Monthly Archives: February 2014

botox and its enemies

Dr Singh who runs his botox clinic in Stevenage, Hertfordshire, in his latest blog talks about what we can do to prolong the effects of our botox treatments.


By having botox injections we are either aiming to reduce or eliminate our fine lines or slow down the ageing process. Whatever your reason for having botox treatment, there are certain things you can avoid to help you maximise the effects of the botox treatment.


Alcohol – this is know to dry (dehydrate) the skin. In addition in excessive amounts alcohol could cause tiny red veins appear on your skin.


Smoking – this reduces the blood circulation and thus can stop collagen production. This can result in more fine lines and wrinkles, exactly the opposite effect you want when undertaking botox procedures.


Sleep – we need adequate sleep to allow the body and skin to rejuvenate and recover.


Diet – your skin complexion is directly affected by what you eat. You want to avoid an acidic diet (fast foods, nutrient poor food) and have a green based/alkaline diet.


Stress – when we get stresses, we release a hormone called adrenaline. This hormone reduces blood flow, which can lead to slower cell turnover, resulting in an aged face.


Sun – the best to last. This is the number one reason for premature ageing and I see this in the patients that request botox treatments from me. You must have adequate sun protection or the results of botox will be wasted.


For more information about botox hertfordshire, please call us on 01438 300111.



Botox Types

Dr Singh who runs his botox clinic in Stevenage, Hertfordshire, in his latest blog shares a extract from the CODE association regarding different types of botox and how to mix them.


Botulinum toxin type A

Botulinum toxin type A is a protein produced by the bacterium Clostridium Botulinum which reversibly paralyses muscle to smooth and soften the wrinkles caused by dynamic or hyperfunctional muscle activity. It acts by blocking the release of acetylcholine at nerve endings thus inhibiting muscle contraction. By selective injection, the lines caused by muscle activity such as crow’s feet or frown lines can be reduced; in most cases these lines soften and become less visible within a week to 10 days. Botulinum toxin type A is generally known as ‘Botox’ but the UK formulation that has recently received a licence for cosmetic use in the glabellar region is registered as Vistabel.


Dysport (Ipsen Ltd) is another commonly used formulation of botulinum toxin type A.



Vistabel is only licensed for the treatment of glabellar lines, which are the frown lines between the eyes. Use on any other areas of the face, e.g. crow’s feet, is still ‘off-licence’. You will need to make this clear to your patients if you intend to use it in areas that are outside the licensed indication.


Botox and Dysport can also be used in these unregistered indication areas, so long as you inform the patients (this should form part of the consultation process).


Approval of Vistabel for glabellar lines, however, does mean that you can assure patients about the proven safety profile of the product and substantiate claims with scientific data from properly conducted clinical studies. Vistabel is available in 50 unit vials, licensed for single patient use only, the vials have a purple label, a red lid and the Allergan hologram on the label.



A Botox vial contains 100 units of toxin and is usually used for more than one patient. In the UK, all uses of Botox for wrinkle treatments are off-licence.



A Dysport vial contains 500 units of toxin but the dose administered is 3-5 times higher than the dose of Botox or Vistabel for each area of skin treated. The treatment of wrinkles with Dysport is also an off-licence use. The CODE AFA Board currently recommends that Dsyport is used 3:1 compared with Botox and Vistabel units. E.g. if you need to use 4 units of Botox, you would use 12 units of Dysport, see the next section for further information.



We recommend that inexperienced users should reconstitute both Botox and Dysport with the same volume of preserved saline – 2.5 ml. The volume of product used in each area of the face will then be similar. (Note that Vistabel would require 1.25 ml.) For example one way of treating the glabellar region is:


5 injection sites – 1 in Procerus, 2 in each Corrugator


Total dose is 20 units of Botox or Vistabel, 4 units per injection site (0.5ml)


Total dose is 60 units of Dysport, 12 units Dysport per injection site (0.3ml)


With experience you may use different doses and dilutions to achieve optimal effects. The use of botulinum toxin is an art as well as a science, each practitioner develops their own techniques.




For more information about botox hertfordshire, please call us on 01438 300111.




botox – a long term option

Dr Singh who runs his botox clinic in Stevenage, Hertfordshire, in his latest blog talks about why when you have a botox treatment you have to look at the long term game.


Many patients ask me whether when they have their first botox injections, can they stop at anytime. I say, yes, you are not addicted to it and if you stop, you go back to where you were before. Then, I give them a word of warning and say because the effects of botox are so good, it is unusual that anyone would want to stop having botox treatments over a period of time. It is normally die to the affordability of the botox treatment that may prevent them having the botox as regularly as they wish and not because they are unhappy with the results.


When anyone embarks on a course of botox I will say we are looking at a 6 month treatment time. In this, I mean:


  • The first visit will consist of the botox consultation
  • They can either have the botox treatment at this first visit or go home and think about it
  • We will then have a 2 week botox review to look at the results and administer any botox top ups if required
  • We will follow up with a phone call after a month or so, just to check that everything is fine
  • We will then follow up again after 3 months and 6 months to see whether they need a top up of botox or not


During this period,, there are a number of things you can do to enhance and prolong the botox effects, these include such things as:


  • No exercise within 24 hours of your botox treatment
  • Avoid sun beds
  • Always wear sun protection
  • Either sleep on your back or have ‘softening’ pillows


Botox should never be seen as a standalone treatment for eliminating or softening unwanted lines or wrinkles. Botox is the miracle cure in terms of the results are relatively instant, but its how you look after your skin that will determine the long term benefits.


For more information about botox hertfordshire, please call us on 01438 300111.