd. For

equipment for RioBlush Carboxy Therapy and Environ

we anticipate that this investment will play a key role

more information visit the AZTEC Services website at

Ionzyme facials.

in taking the business to the next level as it continues

www.aztecservices.uk.com.

Dr Beattie said, “When we started out five years ago,

to grow organically.”

cosmeticnewsuk.com

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News - Industry News

iiaa team raises money for Cancer Charity Control the pain of cosmetic injections

The team at the International Institute for Anti-Ageing (iiaa)

INSTANTLY

braved the rain to join the 11,000 runners who took part in the

with a clinically proven topical anaesthetic

has helped raise money for Cancer Research UK by taking part in the Race for Life charity event.

The team donned ‘Work Together, Run Together’ T-shirts and 5k run in London.

Their joint running, jogging and walking efforts had already raised more than £700 by the day of the event, with further donations still coming in. iiaa project manager Laura Carrick said, “Cancer has touched so many people we know and this was a fun way to do something

From left to right: Lorraine Miller, Laura Carrick, Louisa Collins, Faye Layton-McCann, Emma Doherty and Pamela Mahoney took part in Race for Life, in London’s Hyde Park for Cancer Research

with our work colleagues and to get everyone who couldn’t come along to support us with donations.”

GRAPESEED EXTRACTS CAN REDUCE THE RISK OF SKIN CANCER

A fast, safe and effective way to help control the pain associated with cosmetic needle procedures For further details and pricing information call

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According to experts it’s often the parts of a fruit that we avoid eating that contain the most potential to help keep us well - from the pith to the skin and seeds.

And according to food experts at the Advanced Nutrition Programme latest research has revealed that consumers who supplemented their diet with grapeseed extracts had a significantly lower risk of getting skin cancer.

The research, published recently in the Journal of the American Academy of Dermatology, examined the supplement consumption habits of 830 people within an epidemiological study - a large scale investigation which can reveal patterns in health characteristics or behaviour that may influence preventative health policies.

The researchers matched 415 people who had skin cancer with 415 control group individuals of equivalent age, race, gender and other factors, who did not develop the disease. As well as the grapeseed extract discovery, they also established that taking a multivitamin supplement was linked with a borderline significant reduction in the risk of skin cancer.

Grapeseed extract fights oxidative stress from UV radiation and has anti-inflammatory and antioxidant properties which inhibit the damaging processes which lead to skin ageing. Grape seeds contain molecules associated with various health benefits, called polyphenols, which include flavonoids and proanthocyanidins, which are richer in antioxidant

potency than vitamins E and C. Previous research has also shown grapeseed extract’s protective effects on collagen and against sun damage.

Lorraine Perretta, nutritional consultant at the International Institute for Anti-Ageing, said: “This new examination of the skin protective influence of grapeseed extract strengthens the case for taking supplements in addition to the fruit and vegetables we eat as a matter of course.”

Grapeseed extract is one of the key ingredients found in Skin Defender, a supplement made by the Advanced Nutrition Programme, a brand created by Patrick Holford to support anti-ageing skincare and wellbeing regimes.

Skin Defender capsules (£33.50 for 60) contain selected vitamins, minerals and plant nutrients, including grapeseed extract, lycopene, green tea extract, curcumin extract, limonene and beta glucans. These support the skin’s natural defences when exposed to sunlight. Studies have demonstrated that these nutrients can not only reduce sunburn, which can lead to cancer, they also boost production of collagen.

The Advanced Nutrition Programme range of skin supplements are available from health and beauty practitioners nationwide: phone 020 8830 8030 for details of nearest stockists, or visitwww. advancednutritionprogramme.com for more information about the range.

Last Chance To Nominate!

Aesthetic the AwArds night for your industry

EUROMEDICAL SYSTEMS LIMITED

T: F: E: w:

01949 838 111 01949 838 844 info@euromedicalsystems.co.uk www.euromedicalsystems.co.uk

With the Aesthetic Awards 2011 steadily approaching

will be announcing the short lists

the last chance to enter is Tuesday September 13th, so

for the Aesthetic Awards. The

there has never been a more important time to make

winners of the Aesthetics Awards

your nomination count! We have had an astounding

will be announced at the lavish

response from the industry so far and would like

prize-giving ceremony taking

to thank everybody who has taken the time to cast

place on Thursday 1st December 2011. The social highlight

their vote. Charlotte Body, Publisher of Cosmetic News

of your calendar will take on a ‘James Bond’ theme, with a

comments “ We are delighted with the reaction and

wonderful a la carte dinner, followed by a DJ and casino to

feedback from the industry for the first ever Aesthetic

keep you entertained.

Awards, we feel this is an excellent opportunity for our

If you wish to book a seat please contact Hollie Dunwell, on

readers have their say.”

01268 754 897 or email hollie@creativemediltd.co.uk - There

Be sure to read the October edition of Cosmetic News, as we

is limited availability.

Awards 2011 c n in AssociAtion with osmetic ews

p l At i n u m sponsor

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fo EW ra dv the an E ce lite d M ha P ir X l re a m se ov r, al

Be Transformed

With the preferred partner of the aesthetic industry.

Demand for skin, hair and body treatments in the aesthetic laser market is experiencing record growth. By 2012, the number of annual procedures being performed is expected to more than double.* That’s not just mere potential —it’s unprecedented opportunity. With Cynosure, you can make the most of it. Our multi-application laser workstations and comprehensive business support systems are designed to transform practices, as well as patients.

Visit www.cynosureuk.com today to start transforming yours.

www.cynosureuk.com | info@cynosureuk.com | +44 (0)1628 522252 Cynosure UK, The Old Barn Offices, Lower Mount Farm, Long Lane, Cookham, Berkshire, SL6 9EE *Source: InMedica Research 2008

AAwards esthetic 2011

The Aesthetic Awards 2011 - Event Preview

the awards night for your industry

p l at i n u m sponsor With the deadline for entries to the inaugural Aesthetics Awards in association with Cosmetic News fast approaching, we tell you how you can enter scoop one of the industry’s most coveted prizes…

The entries for the inaugural Aesthetics Awards in association with Cosmetic News are coming in thick and fast and, with the closing deadline just weeks away, you need to move quickly to make sure you don’t miss out on winning. With a total of 25 categories, the awards have been designed to acknowledge those who have

gone that extra mile over the last year. Gold, silver and

in association with Cosmetic news

The categories are: INDUSTRY AWARDS Sales Representative of the Year

This award is designed to acknowledge the hard work and services provided by sales reps working for manufacturers and suppliers in the UK. Lifetime Achievement Award Award Sponsored By

This award will recognise the achievements of people who have had a long and fruitful career in the aesthetics industry.

bronze awards will be given in each category to the

Services to the Industry

top three nominees.

This category will award an individual who has gone above and beyond in their services to the industry. .

Entering yourself or one of your colleagues into the awards could not be easier. Simply go to www. cosmeticnewsuk.com and download as many entry forms as you need from there. You can enter yourself or nominate someone else in as many of the categories as you would like. Entries must be received by Tuesday September 13. The shortlisted nominees will be announced in the November issue of Cosmetic News.

The awards will be presented at a glamorous James Bond themed gala dinner at Sopwell House in St Albans on Thursday December 1 2011 and will be a chance to celebrate the achievements of everyone working within the arena of medical aesthetics.

THE CLOSING DATE FOR ENTIRES IS TUESDAY SEPTEMBER 13. GO TO WWW.COSMETICNEWSUK. COM TO DOWNLOAD YOUR ENTRY FORM TODAY. Please call Emilia Cops on 01268 754 897 or e-mail Emilia@ creativemedialtd.co.uk if you have any further questions about submitting your entry

Rising Star

Award Sponsored By

cosmeticnewsuk.com

that has gone above and beyond in 2011.

Best Clinic (four rooms or more)

Best Advertising Campaign by a Manufacturer/Supplier

This award will be open to any large clinic in the UK with four or more treatment rooms.

Best Clinic (three rooms or less)

This award will be given to the manufacturer/ supplier with the most memorable and effective UK advertising campaign.

This award will be open to any small clinic in the UK with three or less treatment rooms.

Distributor of the Year

Best Mobile Practitioner

This award is designed for any UK distributor of aesthetic products or systems.

This award will recognise the achievements of solo practitioners.

Best Clinic Website

Best Clinic Customer Service

This award will be given to the clinic in the UK with the best customer service as judged by ‘mystery shoppers’.

This award will be presented to an up and coming practitioner who may not have the longevity of some of their colleagues but who has made an impact in their field.

Best Customer Service by a Manufacturer/Supplier

Best Clinic Chain

Association of the Year

This award will be open to all clinics who have

This award will be presented to the association

This award will be given to the manufacturer/ supplier with the best customer service as judged by their customers.

The most easy to navigate and informative clinic websites will be awarded in this category.

Speaker of the Year

Anyone who has given a lecture at a UK conference or educational meeting will be eligible for this award. The winner will be the person judged to have given the best presentation in 2011.

Clinic Receptionist of the Year

This award will go the member of clinic front of house staff who has excelled in 2011.

PRODUCT/TREATMENT AWARDS Best Product Innovation

The most innovative new products on the market will be recognised in this category.

Best Newcomer

Manufacturers/distributors of any new product launched in the UK market since the beginning of 2011 can enter this category.

Cosmeceutcial of the Year

This award will go to the best cosmeceutcial product range in the UK, as voted for by the readers of Cosmetic News.

Consumer Award Sponsored By Choice Award for Best Product

This award will go to the best product in the UK as voted for by 10

a chain of practices in the UK.

consumers via the Cosmetic Surgery and Beauty Guides.

treatment for the face, as voted for by the readers of Cosmetic News.

Consumer Choice Award for Best Treatment

Treatment of the Year (Body)

Award Sponsored By

This award will go to the best treatment in the UK as voted for by consumers via the Cosmetic Surgery and Beauty Guides.

Injectable Product of the Year

Manufacturers/distributors of injectable dermal filler products available in the UK will be eligible to enter this category.

Treatment of the Year (Face)

This award will be given to the manufacturer/supplier with the best

This award will be given to the manufacturer/supplier with the best treatment for the body, as voted for by the readers of Cosmetic News.

Best Selling Retail Product

Clinics will be able to vote for their top selling retail product in this category.

Equipment Brand of the Year

Manufacturers of lasers, IPLs and any other equipment brand can enter this category.

AAwards esthetic 2011 the AwArds night for your industry

in AssociAtion with cosmetic news

p l At i n u m sponsor

1 december 2011 st

• sopwell house • hertfordshire • call 012 6 8 7 5 4 8 9 7 o r e m a i l hollie@ cr eati v em ed i altd . co. u k to boo k y o u r tabl e

Special Feature - Fractional Lasers

The perfect equation We take a look at fractional lasering and examine some of the best products on the market

Fractional laser skin resurfacing, both ablative and non-ablative, has gained popularity in recent years as it offers comparable results to conventional ablative laser skin resurfacing but with lower downtime.

Laser treatments have dominated the non-surgical aesthetic facial

damages parts of it, leaving areas of undamaged skin in between.

rejuvenation industry over the last decade because of their impressive

As such, during fractional treatments, only microscopically small areas of

results in treating a variety of skin concerns. However the downside of

the skin surface are ablated. After treatment small dot-like marks can often

traditional laser resurfacing has always been its side effects and substantial

be seen on the areas of skin that have been treated. This method of only

recovery period. In recent years fractional laser resurfacing has changed

causing ‘fractional’ damage to the skin allows for much faster skin healing

all that by offering patients comparable results with less side effects and

than with traditional laser, which is why the downtime is significantly

minimal downtime.

reduced. Additionally, the risk of side effects such as pigment changes or scars is drastically reduced and the thermal stimulation leads to a neo-

The process of using a laser light source to target a selected area of the

synthesis of collagen in deeper skin layers.

skin in order to cause a wound healing response is known as ‘selective photothermolysis’. ‘Fractional photothermolysis’ does the same thing

On the folowing pages, we round up some of the best fractional

however, rather than damaging the whole of the selected area, it only

systems on the market….

Syneron/Candela (ePrime/CO2RE/eMatrix) A high demand for increased safety and reduced downtime was the driving force behind the research and development department at Syneron/Candela developing three exciting new fractional devices. A deeper understanding of the mechanism of neo-collagenesis and neo-elastogenesis, along with an increased experience of working with existing technologies, has helped to reduce the risks of PIH (Post Inflammatory Hyperpigmentation) and also increased knowledge about the amount of energy to deliver into skin and at which specific level.

12

cosmeticnewsuk.com

ePrime

from the heat as the upper section of the needles are

Skin healing after any treatment is the basis of skin tightening

insulated. Thus, a high dermal temperature can be achieved

and energy based volumisation procedures. As the skin

to obtain the desirable results without any fear of heat

heals there is a complex sequence of events set in place,

damage to the epidermis. This is a very important feature of

demonstrated immunohistochemically in a recent study

ePrime that offers a distinct advantage over other treatments.

on the new ePrime device, which tracked the production of

Moreover, ePrime is the first technology to demonstrate neo-

collagen chaperones HSP47 and also demonstrated increases

collagenesis and neo-elastogenesis in human skin following

in tropoelastin and fibrilin for the first time.

radio-frequency treatment.

This innovative, minimally invasive micro-needle procedure

Dr Henry Chan, Hong Kong Dermatology and Laser Centre,

delivers measured controlled radio-frequency energy directly

stated at the recent IMCAS meeting in Asia: “It has been

into deep dermis to cause dramatic results after just one

demonstrated that results from a single ePrime treatment are

aesthetic treatment.

equivalent to 37% of a surgical face-lift procedure. Plus, there

ePrime is unique in that the treatment can induce a 1-2mm

is no risk of adverse effects and complications associated

deep dermal injury at a temperature as high as 70-72

with the invasive surgical procedure. Thus ePrime has

degrees which is maintained for four seconds. This produces

established a valuable option for improving facial skin laxity

significant dermal damage to stimulate the formation and

with minimally invasive fractional radio-frequency treatment.”

deposition of elastin and collagen.

According to Dr Chan, “The dramatic treatment effects of

The system utilises a micro-needle electrode array

ePrime may be attributed to the peak temperature achieved

comprising of 32-gauge needles, which are inserted into the

and the time for which it is maintained. The treatment

skin at a 20 degree angle to deliver radio-frequency directly

produces not only improved skin tone and volume, but also

into deep dermis. While doing this, the epidermis is protected

enhances skin elasticity, pliability, and extensibility.”

There are many practical advantages associated with the use of ePrime for increasing dermal volume. “All skin types can be treated with this device, which is indicated for use on the lower face and submandibular areas, so far. Moreover, a single treatment, lasting about 20−30 minutes, is required for visible improvement, and the social downtime is just two to three

Multi-functional Alexandrite, KTP and Nd:YAG Laser platform

days. Treatment effects are visible after three months, becoming more pronounced after six months and persisting for up to two years without the need for any maintenance treatment.

One of the revolutionary features of ePrime is the Intelligent Feedback System™ (IFS) that ensures treatment consistency.

“Because of IFS, the system automatically makes real-time adjustments in energy, based on skin resistance and measured tissue temperature to achieve the target temperature and time set by the physician. This helps in preventing over- and under-heating and treatment variation,” remarks Dr Chan.

In addition, IFS further improves patient comfort by allowing physicians to use local anaesthesia to manage pain associated with the procedure, which may not be possible with non-invasive monopolar radio-frequency devices.

CO2RE While many fractional devices have come to the market in recent years, Syneron/Candela’s CO2RE CO2 system provides advantages for treating conditions such as deep rhytids, pigment disorders such as, actinic damage, lentigines and scars including acne scars. What makes CO2RE so special is that it is the only system on the market with the ability to treat both superficial and deep skin layers simultaneously. In addition, it can be safely used in a large variety of patients. CO2RE is ideal for treating patients with Fitzpatrick skin types I-III, but the system can also be used in those with skin types up to VI. CO2RE’s six operating modes provide physicians with multiple treatment options.

These include four fractional ablative modes for aesthetic treatments (CO2RE Light, CO2RE Mid, CO2RE Deep and CO2RE Fusion), a classic resurfacing mode and an incision/excision mode. These attributes impart versatility to the device not observed with purely fractional systems. CO2RE offers the choice to select a treatment parameter from the different ablation modes as per patient needs.

These are pre-programmed, helping in better time management. The digital and radio-frequency-excited super pulse delivers higher peak power ablative energy per pulse than standard lasers and allows deep skin ablation without the undesirable damage due to overheating. Moreover, sufficient energy is provided per shot for ablation, and each ablation depth is reproducible which avoids unnecessarily deep ablation. These treatment parameters lead to improved treatment

LIGHT SERIES APPLICATIONS Hair removal Pigmented lesion Vascular treatments Skin rejuvenation

precision, short downtime and reduced patient discomfort.

FEATURES

eMatrix

Large spot sizes Integrated cooling Complete solution in system Outstanding clinical results Cost effective system

eMatrix technology is based upon sublative rejuvenation, a treatment category that results in bright, wrinkle-free, and smooth facial skin.

This treatment involves delivery of bipolar fractional radio-frequency to cause minimal epidermal and a high percentage of deep dermal damage. This induces rapid healing while providing strong new collagen formation and restructuring. The epidermal sparing technology of eMatrix gives it an upper hand over non-ablative fractional therapies. To obtain optimal results, traditional non-ablative fractional treatments need to induce a high percentage of damage at the dermal-epidermal junction, which is an area rich in melanocytes. As a result of the high epidermal coverage, these treatments have an increased risk of intense melanocyte inflammation and consequently post-inflammatory hyperpigmentation (PIH). However, sublative treatments are associated with minimal damage at the dermal-epidermal junction while causing high percentage of dermal damage.

Thus, there is very low risk of PIH and the level of clinical benefit is high.

For more details or to arrange a demonstration call or visit.

Tel 01477 536977 Web www.lynton.co.uk

The unique laser platform featuring 3 lasers for removal of all tattoo colours

ABC Lasers (Pixel/Pixel CO2 OMNIFIT) The Harmony XL™ I-Pixel™ Laser provides a unique IN-MOTION fractional delivery which is the world’s first of its kind and provides quicker and more consistent treatment results than other lasers.

The i-Pixel™ Laser is Alma Lasers’ fastest and most powerful laser module. Designed for use with the Harmony XL and with Pixel CO2 Platform, the i-Pixel™ Laser speeds up treatment time while delivering greater results for skin rejuvenation, skin tightening, skin resurfacing and the improvement of lines and wrinkles. The i-Pixel™ Laser rests on 2 small wheels at the tip of the module which roll across the patient’s skin. Unlike traditional CO2 lasers which use a stamping or scanning technique, the i-Pixel™ Laser allows you to treat the targeted area with high speed and elegant efficiency. Compared to ANY other fractional lasers, the i-Pixel™ Laser can significantly shorten treatment time and reduce recovery time.

The i-Pixel™ Laser releases (4Hz) 4 laser pulses per second that are split into a single row of 7 pixels as it glides over the treatment area. Compared to a stationary module, where the laser is dispersed in a 7X7 or 9X9 pattern, the energy per pixel of the i-Pixel™ Laser is up to 10 times more powerful. The greater power of the i-Pixel™ Laser means enhanced ablative and thermal damage and improved results for you and your patients.

The fine spacing in-between the 7 pixels minimizes the treatment area by forming a reservoir of skin that remains undamaged by the laser, thereby improving results and reducing patient down time by allowing the tissue to heal and collagen to strengthen.

Courtesy of Hospital West Midlands, UK ABC Harmony i-Pixel Laser BEFORE

BEFORE

after

AFTER

Courtesy of Shadi Danin Group of Clinics UK ABC Harmony i-Pixel Laser

Lynton (MATISSE)

Q-PLUS APPLICATIONS Epidermal and dermal Pigmented lesions Multicoloured tattoo removal including green.

FEATURES High Power LCD easy to read display Compact and robust Optibeam technology Fast and effective treatments

For more details or to arrange a demonstration call or visit.

Tel 01477 536977 Web www.lynton.co.uk

MATISSE is a state-of the-art 1540nm Er:Glas fractional laser platform for skin resurfacing and rejuvenation. This wavelength easily penetrates into the deeper layers of the skin, and, thanks to the minimal absorption of melanin at this wavelength, it can be used safely on all Fitzpatrick Skin types. MATISSE technology works via an extremely precise fractional photothermal interaction with the skin, enabling uniform skin regeneration and dramatic clinical improvement with minimal downtime.

Adding to the platform an optional high power Alexandrite Laser, the ‘gold standard’ for hair removal, results in a combined system with unparalleled treatment and revenue earning possibilities.

MATISSE can be used for fractional skin rejuvenation, photo-ageing, scarring and dyschromia treatments. It greatly improves overall skin texture, tone and laxity. Clients benefit from a natural, rapidly occurring

healing process as the untreated areas form a bridge between treated zones, leading to minimal ‘downtime’ following treatment, all achieved without compromising results.

Using a special micro lens array, MATISSE produces an intense concentration of laser energy in well-defined micro-thermal spots (MTS). The skin is rapidly heated inside the micro-thermal areas, producing tiny columns of damage. The surrounding areas of skin undergo a diffuse thermal effect, which stimulates collagenesis over the entire treated area.

MATISSE fractional treatments combine skin resurfacing with non-ablative dermal re-modelling. The combination of these two actions produces new dermal tissue in the treated areas and achieves dramatic results without downtime and with minimal risk to the patient. No anaesthesia or gel are required thanks to the use of an integrated skin cooler. This ensures fast and pain-free treatments.

Cynosure (Performa CO2) The Cynosure-Performa CO2 laser has been coined the ‘ice-hot’ laser as it uses a new aircooling system (Cynosure Smart Cool), which utilises cold air to cool down the skin, and deliver radical results in just one treatment.

Because it cools the skin prior and post lasering, it helps to lessen bruising, redness and thermal damage with speedier recovery.

In addition, the Cynosure-Performa CO2 has been designed to penetrate the skin’s tissue without damaging the surrounding area, delivering a less aggressive procedure that’s kinder on skin and without the aggressive

or painful side effects of previous CO2 lasers.

It is very powerful but much softer on skin, with a dramatic reduction in redness, thermal damage and downtime for the patient.

The ice-hot laser accurately helps to maximise the skin’s untouched tissue to heal more quickly. By selecting fractional technology, the size and shape of the laser used is determined by the person’s facial shape. This enables the skin to be treated in small micro-ablative areas, controlling the wave.

The Cynosure-Performa can be used to treat severe acne scarring, fine lines and wrinkles, pigmentation from sun damage, and surface lesions.

Results You Can RelY on BEST EUROPEAN LASER DISTRIBUTOR

“The ultimate in combination laser and light therapy for face, hands and body to optimize results.”

InnovatIve technology Safe, effective treatments with the industry’s most dynamic product portfolio, distinguished by expandable modular platforms that adapt to your changing needs and future breakthroughs.

Before

Before

After

Mini 360 Protocol for the face and neck Photos courtesy: James Chan, MD

After

Before

AFT 570 SR

Photos courtesy: Fernando Stengel, MD

After

Pixel Laser

Photos courtesy: Amber Brown, MD

Multiple technologies can be combined during a single session or repeated frequently and spread out over 60 days.

• When performed in a single treatment session, the Mini Laser360TM program consists of AFT for pigment and vascularity, ST for skin tightening, and Pixel for fractionated skin resurfacing.

• The Traditional Laser360 treatment consists of 4-6 treatment sessions, layering multiple technologies (AFT, ST and Pixel), spaced about 10-15 days apart over a 60-day period.

Pixel ST

Before

AFT

After

Before

AFT 420 Acne

Photos courtesy: Elizabeth VanderVeer, MD

Before AFT 540 VP

After

Photos courtesy: Elizabeth VanderVeer, MD

After

Pixel Laser

Photos courtesy: Bhupendra Patel, MD

Before

After

Tattoo Removal - Photos Courtesy: Fernando

Urdiales, Instituto Médico Miramar, Málaga , Spain

ContaCt us on: tel: 0845 1707788, info@a-b-c-uk.com, www.abclasers.co.uk

Before

After

Traditional Laser360

Photos courtesy: Rick Jackson, MD

WINNER - UK BEST LASER SUPPLIER 2008-2009 As voted by clinics

The leading fractional laser platform for dramatic skin rejuvenation & resurfacing

Cutera (Pearl Fractional/Pearl Fusion) Pearl Fractional is a fractional ablative laser with YSGG (2790nm wavelength) technology. This exclusive laser wavelength was selected to maximise results and safety while minimising downtime – all in a single treatment – through an optimised combination of ablation and coagulation. Pearl Fractional’s YSGG laser aggressively treats the signs of photo-ageing, deep dermal imperfections and difficult-to-treat perioral and periorbital areas.

Optimal treatment results demand both deep ablation and thermal coagulation. Moderate levels of coagulation are needed to minimise operative bleeding, but healing times and related risks of complications increase with excessive zones of thermal coagulation. Therefore, the ideal device combines deep ablation with controlled thermal coagulation to maximise results while minimising downtime. Due to its specific water absorption characteristics, YSGG is the only laser wavelength capable of providing the dual benefits of deep dermal ablation with a controlled zone of coagulation, according to the manufactuers.

Dr Richard Green says, “Pearl Fractional was specifically designed with the YSGG wavelength to combine the clinical advantages of both CO2 and Erbium without the recognised limitations long associated with both lasers. YSGG is an extremely versatile laser wavelength that can be tailored to safely and predictably address dermal imperfections even in the difficult-to treat peri-oral and peri-orbital areas.”

Brian Biesman, MD adds, “Pearl Fractional is especially good for treating the peri-orbital, peri-oral and jaw-line areas.

When combined with the Pearl laser for full epidermal renewal, I have a unique solution for a deep and full coverage treatment. My patients are thrilled to see improvements in their wrinkles, uneven skin texture, pigmentation and sun damage.”

Pearl Fusion combines Pearl and Pearl Fractional for full epidermal coverage and deep fractional ablation.

Indications include wrinkles, fine lines, dyschromia, pore size, skin tone and texture.

Cutera’s novel wavelength, YSGG (2790nm) optimises patient comfort and healing and enables the combination of confluent resurfacing with deep fractional ablation.

MATISSE APPLICATIONS Rejuvenation of the face Scars & stretch marks Body rejuvenation Wrinkles Pigmentation Hair removal

FEATURES Meets the demand of the 2 most sort after laser treatments Gold standard Alexandrite laser Integrated skin cooling Sliding or Stamping technique High patient satisfaction

For more details or to arrange a demonstration call or visit.

Tel 01477 536977 Web www.lynton.co.uk

Fraxel™ (Solta Medical)

laser is an aggressive treatment for moderate to

The first Fraxel device to be launched onto the market

severe photodamage. The hand-pieces for the Fraxel

was the Fraxel™ SR followed by the Fraxel™ SR 1500.

SR, SR 1500, re:fine and re:store are designed to glide

Solta Medical has subsequently developed a range

comfortably across the skin and use patent pending

of Fraxel devices for various indications including the

technology called the Intelligent Optical Tracking

Fraxel Re:fine™, Fraxel Re:store™ and Fraxel Re:pair™.

System (IOTS), which ensures that the laser creates a

Fraxel Re:fine™ is a non-ablative treatment which

consistent pattern of treatment by self-adjusting to

delivers a gentle yet effective option for skin

the speed of the operator. The Fraxel re:pair carbon

rejuvenation and resurfacing. The Fraxel re:fine

dioxide laser fires a 10,600nm wavelength and is,

erbium fibre laser fires a 1410nm wavelength which

according to the manufacturer, “the only CO2 laser on

is designed for superficial treatments at lower energy

the market that delivers the efficacy of conventional

levels. It targets water in the tissue and not melanin

bulk ablative lasers – without the prolonged

(skin pigment) and can treat up to 650 µm deep into

downtime, risks or complications”.

the dermis of the skin on all skin types (colours).

The Fraxel SR, SR 1500, Fraxel re:fine and Fraxel

Fraxel re:store™ is a non-ablative treatment for skin

re:store machines were awarded clearance by

resurfacing and rejuvenation. The Fraxel re:store

the US Food and Drugs Administration (FDA) for

erbium fibre laser fires a 1550nm wavelength, much

dermatological procedures requiring soft tissue

like the original Fraxel SR and SR 1500 devices, which

coagulation; for the correction of peri-orbital wrinkles

is deep penetrating, also targeting water in the tissue

(crow’s feet) and pigmented lesions, including age

and not melanin. In addition the device is available as

spots, sun spots and skin discolouration; for skin

the Fraxel re:store Dual, which, as well as the 1550nm

resurfacing and for the treatment of melasma, (dark

erbium fibre laser also includes the option for the

skin colouration which forms on sun exposed skin).

practitioner to use a more superficial thulium fibre

Fraxel re:pair is cleared by the FDA for ablation and

laser which fires a 1927nm wavelength, allowing for

resurfacing of soft tissue, rhytides, pigmented lesions,

treatment of a variety of conditions, on all skin types

wrinkles, fine lines, furrows and textural irregularities.

and anywhere on the body.

It is also the only fractional ablative device with FDA

Fraxel re:pair® is an ablative treatment using a CO2

clearance for vascular dyschromia.

Discover The Light

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The elure™ Promise • Unique scientific discovery • Proven faster, safer, more visible results • Revolutionary patented formula • Melanozyme – a safe, naturally occurring enzyme • Hydroquinone free, dermatologist tested, clinically proven • Healthier, brighter, younger looking skin

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t h e u k ’ s o n ly free of charge aesthetics exhibition

Before China Clinical Trial

After (Day 28)

Before

After (Day 28) Courtesy: Tess Mauricio, M.D.

Coming soon to the UK! Sold exclusively through physicians. www.elureskin.com, info@elureskin.com, www.facebook.com/elureskin © 2010 . All rights reserved. Syneron, the Syneron Logo, and elure are trademarks of Syneron Medical Ltd. and may be registered in certain jurisdictions. PB74971EN

Sciton (ProFractional) ProFractional is Sciton’s solution for achieving excellent resurfacing results with minimal

The UK’s Leading Laser Manufacturer

downtime. Unlike full field resurfacing, which removes the entire surface area of a treatment site, ProFractional ablates narrow-diameter channels into the skin, covering a fraction of the total treatment area. This action initiates the body’s wound healing response, which stimulates fibroblasts to produce new collagen and elastin, while leaving the surrounding tissue intact for rapid healing. The benefits of ProFractional include increased patient comfort, shorter healing times, and tunable results that can range from subtle to dramatic.

ProFractional utilises a 250µm spot size and offers a range of treatment densities from 1.5% to 30% coverage. ProFractional-XC utilises a 430µm spot size and predefined treatment densities for greater speed.

ProFractional-XC also provides the ability to add depth-selectable tissue coagulation for enhanced collagen remodeling.

WHY LYNTON? • Our lasers and IPLs are designed and constructed by leading scientists in the field of optical physics • Dedicated marketing team to help grow your business • On-going clinical support for life • We have the largest team of technical and specialist support in the UK

“ProFractional creates clean, micro-ablated channels in the skin, which activate fibroblast production and rejuvenate the collagen matrix. The result is the formation of new collagen and elastin, which combine to bring increased turgor and thickness to the skin.

Leaving surrounding tissue intact helps promote rapid healing due to presence of stem cells and melanocytes in the papillary dermis.”

ProFractional creates clean, micro-ablated channels

by water, CO2 lasers have lower ablation efficiency

in the skin, which activate fibroblast production

and therefore, unavoidably, conduct a significant

and rejuvenate the collagen matrix. The result is

amount of heat into the tissue.

the formation of new collagen and elastin, which

combine to bring increased turgor and thickness

Erbium’s high water absorption is only part of the

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Topical Application of Oxygen

S omet hing in the ai r

Dr Peter Pugliese on the practical use of topical oxygen

This article has been written to provide the aesthetic practitioner with a working knowledge of oxygen as a therapeutic modality. It is important to understand that oxygen is not a miracle remedy; it is, however, a very effective agent to treat many skin conditions that the aesthetician sees almost daily.

A

Dr Peter Pugliese Dr Peter Pugliese is a biomedical consultant to the cosmetics and pharmaceutical industries. His major research interest is normal skin physiology and mechanisms of skin ageing.

He brings more than 50 years of knowledge and experience and has gained an international reputation as a respected authority in the research areas of ageing skin and longevity.

He is a member of the American Academy of Dermatology, the Society of Investigative Dermatology, and the Society of Bio-engineers of the Skin, the American Chemical Society and the Society of Cosmetic Chemists. He has written more than 60 scientific papers, given more than 100 world-wide presentations at scientific meetings, has contributed more than ten chapters to scientific texts, and has published five books including Physiology of the Skin Iand II and the new edition of Advanced Professional Skin Care – Medical Edition. He is on the board of the American Aaestheticians Education Association as director of medical aesthetics.

lthough this article won’t go into great detail

Oxygen and energy

about the science of oxygen or free radical

With the advent of oxygen in the atmosphere, cells that were

theory, it will touch on these topics lightly,

able to adapt to the presence of oxygen made great use of it

as well as what skin conditions respond best

as part of their energy systems. All energy on Earth is derived

to oxygen and why. The conditions to be

from the sun, in one form or the other, but humans’ biological

covered include oxygen use in the treatment of acne, rosacea

energy comes indirectly from plants. Plants synthesize sugars

and ageing skin.

via photosynthesis, people then eat the plants and break down the sugars to release biological energy in the form

Oxygen in the atmosphere

of adenosine triphosphate (ATP). Don’t worry about all the

About two billion years ago, oxygen first appeared in the

steps involved, just remember that oxygen is essential for

atmosphere as a by-product of single-cell metabolism.

that process to occur. A large amount of the oxygen used by

These creatures ran out of the initial food-stuff in the

the skin passes into the skin from the atmosphere. A critical

oceans and had to synthesize their own food. Three raw

point to remember is that oxygen must diffuse into the skin

materials were available to them: water, air (carbon dioxide)

and then down to the basal layer of the epidermis. Although

and sunlight, and from these, they synthesized sugars, or

a certain amount is used by the upper layers of the epidermis,

carbohydrate compounds. Water was split into hydrogen

the basal layer consumes most of the epidermal oxygen. Why

and molecular oxygen; carbon dioxide was split into cabon

is this important? Without the ability to get the oxygen into

and oxygen; and the sun, in the form of photons, supplied

the skin first and then down to the basal layer next, it would

the energy necessary to do all this work. Although the

not make any sense for oxygen to be used as a therapeutic

details are a fascinating read, this is not the place to go

modality. Diffusion laws are complex and the physics are a

into depth with them. One important fact that you need

bit stiff. but you really do not need to know all of that to be

to know is that this process produced a lot of molecular

able to use oxygen effectively. There are three conditions that

oxygen in the form of O2.

respond to oxygen therapy: acne, rosacea and ageing skin. For

Now keep in mind that all the organisms on Earth this time

each of these biological disorders, the underlying pathology

lived with oxygen (anaerobic), so oxygen became toxic to

must be examined in order to appreciate and understand the

them and many hundreds of thousands of species died

role of oxygen in the treatment process.

because of the toxicity of atmospheric molecular oxygen.

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Some species obviously adapted to the presence of oxygen

Acne vulgaris

and survived, otherwise people would not be on the planet

The pathogenesis of acne vulgaris is characterised by four

today. These species had mitochondria, which enabled

factors. Follicular epidermal hyperproliferation is the first

them to make maximum use of oxygen as an energy

and is associated with subsequent follicular plugging. Next

source along with the sugars. The take-home lesson here

is the overproduction of sebum, with the third factor being

is that oxygen is essential for life, and it became involved

the anaerobic bacteria Propionibacterium acnes (P.acnes),

in the development of humans during the course of many

which is associated with the fourth factor, inflammation. The

millions of years in many ways. Even today, not every

aesthetician needs to appreciate these and know how to

biological function of oxygen is known.

contend with each.

•

Epidermal hyperproliferation

Starting with the formation of adrenal androgen before puberty, the sebaceous follicle is triggered to proliferate and is followed by the plugging of the follicle. It is believed that the adrenal hormone dehydroepiandrosterone (DHEA) is the cause of this early manifestation of acne because the appearance of comedones is first noticed during this time. It requires the presence of androgen receptors in the follicle to form a comedone, since those individuals

MICRODERMABRASION SPECIALISTS

who lack these androgen receptors or who have poorly functioning androgen receptors do not get acne.

•

Sebum overproduction

The second factor, the overproduction of sebum, is also related to the action of androgens.

For some reason, linoleic acid is low in the follicles of people with acne, while in those mostly acne-free, it is normal. As a result of excess sebum, acneic skin tends to be oily and appear shiny.

•

P. acnes and inflammation

The third factor, the presence of P.acnes, is also related to the fourth factor, inflammation.

DIAMOND PEELING

Oddly, P.acnes are rarely seen in early acne lesions – the microcomedo – and is generally not found until later. Keep in mind that this organism is anaerobic and resides deep in the follicle, away from atmospheric oxygen, which it does not like. It is the P.acnes that is responsible for the inflammation seen in acne, the papule and the pustule, as well as the cyst in cystic acne. As with many bacteria, P.acnes produces mediators of inflammation that start the

FULL TRAINING

cascade of inflammation propagated by white blood cells, the leukocytes.

Here is a new term for you to remember: the toll-like receptor. This is a primitive defense receptor on monocytes and neutrophiles (two kinds of white cells), which, when activated, leads the cell to produce cytokines, such as Interleuken 12 (IL-12), IL-8 and tumor necrosis factor (TNF). In addition, IL-la is also present and may be a contributing factor. Now, if you

C R Y S TA L PEELING

are not familiar with cytokines, you might say. “So what?” Briefly, cytokines are special signaling proteins and proteins linked with sugars called glycoproteins. They are very much like hormones that are able to provide Signals to other cells by cellular communication.

Cytokines are a diverse class of compounds arising from many origins and having multiple functions. Both blood cells and non-blood cells can produce them, and their effects can be felt by cells nearby and throughout the body. Mainly, they are a response to trouble, but they often produce more trouble. The body could not exist without them.

In summary, inflammation in acne is mainly the result of P.acnes and the cytokines they evoke from white blood cells. Along with the other factors. the acne follicle is a roaring source of inflammation.

Oxygen in acne treatment

GREAT VERSATILITY

Every effective therapy treats the causes of the disease.

PROVEN EFFICACY

When looking at the causes of acute acne, the presence of P.acnes stands out as a major factor in the formation of pimples or cysts. It is important for the aesthetician to understand just what is happening when oxygen is being delivered to the skin (see Figure 1).

•

Diffusion of atmospheric oxygen

RESULTS DRIVEN TREATMENTS HIGH RETURN ON INVESTMENT 5 YEAR WARRANTY AFFORDABLE QUALITY

The excellent work of Strucker et al , shows that the needs 1

of the epidermis can be supplied with oxygen from the atmosphere through a diffusion process. The epidermis, however, needs additional oxygen, which is supplied by the capillaries. The skin uses oxygen to kill bacteria, to supply energy to the cells, to reduce swelling, to stimulate fibroblast activity, to inhibit lipid peroxidation and to initiate new blood vessel production. It is unknown how these actions occur, but it has been identified through experience with medical hyperbaric oxygen that they do occur (Hyperbaric oxygen is usually administered in a sealed, heavy-walled chamber. By definition, hyperbaric oxygen is

01903 768 380 info@thecarltongroup.co.uk

www.thecarltongroup.co.uk

Topical Application of Oxygen

above one atmosphere of oxygen pressure, normally about 160mm

Rosacea

mercury). By using wet oxygen-either mist-laden or in a solution-

Of all the many diseases of obscure etiology, rosacea should rank

you are able to get effective levels of oxygen into the hair follicle,

near the top of the list. It is known that a lot of people have rosacea

deep enough to reach the sebaceous gland. This is the No.1 reason

– an estimated 13-14 million in the United States2. It occurs most

for using topical oxygen for acne.

frequently in people ranging from 30-50 years of age and is found primarily in fair-skinned people with northern European ancestry.

•

Bacterial kill mechanism

Women, for some reason, are affected about two to three times

It is most likely that a free radical

more often than men3. Rosacea is characterised by a persistent

reaction occurs at the cell surface of

erythema of the face for a duration of at least three months.

the bacteria. Oxygen can form very

Diagnostic signs include flushing, papules, pustules, telangiectasias,

reactive by-products, such as hydrogen

edema, plagues, a dry appearance, ocular manifestations and

peroxide and superoxide, when they

phymatous changes. Symptoms include burning and stinging.

enter a cell. The targets of the reactive

A major finding is central facial flushing, often accompanied by

oxygen species (ROS) are protein and

burning or stinging. Patients generally have finely textured skin,

DNA, which denatures both these

although the face may appear rough and scaly, suggesting a low-

compounds. It is not fully known

grade dermatitis. Known triggers to flushing include emotional

what the antimicrobial mechanisms

stress, alcohol, spicy foods, exercise, cold or hot weather, hot drinks,

of oxygen are, but some of these

and hot baths and showers.

processes are understood. For example, the cell envelopes of bacteria consist

Rosacea patients frequently have sensitive skin and may feel pain

of polysaccharides (complex sugars)

with many products, even when they are gently applied to the

and proteins. Some bacteria have a lot

skin. A present controversy is the concurrent existence of acne and

of complex lipids in their membranes, including glycolipids and

rosacea. As a rule, no comedones are seen in rosacea. My personal

lipopolysaccharides.

opinion is that acne is a separate disease from rosacea. I base this on the fact that rosacea is characterised histopathologically with the

Oxygen reacts with the lipid layer in cellular membranes, usually

appearance of perivascular infiltration. This would suggest some

forming hydroperoxides and a lot of other nasty-but-active germ-

basic vascular pathology, which is to say. it covers a lot of area, but it

killing compounds. Net result: Oxygen breaks the bacterial cell

presents a clue or starting point. Why do only men get rhinophyma

envelope by lipid peroxidation. So basically, oxygen has effectively

with rosacea? Studies have shown possible associations between

punched holes in the cell’s membrane, causing the bacteria’s nucleic

rosacea and the face mite Demodex folliculorum4,5 and Helicobaeter

acids and other critical compounds to exit the cell, thereby killing

pylori infection6,7,8.

the bacteria. Besides this method, oxygen kills bacterial pathogens disrupting the system that creates the cell’s energy, as well as

•

crippling the critical proteins’ manufacturing systems (see Figure 2).

Treatment by the medical profession for rosacea is essentially

Treating rosacea with oxygen

an attack with antimicrobial agents, but for more resistant cases, •

Treating acne with oxygen

physicians use surgery, dermabrasion, laser and more recently,

The current acne treatment regimen used should continue

intense pulsed light (IPL). The aesthetician has limited use of

and the oxygen treatment should be adjusted according to the

these modalities, but there are still effective treatment methods

acne’s severity. In severe non-cystic acne, use oxygen therapy

available. Since there appears to be a bacterial component to

three times a week for the first week (cystic acne should always

rosacea, an antimicrobial product should be used along with an

be treated by a physician).

anti-inflammatory. You have your choice of many anti-inflammatory agents, both natural and synthetic. Bioflavanoids and other

During the second week, reduce to two treatments administered

polyphenols from green tea are effective. Consider also bisabolol

at least two to four days apart. On the third week and

from the plant chamomile. One very powerful antioxidant found

subsequent weeks, oxygen used once a week should produce

in pomegranate is ellagic acid, with a great many other positive

good and lasting results. Have the client return in a month to

properties, such as an antiperoxidant, antiseptic, antibacteriall

check for comedones, both open and closed. As you are well

astringent, antifungal, antiyeast, and it is a sunscreen, as well when

aware, acne is a recurrent disease and those experiencing it

added at 0.5%.

should be followed up with regularly, often beyond the teen years. Acne and ignorance are the scourges of youth.

Topical oxygen should be applied in a wet form, carefully following

There are only two methods of oxygen application that I

the directions of the manufacturer. When you see the skin blanch,

recommend and both use wet oxygen. The nebulizer format

you know you have reached the top of the dermis with your

allows aestheticians to use additional agents during the

oxygen treatment. At the same time, you will have killed many of

application, such as essential oils or plant extracts. The other

the superficial and deep-surface bacteria, and probably killed the

form is oxygen generated in situ-that is, on the skin-and can be

demodex, or else made them very unhappy.

effectively used in a treatment lasting less than 10 minutes. Both

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of these systems are commercially available. Whatever system

The treatment program for rosacea should follow an initial three

you use, make sure you understand it, and follow the directions

treatments the first week, two the second week and one the

of the supplier.

third week. Depending on the improvement, scheduling of the

w w w. c o s m e t i c - i n s u r a n c e . c o m / c o s m e t i c n e w s

Topical Application of Oxygen

METABOLIC PROCESSES THAT REQUIRE OXYGEN Oxygen is so important to life that humans cannot live without it. After three minutes without oxygen, the brain begins to lose consciousness; the brain cells will die in eight minutes without oxygen; and many cells will suffer irreversible damage in 10 minutes. Following are some crucial metabolic

•

Respiration

•

Metabolism of carbohydrates, fats and proteins

•

Collagen and elastin metabolism

•

Many enzyme reactions

•

The destruction of bacteria

•

Thousands of everyday biochemical

process that require oxygen.

How often can you use oxygen therapy?

reactions

The cost of the treatment must be considered, but the client is the most important factor.

subsequent treatments can vary from biweekly to monthly.

immune system. The skin is also insulted daily with free

As the reader is well aware, rosacea clients do not all

radicals, both inside and outside the body. Any treatment

respond the same, so adjust your treatment to meet the

of ageing skin should begin with an adequate antioxidant

needs of a particular client.

regimen. A good, glycation-free diet with a modest caloric intake can prevent many unnecessary hospital days.

Ageing skin

Remember that using oxygen is an art. You must know how to use it. If a company tries to sell you an oxygen treatment without adequate education or instruction, steer clear of it. You will begin to see oxygen used more often in aesthetics within the next few years, and perhaps in combination with other treatment systems.

Ageing remains a major topic in science because, even

•

Treating ageing skin with oxygen

today, the process isn’t fully understood. It is known, for

Oxygen can be used as an adjunct treatment in a skincare

example, that tissues and cells undergo damage, that

anti-ageing program.

a person’s DNA may also be damaged, and that a lot of

Remember to always use wet oxygen. Include in your

systems do not work as well at age 50 as they do at age

ageing skin treatment program three oxygen treatments

20. There are many questions, but few answers, although

during the first week, and a series of three treatments the

a great deal has been learned during the past few years

next week. During this time, you could use one enzyme

about some important aspects of ageing that can be

peel each week for the first two weeks. During the third

translated into skincare. Energy and living are forever

week, look for changes in texture, color and fine lines. The

linked, and so is the ageing process. Having adequate

third week, give two more oxygen treatments-although

energy for every organ is essential for the normal function

the timing is not critical, they should be two to three days

of each organ, and that means each cell must have a good

apart, but do nor administer them back to back. After the

supply of energy.

third week, you can adjust your treatments to once a week or alternate weeks for six to eight weeks, depending on the

The skin is one organ that almost always comes off on

condition of the client’s skin.

the short end of the metabolic stick. Waste products accumulate in the skin, its blood and nutrients are shunted

Look at two parameters in order to evaluate wrinkles.

REFERENCES

to other organs in emergency situations, and nasty

How deep are they? Even one or two deep wrinkles

1. M Strucker et 01, The cutaneous uptake of

metabolic by-products are frequently sent to the skin to

suggests a great deal ofdamage to the dermis. Little

atmospheric oxygen contributes significantly

be neutralized. The sun and cold are not the skin’s friends,

wrinkles will hold a thread; moderate wrinkles will hold a

nor are harsh detergents and soaps. Next to the stomach,

string; severe wrinkles are deeper and wider than the wire

the skin is the most abused organ in the body. The skin can

in a coat hanger.

Nurse Pract (26) 13-15, 19-23 (2001)

be helped, however, if enough energy is supplied to it, and

How long are they? Except for the nasolabial fold and the

3. M Berg, S Liden, An epidemiological study of

that is one thing oxygen therapy can do.

labiomental fold, wrinkles that measure longer than an inch

rosoceA. Acta Derm Venereol (69) 419-423 (19B9)

are really bad. These wrinkles reveal that there is a great •

The mitochondria

Tremendous strides in the information known about

deal of dermal damage and will most likely fail to respond to anything other than deep surgical peels.

to the oxygen supply of human dermis and epidermis. J Physiol (538) 985-994 (2002).

2. T Cuevas, Identifying and treating rosacea.

4. T Roihu, AL Koriniemi, Demodex mites in Acne rosocea. J Cutan Pathol (25) 550-552 (1998) 5. Z Erbagci, 0 Ozgoztasi, The significance of Demodex folliculorum density in rosacea. IntJ Dermatol (37) 421-425 (1998)

mitochondria have been made during the past 30 years.

6. B Wedi, A Kapp, Helicobacter pylori infection

They are the major energy source for the cell and are

•

Oxygen and the skin

damaged rather easily because they do not have adequate

Oxygen revitalises the epidermis and stimulates cellular

repair mechanisms.

growth by increasing cellular proliferation. It will kill surface

Every movement or thought, and most chemical reactions

bacteria, deep anaerobic bacteria and fungus. Oxygen will

Gongeness, Effect of treatment of Helicobacter

that occur in the body, require ATP. In fact, so much ATP is

supply energy to the epidermis and to the dermis, helping

pylori infection on rosacea. Arch Dermatol (135)

used by the body that, each day, it makes and uses about

to heal any small wounds and irritations. In the dermis, it

659-663 (1999)

80 pounds of it. Staggering! Oxygen is critical to the process

will help produce collagen and elastin and help restructure

of generating ATP.

the extracellular matrix. Oxygen is a micronutrient and it

and skin diseases. ) Physilo Pharmacol (50) 753776 (1999) 7. JT Bomford, RL Tilden, JL Blonkush, DE

8. VK Shormo, A Lynn, M Kaminski, RVasudeva, CW Howden, A study of the prevalence of Helicobacter pylori infection and other markers

will assist with many metabolic processes in the skin. Lastly,

of upper gastrointestinal tract disease in

Ageing skin features a decrease in circulation, metabolic

it is critical for many enzyme reactions, and the presence of

patients with rosacea. Am )Gastroenterol (93)

REQUIRE OXYGEN activity, ATP production and a sluggish

oxygen can often accelerate these reactions.

220-222 (1998)

This article was originally published in the September 2008 issue of Skin Inc. magazine, and is being reprinted with permission. All rights reserved.

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VIEW ON - Ultherapy®

TwoowT ViewssweiV Ultherapy has been one of the most talked deklat tsom eht fo eno neeb sah yparehtlU about treatments in the US this year. Here we get teg ew ereH .raey siht SU eht ni stnemtaert tuoba the views of two stateside plastic surgeons, Dr rD ,snoegrus citsalp edisetats owt fo sweiv eht Andrew Campbell and Dr Matthew White, on this siht no ,etihW wehttaM rD dna llebpmaC werdnA revolutionary procedure erudecorp yranoitulover

Ultherapy®, a novel micro-focused ultrasound modality for non-invasive, non-surgical skin rejuvenation and lifting, is capturing growing niche. By treating the underlying facial tissue superficial muscular aponeurotic system (SMAS), as well as the skin dermis, Ultherapy represents an entirely unique approach to rejuvenating the ageing face. It can stave off the need for surgery or serve as an alternative to those unwilling to go under the knife. As the device adoption continues to expand, aesthetic practitioners and patients alike are gaining increased experience with and exposure to the technology. Two facial plastic surgeons experienced with Ultherapy, share their views and perspectives on the subject.

P

Practicing out of Wisconsin, facial plastic surgeon

age with early signs of laxity. “Improvement is much more noticeable

to the physics behind Ultherapy. “I did some

on someone with early, as opposed to advanced, laxity”, he says.

research before it received FDA clearance, and I realised right away they had something unique on

IN PRACTICE

their hands”, he says. “By focusing the ultrasonic energy, completely

Manhattan-based facial plastic surgeon Dr Matthew White sees his

bypassing the epidermis but still successfully depositing a therapeutic

share of on-the-go, upwardly mobile business people who work on Wall

level of energy in deeper tissues, Ultherapy treats facial laxity without

Street. “A lot of patients are looking to stay competitive in the workplace,

surgery, and nothing else does that.

which they think is tied to their appearance. Whether it’s improving their appearance to look more vibrant or the associated confidence

“

This is tailor-made for patients who may not need or want surgical intervention, but still want results. I’ve tried other technologies purported to serve this segment and the results were underwhelming at best

“

DR CAMPBELL

Dr Campbell’s classic patient, he said, is between 40 and 60 years of

Andrew C Campbell, MD, was initially attracted

boost, people perceive this to be important, and they come into my office looking for help. Ultherapy offers a distinct advantage over other non-surgical alternatives, according to Dr White. “Just about every other non-surgical, energy-based rejuvenation modality only treats the surface,” he explains. “Ultherapy goes deeper, providing a different dimension to rejuvenation. Unlike traditional lasers and RF devices of the past, Ulthera is able to deposit ultrasound energy at very precise depths, creating independent Thermal Coagulation Points (TCPs). In addition, those TCP’s reach a precise temperature (65-70° C) in the therapeutic zone, which leads to aggressive neo-collagenesis in the deep soft tissues and ultimately produces a lift from below. With dual-layer treatment,

“This is tailor-made for the large market composed of patients who

we can produce an effect closer to the surface as well, creating a more

may not need or want surgical intervention, but still want results. I’ve

well-rounded result. And, unlike surgery, which requires time off from

tried other technologies purported to serve this segment of the patient

work, Ultherapy has no downtime, so patients can get right back to the

population, and the results were underwhelming at best. Ultherapy is

corner office.”

remarkably consistent in that it regenerates collagen in everybody; in

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that sense, there are no non-responders. There are, however, people

Because the effect occurs below the surface, treating facial areas or

whose laxity is just too great for Ultherapy to overcome. These people

the submental region individually is certainly possible with Ultherapy.

need a face-lift.”

However, most patients select full-face treatment and can be prompted

to do so through careful and thorough education. “By far, the majority of

I don’t think the cooling has nearly the impact that the simple

our Ultherapy patients opt for full-face treatment. It’s the best option for

distraction factor does. For patients who are very concerned, I may

a more uniform result, and we offer package pricing to influence patients

offer narcotic pain relief.”

in their choice,” says Dr Campbell.

Ultherapy is an ideal adjunct to other commonly sought treatments, In Dr White’s practice, around 80% of patients receive full-face treatment.

according to Dr Campbell. “Laser skin treatments and Ultherapy are an

“Most come in for jowl and neck laxity, but, in the end, they choose

obvious complementary package,” he says, “because the laser adds the

full face”, he says. “I feel that a full-face treatment really puts the facial

resurfacing component to the global result, but you can combine it with

features in harmony and allows for a more balanced, natural result. It only takes about an hour, and when they walk out of the office, they can go right back to work. I’ve seen mild bruising in maybe 2% of patients that lasts a few days at most, but that’s all.”

GREAT EXPECTATIONS As with any aesthetic procedure, expectation management is a major component to the overall treatment protocol. “This is fairly easy to do,” says Dr White, “because the result is very natural. It isn’t a face-lift, and we need to make that clear. But, outcomes are visible as long as you don’t

Ultherapy has been a gateway “treatment for my practice... it quadrupled new patient traffic, which we’ve been able to maintain, giving people an opportunity to see the spectrum of my expertise

“

treat the wrong patient. Ulthera provides great audiovisual materials I can show patients that effectively explain the way the device works.

They tend to be comfortable with ultrasound because it’s well known

anything without worry because ultrasound is so safe.”

to be safe.”

Ultherapy fixed local media attention on Dr Campbell and his

Satisfaction with Ultherapy is high for both patient and physician.

practice, allowing him to showcase the device on local television

“Typically, if patients aren’t satisfied with a particular treatment, I

news. “That literally opened the floodgates; close to half the total

re-treat at no cost to the patient,” says Dr Campbell, “and I haven’t

number of patients we’ve treated were influenced in some way by

had to do much of that with Ultherapy. This technology enables me

that newscast exposure.”

to get it right the first time.”

Dr White says, “Ulthera has done a great job promoting this nationally.

DR WHITE

Once it was featured on the larger talk shows, our phones were ringing Highly trained registered nurses perform treatments in his office.

off the hook and have continued to do so.”

“They love performing a treatment that brings patients back in saying, ‘Wow, this is amazing.’ Dr White explained that, while he recognises

“Ultherapy has been a gateway treatment for my practice,” he adds. “It

that Ultherapy is suitable for use by well-trained ancillary personnel,

quadrupled new patient traffic, which we’ve been able to maintain,

he prefers to perform the treatment himself. One exciting aspect of

giving people an opportunity to see the spectrum of my expertise.

Ultherapy treatment: the half-time assessment. “We do half the face

About 90% of them undergo some type of procedure, so Ultherapy has

then let patients see the difference in the mirror,” he says. “They can

grown other aspects of my practice, such as facial injectables and even

see the results, and that’s very satisfying to everyone involved.” His

face-lifts as well. It paid for itself within a few months. Ultherapy has also

key for managing discomfort during treatment is thorough education

given me a chance to build relationships with my patients. They come in,

and talking them through the procedure. “Other than giving them

we get to know each other, they see results they can get excited about,

mild oral analgesia (Tylenol), I just make sure they know what to

and that patient stays in my practice. It’s very rewarding.”

expect during treatment, beginning with a test spot on their neck.

Once properly acquainted with the sights, sounds, and sensations of

FOR FURTHER READING

Ultherapy, patients don’t seem to need anything else.”

(1) Alam M, White LE, Martin N, et al. Ultrasound tightening of facial and neck skin: a raterblinded prospective cohort study. Dermatol Surg 2010;62:262-9.

(2) Laubach HJ, Makin IRS, Barthe PG, et al. Intense focused ultrasound: evaluation of a new treatment modality for precise microcoagulation within the skin. Dermatol Surg 2008;34:727-34.

(3) Gliklich RE, White WM, Slayton MH, et al. Clinical pilot study of intense ultrasound therapy to deep dermal facial skin and subcutaneous tissues. Arch Facial Plast Surg 2007;9:88-95.

Dr White has treated well over 100 patients in this fashion. Dr Campbell uses a Zimmer cooler to manage patient comfort. “One patient who underwent treatment using old protocols, then later with my newer ones using the Zimmer cooler, said her treatment experience was at least 50% better with the addition of the Zimmer.

cosmeticnewsuk.com

29

ACNE

Hitting the Spot Mr Paul Banwell Paul Banwell is a plastic and cosmetic surgeon based in the South East. Paul has developed an international reputation in the fields of cosmetic surgery, skin health and skin cancer and lectures worldwide on these subjects. He has published extensively and is a Visiting Professor of Plastic Surgery to Harvard Medical School. He has just been listed in the Times Magazine as one of the UK’s Top 100 Doctors and is a familiar face in

The treatment of acne is probably one of the biggest growth areas in cosmetic medicine practice today. Dr Sam Bunting and Mr Paul Banwell, two of UK’s leading skin experts, have joined forces to give a perspective on integrating acne into your aesthetic practice

the national media both on TV and in the Press.

Dr Sam Bunting Cosmetic dermatologist Dr Sam Bunting is a

A

cne is one of the most common skin

elements are present.

disorders for which people seek specialist

This distinction is important as the predominant lesion type will

advice. In the UK alone, acne vulgaris affects

determine not only the most beneficial treatment options, but

approximately eight to 10 million individuals

also help manage patient expectations-certain patterns represent

each year. Whilst it is commonly perceived

leading skincare expert widely featured

to be a disorder of adolescence, affecting some 85% of all

in the popular press, on radio and

teenagers, statistics show that its prevalence remains high well

tv. She has a particular interest in the

into later life. Acne affects some 40- 50% of men and women in

management of adult acne and has

their twenties, and may still affect up to 10-20% in their forties

successfully incorporated this expertise

and fifties. The complex pathophysiology of this condition is

into her private practice.

reflected by the many treatment options available, and whilst

a greater treatment challenge than others.

conventional medical therapies (eg. Antibiotics) remain firstline in the therapeutic armamentarium, emerging treatment strategies such as cosmeceuticals, light, laser and PDT attempt to offer better efficacy with fewer side effects and quicker results, particularly in more resistant cases.

Acne Pathogenesis Abnormal follicular desquamation leads to micro-comedone formation, which is the primary lesion in acne vulgaris.

Sebum secretion, which typically increases at puberty leads to accumulation in the blocked follicle, which encourages proliferation of P. Acnes. This incites an inflammatory response, which may lead to the development of papules, pustules, nodules or cysts. Thus acne can be classified in terms of the primary lesion: l Comedonal, where open and closed comedones predominate, and inflammatory lesions are rare l Inflammatory, where papules, pustules and nodulo-cystic cosmeticnewsuk.com

31

ACNE

Clinical Presentation When assessing an acne patient, it is useful to classify disease severity in a meaningful way, in order to document response to treatment. l Mild disease: <20 comedones, <15 inflammatory lesions, l Moderate disease: 20-100 comedones, 15-50 inflammatory lesions l Severe disease: >5 cysts, >100 comedones, >50 inflammatory lesions.

It is also useful to document the presence of secondary lesions including excoriations from picking, erythematous macules from recent spots, pigmented macules from old spots and the presence of scars. Off course, the face, chest and back should all be examined and photographs are essential for monitoring progress with treatment.

Approach to treatment Patient education is critical to treating acne successfully.

Patients are often psychologically traumatised by their ongoing battle with this pernicious condition and many have had negative experiences in the past at the hands of unsympathetic professionals as acne is often trivialised. Expectations must be managed, as must management of treatment side effects if compliance is to be achieved.

Mild acne Acne prevention regimen

A good skincare regimen may be sufficient for those with mild

a once-daily multi-pronged attack on both comedonal and

acne. Retinoids, salicylic acid and azelaic acid will all have impact on

inflammatory lesions. Studies show that its onset of action is

comedonal lesions, whereas benzoyl peroxide (BPO) and salicylic

faster and its tolerability is no worse than either agent used

AM

acid have good anti-inflammatory properties. The core of any acne

alone- leading to better compliance.

l Mild 2% Salicylic acid wash

regimen is the use of an anti-comedonal agent as this is the primary

lB PO plus/minus topical

lesion of acne vulgaris.

antibiotic or azelaic acid 20% lN on-comedogenic

Topical niacinamide has also emerged as a useful antiinflammatory agent in the treatment of the papulo-pustular

Its important to explain to patients that gradual incremental use

element of acne. Studies show it to be as effective as topical

moisturising SPF 50 broad-

of topical agents ensures maximum tolerability. Quantify amounts

1% clindamycin and its main advantage there is no risk of the

spectrum sunscreen (in

used so dose-reduction can be performed intelligently if side effects

development of bacterial resistance. In addition, it improves

conjunction with topical

become excessive. If patients understand that a condition gets

post-inflammatory hyperpigmentation, a common feature

retinoids)

better over the course of six to 12 weeks, they will then understand

of acne vulgaris. This is available in serum formulation from

that there is no need to blitz their skin with excessive product

Rationale Skincare and Medik8.

PM

use, resulting in inevitable irritancy and compliance improves

l Mild 2% Salicylic acid wash

accordingly. Written instructions will help enormously.

Cosmeceuticals

l Topical retinoid lN on-comedogenic emollient therapy as needed

Cosmeceuticals (medical grade skincare) represent a marriage

Moderate and severe acne

between cosmetics and pharmaceuticals and are a more

Moderateacnewilloftenrequiretopicalororalantibioticsinconjunction

sophisticated approach to tackling acne than traditional over-

with topical therapy. Topical antibiotics should not be used in

the-counter products or prescription medications. Ranges are

isolation - to limit development of antibiotic resistance- and therefore

typically based on vitamin A-derivatives and hydroxy acids. For

combinations with BPO or Zinc is preferred. Typically a course of oral

instance, the SkinCeuticals Acne System utilises retinol, glycolic and

antibiotics will utilise tetracyclines or erythromycin and will last three to

mandelic acid whilst Medik8 Anti-Acne kit employs azelaic acid,

sixmonths.Unfortunatelyantibiotic-resistantP.Acnesisnotuncommon,

salicylic acid and niacinamide. These products have a more elegant

particularly to erythromycin. Side effects can occur which limit

feel with additional anti-ageing benefits, and are therefore an

tolerability and oral antibiotics donâ&#x20AC;&#x2122;t target excess sebum production or

excellent choice for the adult acne population. Obagi Clenziderm

comedone formation. Some patients will therefore merit a course of oral

Acne Therapeutic system combines solubilised 5% BPO with 2%

isotretinoin, under specialist guidance - again side effects limit suitability

salicylic acid-advances in the formulation minimises irritancy whilst

for all. However, in the event of recalcitrant nodulo-cystic disease with

effectively delivering the active ingredients into the pilosebaceous

scarring, this is the treatment of choice. All oral retinoids have teratogenic

unit.

effects and patients must be cautioned to avoid pregnancy whilst taking these medications. Oral hormonal therapy may be appropriate in some

Light therapies (blue/red light)

female patients, but is best incorporated into a good skincare regimen.

A desire to avoid the side effects associated with medical therapies for acne has also led to increased interest in adjuvant

New therapies

therapies. Perhaps one of the most promising is the use of

So in light of the limitations of conventional therapy, it is useful

continuous-wave broadband visible light.

to look at newer strategies and work out where they best fit into

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cosmeticnewsuk.com

our current practice.

Light therapy is based on the premise that P. acnes produce

New topical agents

endogenous porphyrins, which absorb light to produce reactive

Epiduo is a combination of BPO and adapalene, which provides

oxygen species that lead to cell death. Blue light activates

source leads to activation of the porphyrins, resulting in cell damage. Partial destruction of the sebaceous glands is thought to be the main mechanism of action.

Studies so far have utilised small numbers and differing treatment parameters mean that it is difficult to draw conclusions about the efficacy of this group of treatments. In addition, treatment is typically painful and can cause the PDT effect (downtime experienced during the healing process), which consists of acneiform folliculitis, post-inflammatory hyperpigmentation (PIH), superficial peeling, and crusting.

Chemical Peels Chemical peels are more typically used for facial resurfacing where removal of the epidermis promotes reepithelization leading to rejuvenation. However, in the context of active acne, alpha-hydroxy acids (eg. Glycolic) and salicylic acid peels have benefits due to their keratolytic activity, which is helpful in tackling the comedonal aspect of acne. Theoretically salicylic acid, which is lipophilic may be more effective due to increased penetration into the pilosebaceous unit and also because it has additional anti-inflammatory properties due its effect on the arachidonic acid pathway.

endogenous porphyries, leading to structural damage to P. acnes

Marketing Your Acne Services

and potentially, cell death. Red light, on the other hand, has a

Acne is a common disorder - ensure that all your staff are able

longer wavelength and penetrates more deeply-it is absorbed

to recognise the lesions associated with the condition and have a

by endogenous porphyrins (though less strongly than blue

good understanding of the therapeutic options required to treat it

light) but may also suppress sebaceous gland function and

successfully. Winning patients’ confidence is key.

modulate inflammation. Both treatments tend to be well

Use your database to market your acne services. Many of your

tolerated.

patients will have acne or if they do not, they may have children

The combination of blue and red light therapy has proven

with acne! The numbers here are potentially huge

more successful than blue light in isolation or monotherapy with BPO at reducing the number of inflammatory lesions

Ensure that you offer a dedicated acne skincare line and teach

(although it was not more effective at reducing the number

patients how to use them properly to maximise compliance (hand-

of comedones) suggesting that blue and red light have a

outs are useful). Acne is a chronic disorder so once patients find a

synergistic effect on the inflammatory aspect of acne.

successful regimen, they will stick with it-so this should prove to be a source of recurring income.

In contrast to monochromatic light sources, IPL utilises polychromatic light. In addition to delivering light in the

Provide a comprehensive acne information section in your website

blue-red spectrum it is thought to also have a photothermolysis

and ensure your keywords are optimised. Patients appreciate the

effect due to heating of sebaceous gland blood vessels, leading

added value-education is an important aspect to winning their

to diminished sebum production. However results of studies

trust in helping them manage this debilitating condition.

so far have been mixed and side effects such as pain, erythema, swelling, blistering and crusting limit treatment tolerability-

Hold skin evenings for your patients and include your acne

further studies are needed to determine the future role of IPL

treatment services in your offering. Many patients will have

in acne therapy.

annoying breakouts that you can offer a solution!

Lasers

Tell people you have knowledge. Social media is very important to

Lasers in the green and yellow part of the visible light spectrum

teenagers and 20-somethings, who form a big part of your target

have also shown promise in the treatment of mild-moderate

audience. Create acne-focused discussions on your Facebook fan

acne. However the treatment parameters are not yet well defined,

page, tweet about new treatments you offer and consider uploading

nor is there much comparative data with conventional medical

a video about acne management strategies on to YouTube.

therapy to be clear on where they sit in terms of efficacy.

Conclusion Photodynamic Therapy

Ultimately, treating acne well is tremendously rewarding, both for

Photodynamic therapy (PDT) refers to the use of a

your patients and for your business – it is a ‘win-win’ situation.

photosensitizing agent to enhance the effect of subsequent

The adult acne population in particular represents a group with

light or laser therapy. The most extensively studied is

unmet needs who are likely to remain loyal to your practice if you

aminolaevulinic acid (ALA). This is applied topically

can provide successful solutions for this common, chronic disorder.

where it is taken up into epidermal cells and converted

In addition, the dialogue generated about products and skincare is

into porphyrins - it accumulates in both epithelium and

a valuable entrée into discussions regarding other aspects of facial

pilosebaceous units. Illumination with an appropriate light

aesthetics such as scar treatment and rejuvenation. cosmeticnewsuk.com

33

Advanced & clinically proven

Daily dermo-cosmetic natural skin regeneration

Unique SCA Biorepair Technology harnessing natural-growth-factors

For product and scientific information Freephone 0800 0195 322

www.aestheticare.co.uk

The Professional Choice Advanced dermo-cosmetic and dermatological research-based products

Treatment Spotlight - Hand Rejuvenation

A helping

hand We take a look at hand rejuvenation treatment options

T

he hands can give away a person’s age just as much as their face.

We have all seen pictures of celebrities such as Madonna and Angelina Jolie who are widely regarded as beautiful but whose veiny looking hands make them appear older. The skin on the hands is exposed to the harshness of everyday life more so than any other part of the body and, as such, is very susceptible to premature ageing.

But while many people spend fortunes on looking after the skin on their face, they neglect to look after the skin on their hands, leaving them with the telltale signs of how old they really are.

As such, the medical aesthetics industry is

The Problem: Pigmentation i.e age spots and

becoming more and more passionate about devising

liver spots

treatments for this area. As many of the age related

The Solutions: Chemical peels, microdermabrasion,

problems visible on the hands are the same as those

laser and IPL, fractional laser skin resurfacing, topical

on the face (sun damage, pigmentation, loss of

skincare

fat etc) most aesthetic clinics already have in their

Pigmentation affects the epidermal level of the hands

armamentarium a wide range of treatments that

and manifests itself as patchy, uneven, discoloured

can be tailored to the hands. These include:

spots on the skin that are darker in color than

l Chemical peels

the normal surrounding skin. Abnormal skin

l Dermal fillers for plumping the skin

pigmentation occurs when there is excess in melanin

l S kin hydrators (such as Restylane Vital and

production, which forms deposits in the skin and can

Juverderm Hydrate)

be caused by a variety of factors including hormones,

l Mesotherapy

genetics, medication, the ageing process, skin diseases

l Fractional laser skin resurfacing

such as acne and injuries to the skin, but by far

l Laser and IPL

the biggest cause is sun damage. By far the most

l Collagen Induction Therapy/Medical Skin

common types of pigmentation found on the hands

Needling

are age spots or ‘liver’ spots, which are caused by sun

l Microdermabrasion

damage, and are referred to by medical professionals

l Topical skincare

as ‘solar lentigines’. Age spots can vary in colour from brown to gray and black. They can also be very

Common aesthetic problems of the hands

small or quite large and often appear in groups or

There are many reasons that the hands are so prone

skin who don’t have as much natural protection from

to premature ageing. For one thing protecting them

the sun. The reason they are known as age spots is

from the sun can be hard. Even if your clients do

due to the fact that the melanin accumulating in your

apply sunscreen to their hands, it is just as quickly

skin over the years as you age can make you more

washed off with repeated exposure to water and

susceptible to them but these pigmentation marks are

cleaning detergents, making it difficult to shield

not exclusively caused by ageing. Although they are

them from the harsh and ageing effects of the sun

also sometimes known as liver spots this has nothing

such as age spots or liver spots. As we age our skin

to do with liver or anything that is associated with the

also becomes thinner and we begin to lose fat, so

function of the liver. Treatments which aim to remove

the hands become less plump and veins are more

the top epidermal layers of the skin and encourage

visible through the thinner skin.

skin rejuvenation are the most effective treatments

clusters. They are more common on people with fair

for pigmentation these include chemical peeling, microdermabrasion and laser and IPL treatments.

cosmeticnewsuk.com

35

Treatment Spotlight - Hand Rejuvenation

The Problem: Protruding veins due to loss of

AnimalStabilisedHyaluronicAcid)

fat/volume

technology.

The Solutions: Dermal fillers, collagen induction therapy, fat transfer

The Restylane Vital range of

Loss of volume can lead to hand appearing ‘veiny’ and

products provides deep dermal

old. The use of dermal fillers in the hands is becoming

hydration, which restores

an increasingly popular way of addressing this problem.

hydrobalance, improves skin

Great care must be taking when using fillers in the

elasticity, structure and firmness.

hands however as the skin is much thinner than that on

Designed By increasing the

the face and, in some cases, the product can be seen or

skin’s moisture retention the

felt through the skin.

skin becomes more resistant to dehydration and retains its

Created by Allergan, Juvéderm® Hydrate is a new un-crosslinked hyaluronic acid (HA) injectable treatment with mannitol comprising 13.5mg/g uncross-linked hyaluronic acid plus 0.9% mannitol.

Fat transfer can also be used to replace lost volume in

turgor and structure. Clinical

the hands, however, this is a more invasive procedure

studies show that Restylane

and results can be unpredictable, so many patients

Vital significantly increases skin

prefer to have fillers. Filler treatment can also help

elasticity and promotes skin

by multi-injection into the dermal/epidermal junction

stimulate collagen production and as hyaluronic acid

smoothness and also makes thin skin plumper and

and into the superficial dermis to improve skin tone

has a hydrating effect, it can help plump the skin on

firmer.

and reduce fine lines and wrinkles. The addition of mannitol leads to reduced free radical degradation of

the hands nicely.

Results of an independent clinical study by The Problem: Dehydration

dermatologist Dr Stefanie Williams et al., published

the hyaluronic acid to extend longevity.

The Solutions: Skin hydrators, mesotherapy, topical

in the Journal of Cosmetic Dermatology (JCD 2009,

The product has been clinically proven to deeply

skincare

8: 216-225) has proven that hand rejuvenation with

hydrate the delicate skin of the face, neck and

Skin hydrators such as Restylane Vital and Juverderm

Restylane Vital is highly effective.

décolletage areas. Results presented by Paris-based

Hydrate, as well as mesotherapy, have proved to be a

Dr Maryna Taieb at the Anti-Aging World Congress

very popular treatment for rejuvenating dehydrated

This is the first study to demonstrate injecting HA

in Monte Carlo in 2010, showed that 95% of patients

hands. They work by injecting hyaluronic acid, or in the

can not only improve the clinical appearance of

treated with Juvéderm® Hydrate were pleased with

case of mesothertpay, a cocktail of ingredients, into

hands but also change parameter of skin physiology

the results of their treatment and 85% said they

the skin on the hand to make it appear smoother and

towards that of a younger skin. The study also

would recommend the treatment to a friend. The

plumper.

provides evidence that Restylane Vital, stabilised

two-month multi-centre clinical trial saw 27 patients

non-animal hyaluronic acid, has a greater effect on

treated with Juvéderm® Hydrate in the face, neck and

The aim is to replace minerals, vitamins and amino

clinical appearance and skin physiology on the backs

décolletage areas. Physicians assessed the patients at

acids that are found in lower levels in skin as we age,

of hands, when compared with a non-stabilised

baseline, on day 15, on day 30, and on day 60.

with one of the main aims being to boost levels of

hyaluronic acid product.

hyaluronic acid in the skin. As the skin ages, levels

By the end of the study, skin texture, brightness,

of hyaluronic acid decrease, and it is claimed that

The study found that intradermal injections of

hydration and appearance were judged by physicians

injecting more hyaluronic acid into the dermal layers

stabilised hyaluronic acid (HA) generated significant

to be significantly improved following Juvéderm®

(just below the surface of the skin).

improvement in skin elasticity and skin smoothness.

Hydrate in over 80% of patients treated. Further, the

On the hands treated with non stabilised HA there

treatment was well-tolerated with all side effects

These treatments have also been shown to encourage

was improvement but it was not significant. It also

related to injection technique rather than to the

collagen induction because of the multiple puncture

showed that skin hydration with stabilised HA

product.

wounds created during treatment and as they are not

started to improve after the first treatment and

filling agents, like

was maintained until three months after the last

Hand creams have long been used to rehydrate and

dermal fillers, the

treatment. Hands treated with stabilised HA displayed

soften tired skin on the hands so it is no surprise

risks of any product

a significantly higher hydration level and lower

that cosmeceutcial brands have jumped on the

being seen under

transepidermal water loss compared with the non

band wagon and made creams for this purpose that

the thin skin on the

stabilised HA after the treatment course. At week 24,

have more active and potent ingredients than those

hands is reduced.

the treatment effects began to return to baseline but

that can be purchased in consumer retail outlets.

With numerous

the stabilised HA continued to offer better results

Leading dermal filler brand Restylane recently

clinical studies

compared to the non-stabilised HA.

launched its own range of skincare, which includes a hand cream. The products are based on Q-Med’s

proving its efficacy Restylane Vital can

Created by Allergan, Juvéderm® Hydrate is a new un-

patented and scientifically proven NASHA™ (Non-

achieve impressive

crosslinked hyaluronic acid (HA) injectable treatment

Anmal Stablised Hyaluronic Acid) technology

results on the

with mannitol comprising 13.5mg/g uncross-linked

which enhances the moisturising effect of the

improvement

hyaluronic acid plus 0.9% mannitol.

cream.

particularly on

The product has been clinically proven to deeply

Restylane Hand Cream contains therapeutic doses

the hands. Like

hydrate the skin by delivering hyaluronic acid (HA)

of stabilised HA, Biotin (vitamin B) and rice bran

its sister range

into the skin through a series of tiny injections. As well

extract. The Biotin increases keratin, strengthening

of dermal fillers

as containing HA, it also contains the anti-oxidant,

nails. The rice bran extract protects the important

Restylane Vital uses

mannitol and together, these allow the skin to regain

antioxidative shield of the outer skin layer. The

Q-Med’s patented

its natural smoothness and reveal a healthy glow. It is

product leaves hands feeling, soft, smooth and

NASHA™ (Non-

indicated for improving skin hydration and elasticity

moisturised, whilst also strengthening nails.

of skin quality, Restylane Vital can achieve impressive results on the improvement of skin quality, particularly on the hands. Like its sister range of dermal fillers Restylane Vital uses Q-Med’s patented NASHA™ (Non-Animal Stabilized Hyaluronic Acid) technology.

36

cosmeticnewsuk.com

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Product Focu s Venus Freeze

Freeze frame

We find out how the Venus Freeze painlessly achieves significant rejuvenation and body shaping results The global body shaping and rejuvenation market is huge so it is no surprise that new devices designed to meet the demand for these indications are constantly emerging on to the market. One such devise, which is taking the aesthetics industry around the world by storm, and has recently been introduced to the UK market by Ellipse, is the Venus Freeze from Venus Concept.

This novel all-in-one aesthetic device can

the bi-lipid cell membrane layer of dermal cells, that results

effectively accomplish circumference reduction,

in the stimulation of molecular and cellular activities and

cellulite improvement, skin tightening and anti-

reactions. Magnetic Fields have been shown to increase

agieng without causing any pain to the patient.

fibroblast-derived-collagen production through a non-

Distributed in more than 40 countries worldwide,

thermal mechanism of membrane stimulation and the

the Venus Freeze is FDA approved for the

stimulation of fibroblast mediated angiogenesis and hence

treatment of facial wrinkles and rhytides, as well

facilitate and enhance wound healing in tissues.

as Health Canada approved for skin tightening and

The Pulsed Magnetic Field affects several biological

temporary cellulite reduction.

processes in the skin. It stimulates the synthesis of collagen,

Powered by innovative (MP)2 technology (multi-polar

triggers the proliferation of fibroblasts and promotes

radiofrequency and magnetic pulses), Venus Freeze takes

angiogenesis. It was demonstrated that exposure of

aesthetic treatments to a new level by creating a unique

fibroblasts to low frequency Pulsed Magnetic Field (1.3

synergy between a matrix of bi-polar radiofrequency (RF)

mT, 60 Hz) significantly increases production of collagen.

and magnetic pulses (PMF), which results in proliferation

In addition, Pulsed Magnetic Field triggers the release of

of fibroblasts, neocollagenesis and neo-vascularity in the

FGF-2 by endothelial cells. FGF-2 in turn, stimulates the

targeted areas.

proliferation of fibroblasts and the formation of new small

The Venus Freeze system consists of two applicators -

blood vessels in the dermis (angiogenesis).

OctiPolar with 8 (MP)2 synthesizers for large treatment areas

The Role of Radio-Frequency Matrix in (MP)²

(abdomen, thighs, arms and buttocks) and DiamondPolar

The RF bipolar matrix supplies high-frequency alternating

with four (MP)2 synthesizers for smaller treatment areas

electrical currents that penetrate into the skin and generate

(face, neck and arms). Each synthesizer simultaneously

heat. The RF current is produced between any two

emits both RF and Pulsed Magnetic Fields. The energy

electrodes in the array, and allows for a fast and uniform

rotates between any two synthesizers in an organized

elevation of temperature in the treatment area, without

matrix that homogeneously raises the temperature over

any associated discomfort caused by RF focal ‘hot spots’.

the entire treatment area and creates highly efficient woven dense energy matrix that penetrates deep into

The heat generated in the tissue by the RF Matrix directly

different skin layers for maximum efficacy.

affects fibroblasts, extra cellular matrix (ECM) and fat cells.

The generated heat triggers the natural wound healing

The Role of Pulsed Magnetic Fields in (MP)²

process of the skin, a process that results in synthesis of

The Pulsed Magnetic Fields (PMF) is an important and

new collagen and elastic fibers. In addition, the heat causes

successful modality, approved by FDA, to treat a wide

contraction of collagen fibers and lipolysis.

range of clinical disorders. Pulsed Magnetic Field is induced

The synergy between Pulsed Magnetic Field and RF

by short pulses of electrical current through coils in the

significantly increases collagen and elastic fiber production

applicators. The magnetic field penetrates into the skin

in the dermis, via two separate mechanisms. Through

and results in Foucult (Eddy) electrical currents around the

angiogenesis, (MP)2 improves the dermal blood circulation

cell membranes of the treated tissues. Foucult currents

and the supply of nutrients and oxygen, and thus enhances

change the electrical potential of charged receptors on

the function of skin cells. In addition, the induced lipolysis reduces the size of fat cells. These biological effects result in improved tone, texture and appearance of the skin, and a defined body contour. Venus Freeze software is also programmed with preset protocols and treatment times, allowing trained staff to safely perform treatments, saving much valuable time for physicians. A typical protocol would be once weekly or bi-weekly for a total of six treatment sessions. After the series, maintenance treatments are recommended at least quarterly.

38

cosmeticnewsuk.com

Ellipse I2PL+ The NEW and more advanced system for aesthetic & dermatologic treatments � Hair removal - faster than ever � Remove vascular lesions safely and effectively � Remove pigmented lesions gently � Treat sun-damage on the face and body � Improve skin texture; reduce pore size & fine lines � Treat acne without anti-biotics “I have investigated several lasers and IPLs, with the view to purchase a suitable medical device for my aesthetic practice. Based on results, technical back up, training offered and expert advice, I decided on Ellipse. So much so that I have already bought a second machine and in the process of buying a third!”

Dr. J. Huskisson South Africa

Call 020 7581 4499 or email ellipseIPL@aol.com or simply visit our website www.ellipseipl.co.uk Ellipse Beautylight Ltd, 39 Brompton Road, Knightsbridge, London SW3 1DE

The only radio frequency (RF) system in the world combining magnetic pulse technology that delivers long lasting results

“

I have deployed non-invasive, RF based skin tightening and circumferential reduction technologies profitably in my clinics for the past 8 years. In 2010, we began conducting clinical trials using the Venus Freeze system, powered by (MP)2 technology.

Compared to other RF mono-polar, bipolar and multi-polar systems I have used, with or without suction, the Freeze provides the most uniform heating I have seen, together with speed and ergonomic ease of use.

Dr. R. Stephen Mulholland, M.D. Plastic Surgeon Toronto, Canada

”

Anti-Ageing Skin Tightening Body Contouring Cellulite Reduction

Call 020 7581 4499 or visit our website www.venusconceptuk.co.uk or simply email info@venusconceptuk.co.uk

Clearskin Treatments Limited 39 Brompton Road Knightsbridge London SW3 1DE

®

Radio Frequency (RF) and Magnetic Pulse Technology

Product News FDA approval for Xeomin® Xeomin® has received cosmetic approval from the US Food and Drug Administration (FDA) for the temporary improvement in the appearance of moderate to severe glabellar lines, or frown lines between the eyebrows, in adult patients.

The approval of Xeomin® is based on the results of two pivotal US clinical trials involving 16 investigational sites and included 547 healthy adult patients. In both studies, Xeomin® significantly improved the appearance of glabellar lines 30 days following the first injection, when compared to placebo. Xeomin® is the only botulinum toxin currently approved in the US that does not require refrigeration prior to reconstitution.

Xeomin® has been available in the UK since 2008. The cosmetically licensed version of the product is known as Bocouture® in the UK and Europe. In contrast to the other commercially available preparations for aesthetic use, Bocouture® contains the pure 150 kD neurotoxin, which means it has the lowest content of protein on the market.

DermaQuest™ Skin Therapy SkinBrite Collection

JMSR releases new nonhydroquinone products for photoageing and pigmentation Jan Marini Skin Research (JMSR) has launched two new products to combat photo-ageing and hyperpigmentation.

Age Intervention Enlighten Plus and Enlighten MD are two new antiageing and pigmentation solutions comprising high concentrations of both retinol and multiple proven non-hydroquinone based Tyrosinase inhibitors. Both products use the original and popular Age Intervention Enlighten as a base and then enhance it by introducing additional Tyrosinase inhibitors and increasing the concentrations of select key ingredients. The result is a significantly more concentrated product with a 50% increase in the concentration of brightening technologies.

New Environ Body Roller Treats Large Areas Environ has introduced the Body RollCIT, a new instrument to treat larger areas based on the principle of collagen channelling.

The new body roller features a patent pending, component designed by Dr Fernandes, the inventor of the orginal 1mm Roll-CIT and founder of the Environ Skin Care range, so that skincare and medical professionals can easily treat large curved surfaces on the torso, arms and legs. The hand held device takes into account the fact that no surface of the body is flat. It consists of two roller heads that are tilted at an angle to allow for greater coverage.

It is particularly effective in treating larger surface areas quickly as the time for needling is decreased due to the simultaneous action of the two heads.

There are two types of Environ Body Roll-CIT, featuring either 1.5mm or 3mm needle lengths. The 1.5mm Body Roll-CIT is designed to treat lax skin and can be used on the arms, abdomen, upper and lower arms and the crepe skin in the front part of the elbows, or inner thigh skin. It is also the ideal treatment for stretch marks. A topical anaesthetic cream is applied prior to treating the skin. The 3mm instrument has been devised for use by doctors and surgeons to use for acne scars on the back and chest and for lax skin all over the body, and gives excellent results on stretch marks. For smaller areas, the procedure may be done with topical anaesthetic. When used for extensive areas, a general anaesthetic is required.

New REVITALASH® ADVANCED Athena Cosmetics, Inc. has marked its fifth year

anniversary milestone with the introduction of the

DermaQuest™ Skin Therapy has introduced a new range of skin brightening products.

The SkinBrite Collection is designed to brighten the skin by reducing the appearance of hyperpigmentation, sun damage, melasma, or post-inflammatory hyperpigmentation and incorporate the latest skin brightening ingredients including chromabright, BV-OSC and emblica.

Chromabright is a highly stable tyrosinase inhibitor shown to have a higher lightening efficacy than kojic acid. BV-OSC is a highly stable and effective form of vitamin C that contains whitening, UV protection, and collagen protection properties. Emblica is a potent anti-oxidant, which also lightens pigmentation, increases skin hydration and reduces inflammation.

The brand will also be introducing a new peel to treat hyperpigmentation, PIH and melasma. The Skin Brite Peel comprises of 20% lactic, madelic, phytic and citric acid and has a PH 1.7+.

40

cosmeticnewsuk.com

‘next generation’ of its popular RevitaLash eyelash conditioner, REVITALASH® Advanced.

This new cosmetic formulation features the company’s proprietary blend of functional cosmetic ingredients, including a selection of powerful peptides and botanicals, and is supported by clinical studies that show dramatic, eye-catching results. Coinciding with the launch of REVITALASH® Advanced, Athena has also upgraded its product packaging with a luxurious ‘soft-touch’ box.

RevitaLash products have an unparalleled safety and cosmetic efficacy history, and recent independent clinical studies on RevitaLash® Advanced confirmed that over 90% of test subjects noted improvement in the appearance of their eyelashes after eight weeks of product use.

Statistically significant improvements in the appearance of the eyelashes were noted at each data point in the study: at Day 21, Day 28, Day 42 and Day 56. Ease of application of the cosmetic eyelash conditioning product was appreciated by 90% of the subjects and over 92% said that their eyelashes appeared more lush and youthful.

Safety studies on RevitaLash® Advanced concluded that the product is “safe for use as an eyelash conditioner.” No adverse reactions of any kind were reported during the course of the study, and an additional safety study concluded that RevitaLash® Advanced would have “practically no ocular irritation potential.”

PROFESSIONAL OXYGEN SKIN CARE TREATMENT CREATED BY DR PETER T. PUGLIESE

Oxygen is essential to life and to keeping the skin looking young and healthy.

Through his research and product analysis, Dr Peter T Pugliese found that the amount of Oxygen delivered to the skin by many current available treatments could not be determined.

The circadian Oxygen Rx System is formulated to deliver a measured and controlled amount of oxygen to skin, ensuring the oxygen delivered to the skin will be maximally beneficial while minimizing risk of free radical damage.

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28/7/10 17:17:30

abstracts

Abstracts

We summarise some of the most recent studies you may have missed Title: Treatment of Hidradenitis Suppurativa with

treatment of deeper rhytides, photodamaged skin, and

animal experiments for the development of cosmetics.

Intense Pulsed Light: A Prospective Study

scars, with shorter recovery and a decreased side effect

Future debates on sunscreens are likely to focus on

Authors: Highton, Lyndsey; Chan, Woan-Yi; Khwaja,

profile as compared to traditional CO2 laser resurfacing.

nanoparticles and environmental issues, along with

Nadeem: Laitung, J

Objectives: To study the rate of the adverse events

motivation campaigns to persuade consumers to protect

Published: Plastic and Reconstructive Surgery:

associated with the use of deep fractional CO2 laser.

their skin. However, more efficient sunscreen use will also

August 2011, Volume 128, Issue 2, pp 459-466

Abstract

Methods: A retrospective study of 490 fractionated

continue to raise questions on the benefit in preventing

CO2 laser treatments in 374 patients by ten physicians

vitamin D synthesis in the skin induced by sunlight.

within one practice was performed between March 3, 2008 and July 28, 2010. Treatment areas included the

Title: Occurrence of Fat Embolism After Liposuction

face, neck, chest, hands, back, and abdomen.

Surgery With or Without Lipografting: An Experimental

chronic skin condition characterised by recurrent

Results: Of the 490 treatments, 365 were of both

Study

inflammation and infection of skin in intertriginous

superficial and deep fractional treatments while

Authors: Franco, Fernando F; Tincani, Alfio J ;

areas containing apocrine glands. Intense pulsed

125 treatments were deep. Patients treated were

Meirelles, Luciana R; Kharmandayan, Paulo; Guidi,

light uses high-energy broad-spectrum light. Current

of Fitzpatrick skin types I–IV. Four hundred ninety

Marcelo C

applications include hair removal and the treatment of

treatments resulted in 67 adverse events (13.6%) in

Published: Annals of Plastic Surgery: August 2011,

acne vulgaris, which has a pathogenesis similar to that

63 patients (16.8%), the most frequent adverse events

Volume 67, Issue 2 , pp101-105

of hidradenitis suppurativa. The authors conducted a

were acneiform eruption (5.3%), herpes simplex

study to determine whether intense pulsed light is an

outbreak (2.2%), bacterial infections (1.8%), yeast

effective treatment for hidradenitis suppurativa.

infections (1.2%), hyperpigmentation (1.2%), prolonged

Background: Hidradenitis suppurativa is a

Methods: Eighteen patients were randomised to

erythema beyond one month (0.8%), and (0.8%)

Background: Liposuction in plastic surgery

treatment of one axilla, groin, or inframammary area

contact dermatitis. There were no reports of scarring or

consists of the removal of excess fatty tissue in

with intense pulsed light two times per week for four

hypopigmentation.

healthy individuals. In recent decades, this procedure

weeks using a Harmony Laser. The contralateral side

Conclusions: Fractional deep CO2 laser is a safe

has become more common worldwide. Associated

received no treatment and acted as a control. The

method for treating rhytides, photodamaged skin, and

with liposuction, lipografting has also been used for

response to treatment was assessed using a validated

scars with a low incidence of adverse events.

improving body contours, and has become known

examination and clinical photographs, and by

as liposculpture. Liposuction sometimes causes

measuring patient satisfaction on a Likert scale.

complications, including fat embolism, as described

Results: After treatment, there was a significant

Title: Sunscreen Use: Controversies, Challenges and

in the medical literature. The present study aims at

improvement in the mean examination score that

Regulatory Aspects

ascertaining whether there is intravascular mobilisation

was maintained at 12 months (p < 0.001, logistical

Authors: M Lodén, H Beitner, H Gonzalez, DW

of fat after mechanical liposuction surgery and/or fat

regression analysis). The improvement was confirmed

Edström, U Åkerström, J Austad, I Buraczewska-Norin, M

graft when carried out using one of the most common

by independent assessment of clinical photographs

Matsson, HC Wulf

specific procedures used for liposuction, the superwet

(interrater reliability, 0.79; p < 0.001). Patients reported

Published: British Journal of Dermatology, Volume

technique.

high levels of satisfaction with the treatment. There

165, Issue 2, pages 255–262, August 2011

control side.

Methods: A total of 30 Wistar rats were included in this study. Before the surgery, the animals were

was no concurrent improvement on the untreated

Abstract

Conclusions: This small study suggests that

placed in the supine position and anesthetised with thiopental for 50 to 60 minutes, as it is generally

intense pulsed light may be an effective treatment

Mismatches between skin pigmentation and modern

performed in clinical practice. The animals were divided

for hidradenitis suppurativa. It could be added to

lifestyle continue to challenge our naked skin. One of

in the following three groups. Group A, consisting of

treatments used for this condition, particularly for

our responses to these challenges is the development

10 rats, served as controls, and were only anesthetised.

patients keen on avoiding surgery and those with groin

and use of sunscreens. The management of sunscreens

Group B consisted of 10 rats, which underwent only

and inframammary disease. Further studies are required

has to balance their protective effect against erythema,

liposuction. Group C also comprised 10 rats, which

to confirm the efficacy and mechanism of action of

photocarcinogenesis and photoageing owing to the

were liposuctioned and then lipografted in the dorsal

intense pulsed light in hidradenitis suppurativa.

potential toxicity of the ultraviolet (UV) filters for humans

region. Blood was collected just before and again, 48

and the environment. The protection against UV radiation

hours after the procedure. After 48 hours, the animals

Title: The Adverse Events of Deep Fractional CO2: A

offered by sunscreens was recently standardised in the

were killed, and the lungs, kidneys, liver, and brain were

Retrospective Study of 490 Treatments in 374 Patients

European Union (EU) based on international harmonisation

histologically examined.

Authors: Omar Shamsaldeen, Jennifer D Peterson,

of measurement techniques. Four different categories

Results: All the collected samples were analyzed

Mitchel P Goldman

of sun protection have been implemented along with

microscopically with two different stains, namely,

Published: Lasers in Surgery and Medicine,

recommendations on how to use sunscreen products in

hematoxylin and eosin, and Sudan black. Fat particles

Volume 43, Issue 6, pages 453–456, August 2011

order to obtain the labelled protection. The UV filters in

were found in the lungs of three animals in group B

sunscreens have long been authorised for use by the EU

(those that underwent only liposuction) and in six

authority on the basis of data from studies on acute toxicity,

animals of group C (liposuction and lipografting). No fat

subchronic and chronic toxicity, reproductive toxicity,

particles were found in any organ of the control group.

Abstract

42

Abstract

Background: Fractionated carbon dioxide

genotoxicity, photogenotoxicity, carcinogenicity, irritation,

Conclusions: With this experiment, the authors

CO2 laser resurfacing unites the idea of fractional

sensitisation, phototoxicity and photosensitisation as well

showed that there is a risk of systemic mobilisation of

photothermolysis with an ablative 10,600nm

as on environmental aspects. New challenges with respect

fat after liposuction surgery and that this risk is even

wavelength. This technology permits effective

to the safety of UV filters have arisen from the banning of

higher when fat grafts are also carried out.

cosmeticnewsuk.com

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Q&A - Peter Smith

Q&A

We speak to Med-fx’s superintendent pharmacist, Peter Smith, about his role at the UK’s largest medical aesthetics supplier.

When most people think about a pharmacy they think of the place where they pick up their prescriptions or buy their over-the-counter medicines, but the pharmacy at Med-fx does not fit that mould. Not open to the public, the pharmacy, based within the company’s stateof-the-art warehouse in Witham, Essex, deals purely in prescriptions for medical aesthetic(s) products coming through its automated ordering system, so its superintendent pharmacist, Peter Smith, has a specialist knowledge of the needs of medical aesthetic practitioners. Here we talk to him about his role at the pharmacy and why the unique facility offers advantages to aesthetic practitioners.

Cosmetic News:

the rest of the stock, we know the details of which product has been sent to which patient along with the batch number and expiry date of that product.

All of this information is available at any time and consequently if there were ever to be a problem with the integrity of any product we can easily determine which patients might be affected. This in turn means we can go straight to the prescribers we have dealt with and say ‘these are your patients and this is the amount of product that we have dispensed to them’ and although we have never had to do that I believe it is extremely reassuring

What is your role at Med-fx?

Service prescriptions, so we are purely focused

for the prescriber that we have that level of product

Peter Smith: Five years ago, when the

on the private sector, and purely on aesthetic

traceability.

directors of Med-fx decided they wanted to open

products. I believe that we are the only specialist

a pharmacy to support the growing business they

aesthetics pharmacy in the UK, so we don’t have

knew that it was a legal requirement to either

anything else that distracts us or interrupts what

PS: We do not deal with remote prescribers. We

have a pharmacist on the board of directors,

we do, and I’m sure this helps us to dispense

ask doctors who come to us and talk to us about

or to appoint a pharmacy superintendent. My

accurately, quickly and efficiently as a result.

remote prescribing to sign a letter to say that all

role, when we opened, was to make sure we had a discreet area within the building that met the

CN:

CN:

What is your view on remote prescribing?

of the patients they issue prescriptions to are seen What kind of products do you dispense?

by them – so they confirm that they have a face

physical requirements for product storage and

PS: The majority of prescriptions are for either

to face consultation with the patient – and, as far

supply set by the General Pharmaceutical Council.

a brand of botulinum toxin and, these days, most

as I am concerned, the signature on that letter

In addition, we spent a lot of time thinking about

prescriptions specify Azzalure®. The other main

is enough. It is very difficult in reality to check

how we would run the business from a stock

category of products that we dispense, both in

that the face to face consultation takes place, but

movement point of view, and, of course, we also

terms of numbers and also value, are facial aesthetic

we trust the professionals we are dealing with to

had to integrate the pharmacy operation into

fillers. We then also have a number of other

operate within their own professions’ guidelines.

the sophisticated IT systems that already existed

products such as facial peels and cosmaceutical

within the business. I then wrote a series of

products. In fact, Botulinum toxin is classed as a

CN:

standard operating procedures, to make sure that

prescription-only medicine and we have a stringent

grown in the last three and a half years?

every process from the receipt of the prescription

process by which we check that a prescriber is

PS: Year on year our pharmacy sales have at

to the final dispatch of the items is controlled,

who they say they are – that they are a qualified

least doubled and we are still getting new business

regulated and documented. I now spend time

doctor, dentist, or nurse prescriber – and that they

every day.

not only acting as the pharmacy superintendent

are able to not only write the prescription, but are

for Med-fx, but I also work in the pharmacy

also trained correctly to administer the products

CN:

dispensing prescriptions on a day to day basis,

to their patients. Consequently we insist that we

prescriptions from Med-fx?

and this helps to keep me close to the needs of

see training certificates for these professionals and

PS: Well, apart from our prices, the breadth of

our prescribers, their patients and of course our

this helps us to ensure that all products are being

our inventory, and the fact that we can also supply

suppliers.

supplied to legitimately qualified professionals

a huge range of sundry items, there is also our

who have been trained to administer the products

commitment to the accurate and timely delivery of

to their patients correctly and safely. All of our

all our products to our customers, whether they

CN:

How is the pharmacy at Med-fx different

How has the pharmacy side of the business

What are the advantages of getting your

from other pharmacies?

prescribers keep a record of the prescriptions they

are being supplied on prescription or through our

PS: The biggest difference is that we don’t have

have written for their patients and this will form

warehouse. All of this is underwritten by a single-

customers that walk through the door, which is

part of the patients’ overall medical records. The

minded commitment to providing an excellent

very unusual. The public doesn’t have access, and

pharmacy at Med-fx is also required to keep a copy

quality of service for everyone associated with the

so they can’t come in and buy medicines. Neither

of all prescriptions and because of the systems and

business, and that includes our prescribers, their

do we have a license to dispense National Health

processes we have within the company that manage

patients and our suppliers.

44

cosmeticnewsuk.com

the uk’s largest aesthetics Meeting

train with the Best to overtake the rest!

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Over 35 exhibitOrs have already signed up again fOr the third cOnsecutive year catch up with all yOur suppliers under One rOOf gain cpd accredited educatiOn netwOrk with Other aesthetic practitiOners take advantage Of great shOw deals see new prOducts first

CosmetiC n ews E the uk’s only free of charge aesthetiCs exhibition

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xpo 2012 29th - 30th april 2012 | business design Centre, islington, london

changes

for 2012

conference programme due to the demand there will be a small charge of £45 for the 2012 conference.

the conference is an excellent opportunity for delegates to see the very best uk and international speakers,discussing the latest topics and demonstrating the most up-to-date techniques. a complimentary lunch will be incorporated into the delegate package, with refreshments provided throughout the conference breaks. early Bird discount - receive 10% off on your conference ticket, book before the 30th september 2011 (you will also receive a complimentary vip party invite,which will include an evening of free food and alcohol)

r e g i s t e r o n l i n e f o r yo u r f r e e o f c h a r g e e x h i B i t i o n t i c k e t w w w . c o s m e t i c n e w s u k . c o m

BEST PRACTICE – Self Regulation

STEPS TO SUCCESS Mark Grainger from CHKS provides a step-by-step guide to registering with Treatments You Can Trust

With over 10 years experience in the health industry, Mark Grainger takes a lead role in CHKS for the management of the Department of Health backed register of cosmetic injectable providers www.TreatmentYouCanTrust.co.uk. Mark and his team oversee a rigorous process for applications from those doctors, dentists and registered nurses who meet the standards and training principles as set by the Independent Healthcare Advisory Services in consultation with the General Medical Council, Nursing and Midwifery Council and General Dental Council.

In 2011 an estimated 1.4 million cosmetic injectable treatments will take place in

registrant the other day who had been contacted by a member of the public

the UK alone. The establishment of Treatments You Can Trust came after six years

who wanted to go to them for treatment but who said ‘I am not going to

of discussion between the industry and the Department of Health to provide

come to you until you are on the register’. Some insurers are also now saying

consumers with the methods to find an appropriately qualified and medically

to people that before they can get their indemnity they have to register with

trained provider of cosmetic injectables.

Treatments You Can Trust and that has obviously had an impact.

The self-assessment form is comprehensive and includes health and safety,

“I think the most important thing about this is that we are making it safer for

management of medicines and cosmetic injectable products, the promotion

the patient but we are also protecting physicians because by having these

of services, communication with patients, policies and procedures, complaints

procedures in place it protects them if anything, God forbid, should go wrong.”

procedures, infection prevent and control, confidentiality, managing medical emergencies and training. People may have been put off of registering because they think the process will be too time consuming or laborious. However Mark is reassuring that it is actually quite straight forward and that he and his team can offer support to all those going through the process.

He explains, “It is quite an in depth and robust process but it is actually fairly straight forward, however we do need people to read the information because it can save a lot of time. Some people will find it a lot easier than others but we do give quite a lot of assistance and guidance to clinics. We have had clinics who have phoned up and said ‘I can do all of this but I am really struggling with that’ but we can give them advice on what they need to do. I would urge people to contact us if they are having any problems – we are here to help. ” Once they have received applications the CHKS has a time limit of 10 days to turn it around. As organisations vary in size and nationality, the service that Mark and CHKS provides is required to be flexible and his role includes organising randomly selected inspections, with only 24 hours’ prior notice to registrants who have been awarded the Quality Assurance Mark.

The scheme has received some criticism from people in the industry but Mark says support for it is growing and more and more clinics are beginning to come on board. More than 400 applications for a place on the register are currently being processed by CHKS with a lot of these being clinics with

MARK’S SIMPLE STEPS FOR REGISTRATION: Step One

Visit www.TreatmentsYouCanTrust.co.uk to calculate your cost for registration and proceed to make your initial payment. Top tip: Make sure you enter your e-mail address correctly when completing your form, as your username and password is sent to this address and check your ‘spam’ and ‘junk’ folders. Login and read through the standards and training principles carefully.

Step Two Once you are familiar with the standards, you are now ready to proceed to ‘full registration’ where you can make your final payment. Top tip: This part of the process can take a few days, so make sure you set time aside to complete the forms fully. A plan of action on how you will meet the standards is always useful.

Step Three Click on ‘practitioners information’ click on ‘second stage’ and proceed to self-assessment. Once completed, click on ‘submit’ for your application to enter the verification process. Top tip: There are eleven standards in total and you can save your answers at any time as you work your way through.

Mark and his team offer a help service for those providers who need assistance with their application, via Ihascosmetics@chks.co.uk .

The registration fee structure has been in place since inception of the scheme and is reviewed by the Governance Group.

Fee

Rate (plus VAT)

1.3.1.1 Initial Registration (Schedule 1 Para 1.2)

£50

1.3.1.2 Individual Mobile Registrant working in maximum of 10 sites (Annual Fee)

£500

1.3.1.3 Individual Mobile Registrant working in > 10 sites (Annual Fee)

Additional £50 per site

part of a recognised Quality Mark scheme that is growing and becoming

1.3.1.4 Single organisation with one site (Annual Fee)

£1000

more and more well known. It does take time but there is a lot of public

1.3.1.5 Organisation with more than one site (Annual Fee)

Additional £200 per each site

multiple locations. Mark says, “I speak to an awful lot of registrants during the course of a week and they are very keen for this to be in place. I think as an industry people are getting fed up with seeing all the news articles promoting a negative image of cosmetic medicine and they want to be part of this to address the balance.

“It is still very much a voluntary scheme, it is not regulatory, so people don’t have to join, but from our perspective the advantage of joining is being

interest around it now and people are beginning to check their local areas for practitioners that are on the register. I had an interesting conversation with a

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1.3.1.5 Definitions: 1.3.1.5.1 Individual mobile registrant: Registered self-employed or sole trader or partnership of no more than 2 people.

1.3.1.5.2 Site: A place where treatment takes place that meets the Standards.

1.3.1.5.3 Organization: A VAT registered Partnership of more than two people; company registered at Companies House; or an established subsidiary of either.

Business Focus - Debbie Brady

Going it alone Blue Horizons Marketing ran a competition to ‘win a website’ at the Cosmetic News Expo 2011.

In a series of interviews, we catch up with winner, Debbie Brady to see what it’s like setting up on your own in aesthetic medicine – the highs, the lows and all the in-betweens.

Debbie Brady recently made the decision to set up her own aesthetics practice and was given a helping hand after winning a competition at the Cosmetic News Expo in May to have her website designed by marketing company Blue Horizons.

Originally from Formby, Debbie left school in 1986 with 8 O levels unsure of what career she wanted. She worked for Natwest until in 1991 (then aged 22) she made the decision to go to Liverpool John Moores University and train to be a nurse.

“My time at the hospital afforded me vast experience in many conditions and eventually managing wards”, she remembers. “I found the ‘revolving door’ patients, with the same conditions readmitting time after time quite frustrating and thought a move to practice nursing would allow me to work in the health promotion field, to prevent this in some small way.”

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In 2001, she acquired her BSc (hons) Community health care nursing with specialist practitioner status in general practice nursing. Debbie returned to University in 2009 to do a Non-medical prescribing qualification, which enabled her to prescribe medication and manage independently all her patients with chronic diseases, without the need to liaise with the GP regarding appropriate treatment.

Since 2006 to date, Debbie has also been the lead nurse in her local GP Practice based commissioning group, acting as a conduit between the board and local nurses, facilitating change and organising education meetings.

Moving into facial aesthetics A working mother entering her 40’s Debbie herself had become more aware of ageing concerns and therefore has a great amount of empathy with other women. As she became more aware of Botox® and fillers she saw that she could provide a service to women who would trust her, her qualifications and professional approach. This all culminated in realising an ambition of setting up her own business.

She says, “I always felt I should have worked for myself, I’m always conscientious, give 100% to employers, and have high standards, but it wasn’t really a possibility nursing in the NHS. I also felt that

Building the business • Gained foundation qualification in Botox® and Dermal fillers.

• Registered with an aesthetic agency to gain practical experience and confidence.

• Joined a Liverpool ‘women in business’ organisation for guidance/ support/ grant.

• Registered company name.

• Insured self.

• Recruited accountancy services.

• Attended cosmetic news expo for contacts, education and resources.

• Created a logo and website holding page.

• Produced business stationery.

• Registered with facial aesthetic internet forum.

• Joined a Northern Aesthetic Practices Association.

• Opened accounts for stock.

• Subscribed to aesthetic journals.

• Bought uniforms.

• Created clinic setting.

• Sourced potential alternative clinic settings.

• Registered with consultingroom.com

I did not have an ideal work/life balance.

Once I had gained my non-medical prescribing qualification and began to hear more about facial aesthetics, I looked into the possibility of training in this field and realised it was achievable. It is something I felt could work alongside my current job (where I have no further capacity for career progression unless into management structure), and could afford me a better quality of life financially, and possibly allow me to reduce the hours in my main job, leading to a better work/ life balance.”

Debbie feels a real sense of achievement in having made a start towards self-employment, instead of merely talking about it. She says, “I am happy to utilise facial aesthetic skills that are in such demand, alongside my ability to independently prescribe and deliver health care advice accrued in 20 years of nursing.

This is a real opportunity to influence women who may feel that their only goal is to improve their facial appearance. I can provide health promotion in areas such as smoke cessation, nutrition, exercise, sun protection, and stress management as well as gently highlighting the need to attend for cytology and breast cancer screening programmes. I feel strongly that this holistic approach will lead to an improvement of their overall health and possibly contribute to reducing issues of anxiety, low self esteem, depression and of course the major chronic diseases caused by an unhealthy lifestyle.”

In particular, Debbie has been interested in the high uptake of Botox® amongst a lower socio economic group of women in Liverpool - which is deemed to be one of the unhealthiest cities in Europe, regarding mortality and morbidity rates. It strikes her that this is a captive audience who may otherwise not listen to, or access the advice health professionals spout. Debbie is motivated by the potential influence she can make but her biggest influence has been her dad. “My Dad, who has always instilled in his daughters a sense of ambition, hard graft

and striving for nothing less than perfection; believing that the rewards are not just financial, but deliver a real sense of personal worth, achievement and satisfaction.

Nursing has managed to deliver most of this for me, but I still feel there’s more I can achieve.”

When asked what her biggest challenge has been Debbie laughs, “In a word everything!”

But on a more serious note one of the major challenges she has faced is time constraints.

Working full time, raising two young children, and trying to set a business up whilst consolidating her learning hasn’t been easy.

“It is a completely different arena to where I’ve been working for the past 20 years. Not knowing where to access reliable resources and support to find information, whilst wanting to be professional and follow guidelines, protocols and legal frameworks.

I was surprised that it seems demand is being met. Every salon I have contacted has either a visiting clinician providing facial aesthetics or refers elsewhere – making the job of selling my services that bit harder!”

Looking forward to the future, Debbie hopes facial aesthetics will have “an increasingly raised profile, becoming safer, more regulated, accepted and more common place”.

Marketing Marketing is one of the key aspects when setting up a new business and Debbie knew that in order to make her a business a success she needed to carry out effective research. Debbie distributed questionnaires to the local beauty and hair salons to assess their current demand and see if they already provide the service, assess current costs, opinions, and whether they would consider using her business, i.e. a new provider.

She also produced a separate questionnaire for their clients to assess their opinions/ demand for her business.

“I always felt I should have worked for myself...but it wasn’t really a possibility nursing in the NHS. I also felt that I did not have an ideal work/life balance.”

“It goes without saying that a key marketing strategy I plan to utilise to maximum effect is ‘word of mouth’ referral to family, friends, colleagues, and associates – getting my name out there as much as possible. I have also: Undertaken branding including developing business stationery Registered with consultingrooms.com Over the next few months she plans to: • Create marketing literature such as brochures and fliers to further promote my services • Create a website to generate new leads and raise awareness • Communicate through Social Media including Facebook, Twitter Debbie was keen that her all her marketing communications helped to attract and maintain potential clients’ interest and custom – answering questions, reassuring and informing whilst reflecting her personality and professionalism.

“I won a website with Blue Horizons Marketing, and was impressed by their professionalism, examples of work and reasonable costs. Prior to this opportunity arising I had not really considered the need for a marketing partner to assist, although now realise the value. They have been excellent, friendly, reassuring, trustworthy, reliable, supportive, professional and vital to my business.”

When deciding on her brand identity Debbie said she wanted something that was “modern rather than particularly trendy”. She explains, “I wanted it to be clean and clinical looking, reflecting a health professional so distinguishable from a beautician. I also wanted my brand identity to be memorable but at the same time subtle and tasteful, not bright or brash.”

And her top tips for anyone thinking of setting up on their own?

1 market research, assess demand 2 know your product 3 use a marketing company to help create a professional image.

We’ll be catching up with Debbie again in six months time to see how she is getting on and to see how successful her marketing strategy has been.

cosmeticnewsuk.com

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Company Profile - Galderma

A s t rateg i c f i t We find out how Galderma and Q-Med have joined forces to make a powerful product portfolio

A significant complementary portfolio

T

he past few months have seen two substantial developments in Galderma’s aesthetic corrective business. In January the company launched its Emervel® range of dermal fillers and in February it completed its acquisition of Swedish medical device company Q-Med. The acquisition was the largest in Galderma’s history and marked a major milestone by bringing together two strong companies and creating a powerful product portfolio to meet physician and patient needs. Negotiations for the acquisition opened late last year, resulting in a public share offer announced on December 13 2010, unanimously recommended by the board of Q-Med. On February 24 2011, Galderma announced that it had acquired 93.98% of Q-Med shares, effectively assuring that the remaining shares would be acquired.

On Q One of the most well-known names in the industry, Q-Med is a fast-growing, medical device company which develops, produces, markets and sells medical implants based on its patented NASHA technology, for the production of non-animal stabilised hyaluronic acid. It is an industry leader in developing and commercialising products based on hyaluronic acid (HA). Q-Med’s portfolio includes the dermal filler Restylane®, the global market leader and gold standard for smoothing out wrinkles and lines, for filling out and shaping lips, defining facial contours and improving the quality of the skin. Other flagship brands are Macrolane, for body contouring; Deflux, a world-leading niche product for the treatment of VUR (vesicoureteral reflux) and Durolane, for the treatment of osteoarthritis and Solesta for the treatment of fecal incontinence.

Based in Uppsala near Stockholm, the company has offices in 21 countries and relationships with independent distributors that allow consumers in over 70 countries to benefit from its products. With sales of €145 million in 2010, the company employs approximately 640 people, of whom 350 work in Uppsala.

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Together, Galderma and Q-Med now have a significant portfolio of products for aesthetic medical treatments. The new portfolio, with the mix of dermal fillers and muscle relaxants in particular, offers significant complementarities: the combination of Q-Med’s Restylane® with Galderma’s botulinum toxin product Azzalure® and Emervel®, will allow the company to have a stronger market position in this highly competitive industry segment. The expanded portfolio accelerates Galderma’s strategy for growing its aesthetic corrective business, catapulting the company into a leading position in the global market for injectables. Valued at around $1.7 billion ($1.2 billion), this segment offers enormous opportunity for rapid growth. Minimally invasive procedures are swiftly becoming the preferred treatment for aesthetic interventions, but market penetration remains relatively low. Renewal rates after an initial procedure stand at 95%.

A new global center of excellence Q-Med has robust, sophisticated manufacturing and distribution operations, securing the highest quality standards in the industry, offering real competitive advantage. Its automated facility has the potential to meet market needs well into the future, providing Galderma with access to proven experience and globally recognized excellence in the production of fillers. Q-Med’s focused and talented R&D team have a solid track record in the development of medical devices and in HA research. It continues to innovate, with an array of new products in the pipeline that will further enhance the effectiveness of its HA fillers. Q-Med is strong on biopolymers and engineering, which is an excellent fit with Galderma’s own expertise in skin biology. Working together, the two companies’ R&D teams will constitute a new global center of excellence for aesthetic treatments, expanding their combined ability to innovate.

A strong access to new markets Geographically, the two companies are also highly complementary, broadening Galderma’s footprint while offering considerable scope for expansion. Albert Draaijer, vice president of marketing and markets said, “Galderma’s strong presence in Latin America will provide a solid base for marketing Q-Med products there, while in North America, Galderma will have a strong distribution partner who is an established market leader in dermatology and aesthetic procedures. In Asia, Galderma and Q-Med’s operations are also a good fit: Q-Med has approvals in China, for example, opening up new possibilities for Galderma in one of the world’s most dynamic markets. Q-Med sales and marketing teams are highly motivated and professional, having built up strong relationships with doctors in their markets, to whom they also offer training in Q-Med products and devices. This acquisition creates exciting opportunities for both companies’ employees. The integration of Q-Med’s experienced, innovative and talented teams provides the dermatology community with further assurance of the quality and reliability of Galderma’s products and services.”

“This is great news for physicians and patients aspiring for even better medical solutions for their corrective and aesthetic needs”, adds president and CEO Humberto C. Antunes. “Both Galderma and Q-Med have developed strong product portfolios and commercial organisations, sharing a commitment to R&D and product excellence. The combination of the two companies, each leader in their respective fields, will further enhance service to physicians in the short-term and advance science in the long term.”

Q - M ed at a glance

MAKE THIS SPACE WORK FOR YOU! The essential tool for your business.

To reach over 15,000 specialists in the cosmetic market Call a member of the sales team today 01268 754 897 www.cosmeticnewsuk.com

CosmetiC news CosmetiC news th e

voiCe

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y our

industry

www.CosmetiCnewsuk.Com

the uk’s only free of charge medical aesthetics trade magazine

• A medical device company focused on products based on its patented NASHA technology for the production of non-animal stabilised hyaluronic acid • Founded in 1987 by Bengt Agerup • Head Office in Uppsala • Q-Med employs approx, 640 people, including 350 in Sweden • Restylane® approved for sales in Europe in 1999 and in the US in 2003 • Q-Med products are distributed in more than 70 countries • Sales in 2010 of £145 million • 21 affiliates, mainly in Europe and Asia • Q-Med major brands include Restylane® (dermal fillers), Marcolane (body contouring), • Deflux, (VUR vesicoureteral reflux), Durolane (Osteoarthritis), Solesta (fecal incontinence)

G alderma at a glance • A global specialty pharmaceutical company with an exclusive focus on dermatology • In 2010, Galderma reported sales of € 1.2 billon, an increase 16.1% on the previous year, at comparable exchange rates • Headquarters in Lausanne, Switzerland • 31 affiliates in all major countries and continents, with more than 3,300 employees • Galderma products distributed in more than 70 countries • In 2010, 21.3% of revenues invested annually to discover and develop new drugs and access innovate technologies • Galderma research efforts have allowed the company to publish 1,700 scientific publications, develop more than 500 inventions and file more than 5,000 patient applications and patents • Three R&D centers (France, United States and Japan) • Three manufacturing sites (France, Canada and Brazil) • Created in 1981 as a joint venture between Nestle and L’Oreal • Galderma major brands include: Differin (acne), Epiduo (acne), Efracea (rosacea), Etrivex (scalp psoriasis), Loceryl (fungal nail), Silkis (psoriasis), Rozex (rosacea), Metvix (skin cancer), • Azzalure® (skin senescence), Emervel® (skin senescence), Cetaphil (therapeutic skin care line) and Curanail (fungal nail)

SaleS executiveS, london and Home countieS

We are looking for highly motivated Sales Executives with experience in the Professional Skin Care industry for new business sales roles following our 2011 launch in the UK. Intraceuticals is an Australian company that has built a strong, global niche brand at the premium end of the Professional Skin Care industry with its results driven treatments and products. Instant and sustainable results combined with a strong celebrity following, provides a compelling business model to our partner clinics and spas.

As you will have proved in previous Sales Executive roles, you will possess the drive and ability to open new accounts in your designated territory. You will have a minimum of 3 years wholesale sales experience and a proven track record in the Professional Skin Care industry, specifically, high-end beauty salons, spas, resorts and Med Spas/dermatologists.

A beauty therapy qualification would be beneficial but not essential. A passion for quality skincare is essential.

Salary Package is negotiable and will be based on experience and qualifications. Great career prospects exist within Intraceuticals, especially for those that demonstrate both new business sales and management capabilities.

Please visit our website for product information, etc. www.intraceuticals.com To be a part of our dynamic team, please email your resume in confidence to James Stringer: james.stringer@intraceuticals.com

Dates for the Diary

SEPTEMBER

diary

We round up upcoming events, training courses and meetings

bioptica Laser Safety Consultants Bioptica: Laser Core of Knowledge course given at YOUR clinic on a date that suits YOU. Visit www.bioptica.co.uk for more information or call 07766 591 085.

2 Wigmore Medical Training, Sculptra Training Day One (day two six weeks later), London, training@wigmoremedical.com 2-3 IAAFA Annual Conference 2011, Royal Society of Medicine, London, www.iaafa.net 3 Meeting of the Society of Cosmetic Physicians & Surgeons (SCPS), Birmingham, www.scps-uk.org 3 Dermis Deep Microsclerotherapy Course, Birmingham, www.ddassist.com 3 Cosmetology Dermal Fillers Foundation, Manchester, www.cosmetologyuk.com 4 Cosmetology Botox Vistabel Foundation, Manchester, www.cosmetologyuk.com 4 Body Silk Consulting Introductory One-day business course for beauty and medical start-ups, www.bodysilk.co.uk/home/training-courses 5 Wigmore Medical Training, CPR, London, training@wigmoremedical.com 5 Aesthetic Academy + Dermal Filler Basic Course, Swansea, www.aestheticstraining.co.uk 6 Aesthetic Academy + Botulinum Toxin Basic Course, Swansea, www.aestheticstraining.co.uk 6 LCS Academy Core of Knowledge, www.lcsacademy.co.uk 7-8 Sterex Advanced Cosmetic Procedures, Birmingham, www.sterex.com

OCTOBER 1 Cosmetology Botox Vistabel Foundation, Birmingham, www.cosmetologyuk.com 2 Cosmetology Dermal Fillers Foundation, Birmingham, www.cosmetologyuk.com 2 Wigmore Medical Training, Introduction to Skincare and Chemical Peels, London, training@wigmoremedical.com 3 Wigmore Medical Training, Camouflage, London, training@wigmoremedical.com 3 Aesthetic Academy + Dermal Filler Basic Course, Leeds, Yorkshire, www.aestheticstraining.co.uk 3-5 LCS Academy BTEC Medical Laser/IPL Part 1 (Pt 2: 21-22 Nov), www.lcsacademy.co.uk 4 Aesthetic Academy + Botulinum Toxin Basic Course, Leeds, Yorkshire, www.aestheticstraining.co.uk 4 Wigmore Medical Training, Sculptra Training Day One (day two six weeks later), London, training@wigmoremedical.com 4-5 SkinCeuticals Training, Cheshire, www.SkinBrands.co.uk 4-5 Medik8 Training, London, www.

SkinBrands.co.uk 5 Botox and Dermal Filler, Int/ Advanced level, Glasgow www. inspiredcosmetictraining.com 6 Dr Bob Khanna Training Institute, Dermal Fillers – Advanced, www.drbobkhanna.com 7 Wigmore Medical Training, CPR, London, training@wigmoremedical.com 7 Dr Bob Khanna Training Institute, Oral Facial Course, www.drbobkhanna.com 7 CORE OF KNOWLEDGE (Nottm) training@mapperlypark.co.uk 8 Wigmore Medical Training, Microsclerotherapy and Facial Telangiectasia, London, training@wigmoremedical.com 10 Aesthetic Academy + Dermal Filler Basic Course, Scotland, www. aestheticstraining.co.uk 10 – 13 – Btec Award Laser and Light Based Hair Removal and Photorejuvenation 52

cosmeticnewsuk.com

7-8 Medik8 Training, London, www.SkinBrands.co.uk 10 Cosmetic Courses Foundation Botulinum Toxin and Dermal Filler Course, www.cosmeticcourses.co.uk 10 Dermis Deep Botox Course, Belfast, www.ddassist.com 10 Dermis Deep Dermal Filler Course, Belfast, www.ddassist.com 10 Wigmore Medical Training, Microsclerotherapy and Facial Telangiectasia, London, training@wigmoremedical.com 10 Cosmetology Botox Vistabel Foundation, London, www.cosmetologyuk.com 11 Cosmetology Dermal Fillers Foundation, London, www.cosmetologyuk.com 12 Wigmore Medical Training, Medik8 DermalRoller, London, training@wigmoremedical.com 13 Aesthetic Academy + Dermal Filler Basic Training, Birmingham, www.aestheticstraining.co.uk 13-14 SkinCeuticals Training, Cheshire, www.SkinBrands.co.uk 14 Aesthetic Academy + Botulinum Toxin Basic Course, Birmingham, www.aestheticstraining.co.uk 14 Wigmore Medical Training, Introduction to Skincare and Chemical Peels, London, training@ wigmoremedical.com 15 CORE OF KNOWLEDGE (London) www.mapperleypark.co.uk/training 15 Wigmore Medical Training, Introduction to Boutlinum Toxin Type A, London, training@wigmoremedical.com 16 Wigmore Medical Training, Introduction to Dermal Fillers, London, training@wigmoremedical.com 17 Dermis Deep Advanced Botox Course, Central

(Nottm) training@mapperlypark.co.uk 11 Aesthetic Academy + BotulinumToxin Basic Course, Scotland, www.aestheticstraining.co.uk 13 Aesthetic Academy + Dermal Filler Basic Course, Newport, Wales, www.aestheticstraining.co.uk 13 Dr Bob Khanna Training Institute, Peel Course, www.drbobkhanna.com 13 Wigmore Medical Training, Introduction to Boutlinum Toxin Type A, London, training@wigmoremedical.com 14 Aesthetic Academy + Botulinum Toxin Basic Course, Newport, Wales, www.aestheticstraining.co.uk 14 Wigmore Medical Training, Introduction to Dermal Fillers, London, training@ wigmoremedical.com 15 Cosmetic Courses Botulinum Toxin and Dermal Filler Course, www.cosmeticcourses.co.uk 15 Dermis Deep Superficial and Medium Chemical Peels, Manchester, www. ddassist.com 15 Cosmetology Botox Vistabel Foundation, Manchester, www.cosmetologyuk.com 16 Cosmetology Dermal Fillers Foundation, Manchester, www.cosmetologyuk.com 18 Medik8 Training, Cheshire, www.SkinBrands.co.uk 19 SkinMedica Training, Cheshire, www.SkinBrands.co.uk 19 Aesthetic Academy + Dermal Filler Basic Course, Manchester, www.aestheticstraining.co.uk 19 Aesthetic Academy + Dermal Filler Basic Course, Windsor, Berkshire, www.aestheticstraining.co.uk 19-20 Sterex Advanced Cosmetic Procedures, London, www.sterex.com 20 Aesthetic Academy + Botulinum Toxin Basic Course, Manchester, www.aestheticstraining.co.uk 20 Aesthetic Academy + Botulinum Toxin Basic Course, Windsor, Berkshire, www.aestheticstraining.co.uk

London, www.ddassist.com 19 Wigmore Medical Training, GloMinerals, London, training@wigmoremedical.com 20 Medik8 Training, Cheshire, www.SkinBrands.co.uk 20 Laser/IPL Core of Knowledge Training, www.lasersafe.co.uk 20 Wigmore Medical Training, Glo Therapy, London, training@wigmoremedical.com 21 SkinMedica Training, Cheshire, www.SkinBrands.co.uk 21, Botox and Dermal Filler, Foundation level, Glasgow www.inspiredcosmetictraining.com 22 Aesthetic Academy + Botulinum Toxin Basic Course, Newcastle, www.aestheticstraining.co.uk 23 Aesthetic Academy + Dermal Filler Basic Course, Newcastle, www.aestheticstraining.co.uk 24 Wigmore Medical Training, Microsclerotherapy and Facial Telangiectasia, London, training@wigmoremedical.com 24 Dermis Deep Botox Course, Manchester, www.ddassist.com 27 Wigmore Medical Training, Introduction to Skincare and Chemical Peels, London, training@ wigmoremedical.com 27-28 SkinCeuticals Training, London, www.SkinBrands.co.uk 28 Dr Bob Khanna Training Institute, Botulinum Toxin Beginners, www.drbobkhanna.com 29 Dr Bob Khanna Training Institute, Botulinum Toxin Advanced, www.drbobkhanna.com 29 Wigmore Medical Training, Advanced Toxins and Fillers, London, training@wigmoremedical.com 30 Dr Bob Khanna Training Institute, Dermal Fillers – Beginners, www.drbobkhanna.com

22 Dermis Deep Botox Course, Central London, www.ddassist.com 22 Dermis Deep Dermal Filler Course, Central London, www.ddassist.com 24 Wigmore Medical Training, GloMinerals, London, training@wigmoremedical.com 24 Dr Bob Khanna Training Institute, Botulinum Toxin - Beginners, 24 Advanced Skin Science, Ealing, London, www.sallydurant.com www.drbobkhanna.com 25 Dr Bob Khanna Training Institute, Botulinum Toxin - Advanced, www.drbobkhanna.com 25 Wigmore Medical Training, Introduction to Skincare and Chemical Peels, London, training@wigmoremedical.com 25-26 SkinCeuticals Training, London, www.

SkinBrands.co.uk 26 Dr Bob Khanna Training Institute, Dermal Fillers – Beginners, www.drbobkhanna.com 26 Wigmore Medical Training, Medik8 DermalRoller, London, training@ wigmoremedical.com 29 Dermis Deep Botox Course, Glasgow, www.ddassist.com 29 Dermis Deep Dermal Filler Course, Glasgow, www.ddassist.com 29 Cosmetology Botox Vistabel Foundation, Glasgow, www.cosmetologyuk.com 30 Cosmetology Dermal Fillers Foundation, Glasgow, www.cosmetologyuk.com 31 Consultative Analysis and Advanced Skin Assessment, Ealing, London, www. sallydurant.com

NOVEMBER 1-2 Medik8 Training, London, www.SkinBrands.co.uk 2 – CORE OF KNOWLEDGE (London) training@mapperlypark.co.uk 6 Cosmetology Advanced Facial Aesthetics, Glasgow, www. cosmetologyuk.com

7-8 Sterex Advanced Electrolysis, www.sterex.com 7-11 November – Btec Award Laser, Light and Associated Aesthetic Therapies (Nottm) training@mapperlypark.co.uk 8-9 SkinCeuticals Training, Cheshire, www.SkinBrands.co.uk 9 Wigmore Medical Training, Introduction to Skincare and Chemical Peels, London, training@wigmoremedical.com 9 Dr Bob Khanna Training Institute, Botulinum Toxin - Beginners, www.drbobkhanna.com 10 Dr Bob Khanna Training Institute, Botulinum Toxin - Advanced, www.drbobkhanna.com 10 Wigmore Medical Training, Introduction to Boutlinum Toxin Type A, London, training@wigmoremedical.com 11 Dr Bob Khanna Training Institute, Dermal Fillers – Beginners, www. drbobkhanna.com 11 Wigmore Medical Training, Introduction to Dermal Fillers, London, training@wigmoremedical.com 12 Dermis Deep Microsclerotherapy Course, Birmingham, www.ddassist.com 12 Cosmetic Courses Foundation Botulinum Toxin and Dermal Fillers, www.cosmeticcourses.co.uk 12 Wigmore Medical Training, Microsclerotherapy and Facial Telangiectasia, London, training@wigmoremedical.com 12 Cosmetology Botox Vistabel Foundation, London, www. cosmetologyuk.com 13 Cosmetology Dermal Fillers Foundation, London, www. cosmetologyuk.com 14 The Causes Development and Management of Acne, Ealing, London, www.sallydurant.com 15 Laser/IPL Core of Knowledge Training, www.lasersafe.co.uk

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ABC Laser Contact: Guy Gouldsmit T: 08451 707 788 E: info@a-b-c-uk.com W: www.abclasers.co.uk ABME Tech Contact: David Leahy T: 01843 297110 E: david.leahy@abmetech.com W: www.abmetech.com

Cosmedix Contact: Aysha Capion-Awward T: 0844 855 2499 E: info@cosmedix.com W: www.cosmedix.com

Aesthetic Academy + Training Contact: Chantalle Coombes T: 0845 519 4823 W: www.aestheticstraining.co.uk E: training@aestheticacademy.co.uk

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Aesthetox Academy Service: Training Contact: Lisa Tyrer T: 0870 0801746 E: treatments@aesthetox.co.uk W: www.aesthetox.co.uk Barnes Roffe LLP Service: Chartered Accountants, Business and Tax Advisors Contact: Shen Yap T: 020 8988 6100 E: s.yap@barnesroffe.com W: www.barnesroffe.com

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Medical Aesthetic Group Contact: David Gower T: 02380 676733 E: info@magroup.co.uk W: www.magroup.co.uk Merz Aesthetics Contact: Merz Aesthetics Customer Services T: 0333 200 4140 E: info@merzaesthetics.co.uk

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Morning Star Surgical S.A. (Pty) Ltd Contact: Brian Nielsen T: +27 (82) 667 2506 E: brian@morningstar-medical.com W: www.morningstarsurgical.co.za

Euromedical Systems Ltd. Contact: Phillip Richardson T: 0845 130 4949 W: www.euromedicalsystems.co.uk E: info@euromedicalsystems.co.uk

Hamilton Fraser Contact: Wai Chan T: 0845 3106 300 E: cosmetic@hamiltonfraser.co.uk W: www.hamiltonfraser.co.uk

Health xchange Contact: Customer Service T: +44 1481 736832 E: orders@healthxchange.com W: www.healthxchange.com LCS Academy Contact: Dr Elizabeth Raymond Brown T: 0845 0037315 E: admin@lcsacademy.co.uk W: www.lcsacademy.co.uk

MACOM Compression Garments Contact: MACOM Customer Services T: 020 7386 0011 E: info@macom-medical.com W: www.macom-medical.com

Skin Geeks Ltd Contact: Trishna Shah T: +44 (0)1865 338046 E: trishna@skingeeks.co.uk W: www.skingeeks.co.uk Specialist Make-Up Services Ltd Contact: Mike Lawrence T: 0845 2302021 E: enquiries@permanent-makeup.com W: www.permanent-makeup.com Services: Permanent Make-Up

Med-fx Contact: Faye Price T: 01376 532800E: sales@medfx.co.uk W: www.medfx.co.uk

E-Clinic Contact: Mark Lainchbury T: 01274 530 505 E: info@e-clinic.uk.com W: www.e-clinic.uk.com

Harley Aesthetics Contact: Dr Mark Harrison T: 02074872772 E: enquiries@harleyaesthetics.com W: www.harleyaesthetics.com Services: Training

Boston Medical Group LTD Contact: Iveta Vinklerova T: 0207 727 1110 E: info@boston-medical-group.co.uk W: www.boston-medical-group.co.uk Candela UK Ltd Contact: Ben Savigar-Jones T: +44 08455210698 E: alex@alexsilver.co.uk W: www.candelalaser.co.uk

DermaFx Micropigmentation Service: Permanent Make Up Contact: Evie Adams T : 08703002078 E: dermafx@evieadams.com W: www.evieadams.com

Galderma Contact: Azzallure Sales Team T: 01923 208950 E: info.uk@galderma.com W: www.galderma.co.uk

Skin brands Contact: Tracey Beesley T: +44 (0) 2089978541 E: tracey@skinbrands.co.uk W: www.skinbrands.co.uk

Mayfair Medical Contact: Mike Filapiuak T: +44 02076296269 E: mike@ericson-laboratoire.co.uk W: www.ericson-laboratoire.com

Energist Contact: Andrew Snoddon T: 01792 798768 E: enquiries@energist-international.com W: www.energist-international.com

Betheny Workwear Service: Uniforms Contact: Siju Jacob T: 01516 776 777 W: www.betheny.co.uk E: enquiries@betheny.co.uk

Lifestyle Aesthetics Contact: Sue Wales T: 0845 0701 782 E: info@lifestyleaestheics.com W: www.lifestyleaesthetics.com

Mapperley Park Training www.mapperleypark.co.uk/training Email: training@mapperleypark.co.uk Tel: 01159 690 111

Cutera (Europe) Contact: Stephen Ritchie T: 07969993296 E: sritchie@cutera.com W: www.cutera.com

Eden Aesthetics Contact: Anna Perry T: 01245 227 752 E: info@edenaesthetics.com W: www.edenaesthetics.com

Beehive Medical Solutions Contact: Kevin Rendell T: 020 8550 9108 E: enquiries@beehive-solutions.co.uk W: http: //www.beehive-solutions.co.uk/ catalog

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Cosmetic Courses Contact: Morag Hague T: 0845 230 4110 E: info@cosmeticcourses.co.uk W: www.cosmeticcourses.co.uk

Allergan Contact: Customer Service T: 01628 494444 W: www.juvedermultra.co.uk

Sanofi Aventis Contact: Customer Service T: 01483 554 809 W: www.sanofi-aventis.co.uk

Lynton Contact: Customer Services T: 0845 6121545 E: info@lynton.co.uk W: www.lynton.co.uk

Cordcourt Limited Service: Uniform Supplier Contact: Gina Unsworth T: 0161 724 6009 E: sales@cordcourt.co.uk W: www.cordcourt.co.uk

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My Cells/Scandinavian UST Ltd Contact: John Tucker T: +35361 312979 E: info@mycells.ie W: www.my-cells.net Polaris Lasers Contact: Neil Calder T: 01234841536 E: njc@polaris-laser.com W: www.polaris-laser.com Q-MED Contact: Customer Service T: 0207 796 3290 E: info.uk@q-med.com W: www.q-medpractitioner.com/uk Qutis Contact: Marea Brennan Thorns T: 01844 213007 E: info@qutisclinics.co.uk W: www.qutisclinics.co RECOVA COMPRESSION GARMENTS Contact: Eva Sanchez-Smith E: eva.sanchez@recovapostsurgery.com W: www.recovapostsurgery.com T: 0207 000 1044 Rosactive Phytoceutical U.K. Contact: Mr. Naci Gulsan T: 020 85090907 E: hunalp@hunalp.co.uk W: www.rosactive.co.uk www.hunalp.co.uk

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Surface Imageing Solutions Contact: Nick Miedzianowski-Sinclair Telephone : +447774802409 E: nms@surfaceimageing.co.uk W: www. surfaceimageing.co.uk Service: Skin Analysis systems & services Ulthera Contact: Phillip Andrews (UK Sales Director) T: 07825442968 E: p.andrews@ulthera.com Vaser Lipo/ Sound Surgical Technologies LLC Contacts: Simon Davies T: +44 (0) 7971 686114 E: SDavies@soundsurgical.com W: www.vaser.com Wealden Projects Contact: Kevin Dewhurst E: kevin@wealden projects.com W: www.wealdenprojects.com T: 01892 611552 M: 07969 697593 Wellness Trading Contacts: Adam Birtwistle T: 01746 718123 E: contact@wellnesstrading.co.uk W: www.wellnesstrading.co.uk Zanco Models Contacts: Mr Ricky Zanco T: 08453076191 E: info@zancomodels.co.uk W: www.zancomodels.co.uk

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Your partner in injectable facial aesthetics

Bocouture® Bocouture is indicated for the temporary improvement in the appearance of moderate to severe vertical lines between the eyebrows seen at frown (glabellar frown lines) in adults below 65 years when the severity of these lines has an important psychological impact for the patient.

Bocouture ® 50 Abbreviated Prescribing Information Please refer to the Summary of Product Characteristics (SmPC). Presentation 50 LD 50 units of Botulinum toxin type A (150 kD), free from complexing proteins as a powder for solution for injection. Indications Temporary improvement in the appearance of moderate to severe vertical lines between the eyebrows seen at frown (glabellar frown lines) in adults under 65 years of age when the severity of these lines has an important psychological impact for the patient. Dosage and administration Unit doses recommended for Bocouture are not interchangeable with those for other preparations of Botulinum toxin. Reconstitute with 0.9 % sodium chloride. Intramuscular injection (50 units/ 1.25 ml). Standard dosing is 20 units; 0.1 ml (4 units): 2 injections in each corrugator muscle and 1x procerus muscle. May be increased to up to 30 units. Not recommended for use in patients over 65 years or under 18 years. Injections near the levator palpebrae superioris and into the cranial portion of the orbicularis oculi should be avoided. Contraindications Hypersensitivity to Botulinum neurotoxin type A or to any of the excipients. Generalised disorders of muscle activity (e.g. myasthenia gravis, Lambert-Eaton syndrome). Presence of infection or inflammation at the proposed injection site. Special warnings and precautions.

Should not be injected into a blood vessel. Not recommended for patients with a history of dysphagia and aspiration. Adrenaline and other medical aids for treating anaphylaxis should be available. Caution in patients receiving anticoagulant therapy or taking other substances in anticoagulant doses. Caution in patients suffering from amyotrophic lateral sclerosis or other diseases which result in peripheral neuromuscular dysfunction. Too frequent or too high dosing of Botulinum toxin type A may increase the risk of antibodies forming. Should not be used during pregnancy unless clearly necessary. Interactions Concomitant use with aminoglycosides or spectinomycin requires special care. Peripheral muscle relaxants should be used with caution. 4-aminoquinolines may reduce the effect. Undesirable effects Usually observed within the first week after treatment. Localised muscle weakness, blepharoptosis, localised pain, tenderness, itching, swelling and/or haematoma can occur in conjunction with the injection. Temporary vasovagal reactions associated with pre-injection anxiety, such as syncope, circulatory problems, nausea or tinnitus, may occur. Frequency defined as follows: very common (≥ 1/10); common (≥ 1/100, < 1/10); uncommon (≥ 1/1000, < 1/100); rare (≥ 1/10,000, < 1/1000); very rare (< 1/10,000). Infections and infestations; Uncommon:

Botulinum toxin type A free from complexing proteins

bronchitis, nasopharyngitis, influenza infection. Psychiatric disorders; Uncommon: depression, insomnia. Nervous system disorders; Common: headache; Uncommon: facial paresis (brow ptosis), vasovagal syncope, paraesthesia, dizziness. Eye disorders; Uncommon: eyelid oedema, eyelid ptosis, blurred vision, eye disorder, blepharitis, eye pain. Ear and Labyrinth disorders; Uncommon: tinnitus. Gastrointestinal disorders; Uncommon: nausea, dry mouth. Skin and subcutaneous tissue disorders; Uncommon: pruritus, skin nodule, photosensitivity, dry skin.

Musculoskeletal and connective tissue disorders; Common: muscle disorders (elevation of eyebrow), sensation of heaviness; Uncommon: muscle twitching, muscle cramps. General disorders and administration site conditions; Uncommon: injection site reactions (bruising, pruritis), tenderness, Influenza like illness, fatigue (tiredness). General; In rare cases, localised allergic reactions; such as swelling, oedema, erythema, pruritus or rash, have been reported after treating vertical lines between the eyebrows (glabellar frown lines) and other indications. Overdose May result in pronounced neuromuscular paralysis distant from the injection site. Symptoms are not immediately apparent post-injection. Bocouture ® may only be used by physicians with suitable qualifications and proven experience in the application of Botulinum toxin Legal Category POM. Basic NHS Price 50 U/vial £72.00. Product Licence Number PL 29978/0002 Marketing Authorisation Holder Merz Pharmaceuticals GmbH, Eckenheimer Landstraße 100, 60318 Frankfurt/Main, Germany. Date of revision of text JAN 2011. Full prescribing information and further information is available from Merz Pharma UK Ltd., 260 Centennial Park, Elstree Hill South, Elstree, Hertfordshire WD6 3SR. Tel: +44 (0) 333 200 4143 Adverse events should be reported. Reporting forms and information can be found at www.yellowcard.gov.uk. Adverse events should also be reported to Merz Pharma UK Ltd at the address above or by email to medical.information@merz.com or on +44 (0) 333 200 4143.

1054/BOC/MAR/2011/JH. Date of preparation April 2011 BOCOUTURE® is a registered trademark of Merz Pharma GmbH & Co, KGaA.

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onfidence is...

Her happiness.

Your expertise.

Our experience.

Vistabel® is licensed for the treatment of moderate to severe glabellar lines Delivers lasting patient satisfaction, time after time1,2 Trusted with over 1 million cosmetic procedures across Europe3* The world’s first and most studied botulinum toxin4†

Satisfaction that shows

Vistabel® (botulinum toxin type A) Abbreviated Prescribing Information Presentation: Botulinum toxin type A (from clostridium botulinum), 50 Allergan Units/vial.

Indications: Temporary improvement in the appearance of moderate to severe vertical lines between the eyebrows seen at frown, in adults <65 years, when the severity of these lines has an important psychological impact for the patient.

Dosage and Administration: See Summary of Product Characteristics for full information.

Do not inject into blood vessels. Doses of botulinum toxin are not interchangeable between products. Not recommended for patients <18 or >65 years. Use for one patient treatment only during a single session. Reconstitute vial with 1.25ml of 0.9% preservative free sodium chloride for injection (4U/0.1ml). The recommended injection volume per muscle site is 0.1ml (4U). Five injection sites: 2 in each corrugator muscle and 1 in the procerus muscle: total dose 20U. Contra-indications: Known hypersensitivity to any constituent. Myasthenia gravis, Eaton Lambert syndrome. Infection at proposed injection sites. Pregnancy or lactation.

Warnings/Precautions: Use for one patient treatment only during a single session.

Relevant anatomy and changes due to prior surgical procedures must be understood prior to administration. Product contains less than 1mmol sodium (23mg) per dose. Do not exceed recommended dosages and frequency of administration. Epinephrine (adrenaline) or any other anti-anaphylactic measures should be available. Very rare reports of adverse reactions possibly related to spread of toxin distant from site of injection. Therapeutic doses may cause exaggerated muscle weakness. Caution in patients with history of dysphagia and aspiration. Patients or caregivers should seek immediate medical care if swallowing, speech or respiratory disorders arise. Too frequent or excessive dosing can result in risk of antibody formation, which may lead to treatment failure. Caution in the presence of inflammation at the proposed injection site(s) or when excessive muscle weakness or atrophy is present. Caution when used in patients with amyotrophic lateral sclerosis or with peripheral neuromuscular disorders. Effects of administering different botulinum toxin stereotypes simultaneously, or within several months of each other, is unknown and may cause exacerbation of excessive neuromuscular weakness.

Interactions: Theoretically, effect may be potentiated by aminoglycoside antibiotics or other drugs that interfere with neuromuscular transmission.

Adverse Effects: See Summary of Product Characteristics for full information on side effects. Based on controlled clinical trial data, the proportion of patients that would be expected to experience an adverse reaction after treatment is 23.5% (placebo: 19.2%).

These adverse reactions may be related to treatment, injection technique or both. In general, reactions occur within the first few days following injection and are transient and of mild to moderate severity. Pain/burning/stinging, oedema and/or bruising may be associated with the injection. Frequency By Indication: Defined as follows: Very Common (≥1/10), Common (≥1/100, <1/10), Uncommon (≥1/1,000, <1/100), Rare (≥1/10,000, <1/1,000), Very Rare (<1/10,000). Infections and infestations. Uncommon: Infection.

Psychiatric disorders. Uncommon: Anxiety. Nervous system disorders. Common: Headache. Uncommon: Paresthesia, dizziness. Eye disorders. Common: Eyelid ptosis.

Uncommon: Blepharitis, eye pain, visual disturbance. Gastrointestinal disorders.

Uncommon: Nausea, oral dryness. Skin and subcutaneous tissue disorders. Common: Erythema, Uncommon: Skin tightness, oedema (face, eyelid, periorbital), photosensitivity reaction, pruritus, dry skin. Musculoskeletal and connective tissue disorders. Common: Localised muscle weakness, Uncommon: Muscle twitching. General disorders and administration site conditions. Common: Face pain, Uncommon: Flu syndrome, asthenia, fever. The following have been reported rarely for glabellar lines and other indications: rash, urticaria, pruritus, erythema multiforme, psoriasiform eruption, anaphylactic reaction (angiodema, bronchospasm), alopecia, madarosis, tinnitus and hypoacousia. Adverse reactions possibly related to spread of toxin distant from injection site have been reported very rarely (muscle weakness, dysphagia, or aspiration pneumonia which can be fatal).

Price: £85.00 per vial.

Marketing Authorization Number: PL 05179/0010 Marketing Authorization Holder: Allergan Pharmaceuticals (Ireland) Ltd., Westport, Co. Mayo, Ireland.

Legal Category: POM. Date of preparation: December 2008.

Adverse events should be reported.

Reporting forms and information can be found at www.yellowcard.gov.uk Adverse events should also be reported to Allergan Ltd. UK_Medinfo@allergan.com or 01628 494026 References: 1. Stotland MA et al. Plast Reconstr Surg, 2007;120:1386-1393.

2. Carruthers A et al. Journal of Clinical Research, 2004;7:1-20. 3. Allergan Data on File (DoF) VIS/003/DEC 2010. 4. Allergan Data on File (DoF) VIS/005/MAR 2011. *Given in 5 key EU countries since VISTABEL® launch. Data taken from UK, France, Spain, Italy and Germany.

Global figures. Launched in 1989 in the U.S. Search strategy conducted using; Medline, Embase, Embal, Biosis, SciSearc, Pascal, HCAPlus, IPA. Search applied to Allergan, Ipsen & Merz botulinum toxin type A presentations (cosmetic indication).

†

Date of search: February 2011.

UK/0101/2011 Date of Preparation: March 2011