It is no secret that the aesthetic industry as we know it is in a state of flux. Following last year’s PIP implant scandal — of which the industry is still feeling the effects, and which will continue for a good while yet — the industry and its professionals have been put under the microscope for the way in which we work, how products are tested and certified, and even how products
In the UK in particular, the Government and Department of Health (DH) have set up a number of reviews and calls for evidence to investigate the ways in which the industry operates, and how it could potentially be improved.
The biggest concerns for many, perhaps, are the question of what should be categorised as a medical device, and who should have the right to administer aesthetic treatments (e.g. dermal fillers, toxins, lasers and lights).
The rise of aesthetic nursing
One profession that has been particularly affected by this and the Keogh Review, is that of UK aesthetic nursing.
‘When I first joined the industry, there were already a number of nurses, but they were very much frowned upon by NHS [UK National Health Service] nurses,’ says Lorna.
‘They were working under quite difficult circumstances because no-one understood what their role should be and where the boundaries were.’
In the last decade, however, the role of the nurse has become a far more highly respected profession in the UK — in the eyes of both the public and colleagues — coupled with the advent of nurses being able to prescribe from the British National Formulary, and the increasingly high standards with which they are trained and work.
However, aesthetic nurses have struggled with levels of acceptance, not least when the Royal College of Nursing (RCN) in the UK disbanded the forum for aesthetic nurses as part of a major down-sizing for forums. Fortunately for Lorna and her colleagues Liz Bardolph, Emma Davies, Sharon Bennett, and Sharon Brown, they were able to form the British Association of Cosmetic Nurses (BACN) with the blessing of the RCN.
‘As a group we felt that the needs of aesthetic nurses weren’t being listened to,’ she says. ‘We felt that we needed a strong body that would be able to take forward the vast amount already achieved, like the RCN nurse competences that had been produced by the aesthetic nurse forum, and to provide a support network for aesthetic nurses in the UK.’
The UK model is unique as most aesthetic nurses throughout the world do not have the same treatment or prescribing rights, as the advanced nursing community in the UK.
The success of the BACN — now with 650 members and rising — has allowed them to contribute to and influence the UK Keogh report and the wider CEN throughout Europe.
‘As far as the Keogh report is concerned, when the BACN first discovered that there wasn’t a nurse on the panel, they took immediate action, wrote to the
DH, and put an in-depth document together detailing why nurses should
be part of the panel, and why they should be able to do these treatments, whether they are prescription medicines or not,’ Lorna explains.
‘I’m a strong believer that you don’t have to be a nurse independent prescriber to work as a valid aesthetic nurse,’ she continues. ‘If you are working within your scope of practice as part
of a team where there are prescribers — whether that be a doctor, dentist or nurse — within the team and working under their care, then you can provide an extremely high level of care.
‘If you’re going to work independently then you absolutely have to be a nurse prescriber, because you need to be able to deal with the problems that aesthetic patients may come across and look after them holistically.’
Finding the niche
Although Lorna was a founding member of the BACN, her professional career has meant that she hasn’t always felt it ethical to sit on the board.
Lorna’s interest in dermatology was cemented during her nurse career at Charing Cross Hospital in London, but she soon left the NHS to learn more about management and the pharmaceutical industry, during which time she applied for a role with the Collagen Corporation. She spent 2 years with this company training doctors, nurses and dentists to administer dermal fillers and offering business development support, after which she set up her own chain of clinics: the Bowes Clinics.
‘We had clinics all over the UK and, with a team of nurses, we delivered collagen injections and skin care, as well as hyaluronic acid fillers and botulinum toxin therapies when they appeared on the market.’
Working to her original business plan she sold the successful business and went to work for Q-Med, taking part in their International Task Force and Group Expert Restylane. At that time, Q-Med and Italy were co-marketing the product with NeoStrata, which reinvigorated Lorna’s interest in skin health as opposed to just needle technique
Over the next few years working with Q-Med, and then as head of Aesthetic Dermatology at Wigmore Medical, Lorna got to know many skincare ranges as well as having the opportunity to work with the full range of toxins and fillers. Her love of training like-minded aesthetic professionals and her passion for skincare (the NeoStrata brand in particular) ultimately led her to set up Aesthetic Source alongside her training and clinical practice.
Despite such a successful and varied career, Lorna doesn’t plan to rest on her laurels just yet, and has many thoughts on what the future may hold for the aesthetic and anti-ageing industry.
‘I think that there will be more people undergoing procedures, but also a greater move towards skin health alongside injectables and surgery,’ she predicts.
‘I think there will be a faster growth in the cosmeceutical sector, and that we’ll see a lot more technologies emerge within the next 5 years; particularly with regard to cosmetic dermatology with topical treatments, which can make a more fundamental change to the dermal components and structure.’
(Such topical treatments may include topical forms of botulinum toxin, for which Lorna says she has seen some good evidence in specific areas.)
And one of the things hoped for, is a change to CE marking for dermal fillers,
to resemble something more akin to the FDA approval process.
‘CE marking is far too easy to achieve and while many consumers and patients don’t understand the meanings of the various marks, neither do many practitioners, so understanding the safety of the injectable products we select from those available to us is paramount to building a respected practice,’ she says.
‘It would be brilliant to have dermal fillers moved up into the prescription-only category, but I also think that skincare ingredients need to be looked at more closely, creating a formal cosmeceutical category.’
However, perhaps what Lorna hopes for most in the aesthetic industry, is that nurses continue to receive the support and recognition they deserve, continuing carrying out the treatments they are qualified to do:
‘When you look at what nurses are doing in the community and NHS, the procedures performed and the treatments UK nurses are now qualified to administer, the decisions they’re able to take are so advanced compared with nursing 30 years ago. Aesthetic nursing can both learn from and positively influence the enhanced role of the UK nurse, as well as the wider aesthetic field ‘