A leading light in the world of aesthetic nursing, Emma Davies (RGN, NMP) co-founded both the British Association of Aesthetic Nurses (BACN) and the British Association of Sclerotherapists (BAS), as well as being Chair of the BACN until 2014. She has worked tirelessly to champion the interests of aesthetic nurses, drive best practice and improve patient safety, and has been recognised by numerous awards and plaudits, including ‘Aesthetic Nurse of The Year 2012’, the ‘Services to Industry’ awards by Cosmetic News Magazine and Tatler's ‘Top 10 list of Aesthetic Nurses’ in 2016.
‘A happy accident’ is how Davies describes her beginnings in microsclerotherapy.
Starting out in the embryonic field of aesthetics in 1998 by providing collagen injections, Davies was keen to add to her treatment menu and was encouraged by a mentor to train in the treatment of leg veins. Between 40 and 50% of the adult population suffer from unsightly leg veins, and there is generally no treatment offered by the NHS, as this is considered to be a ‘cosmetic’ concern.
Davies went on to establish her own successful aesthetic and sclerotherapy practice, Horrington Clinic in Somerset, as well as Veincare Training, one of the most respected providers of microsclerotherapy courses. She is also Clinical Director of voluntary accreditation register Save Face, and also sits on the board of The Aesthetic Complications Expert Group (ACE).
Davies will be speaking at the BAS 2019 Sclerotherapy Conference in May on the topic of microsclerotherapy marketing, where she hopes to reignite practitioners' enthusiasm and inspire them to drive their practices more successfully. In this interview piece, she shares her best advice with author Hilary Furber.
Q: What is microsclerotherapy?
A prescription-only sclerosing solution is injected, with a tiny needle, into the thread or spider veins (telangiectases). This solution damages the endothelium, causing it to fibrose. Compression—in the form of a graduated medical stocking—is then applied to promote the process and minimise complications. Relatively painless, microsclerotherapy can effectively treat veins up to 3 mm in diameter in the absence of varicose veins.
Q: What other treatments for leg veins are available to nurses?
The most reliably successful and virtually painless option is undoubtedly microsclerotherapy, but other types of treatment might include certain types of lasers, ND-Yag for example, and for limited types of vein, intense pulsed light (IPL) treatments can be used. Thermocoagulation devices are more effective on facial capillaries, which sclerotherapy is not licensed for.
Q: What adjunctive treatments do you yourself use?
None. I treat all leg thread and spider veins with microsclerotherapy, although I would recommend adding a treatment modality for facial veins, as this is another common concern.
Q: What makes microsclerotherapy appealing to you as a practitioner?
Of all the treatments I offer, microsclerotherapy is the most medical, and there's a slightly different client base. I also find it a relaxing treatment to do, it can be quite meditative, and patients tend to have straightforward expectations compared with cosmetic clients. It's so rewarding when the results are life-changing for patients, who have often been avoiding swimming or beach holidays for years due to embarrassment about their veins.
Q: What would a new practitioner need in order to introduce microsclerotherapy into their clinic?
Primarily, training! Clinics will already have the necessary facilities, and microsclerotherapy requires minimal capital investment and no expensive consumables.
The use of a Doppler ultrasound is recommended as a basic screening tool, and a Veinlite® vein finder can be very useful.
Q: What are the main challenges or pitfalls?
The main challenge is that the treatment does have to be marketed. Consumer awareness is low, and people won't ask for it if they don't understand the treatment. The other thing is that while your cosmetic patients may have leg veins they are unhappy with, there are other potential clients who aren't necessarily looking for Botox or dermal fillers. When a practice fails to develop, it is often due to a lack of marketing.
Q: What marketing approaches have you found successful in building your practice?
The same approach as for promoting any other treatments, really. Today, the internet has become the most powerful marketing tool: a good website, an active presence on social media, and sclerotherapy-related blogs, e-shots and newsletters to inform current clients are all essential. Point of sale leaflets and events, such as open evenings talking about vein conditions, can help to highlight the benefits and drive up demand.
Practitioner finders such as the British Association of Sclerotherapists' member directory, Save Face and Consultingroom.com can also bring in new enquiries.
Adverts and articles in local publications and lifestyle magazines can get you noticed and help establish you as an authority in this treatment area.
Prospective patients may well not know about sclerotherapy, so the terms ‘leg vein treatment’ or ‘unsightly leg veins’ may be more likely to catch their attention. An interesting snippet: Google Adwords in 2017 reported 42 000 searches per month related to leg veins, and 20 200 for ‘Botox’. So, there is a real demand for services offering treatment for leg veins.
I found relationships with vascular consultants in my area were mutually beneficial, so networking is always helpful. Vascular surgeons are often not so keen to treat smaller veins.
I work extremely hard at giving each patient a positive experience, which has paid off—nowadays most of my new patients are gained through word of mouth.
Q: What is the single most useful piece of advice you'd give to a practitioner?
Avoid the mistake of expecting patients to roll up asking for treatment. If they don't know you offer it, they won't ask.
Q: What CPD resources are available for practitioners?
One of the main reasons the British Association of Sclerotherapists was set up in the first place was that there were really no CPD resources other than self-directed learning on the internet or journals, or perhaps finding a mentor. The BAS annual one-day CPD conference is the only UK event that focuses solely on leg veins; it's excellent for networking with vascular specialists, and the BAS website has a wealth of resources for practitioners and the public.