Does Botox get rid of all wrinkles? Anon, Whenuapai Botox® is a clever tool used to paralyse muscles, so can tactfully be injected to stop skin from creasing. A common source of confusion however, is the extent to which Botox® can treat wrinkles. Two different types of wrinkles exist – dynamic and static. Dynamic lines are present when muscles are contracting during facial expression, so respond very well to Botox®. Static lines however are caused by repetitive contractions over time in conjunction with ageing, where skin and fat become thinner. The smoothening effect of these tissues is therefore diminished, leaving behind lines that stay there even after Botox® treatment. This can seem disheartening, however with repeated Botox® treatments, good skincare, injectable skin treatments and sun protection, pesky static lines can eventually fade. Botox® also indirectly stimulates skin cells (fibroblasts), leading to improved skin quality and a fresher appearance, regardless of how many static or dynamic lines are present. Facial expressions associated with negative emotions such as frowning are also minimised, leading to a lighter, positive demeanour. This is in turn causes re-wiring of our brains, triggering us to feel happier, and as we subconsciously mirror each other’s expressions, people around us feel happier too. The beauty of cosmetic treatments such as Botox® lies within its diversity and depth of action. Not only does it act on muscles, it also acts on our brains, in the most wonderfully positive way. In addition to its ability to stimulate skin cells, it is the perfect treatment for that refreshed glow we are all looking for. Quick Answers: Does Botox® get rid of all wrinkles? No. Botox® is most effective for wrinkles caused by muscle movement and does not instantly remove all static lines. What wrinkles does Botox® treat best? Botox® works best on dynamic wrinkles, which appear when muscles contract during facial expressions, such as frowning or squinting. What is the difference between dynamic and static wrinkles? Dynamic wrinkles appear with movement, while static wrinkles are present at rest and are caused by long-term muscle activity combined with ageing and skin thinning. Can Botox® improve static wrinkles over time? Yes. With repeated Botox® treatments, good skincare, injectable skin treatments, and sun protection, static lines can gradually soften. Does Botox® improve skin quality as well as wrinkles? Yes. Botox® can stimulate skin cells, improve skin quality, and contribute to a fresher, more radiant appearance. Can Botox® affect mood or facial expression? Yes. By reducing frowning and other negative expressions, Botox® can influence emotional feedback pathways and contribute to a lighter, more positive demeanour. If you have a question for Dr. Heather you would like answered anonymously, please email askdrheather@allor.co.nz Written by Dr. Heather Anderson, MBChB, BSc, FRNZCUC, PGDip Cosmetic Medicine, NZSCM | ALLOR Cosmetic Medicine, Auckland Botulinum toxin injections are prescription only medicine for the treatment of frown lines, horizontal forehead lines, and crow’s feet round the eyes. Botulinum toxin injections have risks and benefits. Ask your doctor if botulinum toxin injections are right for you. If you have side effects, see your doctor. You will need to pay for your botulinum toxin injections and clinic fees will apply. For details on precautions and side effects consult your doctor or go to www.medsafe.govt.nz. Botulinum toxin injections last about 4 months and further courses of treatment may be necessary. Should only be administered by trained medical professionals. Botox®, Prescription Medicine For the treatment of frown lines and crow’s feet around the eyes. Botox® has risks and benefits. Ask your doctor if Botox is right for you. Botulinum toxin type A 50, 100, 200 Units. For product information check with your doctor or Consumer Medicine Information on www.medsafe.govt.nz. Click for further details. Allergan, Auckland.

If you’ve been curious about softer, subtler options for smoothing wrinkles, you might have heard about something called Baby Botox®. Baby Botox® is a treatment that uses smaller doses of Botox® to gently soften lines, while keeping your natural look and facial movement. People often tell me they want to look well-rested and not dramatically different, and that’s exactly what this trend is all about. By using less product, Baby Botox® can give the skin a smooth, fresh feeling without making you look like you’ve had anything “done.” That touch of freshness - without giveaway shine or stiffness - has made this approach especially popular with people who value a natural appearance but still want results. If you’ve ever hesitated about more traditional Botox® because you worried about looking too stiff or losing your expressions, Baby Botox® might be a gentle introduction. I find that it’s a helpful option for anyone just starting out with wrinkle relaxers, or for those who want to maintain a softer look. What is Baby Botox® and How is it Different? Baby Botox® is a cosmetic treatment that uses smaller, more precise doses of Botulinum toxin type A than traditional Botox®. This approach aims for a softer refresh, allowing facial movement and subtle expressions to shine through. Baby Botox® can also be injected directly into the skin to tighten pores and improve skin texture. Comparing Baby Botox® to Traditional Botox® Traditional Botox® treatments often focus on smoothing out deeper lines and freezing muscle action in targeted facial areas to create a smooth surface, especially in areas like the forehead, frown lines, and around the eyes. Baby Botox® uses the same botulinum toxin type A, but with smaller doses. By reducing the amount injected with each treatment, patients tend to see subtle, natural results. Facial expressions remain soft as movement isn’t as restricted. Here’s a simple table for a side-by-side look Why Choose a Subtle Approach? Many people - especially younger adults or those new to cosmetic procedures want a gentle refresh where lines are softened without that “frozen” look. With Baby Botox®, tiny tweaks deliver a subtler finish. Crow’s feet soften, but your laughter still shows. Frown lines ease, but you don’t look motionless. Some people even use it as a preventative, starting early to keep fine lines from deepening as they age. It’s worth noting, though, that Baby Botox® will not offer as dramatic a result for more obvious wrinkles and longevity of results will be less than that of traditional Botox®. The right choice depends on your goals and how much correction you want to see. Understanding the Technique The Baby Botox® technique is really about precision and balance. I use a subtler approach, spacing out small amounts of botulinum toxin in very careful spots beneath the skin. This allows me to soften specific lines - like around the eyes or forehead - without flattening out your natural expressions. Each treatment is a little different, tailored to what you actually need, rather than relying on a one-size-fits-all pattern. Most people notice the effects within a few days, with peak effect expected at two weeks. The results tend to last up to three to four months, depending on dosage used (higher doses last longer). Dose adjustments can be made at subsequent appointments to suit any changing needs or preferences. Baby Botox® Treatment Experience Baby Botox® isn’t just about smoothing lines - it’s a blend of personal goals, tailored care, and subtle changes that still look natural. Each step, from the first conversation to the days after your appointment, is shaped to your needs and comfort. What Happens During a Consultation? When I meet with someone for a Baby Botox® consultation, I start by asking about their goals and what concerns they’d like to address. There’s no pressure and definitely no rush to have any treatments. You get the chance to show me the areas you’re noticing changes, whether that’s faint lines, forehead movement, or a general wish for softer expression. I ask about your medical history, any previous injectables you’ve tried, and what you hope to achieve. We talk openly about the risks and benefits so you feel confident about both the science behind the treatment and what results we expect you to experience. By the end, I give you a clear treatment plan, an idea of the Baby Botox® cost involved, and answer any questions you might have. How an Appointment Unfolds Once we’ve settled on a treatment plan and you’re ready, the actual appointment usually takes less than 30 minutes. I ask you to gently move your face - raise your eyebrows, frown, smile - so I can see those little dynamic lines in action. It’s a bit like seeing where paint would settle on a canvas. I use a fine needle and carefully inject very small amounts of Botulinum toxin into specific muscles. This is the key difference with Baby Botox®: much lower doses are used compared to traditional treatments, which helps you keep your natural expressions. Most people say the sensation is mild, like a tiny pinch or a mosquito bite. I check in on your comfort the entire time and can use numbing cream and/or a distraction tool if you’re sensitive. Afterwards I apply a clean, tinted SPF and you’re usually able to head back to your day straightaway. Aftercare instructions are provided detailing what to expect and what activities to avoid in the days following your treatment, with a contact number in case you have any questions or concerns. Your First Few Days After Treatment Most people find that the first days after Baby Botox® are uneventful. There may be a little redness or swelling at the injection sites, but it fades quickly. Sometimes there’s a light bruise, but it’s small and easy to cover with make-up. I advise avoiding heavy exercise, rubbing the area, or lying on your face for about 48 hours after your treatment. This helps the product settle just where it’s supposed to. You can wash your face gently and go about most other normal activities. Within three to seven days, you’ll start to notice the softening of lines, but not a frozen or “done” look. You’ll still look like yourself - just a little fresher. If you have any concerns, I’m always just a phone call or message away. Areas Treated and Results you can Expect Baby Botox® is designed for small, precise improvements in facial lines and subtle changes that keep natural muscle movement. By targeting specific muscle groups, it can soften lines and wrinkles without freezing your expressions or creating an artificial look. Natural-Looking Changes Most people who come to me want to look like themselves - just a bit more refreshed. Baby Botox® is about supporting your own facial expressions rather than hiding them and keeping your skin looking its best. I focus on preserving your unique features and making sure movement is never frozen. One thing I notice: the best results are the ones where nobody can quite put their finger on what’s different. There's improved smoothness, but you can still smile, frown, or laugh as you always have. That’s why I always start conservatively and adjust based on your specific anatomy and goals. If you’re worried about losing your natural charm or looking too “done,” Baby Botox® is a good option to explore. We can always add more, but starting with less is the gentlest path to subtle changes. Results will gradually fade, making it easy to decide when you’d like another treatment. This flexibility is actually one of the reasons both younger patients and seasoned Botox® regulars like it. Creating a Maintenance Plan If your goal is to keep your skin looking consistently smooth, a regular schedule helps. Most people find that booking touch-up treatments every 3 or 4 months works well. These appointments don’t have to be set in stone, but keeping a routine does make a difference for ongoing results. Think of maintenance as “topping up” your treatment before old lines creep back in. A steady approach can mean you need fewer units each visit, and you’ll avoid the cycle of peaks and valleys that sometimes happen with longer gaps in between. This also gives you a sense of control with your anti-aging plan, so you’re never caught off guard. I also suggest reviewing your plan together at each visit, especially if you notice changes in how your skin responds or if your lifestyle shifts. Treatments should always fit where you are right now, not just what worked last year. Using Baby Botox® as a Preventative Measure There’s a growing trend of people in their 20s and 30s starting Baby Botox® before deep lines form. The thinking here isn’t just about turning back the clock, but slowing it down a little. By gently relaxing the muscles that cause expression lines, smaller doses can help prevent fine lines from setting in as strongly over time. This preventative approach is subtle - it doesn’t mean you’ll look like you’ve “had work done.” Instead, it’s like smoothing a piece of paper just before it gets creased. You stay looking naturally yourself, just with less wear showing in the usual places. Not everyone needs to start early. It depends on your family history, how expressive your face is, and your personal preferences when it comes to anti-aging. I always encourage an open conversation about your goals so we can make sure your plan feels right for you. Safety, Side Effects, and Recovery Like many aesthetic treatments, Baby Botox® is generally considered safe when performed by a qualified professional. There are a few side effects you’ll want to be aware of, and the recovery process is almost always straightforward, with little to no downtime required. Possible Side Effects to Know Most people experience only mild and temporary discomfort after Baby Botox®. The ones I see most often are a little redness or swelling where the needle went in. Sometimes, people notice a bit of bruising, which is a lot like what you might get after a standard blood test or injection. If you’re unlucky, you might have a mild headache or feel slightly achy for a short time after your treatment. These usually settle with simple pain relief such as paracetamol within a day or two without needing any special treatment. Some notice the area feels a bit tight or odd for a while, but this sensation fades as the product settles in. Very rarely, more significant issues like eyelid drooping or persistent discomfort can happen, but these aren’t the norm - especially when you’re seeing someone with skill and experience. If anything feels off, it’s always worth checking in, just to be on the safe side. Prioritising Safety and Comfort When it comes to safety, who you see matters more than anything. I always recommend checking your practitioner’s qualifications and not being afraid to ask about their experience. Good technique and clean conditions reduce the chance of infection, pain, or unusual side effects. If you’re nervous about discomfort, you can ask for numbing cream, but most people find the treatment very tolerable - like a quick pinch. I always take time to explain what to expect so you feel informed and relaxed beforehand. Your comfort is my priority throughout, not just during the injections. If you have questions, want to pause, or need reassurance, it’s completely okay to speak up. Feeling looked after is just as important as the results themselves. Questions to Ask and Alternatives to Consider Deciding on Baby Botox® isn’t just about saying yes or no. It helps to get curious about your goals, understand what goes into the treatment, and know what other options are available when it comes to smoothing lines or keeping your look fresh. Is Baby Botox® Right for your Goals? When people ask me about Baby Botox®, the first thing I want to know is what they’re hoping to achieve. If the goal is to gently soften fine lines while keeping as much natural movement as possible, this treatment might be a good fit. Some people imagine Baby Botox® as a preventative tool, starting in their late twenties or early thirties to slow down the development of wrinkles. Others are looking for a subtle refresh, rather than a dramatic change. In both cases, clear communication with the injector is essential. Asking the right questions helps set realistic expectations. I encourage people to be honest - What areas are you most concerned about? Are you open to just a little improvement, or looking for something more noticeable? Every face is unique, and so is every decision in aesthetic procedures. Making sense of Dosage and Price The “baby” in Baby Botox® really comes down to the amount of product used. While standard Botox® treatments rely on regular doses to freeze larger muscles, Baby Botox® uses smaller, precisely-placed amounts. This gives softer results with less risk of a stiff or “frozen” look. Pricing can vary quite a bit. Clinics often charge per unit, so the fewer units needed, the lower the cost - at least in theory. But costs add up with multiple areas or repeated touch-ups. It’s worth asking: How many units will I likely need for my goals? Will more frequent visits end up costing about the same as a traditional treatment? Here’s a quick comparison Feel free to use this as a way to start the conversation at your consultation. Considering Fillers and Other Injectables Botox® isn’t the only player in town, and sometimes the best result comes from combining options. Dermal fillers, for example, can restore volume in cheeks or lips and fill deeper lines that even Botox® can’t touch. Think of them as the plump to Botox’s smooth. There are also newer injectables, like Profhilo® and NCTF®, or even non-injectable treatments for boosting collagen such as microneedling and chemical peels. Each has pros and cons, and some people rotate between several. If you’re curious about what would work best - or just want to compare - bring this up with your provider. Sometimes a tailored blend gives the best and most natural outcome. Written by Dr. Heather Anderson, MBChB, BSc, FRNZCUC, PGDip Cosmetic Medicine, NZSCM | ALLOR Cosmetic Medicine, Auckland Botox®, Prescription Medicine For the treatment of frown lines and crow’s feet around the eyes. Botox® has risks and benefits. Ask your doctor if Botox is right for you. Botulinum toxin type A 50, 100, 200 Units. For product information check with your doctor or Consumer Medicine Information on www.medsafe.govt.nz. Click for further details. Allergan, Auckland. ART FILLER® containing low & high molecular weight hyaluronic acid, is a Class III medical device for the treatment of facial contours for redefinition, laxity and remodelling where skin laxity is a problem. ART FILLER® has risks and benefits. Do not use with treatments such a laser resurfacing or medium deep skin-peeling. Caution in people on blood thinning medicines. Do not inject into inflamed areas or intravenously or intramuscularly. Possible side effects: pain and swelling at injection site. Distributed by Cryomed Aesthetics Ltd. Auckland. PROFHILO® containing low & high molecular weight hyaluronic acid, is a Class III medical device for the treatment of the face and body for contours redefinition and laxity remodelling where skin laxity is a problem. Profhilo® has risks and benefits. Do not use with treatments such a laser resurfacing or medium deep skin-peeling. Caution in people on blood thinning medicines. Do not inject into inflamed areas or intravenously or intramuscularly. Possible side effects: pain and swelling at injection site. Accelagen Pty. Ltd. Whanganui. Dermal Filler, Medical Device Class III to smooth facial wrinkles and folds, correct facial atrophic scars, restore or enhance the lips or restore facial volume. Dermal filler has risk and benefits. Ask your doctor if dermal filler is right for you. For product information check with your doctor or from product details with the supplier.

I've noticed more brown spots on my skin in the past few months and was wondering what I can do to get rid of them? Anon, Whenuapai Brown spots can be very frustrating and are common at the end of Summer (cue crying emoji face). All the wonderful long sunny days pepper us with bits of ultraviolet radiation, even when wearing sunscreen. Now that's not to say SPF isn't necessary (if anything it shows just how necessary it is), but even with the best sun protection, we can develop unwanted pigmentation just from the increased exposure over the glorious long days of daylight savings. Thankfully there are treatments that can help. Chemical peels in particular are wonderful at lifting pigmentation, and as the weather cools, they are the perfect treatment as we start to spend more time inside. Peels also are fantastic for anti-ageing as they remove old skin and expose fresh, clearer baby skin. Winter glow anyone? The real key to a successful peel is for skin to be prepared with the right skincare in the weeks prior to ensure it is ready for pigment removal, followed by maintenance after the peel to sustain results. Just as the old, brown leaves shed off the trees in Autumn to make way for new growth, you too can shed old aged cells to reveal a glowy new you. After all, we have to make most of all the seasons of life, even if it means cold weather (cue crying emoji face). Quick Answers: What causes brown spots on the skin? Brown spots are usually caused by sun exposure. Ultraviolet (UV) radiation triggers excess pigment production, which often becomes more noticeable after summer. Can brown spots appear even if I use sunscreen? Yes. Sunscreen is essential, but increased daylight and cumulative sun exposure can still lead to pigmentation over time. What treatments help reduce brown spots? Chemical peels are particularly effective at lifting pigmentation and improving skin clarity, especially in the cooler months. Why is autumn or winter the best time to treat pigmentation? Cooler seasons mean less sun exposure, which reduces the risk of new pigmentation forming while the skin is healing. Do I need to prepare my skin before pigmentation treatments? Yes. Preparing the skin with the right skincare beforehand and maintaining results after treatment is key to successful pigment reduction. Can treating brown spots also improve skin quality? Yes. Treatments like chemical peels not only reduce pigmentation but also refresh the skin, improve texture, and support anti-ageing. If you have a question for Dr. Heather you would like answered anonymously, please email askdrheather@allor.co.nz. Written by Dr. Heather Anderson, MBChB, BSc, FRNZCUC, PGDip Cosmetic Medicine, NZSCM | ALLOR Cosmetic Medicine, Auckland

Can men get cosmetic treatments too? Anon, Riverhead Ask Dr. Heather Column Absolutely! Cosmetic treatments are for everyone, regardless of gender. Men generally don't talk about it as much, but there are plenty who like a wee tweak now and then to keep them looking and feeling their best (Brad Pitt anyone?). Fortunately the stigma of cosmetic treatments is diminishing, however it can still feel stigmatised for some, especially men. Discretion is key and something every injector should adhere to as dictated by the Health and Disability Code of Rights. You should also never feel judged by your injector. Our journeys are personal, so always choose someone who makes you feel safe, comfortable, seen and heard. If any of those niggly uneasy feelings surface, best to move on as our intuition is a great guide to picking out what is right for us. Every gender requires a different approach, as masculine and feminine features manifest differently in our faces. Feminine features include wider cheekbones and fuller cheeks whereas masculine features include a wider jaw in line with cheekbones and flatter cheeks. Understanding and appreciating these differences applies to men, women and gender diverse individuals. All facial features must be respected and discussed, so you feel confident your goals are addressed. Skin quality should also be taken into consideration. We are all humans who deserve to feel great in our skin, regardless of gender, ethnicity or age. It all depends on your priorities and your injector must respect these and involve you at every step, in a kind, discrete way. Quick Answers: Can men get cosmetic treatments? Yes. Cosmetic treatments are suitable for men and can help improve confidence, refresh appearance, and support skin health. Are cosmetic treatments for men different from those for women? Yes. Men and women have different facial structures, so treatments are tailored to respect masculine features such as jaw width, flatter cheeks, and overall facial balance. What cosmetic treatments are popular with men? Common options include anti-wrinkle injections, dermal filler for structure, and skin treatments to improve skin quality and texture. Is cosmetic treatment for men still stigmatised? Less than it used to be, but some men still feel hesitant. Discretion and privacy are important parts of good cosmetic care. Should I feel judged when asking about cosmetic treatments? No. You should never feel judged. A good injector will make you feel comfortable, respected, and involved in every decision. How do I choose the right injector for men’s cosmetic treatments? Choose an injector who understands male facial anatomy, respects your goals, and prioritises natural, discreet results. If you have a question for Dr. Heather you would like answered anonymously, please email askdrheather@allor.co.nz. Written by Dr. Heather Anderson, MBChB, BSc, FRNZCUC, PGDip Cosmetic Medicine, NZSCM | ALLOR Cosmetic Medicine, Auckland Dermal Filler, Medical Device Class III to smooth facial wrinkles and folds, correct facial atrophic scars, restore or enhance the lips or restore facial volume. Dermal filler has risk and benefits. Ask your doctor if dermal filler is right for you. For product information check with your doctor or from product details with the supplier. Botulinum toxin injections are prescription only medicine for the treatment of frown lines, horizontal forehead lines, and crow’s feet round the eyes. Botulinum toxin injections have risks and benefits. Ask your doctor if botulinum toxin injections are right for you. If you have side effects, see your doctor. You will need to pay for your botulinum toxin injections and clinic fees will apply. For details on precautions and side effects consult your doctor or go to www.medsafe.govt.nz. Botulinum toxin injections last about 4 months and further courses of treatment may be necessary. Should only be administered by trained medical professionals.

I’m struggling to sleep as Christmas approaches, any tips? Anon, Whenuapai The holiday season can be stressful. Events, presents, gatherings, spending time with people you may not want to, it’s a lot. Squeezing in too many things can make us feel the weight of the world on our shoulders, and this commonly leads to poor sleep. Sleep hygiene is a great place to start when trying to achieve more slumber. It is where we do things to encourage our body clock to tick as it should, so we secrete the right amounts of the hormone melatonin and therefore achieve quality sleep. This means getting up and going to bed at the same time each day (easier said than done when there are presents to wrap). If that is difficult to achieve during the holidays, other tweaks such as exposing yourself to natural daylight as soon as you wake and darkening your bedroom with block out curtains can help. Our bodies like to be between 16 and 18 degrees Celsius for optimal sleep, so unless you have air conditioning (heaven!), it would be sensible to invest in a fan. There are clever mattress protectors that cool when you touch them, so are also a great option. A cold shower just before bed and sleeping with your hair wet is a great way to lower and maintain core body temperature as well - much easier to achieve if you start warm then go cold right at the end for a minute or so. Cold showers are also fantastic for stimulating release of anti-ageing proteins, strengthening the immune system, releasing endorphins and stimulating production of brown fat (fat that keeps us warm and helps us lose weight). A great option to add to your routine for multiple benefits – I now miss it if I don’t go cold at the end of my showers! Other great ways of stimulating sleep is to exercise during the day (a good walk can do wonders), avoid daytime naps and reduce blue light exposure from screens before bed. Avoiding caffeine at least 6 hours before bed is also recommended, as is having a solid bedtime routine, where you wind down with same sequence of events. A great example would be a cold shower, reading a book, meditating and a non-caffeinated tea such as chamomile. Writing a list of things you need to do to remove them from your mind is also a great way to minimize brain chatter when lying in bed. If these fail, the next step would be to have a chat with your family Doctor about medications and to address any other possible causes of insomnia, such as anxiety or thyroid dysfunction. Sleep is something we don’t miss until it’s gone. Sleep disruption is common, especially around the holidays so remember to be kind to yourself. Sometimes letting go of our own self-criticism can unlock the barriers we have with sleep, allowing a much more enjoyable slumber and holiday season. Quick Answers: Why do I struggle to sleep during the holidays? Holiday stress, overcommitment, and disrupted routines commonly interfere with sleep and can lead to short-term insomnia. What is the best way to improve sleep during the holidays? Focus on good sleep hygiene. Keep consistent sleep and wake times where possible, get daylight exposure in the morning, and darken your bedroom at night. What temperature is best for sleep? Most people sleep best in a cool room, ideally around 16–18°C, as a lower core body temperature supports melatonin release. Can cooling techniques help with insomnia? Yes. Using a fan, cooling bedding, or taking a cold shower before bed can help lower body temperature and promote sleep. What habits should I avoid if I can’t sleep? Avoid caffeine within 6 hours of bedtime, limit screen use before bed, avoid daytime naps, and reduce blue light exposure in the evening. When should I talk to my GP about insomnia? If sleep problems persist despite good sleep habits, or if anxiety or medical causes are suspected, your GP can help assess and discuss treatment options. If you have a question for Dr. Heather you would like answered anonymously, please email askdrheather@allor.co.nz. Written by Dr. Heather Anderson, MBChB, BSc, FRNZCUC, PGDip Cosmetic Medicine, NZSCM | ALLOR Cosmetic Medicine, Auckland

Can Botox® be used for sweating? Anon, Kumeu Botulinum toxin (commonly known as Botox®) is a versatile beast. In addition to its well-known function of relaxing muscles, it can also stop sweat glands from working so is a great treatment for sweating. When injected at a superficial depth (very close to the surface of the skin), it acts to interfere with sweat glands and results can last up to 6-9 months. It is particularly helpful for those who experience excessive sweating (hyperhidrosis), which can affect a variety of areas including armpits, hands, feet and face. The very superficial nature of the injections minimize muscle involvement, however sometimes muscles close to the skin surface are also weakened, so a tailored approach is needed to ensure treatment is appropriate. It is also important to ensure your injector is confident other causes of hyperhidrosis have been excluded such as tumour, thyroid disturbance, medications and diabetes. If any doubt, it is always best to check with your GP in the first instance. As the warmer months approach (yay!), so too does sweating. This can be embarrassing and affect quality of life significantly. It is helpful to know reliable treatments for this exist and our good ol’ friend Botox® can help us once again. Quick Answers: Can Botox® be used to treat excessive sweating? Yes. Botox® can block the signals to sweat glands and is an effective treatment for excessive sweating (hyperhidrosis). How does Botox® reduce sweating? When injected very superficially, Botox® interferes with sweat gland activity rather than muscle movement, reducing sweat production. How long does Botox® for sweating last? Results can last 6–9 months, which is often longer than cosmetic Botox® used for wrinkles. Which areas can be treated with Botox® for sweating? Common areas include the armpits, hands, feet, and face, depending on where excessive sweating occurs. Is Botox® for sweating safe? Yes, when performed by an experienced practitioner using correct technique. Treatment must be tailored to avoid unwanted muscle weakness. Should other causes of excessive sweating be ruled out first? Yes. Conditions such as thyroid problems, medication effects, diabetes, or rare tumours should be excluded, and a GP review is recommended if there is any doubt. If you have a question for Dr. Heather you would like answered anonymously, please email askdrheather@allor.co.nz. Written by Dr. Heather Anderson, MBChB, BSc, FRNZCUC, PGDip Cosmetic Medicine, NZSCM | ALLOR Cosmetic Medicine, Auckland Botox®, Prescription Medicine For the treatment of frown lines and crow’s feet around the eyes. Botox® has risks and benefits. Ask your doctor if Botox is right for you. Botulinum toxin type A 50, 100, 200 Units. For product information check with your doctor or Consumer Medicine Information on www.medsafe.govt.nz. Click for further details. Allergan, Auckland.

How long does Botox® last? Anon, Whenuapai. Botulinum toxin, more commonly known at Botox® is a neurotoxin that relaxes muscles. It is injected in different areas at different doses, in order to target muscles we no longer want to contract. Results tend to last approximately 3-4 months, however this is dependent on a few factors. Some injectors (and companies) argue certain brands of Botulinum toxin last longer than others, however research has consistently shown dose injected is the most important factor, as the higher the doses used, the longer results last. Higher doses however are associated with more muscle paralysis, so a more “frozen” look, which can appear less natural. A more targeted approach to individual anatomy can also yield longer results as no unit of toxin is wasted on muscles that do not need treatment. Even though typical results last 3-4 months, repeat treatments often aren’t required for a bit longer as the facial muscles take time to re-train and catch up to the rest of the face to resume normal expression. This means one can often obtain 5-6 months of longevity out of their anti-wrinkle treatments, which has the added benefit of allowing muscles to regain full strength before repeat treatment, so are less likely to waste and lead to an odd appearance long term. It is also fantastic for the budget! Utilizing evidence-based products from reputable brands that are reconstituted correctly, not expired and stored correctly will also enhance results. It is always important to ask your injector what they use and why, and check they store their products correctly. Make sure you also keep an eye on long-term changes in your face as result of anti-wrinkle injections, as repeated high-dose treatments when not required can often lead to heaviness and/or an odd appearance with strengthening of other muscles in order to maintain normal facial expression. Quick Answers: How long does Botox® last on average? Botox® typically lasts around 3–4 months, although this can vary between individuals. What factors affect how long Botox® lasts? The dose used, injection technique, and individual muscle strength all influence how long results last. Higher doses tend to last longer but can look less natural. Do different Botox® brands last longer than others? Not usually. Research shows that dose matters more than brand, with higher doses producing longer-lasting effects. Can Botox® last longer with repeat treatments? Yes. With repeat treatments, muscles often take longer to regain full strength, meaning results can last 5–6 months for some people. Is it better to wait until Botox® fully wears off before repeating treatment? Often, yes. Allowing muscles to fully recover can reduce the risk of long-term muscle wasting and help maintain a more natural appearance. Does product quality affect how long Botox® lasts? Yes. Using reputable brands known to be stored, reconstituted, and injected correctly can help optimise results and longevity. If you have a question for Dr. Heather you would like answered anonymously, please email askdrheather@allor.co.nz. Written by Dr. Heather Anderson, MBChB, BSc, FRNZCUC, PGDip Cosmetic Medicine, NZSCM | ALLOR Cosmetic Medicine, Auckland Botox®, Prescription Medicine For the treatment of frown lines and crow’s feet around the eyes. Botox® has risks and benefits. Ask your doctor if Botox is right for you. Botulinum toxin type A 50, 100, 200 Units. For product information check with your doctor or Consumer Medicine Information on www.medsafe.govt.nz. Click for further details. Allergan, Auckland.

What is the best skincare regime? Anon, Whenuapai. Skincare is complex. There is a lot of noise in the market with zero regulation. Most of us start (and often continue) a very basic regime inspired by supermarket shelves, television adverts and people we know. I myself have been victim of using all the no-no things including face cloths, soap and the dreaded St Ives Apricot Scrub. A good regime consists of a few basics. Firstly, a pH balanced cleanser should be used to gently cleanse the skin without compromising the naturally acidic skin barrier. It doesn’t really matter what product you use if the pH is balanced, however be weary of marketing ploys such as foam (foam does not equal better cleaning) and addition of ingredients such a hyaluronic acid as they are washed away during the cleansing process. After cleansing, application of an antioxidant serum is a great idea. Vitamin C is a fantastic option for daytime as it is great for environmental protection, minimising pigmentation and encouraging collagen production. A good alternative for day (or nighttime) is Vitamin B, which helps minimise wrinkles, improve skin tone and also acts to enhance collagen production. Another great serum for nighttime is the famous Vitamin A, AKA, retinol. The hero ingredient to any skincare regime, this powerful micro-nutrient speeds up skin cell turnover, minimises pigmentation, reduces acne, stimulates collagen production and diminishes wrinkles. Care must be taken when starting retinol however as it can cause skin irritation, so staggering its use initially and slowly building to nightly application is recommended. Many products on the market claim to contain retinol, however shop around as some instead contain very weak retinoid esters (retinyl palmitate, retinyl acetate and retinyl linoleate), that take many years of consistent use to have effect. On top of serums, one should then apply a quality moisturiser that suits your skin type. Dry skin needs thicker moisturisers, whereas oily skin prefers oil-free concoctions. Choose something that smells and feels good and be sure to also apply it on the neck and backs of the hands as these areas are often neglected and eventually become telltale signs of a person’s true age (you’ll start noticing those celebrity close-ups now). Finally, during the day don’t forget SPF! Super important to minimise ageing as the harsh ultraviolet rays from the sun (on cloudy and clear days) will undo all the good work you do with your skincare regime. Just be sure to pick a product that you like that doesn’t make you look and feel like a greaseball. Everyone can benefit from a good skincare regime; the key is to understand the basics and resist marketing tactics by big brands. A good rule of thumb is if it’s advertised in mainstream media, it probably isn’t worth your time (and money) as quality products don’t need big advertisements to demonstrate their worth. Quick Answers: What is the best skincare routine? There is no single best routine. An effective skincare regime is built around a few core steps tailored to your skin type. What are the essential steps in a daily skincare routine? A good routine includes a pH-balanced cleanser, targeted serums, a moisturiser suited to your skin type, and daily sunscreen. What cleanser should I use for healthy skin? Use a gentle, pH-balanced cleanser that cleans the skin without stripping the natural skin barrier. Foam and added “hero” ingredients do not mean better cleansing. Which serums are most important in a skincare regime? Vitamin C or B serums are useful during the day for protection and collagen support, while Vitamin A (retinol) is best at night for cell turnover, acne control, pigmentation, and wrinkle reduction. How should I start using retinol safely? Introduce retinol slowly. Start a few nights per week and build up gradually to avoid irritation. Is moisturiser necessary if my skin is oily? Yes. Oily skin still needs moisturiser, but lighter, oil-free formulas are usually best. Why is sunscreen essential in a skincare routine? Daily sunscreen protects against UV damage, which accelerates ageing and can undo the benefits of even the best skincare products. If you have a question for Dr. Heather you would like answered anonymously, please email askdrheather@allor.co.nz. Written by Dr. Heather Anderson, MBChB, BSc, FRNZCUC, PGDip Cosmetic Medicine, NZSCM | ALLOR Cosmetic Medicine, Auckland

What is filler made of? Anon, Whenuapai. Dermal filler is commonly made of Hyaluronic Acid (HA). HA naturally occurs in our tissues and attracts water to help hydrate them. Filler contains artificially made HA, chemically bonded together with various degrees of cross-linking to create different gels. The more cross-linked a filler, the firmer the gel. The firmer the gel, the longer it lasts in tissues and the better it is as mimicking bone lost to ageing. Different fillers are injected into different areas of the face to replace lost tissue. When done appropriately, this leads to a harmonious, natural result where it is difficult to tell if someone has had “work” done. Too much filler leads to a puffy overdone look, as does too firm filler too close to the skin’s surface as modelled by many in the media (think girls of “Married At First Sight Australia”). HA filler can be dissolved with the enzyme Hyaluronidase, also a naturally occurring entity we make in our tissues. Cosmetic injectors should always have this at hand for dissolving HA filler in cases of emergency such as blocked blood vessels, as well as correcting overdone or undesirable results. Irreversible fillers such as calcium hydroxyapatite are used less frequently; the latter used more commonly for skin rejuvenation and reduction in fine lines, although some also use it to alter facial structure. Historically fillers such as silicone have been injected, however thankfully this is no longer a common occurrence as a raft of complications have been described with its use including chronic inflammation, lumps, swelling and skin changes. The world of fillers is a rapidly growing one. Products are becoming increasingly safer with better testing leading to improved outcomes. Better results are achieved by injectors who appreciate the nuances of these products existing amongst a saturated market, coupled with their technical skills. Just as our faces are multifaceted, so too should be our injectors. Quick Answers: What is dermal filler made of? Most dermal fillers are made from hyaluronic acid (HA), a substance that naturally occurs in the body and helps attract and retain moisture in the skin. Is hyaluronic acid filler safe to use in the face? Yes. When used by a trained practitioner, HA fillers are well studied, biocompatible, and widely used in cosmetic medicine. Why are some dermal fillers firmer than others? Fillers vary in how much they are cross-linked. More cross-linking creates a firmer gel, which lasts longer and is better suited to deeper structural support. Can dermal filler be dissolved if needed? Yes. Hyaluronic acid filler can be dissolved using hyaluronidase, an enzyme that naturally exists in the body and should always be available to cosmetic injectors. Are all dermal fillers reversible? No. Some fillers, such as calcium hydroxyapatite, are not reversible and are used more selectively, often for skin rejuvenation rather than major structural change. Why do some people look overfilled? Overfilled results can occur when too much filler is used, the wrong type of filler is chosen, or it is placed too close to the skin’s surface. If you have a question for Dr. Heather you would like answered anonymously, please email askdrheather@allor.co.nz. Written by Dr. Heather Anderson, MBChB, BSc, FRNZCUC, PGDip Cosmetic Medicine, NZSCM | ALLOR Cosmetic Medicine, Auckland Dermal Filler, Medical Device Class III to smooth facial wrinkles and folds, correct facial atrophic scars, restore or enhance the lips or restore facial volume. Dermal filler has risk and benefits. Ask your doctor if dermal filler is right for you. For product information check with your doctor or from product details with the supplier.

What is the best treatment for acne? Anon, Kumeu. Acne is a frustrating beast. It can rear its ugly face at all ages and can fluctuate at different stages of our lives. Back in the infomercial days of acne skincare, many of us will remember the “miraculous” treatments all the popstars used that seemingly served to only irritate our skin, without any real solution (sorry Beibs). Several types of acne exist, all relating to different stages of hair follicle blockage and inflammation. These stages are referred to as Comedomal Acne (red spots and blackheads), Acne Vulgaris (pimples and blackheads), and Nodulocystic Acne (angry red pimples and sores). Often an array of these features co-exist, and are further categorized as mild, moderate and severe. Treating hormonal imbalances, tweaking medications, restricting the use of occlusive cosmetic products and reducing intake of dairy and high GI foods can all help as a starting point to minimizing acne. Cleansing the face twice daily with a pH-balanced cleanser, ideally containing salicylic acid is the next step, followed by use of topical Retinol (Vitamin A). The latter is famous for not only controlling acne, but also sports marvelous anti-ageing effects, plumping skin and evening pigmentation. Hardy versions of retinol are available on prescription. Chemical peels and microneedling can also help settle the skin; however need to be done on skin without active infection present. Failing that, oral medication such as doxycycline and isotretinoin (Roaccutane) are an option to really help things clear. Like any oral medication, these must be prescribed by a Doctor and monitored closely to ensure safety and adequate response. As acne clears and scars emerge, these too can be minimized by treatments such as chemical peels and microneedling. As complex as acne can be, advancements in skincare, topical and oral medications have thankfully altered the course of how we can treat this problem. Goodbye pizza face, hello smoothness! Quick Answers: What is the best treatment for acne? There is no single best treatment for acne. The right approach depends on the type and severity of acne and often involves a combination of skincare, lifestyle changes, and medical treatment. What types of acne are there? Common types include comedonal acne (blackheads and small red spots), acne vulgaris (pimples and blackheads), and nodulocystic acne (deep, painful red pimples and sores). Can skincare alone help treat acne? Yes, for mild to moderate acne. Using a pH-balanced cleanser twice daily, salicylic acid, and topical retinol can significantly improve breakouts. Do diet and hormones affect acne? Yes. Hormonal changes, certain medications, dairy intake, and high-GI foods can all contribute to acne and may need to be addressed as part of treatment. When are medical treatments needed for acne? Moderate to severe acne may require prescription treatments such as oral antibiotics or isotretinoin, which must be prescribed and monitored by a doctor. Can acne treatments also help with acne scarring? Yes. Once active acne has settled, treatments such as chemical peels and microneedling can help improve acne scarring and skin texture. If you have a question for Dr. Heather you would like answered anonymously, please email askdrheather@allor.co.nz. Written by Dr. Heather Anderson, MBChB, BSc, FRNZCUC, PGDip Cosmetic Medicine, NZSCM | ALLOR Cosmetic Medicine, Auckland

A friend asked me the other day, why is sunscreen so important? With the upcoming long hot summer El Nino is expected to deliver (wahoo!), it got me thinking. Why do we bang on about sunscreen? It must seem like sunscreen companies are sponsoring us to (they aren't). It all comes down to science. When the sun stuns us with her rays, she emits Ultraviolet Radiation (UV). There are different types of UV, the main ones that affect us are UVA and UVB. The energy they carry penetrates our skin and cooks us in a similar way to how a microwave heats up our dinner. Limited amounts of cooking (up to 15 minutes or so) are good for our tissues as it stimulates beneficial pathways in our body such as the production of Vitamin D, good for anti-ageing, bone and immune system maintenance. Too much of a good thing causes changes in our skin including altered pigmentation (spots), damaged collagen and dysfunctional deposits of elastin leading to wrinkles. Pigmented lesions/spots can also be triggered to mutate, leading to formation of cancer cells and the dreaded Melanoma. Sunscreen protects us from this radiation, broad spectrum the preferred choice to combat UVA (penetrates deeper and through glass, causing us to tan) and UVB (penetrates less deep and causes us to burn). Using this every day (even in Winter and when its cloudy) helps prevent and treat these changes. Like the necessity of wearing clothes, sunscreen should be part of the wardrobe. To be worn every day, except when the curtains are drawn and one is hiding inside. Quick Answers: Why is sunscreen important for your skin? Sunscreen protects your skin from ultraviolet (UV) radiation, which damages collagen, alters pigmentation, accelerates ageing, and increases the risk of skin cancer. What damage does the sun cause to skin over time? Too much UV exposure can cause pigmentation spots, wrinkles, collagen breakdown, elastin damage, and mutations that can lead to melanoma. What is the difference between UVA and UVB rays? UVA penetrates deeper into the skin, contributes to ageing and tanning, and passes through glass, while UVB causes surface damage and sunburn. Should I wear sunscreen every day, even in winter or when it’s cloudy? Yes. UV radiation is present year-round, even on cloudy days and in winter, so daily sunscreen use helps prevent long-term skin damage. How should sunscreen fit into a daily routine? Sunscreen should be part of your everyday routine, like clothing, and applied daily whenever your skin is exposed to daylight. If you have a question for Dr. Heather you would like answered anonymously, please email askdrheather@allor.co.nz. Written by Dr. Heather Anderson, MBChB, BSc, FRNZCUC, PGDip Cosmetic Medicine, NZSCM | ALLOR Cosmetic Medicine, Auckland

How do you know if you need cosmetic treatments? Anon, Whenuapai. A great question. Often pondered by the masses, taking the leap to having "work done" can be a daunting one. First, we must clarify what "work" entails. Cosmetic treatments are designed to help us look and feel better. The looking better part is really up to you. It ranges from glowy, clear skin to less wrinkles to restructuring facial features, creating harmony and a refreshed appearance, where people comment you look great, but can't quite put their finger on it. A holiday to the tropics? A new diet? New earrings? Therein lies the beauty of well-executed cosmetic medicine. Both an art and a science, the delicate balance lies in the hands of the injector. One who sees your unique beauty with acute awareness of the aesthetic end point. Various media have highlighted the dark side of cosmetic treatments, where aesthetic end points were crossed so fiercely, naturally beautiful people were given new identities. Lovely lips turned to sausages, cheeks turned to chipmunks and jawlines turned to jagged messes. Such stories are wonderfully entertaining, alas not helpful for those seriously wanting the odd tweak to help them look and feel their finest. Thankfully, there are a raft of ethical practitioners out there, properly trained with your best interests at heart. So it really all depends on you. If that pesky frown is making you look grumpy, those forehead lines are becoming crevices for your make up, your skin is looking dull, you're tired of looking tired or if you just want a professional someone to cast an objective eye, then you are ready. The key is to sit firmly in the driver's seat, accept no pressure and do what feels comfortable for you and your budget. The right practitioner will guide you, support you and care for you at every step. Your face and feelings are precious, so should always be handled with kindness, dignity and respect. Quick Answers: How do I know if I need cosmetic treatments? If something about your face or skin is bothering you, or you feel you look tired, grumpy, or less refreshed than you feel, you may be ready. What are cosmetic treatments meant to achieve? Cosmetic treatments are designed to help you look fresher and more balanced, while still looking like yourself. What kinds of cosmetic treatments are included? They can range from improving skin clarity and glow, to softening wrinkles, to subtle facial restructuring for better harmony. What should good cosmetic treatment results look like? People may say you look great, but they should not be able to tell exactly what has changed. How do I avoid overdone or unnatural cosmetic results? Choose an ethical, properly trained practitioner who has a clear aesthetic end point and does not pressure you into treatment. If you have a question for Dr. Heather you would like answered anonymously, please email askdrheather@allor.co.nz. Written by Dr. Heather Anderson, MBChB, BSc, FRNZCUC, PGDip Cosmetic Medicine, NZSCM | ALLOR Cosmetic Medicine, Auckland