Confused about non-surgical treatments? Make sure you’re properly clued-up before taking the plunge. Industry expert Norman Waterhouse gives us the lowdown…

Words Norman Waterhouse

Non-Surgical Treatments

There is huge pressure on us all to be the best we can be, and this is reflected in the enormous increase in non-surgical treatments available. The growth in demand has come about largely as a result of an increase in effectiveness from the available treatments. Still however, there is a lot of pseudoscience around, and one needs to be wary of some non-surgical treatments that promise a lot, but in reality deliver little and may even be harmful.



Before you spend any money on skincare make sure you do the simple things properly. I always say that the most important thing you can possibly do for your skin is not to smoke. This is the single most helpful advice you can have in allowing your skin to stay young as you age.


The other critical issue is sun exposure. Although it is entirely normal to desire a light tan – and indeed it is important that we all have sufficient levels of vitamin D – it is also true that excessive sun exposure will age our skin. Not only does it cause structural changes within the skin, thinning it and losing elastic tissue, it also predisposes us to sun related spots, melasma and keratoses on the skin. As we get older, these can turn into cancerous growths. The reality is that to protect your skin you should wear a sunblock through all four seasons on a daily basis, and during the summer the SPF factor needs to be high (in the region of 50) to be effective.


Diet is also thought to be of great importance, and we all know that there is a strong lobby for vegetarianism, veganism and gluten-free diets claiming benefits for the skin. Whilst I believe that there are many toxins in food, particularly in processed foods that are very bad for our skin, in general I think anyone with a balanced nutritious diet should be receiving all the nutrients they need to maintain a clear skin. For some people, allergies may be an issue and it is well worthwhile having allergy tests if you suspect you may have a specific food allergy which may adversely affect your skin.


In terms of skincare, a cleanser and a moisturiser are fundamental. The next most important skincare product should be an antioxidant containing vitamin C. Although I do not like to specifically recommend brands, CE Ferulic by SkinCeuticals is an excellent product. It is important to realise that not everything that says vitamin C on the bottle will have an active ingredient.



Hydrafacials are one of the best non-surgical treatments for rehydrating the skin and giving a bloom to the complexion. At Waterhouse Young we offer Hydrafacials and also a skin resurfacing treatment call the Fire and Ice Facial, which is a mask that soothes and hydrates the skin. These treatments give an immediate result with smoother skin and refreshed appearance. They need to be repeated, but the wow factor is impressive.


As far as neurotoxins are concerned, there is a lot of misinformation, and the media often focuses on examples of the overuse of wrinkle relaxing injections (such as Botox). The reality is that Botox, like any other treatment, needs to be tailored and bespoke to suit individuals and is usually highly effective in improving appearance and reducing wrinkles, particularly around the forehead and lateral crow’s feet area.

An interesting development in Botox treatment is the recent innovation of “Micro Botox”. Micro Botox is essentially a treatment using exactly the same Botox as used in standard treatment but it is highly diluted and used all over the skin of the face and the neck. The use of Botox in this way is effective at gentle reduction of wrinkles, but is also useful both to reduce sweating and sebaceous gland activity. This often gives a dramatic glow to the skin and improves skin quality and appearance.


The whole issue of peels is a little ubiquitous. Essentially the deeper you go with the peel the more potential benefit, but also the more potential disadvantages and complications, including hyperpigmentation and hypopigmentation. Peels need to be thought about carefully and anyone starting to think about resurfacing should dip their toe in the water and start with very gentle fruit acid peels or extremely light peels. One step up is the 30% TCA peel, which can be highly effective in smoothing the skin and removing very minor wrinkles and blemishes. Again, only undertake peel treatment in the care of experienced aesthetic physicians and nurses.


Micro medical skin needling procedures can also be very helpful in stimulating the production of collagen and elastin. This is often helpful to improve the appearance of lines and wrinkles, sun damage and even some scarring. This is usually done with a derma roller, but again it is important to note that there are a number of micro-needling techniques which do not involve appropriate genuine derma roller equipment. It is essential that an appropriate derma roller is used to achieve the best results.


Be careful about fads. I have some major reservations about so-called ‘wonder’ treatments. These include PRP or the so-called vampire facelift, which as far as I am concerned has very little scientific basis to recommend it and has become an industry based on pseudoscience.

It is also true that to date we have been a little disappointed with the long-term results of thread lifts. I have used threads for a number of years now and there is no doubt that they can give rise to an impressive improvement in signs of internal gravitational ageing of the face, such as jowling and laxity in the neck. However, the reality is that these are not permanent treatments and the effect can last for a disappointingly small time. Many patients will report that the effect of threads last only two or three months and on this basis, it is important to realise this temporary nature of the improvement as the treatment itself can be quite expensive.

I do not wish to completely write off threads as I strongly believe that further technological improvement in this area may give rise to some therapies whereby the internal structure of the face can be affected without making cuts on the outside. However, at this moment in time there is no doubt that the gold standard to improve established gravitational changes of ageing, including neck laxity, bands in the neck, loss of the jawline, heavy nasolabial folds and descent of cheek tissue, remains a surgical facelift.


All in all, a sensible holistic approach needs to be taken to keep your skin in the best condition possible. This involves an assessment of your skin condition and a tailored bespoke programme that suits your skin type and expectations.

Enjoy this piece on non-surgical treatments? Don’t miss Absolutely’s round-up of the best spa destinations here.


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