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

Goodbye Pigmentation Addressing the most visible signs of ageing with Jan Marini Skin Research

And the Aesthetic 2011 Nominees are… Awards the AwArds night for your industry

Find out who is in with a chance of scooping a coveted prize at the Aesthetic Awards as we announce the shortlisted nominees

in AssociAtion with cosmetic news

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Welcome to the October issue of Cosmetic News. There has been a flurry of excitement in the Cosmetic News offices over the last few weeks as the entries for the inaugural Aesthetic Awards have come flying in. And what a response we have had! More than 4,500 people entered in a bid to win one of the coveted 25 awards being presented on the night – the best response Body Media has ever seen in its history of hosting awards. With so many high caliber entries hittling the nominees down to create the final shortlist has not been an easy task and I would like to congratulate all those who have made the grade and are now in with a chance of taking home a gong on the night. The Awards are being hosted at a glamorous James Bond themed night at Sopwell House in St Albans on December 1 and it is definitely going to be a night to remember, especially as it is the only event in the aesthetic calendar that celebrates the achievements of all those who work hard to make this industry what it is. Turn to pages 14-18 to find out if you have made the final shortlist and don’t forget to get people to vote for you by visiting Voting closes on October 21. Good luck to all the nominees – we look forward to celebrating with you on the night!

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October 04 EDITOR’S CHOICE The latest treatment from Syneron/Candela – Elevate with ePrime 06 INDUSTRY NEWS We round up the latest industry news   10 ON THE SCENE We report on the BACN AGM and IAAFA conference and charity ball 14 AESTHETIC AWARDS Find out who has been shortlisted for the Aesthetic Awards in Association with Cosmetic News, and how you can vote

Elevate with ePrime One treatment that has had everyone talking in recent months is the newest innovation from Syneron/Candela – the ePrime. Launched to the trade at the FACE conference in July, the Elevate with ePrime treatment was recently unveiled to the UK’s press at an exclusive event at the Haymarket Hotel in London, and has been hitting the headlines ever since. Touted as the new ‘45 minute non-surgical face-lift’, the treatment has gained popularity with the UK’s media because it is clinically proven to lift, tighten and volumise the skin from the deeper layers in just a single 45 minute treatment.

2 1 - 2 3 S P E C I A L F E AT U R E – MESOTHERAPY We take a look at mesotherapy and examine some of the best treatments and products on the market

The treatment was developed following eight years of extensive research and harnesses the deep delivery of bi-polar radio-frequency to the dermis to provide 37% of the result of a traditional face-lift procedure*, but at a fraction of the cost making it a safe and effective alternative to surgery without the downtime.

2 4 T R E AT M E N T S P OT L I G H T HB Health’s Leshem Aloni on the Accent VShape

When lotions and potions aren’t enough and a face-lift is too far a step, an Elevate with ePrime procedure is the perfect solution to address the

28 Q&A LPG’s Christian Gagniere on its latest campaign 3 1 I N N O VAT I O N S David Leahy on treating fungal toenails with 1064nm Nd:YAG lasers 34 CLINICAL STUDY We examine the results of a clinical study on a MultiIngredient Non-Hydroquinone Pigment and AntiAgeing Solution

early signs of ageing such as lack definition in the jaw line (jowls), sagging skin and deeper wrinkles around the mouth and cheek area. The treatment helps to smooth, tighten and contour skin with gradual, natural looking results, as opposed to the dramatic change that invasive surgery produces. Full results develop over the course of three months, so, rather than looking like you’ve had surgery, you’ll look fresher, younger and rejuvenated. Best of all, you can turn back the clock without rearranging your life for complex procedures or long recoveries. Downtime is so minimal that the following day you can apply your make-up and go about your usual routine. Sounds good to me!

40 PRODUCT NEWS We round up the latest product news 44 ABSTRACTS We round up the latest clinical studies 46 BEST PRACTICE Award winning lawyer Norman Rea on hot topics for clinics in employment law 49 BUSINESS FOCUS Ahmed Zubair on IT trends 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

* Macrene Alexiades-Armenakas, MD, PhD, David Rosenberg, MD, Bradley Renton, PhD, Jeffrey Dover, MD, Kenneth Arndt, MD. Blinded, randomised quantitative grading comparison of minimally-invasive fractional radiofrequency and surgical face-lift for the treatment of skin laxity. Arch Dermatol, Vol 146 No. 4, April 2010

Meet the Cosmetic News team Charlotte Body Publisher 01268 754 897

Peter Johnson, Art Director 01268 754 897

Vicky Eldridge Editor 01268 754 897 M: 07940 083 677

Loraine Winter Designer 01268 754 897

Emilia Cops Associate Publisher 01268 754 897

Shauna Peters Production Assistant 01268 754 897

Hollie-Jane Dunwell Account Manager 01268 754 897 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

Q-Med sponsors inaugural Aesthetic Awards Q-Med will be the Platinum Sponsor of the inaugural Aesthetic Awards in association with 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. Q-Med is an industry leader in developing and commercialising products based on its

lighted that Q-Med has decided to be the Platinum Sponsor of the inaugural Aesthetic

patented NASHA™ technology. The company’s portfolio includes the market-leading

Awards. Q-Med is one of the most well-known names in the industry and Cosmetic

dermal filler Restylane® as well as Restylane Skincare. Over recent months Q-Med has

News is happy that they have decided to follow Galderma’s long standing tradition of

been acquired by Galderma, a major milestone in the aesthetic industry – bringing

supporting the UK’s aesthetics industry.”

together two very strong companies to creatie a powerful portfolio that meets the

The shortlisted finalists for the Aesthetic Awards have now been announced. Turn to

physicians’ and patients’ needs. Body Media publisher, Charlotte Body, said, “We are de-

pages 14-18 to find out who has made the cut and get voting!

GALDERMA TRAINS BACN MEMBERS IN AESTHETIC DERMATOLOGY Galderma (UK) Ltd is running a series of Study Days in aesthetic dermatology for the 11 regional groups of the British Association of Cosmetic Nurses (BACN). Frank Ward, Galderma’s key accounts manager, who is supervising the programme, explained that the company has a heritage of training in the field of dermatology and, given Galderma’s recent entry into the aesthetics market, is now replicating that expertise in this area too. “Our Study Days for the BACN are linking the two sectors and giving added value to members of the association”, he said. With their backgrounds as trained nurses and being registered by the Nursing and Midwifery Council (NMC), members of the BACN have joined the organisation as independent injectors of dermal fillers and botulinum toxin. By taking advantage of Galderma’s workshops they will learn how to diagnose and treat skin conditions such as acne, rosacea, eczema and psoriasis. Following two introductory BACN Study Days in the North West and South West – which have established a successful agenda -  the next Galderma workshop will be in London in November at the Wellcome Trust in Euston.  A series of events in 2012 will cover the rest of the UK.  Details will be listed on the BACN website at Non-BACN members wishing to find out how to become involved should call 01749 836 328.

New Training Room for SkinBrands Skin Brands has announced the opening of its new training room in Ealing Common, West London. This brand new venue encapsulates SkinBrands dedication to the service it provides and with a committed training team and an extensive programme already in place, clients will receive even more comprehensive support.  Training is offered complimentary to all ongoing SkinBrands customers.  Tracey Beesley, owner of SkinBrands, said, “We are passionate about the superb brands we distribute and are proud to do so.  For us it was time to get our own venue that represented professionally and stylishly each of the brands but at the same time would allow our customers to get a feel for what we could potentially offer our customers in terms of marketing and support. Our customers and their needs are our priority.  We believe training to be a quintessential part of our offering, and we want our customers to leave our training sessions, motivated, enthused and passionate about the brand(s) they offer their customers. Not only can the new venue be utilised as a showroom for all the brands in our portfolio but it allows our clients to send their staff to a comfortable training venue which offers them the best chance of learning outside of the clinic environment. In addition, our team of account managers can utilise the facility to present the products to their customers and offer them the highest levels of training. With Martine Jarman – account manager for the North - offering a mirrored training programme in the Manchester area we are working hard to meet our customer needs”.  

UK website for Pastelli


Professional clothing brand Pastelli has launched a new UK based website The Italian based company has been manufacturing professional garments and uniforms for the medical, dental and beauty industries for decades, and is now distributed in the UK through Robert Eaglestone and Wigmore Medical. The garments are world-renowned for their quality and elegance and are currently sold to medical, dental,

Territory Managers – North & Scotland A fabulous opportunity awaits high calibre professionals to work with the UK’s leading cosmeceutical pharmacy specialist, Healthxchange Pharmacy

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pharmaceutical and beauty industries in 42 countries worldwide. The collection offers more than 150 styles in 32 colours as well as bespoke services. As well as coats and tunics the company also makes shoes, skirts, trousers and T-shirts. 6

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News - Industry News

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Dr Dan Dhunna and Cindy Jackson appear on CBS’ Inside Edition USA Cosmetic doctor Dan Dhunna and cosmetic surgery record-holder Cindy Jackson have appeared on Inside Edition USA. The pair have been firm friends ever since filming for the BBC’s Weakest Link ‘Body Beautiful’ episode in September 2010. Dr Dhunna has since performed a number of procedures on Cindy who, at 56, is the Guinness World Record holder (confirmed in May 2011) for having had the most number of cosmetic surgery procedures. The TV crew came over to the UK to film Dr Dhunna demonstrating Photo by Celebrity Photographer James Nader live procedures including his ‘London Lift’. He said, “Cindy has had cheek implants and a lower lip and chin implant; the cheek area needed some support tissue rebuilding around the apple of the cheek and around the cheek implants, the lips required some slight asymmetry addressing and the volume required some boosting, and her neck and jaw line needed to look tighter and smoother” Cindy added, “Dan has a fantastic eye and perception of perfection as far as the face is concerned. Some of the ‘adjustments’ are subtle and other aestheticians may not go so far as to pick up on them and go to the lengths that he goes to really make a difference and give you a ‘wow factor’. He’s known as the Michelangelo of Botox®; I like to say he is the Da Vinci of dermal fillers.”

Journalists give Genuine Dermaroller™ Therapy ™ the thumbs up More than 90% of journalists who have tried Genuine Dermaroller™ Therapy™ would recommend the treatment to others, according to a survery carried out by AesthetiCare®. Publications surveyed included The Daily Mail, Prima and The Evening Standard. Journalists polled also commented that they saw Genuine Dermaroller™ Therapy ™ as a fantastic alternative to more invasive skin treatments and more than 70% stated that they found the procedure to be uncomfortable rather than painful. Many polled also felt that the treatment would be around for a very long time. AesthetiCare® manageing director Roger Bloxham said, “This interesting survey of top beauty journalists who really know their stuff, demonstrates what a valuable and now established treatment Genuine Dermaroller™ Therapy™ is and I would like to thank all the medical aesthetic practitioners through out the UK who have delivered this treatment and enabled thousands of their clients to receive the great benefits the journalists in this survey refer to. “Also I would like to thank them for maintaining the standards that we in the medical aesthetic community aspire to by using the highest quality Genuine Dermaroller™ German manufactured medical devices and spreading the message that this is a treatment that needs to be conducted in a medical aesthetic setting, this has enabled the reputation and therefore the benefits of this great treatment to be maintained in an environment which is otherwise currently unregulated in the UK”.


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SURGEON CALLS ON GOVERNMENT TO REINSTATE THE NATIONAL BREAST IMPLANT REGISTRY Midlands cosmetic surgeon Dalvi Humzah is calling on the Government to reinstate The National Breast Implant Registry (UKBIR). Following the recall of PIP implants by French medical authorities, Mr Humzah says it is essential the government adopts the mandatory registration of all implants by both private health consultants and NHS consultants. French company Poly Implant Perthese (PIP) is being investigated after authorities discovered PIP implants contained a non-approved silicone gel and had a high rupture rate leading to complications. The potentially dangerous implants are believed to have been used in up to 50,000 breast augmentation procedures in the UK. In the last six months alone, Mr Humzah has treated several patients with ruptured PIP implants. Most involved the removal of the implants, breast clean up and placing new implants in one single operation. “At the moment, there is no way of knowing for sure how many women have been given PIP implants. If the registry was reinstated, we could easily access this information to ensure patients affected are treated and made aware of such complications,” said Mr Humzah. Following its launch in 1993, The Department of Health decided to close the UKBIR in March 2006 claiming only a limited number of implanted women were willing to take part in the scheme. Mr Humzah continued, “Many problems associated with implants surface after several years. With no comprehensive record-keeping mechanism, necessary long-term information is unavailable. Ideally, we need a new registry that protects women’s privacy, yet enables the research we need to make sound, informed safety decisions. Just as importantly, it means women can be alerted quickly to any health threats that develop.”

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on the scene

IAAFA 2011

BACN, AGM, Birmingham

We report on the annual International Academy of Advanced Facial Aesthetics (IAAFA) meeting and charity ball in London

The British Association of Cosmetic Nurses (BACN) held its second annual conference and AGM at the Conference Aston, Birmingham last month.

Last month the International Academy of

One of the hot topics

Advanced Facial Aesthetics held its annual

covered at the event

conference and charity ball in London. The

was the change in the

two-day event took place at the Royal Society of

way anti-ageing fillers

Medicine and kicked off on Friday September 2

are being administered using cannulas to minimise the risk of

with a welcome by the association’s president Dr

bruising and swelling.

Stephen Ritchie from Cutera chats to a customer on his stand

Bob Khanna. A packed programme of lectures and educational workshops then followed with The IAAFA charity ball was held at the Portman Radisson SAS Hotel

topics including everything from dentistry and plastic surgery to cosmetic injectables. The CPD accredited conference always attracts a high caliber of speakers with extensive experience in all areas of facial aesthetics, and this year is no different with the line up

JMSR exhibited at the show

including Dr Bob The Galderma girls along with Dr Beatriz Molina (second left) and Cosmetic News Hollie Dunwell (far right)

Khanna, on Total Facial Sculpting;

Manufacturers of several

Prof Piet Haers on Orthognathic Surgery Demystified; Mr Jonathan

leading dermal filler brands

Britto on the Anatomical Principles of Aesthetics; Dr Tapan Patel

are now advocating the use

on The Use of Lasers in Facial Aesthetics; Mr Raj Ragoowansi on

of cannulas over needles for

Patient Assessment Criteria for Optimising Aesthetic Outcomes;

IAAFA president Dr Bob Khanna and wife Sonia

The Galderma stand

certain treatments including

Dr Mark Devlin on Aesthetics v Deformity: Beauty and the Beast;

Q-Med, who gave a workshop

Dr Kimberley Taylor on Patient Consultation and Developing

on the use and benefits of

an Aesthetic Practice; Bobbi Anthony; Dr Chris Orr on Optimal

its patented range of pix’L®

Dental Aesthetics – Current Concepts and Eddie Hooker on Risk

microcannulas and Allergan,

Management in Aesthetic Practice. An exhibition also ran alongside

who sponsored several

the conference.

speakers at the meeting, including including Dr Rodrigo The highlight of the event, as

Caceres and Dr Helga Van

always, was the Charity Ball

Den Elzen.

held at the Portman Radisson

Emma Davies, chair of the

SAS Hotel, which had an

British Association of Cosmetic Nurses (BACN) commented,

Arabian Nights theme this year. The glitzy event raised Cosmetic News’ Shauna Peters meets a snake at the Arabian Nights themed ball

“The introduction of the cannula is truly a technical revolution The Healthxchange team exhibited at the show

for professional injectors using facial fillers. Using cannulas

money for the Make-A-Wish Foundation, a charity that grants the

instead of needles takes practice but the BACN is fortunate

wishes of dying children.

that several companies behind this innovation are willing to train members both during our conference, and in workshops that will follow this event. Quite a few BACN members have already been working with cannulas for a while and the conference proved inspiring for many others.” Other topics covered ranged from botulinum toxin in the lower and upper face as well for migraines and hyperhidrosis; challenging lips; non-surgical nose correction and VAT. The meeting ended with the AGM and a closing speech by BACN chair Emma Davies.

The Hamilton Fraser Cosmetic Insurance Team


Mary-Kay Sheehy demonstrates on the Nordson stand

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w i t h L i d o c a i n e

the AwArds night for your industry

AAwards esthetic 2011 in AssociAtion with cosmetic news p l At i n u m gold

sponsor sponsor

And the nominees are… It’s the event that everyone is talking about, but who is on their way to winning a coveted Aesthetic Award? We announce the shortlisted finalists


ver the past few weeks the entries have been flooding in for the inaugural Aesthetic Awards in Association with Cosmetic News. We have been astounded with the response from the industry, with more than 4,500 entries coming in – the most Body Media has ever seen in its history of hosting awards. With so many high caliber entries to sort through, picking the final shortlisted nominees has not been an easy task. Those who have been lucky enough to make the final cut will now be in with a chance of taking home a gong on the night. With a total of 25 categories, the awards have been designed to acknowledge those who have gone that extra mile over the last year. The Aesthetic Awards is the only event of its kind in the industry that gives both practitioners and suppliers a chance to celebrate their achievements with their friends and peers. The event is being sponsored by Q-Med (Platinum Sponsor) and Silderm (Gold Sponsor). Q-Med is an industry leader in developing and commercialising products based on patented NASHA™ technology. The company’s portfolio includes the market-leading dermal


filler Restylane®. Over recent months Q-Med has been acquired by Galderma, a major milestone in the aesthetic industry, bringing together two very strong companies and creating a powerful portfolio to meet the physicians’ and patients’ needs. Body Media publisher, Charlotte Body, said, “We are delighted that Q-Med has decided to be the Platinum Sponsor of the inaugural Aesthetic Awards. Q-Med is one of the most well-known names in the industry and Cosmetic News is happy that they have decided to follow Galderma’s long standing tradition of supporting the UK’s aesthetics industry.” 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. MyFaceMyBody’s Stephen Handisides will be hosting the event and announcing the winners. As well as a champagne reception, decadent three course meal and a free bar, guests will be left shaken and stirred by the entertainment, which will include a casino and live music. When it comes to putting on a night to remember, Nobody Does it Better!

The nominees are… I N D U S T RY AWA R D S S ales R epresentative of the Y ear This award is designed to acknowledge the hard work and services provided by sales reps working for manufacturers

Sponsored by

and suppliers in the UK. The finalists in this category are those who received the most nominations from their customers.

L ifetime A chievement A ward

The winner will be decided by the number of votes they receive from their customers. To vote in this category please visit

This award will recognise the achievements of an

individual who has had a long and fruitful career in

T he nominees are :

the aesthetics industry. The recipient of this award has

• •

L orraine mclaughlin , M er z J emma C oo k e , G alderma

• • •

P aula D ene , M er z J a z z D hariwal , R ioblush B everley P owell , S k in B rands

been selected by the Aesthetics Awards team from the nominations submitted and there will only be one winner who will be announced on the night.

S ervices to the I ndustry This category will award an individual who has gone above and beyond in their services to the industry. As with the lifetime achievement award, there will only be one winner in this category. We had so many fantastic nominations in this category that we have decided to create a shortlist and let people in the industry vote on who they think deserves to win. To vote in this category please visit

T he nominees are : D r Patric k B owler

R on M yers

E mma D avies

Co-Founder and Fellow of the British

Ron Myers has more than 13 years

Emma Davies has been an aesthetic nurse since 1998, with her own clinic in Somerset.

Association of Cosmetic Doctors

experience in the pharmaceutical

With a special interest in sclerotherapy she established, in partnership with a vascular surgeon,

and Medical Director of Courthouse

industry in a variety of sales and

Veincare Training, to teach and promote best practice in the treatment of thread veins and


marketing, sales management and

went on to bring together cosmetic specialists with vascular specialists to learn from each other

Dr Patrick Bowler is pioneer of non-

business development roles working

and support continuing professional development, establishing The British Association of

surgical cosmetic treatments in the

for Smith Kline Beecham, Novartis, and

Sclerotherapists, now recognised by The Vascular Society and Venous Forum and represented

UK with 20 years experience. He has

Allergan Pharmaceuticals. Ron was

internationally. Passionate about this field and how nurses contribute to it, she has been an active

lectured extensively in Europe, the

involved in the launch of Botox® and M.D.

member of the RCN Aesthetic Nurses Forum Committee, and is proud of the achievements of

Middle East, the US and Australia and

Forté® glycolic peels into the UK market

this group. Whilst supported by the RCN the forum group was able to find a credible political

has had his research published in a

place in 1994. He set up a specialist

voice, all be a quiet one, and published several important documents that have informed practice

number of clinical journals. In 1993 he

consultancy service in 2002 with business

and been recognised and referenced by others establishing standards of practice. Although the

co-founded Cosmeceuticals Ltd and

partner Martyn Roe. Since then they

restructuring of The RCN and subsequent disbanding of the Forum was a huge disappointment,

in 1998 opened the first Court House

have been busy working on a variety of

Emma went on to become a founding member of the British Assocation of Cosmetic Nurses,

Clinic in Brentwood Essex. He is the

high profile projects in the aesthetics

of which she is chair. She hopes the association will provide a platform for excellence to be

co-founder and a Fellow of The British

industry, including the development of

celebrated and shared, to support and inspire us all and to give us a voice that will be heard.

Association of Cosmetic Doctors and

Wigmore Medical’s concept as a specialist

served as its chairman for the first seven

aesthetic distributor; the launch of the

years. Dr Bowler has researched and

Facial Aesthetic Conference and Exhibition

developed the effects of anti-oxidants

(F.A.C.E.) – now the UK’s largest non-surgical

on the skin culminating in the launch

medical aesthetic conference; business

of his own skincare range Vitage, in

development projects with individual

September 2004 and is frequently

medical aesthetic clinics and website design

quoted on skin and cosmetic problems

and development – including e-commerce

in the national papers and magazines

sites and the launch and management of

and regularly appears on national TV on

MediZen – a non-surgical medical aesthetic

news/current affairs shows including

clinic - in conjunction with Dr David

CNN and BBC Breakfast, Five News and

Eccleston. In addition Ron and Martyn

consumer programmes such as LK Today,


GMTV and UK Living. He was one of the

– launched in 2003, and now the largest

experts featured on the first two series

specialist aesthetic information website

of Channel 4 series 10 Years Younger and

in the UK, and winner of “Best Aesthetic

the Who’ll Age Worst on UKTV Style.

Patient Information Website” at the 2008 Aesthetic Medicine Awards.

E ddie H oo k er , Eddie Hooker has been involved in the insurance industry since 1985. He worked with many large insurers such as Legal & General prior to setting up his own brokerage, Hamilton Fraser Insurance, in 1995. Hamilton Fraser Insurance now employs over 115 staff out of their North London office. Eddie and Hamilton Fraser Insurance first started to insure cosmetic practitioners as early as 1996 when they became involved with nurses practicing in Collagen injections. Hamilton Fraser launched the UK’s first ‘aesthetics specific’ medical indemnity policy in 1998 and now insure over 2,500 individual practitioners and businesses within the sector, growing by over 100 new practitioners each and every month. By working closely with the sector’s leading practitioners and distributors, Eddie and his team have built up a detailed knowledge of the aesthetic market which has been highlighted in a recent customer survey finding that 95% of Hamilton Fraser’s customers were satisfied or more than satisfied with the service provided by the company. In 2005, Eddie and his team bid and were successful in securing one of only three government authorised tenancy deposit protection schemes,, and the scheme was launched in April 2007. To date mydeposits has protected in excess of 1,000,000 tenant rent deposits for more than 200,000 landlords country wide, increasing at a rate of over 20,000 new deposits each month. Eddie is keen to see and help bring about better standards of training within the aesthetics market and supports initiatives which raise standards overall.


the AwArds night for your industry


sponsored by

Awards 2011 in AssociAtion with cosmetic news p l At i n u m gold

sponsor sponsor

R ising S tar

T he nominees are :

This award will be presented to an up and coming practitioner who may not

H ilary H aw k , C linica F iore

have the longevity of some of their colleagues but who has made an impact

L indsey M c E nroe , I nnercore C linics

in their field. The shortlisted finalists were selected based on the nominations

J ac k ie P artridge , D ermal C linics

they received.

D r R aina Zarb A dami , A esthetic V irtue

Best Clinic Chain

T he finalists are :

and their feedback as well as feedback from customers will determine the

• • •

Mystery shoppers will be sent to the clinics that have been shortlisted winner. If your clinic has been shortlisted then you can get your customers to vote for you by visiting

C ourt H ouse C linics E F M edi - S pa R enew M edica

Best Clinic (four rooms or more)

Best Clinic (three rooms or less)

This award will be presented to the best

This award will be presented to the best

large clinic in the UK with four or more

T he finalists are :

• •

treatment rooms. Mystery shoppers will be sent to the clinics that have been shortlisted and their feedback as

• • •

well as feedback from customers will determine the winner. If your clinic has been shortlisted then you can get your

Clinica Fiore, London The Cosmetic Skin Clinic, Buckinghamshire Dermal Clinic, Edinburgh Medizen, Birmingham Riverbanks, Bedfordshire

small clinic in the UK with three or less treatment rooms. Mystery shoppers will be sent to the clinics that have been shortlisted and their feedback as well as feedback from customers will been shortlisted then you can get your customers to vote for you by visiting

Absolute Aesthetics, Guildford CC Kat, Birmingham European Dermatology, London The Grampian Cosmetic Clinic, Aberdeenshire The Hadleigh Clinic, Essex Health + Aesthetics, Farnham The Medical Aesthetic Clinic, Winchester Temple Aesthetics, Aberdeen

determine the winner. If your clinic has

customers to vote for you by visiting

• • •

T he finalists are :

• • • •

Best Mobile Practitioner

sponsored by

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 recognise the achievements of solo

The shortlisted finalists are:

practitioners. The shortlisted finalists have been chosen based on the number of nominations they received. Mystery shoppers will be sent to the practitioners who have been shortlisted and their feedback as well as feedback from customers will determine the winner. If you

The Cosmetic Skin Clinic, Buckinghamshire

Paul Banwell Cosmetic Surgery Clinic, Sussex

Medizen, Birmingham

Riverbanks, Bedfordshire

Best Customer Service by a Manufacturer/Supplier

have been shortlisted then you can get your customers to

This award will be given to the manufacturer/supplier

The nominees are:

vote for you by visiting

with the best customer service as judged by their


customers. To vote for the manufacturer/supplier who


you think offers the best customer service visit

Med-fx .

Merz Aesthetics


T he finalists are : • Monnica Berrange

• Frances Furlong

• Dr Susanne Farwer

• Wendy Demir

Association of the Year

Best Advertising Campaign by a Manufacturer/ Supplier

This award will be presented to the association that has gone above and beyond in 2011. There will only be one winner in this category. To vote for the association that you think deserves to win this award, please visit

This award will be given to the

manufacturer/supplier with the most

The nominees are:

memorable and effective UK advertising


This award is designed for any UK

This award will be given to the person

distributor of aesthetic products or

deemed to have given the best lecture

systems. To vote for the distributor who you think deserves to win visit

at a UK conference or educational meeting in 2011. The shortlisted finalists were chosen based on the number of

The nominees are:

The finalists are:


They are:

ABC Lasers

Dr Tim Flynn



Dr Ravi Jain

Wigmore Medical

Dr Bob Khanna

Dr Tracy Mountford

Dr Stefanie Williams

The British Association of Cosmetic Nurses

Allergan (Juvederm)

The Society of Cosmetic Physicians

Cosmeceutcials (PRIORI)

and Surgeons


Merz Aesthetics

Speaker of the Year


The British Association of Cosmetic Doctors

Distributor of the Year

nominations they received. • 44 (0)560 314 1956

the AwArds night for your industry


Awards 2011 in AssociAtion with cosmetic news

p l At i n u m


sponsor sponsor

Best Clinic Website

Clinic Receptionist of the Year

The most easy to navigate and informative clinic websites will be

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

awarded in this category. Mystery shoppers will be asked to rate the

in 2011. The shortlisted finalists have been chosen based on the number of

websites on ease of use, information and style.

nominations they received. Mystery shoppers will be sent to the clinics that

The shortlisted finalists are:

have been shortlisted and their feedback as well as feedback from customers

will determine the winner. If you have been shortlisted then you can get your

Auroa Plastic Surgery and Aesthetic Centres –

customers to vote for you by visiting

CC Kat Aesthetic Clinic –

The Cosmetic Skin Clinic –

Jo Andrews, Outline Skincare

Court House Clinics –

Debbie Bower and Liz Kidd, Medizen

The Hadleigh Clinic –

Debbie Keen, Cosmetic Skin Clinic

Riverbanks –

Cathesha Williams, Court House Clinics

P R O D U C T / T R E AT M E N T AWA R D S Best Product Innovation

Best Newcomer

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

Manufacturers/distributors of any new product launched in the UK market since the

vote for the product that you think is the most innovative visit www.cosmeticnewsuk.

beginning of 2011 can enter this category. To vote for the product that you think is the


most deserving winner visit .

The shortlisted products are:

The shortlisted products are:

Artiste Injection System (Nordson)

Artiste Injection System (Nordson)

Pix’L Micro Cannula (Q-Med)

Bocouture (Merz Aesthetics)

SkinCeuticals Pigment Regulator

Emervel (Galderma)

SkinMedica Calmplex

Medik8 Blue Aox


SkinCeuticals Sheer Mineral Defense

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. To vote winner visit The shortlisted ranges are: Heliocare





Treatment of the Year (Face)

sponsored by

Consumer Choice Award for Best Treatment

This award will go to the best treatment in the UK as voted for by consumers via the MyFaceMyBody TV show and website. The winner will be announced on the night.

Treatment of the Year (Body)

Injectable Product of the Year

This award will go to the manufacturers/distributors of the

This award will go to the best product in the UK as voted for by consumers via MyFaceMyBody TV show and website. The winner will be announced on the night.

for the product range that you think is the most deserving

sponsored by

Consumer Choice Award for Best Product

Best Selling Retail Product

best injectable product available in the UK, as voted for by the readers of Cosmetic News. To vote for the product that you think is the most deserving winner visit www. The finalists are: •

Azzalure (Galderma)

Juvederm (Allergan)

Radiesse (Merz)

Restylane (Q-Med/Galderma)

Equipment Brand of the Year

This award will be given to the

This award will be given to the

The finalists have been selected from the

The winner of this award will be the

manufacturer/supplier with the best

manufacturer/supplier with the

number of nominations they received from

manufacturer/supplier of what is deemed

treatment for the face, as voted for

best treatment for the body, as

clinics. Clinics will be able to vote for their

to be the best equipment brand by the

by the readers of Cosmetic News.

voted for by the readers of Cosmetic

top selling retail product in this category

readers of Cosmetic News. To vote for the

To vote for the treatment that you

News. To vote for the treatment

by visiting The

brand that you think is the most deserving

think is the most deserving winner

that you think is the most deserving

nominees are:

winner visit

visit The

winner visit www.cosmeticnewsuk.

The finalists are:

finalists are:

com. The finalists are:

Genuine DermalRoller


PRIORI Idebenone Peel

SkinCeuticals Pigment


ABC Lasers

Heliocare Sunscreen



Obagi Vitamin C serum



SkinCeutcials Phloretin CF

Sound Surgical (VASER)

Soprano Pain Free

SkinMedica TNS Recovery

Hair Removal •

Hydrating Anti-Ageing

Medik8 Titanium

Balancing Masque


Image SKINCARE Vital C



Voting now open

In some of the categories the winners’ will be decided by the readers of Cosmetic News. Visit to cast your vote now! Voting closes on Friday October 21.


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Mesotherapy special

NEEdlE POINT We take a look at mesotherapy treatments and techniques

When it comes to treatment options, not many procedures offer the variety of indications and methods of administration that mesotherapy does. The treatment can be used for both fat and cellulite reduction and to address skin ageing and can be performed using either manual syringes, specialised mesotherapy guns or via no-needle alternatives, which use an electrical current, rather than a needle, to push the products through the skin.


he concept of mesotherapy is that it is better to deliver medications directly to the area being treated than to ingest them through a tablet. Mesotherapy preparations usually comprise of a cocktail of vitamins, serums, medications or amino acids, which can be tailored for specific patients and indications.

For skin rejuvenation, the aim is to replace minerals, vitamins and amino acids that are found in lower levels in skin as we age. One of the main aims is to boost levels of hyaluronic acid in the skin. As the skin ages, levels of hyaluronic acid decrease, and it is claimed that injecting more hyaluronic acid into the dermal layers (just below the surface of the skin) helps to stimulate more collagen production, which, in turn, improves skin tone and helps to reduce fine lines and wrinkles. One of the most popular uses of mesotherapy in aesthetics is for the treatment of fat and cellulite. The fluid injected is a cocktail of vitamins and different medications designed to break down fat. The treatment is particularly good for dealing with cellulite but can also minimise fat on the stomach, thighs, chin and love handles. The ideal candidate for fat reduction treatment would be near or at their ideal body weight with small areas of stubborn, localised fat that cannot be shifted with diet and exercise.



Traditional mesotherapy involves a series of very small (micro) injections into the area being treated. The treatment is done using a very fine hand-held needle or a ‘meso-gun’ and is virtually painless. The practitioner will inject measured amounts of different medications just under the skin. Puncturing the skin with micro-injections is also thought to induce new collagen production in the skin. For body treatments active ingredients that help to break down cellulite and localised trapped fat and improve circulation, lymphatic and venous drainage are used. The treatment takes around 30-45 minutes, depending on the size of the treated area. A course of up to eight treatments is usually required at one to two weekly intervals.


With no needle mesotherapy the cocktail of ingredients are applied directly onto the skin. An electrical current is then used to ‘push’ the ingredients through the skin. This treatment is virtually pain free and is ideal for people who don’t like needles. The procedure takes about half an hour and a course at weekly intervals is usually required to achieve the full effect. The side effects of the treatment are relatively minor so patients can return to their normal daily routine or work afterwards.


Mesotherapy special

MESOTHERAPY PROdUCTS INNO-TdS® Mesotherapy Cellulite Programme (Medical Aesthetic Group)

Viora Infusion System (AZTEC Services)

INNOSEARCH has developed a new generation product line – INNO-TDS –

is a safe, no needle alternative

designed specifically to help the cause and effects of cellulite. Based on high

to traditional mesotherapy.

concentrations of active ingredients and backed by scientific research, the range

Infusion™ revitalises the skin

uses mesotherapy techniques, which involves microinjections of conventional

with enriching solutions

or homeopathic medication and/or vitamins into the skin to achieve a desired

that leave it feeling supple,

therapeutic result. Treatments include: INNO-TDS® Anti-Cellulite, lypolitic

refreshed, and radiant. Based

treatment; INNO-TDS® Homeocel, homeopathic anti-cellulite treatment; INNO-

on the well-established science

TDS® Homeocel, homeopathic anti-cellulite treatment and INNO-TDS® Drainer,

of electroporation, Infusion™

Anti-cellulite and anti-retention treatment.

maximizes cell permeability

Infusion™ Electro-mesotherapy

and absorption and enhances the overall appearance of the face and body. Designed for aesthetic professionals, Infusion™ offers the perfect, non-invasive solution to a wide variety of cosmetic conditions and significantly expands treatment options with such aesthetic mainstays as: • Anti ageing and wrinkle reduction • Collagen regeneration

Juvederm Hydrate (Allergan)

• Skin rehydration • Skin firming and toning

Juvéderm® HYDRATE is a un-crosslinked hyaluronic acid (HA) injectable

• Body sculpting and cellulite reduction

treatment comprising 13.5mg/g uncross-linked hyaluronic acid plus 0.9%

• Stretch mark reduction

mannitol. Although the treatment is classified as ‘skin revitilisation’ rather than mesotherapy, the techniques and principles behind the treatment are

The Infusion™

virtually identical. The product has been clinically proven to deeply hydrate by

Ionwave™ increases skin

delivering hyaluronic acid (HA) into the skin through a series of tiny injections. As

permeability to allow the

well as containing HA, it also contains the anti-oxidant, mannitol and, together,

safe passage of natural

these allow the skin to regain its natural smoothness and reveal a healthy glow.

healing compounds.

It is indicated for improving skin hydration and

Precisely crafted pulse

elasticity by multi-injection into the dermal/

waves temporarily open

epidermal junction and into the superficial

micro channels through

dermis to improve skin tone and reduce fine

the cell membrane to

lines and wrinkles. The addition of mannitol

bypass the stratum

leads to reduced free radical degradation of the

corneum layer without

hyaluronic acid to extend longevity.

puncturing the skin. Scientifically engineered

Mattioli Transderm System (Polaris)

to achieve the desired effect, the interplay between the Ionic solution and the Infusion™ device determines the penetration depth and ensures sufficient

Mattioli’s Transderm is a new non-invasive, stand-alone powered

permeability Each solution is a blend of special serums, proteins and healing

drug-delivery system utilising Dermoelectroporation® Technology,

agents and is precisely formulated for the specific application. The use of these

which is FDA cleared as a no-needle method of delivering active

unique Infusion™ solutions in conjunction with the Infusion™ system is highly

substances into the body for medical and cosmetic purposes.

recommended to attain optimal results.

Dermoelectroporation®, increases the skin’s permeability using the it’s water-based channels, which are opened by a controlled

mesoestetic (Wellness Trading)

current, delivered to the patient skin and allowing the substances

Wellness Trading has recently introduced two new CE marked mesotherapy

to absorbed to hypodermis and muscle membranes. The system

injection products from mesoestetic.

has been FDA approved for the “local administration of ionic drug

The mesoestetic mesohyal ™ range is designed for anti-ageing and skin

solutions into the body for medical purposes and can be used as an

rejuvenation and includes:

alternative to injections”. Dermoelectroporation allows the transdermal delivery of both micro- and macro

neck, chest and back of hands.

modifying the ionic drug solution pH, as with traditional iontophoresis, ensuring that the patient experiences no discomfort or irritation and both positive and

mesohyal ™ NCTC109, a revitalising solution that combines hyaluronic

negative ions are transdermally delivered. Dermoelectroporation also does

acid with an array of vitamins, amino acids, minerals and coenzymes

not require a pH compensation patch, driving gels, or pre-charged ions. Unlike

to repair and anti-oxidant action. This balanced formula is designed for

traditional iontophoresis, Dermoelectroporation does not have an electrolysis

stimulating biochemical processes and increasing cellular nourishment

reaction at the site of the electrodes. There is no degradation of the molecule

of connective tissue fibres to achieve integral revitalisation of skin lacking

being delivered.This means that both positive and negative ions of the drug are

in brightness, elasticity or firmness. Mesohyal NCTC 109 bio-revitalisation

delivered into the body - the drug is delivered as a whole.


mesohyal ™ HYALURONIC, a non-cross-linked hyaluronic acid solution with tratamientode, indicated for fine wrinkles and hydration of the face,

molecules (more than 800,000Dalton) safely into the body without the need of

cocktail produces an immediate repairing and anti-ageing action.

Other benefits of Dermoelectroporation are that it is non-invasive and there is no

Mesohyal HYALURONIC and NCTC 109 can be used in conjunction with other

trauma or bruising from an injection.

aesthetic injectables to enhance and prolong their effects.

Simildiet Face Antiageing (Medical Aesthetic Group) FACE ANTIAGEING is a sterile biological solution created for facial rejuvenation, hydration, toning and revitalisation.


It comprises nutritional, structural and metabolic elements essential for optimum skin regeneration and repair. The formulation, which includes vitamins, minerals, enzyme co-factors, hyaluronic acid and nucleic acid precursors. is presented as a single use sterile vial and contains the optimum proportions of each component required for skin cell metabolism. FACE ANTIAGEING can be used as a stand alone treatment or immediately following a glycolic acid mask or peel. The results will be enhanced and skin healing improved. It can be administered either using the intradermal technique with a needle or the meso electroporation transdermal system

Mesoscience by Skeyndor Mesoscience by Skeyndor is a virtual mesotherapy treatment that breaks through the resistant barriers in the skin, transporting the active ingredients to an unlocked cell, whilst lifting the skin at the same time. Mesoscience provides a patented four current system to ensure excellent results within the shortest period of time.


Specific treatment programmes include Line Filling of the face and neck area with hyaluronic acid, pigmentation reduction and melanin regulation via the use of concentrated vitamin C – Nikkol VCPtm, cellulite reduction and firming and toning treatments. The latest addition to the treatment range offered, Mesolift works on a system of Micro and Macro Lifting to sculpt, firm and lift


the facial skin. Pre-programmed chipped cards are provided with the Mesoscience, virtual mesotherapy device for ease of use guiding the therapists through the four stages of each treatment. Compared to injectable method’s the Mesoscience, virtual Mesotherapy device can treat much larger areas of application in one session and the use of Nano technology products guarantee deep penetration of active ingredients. For best results a course of weekly treatments are required and these should be followed by monthly maintenance treatments thereafter.


Restylane Vital (Q-Med) Like Juvederm Hydrate, Restylane Vital is part of a new category of treatment, which bridges the gap between mesotherapy and dermal fillers. With numerous clinical studies proving its efficacy Restylane Vital can achieve impressive results on the improvement of skin quality, elasticity and smoothness, particularly on the hands, décolletage and face and has recently been used in the lips to give a subtle enhancement, achieved through hydration. Like its sister range of dermal fillers Restylane Vital uses Q-Med’s patented NASHA™ (Non-Animal Stabilised Hyaluronic Acid) technology. The Restylane Vital range of products provides deep dermal hydration, which restores hydrobalance, improves skin elasticity, structure and firmness. By increasing the skin’s moisture retention the skin becomes more resistant to dehydration and retains its turgor and structure.

Advanced Skin Technologies


Advanced Skin Technologies aesthetic mesotherapy product range is designed to be used alongside its Cryoderm System. Ultra sound acts as a delivery mechanism for the active ingredients, pushing product through the dermal layers of the skin without the use of a needle. In turn it will temporarily allow the cell membranes to become permeable allowing the cell to absorb the vital nutrients contained within each active ingredient. This technology allows the transdermal infusion of products designed and formulated to create a no needle version of mesotherapy. All of the company’s new mesotherapy product range uses liposomes as the delivery molecule. The advantage of this is the fact that, as the liposome is made up of the same material as the cell membrane, it will not be rejected, in fact the lipid bilayer can fuse with other bilayers such as the cell membrane, thus delivering the liposome contents e.g active

01903 768 380



Treatment Spotlight

The W


of things to come… We speak to HB Health’s Leshem Aloni about the Accent VShape

ith so much competition in the beauty and aesthetics industry, it is paramount that your clinic is able to

ageing procedures, they want to look themself at their best, and I find

provide a treatment that makes you stand head and

the Accent VShape helps achieve these results.”

shoulders above your peers. ABC Lasers invests in

ensuring that its products are at the cutting edge of laser

How does the Accent Ultra VShape work?

technology and always one step ahead when it comes to aesthetic

The VShape works by utilising two operationally designed

trends and client demand. Famed for its Soprano XL machine,

UltraFace and UniFace modules. The UltraFace module uses

considered by industry insiders to be the ‘Rolls Royce’ of hair

ultrasound to contour and reduce fat from the face and neck,

removal, and with glowing reviews for its Accent XL treatment

and then two distinct ultrasonic modalities target tissue. The

in publications such as Glamour, Stylist and Metro, it seemed

‘hot mode’ uses compression waves to preheat the targeted areas

a natural step that ABC Lasers should embark on a brand new

and enhance the effectiveness of the cold mode. The ‘cold mode’

technology which focuses solely on retaining a natural aesthetic

uses shear waves to selectively damage fat cells and tissue with

results for the face and neck areas.

minimal damage to surrounding cells. The UniFace module uses radio-frequency energy to tighten the skin and improve

The brand new Accent Ultra VShape from ABC Lasers utilises the

collagen production, while increasing the lymphatic drainage and

strengths of the standard Accent XL technology, while introducing

eliminating the excess of fat safely and effectively.

two new ergonomically designed modules with ultrasound and radio-

The results display a gentle ‘lift and stretch’; firming and toning skin

frequency, which contour to the unique proportions of the face and

around the jaw, jowls, temples and neck without losing any of the volume

neck. This allows for a more thorough treatment, excellent results, and

of the face. In fact, the Accent VShape promotes collagen production so

above all, customer satisfaction. It is the brand new solution to the non

that areas, which are subject to sagging and volume loss, such as around

surgical face-lift.

the cheeks and eyes, are plumper and restored, giving a natural aesthetic.

The VShape at HB Health

“From a therapist’s point of view, the machine is designed so that it


Clinic manager of Knightsbridge’s exclusive HB Health, Leshem

is fool proof”, adds Leshem. “The Accent Ultra VShape harnesses the

Leshem Aloni has

Aloni, describes working with the Accent Ultra VShape and why he

same touch screen technology that you find with all ABC Lasers. The

been with HB Health

thinks this unique machine is the shape of things to come. He says,

machine itself is very compact so doesn’t take up too much space in

since 2005. As the

“We bought the Accent Ultra this year and have been delighted

the treatment room. There’s nothing worse than having an eyesore of

clinic manager of HB

with the results it has given on areas such as the thighs, arms and

a machine in the room, so it’s great that the Accent Ultra VShape looks

Health, Knightsbridge,

tummy. It is a fantastic treatment for cellulite, stretch marks and

good and not out of place at all. The Accent Ultra VShape is the only

Leshem’s main

general body contouring, so when I heard they were introducing

device with a two-in-one technology so I have piece of mind that I am

objective is to

the VShape modules, I jumped at the chance to be one of the first to

able to offer something unique to my clients.”

maintain the clinic

have this in my clinic and invested in one three months ago.

on the highest

“The best thing about the Accent VShape is that it provides my clients

Room for improvement

professional level

with a really natural aesthetic result. Many clients are wising up to the

Not only does the Accent Ultra VShape allow for top up

with high quality and

fact that fillers and Botox® injections are not a ‘one size fits all’ solution

treatments, and therefore repeat business, it also provides scope for

excellent client service.

to ageing and, for those who are afraid of needles, this is the perfect

selling in other treatments and packages.


“I find I can always rely on ABC Lasers’ machines to help me sell in other treatments”, says Leshem. “Clients see the results we get with


“The Accent VShape provides an alternative to clients who do not

the Accent Ultra VShape and then ask if we do laser hair removal,

wish to go under the knife and the needle, yet are happy to invest in

and which other machines we use. Once they know that one ABC

the results and take anti-ageing seriously. These days, clients are more

Lasers machine can provide outstanding results, they trust that this

educated on the treatments available and are very headstrong when

will be the case with the next.

it comes to the results they want. Men and women no longer assign

“I find that the Accent Ultra VShape appointments are an ideal

to the ‘new you’ mantra that is so commonly associated with anti-

opportunity to talk about the Accent Re-Shape body contouring

and find that most clients are curious to see what results they

“What’s more, the Accent Ultra VShape not only allows us to sell in

can get from a variety of procedures. I have also found that since

other ABC treatments, but also treatments such as Dermaroller, cosmetic

purchasing my Accent Ultra at the start of the busy summer

acupuncture, mesotherapy, high performance skin peels and more. Not

months, I have been able to recover the cost of the machine, and

only have we been inundated with appointment bookings for the

I see the upgrade of the Accent VShape as a way of enhancing the

procedure and are recovering the cost of the machine, the Accent

range of treatments we offer.”

Ultra VShape has introduced a whole new demographic of clients. As the Accent Ultra VShape works all over the face, neck and

Who is suitable for the Accent VShape?

sensitive décolletage area, and there is no risk or any significant

While there is room for a whole range of anti-ageing procedures

side effects what so ever, which will naturally make clients less

and products, clients will find some to be more successful than

intimidated. “The sensation of the treatment is often associated

others. The Accent VShape offers a ‘refreshed’ rather than

with hot stone massage. This new clientele makes a real difference

‘remodelled’ appearance and is a great starting place for clients

to the clinic, not only financially, but also with our reputation,

looking to embark on a course of treatments.

service palate and performances. We have not yet advertised

The Accent VShape takes just 30 minutes so ideal for a lunchtime

this treatment, but have found that due to word of mouth, our

treatment, and the client can wear make-up as standard afterwards.

therapists are constantly fully booked.

Results can be seen after three to five treatments, but a full course

“After a very busy summer with both the Accent Ultra XL for

of five is suggested. These can be performed every seven to 12 days

‘beach body’ contouring and the Accent Ultra VShape for anti-

and the optimum results can be seen after about three months.

ageing, we are now moving into the party season where men and

Maintenance can be done every two to three months.

women alike are preparing for Christmas and the New Year. We find clients range from the professional woman who is rejecting

Building the business

injectables but looking for an alternative anti-ageing treatment, to

“I have five other beauty specialists on the same stretch of road as HB Health,

the woman who might normally be opting for a facelift, but has

so being able to provide an exclusive and high performing treatment gives

chosen the Accent Ultra VShape instead, to men from the City who

us the edge over competing businesses”, comments Leshem. “As the clinic

simply want to look refreshed after a lifestyle of late nights.

manager, it is up to me to invest in the newest technology and build the

“The Accent Ultra VShape is suitable for anyone looking for a non-

business so that we are always one step ahead. I find that having the latest

invasive and risk-free anti-ageing procedure, and perfect for beauty

technology converts into sales as patients are always interested in the newest

professionals looking to expand their services, further their reputation

treatments and are open minded when it comes to new treatments.

and ultimately, increase profits.”


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Q&A - Christian Gagnière


We chat to LPG Systems marketing director Christian Gagnière

For LPG Systems this year was a year of innovation with the launch of the new Cellu M6® Integral and Cellu M6® Endermolab. 2011 not only turns a new page with the 25th anniversary of the brand but also unveils a totally new campaign making use of non-retouched images, a concept that is in complete harmony with LPG’s 100% natural approach and consumer’s expectations. Christian Gagnière, LPG Systems marketing director

Marseille, with about forty people ranging from 20

outlines the reasons they embarked on this ground

to 75 years of age. Without disclosing LPG’s identity

breaking campaign...

or involvement to the participants, we asked them about their views on beauty.

Cosmetic News: What is new about this campaign?

It emerged from these very enlightening discussions that women now identify with true beauty, that is to

Christian Gagnière: Our major innovation

say, the notion of natural beauty they associate with

“It emerged from these very enlightening discussions that women now identify with true beauty, that is to say, the notion of natural beauty they associate with the concept of wellbeing.”

in 2011 is a new ‘non-standard’ communication

the concept of wellbeing.

campaign, since we are one of the first companies

worldwide to implement an advertising campaign

We retained some very emotive words, for example:

based on non-retouched photos.

truth, lies, beauty, authentic, natural, wellbeing - which

Before the photo shoot, she had eight Cellu M6

we used for our campaign slogan ,“True beauty

sessions, certified by an affidavit drawn-up by a legal-

does not lie”. On this basis, we decided to conduct a

professional and with a contract stipulating that she

campaign with real, un-retouched photos. We therefore

had never had plastic surgery, cosmetic surgery or

chose a 39-year-old professional model who is a

injections etc.

Societal, under the leadership of the sociologist

mother of two children, a beautiful woman but by no

Christine Detrez. Four focus groups were organised

means perfect!

We then wished to collaborate with a female

CN: Can you explain your approach? CG: We first conducted a survey, called LPG in four major French cities: Lyon, Paris, Lille and

photographer, who would also adhere to our policy of not retouching the photos. Our choice was Kate Barry, daughter of actress and musician Jane Birkin and film composer John Barry. She is a renowned photographer whose work always strives for a natural and spontaneous look which was clearly appropriate for our campaign. The campaign is spread across two ads, one dedicated to the body, the other to the face and was published in French Elle, Marie Claire and Physiologies.

CN: In conclusion? CG: LPG is growing, and one phrase sums up this development well: “The beauty and anti-ageing routine”. More and more women now adopt LPG techniques as a beauty and anti-ageing routine, in the same way they use make-up or go to the hairdresser – hence our new line of communication!

25/07/11 16:07 1.indd 1



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25/07/11 16:10


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

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David Leahy on fungal toenails – a novel application for Nd:YAG lasers

Toe the point W

ith the more mainstream laser procedures

non-dermatophytes (usually candida) account for a smaller

becoming more competitive, and in some cases

percentage (10% to 20%) of toenail onychomycosis. The infection

less profitable, I am increasingly asked by laser

may occur in various patterns: fungal invasion of distal or lateral

users how they can use their 1064nm Nd:YAG

margins of the nail (distolateral subungual onychomycosis);

lasers in other clinical, and possibly more profitable,

direct effect from above or on top of the nail with a powdery,

applications. New applications for 1064nm are not launched that

white, patchy discoloration (superficial white onychomycosis); or

often by laser manufacturers, but one that has created quite some

infection beginning from the proximal location beneath the nail

attention is the use of these lasers to very successfully treat fungal

bed (proximal subungual onychomycosis).

toenail (and fingernail) infection.

David Leahy Anatomy of the Nail

David has spent 15 years as a pharmacologist, working


To have a better understanding of how onychomycosis affects the

primarily in dermatology,

Fungal toenail or onychomycosis, is a fungal infection of the toenails or

nail, a basic knowledge of the anatomy of the nail is helpful. The

before starting his own

fingernails. In some cases patients have both toenails and fingernails

nail, or nail unit, consists of the following parts:

company ABMEtech Ltd. The

infected simultaneously. Onychomycosis causes the infected nail to

The nail matrix (where the nail starts) is where nail cells multiply

company distributes Fotona

thicken, discolour, disfigure, and split. In its early stages, onychomycosis

and keratinize (harden and form into nail material) before being

Laser systems to the UK

appears to be only a cosmetic concern but without treatment, the

incorporated into the fingernail or toenail. Most of the matrix is not

market as well as various other

toenails can become so thick that they press against the inside of the

visible. The matrix starts under the skin 5mm below the nail fold (the

aesthetic surgical consumable

shoes, causing excessive pressure, irritation, and pain. The condition

area of the cuticle where the finger or toe skin meets the nail) and

components to healthcare

causes a great deal of psychological suffering as it prevents sufferers

covers the area called the lunula, or half moon (the white half moon-

professionals. The company has

from wearing any footwear that will expose their toes as they can

shaped area at the bottom of the nail).

now partnered with Med fx to

look disfigured, even when painted. Feet, however, can be covered by

The cuticle is a fold of modified skin where the finger or toe meets

provide accredited training for

shoes, but fingernail infection may cause even more psychological,

the nail. The cuticle acts to protect the matrix from infection.

aesthetic practitioners.

social, or employment-related problems, as it can leave the fingers on

The nail plate is the nail itself.

the hands of the sufferer looking deformed and unclean.

The nail bed is the soft tissue underneath the nail, anchoring the nail plate. The nail plate protects the nail bed.

Half of all the nail disorders commonly seen are caused by onychomycosis, which is the most common nail disease in otherwise

Subtypes of Onychomycosis

healthy adults. Toenails are fair more likely to be infected than

Onychomycosis is divided into clinical subtypes based on the

fingernails, with the prevalence of onychomycosis in the UK adult

cause and progress of the infection.

population (20-55 years old) estimated at being between 2% to 18%, with prevalence increasing to 20% and 30% for those older than 60

Distal lateral subungual onychomycosis

years and 70 years respectively.

Distal lateral subungual onychomycosis (DLSO) is the most common form of onychomycosis. In DLSO, the fungus

Onychomycosis is caused by pathogenic fungal spores that

generally spreads from the skin and invades the underside of

have infected the nail. These fungal spores or dermatophytes,

the nail where the nail meets the nail bed. Inflammation in

are trichophyton rubrum and trichophyton mentagrophytes

these areas of the nail causes the symptoms of DLSO. In this

are the predominant pathogens in onychomycosis; but

form the nail plate is thick with a cloudy appearance


INNOVATIONS (opaque), the nail bed underneath the nail thickens and hardens (nail bed

Onychomycosis related to candidal (yeast) infection is slightly different from

hyperkeratosis), and the nail separates from the bed underneath (onycholysis).

onychomycosis related to other fungal infections. Candidal onychomycosis has

The nail can be discoloured and appear in a range from white to brown. The

several characteristics:

edge of the nail becomes severely eroded.

lO  nycholysis describes the nail separating from the nail bed. The separation is primarily

White superficial onychomycosis

lC  hronic mucocutaneous disease (disease of mucous membrane and regular skin)

caused by yeast called candida. White superficial onychomycosis (WSO) is a rare infection caused by the fungi directly invading the surface of the nail plate and secondarily infecting the nail bed. WSO is usually confined to the toenails. Small white speckled

involves the nail plate (fingernail or toenail) and eventually the nail fold (the skin fold behind the cuticle, where the nail meets the finger or toe). lT  otal dystrophic onychomycosis is not a distinct subtype of onychomycosis.

or powdery‐looking patches appear on the surface of the nail plate. The nail

Dystrophic onychomycosis is the term used to describe the most advanced form

becomes rough and crumbles easily.

of any of the above subtypes, and it involves the entire nail unit. Dystrophic onychomycosis may cause permanent scarring of the nail matrix.

Proximal subungual onychomycosis In proximal subungual onychomycosis (PSO), the least common subtype,

Symptoms of Onychomycosis

the fungi invade the cuticle (the skin around the nail) and the nail fold and

In general, onychomycosis does not cause any symptoms. People with onychomycosis

then penetrate the nail plate (fingernail or toenail). In PSO, an area of white

usually go to the doctor for cosmetic reasons, not because of physical pain or problems

spotting, streaking, or discoloration (leukonychia) develops near the nail fold

related to onychomycosis.

and may extend to deeper layers of the nail. The nail plate becomes white near

As the disease progresses, onychomycosis may interfere with standing, walking, and

the cuticle and remains normal at the end.

exercising. Paresthesia (a sensation of pricking, tingling, or creeping on the skin having no objective

Endonyx onychomycosis

cause and usually associated with injury or irritation of a nerve), pain, discomfort, and

Like DLSO, in endonyx onychomycosis (EO), the fungi reach the nail via

loss of agility (dexterity) may occur.

the skin. Instead of infecting the nail bed, however, the fungi immediately

Risk factors for onychomycosis include family history, advancing age, poor health,

invade the nail plate. In EO, the nail plate has a milky white discoloration,

trauma, living in a warm climate, participation in fitness activities, immunosuppression

but unlike DLSO, the nail does not separate from the bed (no onycholysis).

(can occur from HIV or certain drugs), bathing in communal showers (such as at a gym),

The area under the nail (subungual area) does not thicken or harden (no

and wearing shoes that cover the toes completely and don’t let in any airflow.


The effect of Nd:YAG laser on onychomycosis causing pathogens. There are various opinions as to how the 1064nm laser interacts with the pathogenic fungal spores to cause their destruction and subsequent healing of the nail. Microbiological and biochemical research is still being carried out by many companies manufacturing 1064nm laser systems in order to further evaluate the potent effect of laser in this application. Commonly accepted theories include the heat shock effect of the laser generating reactive oxygen species and denaturation of cellular proteins. that cause the destruction of the intracellular make-up of the spore.

Fig. 2: Trichophyton rubrum treated with

Fig. 6: Candida species treated with VSP

Fig. 1a: The above results to Dr Kozarev’s

VSP Nd:YAG laser: before a), 6 months

Nd:YAG laser : before a), 3 months after b)

initial study showing the efficacy of laser

after b) and 12 months after c)*

and 9 months after c)*

treatment (using the Fotona Spectro Nd:YAG laser) on onychomycosis, as

The procedure of treating a nail with

observed from mycological cultures

1064nm laser is simple and quick,

takenon three and six months and

and no noticeable side effects and complications have yet been reported.

clinically evaluated on 12 months.* Despite the ongoing research into

Fig. 3: Trichophyton mentagrophites

Nd:YAG laser therapy of onychomycosis

the actual process of fungal spore

Fig. 1b: The above diagram shows how

treated with VSP Nd:YAG laser : before a)

is safe and very efficient method for

destruction caused by laser, it is

the delivery of the laser beam in spiral

and 12 months after b)*

treating all types of onychomycosis

universally accepted that 1064nm has a

pattern on the nail plate surface (a),

caused by various fungal species. This

very significant effect to reduce fungal

Thermal images of toenail surface before

method is useful for the broadest range

burden within the nail and promote

(middle top), and after (middle lower)

of patients and is specially beneficial in


irradiation with VSP Nd:YAG laser Beam,

elderly, compromised and hepatopathic patients for which other alternative

yellow represents increased temperature. Temperature increase of the nail plate is

Fig. 5: Trichophyton rubrum treated

clearly visible. Measured temperature at

with VSP Nd:YAG laser: before a) and 12

the nail plate during the laser treatment

months after b)*

(right).* nail and promote healing.


treatments could present some risks. *Results courtesy of Dr Jasmina Kozarev of the Dr. Kozarev Dermatology Laser Clinic, Sremska Mitrovica, Serbia using a Fotona Spectro laser. The treatment was performed using a long pulse VSP 1064 nm Nd:YAG output with fluences in the range of 35 to 40 J/cm², a spot size of 4 mm diameter, and a pulse duration of 35 ms.

● 1064nm laser for treatment of Onychomycosis ● Versatile for multiple Podiatric Conditions ● Maximum ROI. No disposables or per-use fees ● Rapid Delivery. Reduces treatment time ● Light and Ergonomic handpiece ● Temperature Monitoring and real-time feedback


The right


We examine the results of a study on a Multi-Ingredient NonHydroquinone Pigment and Anti-Ageing Solution ABSTRACT Introduction: Because of regulatory and safety concerns associated with hydroquinone, there is significant demand for a nonhydroquinone product to address the appearance of the two most visible signs of ageing - wrinkles and hyperpigmentation. The tested product, Enlighten MD uses a combination of nonhydroquinone ingredients including hexylresorcinol, alphaarbutin, dipotassium glycyrrhizate, kojic dipalmitate, licorice root extract and anti-oxidants plus retinol and salicylic acid. Combination approaches have often been shown to be more effective than single ingredient solutions and retinol is shown to improve both the appearance of wrinkles and the appearance of hyperpigmentation. This study was designed to evaluate the effectiveness of this high-concentration multiingredient non-hydroquinone solution. Methods: Twenty adult subjects with hyperpigmentation on the face were enrolled in an aggressive 12-week, open-label study. Approximately 50% of subjects exhibited hyperpigmentation from melasma, while the remainder were due to photodamage. Subjects applied the investigational product as part of a multi-product skincare regimen (The Skin Care Management System MD by Jan Marini Skin Research) with the investigational non-hydroquinone product introduced over a two-week acclimation period. Results were determined through live assessments conducted pre and post study by the principal investigating dermatologist and by the subjects’ self assessment. Assessments included Melasma Assessment Severity Index (MASI) scores, standardised photo-ageing assessment and quantified assessments of multiple skin aspects including overall skin quality, discoloration, acne, and erythema. At the final visit, subjects were also asked to rate their overall perception of improvement in multiple categories and overall satisfaction. Conclusion: The tested product generated significant improvement in the appearance of hyperpigmentation from both melasma and photo-damage. Improvement in photo-ageing and overall skin quality was also observed by both the principle investigating dermatologist and the study subjects. Subject and investigator satisfaction with the products was high and patient compliance was extremely high with no reported cases of irritation or transient complications. Enlighten MD, in conjunction with the Skin Care Management System MD, constitutes a highly effective non-hydroquinone solution to address the appearance of hyperpigmentation.

Hyperpigmentation and wrinkles are the two most significant signs of ageing. In fact, hyperpigmentation alone, even in the absence of wrinkles, is highly correlated with age and evenly coloured skin is perceived as younger, healthier, more vibrant and attractive (Matts, 2008). A product that can decrease the appearance of both wrinkles and hyperpigmentation is highly sought after by consumers as it can significantly reduce the perceived age of an individual. Hyperpigmentation affects people of all skin types and cultures and is primarily due to cumulative exposure to UV radiation. This cumulative damage results in areas of increased expression of melanin in the epidermis. The prevalence of solar lentigines vs melasma vs freckles varies across cultures but in all cases hyperpigmentation begins affecting large percentages of individuals in their mid to late 20’s and affects nearly 100% of all individuals by the age of 40-50. (Farage MA, 2010) (Schafer T, 2006) Tyrosinase, generated in the epidermis, is a major enabler of melanin production in the synthesis pathway. Inhibiting the expression of tyrosinase will decrease the potential for the body to produce excessive pigmentation. There are many known tyrosinase inhibitors but the most commonly known inhibitor is hydroquinone. Other topical agents such as hexylresorcinol also inhibit the synthesis of melanin by promoting the production of glutathione and inhibiting the production of DOPA to DOPAChrome. As melanin is generated in the epidermis, topical solutions are effective in altering the production and expression of hyperpigmentation. In the US, 4% (or greater) hydroquinone is the most frequently prescribed topical treatment for hyperpigmentation. Hydroquinone, however, has significant controversy and concern surrounding its use. In some people hydroquinone can cause ochronosis, a paradoxical increase in hyperpigmentation, which may not decrease after discontinuation (Westerhof W, 2005). Additionally there is some evidence linking hydroquinone to increased cancer risk (FDA, 2006) (Westerhof W, 2005) through the potential induction of endoreduplication and its potential role in genomic instability and subsequent carcinogenesis (Ji Z, 2009). As a result of these concerns, hydroquinone is banned in many countries around the world, including all the European Union and Japan. In response, research into alternatives for hydroquinone is rapidly growing. Many newer non-hydroquinone technologies combine several technologies to improve efficacy as combination technologies tend to be more effective than single technology solutions (Halder RM, 2004). Yet few, if any, products contain technologies that address multiple stages of the melanin production cycle, improve penetration, enhance results and provide additional anti-ageing benefits. The tested product contains significant concentrations of over seven different proven technologies including: hexylresorcinol, alpha-arbutin, dipotassium glycyrrhizate, kojic dipalmitate, licorice root extract, retinol, anti-oxidants and salicylic acid. This use of several proven technologies in a single product is intended to both increase the efficacy and response rate (compared to alternate, less concentrated, non-hydroquinone solutions) and improve the antiageing benefits of the product. This study investigates the efficacy of the cumulative product in each area.


M ethods Twenty adult subjects aged 30-65 with

topical prescription tretinoin (0.05%) in addition to

period starting at week two.

hyperpigmentation on the face secondary to photo-

the tested configuration to determine effect and

Assessments included live review by the principal

ageing and melasma (n=12) were enrolled in an

tolerance as retinoids are a common component of

investigating dermatologist and patient self-assessment.

aggressive 12-week, open-label study. The study

hyperpigmentation therapies. Since there was little

Quantification of melasma was determined by physician

was designed to be only 12 weeks (vs. 24) to assess

to no sensitivity reported in either the prescription

assessment using Melasma Assessment Severity Index

the product’s ability to produce rapid changes in the

topical tretinoin group or the non-tretinoin group, the

(MASI) scores. Photo-ageing was assessed using a

appearance of hyperpigmentation. Subjects were

investigational product was modified to increase the

multi-factorial four-point scale developed by Dr. Macrene

enrolled in the study between the end of November

percentage of retinol. All other ingredients remained

Alexiades-Armenakas published in JDD Sept. 2006 for

2010 and beginning of February 2011. This timing

constant. The final six subjects used the modified

assessing photo-ageing pre and post non-ablative laser

was designed to eliminate the impact of summer sun

product with higher retinol concentration.

treatments. This scale was used in place of a standard

exposure and seasonal changes on appearance of

wrinkle score due to its increased granularity to measure

pigmentation over the course of the study.

Subjects followed a detailed protocol including a two-

changes in texture, erythema, elastosis and wrinkles.

To control all aspects of the test subject’s skincare routine,

week acclimation period to integrate Enlighten MD into

Improvement was further determined by the principal

subjects applied the investigational product as part of

the subject’s skincare routine. During the acclimation

investigator using a 10-point scale to assess overall skin

a layered skincare system (The Skin Care Management

period, the resurfacing step was applied AM only and

quality, overall hyperpigmentation, overall erythema and

System MD by Jan Marini Skin Research). This regimen

the test product was applied every other night during

overall photo-ageing.

consists of a total of six products applied in succession

week one and nightly during week two. From week

Statistical significance was determined by paired t-test.

including: a glycolic acid cleanser, a vitamin C serum, a

three through the end of the study all products (with the

Unless otherwise specified, statistical significance was

resurfacing gel, Enlighten MD, a hydrating anti-ageing

exception of the sunscreen) were applied AM and PM.

determined by comparing complete sets of pre and post

product and a broad spectrum sunscreen.

In the tretinoin arm, nightly application of prescription

treatment data. A p value of less than 0.05 was used to

Six of the initial 14 study participants applied a

tretinoin was integrated into the routine over a 3 week

determine significance.

R esults Compliance was extremely high with only one participant lost

Age distribution ranged as follows: six individuals between 30-39

to follow-up. Acclimation was minimal with no reported cases

years of age, seven individuals between 40-49 years of age, four

of skin irritation in either study arms. The final population to

between 50-59 years of age and two individuals over 60. Final data

complete the study consisted of nineteen female subjects. The

is separated into two categories, physician assessment and patient

only enrolled male subject was lost to follow-up at the final visit.


P hys i ci a n A sse ssme nt experiencing a reduction in photo-ageing, only 5% of which exhibited an increase in photo-ageing by the smallest possible score increment (• point). Results for standardised physician assessment scores are shown in Figure 1. Physician assessed improvement in overall pigmentation and sundamage was determined using a 10 point grading scale. Improvement in both overall pigmentation (p<0.001) and sun-damage (p<0.001) were statistically significant. Baseline and 3 month scores are shown in Figure 2. Significant Reduction in melasma was significant (p<0.01) with 75% of patients

improvements were also observed in skin quality (p=0.001),

with melasma (nine of 12) experiencing a reduction in MASI scores.

erythema (p=0.005) and acne (p=0.05). Physician assessment

The average MASI index score reduced by 27% over the three month

showed very consistent results with nearly all subjects. 17 of the 19

study period. Further, no subjects experienced a significant darkening

subjects (89%) experiencing measurable improvement in at least

or worsening of their melasma. Improvement in standardised photo-

one or more categories. 16 patients (84%) showed improvement in

ageing scores was also significant (p<0.001) with 74% of subjects

two or more categories.


3 Months


S u bj ec t S e lfA s ses s m e nt 100% of subjects reported improvement in their skin in at least two or more categories. Moderate to significant improvement was observed in six of eight categories including the key pigmentation categories of sun spots, melasma and luminosity. Mild to moderate improvement observed in the final two categories (Figure 3).


3 Months

Quantitative assessments of skin quality taken pre and post study showed a significant reduction in dyschromia (p<0.001) and uneven skin tone (p<0.001) and a significant increase in skin elasticity (p<0.001) indicating a clearer more youthful complexion and improvement in overall skin quality (Figure 4).

Standardised photo-ageing improvement was significant (p<0.001) as was the change in scores denoting the overall quality of their skin (p<0.001) (Figure 5). Subject satisfaction was high with 89% of all participants indicating on the post study that they intended to purchase the products and would recommend them to a friend/family member.

Hyperpigmentation is one of the hallmarks of ageing skin. A

alone (Halder R.M., 2004). Typically, however, due to the

shown to reduce the production of melanin both the intra

product that effectively addresses both hyperpigmentation

irritation associated with both hydroquinone and tretinoin,

and extra-cellular space by interacting at multiple stages

and the many other facets of ageing skin offers significant

these combination products also require the use of a steroid

of the melanin production cycle. In-vivo, hexylresorcinol

consumer value. Available products that are designed

to decrease morbidity.

is shown to have equivalent lightening properties to

D is c us s ion

to decrease hyperpigmentation fall into two primary

hydroquinone at both four and eight weeks with â&#x20AC;˘ the

categories â&#x20AC;&#x201C; hydroquinone and non-hydroquinone

The tested product combines multiple non-hydroquinone

concentration (0.5% vs. 2%) and in vitro, interrupts

solutions. Hydroquinone, typically prescribed at 4%

technologies, each in concentrations proven to be

eumelanin formation more effectively than licorice root,

concentrations in the US, is highly effective and widely

comparable to hydroquinone, using retinol, salicylic

hydroquinone and kojic acid (Syntheon). The tested product

proven but irritation with use is common (Herndon JH Jr.,

acid and additional technologies designed to minimise

contains 2X the concentration used in these comparative

2006) resulting in frequent addition of steroids to minimise

inflammation and skin irritation. The key pigmentation


irritaiton (Davis EC, 2010). Further, concerns with the long-

technologies in the tested product include hexylresorcinol,

term safety use of hydroquinone have resulted in bans in

alpha-arbutin, licorice root extract, dipotassium

Topically, hexylresorcinol stimulates the production

many countries outside the US.

glycyrrhizate and kojic dipalmitate. salicylic acid and

of glutathione, which helps to decrease DNA damage

Many non-hydroquinone technologies have proven to be

retinol in the product increase cellular turnover and

secondary to oxidative stress and reduces the

effective tyrosinase inhibitors and improved results are

provide significant anti-ageing benefits in addition to

appearance of hyperpigmentation. Hexylresorcinol, and

often achieved through the use of multiple technologies

reducing the appearance of hyperpigmentation. They

the stimulated glutathione work on multiple pathways

in a single product. Unfortunately, most products available

also offer the potential to increase the penetration of the

as shown in Figure 6 (Syntheon). Further, it is extremely

today only include one or two technologies, thus limiting

aforementioned pigmentation technologies. Anti-oxidants

safe. It is listed as a safe for use as a food preservative in

efficacy. Studies have shown that the combination of

and anti-inflammatory agents in the product decrease the

the US and many foreign countries and is used in throat

tyrosinase inhibitors (hydroquinone) with retinoids

probability of skin irritation.

lozenges for its anesthetic and antiseptic properties to

(tretinoin 0.5%) is more effective than tyrosinase inhibitors

Hexylresorcinol, a key component in the tested product, is

reduce irritation.


Epionce® Targets Pigmentation Epionce® Melano Corrective System

Melano Corrective System

MelanoLyte Tx

Using an innovative blend of botanical ingredients, the Melano Corrective system effectively reverses and prevents the appearance of unwanted pigmentation. This corrective system addresses each step in the abnormal pigmentation process without causing the irritation and redness caused by many other pigmentation products.

Clinically tested against the Obagi® Nu-Derm System for Pigmentation. Read the study at

What makes MelanoLyte Tx unique? Fast, more complete clearing • Little to no irritation • Prolonged results • Less risk of recurrence • Clinical evidence •

Lightens Irregular Pigmentation

DR CARL THORNFELDT DISCUSSES THE SCIENCE BEHIND HIS SKINCARE LINE ‘If we could make the skin function at its optimum and stay in that optimum state, could we prevent all these diseases that develop as we mature?’ This was Dr Thornfeldt’s original hypothesis before creating his skincare line Epionce®. His objective was to create a range of products safe enough to use over the long term, suitable for all age groups, but that had multiple mechanisms of action to affect complex processes. Skin diseases and conditions all have multiple processes involved to produce what we see manifested visually in the skin. The result of his research and development is Epionce®.

How is Epionce different from other products? Carl Thornfeldt: Epionce® has been developed to modulate the underlying problems that create the visible disease or condition. In other words, not just help fix the symptoms of what the skin conditions are, but rather, to help treat the underlying effect. Epionce® helps to optimise the barrier function of the skin, and helps reverse and prevent chronic inflammation, which is destructive. Epionce Targets Pigmentation Carl Thornfeldt: The Melano Corrective System is comprised of two products that work synergistically to help the complicated process leading to visible hyperpigmentation. It is made up of a combination of herbal and algae extracts with multiple mechanisms of action that were previously evaluated in human skin in vivo trials. They are also able to deliver these active ingredients without destroying the stratum corneum barrier and activating inflammation response. The MelanoLyte Tx is for daily at-home use, that can be used year-round, and the MelanoLyte Pro is a very active mask for in-clinic application.

For more information about the Melano Corrective System and FREE training contact Episciences on 01245 227788 or email

Figure 6 - Hexylresorcinol and and Melanin Production Cycle

DNA damage induced by H202


Competitive binding to Tyrosinase active site

Tyrosinase mediated path






work together to increase the probability of

Interestingly, although the equivalent concentration of

successful treatment.

tretinoin to the retinol in the test product is high, study

Retinoids provide significant anti-ageing

subjects did not indicate skin irritation or sensitivity

benefits by increasing skin thickness and

typically associated with high percent topical tretinoin.

increasing cellular turnover, promoting

The tested non-hydroquinone system is safe for

healthier skin. The standard prescribed

long-term use and, as with any pigmentation product,

retinoid is all-trans-retinoic acid, or

benefits will continuing with use. The subject shown

tretinoin, with concentrations typically

below (outside official study) used the tested system for

ranging from 0.025% to 0.1%. Results

10 months and shows significant reduction in melasma

from tretinoin are significant but irritation

on both cheeks.

and sensitivity is also high is as much as Peroxidase/H202 mediated path

Peroxidase/H202 mediated path

Interaction curve for parameter â&#x20AC;&#x153;Lâ&#x20AC;?: treated zone vs control, difference M1/MO

82% of all subjects using 0.1% tretinoin experiencing at least moderate erythema and scaling more than once over a 10-month study period.


is approximately 10 times the equivalent concentration of


tested product (0.75%) is roughly equivalent to a 0.075%.

Co n cl us ion


all-trans-retinol and tretinoin, the retinol percentage in the

hyperpigmentation. In combination, these technologies


tretinoin. Based on these study data comparing topical

shown to provide effective reduction in the appearance of


a 1% all-trans-retinol is roughly equivalent to a 0.1%

the tested product, each of these technologies has been


Individually, and at concentrations less than those used in


all-trans-retinoic acid (Kurdlandsky SB, 1994). This means


necessary concentration of all-trans-retinol concentration

tyrosinase inhibition.


licorice root extract (glycyrrhiza glabra) responsible for



(Kligman LH, 2000). To achieve comparable results, the


compared to no changes (0 of 3) in the control group.

glycyrrhizate is a pure form of the compound in


of 6) subjects at concentrations of 0.3% and above as

Hydroquinone (Figure 7) (Pentapharm). Dipotassium


results at one month than kojic-acid, beta-arbutin and



orderliness and decreased melanin content in 100% (6


at concentrations of 0.15% with increased keratinocytes

Chinese descent, alpha-arbutin showed more significant


increased epidermal thickness, observed skin changes

in an 80 person skin-lightening study on individuals of


from the bearberry leaves. (Sugimotot K, 2003). Further,



2000). A histologic control comparison study observed


retinoic acid for multiple indications (Kligman LH,

much more strongly than classic beta-arbutin, derived


showing equivalent results to topically applied all-trans

a synthesised form of arbutin shown to inhibit tyrosinase


melanin production cycle (Zhu W, 2008). Alpha-arbutin is



skin, converting it to retinoic acid (tretinoin) with studies


2000). All trans-retinol undergoes a conversion in the

tyrosinase formation, thereby preventing initiation of the


and dipotassium glycyrrhizate all function to inhibit


tretinoin with less potential for irritation. (Kligman LH,


All-trans-retinol is an alternative to Alpha-arbutin, licorice root extract, Kojic Dipalmitate

Figure 7 - Alpha-Arbutin Lightening Effect


10 Months

The high concentrations of multiple lightening technologies combined with high concentrations of retinoids and salicylic acid yielded significant improvement in the appearance of hyperpigmentation due to both Melasma and photo-damage. Additionally, significant improvement was observed by both the principle investigating dermatologist and subjects in photo-ageing and overall skin quality. Subject and investigator satisfaction was high, with extremely high subject compliance and zero reported cases of irritation or transient complications - even in the prescription topical tretinoin arm. The high rate of compliance significantly enhances the ability of the Skin Care Management System to deliver maximum results. Enlighten MD with the Skin Care Management System MD represents a highly effective non-tretinoin solution to address the appearance of hyperpigmentation and overall photo-ageing.

R eferences Davis EC, C. V. (2010). Postinflammatory Hyperpigmentation. J. Clin.

Kligman LH, G. E. (2000). Re-emergence of topical retinol in

Sugimotot K, N. T. (2003). Syntheses of Arbutin-a-glycosides and a

Aesthet. Dermatol , 3 (7), 20-31.

dermatology. J. of Dermatological Treatment , 11, 47-52.

Comparison of Their Inhibitory Effects with Those of a-Arbutin and

Farage MA, M. K. (2010). Textbook of Ageing Skin. Berlin: Springer.

Kurdlandsky SB, X. J. (1994). Biological Activity of Allt-trans Retinol

Arbutin on Human Tyrosinase. Chem. Pharm. Bull , 51 (7), 798-801.

FDA. (2006, August 29). Skin Bleaching Drug Products for Over-the-

Requires Metabolic Conversion to All-trans Retinoic Acid and is

Syntheon. (n.d.). Hexylresorcinol Data Sheet. The New Safe and Effective

Counter Human Use; Proposed Rule. Federal Register , 71 (167).

Mediated through Activation of Nuclear Retinoid Receptors in Juman

Skin Brightener with Protective Effects on the Skin , 14 (2) , 117-123.

Halder R.M., R. G. (2004, June-July). Topical Agents Used in the

Keratinocytes. Journal of Biologic Chemistry , 269 (52), 32821-32827.


Management of Hyperpigmentation. Skin Therapy , 9 (6).

Matts, P. (2008). New Insights into Skin Appearance and Measurement.

Westerhof W, K. T. (2005). Hydroquinone and its analogues in

Herndon JH Jr., S. T. (2006). Efficacy of Tretinoin / Hydroquinone-Based

The Society for Investigative Dermatology , 13.

dermatology - a potential health risk. Journal of Cosmetic Dermatology

Skin Health System in the Treatment of Facial Photodamage. Cosmetic

Pentapharm. (n.d.). Alpha Arbutin Data Sheet. Alpha-Arbutin - the more

, 5 (2), 168-169.

Dermatology , 19 (4), 255-262.

effective, faster and safer approach to skin lightening. Pentapharm.

Zhu W, G. J. (2008). The use of Botanical Extracts as Topical Skin-

Ji Z, Z. L. (2009). The benzene metabolite, hydroquinone and etoposide

Schafer T, M. J. (2006). The Epidemiology of Nevi and Signs of Skin

Lightening Agents for the Improvement of Skin Pigmentation Disorders.

both induce endoreduplication in human lymphoblastoid TK6 cells.

Ageing in the Adult General Population: Results of the KORA-Survey

Journal of Investigative Dermatology Symposium Proceedings , 13,

Mutagenesis , 24 (4), 367-372.

2000. Journal of Investigative Dermatology , 126, 1490-1496.



2011 Seminar


Jan Marini Skin Research (JMSR) is known for creating breakthrough product solutions and dramatic technological advancements. Over the years, the company has established a portfolio of proprietary formulas that reflect itâ&#x20AC;&#x2122;s on-going commitment to be the preeminent developer of skin care products that produce measurable clinical results. Backed by clinical studies and protocols, marketing support and striking branding, Jan Marini Skin Research products are only sold to professional, accredited outlets. As the exclusive distributor of JMSR, JMSR Europe Ltd will be conducting free seminars on the dates opposite. Join us for an opportunity to find out about the portfolio. Learn how leveraging the Skin Care Management System, and other key JMSR accelerator products, can increase your business success. Additionally, we will cover a broad range of relevant marketing and business concepts intended to positively impact your top and bottom line. A buffet lunch and refreshments are provided. For booking details please call 020 8868 4411.

JMSR Europe Ltd.

Seminar Dates 4th October 2011 EDINBURGH Radisson Blu 10-11th October 2011 MANCHESTER Lowry Hotel 26th October 2011 DUBLIN The Burlington Hotel 8th November 2011 LONDON Royal Society of Medicine 29th November 2011 MANCHESTER Lowry Hotel

Product News New FDA clearance for SOPRANO Alma lasers, distributed in the UK and Ireland by ABC Lasers, has received a new FDA clearance indication for the Soprano Xli Blue laser for treatment of all skin types including black skin types and sun tanned skin.

JMSR launches Skincare Management System boxes Following its recent launch of Age Intervention Enlighten Plus and Enlighten MD, Jan Marini Skin Research (JMSR) has announced the arrival of six new full sized Skin Care Management System boxes incorporating either of these products and an extra cleanser. This means each of these new Skin Care Management System boxes will contain seven full sized products for under £300. Both Age Intervention Enlighten Plus and Enlighten MD are 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.

Syneron/Candela launches CO2RE Syneron/Candela has unveiled its latest innovation in fractional CO2 skin resurfacing – the CO2RE. Featuring four treatment modes, CO2RE can be used to rejuvenate the skin in a single treatment and may be used for spot or full face/neck/ decolletage and body treatments. Traditional CO2 laser treatments came with risks, pain and weeks of downtime due to the removal of all the epidermis, but because CO2RE is able to remove a much smaller percentage of the skin, part of the epidermis remains intact, resulting in far less downtime, pain and a reduced risk of post inflammatory hyper-pigmentation, sensitivity and infection. Boasting the fastest CO2 scanning technology in the industry, C02RE delivers spot treatments in a matter of minutes. Adding to its uniqueness, CO2RE’s FUSION MODE allows doctors to treat both the upper and deeper skin layers simultaneously with complete precision. This provides improvement of the skins surface texture and the stimulation of healthy collagen deep in the dermis. Co2RE offers multiple treatment options for skin resurfacing, wrinkles and scar reduction. Offering surface, middle and deep dermal layer treatments to suit the individual’s needs and results. 40

This breakthrough modification in the Soprano Xli SHR (IN-MOTION) Pain Free Hair Removal technology, will now, uniquely and exclusively open the door for Soprano offering clinics, to offer Laser Hair Removal all year round even to those clients who are sun tanned (although fake tans are still prohibited). This recent FDA approval is a result of very extensive clinical research and publication of several peer reviewed studies which provide an overwhelming evidence as to the long term efficacy (at six and 18 months post a six sessions course), presenting an impressive safety record of 0% adverse skin respond of any kind.

SkinMedica launches CalmPlex SkinMedica has introduced the first and only skincare product to contain a patented ingredient clinically proven to reduce visible redness – Redness Relief CalmPlex. A recent discovery made by the team at SkinMedica® saw that Prostaglandin E2 was the major contributing factor for visible redness. CalmPlex is designed specifically to diminish PGE2, which will consequently dramatically even skin tone. SkinMedica also discovered that this was the main cause for most types of visible redness, including sun exposure, extreme temperatures, blushing, menopause, rosacea, acne, infection and cosmetic procedures. Decreasing levels of PGE2 with CalmPlex will prevent the vasodilatory effect, which is the primary cause of redness in post-menopausal women. It will also prevent UV-induced inflammation as well as the reduction of melanin distribution. Further research by SkinMedica additionally shows dramatic prevention of hyperpigmentation. Key ingredients include 4-Ethoxybenzaldehyde, a patented ingredient with proven clinical safety in humans, that suppresses the release of PGE2; Niacinamide, which improves barrier function whilst reducing sebum production and Squalene and Jojoba Oil, which improve barrier function with moisturisation as well as controlling release of inflammatory cytokines.

Inspira Med Ltd to distribute Red + MRS Fine Titanium Derma Roller Inspira Med Ltd will be distributing the Red + MRS Fine Titanium Derma Roller in the UK. The comprehensive range includes rollers for both in-clinic and at-home use. The device comes in a number of sizes: 0.20 mm-0.30mm for home use and 0.50mm-3.00mm for professional use. All rollers are delivered in individual sealed sterile envelopes and plastic cases.

Goodbye Pigmentation!



Six new Skin Care Management Systems featuring Enlighten Plus or Enlighten MD.


Skin Care Management System Plus and Skin Care Management System MD are preconfigured to specifically meet the significant market need to address pigmentation. All systems, featuring seven full sized products are competitively positioned with suggested Retail Prices at under £300. The Skin Care Management System (SCMS) was named “The Best Skin-Care System Sold in a Doctor’s Office” in the 2010-2011 New Beauty Awards and was judged to “Really transform skin into a glowing, youthful complexion.” SCMS Plus and MD combine this award winning system with a dedicated, advanced, non-hydroquinone formulation lightening product (Enlighten Plus or Enlighten MD) and a gentle cleanser. Enlighten Plus Skin Care Management Systems Normal/Combination PLUS: BioGlycolic Cleanser, AI Gentle Cleanser, C-Esta Serum, Bioclear Serum, TGF Cream, Enlighten PLUS, Spf 30 Tube. Catalogue Number: SCMS05 Dry PLUS: BioGlycolic Cleanser, AI Gentle Cleanser, C-Esta Serum, Bioclear Cream, AI Cream, Enlighten PLUS, Spf 30 Tube. Catalogue Number: SCMS06 Oily PLUS: BioGlycolic Oily Cleanser, AI Gentle Cleanser, C-Esta Oil Control, Bioclear Serum, TGF Serum, Enlighten PLUS, Spf 30 Tube. Catalogue Number: SCMS07

Enlighten MD Skin Care Management Systems (for Doctors and nurse prescribers only) Dry MD: BioGlycolic Cleanser, AI Gentle Cleanser, C-Esta Serum, Bioclear Cream, AI Cream, Enlighten MD, Spf 30 Tube. Catalogue Number: SCMS08 Normal/Combination MD: BioGioglycolic Cleanser, AI Gentle Cleanser, C-Esta Serum, Bioclear Serum, TGF Cream, Enlighten MD, Spf 30 Tube. Catalogue Number: SCMS09 Oily MD: BioGlycolic Oily Cleanser, AI Gentle Cleanser, C-Esta Oil Control, Bioclear Serum, TGF Serum, Enlighten MD, Spf 30 Tube. Catalogue number SCMS10

All products to be sold by consultation only, not to be sold on the internet. Supply: Approx 2 months

JMSR Europe Ltd. 020 8868 4411

Product News CE Mark Approval for TissuGlu® Surgical Adhesive Cohera Medical has received CE Mark approval for its lead product, TissuGlu® Surgical Adhesive, allowing the product to be sold in the European Union. TissuGlu is an internal surgical adhesive for large flap surgeries, such as abdominoplasties, that helps reduce fluid accumulation and the need for postsurgical drains. Its unique chemical composition is resorbable, non-toxic, forms a strong bond between tissue layers and allows for natural healing, which ultimately may provide the patient with a quicker return to normal activity. “TissuGlu Surgical Adhesive provides an innovative approach to the way plastic surgeons address wound drainage challenges and helps plastic surgeons improve the overall care of their patients,” said Dr Peter Rubin, Chief, Division of Plastic and Reconstructive Surgery at the University of Pittsburgh Medical Center. “Surgeons will be eager to apply this product to their procedures, which we believe will ultimately save them time and money through the reduction of post-surgical complications and additional OR time.”

“Achieving the CE Mark on our TissuGlu Surgical Adhesive represents a significant milestone and achievement by all of the employees of Cohera Medical,” said Chad A. Coberly, Vice President of Clinical, Regulatory and Legal Affairs for Cohera Medical. “The certification signifies that we have met the rigorous clinical, quality, and performance requirements of the EU authorities and demonstrates the commitment we have to our future customers, partners, and investors.”

Intraceuticals Rejuvenate Range now Paraben-Free Intraceuticals has now released a new paraben-free Rejuvenate product range. Intraceuticals’ Rejuvenate range is designed for intense rehydration of the skin, and is used in conjunction with its proprietary 3-Step Hyaluronic Layering, the underpinning philosophy behind the entire Intraceuticals product range. At Step 1 of the process, Rejuvenate Daily Serum revives the skin from within. The serum’s low molecular weight makes it the perfect vehicle for a deep delivery of carefully selected anti-ageing actives and nutrients to the skin. Rejuvenate Hydration Gel is applied as Step 2 to replenish the skin and provide an invisible barrier against moisture loss. Rich in Hyaluronic Acid, vitamin C and vitamin E, the lightweight gel works synergistically with Rejuvenate Daily Serum to smooth fine lines and wrinkles, allowing osmotic hydration to continue. As the third step Rejuvenate Moisture Binding Cream combats surface dehydration to nourish, moisturise and defend the skin. The active ingredients of the Daily Serum and Hydration Gel are locked into the skin by the Moisture Binding Cream, while adding anti-oxidants and wheat germ for continuous hydration and restoration of the skin’s natural pH balance.

Medik8® betaGel targets acne Medik8® has developed a new product to target acne. Medik8® betaGel™ is a 24 hour, professional strength protection gel for use on individual blemishes or larger problem areas day or night. The lightweight formula contains a fusion of spot fighting actives that can be applied invisibly underneath or over make-up. The deep cleansing action and antiredness properties that alleviate the unwanted redness associated with acne and spot breakouts are what make Medik8® betaGel™ the ideal product for all skin types. Unlike typical anti-acne treatments which induce dryness, betaGel™ keeps the targeted area hydrated and supple reducing the discomfort normally experienced when spots are inflamed or sore. Key ingredients include: Azelaic Acid, Salicylic Acid and Niacinamide.


BOTOX TO BE USED TO TREAT INCONTINENCE The go-ahead has been given in Europe for Botox® to be used for treating certain patients with urinary incontinence in adults with neurogenic detrusor overactivity (NDO), opening up a potentially new market for its maker Allergan. The Irish Medicines Board has given a positive recommendation for Botox® to treat patients with overactive bladder problems caused by multiple sclerosis and spinal cord injury. This is an important step towards securing national licences in the 14 European countries involved in the Mutual Recognition Procedure and marks a key milestone in bringing this innovative treatment to patients suffering from urinary incontinence due to NDO.   The positive opinion is specific for Botox® and is based on Allergan’s successful global phase III programme. Targeted injections of Botox® into the bladder muscle have been shown to reduce the involuntary contractions and increase bladder capacity. In turn, this reduces the number of urinary leaking episodes and may even stop leaking altogether in some patients.

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Before China Clinical Trial

After (Day 28)


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

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cosmetic news xpo 2012 E

29th - 30th april 2012 | business design centre, islington, london w w w. c o s m e t i c n e w s u k . c o m

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

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We summarise some of the most recent studies you may have missed Title:

severe complication of vascular necrosis and

There was no significant difference in the

medicine, and rejuvenation in 2010: the role of

detect impending necrosis after injection of a

degree of reduction in non-inflammatory lesions

adipose-derived stem cells

dermal filler, especially with hyaluronic acid fillers.

between the two peels. There was no significant

Authors: Beeson W, Woods E, Agha R Published: Facial Plast Surg. 2011

Materials and Methods: Case report

reduction in the number of inflammatory lesions.

of a patient who was followed for six months

Both peels were generally very well tolerated.


from time of injection of hyaluronic acid filler to

Conclusion: This study suggests that

complete healing of wound.

lipohydroxyacid peels can be beneficial to subjects with comedonal acne.

Tissue engineering, regenerative


Results:  Complete wound healing was

Facial rejuvenation is rapidly evolving sector

achieved with early recognition and institution of

in the field of facial aesthetics. There is a wide



variety of dermal fillers and many more are in

Conclusion: Early recognition of vascular

by microdermabrasion

development. Over the past few years, the study

necrosis with specific protocol for treatment after

of adult-derived stem cells has become a very

injection necrosis with hyaluronic acid fillers

Authors : Yingcong Zhou, Ajay K Banga Published: Journal of Cosmetic

active area of research.

improves the outcome of wound healing.

Dermatology Volume 10, Issue 3, pages 179–184,

Enhanced delivery of cosmeceuticals

September 2011

Adult stem cells are an attractive option for volume restoration and facial rejuvenation. Adult


stem cells are isolated from adipose tissue-

chemical peel containing a lipophilic hydroxy acid

Background: Microdermabrasion (MDA)

adipose derived stem cells and have mesodermal,

derivative of salicylic acid with a salicylic acid peel

is one of the top five nonsurgical cosmetic

ectodermal, and endodermal potentials.

in subjects with comedonal acne

procedures performed. It is a well-established

Adipose-derived stem cells could conceivably

Authors: Annie Levesque, Iltefat Hamzavi,

technology with widespread applications in the

be an alternative to pluripotent embryonic stem

Sophie Seite, André Rougier, Robert Bissonnette

cosmetic industry.

cells and could play a critical role in the rapidly

Published: Journal of Cosmetic Dermatology

Aims: To investigate the effects of MDA on skin

expanding fields of tissue engineering and

Volume 10, Issue 3, pages 174–178, September

and delivery of cosmeceuticals.

regenerative medicine.


Randomised trial comparing a

Methods: The alternation of skin structure post-MDA was examined by histological

This article reviews the history of soft tissue augmentation using adipose tissue grafting and

Background: Lipohydroxyacid is a

sectioning and transepidermal water loss

the advent of using adipose-derived stem cells.

lipophilic derivative of salicylic acid with

measurements. The effect of MDA treatment

The state-of-the-art stem cell isolation technique

comedolytic properties.

on skin permeation profiles of hydrophilic and

as well as anticipated future therapeutic

Objectives: To compare lipohydroxyacid

lipophilic molecules was investigated by laser

indications are also addressed.

and salicylic acid peels in subjects with

scanning confocal microscopy and in vitro

comedonal acne.

permeation studies.


Methods: In this split face, randomised

Results: Confocal images indicated

hyaluronic acid filler: case report and review of

study, 20 subjects with comedonal acne received

different absorption profiles and permeation

the literature

lipohydroxyacid peels on one side of the face,

depths for hydrophilic and lipophilic molecules.

Authors: Kassir R, Kolluru A, Kassir M Published: J Cosmet Dermatol. 2011

while the other side was treated with salicylic acid

Microdermabrasion enhanced the transdermal

peels. A total of six peels at two-week intervals

delivery of nicotinamide, the model hydrophilic


were performed. Efficacy was evaluated by

compound employed. On the other hand,

counting non-inflammatory and inflammatory

permeation of retinol, the model lipophilic

Background: Use of dermal fillers for soft

lesions and by performing a global change

compound, did not improve after treatment

tissue augmentation has become an integral part

in acne assessment. Safety was assessed by

with MDA. When treated with 20 passes, the skin

of aesthetic practices. Dermal fillers temporarily

evaluating adverse events, global tolerance, and

recovered from MDA induced changes in four

remove the appearance of rhytids and reduce

the presence of erythema, scaling, and dryness.


the depth of skin folds. Even with the most

Results: There was a statistically significant

Conclusion: Permeation of cosmeceuticals

experienced of injectors, adverse effects can and

decrease of 55.6% and 48.5% from baseline to

into skin was found to be affected by their

do occur ranging from mild bruising to severe

Day 98 in the mean number of non-inflammatory

lipophilicity. Application of skincare products

injection necrosis.

lesions for the sides treated with lipohydroxyacid

post-MDA therapy may be promising to improve

Aims: Physicians should be able to treat the

and salicylic acid peels, respectively (P < 0.001).

their dermal uptake.


Extensive necrosis after injection of

BEST PRACTICE - Social media

Hot topics

in employment law Award winning lawyer Norman Rea, consultant at Sydney Mitchell Solicitors, begins a series of interesting legal articles for our readers and, in this article, explores the phenom ena of Social Media sites and their usage in the workplace and beyond.

Social Networking Media – Do you have some twits on Twitter ? The world and how we communicate has changed in the last few years. A lot of us (me included) have profiles on sites such as Facebook, Twitter, LinkedIn, Google+ and MySpace. We all like to share our stories with our friends, followers

Social Media Policy

and fans and we like to listen and comment on what they

On any view it would be extremely wise to have a usage

have to say. More importantly, people trust what we say

policy in place which is clearly understood by all staff and


which sets out unequivocal guidelines of what is or is not acceptable usage within the employment arena.

The widespread availability and use of social media and networking applications brings opportunities to understand

Generally, contracts of employment or staff handbooks

and engage and communicate with our clients and

do not deal with this relatively new issue or are vague

customers in new ways. Used correctly they are an effective

and not coherent which, ultimately, makes it difficult to

marketing tool.

take disciplinary action or to defend employee claims.

However, it is important that, as an employer, you are able


to use this technology and service effectively and flexibly to

Discrimination can occur at every stage of the employment

the benefit, as opposed to the detriment, of your business.

relationship, i.e. during recruitment, during the contractual

The main problem has been employee’s increasing use

relationship and post termination when providing

of personal blogs in situations where there is a blurring


of the relationship between the employee’s work and personal lives.

Note also that employers can be vicariously liable for any acts of discrimination carried out by their employees. If,

Some employers have, quite rightly, embraced the

for example, an employee makes a comment on Facebook

technology and use it for knowledge sharing, positive

about another employee which amounts to harassment ; an

publicity and product information. Others however have

Employment Tribunal may very well hold that the comment


fallen foul of the various legal obligations and traps which

was made “during the course of employment” or indeed

Norman is an award winning

are ready to ensnare the unwary.

may draw inferences from such evidence even if it was not done during working hours.

employment lawyer and experienced tribunal advocate.

Legal Issues

He has written many articles for

It is important to be aware of the legal issues and risks


the legal and national press.

posed by the use of social networking.

Employers face a potential minefield if they use social networking sites to vet and gather further information

He is a member of the Employment Lawyers

Employees have the right to freedom of expression and

on candidates in the recruitment process. Social media

Association and Birmingham Law

a right to privacy. Therefore any action an employer

often contains details about sex, race, religion, etc and if

Society’s Education & Training

takes must bear these rights in mind and balance it

a candidate is rejected on the basis of such information


with their overriding objective, i.e. to protect their

gathered, a discrimination claim is possible.

business. 46

Case Law Examples

Case 3

The following case law examples provide a useful

Recently, an Employment Tribunal decided that a pub

The dividing line between what employees do in their

demonstration of how Employment Tribunals have

manager had been fairly dismissed for gross misconduct

own time and what they do in the workplace can be

dealt with the problematic area of social networking

having made inappropriate comments on Facebook

a thin one, particularly when the use of social media is

and how employers are sometimes too quick to

about her customers in breach of the employer’s e-mail

involved. It is particularly interesting that a chain e-mail,


and Internet policy. The “conversation” on Facebook took

with the imperative to pass it on, was considered to take

place whilst she was at work. It did not matter that she

the e-mail sent from an employee’s home computer to

Case 1

thought that her privacy setting meant that only close

another employee’s home computer, out of the realms

Two sisters were held to have been unfairly dismissed

friends could see her entries. In fact a wider audience

of private life.

following their excessive use of the Internet. The

was able to view her Facebook page including relatives of

employer’s Internet usage policy which permitted access

the customers in question!

The key point was not that the employee intended for

outside “core working times” was held to be unclear.

the material to be passed on, but that he had no control Case 4

over whether it would be.

Case 2

More recently, an Employment Tribunal has found that an

Two employees were held to have been unfairly

employee was dismissed fairly when he sent an offensive

This decision has alarming implications for employees

dismissed after they were sacked for allegedly bringing

e-mail from his home computer to a colleague’s home

who might heedlessly send on a chain e-mail outside

the supermarket Somerfield into disrepute. The Claimant

computer. No privacy attached to the email since it was a

work, only to find their employment jeopardised as a

had posted a video on YouTube showing two of his

chain e-mail asking recipients to pass it on.


colleagues hitting each other with plastic bags. The Tribunal did not accept that there was sufficient grounds

This case highlights the tension that can exist between

for dismissal – it was influenced by the fact that there

the employer’s right to protect its reputation and

were only 8 hits on the video clip and no provable loss

arguments about the employees privacy when

caused to the employer.

employees use social media outside work.

There are also data protection implications if a prospective employer consults

including clients or

online social media to gather additional information about a candidate.

customers, which may be sensitive information

The ‘Genie’ is out of the bottle – Control it!

which could affect the core

It is perhaps now clear that the massive growth in popularity of social media

of the business.

sites is creating issues as well as opportunities in the workplace. In my direct experience employers have a differing range of attitudes to the

Policies and Procedures

strategic importance of social media contribution to their culture and business

Some employers do not allow access to social media during business

and, consequently, a corresponding range of responses.

hours whereas others impose no limits and indeed positively

Some will ban it and others will actively encourage it.

encourage it.

The advantages

handbook to ensure that they specifically address the issues.

Blogs and similar media presentations provide a unique opportunity to get a

Ensure disciplinary policies make specific reference to the use of social media

positive image of a business into the public domain.

and outline precise guidelines and penalties for breach of clearly laid out

External networking with other professionals may lead to business


I urge you to review your employment contracts and/or staff

opportunities and indeed do so.

Social Media Policy The risks

If you already have one in place revisit it and ensure that it is not vague or

Discrimination. As stated above anti discrimination laws can hold employers

capable of misinterpretation. This will make it difficult to defend potential

vicariously liable for discrimination by their employees. Tribunals apply a


very wide test to what is “acting in the course of employment”.

Your policy should clearly set out what is expected of employees, how they should conduct themselves whilst using social media and the penalties for

Confidential information


Employers are exposed to the danger that employees may post confidential


information online. Embarrassing, business information is

It is important to remember that nothing is ever private on these sites

suddenly thrust into the public eye.

Clearly, social media is here to stay and, if used competently and sensibly, it can actively promote your business. However you must decide your particular strategy for dealing with your employee’s use of such sites and the standard of behaviour expected of them. It is then important that policies and contracts

Some social media sites

of employment reflect the same in order to demonstrate a clear and consistent

create a whole host of


fresh problems for the employer owing to the fact that they encourage publication of a list of an employee’s business contacts,

The ‘Golden’ Rule It is important to remember that nothing is ever private on these sites. Basically, if you wouldn’t like your Granny to read it – don’t post it! Forthcoming article on Bribery Act in next issue.



Why do you need an App for your business? Technology has greatly influenced our society and lifestyles over the last decade. Businesses have also adapted to the ever-changing technology. We all remember the dawn of websites when the businesses were faced with the dilemma of having a website or not- eventually it turned out websites became essential for the businesses. Nowadays, every business needs a website and the ones which have not got a website, find themselves having less visibility than the others. Websites became part of the business brand identity and a quintessential tool in their promotions. The story for having a website for your business is going to repeat itself, just this time with an App. Yes a phone App.


o why should businesses have an App? The foremost thing to consider is that there’s an all-time increase in smart phone users – which now includes millions of users from different walks of life, age groups, social and demographic backgrounds. There is a whole generation of users who are now more tech savvy and use their smart phones in everyday activities

e.g. booking tickets, social interactions, cinema viewings, grocery ordering, reviewing and rating services, using maps and finding directions etc. This all leads to a great opportunity for your business to become accessible to the mass audience, where you can market your products proactively to your existing customers as well as attracting new customers. Secondly, in the Google and Groupon age, brand loyalty is diminishing, people are going for the better deals, so there is a great need for customer touch points to maintain a constant and positive engagement with customers. Smart phone Apps offer a host of facilities to achieve better relationships with your customers. For instance, a

Ahmed Zubair

notification facility can help you to be in touch with your customers more frequently,

Ahmed Zubair is head of operations

and due to automation available, it can be done conveniently without hassle. You can

with Welltime Ltd, a technology

send birthday, seasonal, and Christmas greetings to them automatically, along with

company looking into the future with

your offers that can be broadcasted straight to your customer’s phones. This can be

modern business solutions such as

done very cost effectively, usually without any charge -unlike the SMS messageing

iPhone Apps, PatientConnections - a

for marketing interactions where you have to pay for each text message. All this

customer retention solution – and

leads to strengthening your brand and increasing your market share. Apps also

online booking systems.

have the visibility to reach the customers wherever they are, due to the portableand


The pervasive and constant connection to each other, and the world at large, through anytime, anywhere, any device, availability of information, means that the phrase ‘out of sight, out of mind’ applies more than ever

are re-directed to the relevant place to download the App. Spend some time in carefully thinking how your customers would search for it, what words would they use to find your business. You can use different key words (called meta tags) to make your App more ‘findable’. You can use Google keywords and social media (such as Facebook, Twitter, Google+ etc.) to promote your App and of course word of mouth always helps in raising the awareness for your App.

personal nature of mobiles. And most of the messages

Finally your business should consider developing an App as a

sent to the phones get read as compared to other forms of

strategic investment, rather than an expense, because just like

communications. The marketing done via smart phones is

your website, your app is likely to generate you revenues. As a

highly measurable and can provide valuable insights into

business you would be well advised to check the availability of

choices, preferences and interests of your customers, allowing

your business name on the App Store and the App market and

you to serve them better and in accordance with their wishes.

get an App out there as soon as possible, even a basic one, in order to register and safeguard the App name reflecting your

While you are designing an app for your business you should

business. Since there can only be one app with a particular

keep in mind that the apps should have a value for your

name, if another business registers the name you cannot get it

customers, e.g. they should be able to get in touch with you

(like the early days of websites, once a .com or domain for

more easily, book their appointments through their app, find

your business name is gone, its gone, and it becomes a problem

directions to your business etc. As an added advantage for

since by trying to choose an alternative name, the rest of your

the customers, you can provide the functionality where they

marketing would be out of sync and inconsistent with your app

can receive special offers or get notification when you upload

name- which people are most likely to search for on the App

new blog, videos or services. All these aspects should help you

store and the Internet).

to open a new channel for your business to connect to your customers through your app. It should effectively be a further

We are living in exciting times. The pervasive and constant

extension of your brand and should integrate with your

connection to each other, and the world at large, through

current website with the same look and feel.

anytime, anywhere, any device, availability of information, means that the phrase ‘out of sight, out of mind’ applies more


So if you have got the iPhone App developed and launched it

than ever. If you are out of your customer’s thoughts, you

on the App store or the App market, the next pivotal question

may be losing grounds to the competitor who is trying their

is how to market it. Marketing your app is pretty much the

best to get in front of your customers, at the very least, with

same as marketing any new product or service for your

the fast changing information constantly presented to the

business. You should include your App’s information on every

customers, it would be helpful for you to occasionally pop

touch point you have with your customers, e.g. your website

up in front of them – with your special offers- to keep the

should display the App button from where your customers

relationship going strong.

REMOTE CONSULTATIONS • Remote consultations by phone or video call 9am-9pm 7 days/week • UK wide Doctor Visiting Service

• Remote Dermatology Service available

• Botox® Training for Nurses £400 Full Day

• Discounted Aesthetic Products and Insurance

• Free UK and European Advanced Training

• On-line Ordering, Patient Records, Invoices, Training Videos etc

• Annual conference Saturday 24th September, Manchester • For more info on v300 visit

Dates for the 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 for more information or call 07766 591 085.

1 Cosmetology Botox® Vistabel® Foundation, Birmingham, 2 Cosmetology Dermal Fillers Foundation, Birmingham, 2 Foundation Botox® and Dermal Fillers, Birmingham 2 Wigmore Medical Training, Introduction to Skincare and Chemical Peels, London, 3 Wigmore Medical Training, Camouflage, London, 3 Aesthetic Academy + Dermal Filler Basic Course, Leeds, Yorkshire, 3-5 LCS Academy BTEC Medical Laser/IPL Part 1 (Pt 2: 21-22 Nov), 4 Aesthetic Academy + Botulinum Toxin Basic Course, Leeds, Yorkshire, 4 Wigmore Medical Training, Sculptra Training Day One (day two six weeks later), London, 4-5 SkinCeuticals Training, Cheshire, 4-5 Medik8 Training, London, 6 Dr Bob Khanna Training Institute, Dermal Fillers – Advanced, 7 Wigmore Medical Training, CPR, London, 7 Dr Bob Khanna Training Institute, Oral Facial Course, 8 Wigmore Medical Training, Microsclerotherapy and Facial

NOVEMBER 1-2 Medik8 Training, London, 6 Cosmetology Advanced Facial Aesthetics, Glasgow, 7-8 Sterex Advanced Electrolysis, 8-9 SkinCeuticals Training, Cheshire, 9 Wigmore Medical Training, Introduction to Skincare and Chemical Peels, London, 9 Dr Bob Khanna Training Institute, Botulinum Toxin - Beginners, 10 Dr Bob Khanna Training Institute, Botulinum Toxin - Advanced, 10 Wigmore Medical Training, Introduction to Boutlinum Toxin Type A, London, 11 Dr Bob Khanna Training Institute, Dermal Fillers – Beginners, 11 Wigmore Medical Training, Introduction to Dermal Fillers, London, training@ 12 Dermis Deep Microsclerotherapy Course, Birmingham, 12 Cosmetic Courses Foundation Botulinum Toxin and Dermal Fillers, 12 Wigmore Medical Training, Microsclerotherapy and Facial


Telangiectasia, London, 10 Aesthetic Academy + Dermal Filler Basic Course, Scotland, 11 Aesthetic Academy + Botulinum Toxin Basic Course, Scotland, 13 Aesthetic Academy + Dermal Filler Basic Course, Newport, Wales, 13 Dr Bob Khanna Training Institute, Peel Course, 13 Wigmore Medical Training, Introduction to Boutlinum Toxin Type A, London, 14 Aesthetic Academy + Botulinum Toxin Basic Course, Newport, Wales, 14 Wigmore Medical Training, Introduction to Dermal Fillers, London, 15 Foundation Botox® and Dermal Fillers 15 Cosmetic Courses Botulinum Toxin and Dermal Filler Course, 15 Dermis Deep Superficial and Medium Chemical Peels, Manchester, 15 Cosmetology Botox® Vistabel® Foundation, Manchester, 16 Cosmetology Dermal Fillers Foundation, Manchester, 18 Medik8 Training, Cheshire, 19 SkinMedica Training, Cheshire, 19 Aesthetic Academy + Dermal Filler Basic Course, Manchester, 19 Aesthetic Academy + Dermal Filler Basic Course, Windsor, Berkshire, 19-20 Sterex Advanced Cosmetic Procedures, London, 20 Aesthetic Academy + Botulinum Toxin Basic Course,

Telangiectasia, London, training@ 12 Cosmetology Botox® Vistabel® Foundation, London, www. 13 Cosmetology Dermal Fillers Foundation, London, 13 Foundation Botox® and Dermal Fillers Birmingham, 15 Laser/IPL Core of Knowledge Training, 15 Medik8 Training, Cheshire, 16 SkinMedica Training, Cheshire, 18 Wigmore Medical Training, CPR, London, 19 Dermis Deep Botox® Course, Manchester, 19 Dermis Deep Dermal Filler Course, Manchester, 19 Cosmetology Botox® Vistabel® Foundation, Birmingham, 20 Cosmetology Dermal Fillers Foundation, Birmingham, www. 21-22 LCS Academy BTEC Medical Laser/ IPL Part 2, 21-22 Sterex Advanced Cosmetic Procedures, Birmingham, 23 Wigmore Medical Training, Medik8 DermalRoller, London, training@

Manchester, 20 Aesthetic Academy + Botulinum Toxin Basic Course, Windsor, Berkshire, 22 Dermis Deep Botox® Course, Central London, 22 Dermis Deep Dermal Filler Course, Central London, 24 Wigmore Medical Training, GloMinerals, London, 24 Dr Bob Khanna Training Institute, Botulinum Toxin Beginners, 25 Dr Bob Khanna Training Institute, Botulinum Toxin Advanced, 25 Wigmore Medical Training, Introduction to Skincare and Chemical Peels, London, 25-26 SkinCeuticals Training, London, 26 Dr Bob Khanna Training Institute, Dermal Fillers – Beginners, 26 Wigmore Medical Training, Medik8 DermalRoller, London, 29 Foundation Botox® and Dermal Fillers - Birmingham, 29 - Masterclass Botox® and Dermal Fillers - Manchester, 29 Dermis Deep Botox® Course, Glasgow, 29 Dermis Deep Dermal Filler Course, Glasgow, 29 Cosmetology Botox® Vistabel® Foundation, Glasgow, 30 Cosmetology Dermal Fillers Foundation, Glasgow, 24 Wigmore Medical Training, Advanced Toxins and Fillers, London, training@ 24-26 Microsclerotherapy for thread veins of the leg, www.theclinicalexchange. com/courses 25 Foundation Botox® and Dermal Fillers Birmingham, 26 Dermis Deep Botox® Course, Belfast, 26 Dermis Deep Dermal Filler Course, Belfast, 26 Wigmore Medical Training, Microsclerotherapy and Facial Telangiectasia, London, 26 Cosmetology Botox® Vistabel® Foundation, Manchester, 27 Cosmetology Dermal Fillers Foundation, Manchester, 28-29 SkinCeuticals Training, London, 29 Wigmore Medical Training, Introduction to Skincare and Chemical Peels, London,

DECEMBER 1 The Aesthetic Awards in Association with Cosmetic News, Sopwell House, St Albans, 1-2 SkinCeuticals Training, Cheshire, www.

3 Dermis Deep Advanced Botox® Course, Central London, 3 Dermis Deep Superficial and Medium Chemical Peels, Manchester, 3 Cosmetic Courses Foundation Botulinum Toxin and Dermal Fillers, 3 Cosmetology Botox® Vistabel® Foundation, Glasgow, 4 Cosmetology Dermal Fillers Foundation, Glasgow, 5 Medik8 Training, Cheshire, 5 Dr Bob Khanna Training Institute, Botulinum Toxin - Beginners, 6 Dr Bob Khanna Training Institute, Botulinum Toxin - Advanced, 6 SkinMedica Training, Cheshire, 6-7 Medik8 Training, London, 7 Dr Bob Khanna Training Institute, Dermal Fillers – Beginners, 9 Wigmore Medical Training, CPR, London, 10 Foundation Botox® and Dermal Fillers, Birmingham, 10 Meeting of the Society of Cosmetic Physicians & Surgeons (SCPS), London,

CirCadia Fea

tur Monday 24th october cour ed se £225s Advanced Skin Science Monday 31st october Consultative Analysis and Advanced Skin Assessment Monday 14th noveMber The Causes Development and Management of Acne Monday 21st noveMber The Ageing Process and Regenerative Treatments Monday 28th noveMber Nutrition and the Skin All courses take place at enclosed solutions training centre, Ealing, London. iNCl VA T

leading the way in electroporation skin treatment

Full details oF all course agendas are available on our website

• On going support and protocols for electroporation needle free meso therapy • Treating Acne, Rosacea, Pigmentation, Ageing and scars • Electroporation is the only way to penetrate micro and macro molecules Methods Absorption Ability to be absorbed 1. Mesoporation/ 1mm - 10cm 99% by depth of 1cm Electroporation 2. Microneedle therapy 0.3 - 1.5 mm 65% by depth of 6 cm

3. Sonophoresis

4. Iontophoresis



10 - 25%

10 - 25%

Limitation Possible some slight pain Some discomfort and pain during treatment, after treatment skin is bruised Unable to deliver micromolecule medication Able to deliver ionisable medication molecules only.



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≤ 25°C

BOCOUTURE does not require a cold chain. ®

Transport and storage does not require refrigeration prior to reconstitution.

Unopened BOCOUTURE® vials can be stored at controlled room temperature ( 25°C) for up to 3 years.

Botulinum toxin type A free from complexing proteins

BOCOUTURE® 50 Abbreviated Prescribing Information Please refer to the Summary of Product Characteristics (SmPC) before prescribing. Presentation 50 LD50 units of Botulinum toxin type A (150 kD), free from complexing proteins as a powder for solution for injection. Indications Temporary improvement in the appearance of moderate to severe vertical lines between the eyebrows seen at frown (glabellar frown lines) in adults under 65 years of age when the severity of these lines has an important psychological impact for the patient. Dosage and administration Unit doses recommended for BOCOUTURE are not interchangeable with those for other preparations of Botulinum toxin. Reconstitution with 0.9% sodium chloride unpreserved for intramuscular injection (50 units/1.25 ml). Standard dosing is 20 units; 0.1 ml (4 units) injected into each of the 5 injection sites: 2 injections in each corrugator muscle and 1x procerus muscle. May be increased to up to 30 units. Use a thin sterile needle (e.g. 30 gauge). Intervals between treatments at least 3 months. Not recommended for use in patients over 65 years or under 18 years of age. Use immediately after reconstitution. Superior and medial alignment of the needle should be maintained during the injection. Injections near the levator palpebrae superioris and into the cranial portion of the orbicularis oculi should be avoided. Injections into the corrugator muscle should be done in the medial portion of the muscle, and in the central portion of the muscle belly. 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 BOCOUTURE should only be used for one patient for one session. Should not be injected into a blood vessel. Patients may experience exaggerated muscle weakness. Not recommended for patients with a history of dysphagia and aspiration. Seek immediate medical care if swallowing, speech or respiratory disorders arise. Adrenaline and other medical aids for treating anaphylaxis should be available. Caution if bleeding disorders of any type occur. 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. Caution in targeted muscles which display pronounced weakness or atrophy. 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. Use during lactation cannot be recommended. Has a minor or moderate influence on the ability to drive and use machines. Interactions No interaction studies have been performed. Theoretically Botulinum neurotoxin may be potentiated by aminoglycoside antibiotics or other medicinal products that interfere with neuromuscular transmission e.g. tubocurarine-type muscle relaxants. 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, undesirable effects are observed within the first week after treatment and are temporary in nature. Localised muscle weakness, blepharoptosis,

localised pain, tenderness, itching, swelling and/or haematoma can occur in conjunction with the injection. Temporary vasovagal reactions associated with pre-injection anxiety, such as syncope, circulatory problems, nausea or tinnitus, may occur. Frequency defined as follows: very common (≥ 1/10); common (≥ 1/100, < 1/10); uncommon (≥ 1/1000, < 1/100); rare (≥ 1/10,000, < 1/1000); very rare (< 1/10,000). Infections and infestations; Uncommon: bronchitis, nasopharyngitis, influenza infection. Psychiatric disorders; Uncommon: depression, insomnia Nervous system disorders; Common: headache. Uncommon: facial paresis (brow ptosis), vasovagal syncope, paraesthesia, dizziness. Eye disorders; Uncommon: eyelid oedema, eyelid ptosis, blurred vision, eye disorder, blepharitis, eye pain. Ear and Labyrinth disorders; Uncommon: tinnitus. Gastrointestinal disorders; Uncommon: nausea, dry mouth. Skin and subcutaneous tissue disorders; Uncommon: pruritus, skin nodule, photosensitivity, dry skin. Musculoskeletal and connective tissue disorders; Common: muscle disorders (elevation of eyebrow), sensation of heaviness; Uncommon: muscle twitching, muscle cramps. General disorders and administration site conditions Uncommon: injection site reactions (bruising, pruritis), tenderness, Influenza like illness, fatigue (tiredness). General; In rare cases, localised allergic reactions; such as swelling, oedema, erythema, pruritus or rash, have been reported after treating vertical lines between the eyebrows (glabellar frown lines) and other indications. Overdose Increased doses of Botulinum neurotoxin type A may result in pronounced neuromuscular paralysis distant from the injection site. Symptoms of overdose are not immediately apparent post-injection and may include general weakness, ptosis, diplopia, speech difficulties, paralysis of the respiratory muscles and swallowing difficulties which may result in an aspiration pneumonia. BOCOUTURE may only be used by physicians with suitable qualifications and proven experience in the application of Botulinum toxin. Prescriber should consult the SmPC for full information regarding side effects. 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: June 2010. 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 Adverse events should also be reported to Merz Pharma UK Ltd at the address above or by email to or on +44 (0) 333 200 4143. 1047/BOC/JAN/2011/JH. Date of preparation: Jan 2011. BOCOUTURE® is a registered trademark of Merz Pharma GmbH & Co, KGaA.


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 Adverse events should also be reported to Allergan Ltd. 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

op_Cosmetic News October 2011  

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