Focus on Cosmeceuticals: Skin anatomy and photoageing

Skin anatomy The skin of the face provides crucial functions of temperature regulation, reparative functions following injury, facial expression, protective mechanisms against infection and ultraviolet radiation, as well as sensory perception. The integument consists of two principle layers, the epidermis...

Off-label cosmetic use of botulinum toxin in the lower face

Botulinum toxin A (BoNTA) is commonly used as an off-label cosmetic modality to improve the ageing lower face and neck, and may be used as a single line treatment or in combination with other procedures, such as dermal fillers [1]....

Non-surgical management of actinic keratosis, Bowen’s disease and non-melanoma skin cancer

Non-melanoma skin cancers (NMSCs) are primary cutaneous neoplasms comprising mainly of basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs). In 2011, 102,628 cases of NMSCs (74% BCC and 23% SCC) were recorded in England, making NMSC the most common...

Support groups for hidradenitis suppurativa

Hidradenitis suppurativa (HS) is an inflammatory condition characterised by painful inflamed nodules in the apocrine regions of the body. It follows a chronic relapsing clinical course and is a very difficult condition to treat. It has an estimated prevalence of...

Temple restoration

The complex biological process of facial ageing engenders many structural changes that are influenced by the combined effects of gravity, bone resorption, soft tissue atrophy, displacement of fat and a complex synergy of textural skin changes [1]. One of the...

HA dermal filler with lidocaine: initial clinical outcomes

Hyaluronic acid (HA) is a natural occurring body polysaccharide essential for various body functions, present in connective tissues, skin, vitreous humour of eye, extracellular matrix, synovial fluid, etc [1]. It was first isolated in bovine vitreous by Mayer and Palmer...

Lasers and the skin

Laser is an acronym for Light Amplification by Stimulated Emission of Radiation. Lasers have revolutionised the treatment of many skin conditions and are being used both in terms of a medical and an aesthetic context. Laser technology has been advancing...

Thread veins and varicose veins: medical or aesthetic?

I was recently attending a national aesthetics conference when I got talking to a very well-known opinion leader in the aesthetics world. During the conversation, I was astounded to be asked: “What do you think now that NICE has agreed...

When a patient asks for your insurance details…

Coming from a patient, the question “Do you have insurance?” is almost certain to put a medical practitioner on edge. Not being a common query, many do not have a ready answer and instead have to grapple with some questions...

Plastic surgery and aesthetic medicine: specialties and specialists

Dr Nikolaos Metatoxos has written an excellent article ‘How to establish a successful practice in aesthetic medicine’, which looks at the business of aesthetic medicine and underlines some very important ethical issues. When comparing hospital doctors and aesthetic medicine practitioners...

Debate: cannulas vs. needles - Needles

It is generally agreed that the choice of cannula or needle is site and material dependent, but the injector‘s comfort and skill in creating a desired aesthetic result is also important. The two most important considerations are the aesthetic outcome...

Debate: cannulas vs. needles - Cannulas

The question whether a cannula or a needle should be chosen for filler injections does not have a straightforward answer. Injection techniques, as well as filler material, cannulas, needles, injection systems, etc. have to be used in a patient specific...