Ask Alice

Hi Alice, I’m currently weighing up whether to go for PRP or Calecim for hair loss (diagnosed with telogen effluvium and pcos)? Do you have a view as to which is best? The annual PRP maintenance is slightly off-putting.

Hi if you’re anywhere within range of Kelly Morrell of Scalp Confidential (London, west end and SE18, her website is scalpconfidential.co.uk but it’s being reconstructed just now) I’d recommend an appointment with her to ask her suggestions. She has great expertise across a range of different tests and treatments to work out the best route forward for her hair-loss clients. Calecim is great though it’s not a one-off, they recommend maintenance courses after a few months, depending on how your hair is doing.

I have had skin own micro needling and then 2 x Morpheus 8 treatments to form my skin. Following my second Morpheus 8 treatment I have been left with scars around my eyes which make my crows feet worse. I am 55 and feeling that I want to make improvements to my skin and how I feel about myself but am very anxious following my bed experience. I live in Yorkshire and am unsure where to go for good advices. Confidence is at an all time low. Can you advise how to start my journey to Ilan improved and more confident me.

I am so sorry to hear what you’ve been through, this sounds dreadful. Did the practitioner who did this to you have any explanation or make any apology for what has happened? I’m not in a position to offer you specific advice but would suggest you need to find a sympathetic and highly qualified practitioner to offer you some support and advice – starting with effective, appropriate skincare and then perhaps some gentle treatments to coax your skin into better shape – though I’d understand if you felt reluctant to try anything further.

Have a look at the Tweakments Guide’s recommended practitioners in your area using the search tool in that link, they’re all people we would trust with our faces.

Have you written your thoughts about polynucleotides? A known plastic surgeon has said it isn’t worth doing and there is no evidence to support its effectiveness. Thx

Hi I haven’t written about polynucleotides from a personal point of view yet – but I’m trying them at the moment so should have an article and a video out on this in a month or two. Yes, I’ve also heard this from some eminent people in aesthetics, but I’m also hearing from a lot of practitioners who find polynucleotides really helpful for their patients particularly for strengthening the fragile skin around the eyes. Some brands of polynucleotides have scores of published studies on their products. Every practitioner has their own preferences for products and procedures.

What do you think of the INTRAcel treatment

Hi it’s a very decent type of radiofrequency microneedling treatment. You can read a bit here about INTRAcel and practitioners like Dr Sarah Tonks offer it at their clinic.

Hi, what is medical grade skincare?

Hi – Becki, TTG’s Contributing Editor here. Although not a legislated term (meaning there isn’t a legal definition and different brands use it in different ways), generally medical-grade skincare tends to refer to skincare products that are formulated with high concentrations of active ingredients. They are also typically recommended or prescribed by dermatologists and other aesthetic practitioners, and will often be backed by scientific research and clinical studies to help demonstrate their effectiveness and safety. Here at TTG, we believe in results-driven skincare and treating specific skin concerns such as wrinkles, acne, hyperpigmentation, and sensitive skin with tailored formulas. Head to our shop to discover our favourite recommendations..

Hi Alice, I recently had Botox for the first time in three areas and my brows went very arched – I got ‘Spock brow’ although thankfully after three weeks it has calmed down. The practitioner said this happens with some people – is this the case? I can’t decide whether this is my muscles or the injector? Any advice based on previous experience? Unsure whether to try elsewhere or only have two areas!

Ok, two thoughts on this. (1) Yes this does, as your practitioner said, ‘happen with some people…’ when the practitioner has misread your facial muscles or miscalculated the dosage! Ie it’s them, not you. Botox and other wrinkle-relaxing injections are not a one-size-fits-all treatment that can be done to a standard template, even though that’s the way practitioners learn the basics of the treatment. It needs to be adapted according to the way your particular facial muscles move.

Getting toxin ‘right’ in the brows means the practitioner has to work out a balancing act between the muscles that pull your brows up and the ones that pull them down. If your brows are flying up and out after treatment, it will just take a small adjustment, a tiny bit more toxin, to damp down the muscle that’s causing the brow to wing up and out. If your practitioner doesn’t seem to ‘get’ all this, try elsewhere.

Thought (2), having re-read your question – if this Mr-Spock-style arching happened around day 7 after treatment, and by the third week after treatment it had settled down – faces often look a bit wonky between days 4 and 14 after treatment – it takes two weeks for the full effects of the toxin to take hold. Also, if this was with a new practitioner who doesn’t know your face and how your facial muscles adapt to toxin, they will to some extent be guessing as to what will give you an optimum result. If you’re happy with the final result, all’s good.

Either way, there’s nothing wrong with your muscles; it’s the practitioner’s job to work out how to treat them to get the result you’re looking for.

Alice what is you view on CO2 laser I am considering

Great treatment – as long as it is in well-trained and experienced hands. You can read more on laser treatments elsewhere on the site.

Hi , I’m 62 and have noticed crepe-ing on my neck in the centre I went to have Profhilo on the 25th of May then 4 wks later had the second treatment, so 2 wks ago now I had the second lot , I still have some crepe in the middle of the neck and wondered how long it takes to see the result?

Hi, with Profhilo, it takes around eight weeks from the first injections to see a proper result (your practitioner should have let you know this) as it takes time for the extra hydration to kick-start the remodelling of the skin, and this process happens more slowly the older we are, so give it a couple more weeks. I always find that my neck is slower to show results with this sort of treatment than my face – because the skin is thinner and drier on the neck than on the face, so there is more work to be done to soften crepiness and improve hydration, and I need three rounds of treatment in my neck to really see a result. Discuss this with your practitioner to see what they think, but if you have the budget, it might be worth trying a third round of treatment to build on the earlier results.

What collagen supplement would you recommend?

Hi! Becki, TTG’s Contributing Editor here. It depends on what results you are looking for. If you are interested in the skin benefits of collagen supplementation to improve skin elasticity and firmness, I’d recommend trying Totally Derma Tub collagen-boosting skin drink as a collagen supplement. This product is designed to support collagen production in the skin, helping toimprove skin elasticity and firmness. You canfind more information about this collagensupplement and purchase it at the following link: Totally Derma Tub.

If you have any more questions or need furtherrecommendations, feel free to ask!

I have recently lost 20lbs, a lot from my face and neck, 70 years old. What’s the best option for me? I’m in Hampshire, where do you recommend?

Hi, apologies – we’re not sure what concern you’re looking to treat. We have a whole concerns page on our website with suggestions for skincare and tweakments that can help.

You can find an expert practitioner near you using our practitioner finder.

What do you think lemon bottle injection for fat dissolving?

Lemon Bottle is made and widely used in Korea, but it is not licenced for use in UK – not even a CE mark. I can’t find any research about it online. I’ve asked around among my practitioner friends in case I’m missing something obvious about this but they tell me, I’m not. There is no published clinical data to support the product’s claims, even on its own website.

The product is classed by its manufacturers as a cosmetic treatment, so it escapes the need for the safety testing that a medical product has to go through and means non-medics can use it. Although there are surgeons and medical aesthetic practitioners who are offering Lemon Bottle, Lemon Bottle is mostly being targeted at, and used by, beauticans, not by nurse- or doctor-led clinics. That’s a red flag for me.

It’s hard to say what’s doing the dissolving, too. Lemon Bottle says it contains ‘all natural’ ‘botanical based’ ingredients, specifically bromelain and riboflavin  – which are not known as fat-dissolvers. It contains no clinically-approved fat-dissolving ingredients such as deoxycholic acid which other fat-dissolving jabs contain.

If you’re tempted to try it out, you need to be aware that if a substance like this CAN dissolve fat, it will also dissolve anything else in its path. Like, muscle, blood vessels, nerve-sheaths…which is why you really do need an expert injector with a medical background and proper training, to put it in exactly the right place.

Who do I see for fillers around the lips – plastic surgeon? Do not want filler in lips themselves

There are many great practitioners who can offer dermal fillers listed on our website. You can find a practitioner near you using our practitioner finder.

I have terrible smokers lines, I would love for them to be removed permanently. Is there anything that can be done please?

It is unlikely to find a tweakment that can permanently remove smokers lines as they form because of the constant movement and puckering of the mouth, and the loss of collagen and elastin in the skin, but there are ways to minimise the appearance of these lines.

There is a variety of tweakments to treat the upper lip lines. Here are two of the most popular and effective:

• Profhilo, and other injectable moisturer treatments, can hydrate the skin from within. They also encourage the skin to regenerate from within and produce more of its own collagen (which gives it firmness) and elastin (which gives it springiness) and even tighten the skin a little, which is great news for reducing the appearance of lip lines.
• Skin tightening treatments, such as radiofrequency, or a heat treatment, such as Tixel, have a direct effect on the skin. The heat generated in the skin by these treatments makes the collagen contract — so you get a small shrink-wrapping effect — then, over time, the treated area produces more of its own collagen, which will strengthen the skin and makes those annoying barcode lip lines less apparent.

Supplements like collagen and vitamin C can also help regenerate the skin and boost your levels of collagen and elastin.

You can find out more about how to tackle barcode lip lines on our dedicated page.

Hi Alice, Another question please! I take Absolute Collagen but it doesn’t do much for my body – what is a good collagen that will help body skin as well as facial and neck skin please? Thanks again!

Hi Alice, as you know I follow you avidly on Instagram and value your opinion. I am 53, very slim (size 6 to 8) and I am fit, I exercise (run, walk, yoga). I can’t find a treatment to tighten my sagging arms which are very crepey on the upper area. I also have sagging skin inner elbows. There’s no fat, so fat reducing treatments won’t work. I’ve tried RF (intensively). Recently, I had the polynucleotide treatment on my neck with some success (not amazing to be honest but better). I have also had it on my face and I can see a good difference. My practitioner (who is good, certified, over 20 years in the business etc.) thinks it will make a difference to my crepey skin on my arms and help with tightening (but not miracles!). What do you think please? Thank you so much!

Hi, it sounds like you have tried a lot already. If your practitioner thinks polynucleotides will help with the crepey skin on your arms, and you’ve seen benefits on your face/ neck, I would give them a go. I tried Profhilo Body in my inner arms (with Dr Preema, the video is on that link) and saw a definite result. If you don’t already take a collagen supplement, I’d add that in, I am sure it helps my own skin quality. As does HRT, as having oestrogen back in the system enables the skin to produce more collagen, which improves the results you get from any collagen-boosting tweakment.