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The world of Botox® and why I strongly support Dr Leah Totton

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We all like to look good. Myself included. But how far do people go?Earlier this year, unapologetically, I was cheering on Dr Leah Totton who is a qualified doctor from Derry/Londonderry in Northern Ireland who deservedly became the latest winner of BBC One’s The Apprentice (from the very start of the series right through to the end I must add!). She became the first doctor in the history of the programme to be hired by Lord Sugar, the main man of the programme.

Her business venture is to start a cosmetic procedures business, simply called “Dr Leah”, where she plans to open a series of clinics offering a range of cosmetic procudures such as face fillers, anti-wrinkle injections and skin peels. She will also be offering a skincare range. The first of those clinics should, to the best of my own knowledge, be opening in London very soon. Her win on the BBC hit TV programme brought the spotlight onto one particular treatment - Botox®.

But what about Botox®? What really is it? Botulinum toxin is a protein originating from Clostridium botulinum, a kind of bacterium which is Gram-positive. Botulinum toxin can be a very potent and fatal substance if inappropriately utilised and it’s side effects can include fever, pain and even seizures.

But it has been widely used for cosmetic procedures, despite the fact that it hasn’t been officially licensed for that use and Botulinum Toxin Type A has been utilised to minimise the appearance of certain kinds of wrinkles. But certain groups of patients, for instance the over 65’s, those who have had inflammation in the area where the treatment would have been intended for and those with swallowing difficulties cannot receive this treatment. Practitioners who prescribe the treatment should know comprehensively about the patient’s medical history.

There is some really interesting and helpful guidance from the Medicines and Healthcare products Regulatory Authority (MHRA) which answers many frequently asked questions about the supply and administration of treatments such as Botox® (a link is below this blog entry). 

To summarise, however, it states that Botox®, for instance, can be administered by an appropriate practitioner (i.e. a doctor or a dentist, and also (subject to defined limitations) a nurse or pharmacist independent or supplementary prescriber), a person under the directions of an appropriate practitioner or it can be self-administered. Now the third of those three options I have mentioned isn’t a really advisable route to take, regardless of whether you are a qualified healthcare professional or not. It is always better to seek professional advice on those matters for the sake of safety. Also, the MHRA explores other issues and also mentions about guidance and advice issued by the General Medical Council and the Nurse and Midwifery Council.

In the context of all the issues surrounding this topic, some of the concerns that were put on the table by industry experts and leaders about Dr Leah were very understandable and shouldn’t be immediately dismissed. Yet she doesn’t intend on breaking the law and nor is she on a crusade to fly in the face of best practice when it comes to carrying out those procedures.

And yet I found it really upsetting and frustrating that hardly anyone, except for most notably Dr Patrick Bowler (see link below), had the courage to stand up, congratulate and applaud her for her passion, eagerness and enthusiasm to improve the way the cosmetics industry is regulated and for her unambiguous commitment to ensuring and improving patient safety and for her ethical nature. She knows that this new venture must be successful. And she knows that she has the talent and courage to make it work. I only wish people would appreciate those qualities in her, because those that do understand what she is all about will be reassured and confident in her.

Only positivity and a willingness to engage, support and encourage individuals like Dr Totton is in everyone’s interests and will create a better and a more medicalised environment for these kind of treatments. It is in everyone’s interests, whether it’s government, healthcare regulators, healthcare professionals, patients and the general public, that “Dr Leah” is a major success story.

She could be the very person who catalyses major and long overdue progress in ensuring that better regulation is brought forward and applied to the cosmetics industry, because she has managed to bring this issue into the public spotlight on a major TV programme, watched by millions of viewers across the United Kingdom, and she has the advantage of having a public profile thanks to her time on The Apprentice. I learned a lot about her during the past series, by watching the television programme and following her progress on social media.

And although I’ve never met her, yet, she appears to me to be a sensitive, humble and compassionate lady with an admirable passion and enthusiasm for excelling at the highest possible level. Nobody denies that she is still only in the early stages of her career and that she has much experience still to pick up and a lot more to learn.

But if her venture succeeds, particularly with expected public scrutiny, then I feel it is obligatory that Leah’s title should transform from “Dr” to “Dame”. 


MHRA FAQ’s on treatments like Botox® - article on Botulinum toxin type A - 

Dr Patrick Bowler’s blog entry on Huffington Post on Dr Leah -

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