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Botulinum Toxin A

Botulinum toxin is a naturally occurring protein produced by the bacterium Clostridium Botulinum. In a purified form, as is the case with many drugs/medications such as Penicillin, Botulinum toxin is a very safe, effective treatment not only used in cosmetic clinics, but also for a number of medical conditions, including migraine and excessive sweating.

Licensed brands of botulinum toxin A include: Botox®, Azzalure® , Bocouture®, Xeomin®, and Dysport®.

All botulinum toxins are prescription only medicines (POM) and can only be prescribed by doctors, dentists and nurses with the prescribing qualification, following a face to face assessment and consultation with the qualified prescriber.

The toxin blocks the transition of chemical messages sent from the nerve to cause the muscle to contract. Without these messages, the muscle stays in a resting state until the ‘messengers’ recover. This recovery takes approximately 8 to 12 weeks on average.

The aim of this treatment is to significantly reduce the movement of the muscles causing expression lines (dynamic lines). It may not cause the expression lines themselves to disappear completely, this will depend upon the quality of your skin and may take time over a course of treatments.

It may not ‘completely freeze’ the expression, particularly if extreme effort is exerted to make an expression.

Botulinum toxin is not suitable for lines present without expression (static lines), our practitioner will advise you.

There may be only a partial reduction in movement this very much depends on the amount administered and location of product placement. This is not a one size fits all treatment and may be tailored to suit your individual requirements and expected treatment outcomes. Discuss this with your clinician at the time of consultation.

A very fine needle is used and generally this treatment is not painful and can be well tolerated with no anaesthetic. Ice may be helpful in numbing the skin for nervous patients as well as reducing the risk of a bruise.

Though widely used in cosmetic medicine and with an extensive evidence base to support safety and efficacy, Botulinum toxin A brands, Botox ® , Azzalure ® and Bocouture ® are licensed only for the treatment of frown lines; Botox ® recently gained an additional license for crow’s feet. All other indications are, for the time being, ‘off label’, i.e., being used beyond the terms of the original license. Many drugs are routinely used off label. Please discuss with your practitioner if you have any concerns and they will be happy to explain further.

  • Frown lines
  • Worry lines
  • Crow’s feet
  • Lip line
  • Lower face treatment to improve jawline and appearance of neck, known as ‘Nephertite lift’
  • Hyperhidrosis (excessive sweating)

After treatment, it is expected that you will start to see an improvement within 2 or 3 days. The full result may be judged at 2-3 weeks. You may be invited to attend a review appointment at 2-3 weeks where the success of the treatment may be assessed and adjustments to your personal treatment plan made, if necessary.

You will be advised to keep the target muscles active for a few hours and to avoid extremes of heat or cold, vigorous exercise, lying down or leaning over for 4-6 hours.

Results tend to last 3-4 months. Movement will begin recovering from 8 weeks.

Frequent treatment at intervals of less than 3 months is NOT recommended.

All treatments carry a degree of risk. All risks and complications will be discussed with you at consultation and prior to any treatment being agreed.

Botulinum Toxin should be administered by a healthcare professional with specialist training.

Side effects include, but are not limited to:

  • Bruising
  • Swelling at injection sites
  • Redness at injection sites
  • Asymmetry of expression
  • Drooping of the brow, or eyelid
  • Headache or a sensation of ‘tightness’ or ‘heaviness’

Adverse events are uncommon, usually occur within a few days of treatment and are expected to be temporary, usually resolving spontaneously within weeks.

Your practitioner will provide aftercare advice designed to minimise risk and promote speedy recovery from any expected side effects.

Your practitioner will take a detailed medical history and an assessment of your needs and expectations to ensure this is an appropriate treatment for you.

This must be a nurse, doctor or dentist with specialised training, qualified to prescribe.

Except in exceptional circumstances this is not a treatment recommended for those under 25 or over 65.

For best results skin should be in good condition and the target lines not too furrowed. Your practitioner will assess your suitability and advise.

Botulinum toxin cannot be given to pregnant or breast feeding women.

Not suitable for patients with certain neurological disorders.

Not suitable if you are currently taking certain medicines. If you have previously experienced adverse reactions to any botulinum toxin treatment.

With any injectable treatment, Treatment is not recommended:

  • If you are suffering from any skin infection in or near the treatment area or are unwell in any way (even a cold)
  • If you are taking any medicines which affect bleeding, such as aspirin or warfarin
  • If you are currently or have recently completed a course of Roacutane (acne treatment) in the last 18 months
  • If you are pregnant or breastfeeding

If you are planning to attend a special event when a bruise, should it occur, would be unacceptable to you.

If you are planning to attend an important event and any adverse event described would be unacceptable to you, discuss with your clinician in advance of having treatment.

Some over the counter medicines and supplements can also affect bleeding (make you more prone to bruising) as can alcohol which should be avoided the day before and after treatment.

Vigorous exercise, sun exposure, sun beds, sauna should be avoided for 48 hours, or as advised by your clinician, after treatment.

Prices for Botulinum Toxin
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Hyaluronic acid dermal filler

Hyaluronic acid is a naturally occurring sugar chain molecule found in all skin and soft tissues throughout the body, identical across species. It attracts and binds water in the skin, providing volume and hydration, but also ‘cushioning’ and supporting collagen and elastin fibres and providing a medium, or carrier, for chemical messages between the cells. Dermal fillers are manufactured, usually through fermentation and cross linking with proteins to produce a clear, sterile gel for injection into the skin.

In the UK, there are over 160 brands on the market due in some part to weak regulation. Not all hyaluronic acids are the same and legitimate brands are NOT available for general sale on the internet and should only be administered by trained clinicians. Each brand has a range of ‘tissue tailored’ products designed for specific results. One size does not fit all.

Leading and well established brands include, but are not limited to:

Juvederm TM (FDA 2006), Restylane TM (FDA 2003), Belotero TM (FDA 2011), Teosyal TM, Emervel TM

pouted lips

Hyaluronic acid dermal fillers are a clear sterile gel in a syringe for injection into the skin providing instant correction.

Uses:

  • To correct or enhance facial contours; cheeks, temples, jawline, nose, chin
  • To define, correct or enhance lips, to soften and correct facial wrinkles or folds
  • To restore lost volume in hands to reduce the appearance of veins and tendons
  • To correct hollows under the eyes (tear troughs)
  • To improve the tone, texture and hydration of the skin

Most leading brands also contain a local anaesthetic and most clinicians will apply topical anaesthetic cream, or ice, prior to treatment to numb the skin. Treatment need not be painful.

Remove all makeup prior to treatment. Avoid alcohol, Aspirin, Ibuprofen and supplements such as fish oils, Gingko Biloba, Vitamin C and E for 24 hours before treatment, as the may contribute to bruising.

Your practitioner will provide aftercare advice designed to minimise risk and promote speedy recovery from any expected side effects.

Most people are able to continue with normal activities with immediate improvement in their appearance. Some will have some redness, pin prick marks, possibly swelling- particularly in the lips. Possibly bruising. Any swelling and bruising may be more apparent the next day. Make-up should not be worn for 12 hours.

You will be advised to avoid alcohol, vigorous exercise, sunbathing, and extremes of heat or cold for 14 days post treatment.

Longevity does vary between products, and between individuals, but most will last between 6 months and 18 months

All treatments carry a degree of risk. All risks and complications will be discussed with you at consultation and prior to any treatment being agreed. Dermal fillers should be administered by a healthcare professional with specialist training.

Side effects include, but are not limited to:

  • Redness
  • Swelling
  • Bruising
  • Itching
  • Tenderness

The above are temporary and usually resolve within the first few days, swelling is often marked the next morning but settles within hours, bruising can take a week to 10 days to resolve and can sometimes persist for longer.

There are a number of medical conditions and or medicines that may affect the decision to treat or the treatment plan. A full medical history and assessment of your expectations is necessary in advance of any decision to treat.

Treatment is not recommended:

  • If you are suffering from any skin infection in or near the treatment area or are
    unwell in any way (even a cold).
  • If you have previously experienced allergic reactions to any dermal filler or local
    anaesthetic
  • If you are taking any medicines which affect bleeding, such as aspirin or warfarin
  • If you are taking steroids or have autoimmune disease
  • If you have any bleeding disorders
  • If you suffer from a poorly controlled medical condition
  • If you are pregnant or breastfeeding
  • If you are currently or have recently completed a course of Roacutane (Isotretinoin
    acne treatment) in the last 18 months
  • If you are pregnant or breastfeeding

Injections on the face can trigger the cold sore virus. If you are a sufferer, you must advise your clinician in advance of treatment.

You should also inform your practitioner if you have recently had treatment with any other dermal filler or if you are planning to attend a special event when a bruise, should it occur, would be unacceptable to you.

Some over the counter medicines and supplements can also affect bleeding (make you more prone to bruising) as can alcohol- which should be avoided the day before and after treatment.

Vigorous exercise, sun exposure, sun beds, sauna should be avoided for 48
hours, or as advised by your clinician, after treatment. Safety has not been established for those skins susceptible to keloid scarring.

Prices for Dermal Fillers
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Chemical Peel

Chemical peels are one of the oldest cosmetic treatments, which make use of acids derived from fruit and milk to promote healthier looking skin by causing exfoliation of the upper most layer, facilitating movement of the underlying healthier skin cells to the top, thereby improving the texture and feel of the skin.

smiling woman

Chemical peels can be superficial, medium or deep, and are used to treat a variety of skin conditions:

  • Dry/sensitive skin – hydrates skin
  • Hyperpigmentation
  • Acne
  • Fine lines and wrinkles
  • Rosacea
  • Open pores

The peels provided at Dr Zeena Skin & Wellness Clinic are usually superficial to medium depth peels.

Superficial and medium peels have minimal to no downtime and may sting, feel hot or prickly. This usually disappears within a few minutes.

Deep peels however are painful and would require prescriptions to help pain management during and after treatment.

Superficial peel – skin may be pink for a few hours, feel a little dry or tight, there may be no peeling.

Medium peel – Skin may be pink, feel dry or tight, peeling may start on day 3 or 4, and can last for 3-4 days, skin may darken prior to peeling.

Deep peel – Skin may be extremely red for 3 weeks or longer. There may be swelling,
darkening, crusting of the skin, a strict post care regimen is required to be followed.

  • Avoid wearing makeup for 24 hours post procedure
  • Avoid vigorous exercise, facial massages, sauna, steam rooms, hot showers for at
    least 48 hours or as advised by your clinician
  • Avoid sun or tanning beds, Microdermabrasion, laser hair removal, photofacials, chemical peels and other skin treatments for two weeks
  • Avoid peeling the flaking skin or using face scrubs for two weeks
  • Use sunscreen as advised by your clinician


These include, but are not limited to:

  • Redness, tenderness, dry, itching, peeling which are usually temporary and settle within a few days
  • Altered pigmentation may occur, hyperpigmentation which is usually temporary and in rare cases hypopigmentation, which may be permanent

Treatment is not recommended if you:

  • are suffering any skin infection in or near the treatment area or are feeling unwell in any way
  • are pregnant or breastfeeding
  • have an allergy to ingredients used such as aspirin
  • are taking photosensitive medication
  • are currently or have recently completed a course of Roacutane (Isotretinoin acne treatment) in the last 18 months

Chemical peels may trigger a cold sore, let your clinician know if you suffer from
them.

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Skinpen® microneedling

Microneedling is a cosmetic procedure also known as collagen induction therapy (CIT). It involves prickling the skin with tiny sterilised needles, which cause micro-injuries, which cause your skin to self-repair and produce more collagen and elastin which heal your skin for smoother, younger-looking skin.

Results should be seen in a few weeks

A topical numbing cream is applied prior to the procedure to reduce discomfort.  A treatment-appropriate serum is then applied on the area where the procedure is to be carried out and the Skinpen® glides smoothly over it.

The microneedling technology pierces the skin with multiple needles, in rapid succession. The blood vessels below the skin’s surface break and the blood clots. The skin cells rush to heal these microscopic traumas and collagen and elastin is produced.

As the pen is moved across the face it creates fine channels in the skin which increase the absorption and efficiency of nutrients when applied topically, stimulating skin repair and regeneration.

Microneedling at different depths yield different results. At a deeper level, the treatment can deal with acne scars, while mid-penetration is required to treat sun damage, light scarring and to reduce pore size.

Microneedling can be used to treat skin conditions such as :

  • Acne and scarring
  • Hair loss (also called alopecia)
  • Dark spots or patches on your skin (hyperpigmentation)
  • Large pores
  • Stretch marks
  • Sun damage
  • Fine lines and wrinkles
  • Skin that has lost elasticity

It can take up to 6 weeks to for noticeable results as it roughly takes this long for your body to create new, healthy collagen.

This depends on the current condition of your skin as well as the type of condition you are trying to treat. However, generally for moderate acne scars, you may need between 3-4 treatments. For more severe scars and stretch marks you may need 5 treatments. To treat wrinkles and signs of ageing, you may need 1-2 per year to maintain a youthful appearance.

This will depend on your skins requirement and will be discussed during the consultation.

Remove all makeup prior to treatment. Avoid alcohol, Aspirin, Ibuprofen and supplements such as fish oils, Gingko Biloba, Vitamin C and E for up to a week before treatment, as the may contribute to bruising.

Avoid drinking alcohol 24 hours before your treatment, as this also increases the risk of bleeding.

If you are taking any prescribed medication, including aspirin, consult your practitioner or your GP first before you stop taking it.

You may be asked to adopt a particular skincare regime in the weeks prior to your first treatment, in between treatments and after completion. This is to maximise collagen production and skin repair.

After your treatment, your skin is likely to appear red and feel more sensitive. This redness will decrease significantly in a few hours after the treatment and will almost be completely gone in 24 hours. Skin tightness and mild sensitivity to the touch may also occur. After 3 days the skin will return to normal or near normal appearance

Avoid wearing makeup for 24-48 hours post procedure.

Stay hydrated and apply moisturiser to avoid letting your skin dry out.

Avoid vigorous exercise, facial massages, sauna, steam rooms, hot showers for at
least 48 hours or as advised by your clinician.

Avoid direct sun exposure for a week after treatment and use suncream with SPF 30 of greater. Also avoid using skin care products that contain retinol, alpha hydroxyl acids or Vitamin C for up to 10 days after treatment.

These include, but are not limited to:

Your skin may become red, itchy and inflamed post-treatment, a little like sunburn. This should last no longer than 48hrs.

Some other side effects include:

  • Minor flaking/dryness
  • Scabs/skin peeling
  • Milia (small white spots) may appear on the skin
  • Hyperpigmentation (skin darkening)

These occur rarely.

Microneedling may trigger a cold sore, let your clinician know if you suffer from
them.

Unlike many other laser treatments for skin rejuvenation, microneedling is safe for all skin types as the treatment does not damage the epidermis. It can be safely used on sensitive or fragile areas such as on the neck and around the eyes.

Microneedling is unsuitable for anyone who has/is:

  • Suffering from any skin infection in or near the treatment area
  • Pregnant or breastfeeding
  • Used Roaccutane in the last 6 months
  • Has had radiation therapy in the last 12 months
  • Active cold sores or skin infections
  • Skin numbness
  • Keloid or hypertrophic scars
  • Poor wound healing

After microneedling, your skin loses water as a result of needles pricking and damaging your skin cells.

Your skin can appear very dry and lines can appear worse for the first few days after treatment.

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Mesotherapy

Mesotherapy is a minimally invasive technique whereby a series of superfine injection cocktails of vitamins, minerals and amino acid are directly delivered to the mesoderm (middle layer) of the skin. This has a nourishing and rejuvenating effect. It restores hydration and promotes the production of collagen and elastin, for firmer and radiant skin. It can be also be used to treat hair loss.

Mesotherapy can be used for skin rejuvenation, hair loss and dark circles.

woman in brown floral dress standing and smiling
  • Skin rejuvenation
  • Fade wrinkles
  • Reduce cellulite
  • Fading stretch marks
  • Reducing acne
  • Lighten pigmented skin
  • Dark circles under eyes
  • Treat Hair loss (alopecia)

The upper layers of skin, the epidermis and dermis, act as protective barriers to environmental exposure. However, they also reduce the absorption of active nutrients present in skin products aimed at skin regeneration. Mesotherapy gets through this barrier by delivering nutrients directly into the the deepest layer of skin, the mesoderm. As a result, it promotes rejuvenation and regeneration of skin tissue.

The practitioner will customise and administer a cocktail rich in antioxidants, vitamins and minerals. These injections promote the wound healing process which instantly improves circulation by oxygenating the skin under dark circles.

Mesotherapy also stimulates the production of ollagen and elastin, which are essential to thicken and develop subdermal fat to help correct the appearance of under-eye bags.

Personalised treatment information will be provided during the consultation.

Mesotherapy as a single treatment will not give lasting results.

Results usually appear after a course of 6-8 treatments, administered every 2 weeks and improve over time. Once a course is completed, the effects are long-lasting and typically last around 12 months.

With new collagen and elastin being produced and the skin’s metabolism being stimulated, it produces hydrated and more radiant skin, with improved texture.

Remove all makeup prior to treatment. Avoid nonsteroidal anti-inflammatory drugs (NSAID) and aspirin for a week before treatment, as they may increase your risk of bruising and bleeding.

Depending on the area where Mesotherapy has been administered, you may notice some redness and stinging within 15 minutes – 2 hours after treatment.

Avoid wearing makeup for at least 4 hours after the treatment.

Do not take a hot shower for at least 4 hours after treatment

Side effects of Mesotherapy are minimal. There could be some redness, tenderness and swelling on the treated area immediately after the injection. You might also feel an itching sensation. All side effects should subside after a couple of hours.

Mesotherapy may trigger a cold sore, let your clinician know if you suffer from them.

Unlike many other laser treatments for skin rejuvenation, microneedling is safe for all skin types as the treatment does not damage the epidermis. It can be safely used on sensitive or fragile areas such as on the neck and around the eyes.

Microneedling is unsuitable for anyone who has/is:

  • Suffering from any skin infection in or near the treatment area or are unwell in any way
  • Pregnant or breastfeeding
  • Currently using or have used Roaccutane in the last 18 months
  • Has had radiation therapy in the last 12 months
  • Active cold sores or skin infections
  • Skin numbness
  • Keloid or hypertrophic scars
  • Poor wound healing

After microneedling, your skin loses water as a result of needles pricking and damaging your skin cells.

Your skin can appear very dry and lines can appear worse for the first few days after treatment.

Results may take 4-6 weeks to become noticeable as it roughly takes this long for your body to create new, healthy collagen.

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Reiki Healing

Reiki is a form of alternative medicine that uses the variable frequencies of naturally occurring energy for the purpose of physical, mental and spiritual healing. Reiki can work directly on the illness/injury and accelerate the repair process as well as allow the body as a whole to heal itself.

The healing is hands-on but not intrusive. The practitioner will place their hands directly on or above the area to be healed for the required length of time. Please bear in mind that you may require more than one healing session to achieve the desired result.

woman in brown floral dress standing and smiling

The reiki experience – When receiving reiki, some of the following
sensations may be experienced – heat, tingling or cold, pain in area
of injury or surgery, giggly, tearful, upset, muscle twitching etc.
Please note, some people may feel a lot of these sensations while
others may feel nothing at all, nonetheless, the latter does not mean
that energy is not flowing, it is the results that count. You may feel
deeply relaxed or fall asleep during treatment.


Pain experienced at sites of injury/ surgery or in chronic illness does
not indicate that harm is being done, rather, it is the healing process.
Symptoms may also intensify or increase as part of the healing
process. Generally, this is followed by an improvement in the
condition being treated.


Remember, you can request to pause/stop the treatment anytime
should you wish to do so

The upper layers of skin, the epidermis and dermis, act as protective barriers to environmental exposure. However, they also reduce the absorption of active nutrients present in skin products aimed at skin regeneration. Mesotherapy gets through this barrier by delivering nutrients directly into the the deepest layer of skin, the mesoderm. As a result, it promotes rejuvenation and regeneration of skin tissue.

The practitioner will customise and administer a cocktail rich in antioxidants, vitamins and minerals. These injections promote the wound healing process which instantly improves circulation by oxygenating the skin under dark circles.

Mesotherapy also stimulates the production of ollagen and elastin, which are essential to thicken and develop subdermal fat to help correct the appearance of under-eye bags.

Personalised treatment information will be provided during the consultation.

A detoxification process may be initiated by
the Reiki treatment which can manifest as headache or flu like
symptoms and on occasion to pass water more frequently. If the
detoxification process is more intense, an upset stomach, vomiting
or diarrhoea may occur. This is the body’s natural way of eliminating
toxins.
You may feel tired after treatment, this is normal and the body’s
natural way of signalling that rest is required.
You may feel light headed during and immediately after treatment,
this is due to the shift in energy and is part of the healing process.

Reiki is a safe and non-intrusive method that has no contraindications.

However, caution and input/support from your medical practitioner is required for the following:

  • Pacemakers (these are sensitive to electromagnetic energy)
  • Undiagnosed pain (here, the cause of the pain needs to be removed as the illness/injury may remain despite removal of pain)
  • Epilepsy (Reiki will not cause a fit, but the client may have one while being treated which can be distressing)
  • Diabetes (Reiki may lower blood sugar, resulting in overdose of insulin or oral diabetic medication. Here, it is important to frequently monitor the blood glucose and adjust the medication dose accordingly.
  • Mental illness (chemical balance of the brain can be affected when the improvement or change in condition can cause an imbalance with the medication)
  • Prescribed medication (these can be harmful if the condition improves because of reiki treatment. The medication may need to be altered by the doctor. Here, treatment can be provided as long as your doctor is and is willing to monitor you regularly. Also, the detoxification effect of reiki will metabolise the medication faster, hence the dosage may need to be adjusted by the prescriber)

After microneedling, your skin loses water as a result of needles pricking and damaging your skin cells.

Your skin can appear very dry and lines can appear worse for the first few days after treatment.

Results may take 4-6 weeks to become noticeable as it roughly takes this long for your body to create new, healthy collagen.

Prices for Mesotherapy
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Treatment Process

01

No – obligation consultation

Get a personalised treatment plan to suit your skin and desired results, wherein you can discuss your concerns and expectations with your practitioner, the treatment procedures involved, costs, etc.

A treatment plan will be formulated to tailor to your specific needs and will only be carried out after you have consented.

If you’re happy to go ahead we can proceed to step 2.

02

Treatment Plan & Aftercare

We’ll follow the treatment plan as discussed in the consultation and bring out a more confident you!

You will be assessed and treated by a medically trained professional, so rest assured, you are in good hands.

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Consumer Check List

When making your decision on clinic or practitioner, keep the following points in mind to help manage expectations and ensure good decision making.

Always take your time and check the qualifications of the practitioner and the intended product. If it sounds too good to be true that might well be the case.

  • To be seen by a, doctor, nurse or dentist for your consultation and assessment
  • To have sufficient time to consider all the information and avoid making hasty decisions
  • To be treated by a doctor, nurse or dentist
  • A follow up appointment is necessary or desired
  • What is this treatment/product?
  • How does it work?
  • What are the side effects/risks?
  • What are the alternatives I might consider?
  • What results can I expect?
  • What will I look like immediately after?
  • How long will the results last?
  • How many treatments will I need and in what
  • You may want to check the qualifications of a
    • Doctor (www.gmc-uk.org)
    • Nurse (www.nmc-uk.org)
    • Dentist (gdc-uk.org)
  • Ask to see the unopened box of product
  • How many treatments will I need and in what time frame?
  • Are you able to treat complications, should they occur?
  • What happens if I am not happy with the result?
  • Is it painful?
  • How do you minimise pain?
  • What aftercare am I expected to perform?
  • What will it cost and what are the payment terms?
  • Medicine to be used and make a note of it for future reference, should you later see another clinician

Do not proceed with treatment if you do not feel comfortable with the practitioner

  • Do not proceed with treatment if you do not fully understand the information you are given
  • Take the necessary time to make your decisions
  • Ask the practitioner to show you the product in its unopened package prior to treatment
  • Make a note of the practitioner’s name and product used for future reference
  • Ask for copies of before and after photographs for your reference
  • Do not have treatment in your home, at ‘parties’ or exhibitions or in environments that are clearly not clean or appropriate.

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