Todays men & women want to look as good as they feel


It is more important now than ever that we do our best to stay positive in a world which seems constantly to find something negative to disrupt our wellbeing.  From political turmoil, which has dominated the news over the past few years, to the current pandemic.  As important as keeping ourselves well physically, it is at least as important that we keep ourselves mentally fit and happy.

As many of you will know, I am passionate about women getting the right help in the form of HRT in order to help alleviate the mental and physical symptoms that accompany the majority of women in their 40s and 50s.

The symptoms of oestrogen deficiency can have such a negative impact on our lives; many symptoms such as low mood, anxiety, poor sleep pattern and lack of confidence are not always attributed to oestrogen deficiency. In fact, it is common for women with these symptoms to be misdiagnosed as being depressed, when usually all that is needed is the correction of oestrogen deficiency.

The problem is that women who are eligible for HRT are not getting it.  The three reasons are broadly:

  1. Ignorance on the part of GPs.  This has not been helped by the seemingly contradictory information in the media regarding the safety of HRT;
  2. GP budgets for HRT are squeezed (particularly in light of 1 above); and
  3. Availability of HRT preparations.

I’d like once more to draw your attention to the most recent newsletter of Professor John Studd, a renowned HRT expert.  Basically, he continues to insist the following in his annual newsletters, that:

  1. HRT is safe for the majority of women;
  2. Oestrogens do not cause an increase in breast cancer;
  3. Oestrogens increase bone density and reduce the risk of age-related fractures; and
  4. Provided that oestrogens are delivered in patch, gel or implant form (ie. not orally) there is no increased risk of heart attacks and strokes.

Professor Studd’s opinion is that it is progestogens that are associated with the above health risks.  Unless, you’ve had a hysterectomy, progestogens are a necessary accompaniment to oestrogen therapy.   However, the risks can be reduced by taking a biocompatible preparation, such as utrogestone.

I’m attaching a link to his newsletter and hope that you will find it educationally as inspiring as I do.

Covid 19

All of you will be au fait with measures recommended to reduce transmission of this virus.  I just want to reassure you that I’ll be continuing to work, but because my work necessitates close contact with clients, in the interests of taking all possible steps to reduce the chance of transmission, I’ll be wearing a mask and gloves until it is felt that wearing masks is no longer indicated.  I also have alcohol based hand sanitising agents at all my clinics.

Free Lumigan eyelash enhancement

This offer finishes on March 31st 2020 (London) and May 30th 2020 (Bath and Scotland).

I do hope that those of you who have been using Lumigan for the past few weeks have noticed some positive effects on your eyelashes. Research shows that maximum length is achieved after 2 to 3 months of daily use. After that, the effects are thought to be maintained by twice weekly use.

You can purchase 6 months supply for £170 (the price of 4 months).  In fact, a 6-month supply might last you much longer if you reduce usage to twice per week after the first few months.

Tretinoin 0.05% – the benefits on your skin – Cost:  £60 (30g)

For several years I’ve chosen tretinoin 0.05% cream for use as my night cream.  Medical research shows overwhelmingly that this product has more positive effects on the skin than any other, as it:

  1. reverses fine lines and wrinkles
  2. refines the skin, reducing the size of pores
  3. improves blood supply giving your skin a healthy glow
  4. is anti-acne – reduces blackheads/spots and the resulting pigmentation problems once they heal.

It works by speeding up cell turnover, which leads to exfoliation of the top (dead) skin layer.  By stimulating collagen production, it thickens the skin slightly.  It does NOT thin the skin.

Retinol and tretinoin are both versions of vitamin A, but they are not equivalent in dosage.  Tretinoin is much stronger.  As a guide, tretinoin 0.05% (the cream I supply) is four times the strength of retinol 0.05% (the preparations available to buy over the counter).

You should start by using a pea-sized amount for your whole face, only at night.  Most people experience side effects until they become used to it. These include dryness/irritation and skin flaking.  This is normal and will get better with time.  Please don’t get discouraged if you feel you look worse initially.   The long-term benefits outweigh the initial side effects and it is well worth persisting.

It is also more important to protect your skin from the sun, as you may notice that exposure to sunlight makes you become more red than usual.

This cream cannot be used by pregnant or breastfeeding women.

I also use Obagi Elastiderm eye cream at night (15g / £100).  My own routine in the morning includes Obagi Vitamin C 20% serum (30ml / £120).  This serum is an antioxidant and has the advantage of moisturising skin which may be a little dry from tretinoin use the night before.  Obagi Exfoderm 57g (£85) encourages exfoliation and completes my routine.

Add Obagi gel foaming cleanser (200ml / £50) twice daily and you will see that my whole skin routine consists of only 5 products.  The total price is £410.  All these tend to last me 6 months.

To counter any initial dryness and as a lovely, rich, hydrating cream (particularly good as a base underneath make-up), I use Obagi Luxe moisturising cream (48g / £60).

You can order any of these products, pay over the phone and we will send them out to you via recorded delivery.

Botox® – achieving the very best look

Botox® done well makes you look fresher and open-eyed in a natural way. The balance between frown and forehead dose is very important and this optimal ratio varies from person to person.  I’ve seen some sub-standard looks – very shiny foreheads, heaviness in the frown area, coupled with eyebrows that shoot upwards.

The look achieved is dependent not just on the dose, but the positioning of Botox®.  I know that we have become swamped by people offering “Botox®” at ever decreasing prices.  Many are using products which are cheaper to buy than Botox® (e.g. Azzalure, Xeomin).  These alternative products are not the same as Botox®.  Even though the practitioner will tell you they are giving you Botox®,  I would advise you to ask to ask to see the vial. They are made differently and have not been subjected to such rigorous scientific tests.  Moreover, the NHS uses Botox® for medical indications such as chronic migraine, muscular spasms, bladder instability, etc.  It is for these reasons that I only use Botox®.  If you try “cheap” – whether it is the practitioner or the product – you are risking a sub-standard look.

Beware – a common problem (apart from a sub-standard look) is that novices tend to use very small amounts of product.  This means that whatever effect created will not last long, necessitating lots of trips back to (hopefully) the same practitioner that treated you.  Lots of wasted time and an overall negative experience.

At my clinic I give strong doses to those who need it and do not charge more.  Strong is good and looks natural if positioned correctly and the balance is right.

Botox® is safe and “Baby Botox®” misleads the public into thinking that Botox® might be toxic. To me, the term “Baby Botox®” means a weak, sub-standard look and a waste of money, because the effect will not last.

As I’m the first to admit, it is not always possible to get the dose exactly right first time.  I therefore always invite particularly new clients to return up to 3 weeks following treatment for a free top-up.  Once we get the right dose for you, you should not need to return more than 3 times per year.

London clinic timetable

Please note that the timetable below is a guide.  I know that many of you with children of school age need earlier appointments and I will always aim to accommodate you.  I can sometimes offer appointments on Thursdays and Fridays in London too.

Monday    –    Richmond 3pm to 7pm
Tuesday   –    Fulham 3pm to 7pm (except on Chelsea home match days!)
Wednesday – Wimbledon Park 3pm to 7pm

Bath clinics (note new address:  The Apthorp Centre, Weston Road, Bath BA1 2XT)

The first Thursday in each month, 10.15am to 5.30pm.

Scotland clinics (all on Saturdays)

I’m so sorry that the March 21st clinic has had to be cancelled.  Once the current situation is clearer, I’ll re-book as soon as I possibly can.

Edinburgh/Glasgow 2020
–  May 2nd, June 13th, July 25th, September 5th

Aberdeen 2020 
– April 11th, May 23rd, July 4th, August 15th, September 26th

I do hope you all remain healthy and positive and I look forward to seeing you at one of the St. John clinics soon.


With all best wishes,
Lady St John of Bletso MBChB MRCOG
Dr Helen St John
020 8946 9694