Cosmetic News (October 2012) by webwax

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INSIDE OUT

SKINCARE SPECIAL

Growth Factors and Stem Cells in Cosmeceuticals

Why you should book now for the aesthetic event of 2013

also in the october issue of Cosmetic News... CO2 fractional laser

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Image and business

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Editor’s Letter Welcome to the October issue of Cosmetic News. When it comes to skincare, consumer interest is quite often driven by whatever the latest buzzword happens to be. Right now it is all about stem cells and growth factors so, as part of this month’s Skincare feature, we will be lifting the lid on the introduction of these ingredients into cosmeceuticals and examining their effect on the skin (p2425). Leading product formulator, Sam Dhatt, also tells us how you can take a stand against acne, rosacea and hyperpigmentation with the right mix of internal nutrients and topical agents (p26-28) and we take a look at how Sir Bruce Keogh’s review of the industry is moving along (p20-21). As well as this we have all the latest news and views from the industry in our Industry Insider section (pages 6-22); give you the low down on the newest and hottest products on the market in our Product Review section (pages 36-42) and give you tips for running a successful and profitable practice in our Business section (pages 45-56). We hope you are finding the new format of Cosmetic News more user friendly and enjoyed our new look re-launch issue last month. We were really delighted with the feedback we had about it and are looking forward to building on that success. And don’t forget to cast your votes in the Aesthetic Awards by visiting www.cosmeticnewsuk.com. Voting closes on October 15 so there is not much time left to make sure your chosen winners go home with a gong on the night.

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Contents INDUSTRY INSIDER

PRODUCT REVIEWS

Vicky Eldridge on the Intraceuticals Infusion Facial

We find out about the new SkinCeuticals Delicate Skin Repair and Strengthening Treatment Developed by Debbie Thomas

4 EDITOR’S CHOICE

6 INDUSTRY NEWS

We round up the latest industry news

36 TREATMENT SPOTLIGHT

38 TRIED AND TESTED

Find out about the newly launched Cosmetic News website

Dr Lori Brightman on how elure’s natural formulation provides effective topical lightening solution for all skin types

12 VOICE OF THE INDUSTRY

42 PRODUCT NEWS

10 WEBWATCH

Mike Murphy on the importance of trust when buying equipment

We round up the latest product news

14 COSMETIC NEWS EXPO/ AESTHETIC CONFERENCE 2013

Why you should book now for the aesthetic event of 2013 16 ON THE SCENE

From the IAAFA annual conference and charity ball to the BCAM autumn meeting at Celtic Manor, we report on what has been going on out and about in the industry this month

IN BUSINESS

45 BEST PRACTICE

Antonia Mariconda shines the spotlight on the professionals who deliver the concept of image enhancement. 48 CHARITY SPOTLIGHT

20 HOT TOPIC

We update you on review of the industry by Sir Bruce Keogh 22 PEOPLE IN PROFILE

The inspirational and entrepreneurial Ella Tracey talks to us about her role as CEO of the UK’s largest aesthetic clinic chain, DestinationSkin CLINICAL PRACTICE

24-28 [DERMATOLOGY] SKINCARE SPECIAL 24 We examine the introduction of

We find out about the amazing work carried out by Changing Faces and how aesthetic clinics can be involved 50 BUSINESS FOCUS

Zoe Davitt unravels the confusion surrounding website dos and don’ts We chat to Dr Stephen Robertson about his move from being an independent practitioner to becoming part of the CourtHouse Clinic Group 54 A WORKING DAY IN THE LIFE OF…

30 [DEVICES] CO2 FRACTIONALISED LASER

56 TRAINING NEWS

34 VIEW ON

Dr Des Fernandes gives his View On an article on skin needling published in Cosmetic News in August 2012 4

www.cosmeticnewsuk.com

Intraceuticals Infusion Facial It is the oxygen facial that has A list celebrities, from supermodels to Hollywood stars, touting its youth boosting benefits in the press, so I was more than a little excited to try out the Intraceuticals Infusion facial at the Waterhouse Young Clinic last month. After carrying out a VISIA skin analysis and I had the treatment in preparation for being a bridesmaid at my consultation, clinic manager Anna friend’s wedding Silsby RN, prepared my skin ready for the non-invasive treatment, which utilises oxygen to provide rapid absorption of specialised active serums to the skin. The unique technology and specially formulated procedure of the Intraceuticals infusion of therapeutic-grade oxygen and hyaluronic acid is designed to make the skin look instantly brighter, firmer and more flawless. Results are immediate, so it is ideal for those wanting to give their skin a quick ‘pick me up’ or boost. As I was about to be a bridesmaid for the first time, this was the perfect time for me to try out the treatment. Intraceuticals Infusion treatments are available in three different courses (Rejuvenate, Opulence and Atoxelene) each specially formulated to address commonly faced skin issues. I had the Rejuvenate treatment which targets the appearance of fine lines, wrinkles and dramatically enhances overall hydration. The treatment harnesses three elements to achieve instant and dramatic results: Firstly, oxygen, under light pressure, aids delivery of age defying ingredients to the skin at the same time as cooling and calming the skin. Secondly, a hyaluronic layering technique is used to apply the Rejuvenate Serum to the skin. The serum contains lightweight hyaluronic acid and a powerful combination of vitamins and anti-oxidants. The HA helps to instantly hydrate the skin resulting in increased firmness, reduced appearance of fine lines and wrinkles, improved look to facial contours and overall radiance. Finally, treatment support products provide essential layers to seal in and supplement skin nutrients for maximum synergistic effect and longer lasting results.

52 Q&A

growth factors and stem cells into skincare 26 Sam Dhatt on how you can take a stand against acne, rosacea and hyperpigmentation with the right mix of internal nutrients and topical agents

Dr Patrick Treacy on Co2 fractionalised laser for the treatment of Fordyce’s spots

Editor’s choice

The treatment is very pleasant with a cooling, calming, sensation. My skin was left feeling deeply hydrated, balanced and glowing with an instant result as well as a continued improvement over the following days. Needless to say my skin was looking flawless on the wedding day and I was left in no doubt as to why the treatment is so popular with celebs like Katherine Jenkins, Naomi Campbell and Victoria Beckham. www.intraceuticals.com

Antonia Mariconda finds out what a day in the life has in store for consultant plastic surgeon Taimur Shoaib The latest training news

56 DATES FOR THE DIARY

Training course, conference and meeting dates

Contact the Cosmetic News team on 01268 754 897

Charlotte Body Publisher charlotte@creativemedialtd.co.uk

Loraine Winter Senior Designer loraine@creativemedialtd.co.uk

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

Emma Bridges Events/Production emma.bridges@creativemedialtd.co.uk

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

Carly Mcfarlane Sales and Events Assistant carly.mcfarlane@creativemedialtd.co.uk

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

Kelo-cote 速 is the only patented silicone gel clinically proven to smooth, soften and flatten scars while reducing scar redness and relieving itching and discomfort.1,2 In an observational study of 1522 patients, physicians and patients were satisfied with success achieved in terms of scar appearance and feel.1 Kelo-cote 速 is suitable for scars of all ages. It is available as a spray or a gel and with or without SPF 30 UV protection. For more information please visit www.kelo-cote.co.uk

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PIP codes: 325-7474; 328-7356; 365-6931; 325-7466 References: 1. Sepehrmanesh M. Komp Dermatologie 2006; 1:30-32. 2. Sebastien G et al. Akt Dermatol 2004; 30:450.

September 2012 SIP/KEL/505

INDUSTRY News

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CEN

A-Deviation for UK granted by CEN Nurse Independent Prescribers will now be included under the definition of ‘practitioners’ thanks to the acceptance of an A-Deviation by the CEN that takes into account the different way in which aesthetic medicine is practised in the UK to the rest of Europe. The UK was granted an A-Deviation for 2.10 Practitioner based on the Misuse of Drugs Regulations 2012 and the London Local Authorities Act 1991. National deviation from a European Standard is in relation to that country having primary legislation that would be at odds with all or part of the requirements of the Standard. The situation with regard to dentists also needs to be clarified i.e. do they have the same prescribing rights as doctors and registered nurses. The IHAS submission to support the A-Deviation was crucial in securing this

outcome. The definition of ‘practitioner’ has been modified to ‘medical doctor authorised by national competent authority to practise autonomously’. The UK was unable to influence this further. The use of lasers can be licensed in London, Nottingham and Birmingham. For those Local Authorities without the Special Treatments leglisation, the Health and Safety at Work Act1974 would be used. The final wording of the A-Deviation, to be added as an Annex in the standard, will be put together by the TC Secretary. Further clarification will be sought on how this affects the situation in the UK. The title of the Standards was also agreed to be changed to ‘Aesthetic Surgery and Aesthetic Non-Surgical Medical Services’ following a vote which better reflects their scope. The outstanding comments will be discussed at the next meeting on November 30 in Vienna.

KELO-COTE®

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Kelo-cote® sponsor Cosmetic News Expo 2013

PSR peel away the complexities of Insurance

Cosmetic News is delighted to announce that Kelo-cote® will be Bronze Sponsors of the Cosmetic News Expo and Aesthetics Conference 2013. The product, distributed by Sinclair Pharmaceuticals Ltd, has a patented formulation and is recommended by physicians all around the world. The brand will join Gold Sponsors, Merz Aesthetics, Silver Sponsors, Syneron Candela, and Hospitality Sponsor, Obvieline, in supporting the event at the Business Design Centre on February 16-17, 2013. The company will also be sponsoring the Aesthetic Awards 2012/2013 at the Grand Connaught Rooms in Covent Garden on December 1. Kelo-cote® forms a bond with the outer layer of the skin, protecting the scar and allowing it to mature through normal collagen synthesis cycles. This improves the physiologic and cosmetic appearance of the scar. Kelo-cote® softens and flattens raised scars; reduces redness and discolouration and relieves itching and discomfort. Kelo-cote® gel self-dries to a waterproof, gas permeable membrane. Cosmetics can be applied, once the Kelo-cote® has dried. It is suitable for children and people with sensitive skin. Kelo-cote® is available in a gel formulation (15g and 60g) or a spray (100ml). It is also available in a UV gel formulation (15g), which has SPF 30, so that scars can be protected and healed, without additional damage from the sun.

cosmetic news the uk’s largest trade aesthetics exhibition and conference

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exhibition and conference

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PSR has improved its service platform to include specific expertise that conjoins the insurance industry with the aesthetic profession. The move has come as the company felt that professionals in the industry were often frustrated by the ever-changing options associated with purchasing relevant insurance – from business issues to individual needs and regulatory requirements. The engagement of Jacquie Ford – who has more than 20 years’ experience spanning across the medical malpractice and insurance industry – as the leader of PSR’s health care team has enabled PSR to offer a service that breaks down the barriers and complexities, so that its clients have explanations in plain English at competitive prices.

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Unlimited Options. One Easy Choice. The Leader in Medical Aesthetics Alma Lasers offers the most advanced technologies for today’s most in-demand aesthetic procedures. HarmonyXL is a multi-application platform featuring over 70 FDA cleared aesthetic treatments, including ClearChoice for Onychomycosis (nail fungus), the popular Laser360iQ rejuvenation and anti-aging protocol, and iTED, a revolution in ultrasound trans-epidermal delivery. Clinically PROVEN to safely treat ALL skin types. True Breakthrough in treating the most in-demand indications: Stretch Marks, Melasma, Scars, Acne Scars and many more.

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informa healthcare

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Online book cuts through PR minefield

Botox® Rise Linked To Digital Lifestyle

Informa Healthcare has published a new online book written by MD and owner of Wavelength Marketing Communications, Tingy Simoes. The book, How to Cut It in the Media: A PR Manual for Aesthetic Plastic Surgeons and Professionals in Cosmetic Medicine, guides cosmetic surgeons and aesthetic professionals on how to manage their PR and deal with the media.

It offers advice on knowing and understanding journalists’ motives; press outlets and their audiences; proactive and reactive PR; how to handle difficult interviews and the risks of ‘going public’ on an issue. It also highlights how to maximize good publicity and ensure good self-marketing, particularly through the use of social media, and is of as much interest and relevance to seasoned aesthetic professionals as it is to those new to the area. Tingy, who is well known in the industry for managing the PR for the British Association of Aesthetic Plastic Surgeons (BAAPS), has extensive experience from the world of PR for medical professionals in both the UK and the USA. The book is only available to purchase online via www.informahealthcarebooks.com and costs £50.

alma lasers

Alma Lasers Goes Global Alma Lasers Ltd has acquired the assets of Quantel Derma GmbH (formerly known as Wavelight), a French and German based developer of laser technologies. Quantel Derma is part of the Quantel Group and sells its products across the world, with a particularly strong presence in Europe and Asia. Alma Lasers has acquired all of Quantel Derma’s assets from the Quantel Group and will integrate its products within its current extensive portfolio. Quantel Derma’s strong presence and direct operations in the German speaking countries will allow Alma Lasers to expand its business in these strategic markets. In addition, Alma Lasers will further enhance its current dominant global sales network, with existing Quantel Derma distribution channels. “This is an important milestone in executing Alma Lasers’ long term strategic plan”, said Dr Ziv Karni, Alma Lasers’ Founder and Chief Executive Officer. “The acquisition of Quantel Derma brings to Alma Lasers a large, well respected and high quality portfolio of FDA & CE cleared lasers. This acquisition will solidify Alma Lasers position as the world’s leading provider of innovative technology for dermatologists, plastic surgeons and other medical aesthetic practitioners in markets across the globe.”

Court House Clinics (CHC) believe the number of women in their 20s seeking Botox® treatments is, in part, due to the rise of daily computer use and smart phone technology. The analytics company IDC recently reported smart phone shipments of 144.9 million in the first quarter of 2012, compared to 101.7 million units in Q1 in 2011. CHC medical director, Dr Patrick Bowler, believes that constantly peering down at a small screen, such as the ones found on an iPhone, Blackberry or other handheld devices, has caused more facial wrinkles to appear in young women. “We have to accept that our lifestyles are changing as fast as the technology boom is altering our lives”, says Dr Bowler. ”Look around and we see people immersed in their mobiles. Also most people now work with computer screens. When you look at people using these devices they are concentrating hard. The natural reaction of the face when concentrating is the frown or screwing up of the eyes. If you over use any part of your face, lines will develop. This can be seen with smokers, for example, where the lip area becomes more lined and creased. “The new generation of young women are spending more time on these devices with the resultant consequences. Women are now more aware that they can help prevent these lines deepening with the use of treatments like Botox®. It’s not about age, it’s about treating the individual and what is happening to their face, and there has been a noted increase in younger women troubled by static frown lines in the last five years. From 2008 to present day we at Court House Clinics has seen a 410% increase in female patients who are taking up Botox® in their 20s.”

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

Date of Preparation: January 2012 UK/0023/2012

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whatclinic.com

WhatClinic.com raises €2 million investment to enter new markets WhatClinic.com, the website which helps consumers around the world get treated at private health clinics, has announced a €2 million investment by Dublin based venture capital firm Delta Partners. The investment will help the profitable company continue its rapid growth by providing new services including online appointment availability to consumers and through the expansion of its services into new locations.

WEBwatch

8 New WEBSITE goes live

The website currently handles more than one million visits per month from consumers researching and looking to contact private dentists, doctors and surgeons in more than 100 countries. An expansion of the company’s data quality team promises not only that new markets such as Australia, Canada and Brazil will be added, but also that existing listings will enjoy even more frequent refreshes, giving private health consumers access to the most comprehensive and most up to date information available online. Caelen King, CEO and founder of WhatClinic.com said, “We’re delighted to be able to announce this investment by Delta Partners which will allow us to continue our rapid growth and expand our service to cover new and exciting markets such as Australia and Brazil. We’re looking forward to cementing our position as one of the leading providers of consumer information in the $6 trillion global private healthcare market.”

Euro medical systems

Euro Medical welcomes Jon Wilson Euro Medical Systems is pleased to announce that Jon Wilson has joined the company as its new Business Development manager. Jon comes with 12 years experience in the medical and surgical field and will be Euro Medical’s field based representative for the London area and the South.

caci

CACI celebrates a successful July CACI International has had plenty to celebrate this year, with its 20th anniversary and securing new distribution channels in Poland, South America, Turkey, Morocco and Saudi Arabia. And now, the UK manufacturing company has even more reason to celebrate, with its highest July turnover on record, exceeding £1.4 million in sales. Traditionally July is a quieter month for sales due to the holiday period and there being no exhibitions, however this year the sales team sold a total of 50 CACI systems (87% of which were the latest system – the CACI Ultimate) in the UK alone, making it their most successful July yet. Part of July’s success was down to CACI’s scrappage scheme whereby clinics/salons could trade in any make or model of treatment system they owned against a new CACI system for £1,000. The scheme was very well received with 38 of July’s sales machines sold from the scrappage scheme.

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Last month we revealed our new look Cosmetic News magazine and this month we are proud to announce the launch of our newly improved website. Not only has the design of www. cosmeticnewsuk.com been updated, but the site is now more user friendly and interactive than ever before. You can now read the latest issue of the magazine online, before it ‘hits the news stands’, and there will be more online content and feature articles. Social media icons also mean that you can share articles and content on Facebook and Twitter. Our Dates for the Diary section has also been updated so you can find out about all the latest training courses and events with an interactive map showing you exactly where the courses are taking place. And our recruitment section is a fantastic place to search for or advertise jobs. As well as the latest news and digital achieved issues of the magazine, the website contains everything you need to know about our events including the Cosmetic News Expo and Aesthetics Conference 2013 and the Aesthetic Awards. You can register for your tickets to the exhibition, book your place at the conference and see the latest updates to the educational programme. Until October 15 you can also vote in the Aesthetic Awards and, on December 3, log on to find out who all the winners are and see pictures from the night first. Advertisers can take advantage of our randomised spotlight banner positions, which means that every advertiser, no matter what their budget, can get the most from their online campaign. Check out www.cosmeticnewsuk.com today!

Stylage is the first patented single-phase gel consisting of cross linked hyaluronic acid (IPN-Like technology) and mannitol, a natural antioxidant that means less swelling and increased longevity of results. It can be used for filling and smoothing of wrinkles, natural lip correction, volume restoration, hydration, chin remodelling, tear trough correction, neck, décolleté & hand rejuvenation. Stylage is perfectly suited for use with a cannula. Dr Elisabeth Dancey has been using Stylage® for the last 18 months

My clients will not tolerate swelling for any more than a few hours… especially in the lips or eye area. This is why I prefer Stylage® to other HA fillers. We can safely say that all HA fillers are perfect tools for the job, but Stylage® has the added benefit of shortened recovery time and increased duration of results.

For further information about STYLAGE® call Medical Aesthetic Group on 02380 676733 or visit www.magroup.co.uk

INDUSTRY INSIDER

VOICE OF THE INDUSTRY

A question of Mike Murphy asks who can we trust when it comes to business?

ood business is based on trust. We must trust the manufacturers, engineers, salesmen, distributors, trainers and all the other people involved in the production and sale of high-tech equipment. Our clients trust our judgement when buying such equipment for their treatments. Without this trust our lasers and IPL systems are just expensive wastes of money. So what happens when this chain of trust is broken? Recently I became aware of a situation in America which concerned me greatly (published on theFairWarningwebsite).ACaliforniancompanyhad been selling an expensive radio-frequency device for ‘melting fat’ called the ‘Lipotron’. They had sold a good number of these devices, at up to $85,000 each, based on their claimed FDA clearance. The device was described as “truly the only non-invasive way to reduce fat” and was sold all over the US. However, it turns out that the FDA had not cleared that device for that application! The company had submitted it for market clearance (the 510(k) procedure – see “CE no evil” - Cosmetic News, December 2011) but it was rejected due to lack of data, despite repeated requests from the FDA. Consequently the company re-submitted the device as a ‘massager used for

as being ‘FDA cleared’. Consequently, there is a lot of concern among clinics at this time. You might assume that this could not happen here. You would be wrong! This is not a new phenomenon – for years companies have been claiming FDA clearance for one treatment but then selling that equipment for other treatments, which had not been cleared. Some have been stopped from selling, but only in the USA. The FDA has no jurisdiction outside of the US – just because they stop a company selling in the US doesn’t mean they need to stop selling elsewhere. I remember a US company, Thermolase Corp, who were one of the first US companies to receive FDA clearance in 1995 for laser-based hair removal. After many complaints and a class-action lawsuit (in 1998) they were instructed to stop marketing their Nd:YAG laser for hair removal due to the company’s false claims of “permanent, painless hair removal”. They complied with this order in their home market otherwise they would have been breaking US law. But they continued selling the same equipment for the same application outside the US including Europe and Asia. While this was not illegal it was completely unethical and they were obviously lying to their overseas customers.

For years companies have been claiming FDA clearance for one treatment but then selling that equipment for other treatments, which had not been cleared the relief of minor pain’. Since this was described as a Class 1 device by the company there is no requirement for ‘clearance’ by the FDA and therefore the company was allowed to market and sell the device freely. When the FDA were informed by a whistleblower they began an investigation. At the time of writing they have not stopped the free sale of this device, even though it contravenes US law.

Fortunately, by 2000 they had effectively come out of the market. When we submitted our Q-switched ruby laser for tattoo removal back in 1991 we had to undergo 18 months clinical trails in the US with a well-known US laser dermatologist. Backed with data from our own 10-year clinical experience in Scotland we finally achieved FDA clearance to market. But then, we were a British company and we had no

An FDA spokeswoman said that if a device is not legally on the market, “a physician should not have been able to obtain it, much less use it on a patient.” This leaves a lot of users in a precarious position. They had been duped into buying the system and had delivered the treatment to their clients, and many had even marketed the treatment

choice but to comply with American law! I recall having lunch with a well-known beauty equipment supplier some years ago. I was asked for my opinion on a new hair removal device, which he wanted to launch. It was immediately obvious to me that the device was completely inappropriate for the task (due to insufficient

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power). His reply was that the manufacturer was a massive blue chip company with impeccable credentials. While this was undoubtedly true the device was still the wrong choice for hair removal. Unfortunately my opinion was ignored and the device was launched shortly afterwards. It was recalled after a short time due to an increasing number of angry buyers. The company’s reputation was severely damaged as a consequence! I remember thinking, at the time, that he was clearly abusing the trust of his many loyal customers. Conclusion – be aware when buying your next piece of equipment. Ask yourself if you truly trust the salesman, the supplier, the manufacturer and your judgement. I always recommend potential buyers to ask other users for their opinions on the equipment, the results and the supplier/manufacturer. Other users are your allies – they will, invariably, be more honest than any salesman!

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

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Cosmetic News Expo 2013

first for knowledge

If you want to expand your knowledge, be inspired and find out about the latest cutting-edge treatments and technologies on the market, then book your place NOW for the Cosmetic News Expo and Aesthetics Conference 2013. Now in its fourth year, The Cosmetic News Expo is the UK’s largest aesthetic conference and exhibition, bringing together more cosmetic practitioners than any other meeting. With the event being held at the earlier dates of February 16-17, it is now also the FIRST major meeting in the UK aesthetics calendar. Taking place once again at the Business Design Centre in Islington, the event offers aesthetic professionals the chance to gain CPD-accredited education at the same time as networking and exchanging information with their peers, all under one roof. With preparations for our 2013 event already well underway, here’s five reasons why you should book now… 1. Take advantage of our extended early bird offer We are offering all those who book their place at the Cosmetic News Expo 2013 conference before October 30 a 10% discount on the price of their ticket. Tickets for the 2013 conference cost £49 for one day or £85 for both days, if you book in advance, or £75 per day/£150 for both days if you pay on the day. A complimentary lunch will be incorporated into the delegate package, with refreshments provided throughout the conference breaks. Delegates will also receive a complimentary VIP invite to the post-show party, which is a fantastic opportunity to network with speakers and

exhibitors and let your hair down after the show. To book your place visit www.cosmeticnewsuk.com or call Carly on 01268 754 897. 2. Earlier dates make the Cosmetic News Expo and Aesthetics Conference the first key professional meeting in the UK aesthetics calendar Traditionally held in April or May, for 2013 the dates of the Cosmetic News Expo and Aesthetics Conference have been moved to Saturday February 16 and Sunday February 17 to make it the first major meeting of the year for aesthetic professionals in the UK. A lot of thought went into changing the dates for the event and organiser Charlotte Body says it will be an advantage for visitors and exhibitors alike. She says, “By the time April comes around many practitioners have already been to a number of meetings. As the UK’s largest aesthetic exhibition we also wanted to be the first in the calendar to start the year off with a bang and keep the conference content fresh. 2013 will be our fourth event at the Business Design Centre and I am sure it will continue to follow on from the success of our previous shows and continue to grow.” 3. Get CPD-accredited education at the Aesthetics Conference Re-branded as the Aesthetics Conference, the educational programme at the Cosmetic News Expo is an excellent opportunity to see the very best UK and international speakers, discussing the latest topics and demonstrating the most up-to-date techniques, at a fraction of the cost of other industry events. This year the conference

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Why you should book now for the UK’s largest aesthetic exhibition and conference not only has a new look and a new name but, for the first time, is being organised by an independent consultant with years of knowledge and experience of the aesthetics industry to make it even more cutting edge. Key topics for 2013 include: • • • • • • • •

New Trends in Facial Volumising and Shaping New Trends with Toxins Next-Generation Anti-Ageing and Therapeutic Skincare Products Plasma-Rich Protein and Fat Grafting for Facial Rejuvenation Multi-Application Lasers Energy-Based Anti-Ageing Skin Treatments Combination Treatments Hand and Neck Rejuvenation

4. CATCH UP WITH ALL YOUR SUPPLIERS UNDER ONE ROOF The Cosmetic News Expo brings together more aesthetics suppliers under one roof than any other event in the UK. Our exhibitors are made up of the key manufacturers and suppliers in the industry, making the Cosmetic News Expo a must-visit for those new to the industry who are trying to source suppliers and busy practitioners who want to be able to see all their reps under one roof. Because our exhibitors are keen to attract practitioners to their stand, many often offer exclusive show deals. These are the type of deals that can give you great margins and that you wouldn’t necessarily get if you didn’t attend. In tough trading times these are the kind of deals that can really help your business to boom. With more than 40 exhibitors already signed up for 2013 and with Merz Aesthetics as Gold Sponsors, Syneron Candela as Silver Sponsors, Kelo-cote® as Bronze Sponsors and Obvieline as Hospitality Sponsors, this is one opportunity you can’t afford to miss. To book a stand call our events team on 01268 754 897.

5. NETWORK WITH OTHER AESTHETIC PRACTITIONERS From doctors, nurses and dentists to dermatologists, plastic surgeons and aestheticians, the Cosmetic News Expo attracts a wide range of aesthetic practitioners keen to network and share ideas. Networking can be a great technique to help your business, not only to build useful relationships but also to learn things about the market or companies that you wouldn’t normally find out while being stuck in your clinic. Perhaps you want to refer patients to a specialist or share ideas and information with your peers, the Cosmetic News Expo is the ideal place to make contacts and get your face out in the industry. Talking with colleagues about how business is going in different parts of the country and building relationships can benefit even the most successful practices.

To book visit www.cosmeticnewsuk.com or call 01268 754 897.

aes t he t ics c o n f erence 2 0 1 3 p re l i m inar y c o n f erence p r o g ra m m e Saturday February 16

Sunday February 17

9am-10am Registration and Exhibition Viewing

10am-11.30am Session 1: New Trends in Facial Volumising and Shaping (including live demonstrations) A master class in facial volume replacement focusing on anatomical placement and risk management using the most effective products and techniques.

10am-11am Session 1: Multi-Application Lasers With so many lasers on the market how do you choose what to use? This session will explain the value of a multi-application laser and how it can benefit your bottom line, while offering your patients the best results with the least downtime.

11.30am-12pm Coffee Break

11am-11.30am Coffee Break

12pm-1pm Session 2: New Trends with Toxins: A Scientific Approach Hear about the latest trends and treatments with toxins.

11.30am-1pm Session 2: Energy-Based Anti-Ageing Skin Treatments This session will discuss combination energy-based treatments for skin resurfacing and skin tightening, as well as technology for other applications and skin types.

1pm-3pm Lunch Break and Exhibition Viewing

3pm-4pm Session3: Next-Generation Anti-Ageing and Therapeutic Skincare Products This session will provide insight into the many categories of available products and ingredients commonly used in skincare products and cosmeceuticals for both anti-ageing and therapeutic indications. 4pm to 5pm Session 4: Plasma Rich Protein and Fat Grafting for Facial Rejuvenation Regenerative medicine and strategies using the patient’s own tissue are the most modern effective approach for rejuvenation and soft tissue augmentation. Autologous Platelet Rich Plasma (PRP) and autologous fat grafting are two unique techniques for this modern treatment today. Synthetic fillers or implants have their own set of long-term problems which one’s own tissue does not have. Fat grafting is the latest effective technique for volume correction in aesthetic and reconstructive fields.

3pm-4pm Session 3: Working together – Aesthetic Combination Treatments Today’s aesthetics practitioners have a wide and varied palate of materials to use. This session will focus on how to best use them in combination to get the best results for your patients. 4pm-5pm Session 4: Hand and Neck Rejuvenation The most effective rejuvenation treatment for problem areas like the hands and neck. Treatments include mesotherapy and micro droplet injections of fillers. 5pm-6pm Exhibition Viewing

5pm-7pm Exhibition Viewing and Champagne Reception

1 6 th a n d 1 7 th f e b r u a ry 2 0 1 3 , t h e b u s i n e s s d e s i g n c e n t r e , l o n d o n

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on the scene

On the S cene British College of Aesthetic Medicine (BCAM) autumn meeting, Celtic Manor, Wales The luxury 5* golf and spa resort, Celtic Manor, in Newport, Wales, was the setting for the annual meeting of the British College of Aesthetic Medicine.

Charlotte Body and BCAM president Dr Samantha Gammell

The glamorous Lindsey Howarth and Debra Robson from Love Lite Ice

Tia Levey, Julian McGlynn and Lindsey Walsh (Sigmacon)

The one-day educational and scientific meeting is a chance for members to network with their peers, speak to key manufacturers and suppliers in the adjoining exhibition and enjoy a bit of downtime. Lectures and workshops were held throughout the day. BCAM president, Dr Samantha Gammell, addressed the conference welcoming its new exhibitors and thanking its existing exhibitors for their continued support. She gave particular thanks to Healthxchange, Merz and Q-Med who put on the workshops, which were a popular and well-attended part of the programme. One of the hot topics under discussion at the members update at the close of the day was revalidation. Dr Gammell said, “We are moving rapidly towards revalidation and the college becoming a designated body, therefore the new company policies and procedures have been tightened to comply with that.” Saturday night saw a dinner take place at the hotel where practitioners, exhibitors and guests could let their hair down and enjoy a delicious three course meal and entertainment. For those wanting to enjoy the surroundings of the stunning resort, which played host to the 2010 Ryder Cup, a golf day was organized as a fitting end to the weekend on Sunday September 16. The next conference will take place in Autumn 2013 at a venue and date to be confirmed.

Karen Hill (Healthxchange) and Vicky Eldridge

Lee Boulderstone was exhibiting after taking over as UK manager of BTL

IAAFA conference and charity ball, London Comedian Bobby Davro was the star of the show when he hosted IAAFA’s Bollywood themed charity ball in aid of the Make a Wish Foundation last month.

Cosmetic News editor Vicky Eldridge and publisher Charlotte Body with Bobby Davro

IAAFA president Professor Bob Khanna and wife Sonia

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The glamorous event at the Portman Radisson Hotel in London took place as part of the International Academy of Advanced Facial Aesthetics’ annual conference. The two-day educational meeting was held at the Royal Society of Medicine on Friday August 31 and Saturday September 1, with the dinner and dance taking place following the close of the meeting. The ball raised a staggering £15,700 for the Make a Wish Foundation, a charity which grants the dying wishes of sick children. IAAFA president and founder Professor Bob Khanna said, “The IAAFA conference this year has been an amazing two day event – it was well attended, with delegates coming from all over the world including Columbia, Germany, Croatia and even as far as Australia. The ball was another resounding success, both entertaining and rewarding as we managed to raise over £15,700 for the Make a Wish Foundation. As President and founder of IAAFA I look forward to the next conference with bated breath.”

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

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on the scene

True Grace PR press day, Skin Associates, London Syneron Candela stole the show at the recent True Grace PR beauty press day held at Skin Associates, London. Showcasing the new Sublime Collagen Creator, Sublative Rejuvenation and UltraShape treatments to nearly 40 beauty editors from titles including The Times, The Express, Brides and You magazine, the talented team at Skin Associates treated journalists to treatment trials whilst MD Michaela Barker educated the press on the benefits of radio-frequency and the differences with the new generation of treatments. Journalists left fully informed and ready to book in for more trials. Consultant plastic and cosmetic surgeon Mr Paul Banwell was also in attendance speaking to the press about the latest cosmetic technique and promoting the benefits of Sublime and Sublative.

Consulting Room™ coast to coast cycle challenge

Mr Paul Banwell with PR Charlotte Moreso (above) Michaela Barker with journalist Kay Goddard. (above right) Sublime Treatment with Kay Goddard (right)

La Roche-Posay CICAPLAST BAUME B5 launch, London Members of the press gathered at the trendy Oui Rooms in East Castle Street, London, for the launch of La Roche-Posay’s latest dermatological revolution Cicaplast Baume B5.

Following presentations by L’Oreal’s Dennis Donoghue and Jane Toner on the benefits of the new product, dermatologist Dr Vicky Jolliffe, clinical senior lecturer and honorary consultant at The Royal London Hospital, presented the clinical data. Cicaplast Baume B5 is a multi-purpose balm to immediately repair and soothe minor everyday skin injuries and irritations. It can be used on the face, body and lips and is ideal for use post procedure.

The Consulting Room™ Team took part in the 145 mile Coast to Coast (C2C) cycling challenge last month. The C2C 2012 took two days, riding through the Northern Lakes and over the Pennines. From the start in Whitehaven, the team cycled on to Newcastle and Tynemouth where they finished by dipping the front wheels of their bikes in the sea - and of course themselves! The team were raising money for various charities close to their hearts including Chester Childbirth Appeal. So far they have raised £2,002.

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Stars love Lipoglaze It’s the latest craze in body shaping and Lipoglaze is already gathering a celebrity following. Launched in the UK this summer by Debra Robson and Donna Marie McBride of Lizzie Cundy has the Lipoglaze treatment Love Lite Ice, the pain-free, low downtime treatment works by removing fat cells from the body by freezing them. The Lipoglaze Cryo-Lipo machine first gently heats and then rapidly cools the target area. This causes the fat cells to crystallise and permanently destroys up to a third of fatty deposits per session. The body then Debra Robson with Blue Star Antony Costa naturally eliminates this waste tissue over the next few weeks. Stars such as Lizzie Cundy and pop hunks Antony Costa and Simon Webbe from Blue have all tried it. Lizzie, 42, who presents The Movie Show on Watch, was so delighted with the results that she recently posed naked for a magazine. She said, “I go to the gym regularly and am very careful about my diet – but we all need a bit of help getting rid of those stubborn areas. That is why I turned to Donna and Debra at Lipoglaze.”

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industry insider hot topic

Call for evidence

As Sir Bruce Keogh’s review of the industry gets under way with a call for evidence, we update you on the latest behind this landmark report into standards in aesthetic treatments

In August this year, NHS medical director Sir Bruce Keogh, launched his review of the cosmetic surgery industry. The inquiry was requested by the Health Secretary, Andrew Lansley, following the public outcry over faulty PIP breast implants. The scandal shone the spotlight on the aesthetic industry in general, including the clinical safety of treatments and led to serious questions being asked about the regulation of the industry, for example, why the EU regulatory system had not detected the PIP fraud earlier; why it was difficult to reliably trace people who had received cosmetic implants; whether the private cosmetic sector is properly regulated; whether vulnerable people are put under excessive pressure to undergo cosmetic procedures and whether they are properly informed about the risks. The review will cover surgical cosmetic interventions such as breast augmentation as well as non-surgical cosmetic interventions such

as injectable dermal fillers. It will consider a wide range of issues such as regulation and clinical governance, information and consent and outcome based registers. This review aims to provide recommendations to Government on the appropriate arrangements required to ensure patients receive the protection they need when accessing cosmetic services and interventions. Before launching the review, Sir Bruce said there was a “cacophony of concern” about “grubby practices” in the cosmetic surgery industry. He told BBC Breakfast: “There are people who are concerned about the regulation, there are people who are very

Scope of the Review Cosmetic interventions are described as: “operations or other procedures that revise or change the appearance, colour, texture, structure, or position of bodily features, which most would consider otherwise within the broad range of ‘normal’ for that person.” The interventions to be considered for the purpose of this review could potentially include: a) The surgical insertion of a medical device or prosthesis, or other surgery intended to change the appearance of the body, b) Injection with any product, whether medicinal or otherwise, c) Any other form of intervention at the discretion of the review team, where the intervention is not clinically indicated to safeguard or improve the physical and mental health of the recipient. The review does not cover surgery that is clinically indicated, such as reconstructive surgery for a breast cancer patient following a mastectomy.

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“The recent problems with PIP breast implants have shone a light on the cosmetic surgery industry” concerned about the qualifications of those who are conducting, in the dark recesses of the cosmetic industry, procedures that they are not qualified to do. I don’t want anybody to get the impression that the cosmetic surgery industry is all tarred with one particular brush. There are parts of it that are run extremely well, very ethically with very, very high standards. There are, sadly though, some parts where there are some pretty grubby practices going on and that’s why we’re having the review.” Mr Lansley has specifically asked the review to consider implementing a national implant register, for products such as breast implants, to identify all those who received the product and details of their operation. Sir Bruce said, “The recent problems with PIP breast implants have shone a light on the cosmetic surgery industry. Many questions have been raised, particularly around the

“It is hoped the review could lead to tighter restrictions on those operating within the cosmetic surgery and nonsurgical aesthetic markets in the UK” regulation of clinics, whether all practitioners are adequately qualified, how well people are advised when money is changing hands, aggressive marketing techniques, and what protection is available when things go wrong. That’s why I have put together this review committee to advise me in making recommendations to Government on how we can better protect people who choose to have surgery or cosmetic interventions. “I am working with experts from the plastic surgery field to look at what we can do to make sure people who choose to have cosmetic surgery and other cosmetic procedures are safe. I will be looking at all aspects of regulation - at the regulation of implants and fillers, at whether the people who carry out cosmetic interventions have the right skills, at whether the clinics look after the care and welfare of their patients. This would include treatments such as cosmetic surgery, Botox® injections and dermal fillers and other cosmetic treatments where there is a potential risk to health.” Along with Sir Bruce, an expert panel including PIP campaigner Catherine Kydd, former medical director of Bupa Andrew Vallance-Owen and editor of Marie Claire magazine Trish Halpin, has been convened to assist in the evidence gathering and making of recommendations to Government, based on the criteria being looked at and the results of the public consultation. However there have been questions raised already about the fact that key groups from the UK’s aesthetic professionals, in particular aesthetic nurses, have not been represented on the panel. Members of the British Association of Cosmetic Nurses have publically voiced their frustrations on LinkedIn saying: “Sir Bruce Keogh’s panel of experts advising him on safety in cosmetic interventions includes one surgeon, one women’s mag editor, one non- cosmetic GP, who works on TV, and zero aesthetic nurses!!” This makes it even more essential that the industry comes together to voice its views during the call for evidence, which invites all interested

parties to feed in their views for Sir Bruce’s Review Committee to consider by October 15. As part of this ‘call for evidence’ the Department of Health has issued a 71 page document to explain the background behind the review and the areas which is hopes to investigate. The call for evidence will ask for people’s views on regulation and safety in the cosmetic industry and will cover the products and the people who carry out procedures. They also call for evidence from organisations that have the systems in place to look after their patients both during their treatment and afterwards, and how to safeguard that people considering cosmetic surgery and procedures are given the information, advice and time for reflection to make an informed choice.

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Finally they call for evidence as to what improvements are needed in dealing with complaints so they are listened to and acted upon.

NATURAL PROCESS

The 26-question questionnaire includes sections on: • • • • • • •

The regulation of medical devices, implants and other products The regulation of practitioners The regulation of organisations providing cosmetic interventions Insurance and indemnity requirements Consent, information and advertising for cosmetic interventions National implant registry Specific sectors/forms of treatment

It is hoped the review could lead to tighter restrictions on those operating within the cosmetic surgery and non-surgical aesthetic markets in the UK. The expert panel and Sir Bruce will make their recommendations to the Government by March 2013. To have your say visit http://www.dh.gov.uk/ health/cosmetic-form/ Sir Bruce Keogh (left) has launched his review with a call for evidence

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INDUSTRY INSIDER people in profile

Woman on top We chat to the inspirational CEO of DestinationSkin, Ella Tracey

lla Tracey is everything you would expect a female business pioneer and CEO of clinic chain DestinationSkin to be. On the one hand she is a smart, savvy, articulate entrepreneur and on the other she is a well-groomed, glamorous woman who understands what beauty consumers want, because she is one. Her ability to challenge businesses, build teams and achieve company growth has propelled her to the forefront of many major blue chip companies, with past roles including director of marketing at BAA Retail Division and marketing director at Prêt A Manger. Since taking over DestinationSkin (previously known as White Light Clinics) in 2008, Ella has expanded the company by almost 50%, making it the UK’s fastest growing medi-spa chain, with 26 locations up and down the country. In the last year alone the company has taken over Renew Medica and Skin Genesis. We chat to her about her plans for the future, her passion for business and marketing and her views on the aesthetic industry.

zyy Cosmetic News: How did you get into the aesthetics industry? Ella Tracey: I wanted to do something more entrepreneurial so I started looking at interesting VCP backed companies that needed a bit of a marketing boost. Just over four years ago I came across White Light. They talked about nothing but technology – not about the client – so I saw a real opportunity to talk to women. I took all of the technology out of the conversation and put the client in the middle and said: “if this is the client, what would she buy, what would she need and how would she want to be spoken to?” 22 www.cosmeticnewsuk.com

zyy CN: What were the biggest challenges? ET: Firstly, there was no real understanding of commerciality at any level of the business. Secondly there was no understanding of what to do through the client journey. A client would come in to have her bikini line lasered and would have to fill out about 400 bits of paper and forms, some of which were relatively intrusive. A solid health questionnaire is a must in this business but you need to make it relevant to the conversation you are going to have with the client. They would then do the bikini line and never mention the fact the client had acne on her face – that was considered to be positive service; anything else was considered to be selling. In this industry there is a kind of ‘embarrassment’ about selling to the client but I consider it to be a disservice if you don’t tell the client what you can do.

zyy CN: You have built the business up significantly since you took over – tell us about this? ET: Scale was definitely part of the winning formula. Business needs to be profitable in order to expand. Building these clinics is an expensive way to lose money, so that is why we went down the merger and acquisitions route. We need to get to about 50 clinics over the next 12-16 months so we continue to look for M&A opportunities. I don’t see that as a ceiling I see that as a target – I would grow it to 250 if I had the money!

zyy CN: What are your views on Groupon? ET: Groupon is an interesting one. Everyone dived into it at the beginning but now there has been a

little bit of a drawback from it because there were too many desperate people in the market. We used it for things like introductory facials, which effectively is an opportunity for a client to cross the threshold and sit in a clinic for an hour and understand the opportunities. We haven’t used it for laser hair removal. In the last nine months people have been going absolutely crazy on Groupon giving away full legs for £99 – how can you make money from that? We wouldn’t do it for injectables either. I don’t think people should buy injectables on price. As long as you don’t drop your quality or negotiate on any aspect of your safety it is up to you how much you charge but I think if a client is buying like that you have to question whether they are taking the right kind of precautions.

zyy CN: How do you go about sourcing new products and new treatments? ET: The benefit of being a bit bigger in the industry is that an awful lot of suppliers come to us. We do a lot of buying trips, particularly to the States. We don’t buy anything that we don’t first try. We tend to look at six to nine month trials. Some suppliers are happy with that, some are not. Sometimes we do it on a revenue sharing basis. We are not doing it so we can rip suppliers off, we are doing it to see if it sells – if I can make money, you can make money, but I am not going to buy a £60k bit of kit unless I know whether or not women are actually going to spend on the treatment! You have to understand if the benefits support the price tag, and if they do, you have got yourself a good piece of kit that works commercially for the business.

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SKINCARE

Stem Cells and Growth Factors

What ’ s t he b u z z ? We examine the use of stem cells and growth factors in skincare

he aesthetics industry is undoubtedly one of the fastest growing and rapidly expanding sectors of medicine and beauty, especially in terms of innovation. Every month we are seeing new, cutting edge technologies and antiageing ingredients emerging and, in the professional skincare arena particularly, this is driving consumer demand. When it comes to skincare, consumer interest is quite often driven by whatever the latest buzzword happens to be. Right now ‘anti-oxidants’ and ‘peptides’ have been taken over by ‘stem cells’ and ‘growth factors’ in the buzzword top 10. Whether the ingredients are sourced from plants or humans, the power of stem cells and growth factors are now being harnessed in many professional serums, creams, and skincare products as well as in over-thecounter (OTC) brands. However, while in the consumer arena, skincare companies can seemingly get away with incorporating fancy scientific terms into ‘miracle’ creams to create hype and make sales, to cut it in the professional arena, cosmeceuticals need to be backed by science and driven by results. Although stem cells and growth factors have now been used in skincare products for a number of years, what makes this area so exciting right now is that we are watching as the science and evidence proving their value and place in the market unfolds. Clinical data and anecdotal evidence shows that the use of specific stem cells and growth factors applied topically can repair damaged skin by stimulating the cells to build new collagen and elastin; target pigmentation; protect the skin against environmental aggressors, such as UV damage; and replenish and regenerate dying cells and DNA damage. All sounds very promising, but many powerful anti-oxidants and peptides already claim to do the same, so what is so special about stem cells and growth factors or is this just another gimmick to sell skin creams?

>> Stem cells Stem cells are amazingly diverse things. Often described 24 www.cosmeticnewsuk.com

as ‘the building blocks of life’ they can self renew and divide to form new stem cells or transform into different cells with a specialised function, such as skin cells. Stem cells play a key role in tissue development, regeneration, and cellular renewal so it is no surprise that scientists have wanted to harness their power to combat ageing. What has perhaps generated more interest in the marriage of stem cell technology and anti-ageing skincare is the fact that it has been somewhat of a controversial pairing. The debate surrounding the use of stem cells in general has been a tendentious one and some people feel that its rapid use in the anti-ageing market is trivialising its use elsewhere. There has also been particular controversy surrounding the types of stem cells being harnessed in skincare products and the sources of the cells, particularly if they are human derived which, for many, raises moral, ethical and safety issues. There are two ways that stem cells are being utilised in skincare: plant derived and human derived.

>> Human stem cells There are two major categories of human stem cells: embryonic and adult. Embryonic stem cells have the extraordinary potential to form all tissues of the body. They can be found in fertilized human eggs and are also present in the umbilical cord blood collected at birth. Once harvested, these stem cells are grown in cell cultures and manipulated to generate specific cell types so they can be used to treat injury or disease. Adult stem cells are present within our bodies and serve to maintain and repair the tissues in which they are found. Adult stem cells are found in many organs and tissues, including the skin. In fact, human skin is the largest repository of adult stem cells in the body. Skin stem cells reside in the basal layer of the epidermis where they remain dormant until they are activated by tissue injury or disease. It makes sense that human stem cells will work more effectively in the human body than plant derived ones, however, the use of human derived stem cells in skincare products is where much of the controversy in this area has, excuse the pun, stemmed from. There are a number of misconceptions surrounding the use of stem cells in skincare. Firstly, skincare companies are not actually harnessing embryonic stem cells, which raise the most objections from those opposed to stem cell research. The human derived stem cells used in products currently on the market have come from other sources, including neonatal foreskin. Secondly concerns have been raised that if stem cells and growth factors can awaken a skin cell, they also have the potential to awaken harmful or even cancerous cells, however studies have shown this not to be the case. It is also worth noting that skincare brands are not actually using live human stem cells themselves (it is apparently not possible to do this using current technology) what they are using is peptides, enzymes and growth factors extracted or derived from the stem cells. It is these extracts, such as Epidermal Growth Factors (EGF), which are the key ingredients in stem cell based skincare and which are being shown to have powerful rejuvenation and repair benefits to the skin.

>> Plant stem cells

DermaQuest’s Stem Cell 3D Complex, uses selectively harvested botanical stem cells that they claim to be 1,000 times more active than the common stem cells currently used on the market and reduce wrinkle depth by 15% in just 20 days.

Most stem cell based products on the market source their ingredients from plants. Botanical derived actives have become the cornerstone of anti-ageing skincare. Plants are known for their powerful built in protection from the sun, which is why plant derived anti-oxidants have become integral to most cosmeceuticals. In much the same way, plant derived stem cells are now being harnessed to enhance the protective and age combating power of products. Plant stem cells can mimic the skin’s natural process and act as an age preventative. They have been shown to have a positive effect on human skin in not only protecting our own stem cells from damage and deterioration but also by stimulating them to repair.

The new Skin Active range from Neostrata contains Swiss apple stem cells, one of the most talked about plant derived stem cells on the market

>> Growth Factors

>> Delivery systems

Growth factors are proteins that regulate cellular growth and the activity of skin cells. Many growth factors are quite versatile, stimulating cellular division in numerous different cell types; while others are specific to a particular cell-type and/or differentiation. They play an integral role in the skin’s natural ability to repair damage caused by the effects of ageing as they promote healthy tissue repair and renewal, encourage the formation of new collagen and elastin, and interact with other proteins to help mend injuries.

As with most active ingredients a product will only be effective if it has the right delivery system to get the actives into the skin. If the molecules are too large or not formulated in the right way they will have little to no therapeutic effect. This is one reason why the use of products containing growth factors and stem cells is particularly popular alongside treatments such as dermal rollers and stamps, which help the ingredients penetrate into the deeper layers of the skin, thereby enhancing their results.

As we age the rate at which our skin cells divide and renew slows. By utilising growth factors in skincare we can help reverse this type of deterioration caused by ageing by stimulating the cells to divide and multiply, producing vibrant new cells, as well as increasing the amount of collagen and elastin within the skin.

The AQ Recovery serum and dermastamp are used in conjunction to enhance results

AQ Active Serum contains a proprietary mixture of human growth factors and cytokines in combination with antioxidant factors.

>> In conclusion Skin Medica’s Biometa Essential Serum™ features Pichia Pastoris Ferment Filtrate, which has been clinically proven to stimulate the skin’s natural growth factors and work on over 30,000 genes to repair and remodel the skin

Medik8’s new Growth Factor Serum includes the active complex ShOligopeptide-1, which helps inhibit and prevent cellular breakdown. Triple-filtered EGF regulates cell production that slows in efficiency with age.

Stem cell and growth factor technology in skincare is an exciting area of development in the aesthetics industry. Although more scientific studies are needed, evidence has shown that the daily use of a product containing these potent anti-ageing ingredients can repair and protect your clients’ skin. Used in combination with other powerful anti-ageing ingredients, such as antioxidants and peptides, growth factors and stem cells can have a marked effect on the appearance of the skin as well as serving to protect it against further damage.

www.cosmeticnewsuk.com 25

CLINICAL

skin and nutrition

I nsi d e an d O utsi d e Sam Dhatt on how you can take a stand against acne, rosacea and hyperpigmentation with the right mix of internal nutrients and topical agents.

or years, skincare practitioners have known that regular use of benzoyl peroxide, salicylic acid and other topicals offer effective acne treatments. We have also known that certain peptides, some botanicals and vitamin C, can help brighten the skin, even tone and ease pigmentation problems. But, combining these and other topicals with specific nutrients - or, in some cases, avoiding certain foods and supplements can result in even more dramatic effects. Here’s a look at today’s most effective treatments for fighting acne, rosacea and hyperpigmentation, using both an internal and external approach.

Treating Acne from the Top In essence, acne is nothing more than a big traffic jam under the skin. When overactive sebaceous glands pump out excess sebum and a constantly shedding keratin lining clogs the skin’s hair follicles, the oil and dead cells back up the pore, creating the perfect anaerobic environment for Propionibacterium acnes, a bacteria that thrives in the closed, oxygen-deprived environment of a clogged hair follicle. The result? Inflammation, blackheads and whiteheads. To treat acne topically, the Food and Drug

Administration (FDA) recognises four over-thecounter (OTC) drug treatments for acne - benzoyl peroxide, salicylic acid, sulphur and resorcinol - in addition to prescription medicines, which include antibiotics, azelaic acid and tretinoin (vitamin A).

increases cell turnover and neutralises bacteria,

Benzoyl peroxide (BPO): A common ingredient used to treat mild to moderate acne, benzoyl peroxide has been well documented in treating acne either alone or in combination with other topical medications. BPO reduces inflammatory lesions by introducing oxygen into the clogged pore where the anaerobic P. acnes bacteria harbor. BPO also helps reduce oil production, rid the follicle of excess dead skin cells and unclog pores. Unlike some other antibacterial treatments, multiple studies show that P. acnes does not manifest a resistance to BPO. 1 However, this topical ingredient can sometimes irritate skin, especially when used at a higher percentage of 10% versus a 2.5 or 5% level. Clinical studies have shown that lower concentrations are just as effective as higher concentrations and with less irritation. 2

Sulphur: One of the oldest acne treatment, sulphur helps clear comedones and is found in both OTC and prescription remedies. On the downside, sulphur can cause dryness and irritation and has a pungent odour.

Salicylic acid: Derived from the same substance used in aspirin, salicylic acid unclogs pores,

Sam Dhatt is a world-renowned, award-winning cosmeceutical chemist who serves as the CEO and President of the product line DermaQuest Skin Therapy and of Allure Labs, a product formulation company, both of Hayward, CA. During his 20-plus year career as a sought-after formulator, Dhatt has developed and manufactured skincare products for over 700 companies, including many of the best-known brands in the industry. Dhatt is a frequent expert-author of articles featured in many trade journals and skincare publications and speaks often on ingredients and formulation with the goal of increasing the knowledge and success of aestheticians.

26 www.cosmeticnewsuk.com

all of which make this OTC active a popular and effective acne treatment. As an OTC active ingredient, salicylic acid is used in concentrations of 0.5 to 2.%

Resorcinol: Often used in combination with sulphur, resorcinol helps break down rough skin, making it useful for treating blackheads and whiteheads. But, like sulphur, resorcinol also has a drying, irritating side and so should be used in moderation. There are many additional blemish-clearing topicals that, while aren’t classified as OTC drug treatments specifically, can have a big impact on breakouts. Vitamin A derivatives known as retinoids, namely retinol, help by ensuring proper cell division, clear plugged pores and minimise oil glands. According to the Mayo Clinic, the irregular shedding of skin cells serves as a leading cause of acne. Retinoids help correct this problem by normalising the shedding of the skin cells, while helping reduce inflammation. Azelaic acid also offsets inflammation associated with acne by reducing the P. acnes bacteria and clearing pores. The Mayo Clinic reports that a 20% azelaic acid cream seems to work as well as

other conventional acne treatments, including 5% benzoyl peroxide and oral tetracycline. Natural acne remedies include gels containing the natural antimicrobial tea tree oil, the anti-inflammatory boswellin extract and sea buckthorn oil.

The Acne Food Connection Many foods, like pizza, chocolate and French fries, were once villainised as causing acne but have been since exonerated by today’s acne experts. A few foods, however, may be better left out of the diet or at least kept to a minimum, while others still demonstrate the ability to stave off breakouts. Dairy Products: One food connection that has gained lots of attention is cow’s milk, which is produced when pregnant cows pass on high levels of hormones into the dairy products we drink and eat. The theory is that these hormones ‘turn on’ the oil glands in humans, causing them to oversecrete sebum, which then mixes with the shedding keratin cells in the hair follicles, creating a plugged pore, or pimple. The rationale is that the hormones responsible for causing an overproduction of sebum and ‘lining cells’ come

“Many foods, like pizza, chocolate and French fries, were once villainised as causing acne but have been since exonerated by today’s acne experts. A few foods, however, may be better left out of the diet or at least kept to a minimum” from three sources: androgens, or sex hormones; the adrenal glands; and dairy products. The acne and milk connection is a theory embraced by many experts, including Dr CA Adebamowo, who published an article on the subject in the Journal of the American Academy of Dermatology in 2005 and has posted his work on www.acnemilk.com. This website, also coauthored by several physicians, including the head of the Harvard School of Public Health’s School of Nutrition, advise acne sufferers to stop consuming all milk and other dairy products or find dairy-like substitutes. Refined Carbohydrates: Another hypothesis links refined carbohydrates as a possible contributor. One study found that native people living near the coast of Papua New Guinea and the Aché huntergathers of Paraguay do not have acne, which researchers attribute to their low-glycemic diets rich in fresh fruits, vegetables and lean protein. While the studies are compelling, more research is needed. Zinc: The mineral zinc reduces the severity of acne by primarily regulating oil gland activity and reducing inflammation. Zinc is involved in the body’s metabolism of testosterone, a principal hormone involved in acne formation. Some studies suggest low levels of zinc can lead to acne, according to the Mayo Clinic. Zinc also plays a role in wound healing to help prevent scarring. Common food sources include oysters, red meat, poultry beans and fortified cereal. Selenium: Selenium helps regulate glutathione peroxidase,

an enzyme critical to preventing inflammation in acne. When the body is low on this trace mineral, inflammatory conditions, including acne, can flare. Chromium: Another trace mineral, chromium enhances the body’s insulin sensitivity, which can be a key concern for acne patients who don’t metabolise sugar properly. Natural Remedies and Herbs: Some herbal remedies, such as burdock, Oregon grape, yellow dock and dandelion help detoxify and cleanse the skin from within. Bromelain serves as an anti-inflammatory, while methylsulfonylmethane (MSM) offers a natural anti-microbial. The Mayo Clinic reports that a specific strain of brewer’s yeast, CBS 5926, seems to help decrease acne, though it may cause migraines and intestinal upset in some people.

Rosacea Affecting about 14 million people in North America alone, rosacea continues to mystify researchers with a cause that’s still being debated. Demodex folliculorum mites, which are found in large concentrations in rosacea patients’ skin, is one prevailing theory. Others postulate that rosacea occurs when blood vessels expand too easily. The National Institutes for Health (NIH) has funded new research into rosacea, yielding insights from Dr Richard Gallo of the University of San Diego, who along with his colleagues, have found that some rosacea sufferers have high levels of inflammation-causing chemicals in their skin. Often confused with acne, rosacea causes reddening of the cheeks, nose and forehead, spider-like blood vessels (telangiectasia) and, sometimes, pimple-like blemishes and inflamed eyes. Although there is no known cure for rosacea, conventional treatments include antibiotics, such as doxycycline, minocycline or tetracycline.

CLINICAL

skin and nutrition

Topical antimicrobials include prescription metronidazole or azelaic acid. Without a prescription, azelaic acid can help by offering an anti-inflammatory effect. There are also vasoendolethial growth factors (VEGF) inhibitors that help reduce telangiectasia and attenuate skin redness. Topical treatments based on herbs like magnolia and astragalus root may also have some inhibitory effect by reducing redness and supporting the skin’s immunity system. One study involving 246 rosacea patients found that a cream containing an extract of Chrysanthellum indicum significantly improved facial redness compared to placebo. Researchers theorize that the compounds in the extract strengthen the skin’s capillaries. Another study, presented as an abstract at the 2005 American Academy of Dermatology annual meeting, found evidence that a green tea cream may help ameliorate red bumps and pustules associated with rosacea. Often used to improve the skin barrier and reduce inflammation, niacinamide (B3) improved the skin barrier in a small study of 50 participants.3 Some researchers are exploring the B3 vitamin as an oral rosacea treatment as well. Licorice is another useful ingredient to add to your rosacea treatments for its antiinflammatory properties. As with acne, azelaic acid slows the growth of bacteria in rosacea patients and appears to demonstrate efficacy in reducing redness, papules and pustules in rosacea patients. A University of British Columbia study found that an azelaic acid 20-percent cream proved comparable to a topical metronidazole 0.75 percent cream in reducing papules and pustules in rosacea skin. Azelaic acid also appears to have a slight edge over the prescription in reducing redness. As a bonus, azelaic acid has some skin-lightening properties (see below).

Foods in the Red Like acne, food choices can affect rosacea symptoms but, in this case, the choices are more about what not to eat. Spicy foods, hot beverages and alcohol are some of the biggest

triggers of rosacea symptoms. The theory is that these foods may cause the release of chemicals that dilate blood vessels, which lead to the common flushing response. Conversely, one food that may help the condition is apple cider vinegar, which is thought to stimulate digestive enzymes that help normalize the bacteria in the intestines. Nevertheless, it’s best to consult a health practitioner first before introducing apple cider vinegar into the diet as some reports link at least the tablets to esophageal injury. In addition, a 2008 study by Italian researchers in the Journal of Cosmetic Dermatology reported that silymarin from milk thistle eased rosacea symptoms.4

Hyperpigmentation The global skin-lightening market is estimated to reach $10 billion by 2015, according to Global Industry Analysts (GIA). Today’s brighteners are sought by a world population looking to lighten darker skin tones as well as counter hyperpigmentation induced by sun exposure and hormonal changes. Tyrosinase inhibitors, such as vitamin C, arbutin, kojic acid and mulberry, have been favoured for their ability to inhibit melanin by targeting the tyrosinase enzyme, which converts the amino acid phenylalanine into the melanin precursors. Chromabright, a newer treatment comprised of a synthetic molecule, has exhibited significant brightening properties in in vivo clinical trials by demonstrating melanin inhibition on par with hydroquinone, an effective yet controversial skin lightener with potential side effects. Chromabright also helps prevent UVinduced skin damage. In addition, some whitening peptides have demonstrated tyrosinase-inhibiting activity by affecting the proteins in the tyrosinase enzyme. In 15- to 20-percent concentrations, azelaic acid as a melanin inhibitor may be as effective as hydroquinone yet without the irritation, according to some studies. Glutathione works a little differently than mainstay tyrosinase inhibitors. Instead, this natural tripeptide competes with melanin’s

precursors and reduces melanin’s ability to develop pigment. In addition, hexylresorcinol offers not only skin-brightening benefits but may also increase UV protection and minimize the appearance of fine lines and wrinkles. Effective topical vitamins include niacinamide and several forms of Vitamin C, including L-ascorbic acid, magnesium ascorbyl phosphate (MAP) and tetrahexyldecyl ascorbate, an oil-soluble version. In addition to having a direct skin-lightening effect, Vitamin C can help protect against sun damage by neutralizing free radicals that contribute to hyperpigmentation. Studies have shown that Vitamins C and E in combination can improve the efficacy of sunscreen. A great all-around skin vitamin, Vitamin A helps pigmentation problems by treating slight discolorations and evening skin tone. Vitamin A can be taken orally as well as applied topically in the form of a retinol cream or other retinoid.

Foods that Can Change the Tone Interestingly, psoralens (furocoumarin compounds), a common remedy used to treat vitilago, a skin disorder resulting from lack of pigmentation, has demonstrated an ability to absorb radiant energy and stimulate pigment when photoactivated in the presence of UVA or UVB. When certain psoralen-containing foods, such as parsnips, limes, parsley and celery come into contact with the skin, they can augment the effects of sun exposure and increase the risk of age spots. Eating these foods will not have the same effect as handling them with the skin, and, according to a 2009 study, pre-treating the skin with psoralens may have a protective effect against UVB by stimulating production of naturally protective flavonoids and carotenoids.5 On the other hand, eating a diet rich in fruits and vegetables might help prevent UV-induced hyperpigmentation by protecting skin with anti-oxidants. Good examples include berries, kiwi, grapefruit, kale and spinach.

[REFERENCES] 1 J Clin Aesthet Dermatol, 2008, Nov. 1(4): 48-51 2 Int J Dermatol, 1986 Dec; 25 (10): 664-7 3 Cutis, 2005 76(2); 135-41 4 Journal of Cosmetic Dermatol, Vol. 7, Issue 1, March 2008 5 Ecotoxicol Environ Saf, 2009, 72 (4): 1129-36. Epub 2009 Feb 1

28 www.cosmeticnewsuk.com

By understanding the effects nutrients and topicals can have on the skin, we can speed results and work in a more positive direction toward treatment.

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Be enthused. Join us and become one of the first stockists to stock the Retinol Youth Serum and receive an invite to an exclusive launch event on 31st October at the Dermapure Institute of Skin Care, London. Call to book your place and receive a FREE sample bottle of our Retinol Youth Serum at the event this October Distributed exclusively in the UK by Dermapure.

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www.cosmeticnewsuk.com 29 INSTITUTE OF SKIN CARE

CLINICAL

Fordyce’s spots

Spot on Dr Patrick Treacy on Co2 fractionalised laser for the treatment of Fordyce’s spots

ordyce’s spots are small, painless, white spots or bumps approximately 2-3mm in diameter that may appear on the shaft of the penis or on the labia, as well as the vermillion border of the lips of the face. They are usually caused by sebaceous hyperplasia, an overgrowth of the lubricating glands, which keeps the skin hydrated. Fordyce bumps are not known to be associated with any illness and are of cosmetic concern only. These bumps present on the scrotum as well, and cause undue concern in younger men. The papules are named after a nineteenth century American dermatologist, John Addison Fordyce who graduated in 1881 with a degree in medicine from the Chicago Medical College. He began his career in Hot Springs, Arkansas but travelled to Europe in 1886 to study dermatology in Vienna and Paris. He returned to the States and settled down in New York, where he became a specialist in dermatology and syphilis. From 1889 to 1893 he taught at the New York Polyclinic, and later he served as a professor at the Bellevue Hospital College and the Columbia University College of Physicians and Surgeons. The location of these lesions causes

patients to be embarrassed and often prevents them from seeking help or advice. There is also a lack of public awareness of the condition which is odd considering how many people are affected. When they present to general practitioners, the patients are often told ‘not to worry’ as they will cause no health problems. This means that many patients tend to hide these growths, even going so far as to refrain from having any sexual activity altogether. Although this is considered a rather common disorder, treatment options for this condition from only a cosmetic viewpoint remains poorly understood and many patients themselves seek therapeutic options over the internet. Over the years, Fordyce spots treatments have included liquid nitrogen freezing, laser removal, TCA (trichloroacetic acid) chemical peels, and more. I have also seen some strong acne medications, such as Isotretinoin (Roaccutane) used in an attempt to diminish the sebum production. All of these treatment attempts have risk of scarring, pain, and undesirable side effects. In my experience, CO2 ultrapulsed laser can be considered a safe and effective treatment for patients with Fordyce spots, offering excellent cosmetic results. Complete re-epithelisation is usually observed in less than two weeks with no residual Fordyce papules in the treated area and no side effects. This is one of those treatments in medicine that can be life-changing for some patients.

HEADING FOR HERE?

Fordyce spots on the penis

Before treatment

During treatment

zyy Dr Patrick Treacy Dr Patrick Treacy is medical director of Ailesbury Clinics Ltd and Ailesbury Hair Clinics Ltd . He is chairman of the Irish Association of Cosmetic Doctors and is European Medical Advisor to Network Lipolysis. He is an advanced aesthetic trainer and has trained over 300 doctors and nurses from around the world. He is also a renowned international guest speaker and features regularly on national television and radio programmes. He was invited to speak about stem cells and cosmetic medicine at the World Aesthetic Conference in Moscow this year. 30 www.cosmeticnewsuk.com

After treatment

MEDICAL AEsthEtICs:

itâ&#x20AC;&#x2122;s A Question

of QuAlity

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ogo, triniti, Motif, ePlus, Sublime, Sublative and elōs are trademarks of Syneron Medical Ltd. and may be registered in certain * This ad is not intended for use in the U.S. market. ©2012. All rights reserved. Syneron, the Syneron logo, triniti, Motif, ePlus, Sublime, Sublative and elōs are trademarks of Syneron Medical Ltd. and may be registered in certain * This ad is not intended for use in the U.S. market. ©2012. All rights reserved. Syneron, the Syneron logo, triniti, Motif, ePlus, Sublime, Sublative and elōs are trademarks of Syneron Medical Ltd. and may be registered in certain * This ad is not intended for use in the U.S. market. ©2012. All rights reserved. Syneron, the Syneron logo, triniti, Motif, ePlus, Sublime, Sublative and elōs are trademarks of Syneron Medical Ltd. and may be registered in certain jurisdictions. elōs (electro-optical synergy) is a proprietary technology of Syneron Medical. PB77561EN jurisdictions. elōs (electro-optical synergy) is a proprietary technology of Syneron Medical. PB77561EN jurisdictions. elōs (electro-optical synergy) is a proprietary technology of Syneron Medical. PB77561EN

CLINICAL

skin need ling

special/n

eedling skill s

VIEW ON

Dr Des Fernandes gives his View On an article on skin needling published in Cosmetic News in August 2012

“

hen I read the ‘Skill Seeking’ article written by Kamila Kingston in the August issue of Cosmetic News (pp29-30) I was startled. It seems to tell us that 0.5mm skin needling is adequate to cause collagen induction therapy (CIT) and that 1.5mm needles are unnecessarily traumatising. It contends that medical needling at 1.5mm length needle is traumatic and minimally effective. There are only two references and the paper by Majid[1] is an independent peer reviewed report. The second reference comes from the website of the manufacturer and has not been published by peer reviewed journals. They both report on the clinical effects and both of them praise the effectiveness of 1.5mm for CIT!

South African plastic surgeon Des Fernandes MB, BCh, FRCS (Edin) is the founder of the Environ Skin Care range

NOTES 1. Majid, I., Microneedling therapy in atrophic facial scars: an objective assessment. Journal of cutaneous and aesthetic surgery, 2009. 2(1): p. 26-30. 2. Aust, M.C., et al., Percutaneous collagen induction-Regeneration in place of cicatrisation? J Plast Reconstr Aesthet Surg. 3. Ortonne, J.P., Retinoid therapy of pigmentary disorders. Dermatol Ther, 2006. 19(5): p. 280-8. 4. Sorg, O., et al., Retinoids in cosmeceuticals. Dermatol Ther, 2006. 19(5): p. 289-96. 5. Saurat, J.H., Skin, sun, and vitamin A: from aging to cancer. J Dermatol, 2001. 28(11): p. 595-8. 6. Watson, R.E., et al., Repair of photoaged dermal matrix by topical application of a cosmetic ‘antiageing’ product. Br J Dermatol, 2008. 158(3): p. 472-7.

No one in the world as far as I can find has ever published a peer-reviewed paper on collagen induction from 0.5mm needling. The most that can be achieved is enhanced transdermal penetration and then the results are dependent on the topical preparations used and the number of holes made into the stratum corneum. In the papers quoted platelet derived growth factors were involved in producing the results and one only gets platelet derived growth factors from the ‘trauma’ that the author is advocating that we avoid. The speculative contribution of electrical changes to induce growth factors remains an untested theory. We all await scientific studies to show us what is true. A scientist cannot presume. The author advocates that vitamin A should not be used but she gives no scientific evidence of equivalence in results without topical vitamin A. As the pioneer with the greatest experience I think of any single person in the world at this stage, I can speak from experience and not from supposition. There is no doubt that needling works by itself. But the changes can often be subtle and need to be enhanced. I get emails from around the world either complimenting me on the idea or sometimes complaining about their experience. What is common almost without exception amongst people who have complained of unpleasant post-needling experiences or inadequate results, is the failure to use the “soft” version of vitamin A (retinyl esters) to both adequately prepare the skin and then treat it after the needling. Aust examined this in

34 www.cosmeticnewsuk.com

on why skin

needling techn iques

matter

It is extraord inarily rare to find a course needling the taught by som skin to induct eone experien collagen or for accepted that ced at transdermal skin needling absorption. It is taught by background is commonly someone with in needling or no experience knowledge of professional or needles in gen trainer and expe eral. This is the rience using of providing age of the the training. products is no longer a prer equisite There are so

many techniques that can be taugh only improve t that not the treatment and results, but patient comp have higher liance and allow bespoke treatm gaining a true ents. By understandi ng of how skin and can be applie needling works d in actual practi ce clinicians ability to tailor have the the treatments to suit their clients than adopting rather the one size fits all appro promoted in ach commonly the industry. As well as allowi ng bespoke treatments good has other comp technique elling advan occur with the tages. It is quite teach painle practice of skin simple to ss skin needli needling. ng; this is witho Learning tested anaesthetics ut the techniques allows use of if you have the the therapist the highest qualit experience to a recent survey to deliver know how to. y treatment 93% of studen In as well as thorou understand ts that attend Lotus trainin ghly the process. ed the White g reported it The practise not and of needling heavil to be painfu slowly with larger incredible consid l. This seems y needle sizes ering it was the (whether with or a roller) create first time that received and a stamp s unnecessary they had practised these trauma, bleed recovery time. techniques on experienced ing and Ultima each tely this practi therapist can other. An truly use needle se gives skin a bad name in fact should needling with poor patien s painlessly this be the first step t compliance doubts this Googl in accessing . If anyone clinician. the skill of the e a patient forum that on these provides feedb It may help to more damaging ack compare these skin needling is instantly clear practises to those techniques. surgeon. There It that they are of a is no way that found to be unnecessaril a student surgeo painful and not practice y traumatic. n would diligently how Even the purist best to use a recognise that s amongst us commencing scalpel before no matter how will surgery and good the results continue to impro demonstrate once qualified you can in scientific trials ve their skills and experienced you will not patien . It ts achieve results would be unhea for the studen will not come if t to teach or for treatments. rd of even practise often aren’t comp In addition the learning good surgery witho results arable to what methodolog ut can be achiev y and provin skilful techniques competent. They ed when g they were are adopted would also no with high qualit devices, natura doubt learn techniques to y, sterile l products and different perform certain the smallest appropriate procedures and needle size to update their to the condit be willing skills even when ion. When discus they were profic would also use sing this topic ient. They the best mater it is interesting results of severa ials and equip to note the ensure they l scientific studie ment and were sterile. s into the length It is baffling micro needle why this does s required to of not achieve results demonstrated . A 2006 study that collagen induction only takes place to

Kamila Kingst on co- found ed the first cosme tic acupuncture clinic in Austra lasia that was widely featur ed in the media for its innova tive natural techniques. Kamila now resides in the UK and is a director of White Lotus Anti Aging- www. whitelotusan tiaging www.whitelotus.c .co.uk and om.au

“as well as allow bespoke treatm ing en good techniqu ts e has other advanta ges”

cosmeticnews uk.com

depth and has clearly shown that by using retinyl esters and vitamin C and anti-oxidants before and after the needling, they achieved 144% better results than when it was not used.[2] There is no other study to show that any other topical product produces this type of result. Vitamin A makes skin more resistant and resilient. It heals faster, makes more collagen and restores normality to the skin. Normal skin, as seen in a five year old child, is richer in vitamin A than adult skin not treated with vitamin A. Adults all walk around with a localised deficiency of vitamin A in sun-exposed skin so the skin

“No one in the world as far as I can find has ever published a peer-reviewed paper on collagen induction from 0.5mm needling.” is dysfunctional in those areas.[3-5] This manifests as ageing. Topical vitamin A intends to restore the normal levels of vitamin A in the skin. Vitamin A is the safest, most natural product to apply to the skin and simply makes the healthiest skin because we use vitamin A every second of every day in normal physiological activity. If we want healthy skin we simply have to have normal levels of vitamin A in the skin.[6] I struggle to understand what bespoke skin needling is when the author only talks about 0.5mm. That’s one treatment fits everyone! Bespoke should mean that people are treated by needles of varying length for various different conditions. I have researched needle lengths from 0.2mm to 5.0mm and I believe my work has shown how to really do bespoke skin needling.

“

A matter of facts

skill seeking

Kamila King ston

We are trying to build up the intellectual status of skincare professionals so that they can meet doctors and scientists and establish mutual respect. This type of paper can only attract scorn from those scientists.

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A strong pairing We find out about the new SkinCeuticals Delicate Skin Repair and Strengthening Treatment Developed by Debbie Thomas

osmeceutical pioneers SkinCeuticals and leading skincare expert Debbie Thomas have teamed up to launch a new treatment designed to help rejuvenate and strengthen skin, whilst targeting redness and areas of sensitivity. Incorporating red light and ultrasound therapy, the new SkinCeuticals Delicate Skin Repair and Strengthening Treatment begins with a double-cleanse using the Gentle Cleanser, followed by the SM Gel Peel (Salicylic and Mandelic acid). The hydroxy acids in the peel penetrate the epidermis sloughing off the outer layers of dead skin, making way for new skin to grow. Salicylic acid is known to clear pores, increasing the rate of cell turnover, which in turn makes it the ideal treatment for imperfections and redness. Once removed and after a light facial massage is incorporated, Phyto Corrective is applied because it contains anti-inflammatory cucumber and anti-bacterial thyme to soothe and calm the skin. Before the red light therapy begins, anti-oxidants Phloretin CF Gel and AOX+ Eye Gel are applied to help dispel any free radicals which might form during the red light therapy process. The second half of the facial treatment incorporates light microdermabrasion on

I wanted to develop a treatment which would really help strengthen the skin congested areas or if not needed, a gentle scrub. This is followed by another round of red light therapy, as published medical trials have noted improved results when the red light is introduced twice, with a short break in between each session. The Vitamin C Masque is then applied and left to dry, whilst Debbie performs a neck and shoulder massage. Once the masque has dried Debbie uses her NovaSonic sound wave machine over the skin which helps revive cell tissue, excrete skin wastes, and facilitate skin metabolism. The application of ultrasound is commonly used to plump up tired, aged skin and smooth away the appearance of fine lines and wrinkles. Ultrasonic treatment can also help shrink enlarged pores, relieve puffy eyes, fade dark eye circles, freckles and old age spots, improve the appearance of acne and even repair past scar damage. The process is so gentle it is even tolerated by the most sensitive skin types, such as those with rosacea. The masque is then removed followed by cold therapy, which is either the application of a cold compress or the use of a small device with a cooling tip. The final stage of the treatment is the application of anti-oxidants and a broad-spectrum sunscreen to shield the skin from outside aggressors. Phloretin CF Gel, AOX+ Eye Gel and Sheer Mineral Defense SPF50 are the ideal SkinCeuticals products to follow this treatment, leaving skin feeling nourished, hydrated and protected. Debbie says, “Due to a rise in reactive/sensitive skin types I wanted to develop a treatment

36 www.cosmeticnewsuk.com

P roduct S potlight PHLORETIN CF GEL (£150, 30ml) Phloretin CF Gel is a light, fresh gel that immediately penetrates the skin, combating signs of ageing. It diminishes hyperpigmentation, accelerates cell renewal and retexturises the skin, protecting it against free radicals. Potent Action: Formulated with an optimised acid combination of 2% Phloretin, 10% L-Ascorbic acid and 0.5% Ferulic acid, to protect skin from the range of reactive molecules created by environmental insults and help regulate pigment production. This trusted antioxidant trio also accelerates cell turnover and stimulates collagen synthesis to boost skin’s structure for a firmer, brighter complexion. AOX+ EYE GEL (£70, 30ml) AOX+ Eye Gel is a triple antioxidant treatment which combats photo ageing and signs of fatigue. Potent Action: A synergistic antioxidant combination of 1% Phloretin, 5% L-Ascorbic acid and 0.5% Ferulic acid to combat damaging ROS to prevent signs of accelerated ageing and improve skin texture. Ruscus Aculeatus and caffeine support under-eye circulation, improve drainage and the congestion of fluids and reduce the appearance of puffiness and the look of under-eye bags. SHEER MINERAL DEFENSE SPF 50 (£31, 50ml) Sheer Mineral Defense is a weightless, mattifying, protective fluid with a transparent finish. Containing 100% mineral filters, it is paraben and chemical-filter free, providing broad-spectrum coverage for all skin types, even the very sensitive. It protects uniformly across UVB and short and long UVA rays. which would really help strengthen the skin. I have worked with SkinCeuticals products for many years and already incorporate the peel and serums in to my DNA facial with great success. With the introduction of the new Phloretin CF gel and the Sheer Mineral Defence, I was able to really target sensitive skin types, significantly reducing redness and visibly calming the skin. And due to the calming nature of the treatment, any skin type that needs a little TLC will benefit.” The treatment will be available nationwide from November 2012.

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zyy Dr Lori Brightman Is a Board Certified Dermatologist. She specialises in Mohs micrographic surgery, dermatologic surgery, cosmetic dermatology, and laser surgery. After graduating cum laude from Boston College, Dr Brightman received her masters in medical science and medical degree from Boston University Medical School where she was elected to Alpha Omega Alpha, the national medical honors society. She was also the recipient of the Bertha Curtis Humanitarian Award. Dr Brightman completed her residency training at Boston University/Tufts New England Medical Center combined program. Dr Brightman continued her training in Skin Oncology at Boston University as well as Mohs micrographic surgery and procedural dermatology at the Laser & Skin Surgery Center of New York. Dr Brightman regularly lectures nationally and publishes widely about advances in cutaneous oncology, laser surgery and cosmetic dermatology. Her current research involves the use of laser and light devices in the treatment of medical and cosmetic conditions. Her service to the community includes lectures and skin cancer screenings for many community based programs as well as major corporations. Dr Brightman is a member of the American Academy of Dermatology, American Society for Lasers in Medicine & Surgery, American Society for Dermatologic Surgery, and the American Medical Association.

Lighten up

Dr Lori Brightman on how elure’s natural formulation provides an effective topical lightening solution for all skin types

atients seeking skin lightening treatment are often frustrated by skin irritation resulting from topical medicines or the need for multiple, uncomfortable chemical peel or laser procedures. These adverse effects have patients seeking efficacious options without the discomfort and risks.

before and afters

As a board certified dermatologist with The Laser & Skin Surgery Centre of New York, I find many of my patients have experienced irritation or the need for long-term use with hydroquinone- based products. Which is why my clinic now offers elure™ Advanced Skin Lightening Technology as an alternate treatment. The elure topical product line is based on the proprietary enzyme Melanozyme™ – Syneron Candela’s patented version of the naturally occurring enzyme lignin peroxidase (LIP). The product works by breaking down the durable melanin compound within the skin. While other skin lightening treatments work to block melanin biosynthesis, preventing its formation, elure’s active ingredient reduces melanin in the upper layers of the epidermis.

BEFORE

I find elure most useful for patients who have diffuse photodamage. It gives a more even tone and a brighter appearance to the skin; I also recommend elure for use with melasma patients. Many have responded to elure alone. For others, I use elure in conjunction with other treatments, targeting the melanin in two different ways. For example, if a patient can tolerate it, I may prescribe hydroquinone in the evening and elure in the morning to reduce existing pigment. Another attractive feature of elure Advanced Skin Lightening products is the fast-acting results. I find that several of my patients notice quicker reduction of pigment with elure in comparison to other topicals. Also, with other, medicated topicals, many patients need to take breaks in between treatments; adding to the amount of time before positive results are observed. With easy, home-based application, the elure

38 www.cosmeticnewsuk.com

AFTER DAY 28 OF TRIAL

treatment protocol begins with the Advanced Facial Wash, followed by application of the Melanozyme from the patient’s choice of either the Advanced Lightening Lotion or Advanced Lightening Night Cream. Lastly, the Activator is applied to initiate the skin lightening process. After one hour, the product can either be removed or allowed to remain on the skin without fear of irritation. On average, when applied twice a day, results are seen within one month. When treatment is discontinued, results are generally sustained for three weeks. I use elure on all skin types including Fitzpatrick skin types IIIV and have not encountered, a difference in rate of response or percentage of patients with different skin types responding. Furthermore, I have not experienced any episodes of irritation. Irritation and, although rare, ochronosis, are issues associated with extended hydroquinone use. I have actually seen two patients referred to me after very long-term use of hydroquinone with the ochronosis diagnosis. It is sad to see how this affects the patient’s self esteem. They do not want to show their face. I like the fact that I do not have such a risk with elure. The majority of my patients have been quite satisfied with their results. Particularly those who’ve had no response to other treatments or who found other skin lighteners too irritating. They are happy to see improvement without skin irritation issues.

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Before

After

Before

After

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Skin messengers the future of cosmetic medicine I am excited about the emergent field of ‘smart’ molecules as it opens up a whole new era of medicine where synthetic skin messengers can actually command physiological process within the cells to cause internal rejuvenation. This increasingly important branch of cosmetic medicine focuses Dr. Patrick Treacy on molecules such as peptides, glycoproteins and inorganic molecules and their interaction with the metabolic processes of the skin. In essence, they try to imitate skin function by stimulating those processes that slowly deteriorate with the passing of time. It has been known for some time that as a result of ageing and environmental factors, the skin cells own ability to regenerate itself decreases. These biomimetic molecules are synthesised to mirror the function of the cells own molecules by stimulating processes such as collagen synthesis and repair, metabolism of fats, skin renewal and increasingly also are being used for anti-free radical effects. There is increasing interest in the use of nanopeptides as these intelligent messengers can be transported by innovate nanotechnology chemical systems to allow them to penetrate the cell and release them up to eight times deeper into the cell, where most of the biochemical processes occur. Smart molecules renew the skin from within the dermis itself. Most patients know expression wrinkles appear on the face as a result of prolonged muscle contraction. Most doctors know that the neurotransmitter involved in this process is acetylcholine, which is involved at the level of neuropharmacoreceptor. Imagine a new world where biomimetic molecules could act in the same way as acetylcholine without the added side effects or discomforts. That world is upon us with Singuladerm and Dermaheal both competing with products to mimic this effect. The muscle lines relax and the wrinkle lines shrink visibly. The skin loses elasticity with age. More recent Biomimetic molecules such as Acetyl Decapeptide 3 (CG-Rejuline) in Dermaheal’s SR claim to reduce and prevent lines and wrinkles by actively generating new skin cells. This occurs by increasing the number of fibroblasts, hemidesosomes, and keratinocytes, resulting in firmer regenerated skin. 40 www.cosmeticnewsuk.com

This technology will compete with PRP (Plasma Rich Platelets) by producing synthetic rather than autologous growth factors. Other nanopeptides including Decapeptide 4 (CG-IDP2) claim to strengthen skin elasticity by inducing the synthesis of collagen, elastin. Others apparently hydrate dry skin and maintain its optimum moisture balance. The addition of hyaluronic acid to Dermaheal’s HSR retains moisture stimulating the adhesion of fibroblasts and the growth of keratinocytes. This in turn aids in rapid wrinkle repair. One of the biomimetic products of most interest to me is Dermaheal’s HL for hair loss and alopecia. In this process smart molecules such as Oligopeptide 24 (KERAMIN1) can be delivered into base of the hair follicles to prevent hair loss and promote hair regrowth. Others, such as Copper Tripeptide 1 (CG-COPPER PEPTIDE) claim to help strengthen hair while stimulating hair follicles to produce strong hair shaft. There are other messengers to help blood circulation in the scalp and revitalize hair follicles. This process is presently going under trials in Ailesbury to see its effect in stimulating hair growth and density. All of these molecules, including biomimetic molecule CG Edrin may be applied to the scalp area with the aid of microneedling and hopefully will start a new era in the treatment of male pattern baldness and some other forms of alopecia. Biomimetic peptides may also be used to: • revitilise dull skin by increasing cell proliferation • improve aged skin or acne skin, • stop hair loss and allopecia • stimulate hair regrowth • reduce cellulite & local fat. Of special interest to UK doctors will be the use of Oligopeptide-2 (CG-IFG1) in conjunction with low strength phosphotidylcholine to help eliminate the fat content and cellulite layer, smoothing out cellulitic skin and sculpting the contours of the body. The treatment known as ‘Lipolytic Mesotherapy’ is highly effective for reducing localized fat deposits, coupled with regeneration and improvement of skin elasticity. I have used it and am very impressed by the lack of pain and swelling compared to conventional ‘lipodissolve’. Through the use of biomimetic peptides and advanced biotechnology we are now able to – slim knees, thighs, hips, abdomen and also eliminate the “double chin”. Although, it is relatively easy to get insurance for the technique, a doctor may still have to mount a script on a named patient basis.

Dr. Patrick Treacy

Ground-breakingwww.dermagenica.co.uk news in medicine Dr Gabriela Mercik is a biomimetic mesotherapy expert and a progenitor of biomimetic mesotherapy treatments in the UK.

Fibroblasts - before and after

After 72 hours we can monitor morphological changes of fibroblast and keratinocyte cells â&#x20AC;&#x201C; an increase of proliferation and density

Biomimetic mesotherapy Tel: 0044 (0) 75945 34735 Email: info@dermagenica.co.uk Dermaheal HSR Dermaheal SR Wrinkles, Rejuvenation, Acne, Stretchmarks

Results of biomimetic mesotherapy

Dermaheal LL Cellulite, Local Fat

Before

After

Dermaheal SB Skin Brightening

Dermaheal HL Stop hair loss and allopecia. Stimulate hair regrowth

Dermagenica, a UK-based distributor for www.dermagenica.co.uk Dermaheal, is organising a free of charge seminar with workshops:

Before

After

London: Wednesday 17th of October 2012. More info www. Dermagenica.co.uk

PRODUCT News lutronic

thermavein™

Dr Tapan Patel evaluates new Lutronic products

New Technology available for the treatment of thread veins

Dr Tapan Patel is working with AZTEC Services and Lutronic to evaluate two exciting new products at his Viva Clinic in London. The Infini is a new RF system with both fractional RF and needle RF treatment heads. This new technology is becoming extremely popular and Infini is producing great results worldwide. The Spectra Q-switched Nd:YAG laser is a very high spec Q-Switched Nd:YAG laser for tattoos and pigmented lesions and is also FDA cleared for treating melasma. It also has novel treatments such as the Spectra-peel for skin rejuvenation and reducing pore size. Anthony Zacharek of AZTEC services said, “It is great to be working with Dr Patel with these new products”.

A new company, backed by Landmark Investments Group, has secured exclusive use of Veinwave™ technology, which has been incorporated into a new brand called ThermaVein™. The ‘thermocoagulation’ treatment works in a very different way to alternatives and is safe, instant and effective. Clients will see the veins disappear as the treatmentis administered. This is a move away from traditional methods, which can take many weeks to show results and can be painful. In most instances just one 15 minute ThermaVein™ treatment will clear the condition. ThermaVein™ is being launched in the UK, followed by the rest of Europe and the USA, by the end of 2012. Mark Hawthorn, director of ThermaVein™ and Landmark Investments said, “The investment into ThermaVein™ is a departure from our usual business. We spent a lot of time evaluating the market and the alternatives available before making our decision. We firmly believe we will be the number one treatment for facial veins across the World within three years. There is nothing comparable to what we are able to offer. Although we are new to the market our partners Veinwave™ are already well established as the treatment of choice within the medical market. We are genuinely looking forward to our customers and their clients seeing the treatment in action and the instant results it provides.”

Biologique Recherche

Aesthetic Brands announces distribution of Biologique Recherche AESTHETIC BRANDS is delighted to announce its appointment as the exclusive UK distributor of Biologique Recherche. To launch the exclusive French skincare brand, which has an extensive range of conditioning products for face, body and hair, Aesthetic Brands has chosen the award winning EF MEDISPA as its first flagship spa chain. The launch of Biologique Recherche brings 30 years of innovation and the exceptional personalised beauty care to the UK. Made with the high concentrate (over 20% in most products) of botanical, marine and biological extracts, these highly active products contain no artificial fragrances. Esther Fieldgrass, founder of EF MEDISPA, says, “At EF MEDISPA I am always looking for state-of-the-art skincare solutions, but I am also a great believer in ‘back to the future’ beauty. By which I mean the use of traditional

techniques with the most advanced technology and products available, combining ancient wisdom with new scientific knowledge for bespoke beautification. Biologique Recherche achieves this perfectly. I am continually being offered new products to try, and I won’t offer clients any products in my clinics without personally using them first. When I first tried Biologique Recherche, I was so impressed with the results on my skin that I immediately booked the Eurostar to Paris to visit their factory. ”

Medical Aesthetics Ltd

42 www.cosmeticnewsuk.com

Medical Aesthetics Ltd has unveiled its new skincare range - Exposure®. The professional product line has been developed following extensive testing and research. It includes 12 products and an in-clinic treatment – the Exposure® Doctor Facial – which has already been launched in the Urban Retreat Medi-Spa at Harrods.

Alginate Mask; Exposure® Eye Contour Gel and Exposure® Dermatological Facial Exfoliation Cream.

Products in the range include: Exposure® Cleanser; Exposure® Toner Normal/Dry skin; Exposure® Toner Oily skin; Exposure® Glyco 20; Exposure® Dermatological Aloe Vera Gel; Exposure® Professional Roller; Exposure® Instant Glow; Exposure® Sunscreen SPF30; Exposure® Antiaging Serum with Argireline; Exposure®

Medical Aesthetics founder Dr Marc Armangue says, “In my practice my philosophy is to offer evidence-based treatments. The Exposure® product range is an extension of my professional work and has been developed with integrity, creating a programme of dermatological skincare with active ingredients which deliver results.”

The Exposure® range is designed to complement and enhance results obtained from aesthetic procedures. The dermatological skincare range uses only evidence-based active ingredients and is suitable for all skin types.

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business Best PRACTICE

Image is everything ? Facial discrimination or an invitation to take a good look in the mirror? Antonia Mariconda shines the spotlight on the professionals who deliver the concept of image enhancement.

s a beauty writer and coach, I spend hours listening to patients and clients quiz me over what constitutes a good cosmetic doctor. I spend even more hours, days and weeks dedicating myself to the task of locating these excellent surgeons, doctors and other professionals within the aesthetic industry. I do this in order to refer these carefully-selected professionals to the hundreds of patients who turn to me for advice and direction. In my own process for selecting good cosmetic practitioners and surgeons, the top three requisites on my check list are as follows: 1. Education/qualifications/ training 2. Experience 3. Reputation However, I am seriously thinking of expanding that list to accommodate

the very interesting feedback that I receive from patients, consumers and the general public. Last week I opened up a conversation on my Facebook page by inviting a couple of thousand followers and friends to answer the question:

“Does beauty sell beauty?” To facilitate the response, I broke this very general question down by asking more specifically: “Is a well-dressed and wellpresented aesthetic professional more likely to inspire you to use their services?” The feedback was fascinating to say the least. My question opened up a debate that attracted the opinions of people of all ages, colour and sex. Opinions flowed freely, kickstarted by the frank and honest thoughts of a national newspaper journalist who frequently writes health and beauty articles. The woman (who asked to remain

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

anonymous) stated “I believe presentation is equally important as skill, I wouldn’t entirely trust someone shabby or unkempt, especially if they were addressing aesthetic issues.” I further probed her viewpoint and asked whether presentation and image hinged on her decision-making process she replied “categorically yes”. This outlook was echoed by many of the people engaging within my social media conversation. To ensure I had not excluded alternative viewpoints, I looked further afield and discovered that the feelings aired in my research resonated widely. The debate over personal presentation seems to not just be confined to the aesthetic industry; in an online article from Director Magazine called ‘Facial Discrimination’ by Claire Coleman,

the concept of facial discrimination was explored in the work place. This interesting article explored the concept of image and success in the workplace; Cary Cooper, director, columnist and professor of organisational psychology and health at Lancaster University Management School, stated. “We live in a multi-media, youthorientated age where looks are important. Whether you’re speaking to potential employers, clients or even your colleagues, you need to feel confident about yourself and need to look capable.” It is therefore no wonder that the aesthetics industry has an intense spotlight placed upon the professionals who work within it. After all, these are the professionals who deliver beauty and image enhancement; as such, they www.cosmeticnewsuk.com 45

business Best PRACTICE

Opinion Section: seem to be under the spotlight in more ways that they might think. Consumers are now judging their chosen practitioners not only by their credentials but by their looks and presentation. To many savvy clients, these attributes figure just as prominently in the decision-making process. Holly Worton from London believes that “As professionals, they should dress as professionals, and look the part”. Harley Street surgeon Rajiv Grover was quoted in Coleman’s article as saying “There is no question that in the workplace, as everywhere else in society, facial discrimination exists. Once, age and experience were considered the most important attributes when considering the right candidate for a job. Now, potential and stamina are equally important. So being young, or at least looking young, is essential for success.” General opinion gleaned from my social media conversations suggest that weight, hair, skin, nails, teeth, clothes and style are the most important factors in the “image and presentation” of an aesthetic professional, although priority consistently remains on the professionals’ education, training, skill and personality. It seems that charisma also plays an important part in the overall package of identity and personal branding of aesthetic professionals. Sarah Gildersleeve from Hertfordshire reinforced this opinion from a recent visit to a cosmetic surgeon where she observed “He was not only dressed impeccably – he was charming, handsome and spoke to my daughter, not just me. Despite a very busy clinic he took his time. He also took a common sense decision over protocol which will hopefully prevent a very noticeable scar. He was in every way the perfect depiction of a good surgeon.” More and more aesthetic professionals are starting to cotton on to the fact that the right personal image blended with charisma and skill can make for a successful practitioner. As Dr Dan Dhunna

“Is a well-dressed and well-presented aesthetic professional more likely to inspire you to use their services?” “Yes it will definitely impact the decision. When a patient consults a doctor or surgeon the patient will see the professional as an inspiration, they look to the professional as a brand and a representation of their skill and business. People don’t like contradiction and a professional who does not dress well or present well lacks the consistency with what they are trying to achieve which is to improve the body and image, in this business a professional has to walk the talk, you are a walking talking advertisement of your own brand”. Kate Nightingale, Style Consultant and Psychologist “The older professionals seem to take much more care over their appearance and give off a distinguished vibe which is most comforting before a procedure. A shabbily dressed doctor would put me off as also poor personal hygiene would. Beauty definitely does sell beauty and an attractive well presented surgeon is every bit as important as the procedure he or she performs. I don’t believe anyone who takes such care of their own appearance would risk their professional reputation in tandem with a doctor also delivering a first class service”. Nikki Hardman, West Midlands “Do looks really matter? When it comes down to the actual ‘job’ you could have a not so attractive surgeon but who can perform equally as good surgery wise as a very attractive surgeon. Should we judge people by looks? Some people may feel intimidated around people they feel are more attractive.” Lee Owens, Liverpool “I think it would be a disservice to try to generalize about plastic surgeons and the image they may or may not project based on degree of “attractiveness” or dress. Manners at the bedside are more important than the dressing on the outside. What is important is not what we look like in street clothes but what we do in the operating room in plain scrubs. Of course, in the extreme, it is common sense that doctors who greet you unkempt and exuding poor hygiene may not possess the perspective and attention to detail that medicine requires. They should be models of professional behaviour, not necessarily models.” Robin Yuan, Plastic Surgeon, Beverley Hills “I’d be put off if a plastic surgeon was very ‘plastic’ but I do think it gives a good impression if they are smart, professional and well presented - I know it shouldn’t make a difference, it should be their reputation and skill alone but people do judge a book by its cover!” Katie-Jane Konstanz, Plymouth

from Harley Street remarks “you wouldn’t be inspired by a hairdresser with shockingly bad hair or a dentist with horrible teeth would you? So what makes the aesthetics business any different? People want to be positively inspired, good presentation and personality will certainly not detriment your career that’s for sure.” As a beauty writer and coach, I’ve visited numerous clinics, and seen and spoken to so many practitioners and professionals within the aesthetics industry. It would be fair to say there has been more than one occasion when I have wanted to ask the surgeon or

46 www.cosmeticnewsuk.com

aesthetic professional to “smarten up their act”. I believe that more professionals should appreciate the importance of self-presentation and image within this business. Nevertheless, patient Sarah Gildersleeve believes there is also a flipside to aesthetic professionals devoting too much attention to image. As she points out from her countless experiences with the aesthetic community, “There are a certain few who are more concerned with their image, but offer less impressive results with their actual work”. I certainly would never place the looks and image of a doctor or

aesthetic professional over their track record and ability, but equally I believe that in this business the way we look reinforces our individual ‘brand’. When people come to see me for consultations or advice, they will always remark on my skin, my hair and certain features which inspire them to perhaps also make improvements, or purchase a product. As The Cosmedic Coach, I am essentially an advertisement for the aesthetics industry. I promote its fantastic strengths, as well as pointing people in the direction of safe self-improvement where there are weaknesses. It is my own personal responsibility for my brand to practice what I preach, so investing in my image has become integral to establishing the trust and belief of my readers and clients. After some extensive research I have expanded my criteria to five essential elements in finding the right aesthetic professional: 1. Education/qualifications/ training 2. Experience 3. Reputation 4. Communication 5. Presentation Just because Presentation appears last in my list does not mean its importance should be underestimated; it still forms an essential part of the overall package determining your identity and reputation within the aesthetics industry. If you are still not convinced by this concept, don’t just take my word for it – take it from expert image consultant and psychologist Kate Nightingale founder of www. stylepyschology.com who concludes, “You should not forget that the way you look is a representation of your personal brand. You can’t get away with saying ‘my reputation precedes me’. Wrong: it takes three seconds for a prospective patient to make a decision about you. If you don’t look like your ‘product’, how can people trust you and want to buy your service?”

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THE CHANGING FACE OF SKIN CAMOUFLAGE We find out about the life-enhancing services Changing Faces offers to people with disfiguring skin conditions and how you can refer your patients to them

or people suffering from skin conditions the psychological and emotional side effects can be as hard to deal with as the physical ones. One charity that is now making a real difference to people’s lives is Changing Faces, who, since March 2012, have been running the Skin Camouflage Service, previously delivered by the British Red Cross. The service was established in 1975 at the request of the Department of Health following a survey of UK dermatologists that highlighted the need for effective camouflage advice for their patients. Now operating in over in the white and iris of my eye, making 180 locations across the UK, the service reaches more than 6,500 adults my left eye darker than my right eye. and children who benefit from the skills and expertise of the 200 trained “I was afraid to look people in the eye volunteers who work as skin camouflage practitioners for the charity. Skin because my left eye looked so different to camouflage is a crucial part of the tool kit which builds confidence and my right eye. As a result I feel I wasn’t taken seriously and I was easily overlooked empowers individuals to live their lives to the full. It complements the support and dismissed. I felt isolated and meeting people for the first time was always service already offered by Changing Faces, which provides information, stressful. advice, practical and emotional support to children, parents and adults with “For a long time I held out hope that the nevus could one day be removed any condition that affects their appearance. entirely. In my 30s, and early 40s I had extensive laser surgery to try to reduce Skin camouflage practitioners work with, and provide an individual the visibility of the nevus. It was very painful and it was hard for me to accept solution for, people who have scarring, burns, vitiligo, birthmarks, or who that it couldn’t be removed. I’ve come to terms with that now and slowly learned have been through illnesses that have resulted in skin damage. People to be proud of what I am and not to strive after unrealistic results. are referred to the clinics because their appearance is causing them “Since I started using skin camouflage the range and depth of pigments that considerable distress and is preventing them from getting on with their they use in the creams have really improved. I don’t wear skin camouflage at lives. Each consultation lasts about an hour. During this time the practitioner home, but I do find that I rely on it when I am out in public. carefully matches the client’s skin type using a mixture of colours and “Living with an unusual appearance is all about how we cope with our provides advice on how to apply the products, which are then provided feelings and learning to work through other on prescription by the GP. The creams are also people’s negative reactions. I have learnt from waterproof, enabling people to use them whilst skin camouflage Changing Faces that people with good coping swimming. strategies and good social skills, who have For many clients the combination of a practical a positive outlook on life, tend to suffer fewer tool and the supportive, caring interaction with problems of personal intrusion and discrimination. the practitioner is a tremendous boost to their I have learnt to adopt more confident body confidence. It can be the first time they have language and to look a person straight in the eyes, allowed someone to touch them or met someone which allows you to be on equal terms.” who accepts them fully, without being shocked. Consultant dermatologists, general practitioners Clients report that they can face going out in and other health professionals identify people public, can build relationships, apply for jobs and who may benefit physically, psychologically enjoy sports and other activities – all of which they camouflage cream or emotionally from the benefits of the Skin have long avoided. They build more confidence Camouflage service and refer them to the service. and may choose only to use the camouflage on It is provided free to clients who occasion, but it has by then served its function. usually require a single session. Maria Angel, who has used the service said, “Coming to terms with my appearance has been a long journey and I’ve been using skin camouflage as a part of my daily routine since I was 15. I was born with a nevus of ota, a dark grey birthmark with a bruise-like appearance, over my left cheek and eyelid. I also have a lesion 48 www.cosmeticnewsuk.com

To find out more visit www.changingfaces. org.uk/Skin-Camouflage * Pictures courtesy of Piers Allardya

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Web

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TAKE ADVICE FROM THE PROFESSIONALS

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ADD BLOG FOR FEATURE THE SAKE OF IT

Zoe Davitt unravels the confusion surrounding website dos and don’ts

veryone seems to have finally realised the value of having a website to promote their aesthetic practice, but have you assessed your website in terms of its effectiveness? What contribution is it making to your business and how could it be improved? Investing in your website to make it as effective as possible could be the difference between having a website like everyone else that acts as a billboard for your practice and having a website that truly helps build and grow your business and patient base.

zyy Let’s start from the beginning

zyy ZOE DAVITT Zoe Davitt BA (Hons) DipCAM (MComms) is managing director at Blue Horizons Marketing and has been working within the dental, cosmetic and aesthetic sector for over nine years. A regular contributor to dental and aesthetic trade publications, she holds a Diploma in Marketing Communications and is an active member of the Chartered Institute of Marketing (CIM).

50 www.cosmeticnewsuk.com

Everything must begin with a clear strategy. What are your business objectives? Do you have a clear overall marketing strategy? How do you differentiate yourselves from your competitors? Where does your website fit in with the rest of your marketing communications? If you have thought through the answers to the above questions, the brief for your website will be focused, clear and in line with your business objectives. Who – is the website aimed at? It should be all about your clients’/prospective clients’ needs and wants and not about what you want. What – is the purpose of the website, both overall and on each page? What do you want clients to do (call you, email you, sign up to your newsletter)? Ideally you should have a clear goal for each page of your website and a call to action. Why – always try to answer for your clients “what’s in it for me?” For example, don’t just put “Sign up to our newsletter”; give them a reason to leave their details, such as “for tips on looking your best & latest offers sign up to our newsletter”. How – will you measure success? Set yourself realistic targets in terms of visitors, enquiries and so forth. And remember, QUALITY over QUANTITY. Don’t be fooled by promises of thousands of ‘hits’ to your website. The most important metric will be the number of enquiries and

subsequent conversions that you get – actual, real paying clients that come through your door.

zyy Website Dos • Take advice from a professional marketing company/website developer – a reputable company will have your best interests at heart and will challenge you to ensure that your website not only meets your business and client needs but also conforms to statutory requirements. • Ensure you cater for mobile users and tablet users – you have to, it’s a rapidly growing market. Monitor the analytics for your site and, if the proportion of visitors accessing via a mobile device is high, you may want to consider building a separate mobile specific version of your site. At the very least, ensure your site works on mobile devices. • Write the copy/content for clients not for search engines - if you achieve this, search engines will naturally like your site anyway! • Make your website personal to your business – use bespoke photography, client testimonials, team profiles and so forth – ensure that you connect with your audience and really get across what your business is about and what makes you different from the competition. • Ensure your site is easy to navigate - do keep structure consistent throughout the site, left side and top navigation works best – Apple & Microsoft have spent big bucks investigating this so take their word for it, they know what they’re talking about! • Simplify everything - website users are, by nature, impatient. Make sure that you are providing them with everything that they need quickly and that your site is intuitive to use. • Be on brand – your website should showcase your marketing strategy, integrating with other communications and demonstrating your brand values. • Make use of Google Analytics and adjust your site accordingly. In particular, keep an eye on how people are coming to your site (what search

’T D ’T ON DON ECT

E PECT XP EX !! VISITORS VISITORS P ROMOTE PROMOTE SITE OUR Y YOUR SITE

MAKE IT WITH PERSONAL D AN PHOTOS TESTIMONIALS

terms do they use) and what pages do they look at? • Collect data - enable users to ‘opt in’ to marketing messages when they fill out forms. • Make users are aware you collect cookies – in order to meet new EU guidelines.

zyy Website Don’ts • Do it yourself - yes, there are many DIY web packages out there but is a homemade website really the right impression to give? Remember clients cannot judge the quality of your treatments so they will make judgements on the things that they can see/feel/touch, like your website. • Expect visitors - lose the “if you build it, they will come” mentality. Just because your website is there, people are not going to magically visit your site unless you actively get them to. • Add a blog just for the sake of it – are you really going to write regular, meaningful blog posts? A website with an outdated blog can create the wrong impression and may make people think that you are not on top of things and don’t care – NOT the way to impress a prospective client. • Hastily add Twitter and Facebook buttons – you need to ensure that you have a social media strategy in place. It could well be, for example, that Twitter isn’t right for you. First build up your social presence, then commit to posting and engaging your fans on a regular basis… and, only then, promote them on your website. • Feel like you have to try and promote everything you do in one place - take the “less is more” approach and ensure that clients can obtain information quickly and easily. • Over use Flash/animation/music - these can slow down load time, annoy visitors and get penalised by Google. The last thing you want is for a potential client to be unable to open your site

OUR ENSURE Y Y SITE IS EAS ATE TO NAVIG

and then go to your nearest competitor practice instead. • Frighten clients! - Use simple before and after shots and don’t be too graphic. Think in terms of aspiration and selling the end benefit of a confident face/body rather than the process it takes to get there. • Don’t try to fool Google – you won’t win and your site could be completely struck off. • Expect a killer website overnight - good websites take time to build. If you want the best results from your site, be prepared for several months of work. • Forget about your website - ensure that you constantly review your website and keep it up-to date. Hopefully this article has given you food for thought and will motivate you to take the time to reassess not only your website but also the overall marketing strategy for your business.

zyy Website must-haves • T eam Page with pictures & profiles, qualifications and a bit of personal information to humanise you •O verview of treatments & services – think concise information that a client wants and needs to know • F ee Guide – don’t be coy about your fees. Explain what you charge, why and how people can pay – i.e., interestfree finance •H ousekeeping details - Opening hours, contact information, directions, parking, map, accessibility for wheelchair users •C lient testimonials/case studies/ before & afters – always ensure you get a client’s permission to use beforehand •C all to action – whether that is phone, email, sign up to a newsletter – on each page if relevant

DON’T

FORGET TO OUR UPDATE Y ! WEBSITE

Everything must begin with a clear strategy. What are your business objectives? Do you have a clear overall marketing strategy?

www.cosmeticnewsuk.com 51

Q&A in business Q&A

Ho ldi ng c ourt Cosmetic News: How did you get into cosmetic medicine? Dr Stephen Robertson: I have been

practising cosmetic medicine since 1990 when I opened my first clinic and the only treatments available were Collagen & skin peels! In 1994 I was approached to use a ruby laser which expanded treatment options and I opened my second clinic in 1996. The advent of Botox and Hyaluronic Acid fillers in 1997 helped grow my business significantly and I opened satellite clinics in Jersey, Bournemouth, Windsor and Barbados. The growth was good until the recession and things plateaued; I was working harder to stand still despite cutting costs.

CN: What made you decide to make the move from being an independent practitioner to working as part of a group like Court House Clinics? SR: After being in business for 20 years I found myself spending more and more time on things that in truth I didn’t enjoy doing. The time spent on administration and regulation can undoubtedly be better spent dealing with clients/ patients. You also have to question the financial implications of running a group of standalone clinics/or a group of clinics whose income is solely dependent on cosmetic medicine. Profits that may look good on paper suffer from all the costs of running your business, marketing, staff,

“It’s a pleasure to work for a like minded clinic group that prides itself on doctor led treatments” new equipment, rent and maintenance and of course all the hidden costs that suddenly pop up when you least expect them! It gradually dawned on me that even though my client base was expanding the profitability of the business was not increasing proportionately. Running your own clinic takes a great deal of time investment 52 www.cosmeticnewsuk.com

We chat to Dr Stephen Robertson about his move from being an independent practitioner to becoming part of the CourtHouse Clinic Group

for limited financial gain. Another major deciding factor was the fact that Court House is a doctor led clinic which meant I was secure in the knowledge that I would retain my clients and that they would not be passed on to a nurse or a therapist as a cost saving measure. In the past I had turned down offers from other clinic groups because of this problem.

CN: What are the main advantages for you now working with Court House Clinics? SR: The first and most important advantage is there is far less day to day hassle with Court House Clinics, no staff aggravations, no overheads and no more dealings with the Bank Manager. When you run your own clinic everything comes down to you. Every decision seems to wait until someone can speak to you or your manager, in itself an extra expense and it is so time consuming. Now all this has changed and it’s a great relief to leave at the end of the day and know you can switch off because there is an organisation behind you taking care of all the details. I now concentrate on what I do best and that is treating my clients and focusing on my skill and expertise as a doctor and I have a more rewarding job both financially and professionally. I certainly have more disposable income now than when I was running my own business. Also Court House was very supportive during the aftermath of the sale and helped deal with all the administrative and financial problems in the hand over period which was very reassuring. In summary increased net income, no worry and no need for investment, especially in expensive new technology, are the main advantages of working with Court House Clinics.

CN: What were the benefits for you clients? SR: What was attractive about the move to Court House Clinics was the continuity with clients because although CHC took over my business in Bournemouth, Southampton, Windsor and Watford I retained my clients and continued to work with them. There was no interruption to the service. I still work in the same locations but in state of the art facilities, with the

same patients and new patients brought in by their marketing and excellent public relations. Attracting new clients as a business owner was challenging but Court House have professionals dedicated to taking care of this so I no longer have to worry. Court House have also introduced new treatments and more up to date machinery, products and technology which improves client satisfaction and retention.

CN: How has the move changed your working life? SR: With Court House behind me I can concentrate on my clients and utilise my skills as a doctor and let the group take care of the business. I now travel to other Court House Clinics and this provides me with more diversity and different environments. Court House fits appointments around my own personal requirements. It’s also a pleasure to work for a like minded clinic group that prides itself on doctor led treatments. I get to work with some of the best practitioners in the industry and also some of the best equipment and technology that I would not have been able to invest in as an individual clinic owner. I thought I would miss the flexibility I had over my time, being able to chose when I would take holidays, or days off when it suited me, but it’s a very small price to pay for the freedom and peace of mind I now have. In fact I probably have more time to enjoy myself outside of work now when I think about it!

CN: The refurbished Watford Clinic recently reopened tell us a bit about that? SR: The Watford Clinic has been transformed from a rather homely clinic to a modern flagship site. Court House invested a lot of money in the building, which badly needed a makeover, but was difficult to finance when I ran it as my own business. The modern aesthetic look of the clinic suits the clinical treatments and state of the art equipment we have there. It does justice to the quality of treatments and standard of excellence that Court House is known for, and more importantly our clients and patients love it.

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IN business A DAY IN THE LIFE

On Forme Antonia Mariconda finds out what a typical day has in store for consultant plastic surgeon Taimur Shoaib

aimur Shoaib is a cosmetic surgeon with a busy and established practice in Glasgow, located in one of the city’s premier private clinics, La Belle Forme, or ‘the beautiful shape’. Mr Shoaib has specialised in plastic surgery for the face, breast, and body. At his practice, patients receive both surgical and non-surgical treatments of a cosmetic nature, depending on their needs. When necessary, to achieve the best results, he will combine surgical procedures with non-surgical treatments, putting both parts of his expertise to use. Antonia Mariconda discovers what makes this dynamic surgeon tick... “I live in the west end of Glasgow with my wife Ambreen. My alarm rings at 6am and I keep pressing the snooze button! I’ll have a quick milky, sugary coffee to start my day and read the news. I usually read the BBC website on my laptop and The Telegraph has a well designed mobile website, so I read this on my phone too. I’d like to go to the gym, and I should go more often, but I usually manage an hour of squash on a Sunday night. I drive to work; I like a variety of music including easy listening, soul music, 80s rock, 90s dance and some R&B. I went to university in Glasgow, where I also did my initial training as a junior doctor. I then went to Oxford to complete my basic surgical training, but returned to Glasgow to undertake a period of surgical research. I was awarded a Higher Doctorate for this research and continued 54 www.cosmeticnewsuk.com

my specialist training in plastic surgery in the world famous Canniesburn Plastic Surgery Unit in Glasgow. I completed my training by undertaking a fellowship in head and neck cancer surgery, training with head and neck plastic surgeons, maxillofacial surgeons and ear, nose and throat surgeons. I did this also in Oxford, and from there I started my consultant post at the Canniesburn unit in Glasgow as a head and neck plastic surgeon.

schedule for the afternoon which is similar to my morning programme, my afternoons and evenings are spent usually at a clinic or operating.

I have three practices. One is for reconstructive plastic surgery and is based at the Canniesburn Plastic Surgery Unit at the Glasgow Royal Infirmary, where my special interests are in head and neck plastic surgery and skin cancers. I perform my general anaesthetic cosmetic surgery at the Glasgow Nuffield Hospital and I run and own my own clinic called La Belle Forme in

The only annoying thing about my job is that my patients have to wait before they see me - I need to magic up some more time! In the NHS I mainly treat cancers of the face and mouth, and it’s nice to be able to make a difference to someone’s life by removing their cancer and reconstructing the defect left behind. In my aesthetic practice, many people simply want to look normal - they want a nose to match their face or they want to be able to go out and wear normal clothes instead of ones that hide the parts of their bodies they want to improve.

“I’ve been inspired by many people in all walks of life, who have been good at what they do, have been able to see what other people want and have been able to deliver results based on their excellence and results.” Glasgow City Centre. I also teach on aesthetic courses here and this is where the rest of my personal staff work (including two nurses and four aesthetic therapists). My morning usually starts the moment I set foot within work, I either have an outpatient clinic or I have an operating theatre list. Sometimes I’m catching up with administration or doing some research, auditing, teaching or practice development but it’s more likely that I’m doing a clinic or theatre list. Mornings can be hectic and I usually have a rest for 30-60 minutes, to break for lunch, gather my thoughts and

I’m motivated by wanting to provide excellent treatments and results. I’ve been inspired by many people in all walks of life, who have been good at what they do, have been able to see what other people want and have been able to deliver results based on their excellence and results.

We are developing our training academy right now. I already teach on a Botox and dermal fillers training course along with training at an advanced course. However, we’re expanding our training portfolio to include skin treatments, dermarollers, PRP injectables, laser treatments, and a series of master classes designed to help develop people’s businesses. We’re really excited about this and have a website set up at www.inspiredcosmetictraining.com with more information. All jobs carry their highs and lows as well as embarrassing moments. I once forgot the name of one of my work colleagues! I just wanted the ground to open up or at least for me to have been able to see her name badge! I’m most relaxed when I’m spending time with my family. My time with them is very precious and I like to do things with them. The best times are usually when we’re on holiday together and the kids seem to get a few days off school every month! I’m afraid I end my day by catching up with emails and watching some TV (I like watching movies and I have to record them on my set top box). My final reflections for the day; “What did I do today and could I have done it better?”

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training news Mapperley Park delivers new Core of Knowledge short course at BODY 2012. Mapperley Park will be delivering a new one-day ‘What You Need to Know’ course at the BODY conference next month. The course will be held at 2pm on Saturday November 3 as part of the first day of the conference. It is available at the reduced price of £150 +VAT, which includes admission to the exhibitor halls. This three hour introduction to lasers and light derives from a longer delivery but is still delivered and certificated against MHRA 2008 syllabus requirements. The course has 10 years of development behind it and includes practical demonstrations – on home ground – and new, specially recorded HD video material to support. The point of the course is to show rather than to tell the technical elements that are required to understand lasers and light. Content also provides evidence against later BTEC Qualification and as such, is both pre-requisite and part of the evidence portfolio.

dates for the diary

D at e s f o r the Diary We round up upcoming events , training courses and meetings

cosmetic news the uk’s largest trade aesthetics exhibition and conference

expo

exhibition and conference

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This is a unique opportunity to get your Core of Knowledge certificate and meet the manufacturers all on the same day. The Mapperley Park certificate is also an accepted evidence document in its own right – in this case showing attendance only. To book call 0115 969 0111, e-mail training@mapperleypark.co.uk or visit www.mapperleypark.co.uk/training

Lynton expands its training programme Lynton has announced the introduction of two new masterclasses, in Body-Shaping Treatments and Fractional Lasers. The courses will be delivered in conjunction with the University of Manchester and run at Lynton’s state-of-the-art training centre. Lynton also offers a variety of courses in Skin Laser Applications, Core of Knowledge and a variety of more application-specific master classes which offer a detailed insight into specific areas, such as hair removal, tattoo removal, and vascular and pigmented lesions. Dr Samantha Hills, who runs the courses, says, “Our courses are designed to be suitable for both beginners and those who already have experience in performing Laser and IPL treatments. The courses cater for a range of needs, can complement existing training or can teach you all you need to know.” For more information, please visit www.lynton.co.uk or call 01477 536 975.

Mesotherapy Training Workshop Dr Fernando Galcerán, medical advisor for mesoestetic laboratories HQ Barcelona, will host a one day workshop introducing mesoestetics NEW mesohyalTM mesotherapy line on Tuesday November 20 in Ealing, London MesohyalTM intradermal solutions are controlled by independent agencies that certify the quality and safety through the CE mark. The workshop will cover the history of mesotherapy and give a full explanation of the different techniques used in mesotherapy including the preparation of mesotherapy cocktails to treat common aesthetic concerns. A presentation of the mesohyalTM range will also be given by mesoestetic alongside a demonstration by Dr Galcerán with delegate participation. The course costs £600 + VAT and delegates will receive a free starter pack of mesoestetic mesohyalTM line worth £315 alongisde course material and certification. To reserve your booking please contact mesoestetic UK on 01746 718 123.

56 www.cosmeticnewsuk.com

October 2 EndyMed Training, London, 01937 541122 3 Vascular and Pigment Masterclass, Lynton Training Centre, Cheadle, www.lynton.co.uk 4 Obagi Ireland Workshop, Dublin, www.healthxchange.com 5 Genuine Dermaroller Training, London, 01937 541122 8 EndyMed Training, Yorkshire, 01937 541122 10 Core of Knowledge Laser/IPL Training, Nottingham, latoyahallen@mapperleypark.co.uk 13 Cosmetic Courses, Foundation Botulinum Toxin and Dermal Filler Seminar, www.cosmeticcourses.co.uk 15 Blue Peel Workshop, London, www.healthxchange.com 15 Obagi Masterclass, London, www.healthxchange.com 16 Obagi Masterclass, Manchester, www.healthxchange.com 17 Dermagenica, free Dermaheal, seminar and workshops, London www.Dermagenica.co.uk, (0) 75945 34735), info@dermagenica.co.uk 18 Hair Removal Masterclass, Lynton Training Centre, Cheadle, www.lynton.co.uk 19 Obagi Workshop, London, www.healthxchange.com 19 Cosmetic Courses Business, Marketing and Managing Complications Seminar, www.cosmeticcourses.co.uk 22 Genuine Dermaroller Training, Yorkshire, 01937 541122 24 NEW Body Shaping Masterclass, Lynton Training Centre, Cheadle, www.lynton.co.uk 25 Cosmetic Courses Dermaroller Training, www.cosmeticcourses.co.uk 26 Cosmetic Courses Chemical Peel and Medical Microdermabrasion Course, www.cosmeticcourses.co.uk 29 Inspirational Business Training: Marketing, Lynton Training Centre, Cheadle, www.lynton.co.uk 30 Inspirational Business Training: Team Motivation, Lynton Training Centre, Cheadle, www.lynton.co.uk

November 3 Mapperly Park Core of Knowledge Short Course: What you Need to Know; Laser and light Essentials for the Aesthetic Industry. BODY Conference, Royal Society of Medicine, London, www.mapperleypark.co.uk 5 EndyMed Training, Yorkshire, 01937 541122 6 Advanced Skin-Laser Applications (including Core of Knowledge) (3 DAYS), Lynton Training Centre, Cheadle, www.lynton.co.uk

10 Cosmetic Courses Botulinum Toxin and Dermal Filler Seminar, www.cosmeticcourses.co.uk 12 Clinical Update Training Day, Lynton Training Centre, Cheadle, www.lynton.co.uk 12 EndyMed Training, London, 01937 541122 13 Core of Knowledge Laser / IPL Training, London, latoyahallen@mapperleypark.co.uk 14 Obagi Workshop, London, www.healthxchange.com 16 Genuine Dermaroller Training, London, 01937 541122 19 Genuine Dermaroller Training, Yorkshire, 01937 541122 19 Obagi Workshop, Manchester, www.healthxchange.com 21 CORE OF KNOWLEDGE - (1 DAY), Lynton Training Centre, Cheadle, www.lynton.co.uk 28 NEW Fractional Laser Masterclass, Lynton Training Centre, Cheadle, www.lynton.co.uk

December 5 Tatto Removal Masterclass (1 DAY), Lynton Training Centre, Cheadle, www.lynton.co.uk 8 Cosmetic Courses Foundation Botulinum Toxin and Dermal Filler Seminar, www.cosmeticcourses.co.uk 10 Obagi Workshop, London, www.healthxchange.com • The Dates for the Diary section is now a paid for section of the magazine and is a chance for you to advertise your training courses to our readers both in the magazine and online. Advertisers will get free listings of any training courses as part of their campaign. Anyone else wishing to publish training courses can do so for £300 a year. For more details contact Carly McFarlane on 01268 754 897 or e-mail carly@creativemedialtd.co.uk •

recr u i t m en t

RECRUITING

NOW

A BTEC award in lasers and lights expresses professionalism. It sets you apart from the unskilled as one of the few Healthcare or Beauty Professionals to formalise their expertise through Qualification. This is a degree-level qualification, independent of any particular laser or light interest, run by Jo Martin and Paul Stapleton. Jo has run the Clinic - and a daily clinic list - since setting up in 1993. We have delivered more than 200,000 treatments in 20 years of practice - and more than 7,000 training places over the last 10, with clinical delivery now central to the training process.

This Autumn, Mapperley Park begins a new programme of structured Laser Training in London and Nottingham venues.

Mapperley Park currently delivers NEW half-day course covering statutory syllabus as the ‘Core of Knowledge’...

A live demo is worth a hundred slides and where we can’t demonstrate using live equipment, (the London venues), we will use prepared video material to ensure a visual approach.

Weds 10th Oct, Nottingham; £195 + VAT Sat 3rd Nov, London at BODY conference. £150 + VAT Level 4 qualifications in lasers and light for medical professionals and others. This is 5-day, equipment based delivery, based on small-group workshops against the entire range of cosmetic laser/light/ devices in a programme using our own 12 platform suite - plus equipment from top manufacturers. Tutorial and lecture content is delivered in short units by recognised industry experts, providing all the experience that you need across the widest range of laser and light expertise.

Dr Lisa Delamine

MBBS B.Sc. (hons), MBACD

• Experienced in the administration of Medical Aesthetic procedures • Has the ability to work autonomously. • Possess excellent communication skills, be highly organised and motivated. • Looking to join a leading provider in Medical Aesthetics If you are interested in becoming part of this expanding company then please forward you CV to admin@personamedical.co.uk

Tel: 08450 607080

The Keogh Review is raising questions about the adequacy of training and qualification in the cosmetic sector following the PIP scandal.

The BTEC awards...

Persona Cosmetic Medicine are looking for medical aesthetic prescribing practitioners throughout the UK. We are looking for someone who is:

You may be surprised to know that there are as few as 300 qualified laser practitioners in the UK today.

Email: info@personamedical.co.uk W: www.personamedical.co.uk Facebook.com/personacosmeticmedicine Twitter.com/@personamedical

WB Mon 19th Nov, London West End. £2000 + VAT WB Mon 14th Jan, Nottingham. £1500 + VAT For those of you who have already sat the course...

…we will be running a series of conversion workshops so, if you are not one of the 300 but have already sat the course, come and join us for a workshop day and complete the qualification.

Dates to be set. £400 + VAT Masterclass training...

…in small groups using the entire range of appropriate lasers. These one-day events are spent primarily in Jo’s company but may also involve other industry experts. Topics currently include, Tattoo, depilation, vascular, ablative/non-ablative.

Watch the diary or give Latoyah a call to discuss your needs

Call 0115 969 0111 or Email: training@mapperleypark.co.uk mapperleypark.co.uk/training Mapperley Park Clinic is registered and therefore licenced by the Care Quality Commission to provide a range of medical services as Provider ID; 0000026452.

DIRECTORY A

For less than ÂŁ25 per month, you can list your company details here. For more information contact Carly MacFarlane 01268 754897 carly@creativemedialtd.co.uk

C Contact: Guy Gouldsmit T: 08451 707 788 E: info@a-b-c-uk.com W: www.abclasers.co.uk

Chromogenex Service: Laser System Manufacturer Contact: Lauren Roberts T 01554 755444 E: lroberts@chromogenex.com W: www.chromogenex.com

Aesthetic Academy + Training Contact: Chantalle Coombes T: 0845 519 4823 W: www.aestheticstraining.co.uk E: training@aestheticacademy.co.uk Allergan T: 0808 2381500 W: www.juvedermultra.co.uk Aesthetox Academy Service: Training T: 0870 0801746 E: treatments@aesthetox.co.uk W: www.aesthetox.co.uk

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

product range Contact: Anthony Zacharek T: 07747 865600 E: sales@aztecservices.uk.com W: www.aztecservices.uk.com

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

M: 0791 941 6392 E: info@bioactivebeauty.com

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

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

T: 07766 591 085 E: roy@biotica.co.uk W: www.bioptica.co.uk Blue Horizons Marketing T: 01242 236600 E: info@bluehorizonsmarketing.co.uk W: www.bluehorizonsmarketing.co.uk Services: Websites, patient literature, referral literature, brand image, advertising, e-marketing and more. Boston Medical Group LTD Contact: Iveta Vinklerova T: 0207 727 1110 E: info@boston-medical-group.co.uk W: www.boston-medical-group.co.uk

H Hamilton Fraser Contact: Wai Chan T: 0845 3106 300 E: cosmetic@hamiltonfraser.co.uk W: www.hamiltonfraser.co.uk Harley Aesthetics Contact: Dr Mark Harrison T: 02074872772 E: enquiries@harleyaesthetics.com W: www.harleyaesthetics.com Services: Training

Merz Aesthetics Contact: Merz Aesthetics Customer Services T: 0333 200 4140 E: info@merzaesthetics.co.uk Morning Star Surgical S.A. (Pty) Ltd Contact: Brian Nielsen T: +27 (82) 667 2506 E: brian@morningstar-medical.com W: www.morningstarsurgical.co.za My Cells/Scandinavian UST Ltd Contact: John Tucker T: +35361 312979 E: info@mycells.ie W: www.my-cells.net

Q-Med, a Galderma Division Contact: Customer Service T: 01923 208950 E: info.uk@galderma.com W: www.q-medpractitioner.com/uk

RECOVA COMPRESSION GARMENTS Contact: Eva Sanchez-Smith E: eva.sanchez@recovapostsurgery.com W: www.recovapostsurgery.com T: 0207 000 1044

S SkinBrands Contact: Tracey Beesley T: 0289 983 739 E: tracey@skinbrands.co.uk W: www.skinbrands.co.uk Skin Geeks Ltd Contact: Customer Services T: +44 (0)1865 338046 E: info@skingeeks.co.uk W: www.skingeeks.co.uk Specialist Make-Up Services Ltd Contact: Mike Lawrence T: 0845 2302021 E: enquiries@permanent-makeup.com W: www.permanent-makeup.com Services: Permanent Make-Up Surface ImageingSolutions Contact: Nick Miedzianowski-Sinclair Service: Skin Analysis systems & services Telephone : +447774802409 E: nms@surfaceimaging.co.uk W: www.surfaceimaging.co.uk

Med-fx Contact: Faye Price T: 01376 532800E: sales@medfx.co.uk W: www.medfx.co.uk Medical Aesthetic Group Contact: David Gower T: 02380 676733 E: info@magroup.co.uk W: www.magroup.co.uk

Polaris Lasers Contact: Neil Calder T: 01234841536 E: njc@polaris-laser.com W: www.polaris-laser.com

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

Pronokal Service: Medically supervised weight loss programme E: info@pronokal.co.uk T: 0845 604 8834 W: www.pronokal.co.uk

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

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

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

T: 01753 830931

Contact: Roy Henderson

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

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

Anti-Ageing Skincare .. using peptides at clinical levels.

Lawrence Grant, Chartered Accountants Service: Chartered Accountants Contact: Alan Rajah FCCA T: +44 (0) 20 8861 7575 E: lgmail@lawrencegrant.co.uk W: www.lawrencegrant.co.uk/specialistservices/doctors.htm LCS Academy Contact: Dr Elizabeth Raymond Brown T: 0845 0037315 E: admin@lcsacademy.co.uk W: www.lcsacademy.co.uk

Service: Exclusive UK distributor for Viora

Bioptica

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

Contact: Lisa Tyrer

Healthxchange Pharmacy Contact: Steve Joyce T: +44 (0)1481 736837 F: +44 (0)1481 736677 E: SJ@healthxchange.com W: www.healthxchange.com W: www.obagi.uk.com

Clarisonic UK Service: Skincare Contact: Ann Terrington E-mail: uksales@clarisonic.com Website: www.clarisonic.co.uk Telephone: 0800 988 4864

Contact: Customer Service

AZTEC Services

P Candela UK Ltd Contact: Michaela Barker T: +44 08455210698 E: alex@alexsilver.co.uk W: www.candelalaser.co.uk

ABC Laser

V Vaser Lipo/ Sound Surgical Technologies LLC Contacts: Simon Davies T: +44 (0) 7971 686114 E: SDavies@soundsurgical.com W: www.vaser.com

W Wellness Trading Contacts: Adam Birtwistle T: 01746 718123 E: contact@wellnesstrading.co.uk W: www.wellnesstrading.co.uk

Z Zanco Models Contacts: Mr Ricky Zanco T: 08453076191 E: info@zancomodels.co.uk W: www.zancomodels.co.uk

≤ 25°C

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

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

1084/BOC/JUN/2012/JH

Date of preparation June 2012

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

onfidence is Reliable1,2 Rewarding3 Performance4,5 BOTOX® is licensed for the treatment of moderate to severe glabellar lines Delivers long-lasting patient satisfaction, time after time2,3 Has been used for over 20 years in over 26 million treatment sessions worldwide6 Is the world’s first and most studied botulinum toxin*7

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

injection. Frequency By Indication: Defined as follows: Very Common (> 1/10); Common (>1/100 to <1/10); Uncommon (>1/1,000 to <1/100); Rare (>1/10,000 to <1/1,000); Very Rare (<1/10,000). Infections and infestations. Uncommon: Infection. Psychiatric disorders. Uncommon: Anxiety. Nervous system disorders. Common: Headache. Uncommon: Paresthesia, dizziness. Eye disorders. Common: Eyelid ptosis. Uncommon: Blepharitis, eye pain, visual disturbance. Gastrointestinal disorders. Uncommon: Nausea, oral dryness. Skin and subcutaneous tissue disorders. Common: Erythema, Uncommon: Skin tightness, oedema (face, eyelid, periorbital), photosensitivity reaction, pruritus, dry skin. Musculoskeletal and connective tissue disorders. Common: Localised muscle weakness, Uncommon: Muscle twitching. General disorders and administration site conditions. Common: Face pain, Uncommon: Flu syndrome, asthenia, fever. The following other adverse events have been reported since the drug has been marketed: dysarthria; abdominal pain; vision blurred; pyrexia; focal facial paralysis; hypoaesthesia; malaise; myalgia; pruritus; hyperhidrosis; diarrhoea; anorexia; hypoacusis; tinnitus; radiculopathy; syncope; myasthenia gravis; erythema multiforme; dermatitis psoriasiform; vomiting and brachial plexopathy; rash; psoriasiform eruption; anaphylactic reaction (angiodema, bronchospasm); alopecia and madarosis. Adverse reactions possibly related to spread of toxin distant from injection site have been reported very rarely (exaggerated muscle weakness, dysphagia, or aspiration pneumonia which can be fatal). NHS Price: 50 Units: £77.50, 100 Units: £138.20, 200 Units £276.40. Marketing Authorization Number: PL 00426/0074 Marketing Authorization Holder: Allergan Pharmaceuticals (Ireland) Ltd., Westport, Co. Mayo, Ireland. Legal Category: POM. Date of preparation: November 2011.

Adverse events should be reported. Reporting forms and information can be found at www.yellowcard.gov.uk Adverse events should also be reported to Allergan Ltd. UK_Medinfo@allergan.com or 01628 494026. References: 1. De Almeida A et al. Dermatologic Surgery 2007;33:S37–43. 2. Carruthers A et al. J Clin Res, 2004;7:1–20. 3. Stotland MA et al. Plast Reconstr Surg, 2007;120:1386–1393. 4. Beer KR et al. J Drugs Dermatol, 2011;10(1) :39–44. 5. Lowe et al. Am Acad Dermatol, 2006;55:975-980. 6. Allergan data on file. BOTGL/001/SEP 2011 7. Allergan Data on File VIS/006/JUL2011. *Allergan botulinum toxin type A. Global figures. Launched in 1989 in the US. UK/1010/2011 Date of Preparation November 2011