Ask Alice

Please can you advice, why is the best collegen to take, I’m 47 years young

Hi, I’m a fan of Totally Derma which is very good though I appreciate it is a pricey one. There are so many to choose from; what you want is a product that gives you 10,000mg of hydrolysed collagen per daily dose, and you need to take it consistently for three months in order to be able to get an idea of what it is doing for your skin/ hair/ nails/ joints. Here’s a link to some of the videos and articles I’ve done about collagen supplements.

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.

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 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 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.

I’m 74 and thinking of having Microgenesis I can’t find anything about it on your website. Do you think it’s good?

‘Microgenesis’ is term that some clinics, mostly in the USA, use to describe a treatment that involves some kind of microdermabrasion (or perhaps even a HydraFacial) to exfoliate the skin, with Laser Genesis, which is a branded type of gentle laser treatment from Cutera to improve skin tone and skin firmness. It’s a good treatment – a practitioner will recommend that you have between three and 10 treatments for best results.

It seems that my neck is aging faster than my face. I’ve had Botox for the platysmal bands, tried threads and profhilo for the crepiness but I feel as though it hasn’t made much of an improvement. (Botox has helped with the bands.) I’m now considering polynucleotides or secret RF with CO2. I’m not sure which one to go for! Would either make much of a noticeable difference?

Hi, our necks do show our age (and we don’t tend to start looking after them as early as we start on our faces). Of these treatments that you are considering, Secret Pro (that’s Cutera Secret RF plus CO2 laser) should give you a noticeable result. The radiofrequency microneedling will help to firm and strengthen the skin, and the C02 laser should build on this. Polynucleotides would be an icing-on-the-cake option to improve skin quality, but the radiofrequency, needling and laser will have a much greater effect.

The best treatment for lines and loose skin under the eyes. Laser?

Laser could be great for lines and loose skin under the eyes. I’d suggest finding a really good practitioner and discussing your concerns with them, then taking time to consider their advice. Other treatments that they might mention could include polynucleotide injections which help strengthen the skin under the eyes, or if you have serious eye bags, they might suggest considering a lower eye lift.

Can foreo bear be used on skin treated with profhilo?

Yes, you can use the Foreo Bear after Profhilo or any other ‘injectable moisturiser‘ treatment, though your practitioner will advise that you wait for two weeks after treatment before you use it.

Hi Alice – I’ve been looking at the before and after pics on your video with Bob Khanna on bio filler / polynucleotides. Impressive results, but if you go onto Bob Khanna’s website, you’ll see the same patient and visuals, but the results are attributed to thread lift and PRP! Surely some sort of error here?

Hi, I know the pictures you mean; it’s the same patient in both but they are two different treatments filmed a good 18 months apart. We filmed her having biofiller/polynucleotides with Dr Khanna about a year ago (ie April 2023, here’s the video) and we filmed her having the combined treatment with radiofrequency, threads and PRP during the summer of 2021, and published the video online in March 2022 -here’s the video of that procedure– I think her before and after pictures will look similar because they’re always taken in the same room with the same lighting and from the same different angles, for consistency.

Hi Alice, really loving your website and content. It’s so helpful to learn a bit more about this side of beauty and the pros and cons of various procedures. I’m yet to explore this for myself or have anything done, but I know that when I do I will be so much more informed! My question is whether at home microneedling is effective on the decolletage area? I am in my early 30s but have creases in this area from being a side sleeper. These started in my 20s and I think there’s also a genetic factor at play, but I would like to do something about it as I am conscious of them. Thank you so much.

Home microneedling creates tiny punctures in the skin, so any products you use afterwards will sink in more deeply, and if this is something like skin-strengthening peptides or a retinoid, they will hit home rather harder. So it may help. My issue with home needling is that it is very easy to get overenthusiastic and overdo it; to do it patchily; to scratch up and damage the surface of the skin, and you need to be really scrupulous about cleaning the needling device afterwards (to prevent infection), and changing the head regularly. Also, home needling doesn’t go deep enough to stimulate collagen production in the skin – for that you need clinical microneedling, and yes that absolutely works on the decolletage as well as anywhere else on the skin. One last thing – don’t forget daily sunscreen on your neck and decolletage. It really helps preserve your skin for the future.

62 year old with generally good skin but a little laxity. Have had Botox and skin boosters. For laxity around jowls would you recommend neogen or software?

Both NeoGen and Sofwave can be useful for tightening loose skin, I would recommend finding a great practitioner and asking them which of these devices would be more appropriate for your skin, take a look at the Find a Practitioner section to find a recommended practitioner in your area.

due to weight loss laxity and crepe-iness under my chin an on my neck I intend to have a full surgical neck lift but am currently reloosing some gained weight first. I am finding the neck very hard to live with and am considering going for some sort of high energy technique in the interim but I seem to remember Alice talked somewhere about some surgeons disliking eg ultherapy before a neck lift because it ‘mashes the skin together’ etc. are their any lifting Tweakments that don’t do this? For example Alice seemed very pleased with her results with the Profound RF treatment with Dr Shotter – does this method cause similar issues though? how serious is the trade off – would it make the neck lift significantly less good?

Hi, you’re right, cosmetic surgeons dislike patients having energy-based treatments (eg ultrasound, or RF needling) in the year or two before surgery because the way the treatment contracts and tightens up the collagen makes it trickier for them to do their job when it comes to separating the layers of the face or neck. Check this with your surgeon, but I’d hold off and wait for the surgery. I hear that you are finding your neck hard to live with but if you are looking at a surgical neck lift, you will find RF needling doesn’t give you the result you are looking for.