ARE YOU STORING YOUR TOXINS CORRECTLY?

Lec Medical’s senior technical manager Colin Burgess explains best practice for storage of botulinum toxin

As a neurotoxin, botulinum toxin should be stored like other medical product, such as vaccines. The need to refrigerate cosmetic injectables is printed on product packaging by manufacturers and supported by major distributors. What this means in practice is set out in the Code of Practice and Guidance for Practitioners Who Provide Cosmetic Interventions, drawn up by the Joint Council for Cosmetic Practitioners (JCCP) in partnership with the Cosmetic Practice Standards Authority (CPSA). Its guidelines, which every reputable practitioner should follow, echo those set out in the ‘bible’ for medicine storage, the NHS Green Book.

They state that botulinum toxin should be stored in a wellmaintained medical fridge, with a temperature gauge and a lockable door, and that the fridge temperature must be audited and recorded. Additionally, all storage, prescription and dispensing of botulinum toxin must be recorded by an accountable officer. The crucial factor is the stipulation of a medical fridge. It is the only product that can deliver the controlled conditions, monitoring options and safety mechanisms required to ensure secure and safe storage of cosmetic toxins.

There is some debate around the need to refrigerate botulinum toxin, with research by L. Parraga et al indicating that it could remain stable for 14 days at 25°C and seven days at 30 °C.

This is good news in the event of a transportation breakdown or other unforeseen one-off incident that leaves toxin stores exposed to higher temperatures. However, it should not be the overriding factor which informs your everyday storage processes.

The long-term impact of inadequate storage of botulinum toxins remains unknown, so the risk of an inadequately stored product becoming unstable could increase over time. It is this unknown risk which should guide your storage practices if you want to deliver a best-practice service to your customers.

Best practice guidance is universal in stating that you should store your botulinum toxin in line with other cold-chain products, meaning it must be stored within a controlled temperature of between 2°C and 8°C, and never frozen.

This temperature range is guaranteed to keep the molecular structure of the toxin stable and prevent the development of harmful bacteria. A temperature which is too high (or too low) runs the risk of degrading the toxin over time, reducing its effectiveness as a muscle relaxant.

It is a common misconception that a standard domestic fridge is suitable for storing these highly sensitive – and expensive – products. This is not the case.

Use anything other than a medical fridge and you run a similar risk of reducing the efficacy of your botulinum toxin as leaving it out and so delivering a sub-standard service to the people who have paid for cosmetic treatments.

This is in direct conflict with the first key responsibility listed in the JCCP/CPSA code, that practitioners must ‘promote the safety and wellbeing of patients/clients and promote public trust and confidence and not to bring the profession into disrepute’.

Wasted toxins can be costly, so the fact that botulinum toxin should remain stable in the event of cold chain failure is good news. However, the potential legal costs and reputational damage that could be caused in the event of a treatment being flawed due to the use of an ineffective product are equall if not more.

The Save Face industry organisation reports a record number of complaints being made about non-surgical cosmetic procedures – so any perceived failure of service is unlikely to go unnoticed or unchallenged by patients or clients.

The only way to ensure the efficacy of the toxin and mitigate any risk is to store it within the accepted guidance.

STORING TOXINS FOR SAFETY AND EFFICACY

The NHS Green Book provides the foundation for the accurate storage of cold chain products.

The golden rule is that a medical fridge must be reserved exclusively for the storage of botulinum toxin and other cold chain products – so as not to be used to store anything that might present a contamination risk, such as food or drink. It should be sited in a well-ventilated room which is maintained between 10°C and 25 ̊C, away from external windows and all heat sources such as radiators or direct sunlight, and at least 5-10 cm from walls and other units.

The fridge should be filled to no more than 75% capacity to allow adequate air circulation, and stock should be stored according to first expiry. It must be kept clean and serviced regularly, according to the manufacturer’s instructions.

Finally, fridge temperatures should be recorded twice per day by a named and accountable staff member.

When checking the fridge temperature, the NHS Green

Book states that the four ‘R’s should be observed:

• Read – Check temperature at the same time daily and sign the sheet when completed.

• Record – Record temperature in standard fashion on a temperature monitoring chart.

• Reset – Reset the temperature after each reading.

• React – React if the temperature falls outside +2°C to +8°C

Stored correctly, refrigerated, and unopened, 100U vials of toxin will last for up to 36 months and 200U vials for up to 24 months. Reconstituted botulinum toxin is generally considered to be safe for use in refrigerated conditions for four weeks, though it is important to note that multiple withdrawals of the toxin could result in contamination and risk to patients.

Azzalure’s shelf life in temperatures of 2° to 8°C is two years. Once reconstituted the recommended storage time before use is 24 hours maximum, though the advice is that any unused toxin should be destroyed after use.

CHOOSING THE RIGHT REFRIGERATOR

A medical refrigerator will take the pressure off a busy practice wanting to achieve the highest professional standards.

Products, such as Lec Medical’s Pharmacy Plus range, employ Bluetooth technology to enable completely contactless temperature readings, using air and load probes for accurate measurement.

An intelligent fan management system prevents warm air being sucked in when the door is open and automatically restarts when it closes, ensuring temperatures remain stable, while a power failure alarm with battery backup and rechargeable battery offers peace of mind.

Advanced medical refrigerators allow reports to be scheduled remotely and downloaded directly to a mobile device, allowing for remote diagnostics by engineers and reducing the potential for appliance failure.

The cost of a medical refrigerator does not need to be prohibitive – there is a wide choice of size and capacity levels, from as little as 47 litres up to 400 litres.

The CPSA/JCCP Code of Practice was created to bridge the gap until the proposed regulation of the aesthetics industry comes into force when using a medical refrigerator to store toxins is likely to become a requirement rather than a choice.

When you also consider the potential cost of wasted products and, worse, delivering a sub-standard treatment that could damage patients’ health and your professional reputation – the time is right to ensure your botulinum toxins are stored safely. www.lec-medical.co.uk

Reactivate hair growth cycle with Hair-A-Gain

Hair-a-gain from Aashi is a thoughtfully crafted tonic that stimulates the hair growth cycle afresh. Hair-again is a revolutionary solution that beats traditional approaches to hair care. Its water-based formula contains Pea Protein and Ginseng Root extract, which help hair grow faster and become denser. It supports overall hair health with a powerful mix of Biotin, Nasturtium officinale, Amino Acid Complex, Jatamasi Extract, and Rosemary.

It subtly stimulates hair follicles at the molecular level with the backing of Pea Protein and Ginseng Root extract in this non-sticky formulation. Along with strengthening strands, Biotin and Amino Acid Complex make hair denser. Moreover, a combination of Rosemary and Nasturtium Officinale stimulates the scalp, which in turn promotes health and lessens dandruff.

More than just a hair product, Hair-a-gain is a masterpiece of scientific precision. It prevents hair loss, wakes up sleeping follicles, and makes hair stronger, all in one bottle. Now your patients can experience the joy of thick, gorgeous hair with Hair-a-gain, a product that combines science with premium haircare.

Impulse for superior tattoo removal and skin rejuvenation

As an industry leader, Pioneer Lazer Tech Co presents Impulse – a state-ofthe-art professional tool that amalgamates innovation, dedication, and client satisfaction. Impulse changes the game when it comes to tattoo removal and skin rejuvenation. It is safer, more comfortable, and more accurate than ever before. This cutting-edge model boasts a unique blend of laser wavelengths – 532 nm, 1064 nm, and 1320 nm – ensuring exceptional efficacy in treating various-coloured tattoos and addressing diverse skin concerns.

With its 3D cooling system and imported Italian water pump, Impulse is an efficient and versatile device that puts the comfort of its clients first during treatments. Clients looking to remove tattoos or rejuvenate their skin will find each session quite comfortable because of its advanced cooling technology, which assures a pleasant experience.

Crafted with precision, Impulse incorporates Bonding Crystal Bar technology, eliminating the need for mechanical troubleshooting during lamp changes. This innovation optimises operational efficiency, allowing operators to work seamlessly and conveniently, enhancing productivity without interruptions.

Safety is paramount with Impulse. Its intelligent AI Safety system adapts seamlessly to different skin types, ensuring a safe and convenient treatment experience for all clients.

Elevate your practice and redefine precision with Impulse.

Mitchell USA’s Age-less Hair Regimen

Mitchell USA’s Age-less 2-Step Age Slowing Hair Wash Regimen – a groundbreaking solution for voluminous, lustrous, and strong hair. This unique regimen comprises a Pre-Shampoo hair mask and an Antioxidant Shampoo, each enriched with Baobab & Pea Protein in a convenient 200 ml (each) combo pack.

Unlike conventional conditioners that offer temporary visual improvements, this regimen goes beyond surface effects. As we age, hair strands change, becoming thinner, lighter, and losing pigment. Environmental factors worsen this, often reducing hair production and visible balding.

Enter this dermatologist-tested and patented Lotus Seed Extract Anti-aging Hair Wash Regimen. This innovative combo not only slows hair loss but also nourishes, maintains lipid balance, and combats the effects of ageing on hair follicles.

Directions for use are simple: (Step 1) Start with the Mask; apply it generously to hair and scalp, leave it on for 5 minutes before rinsing. (Step 2) Follow with the Antioxidant Shampoo massaging thoroughly before rinsing.

If your patients’ hair is deficient in any of these vital nutrients, recommend this inventive shampoo and hair mask combo. It’s a nutrient-dense wonder that gives their hair a much-needed boost and keeps the moisture in.

Say bye to acne woes with Acnedyne Face Wash

Acnedyne Face Wash by Numero Uno Pharma – the solution to acne-prone skin that paves the way for a clear, confident you. This specially crafted formula is not just another face wash; it is agamechanger in skincare. Combining the potent properties of Salicylic Acid (2%) and Glycolic Acid (5%), it works harmoniously to delicately exfoliate and clear congested pores, effectively preventing acne breakouts.

But that is not all; Niacinamide (3%) takes centre stage, reducing inflammation, shrinking pores, and fortifying your skin’s natural defence system. Tailored for oily, acne-prone skin, Acnedyne goes beyond blemish control – it cares for your pores, promising a smoother, refined complexion.

This face wash is not just about cleansing; it is a steadfast ally in your skincare journey. What’s more, it is formulated without parabens and sulfates, ensuring a thoughtful, gentle approach to treating acneprone skin. Recommend Acnedyne to your patients, offering them the path to healthier, glowing skin and the confidence they truly deserve.

Hair Re-Growth Meso Cocktail

Leaderma’s Hair Re-Growth Meso Cocktail is a wonder potion that promotes healthy hair growth, leading to thicker, bouncy locks.

One approach to treating hair loss is mesotherapy, which involves injecting a combination of vitamins, minerals, and amino acids into the scalp. This technique makes it easy for the nutrients that support the hair follicles to penetrate the hair. As part of a mesotherapy treatment, Hair Re-Growth Meso Cocktail is applied to the scalp to promote healthy hair growth and prevent further thinning and loss. As a helpful alternative that poses no danger to patients, it stimulates regeneration and promotes new hair growth. Enhancing scalp health and potentially encouraging hair growth, it starts the metabolic process in hair follicles by activating the enzymes and chemical processes that break down the protein’s keratin and melanin.

Restore your patient’s voluminous and lustrous hair by recommending this proactive cocktail that contains all the nutrients their hair needs to grow back thick and healthy.

Cordless permanent makeup pen machine

PISHAA’s Permanent Makeup Pen Machine is the ultimate solution for a range of cosmetic procedures including powder brows, ombre brows, eyeliner, lip colour, scalp vitiligo, scar camouflaging reconstruction, and BB Glow treatments. Now available at wholesale prices, this top-tier permanent makeup machine guarantees quality, functionality, and convenience.

Its key features:

• Wireless design: Enjoy the freedom to work without limitations, with two lithium batteries provided for uninterrupted sessions.

• Versatile speed control: With three adjustable speeds, this machine caters to artists of all skill levels, ensuring precision in techniques like ombre powder brows, nano brows, microblading, eyeliner, or lip treatments.

• Customisable settings: Fine-tune needle adjustments and speed settings to suit individual preferences and optimise your procedures for exceptional results.

• MAX needle cartridge compatibility: Compatible with MAX needle cartridges for enhanced efficiency and performance.

The package comprises 1 PMU Pen, 1 AC Adapter, 1 Battery Charging Cord, and 10 1RL Cartridges.

Experience the freedom of a cordless system, the precision of adjustable settings, and the versatility to perform various cosmetic procedures effortlessly with PISHAA’s Permanent Makeup Pen Machine.