Ask Alice

Hi Debbie, you ought to be alright with the eye shields – so many surgeons and laser practitioners contacted me while I was recovering and said they were shocked because they’d been using the shields for years and years and had never had an issue like that. As long as the practitioner is familiar with using the shields, and uses enough lubrication drops as well as anaesthetic drops, you should be fine. The other alternative is to try a radiofrequency or RF microneedling treatment which can be used all around the eyes without requiring those shields.

Have a look on our practitioner finder – you can search by tweakment as well as by area. There are loads of great practitioners on there who do really good tear trough work, and they will advise you whether this is an appropriate treatment for you.

Our practitioner finder doesn’t cover Ireland yet but if you’re in Dublin you could try Dr Patrick Treacy at his Ailesbury clinic or Mr Kambiz Golchin at Beacon Dermatology.

Hi Cath, I don’t know if Zooki’s collagen supplement contains liposomes – the Advertising Standards Authority (ASA) ruled that Zooki’s Vitamin C didn’t contain liposomes in November 2021, so they have been changing their claims since then, and the same may apply to their collagen. Totally Derma is fab and it’s all you need for collagen supplementation, though I back it up with Altrient C which has a proven liposomal delivery system and which boosts collagen production by a different mechanism.

Hello, yes I had blepharoplasty 10 years ago with Mr Naresh Joshi who was and remains the go-to-expert in this speciality. I was 49 then and would have benefitted from having done it a bit earlier, to be honest; I’ve got those sort of eyelids. In terms of how long the results last, it depends on your face/ genes/ lifestyle. Surgery like this resets the clock in terms of how your eyelids are ageing, but it doesn’t stop ageing in its tracks forever. Last year I had another upper blepharoplasty, done in conjunction with with a ptosis correction to correct the drooping in my left eyelid (which was something I’d been aware of for 15 years, but it hadn’t bothered me hugely until I started spending so much of my life in front of a camera). That was done by Miss Elizabeth Hawkes and Professor Richard Collin (her mentor and one of the pioneers of blepharoplasty). I was astonished to find they had excised another 7mm of surplus skin from my eyelids (same as the previous time); obviously, that’s just the way my eyelids age. Will I be a candidate for another bleph in due course? Probably. Will I have the inclination to have it done again in a few years’ time? Who can say. Watch this space.

Exilis is a radiofrequency treatment which has a kind of ‘shrink-wrapping’ effect on the skin; Ultherapy uses focused ultrasound to achieve the same sort of damage-and-remodelling to the collagen in the skin… they’re both good treatments that can produce great results on the right patient. My opinion would be to get your face in front of a great practitioner and ask them what they’d recommend for your particular concerns, and whether you’re the right patient for either of these treatments.

Ah, sympathies. I’d start with your doctor, to consider hormone replacement, as this has such a huge and fundamental effect on everything from brain and heart health, to our skin (more oestrogen means more collagen in the skin, which means stronger, firmer, better hydrated skin that doesn’t look so old and tired). Then skincare! Take a look at the skincare advice on our downloadable factsheet about dry, rough skin, which you can grab on this page.  If you want more detail, I’ve written a whole book called Start with Skincare which you can find on Amazon. In terms of products, start with a gentle cleanser, a vitamin C serum, a moisturiser and a sunscreen every morning, then in the evenings, use the cleanser, some sort of night treatment product with retinol, and moisturiser. Give it a few months and your skin should be looking and feeling much better. Good luck.

Wow, congratulations! Start with your skincare – I’d suggest a gentle cleanser, a vitamin C serum, a moisturiser, and a sunscreen for the day, and for the evening, something with retinol or retinal (a bit stronger) in it, plus the moisturiser. Take a look at this collection to see the sort of products I prefer, and how I’d suggest using them. Then find a great practitioner – you can put your postcode into our practitioner finder – and book a consultation to see what they suggest to treat your other concerns.

You’re right, sebaceous hyperplasia, where you get lots of little bumps under the skin where oil has become trapped, is an absolute pain. I have lots of them on my face and when I went to see a dermatologist about this recently, he told me that they become more common with age, and to get rid of existing ones you need to tackle them directly with lasers. To reduce the rate at which they’re forming, he suggested sticking to skincare that would clean, hydrate and regenerate the skin without adding any extra oil, so that’s a glycolic or vitamin-C based wash-off cleanser, an L-ascorbic acid vitamin C serum in the mornings, plus a hyaluronic acid serum for hydration, then a mineral-based sunscreen, and at night, the same glycolic wash, plus a glycolic-acid night treatment product (or retinoid), or just the hydrating serum if you don’t want to use the treatment product every night.

Hi, oddly enough, microcurrent devices work really well on faces treated with toxin – because the microcurrent helps keep muscle tone in the muscles while they aren’t being worked by the usual facial expressions (toxin doesn’t do anything to the muscles; it disables the neurotransmitters that send messages to the muscles to contract. So, microcurrent is not directly counteracting the treatment). All the device manufacturers suggest you wait for two weeks before using microcurrent after toxin injections, and the same after filler injections (after two weeks, the filler will be properly settled).

When you have an autoimmune condition, tweakments aren’t necessarily off the cards. Many practitioners are happy to treat patients with autoimmune conditions BUT they will want a thorough consultation with your mum first; it might be possible to have injectables such as filler at times when her condition is well under control (but not when she’s had any flare-ups). Same for other treatments like radiofrequency microneedling, which can help with jowls and slack skin. Her best bet is to set up a consultation with a great practitioner in her area who will listen and talk her through suitable and safe options.

Hi, take a look at our free factsheet on treating barcode lip lines – downloadable here – which will give you all the options. To find a great practitioner in your area, go to our practitioner finder and put in your postcode, which will come up with our trusted practitioners in your area.

If your practitioner says toxins won’t work on these lines, maybe that is because they’re being made by the way you sleep, as you suggest, rather than by muscle movement. It might be worth trying something simpler than tweakments, like the Dr Harris Anti-Wrinkle Sleep Mask, which looks like a normal sleep mask but has small silicone bumps on the inside that press on muscle receptors in the face to relax them (it’s clinically proven to relax frown lines between the brows). These slight bumps are set in a pattern that goes over the eyebrows and around the sides of the eyes, and they grip the skin very gently and I find that these stop me from scrunching up my face when I sleep – Dr Harris, the inventor, says the same. It’s a lot cheaper than toxin, so it might be worth a try!

Two products I’m loving just now because they give my skin a brilliant finish: the Pat McGrath Skin Fetish foundation which is v v expensive but completely fabulous, and Monica Blunder’s Blundercover which looks like a concealer but is a foundation and goes on with a brush. They’re both lightweight but you can build them up where you need them, which I think looks better on any skin than piling on a thick layer.

Start with good, active skincare – a vitamin C serum, a moisturiser and a sunscreen in the morning, and a retinoid in the evening – and see what difference that makes. I’m not keen on home microneedling because most skincare products are not designed to be bombed deep into the skin through needled holes, and also most of us are not very careful about needling all areas of the skin equally, and gently. I’d prefer you stuck with skincare and when your skin is acclimatised to the retinol or retinoid that you’re using, moving up to a stronger product, to keep stimulating your skin to renew itself.