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Posted on in Anti-aging, Chemical Peels, Lines and Wrinkle Treatment.


COSMECEUTICALS – Dissecting the Facts

“THE GOOD, BAD and MEDIOCRE ” Today’s Facts :

Alpha Hydroxy acids (AHAs) – Advanced facts:


Stiller et al 1] – Level of evidence IA. A double-blind vehicle-controlled clinical trial

• 74 women over 22 weeks

• ameliorating some of the signs of chronic cutaneous photodamage”


Tsai et al 2] – Comprehensive review of Literature

• Long-term use of Glycolic Acid improve skin texture and

• Youthful appearance – AHA’s induce glycosaminoglycan and collagen synthesis in the dermis leading to improved dermal hydration and thickness”

• AHAs act as exfoliators – detaching keratinocytes from the stratum-corneum = smoother skin. 

• Stimulate fibroblasts = increased collagen production.

• Increased turnover of keratinocytes improves dyspigmentation

• Keratinolytic activity of AHAs improves penetration of other agents such as hydroquinone and Tretinoin. (always add AHA combination with HQ and Tret)

• Glycolic acid also has anti-inflammatory properties and does not induce angiogenesis hence it can be used if patients have photo-induced telangiectasia or rosacea.


1] Stiller, M.J., Bartolone, J., Stern, R., Smith, S., Kollias, N., Gillies, R. et al. 1996. Topical 8% glycolic acid and 8% L-lactic acid creams for the treatment of photodamaged skin. A double-blind vehiclecontrolled clinical trial. Arch. Dermatol., 132(6):631–6.


2] Tsai, T. & Hantash, B., 2008. Cosmeceutical Agents: A Comprehensive Review of the Literature. Clinical Medicine: Dermatology, Volume 1, pp. 1-20.


Eyebags, Pigmentation and Hooded Eyelids

Posted on in Anti-aging, Dermal Fillers, Facial Aesthetics, PRP.


Some people  have tried to reduce bags under the eyes using haemorrhoid creams – the effect is achieved by the local anaesthetic that might even contain small amounts of adrenaline, this is to cause vaso-constriction (closing the blood vessels and reduce pain around the anus) it  reduces oedema or swelling in the skin and it is this effect the users of haemorrhoid cream are after.

The unwanted side effect of the creams is it also contains a local steroid – usually Prednisolone. The  effects of this with long term use on the thin skin, under the eyes can cause (ESPECIALLY in a deviated (higher pigmentation) skin )- HYPERPIGMENATION and HYPOPIGMENTATION, which are well recorded unwanted complications .

1.      Nouv Presse Med. 1974 Mar 16;3(11):665-8.

[Local dermatological complications secondary to corticosteroid injections].

[Article in French]

2.      Rimbaud P, Meynadier J, Guilhou JJ, Meynadier J.


There is a non surgical option for eye bags, hooding and pigmentation:

1)      PlexR fusion. PlexR eye lift.  No cutting, no scarring, amazing results.

2)      Rederm injections. A  patient tried to lighten her skin using lemon juice and baking powder and burnt  her skin and now has severely damaged and pigmented skin. Rederm injections and Profi DeLux spray. Both are a combination of Hyaluronic acid and Succinic acid

3)      PRP combined with Rederm for pigmentation and bags

4)      Plasma for hooding

5)      Dermal fillers in the temple, eyebrow and zygomatic ( cheekbone area).

6)      Ablative pixelated laser combined with PRP meso therapy




·         Redermalization injections using Rederm by Hyalual UK. The solution contains Hyaluronic acid and Succinic acid ( anti oxidant) removes copper from the skin cells. Acts as a catalyst on the fibroblasts and thus increases the amount of elastin, collagen, GAGS etc. Copper causes pigmentation. The method around eyes is papular injecting under the skin by a doctor/nurse. This Increases collagen and elastin.

·         Wow mask;  high 4 % concentration hyaluronic acid, arginiline, apple stemcells.





A dermal filler is injected in the orbital rim area ( eyebrow, crows feet area, tear through, cheek- lid junction , lateral ocular area and temple) . This acts as a remodelling of the lost bone and fat departments that happens with age.



Ocular Rosacea

Posted on in ZO Skin Care.



What is Ocular Rosacea?

Some research has shown a possible link between rosacea and the bacteria called Helicobacter pylori – causing chronic reflux and gastritis . This bacterium also causes gastrointestinal infections.


What does it look like?

• Red, irritated, inflamed upper and or lower eyelids, especially base of eyelashes.

• Red or bloodshot eyes, burning or tearing, and the sensation of a foreign body in the eye.

• An infection of the eyelids

• Sensitive skin


Common Treatments

• Demodex and bacterial colonization control,

• exhibit vasomotor instability,

• require camouflaging of telangiectatic mats,

• inflammation reduction – topical and oral antibiotics

• vasoconstrictor formulations

• Cosmeceuticals enhancing Skin Barier Function.


Why is ocular rosacea reactive to washes and products?

• Cleansers can remove  lipids from the skin surface,

• surfactants remove sebum AND intercellular lipids.

• thorough removal of sebum, may also damage the intercellular lipids, resulting in barrier damage

• manifests as increased facial redness, stinging, burning, and itching.

• counterproductive to use an anti-inflammatory skin cleanser to treat rosacea when, in fact, it enhances inflammation and this is most likely the reason why PATIENTS cannot tolerate  ZO® or similar products and creams.


So what can PATIENTS use?

• Important to get medical opinion – patient see doctor/dermatologist

• If not possible – use ZO®  Hydrating cleanser only

• DO NOT use the scrub and pads AROUND THE EYES as this will affect the intercellular lipids – can use on the rest of the face AVOID THE EYES 🙂

• Best moisturisers to prevent facial rosacea flares combine occlusive and humectant ingredients – Use only the Daily Power Defence

• Use Sun protection


TO TAKE HOME – Underdiagnosed Condition  – BE ALERT 🙂


Photos: Recognition: Dr. Chapa & Virginia Eye Clinic



Platelet – Rich – Plasma

Posted on in Uncategorised.

 PRP Blue water


PRP  is a natural aid to increase tissue and collagen stimulation by using your own blood, your own natural resources to repair and improve your skin tissue.

PRP contains high levels of platelets and when injected into tissue,growth factors and stem cells are released, which are vital to tissue healing and repair. Your skin texture will respond as new tissue cells grow and visible results may take 3-6 weeks and continue up to 6 months.

Treatment will take approx. 1 hour. A course of 3 sessions spread over a period of 3 months, then annual thereafter.


Introductory Treatment Days here at the clinic on Monday 24th April and Tuesday 25th April


On arrival in the clinic you will be greeted  by Dr Norup and her team.  Whom will make you a delicious cup of coffee/tea and give you a tasty biscuit. You’ll then be taken through into the relaxed treatment room where Dr Norup will take a small amount of blood from your arm.

The blood is then processed in our highly specialised, state of the art system, specifically designed to extract the PRP in a safe, clinical manner. Whilst the machine is working it’s magic you can enjoy the rest of your coffee and relax.

Once processed your PRP which is totally natural and organic containing your own growth hormones and stem cells. The treatment can

begin by injecting the PRP into the areas required for rejuvenation.

This can be injected as mesotherapy or conventional filler method or simply spread it on the skin if combined with laser pixel.

Other treatment options:

Injected as a mix with sculptra

Injected as a mix with HA filler

Injected in scars

Injected in tear troughs

Used on burns for wound healing

Used in implantology/periodontology for bone grafting and wound healing

Call the clinic 01372 465 277 or email to discuss further. 10 spaces available and 2 already taken.

We look forward to seeing you soon

The Norup Clinic


ZO Skincare: post CPD peel can cause possible acne breakouts

Posted on in Anti-aging, Chemical Peels, Lines and Wrinkle Treatment, ZO Skin Care.


  •   Acne outbreaks after a CPD Peel. ( Controlled depth peel)

Acne outbreaks are common after either a CPD peel or simply initiating ZO skincare. The skincare is so potent that it activates all the cells in the skin and a new rebalancing takes place.

·         FIRST RULE : Repair the barrier first ( DPD, regulate inflammation and sebum: Cebatrol, Restoracalm or Revitatrol)

·         SECOND RULE : Build Tolerance – follow fundamental 5 + Aknetrol + sulphur Mask + Spot treatment (if still needed add in Tretinoin) – Repair first and then add Retinol and all else.

·         Use Cebatrol rather than Te-Pads



1.      Oilacleanse

2.      Scrub exf polish or vitascrub

3.      Sebum reduction Te- Pads or cebratrol

4.      Alphahydroxy acid for exfoliation – glycogent

5.      Acne specific topical agents – aknetrol and sulphur masque

6.      Barrier repair and stabilising agents -daily power defence ( combo of retinol , antioxidants and anti inflammatory agents )


  • After the CP, this  protocol to be followed strictly!


·         Do not use anything else on your skin from any other range, the moisturisers at this stage would lead to increased sebum production

·         The sulphur masque can be used not only as a mask but as a topical spot treatment at night and leave on to sleep and wash off in the morning. The growth factor serum only around the eyes.

·         Keep well hydrated as well, 2 litres of h2o is a must .

·         Cebratrol is maybe the oil control pads to use rather than the te pads if the acne is not hat severe.


  • Pigment returning after using  Melamix Melamin & Tretinoin.

 When the Tretinoin/HQ is stopped, the exfoliation reduces and the ” CLEAR PINK ” colour of the fresh skin changes back to a normal apricot colour  and some patients interpret this as ”PIGMENT COMING BACK”. Continue with  Brightenex 2 pumps morning and evening with your fundamental 6.


  • C-Bright ( Vit C) stings and feels very sore to use.

 Only use after about 6 weeks,  when the BARRIER is repaired and the skin has built TOLERANCE – introducing this earlier cause severe stinging and can irritate the skin as the pH of the main ingredient – pure Ascorbic Acid 10% is very acidic around 3,2. On a raw, active acne skin this is not a great idea!


Come in and see us to discuss any of the above, 01372 465277




Posted on in Nutrition.

The ambitious world is becoming ever more demanding and so it should!

Living life in the fast lane or should I say the successful lane requires a toned body and fresh looking face at the very least.

But is that all ?

It is not just about having Botox and going to the gym. It requires a much more holistic balance. Inner peace, regular exercise, good genes and a good diet.

NUTRITION is being researched down to molecules and atoms and every day we are bombarded with carcinogenic foods. Deep down we probably know exactly what is

good for us and what is not. Breaking it down into simple measures, it’s about eating just of a balanced diet, and it’s not about starving ourselves.

For me it is simple.

Exercise to burn and to build

Eat sufficient calories to provide the energy spent

In that calculation we want : proteins, healthy fats and slow burning calories – and fibres, antioxidants, vitamins and minerals.

Eat organic and watch if it is

Eat as many raw vegetables and fruits, with high levels of antioxidants and vitamins as you can afford in your carbohydrate accountancy, keeping an eye on the GI, AGE, TAC and minerals and the anti-carcinogenic properties or cancer risk reduction properties.

Most people have heard of GI but maybe not so much TAC or AGE.

TAC : Total Antioxidant Capacity.

In 2004 a team of researchers measured the TAC in more than 100 foods. Those with a high TAC value are super foods, small red beans ( TAC : 13’727) and wild blueberries (TAC: 13,427) to name a few. This varies according to preparation method!! Frying or microwaving reducing the TAC to around 0 !

AGE: Advanced Glycation End products.

Advanced Glycation End products are harmful End products or fat oxidation, which occurs when food is heated to high temperatures or when sugar molecules attach to protein, fat or DNA. It impairs our immune system, accelerates ageing and contribute to Altzheimer’s disease, cardio vascular disease, eye disease, kidney disease, nerve disease and stroke.

Foods that have the highest concentration of

AGEs are broiled, grilled and fried meats.

A frankfurter ( 90grams) contains roughly 10,000 AGEs, boiled potatoes (100g) 117 AGEs. Interestingly cooking or frying vegetables similarly does not produce the same amount of AGEs as the condensation of creatinine with amino acids only is found in muscle. If we spend all our calories on white carbs and fried meats with heaps of trans fats, there won’t be enough of the essential building stones to support our body to defend all the toxic End products. With no exercise our body is like a car not taken out for a drive and the insulin level goes crazy and stores too much fat, whilst we still feel hungry. If we drink wast amounts of alcohol and smoke to add insult to injury, it is no surprise that the body gives up. With the alcohol intake, the body cannot absorb essential vitamins, such as Vitamin B, which again affects our Dopamine and Serotone levels. ( happy hormones). It also causes high levels of insulin and a chronic state of inflammation, which in turn can aggravate asthma, cancer etc. Eating non organic meats, means storing unwanted hormones, mostly female and has a long term effect on our reproductive organs. In certain countries this now results in babies born with both female and male reproductive organs, albeit small. A future where we can choose our sex. Transgender world …

The 20th Century Lip Filler – An interview with Dr Norup, Spears Magazine, Chelsea

Posted on in Dermal Fillers.

Nowadays mainly use Hyaluronic Acid cross linked fillers, which is a natural product that already exists in the body and is adapted easily.

What is the Procedure? takes around 10 minutes with minimal pain. No dental block with lidocaine is required as most fillers today contains it in them. Mostly a numbing cream 20-30 minutes before the procedure is well tolerated.

Is there any Downtime? depends on technique and type of HA filler. The older type fillers such as Restylane and Teosyal and to some extent the Jvederm ultra range tend to take longer to sit in. The newer ones : Jvederm Vycross, Teosyal RHA , Belotero, Emervel ( and more expensive ones ) will feel natural after about two weeks and integrate naturally.

If bruising happens it may take a week or two but usually lipstick will cover. I never recommend having lip filler just before a big event as the first couple of days will show a little swelling.

Are there any harmful effects, what are the potential risks imposed during the procedure? Injecting into the face always carries a risk. The needle penetrates the skin barrier and can potentially enter the blood vessel. If a filler is injected into an artery, it can cause the artery to occlude and take the filler upstream into the nose, forehead or even eye area. This is down to technique and happens rarely but it is imperative that the practitioner is familiar with how to reverse this and at hand instantly.

There’s a minimal risk of infection or allergic reaction. During 10 years of practice I have never seen any of these incidents.

It is also my experience that overuse of very heavy old type fillers and super pouting the lip can destroy the lip line after long term use. This is very difficult to restore.

What are the main trends you’ve encountered now, especially amongst young girls? In your opinion, what are the do/s and don’t/s…There’s a IT difference across the UK and age groups for different trends. Young girls in London and young gays tend to want the big pout look whereas more mature or even younger girls in suburbs such as Surrey are wanting a more natural and gentle look. The Angelina pout is not so desired. Different filler types allow for different shaping and filling. A whole range of aspects must be considered; Cupid’s bow, the vermillion border outline, soft eversion of the body of the lip, oral commissures ( lip corners) lift, proportion between upper and lower lip, proportion from side aspect and in relation to the nose and chin, taking into consideration the framing of the underlying teeth and their support. How the lips can move dynamically and naturally with the filler.

The latest trend is to create a natural looking lip, which is desirably full especially at the mid portion and with a clear definition of the border, swings up at the corners and moves naturally when speaking.  More of a sweet inviting heart ❤️ shape than a long unmoving cartoon pout salami.

How long do lip fillers last? How often do they need to be ‘topped up’ again?

Treating a new patient with extremely narrow lips for the first time is the biggest challenge. Not only does the tissue resist being changed but the patient will feel the change whist speaking and I therefore like to start gently with a very soft filler to build up gradually. This may take a year or it may take a month depending how much change can be accepted. If built up gradually and subsequently with a more solid filler I’d expect top ups annually to maintain. The soft fillers last less.

Share some useful tips on how to take care of lip fillers and make your lips look plump for longer.

It is essential to use moisturisers. ZO skincare has a lip cream which keeps the lip cells moist and healthy. Mesotherapy and peels will help keeping the skin healthy and moist.

Dr Norup

The Norup Clinic

01372 465 277

How to do a Global Rejuvenation of the Neck and Decolletage!

Posted on in Chemical Peels, Laser Treatments, Mesotherapy, ZO Skin Care.



Dealing with the neck and décolletage is very different to the face. The thickness of the skin

is different from the face to the neck and the décolletage, the skin gets progressively thinner

going from the face through to the neck and the décolletage area. The major face/ neck

muscle called Platysma creates a downward pull and stretch, which traumatises and thins

the skin, similarly to the eyelid and under eye area, where the blinking action every

couple of seconds causes this creepy look. The décolletage is furthermore exposed to

serious UV damage as the radiation hits at a right angle.



•When using your basic 6 ZO skin health products in the face, extend the neck and

décolletage using only the cleanser and Daily Power Defense or Brightamax if very

sensitive and SPF!

  • Progress to add renewal crème and then Brightanex, followed by

Radical Night Repair. Finally, a very low dose of Melamix & Tretinoin 0,05% This will

take 12 months plus to achieve.

  • •Use small doses and spread over the larger area of the neck and chest. Gradually

increase the dose/ amount as tolerated.

  • •Once the prepping period is complete, depending on the skin type, aggressiveness

of the level of prep and skin pathologies), the ZO Chemical peels can be applied,

starting with the superficial Stimulator Peel, no preparation needed following on to

a deep 3Step and finally the Control Depth Peel ( 20% TCA) = CDP

  • • The overall protocol will do rejuvenation, tightening, pigment regulation and have a

substantial influence on any early BASAL CELL CARCINOMAS ( empirical only, no

evidence based research) so it is a great ANTI-AGEING TREATMENT

  • • Combine this protocol with BOTOX, FILLERS, LASERS AND MESOTHERAPY for a truly

astonishing out come.

  • •This process can be done on hands and of course the face

Like anything there are no quick fixes. It has taken years to degenerate and it will take hard

effort to rejuvenated against the age progression



Dr Norup

01372 465 277

Back to Skin: ZO Anti-pigmentation Skincare

Posted on in ZO Skin Care.





When a tattoo is performed, the target is to deposit the tattoo ink in the dermis – deep dermis to be precise. This is the very slow turn over part of the skin. If the same ink was deposited in the epidermis only – guess what – the pigment will disappear in about 18 weeks – the epidermis is your quick turn over part of your skin!!

Now, interestingly most medical tattoos are not allowed to use any of the heavy metals like in tattoo ink and is making use of organic pigments like senna etc. These are typically more epidermal than dermal and this might be more prone to be removed by your ZO aggressive program as the increase in cell turnover and exfoliation might just get rid of the pigment in the epidermis, leading to a lightening of the tattoo.


SO what is the verdict then?

For a normal Tattoo in the DERMIS, the HQ is targeting only the melanocytes in the Stratum Basale, which are in the EPIDERMIS and should not affect the TATTOO in the DERMIS –


So therefore, you can go on aggressive ZO – CDP preparation and book yourself into a Controlled Depth Peel.

Likely you can clear the Pigmentation distortion of the TATTOO with the Melamin   Melamix – Tretinoin, two times per day and should not need the CDP.



Dr Norup

The Norup Clinic

01372 465277

Face Fitness & Sculpting: Silhouette Soft Threads

Posted on in Facial Aesthetics.




The face changes shape as we age and certain fat compartments drift or descend. If dividing the face, seen from the front, into 3 vertical columns, it is mainly the sides that drift down and forwards changing our face from oval or an inverse triangle, converting into a more rectangular or even triangle shape. The jowls grow ever heavier and a sausage appears alongside the nose to jaw line, creating a negative/tired looking profile, with very heavy nasolabial folds and marionette lines. If this process has advanced beyond a certain level, it is no longer feasible using fillers, lasers, Botox only. Threads are then more effective and a better option.




In our 20s and 30s these changes are barely visible or requiring treatment, depending on our genetic makeup, ageing factors such as sun, smoking, exercise, diet and whether we remain slim or otherwise.  In our 40s these changes start to show, and certainly for most of us it is very apparent in our 50s.

Most people between 20-40 only need toxin, preventative skincare, including SPF, and possibly a little face sculpting to enhance their appearance. This could be lips/nose and a small change of the facial proportions in the frontal vertical dimension, and equally so in the lateral/ side aspect.

In this day and age, those of you who are younger and have taken good care of your health and skin, won’t need to think about facelifts probably ever until possibly in your 70s.

Presently in your 40s, there’s still a good chance of preserving and delaying any bigger procedures by prevention methods.

If however, you have never had aesthetic treatments, have been a heavy smoker or not stayed healthy and fit, happen to have thin skin (white) with very little collagen/elastin and reaching 50+, with jowls descending, tear through deepening, narrowing of the lips and a sausage appearing next to your nose, then this is the stage where realistically only a THREADLIFT PROCEDURE is going to make a noticeable difference.





Silhouette Soft is a day surgery procedure, done with local anaesthesia and if needed premedication ( Valium). The in surgery treatment takes between 30 minutes up to a couple of hours, depending how advanced a procedure is required. Dissolvable threads, with 16, 24 or 32 circular cones are inserted are into the skin and threaded across the face, in a manner that lifts both the skin and the underlying fat in such a way that the face is lifted and volume is created in a different and strategically better are of the face. Silhouette Soft is the only procedure that actively pulls/lifts the face and also sculpts it. The threads are resorbed and substituted with collagen. The longevity is still fairly unknown. Personally, in my experience it depends on the technique and number of threads plus how firm or heavy the skin is in the first place. So far the procedure has shown some amazing results that wouldn’t have been possible with any other procedure.



Depending on the insertion points, small entry points may be visible for about 7 days. The lifted skin may show some puckering until it settles in the new position, also about a week. Bruising is generally very minimal. Some redness and swelling will show for a couple of days.

Physical activity is restricted for two weeks. Especially sport and facials/peels.

Chewing on beef or likewise hard or chewy foods to minimise the reverse pull on the inserted threads, which can compromise the result. Infection is a risk but the procedure is carried out totally sterile and a light antibiotic gel is applied for prevention, so generally very low if precautions are adhered to.

A very rare complication is haematoma or nerve damage. The threads are inserted in the superficial layer above these tissues and so generally not an occurrence.



As described before longevity depends on skin quality, how heavy/how much fat tissue is weighing down. Amount of lift required and complications, plus finally most importantly the technique applied. I.e. How many threads, where and how long they are.

Expect 2-3 years plus at least.


We would love to hear from you, call 01372 465 277 to speak with Dr Norup and to book an appointment to come and visit us.


See you in the clinic!


Dr Norup







Dentist BDS, Medical Laser Diploma, Danish Dental Association, General Dental Council, Association for Facial Aesthetics AFA, Psychology Dip, Indemnity Insurance

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