NEWS AND ANALYSIS

Survey shows impact of covid-19 on aesthetic practitioners

The impact of covid-19 on aesthetic businesses throughout the UK has been revealed in new data released by specialist insurance provider Hamilton Fraser Cosmetic Insurance.

Since March, the company has been conducting regular surveys and asking practitioners to share insights into how they have adapted their clinics, treatments and businesses as well as to gauge their views on what the future of the sector may look like in a post-covid landscape.

Almost all of those surveyed (99%) said their aesthetic practices had been affected by covid-19, with 86% reporting a reduction in revenue and 72% admitting they had no contingency plan in place.

Despite this, practitioners swiftly adapted their businesses to cope with the changing requirements, legislation and hygiene practices, with many (54%) also re-joining the NHS during lockdown.

The post-lockdown period signified eased restrictions, with 83% re-opening their clinics. However, 88% said that they were still working for the NHS.

When asked if they had noticed any changes to their clientele since re-opening, 84% reported the return of their existing clients, with 34% stating that they now had more new customers. Interestingly, 11% reported treating increased numbers of “younger” patients and 9% said that they were treating a greater number of “older” patients.

Practitioners reported an average of 21 new clients entering their clinic since re-opening, with the increased interest in procedures being largely attributed to a postlockdown “Zoom effect”.

Botulinum toxin was the most popular treatment sought post-lockdown with 82% of practitioners commenting on this treatment. In addition, dermal fillers (54%) and skincare (23%) were popular.

The report concluded that: “Practitioners should look to the future of their clinics with a key focus on business and contingency planning to secure their long-term success. The retention of existing clientele, as well as creating a safe space for new clients, with adapted procedures and wellbeing services that cater for a ‘new covid-19 normal’ are also key.”

Aesthetics Complications Expert Group goes global

The Aesthetics Complications Expert (ACE) Group has launched ACE Group World to offer help, support and education to practitioners in other countries around managing complications.

The ACE Group was established in the UK in 2011 with the remit of producing evidence-based, peer-reviewed guidelines in the management of common and serious complications experienced in non-surgical aesthetic practice. These guidelines are freely available to aesthetic practitioners and many of them have been published in Aesthetic Medicine.

With a 4,000-strong membership, the organisation offers education and support through its website and online forum, email and 24-hour emergency helpline.

International demand has led to the launch of ACE Group World to provide a similar service globally based on the requirements of individual countries. Countries will have their own website, forum and conferences and will work with existing membership organisations to facilitate the management of complications around the globe.

The ACE Group website (acegroup.online) has also been extensively updated with new branding and features. This includes a new easy-to-remember emergency helpline number and a new form and social media channel for members. As well as this, ACE Group practitioners can purchase patient information leaflets to use in their own clinical practice.

Director Dr Martyn King said, “ACE Group works with aesthetic organisations, professional bodies, media, pharmaceutical companies, patient groups, insurers and regulatory bodies to provide professional advice.

“Our mission is to improve regulation in the medical aesthetics sector, to raise standards in training and clinical practice and ultimately, improve patient safety.”

Meta-analysis suggests most effective single-agent peels for dark skin

In a meta-analysis of 13 studies, trichloroacetic acid and Jessner’s solution emerged as the most efficacious single-agent chemical peels for melasma in patients with dark skin.

In a study published in the Journal of Cosmetic Dermatology, single-agent peels were investigated for their efficacy and safety when treating melasma in dark skins, where the increased risk of post-inflammatory hyperpigmentation is considered. The meta-analysis included data from 10 randomised controlled trials and three prospective comparative studies, gathered from the databases of The Medline, SCOPUS, Web of Science, Google Scholar, and Cochrane.

The studies included patients with Fitzpatick skin types III-VI and investigated the relative efficacy and safety of two or more of: alpha-hydroxy acids, beta-hydroxy acids, Jessner’s solution, retinoic acid, or trichloroacetic acid. Melasma area and severity index score (MASI) and incidence of adverse events were looked at as outcomes of interest.

The overall effect estimate favoured a glycolic acid peel over trichloroacetic acid in terms of MASI. On the other hand, the overall effect estimates did not favour glycolic over tretinoin, vitamin C iontophoresis and amino fruit acid in terms of MASI. The overall effect estimates favoured trichloroacetic acid peel and Jessner’s solution over topical hydroquinone in terms of MASI.

Results from the meta-analysis identified trichloroacetic acid and Jessner’s solution as particularly effective for melasma treatment in dark skin. Though side effects were found to be mild in nature, trichloroacetic acid was associated with higher risk for erythema compared with glycolic acid.

Weight loss and toxin most searched-for appearance terms

“How to lose weight”, “What is the best diet?” and “How long does Botox last?” were among the top appearance-related searches in the UK in October.

Swedish health and beauty retailer New Nordic analysed Google search data in major cities around the UK to see what searches were most common throughout October.

The most popular search query was, “What is the best diet?”, with 5,000 searches coming from London and 1,100 from Southampton.

Other weight-related concerns that made the list included, “How to lose weight”, with 3,100 searches from Birmingham and 2,100 from Liverpool; “How to get rid of my fat”, with 1,600 in Leeds; and “How can I lose weight quickly”, with 900 searches in Norwich.

In Bournemouth, “How long does Botox last” had 2,300 searches over the month, while 800 searches in Sheffield wondered, “How quickly will I see results from Botox” and Newcastle had 700 searches for, “How to get rid of wrinkles”.

Hair loss and ageing also emerged as a common concern, with 1,300 searches in Bristol for, “How can I avoid hair loss?”; 900 searches in Coventry for, “How to prevent hair loss”; and 2,500 in Manchester, for “Why am I going bald?”.

In Belfast there were 1,500 searches for, “Why is my hair going grey?”, plus 1,000 in Nottingham.

New Nordic also polled 1,002 Brits of all ages and genders on their biggest image concerns and found that 70% have become more self-conscious since the first lockdown of the year.

Of those polled, two-fifths are worrying about their body more and one in ten feel too self-conscious to leave their home.

65% said they were too embarrassed to speak to a healthcare professional about a more medical concern, leading them to turn to the internet.

Vitamin B3 could help prevent skin cancers

A form of vitamin B3 has been shown to protect skin cells from the effects of UV exposure, the main risk factor for non-melanoma skin cancers. Research presented at the 29th European Academy of Dermatology and Venereology (EADV) Congress showed how researchers in Italy isolated human primary keratinocytes from the skin of patients with nonmelanoma skin cancers for the study.

The cells were treated with three different concentrations of a form of vitamin B3 called nicotinamide (NAM) for 18, 24 and 48 hours before being exposed to UVB.

25µM of NAM 24 hours before exposure was found to protect the skin cells from the effects of UV-induced oxidative stress, including DNA damage.

NAM was also found to enhance DNA repair and block local inflammation by showing decreased nitric oxide release and reactive oxygen species production.

Lara Camillo, one of the research students from the Dermatological Unit of AOU Maggiore della Carità, Novara, Italy, commented: “Our study indicates that increasing the consumption of vitamin B3, which is readily available in the daily diet, will protect the skin from some of the effects of UV exposure, potentially reducing the incidence of non-melanoma skin cancers.

However, the protective effect of vitamin B3 is short-acting, so it should be consumed no later than 24 to 48 hours before sun exposure.”

Searches for chemical peels at an all-time high

Chemical peels are experiencing a surge in popularity, with the search term reaching its peak online. Omniya Clinic in London analysed UK Google search data before and since the start of the pandemic and found that searches for “home chemical peels” have soared by 200% since before coronavirus took hold in the UK, as beauty consumers looked for ways to boost their skin at home while clinics and beauty salons were closed.

Google defines a search term reaching its “peak” as occuring when more people are searching for it than ever before.

Retail skincare brand The Ordinary, famous for its scientific, efficacious formulas in simple packaging at extremely low price points, experienced a 300% increases in Google searches for its home chemical peeling product.

Omniya also looked at the related search terms when users looked up chemical peels. Large numbers of these consumers were also searching for guidance on “hyperpigmentation”, “ageing”, “exfoliation”, “acne” and “mask-wearing”.

KerryLou Herbert, an aesthetician at Omniya Clinic, reminded fellow aesthetic practitioners to communicate the risks of home peeling to patients. She said, “Skin type is a big factor in considering which chemical peel to choose as this can increase the risk of post-inflammatory pigmentation.”

Pilot study suggests effectiveness of microbotulinum

The results of a pilot study published in the journal Plastic Reconstructive Surgery suggest that intradermal botulinum toxin injection, or so-called microbotulinum, is a safe and effective method to treat skin flaws.

Microbotulinum refers to the systematic injection of tiny blebs of diluted botulinum toxin at repeated intervals into the skin. This targets the superficial fibres of the facial muscles and weakens their insertion into the under-surface of the skin, which is responsible for fine lines and wrinkles on the face.

As part of the study, treatment was performed on 60 patients using a 32-gauge needle to deliver injections on a regular 1cm grid from the forehead to the cheek and down to the jawline.

All analysed parameters improved significantly (p < 0.0001) at 90 days with best results achieved in patients aged between 42.7 and 46.8 years.

The authors concluded that, because of the high satisfaction rate among both physicians and patients, further studies are mandatory to determine the optimal number of units needed for a longer and lasting effect with this particular novel dilution. This method of delivery is also increasingly performed with dermal filler, vitamins and other ingredients.

Merz celebrates Radiesse milestone

Medical aesthetics company Merz Aesthetics is celebrating the ten-million milestone with its dermal filler Radiesse. Ten million syringes of the product have now been shipped worldwide over almost 20 years.

Radiesse is a calcium hydroxylapatite (CaHA) injectable filler for volumisation, lifting and contouring. It is also used for skin rejuvenation as CaHA stimulates collagen production in the body. It can be injected in the mid and lower face; to address mid-face volume loss and define the jowls. 

Kristel Hectors, head of marketing EMEA at Merz Aesthetics, commented: “As we are looking ahead, we are excited for what’s to come over the next years for Radiesse.”