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Targeted Assessment · Aesthetics · Skin Nutrition · Pre-Procedure

Before an Aesthetic Procedure:
What Your Bloods Can and Can’t Tell You

Microneedling, laser resurfacing and fillers all rely on your skin’s own repair response. Microneedling is meant to trigger new collagen. In one uncontrolled series, biopsies showed more collagen six months later (Aust 2008), and a systematic review called it safe and effective for scars and wrinkles while noting weak study methods (Ramaut 2018). Mixed. Whether your iron, vitamin C or hormone status changes how well you respond hasn’t been studied. This assessment checks the things that can be checked, so a deficiency isn’t left in place before you spend on a course of treatment.

Collagen buildingNeeds vitamin C and iron. Established physiology.
Hormone therapy and wrinklesNo difference from placebo over 4 years in one large trial (KEEPS, Owen 2016). Strong for that question, one trial.
MicroneedlingMore collagen on biopsy in a small uncontrolled series (Aust 2008). Observational.
£345Pre-procedure nutritional assessment
Who this is for

Anyone planning an aesthetic procedure who wants to know whether anything in their blood work is worth sorting out first

Collagen is the main structural protein of skin, and most aesthetic procedures aim to make more of it or replace lost volume. Building collagen needs vitamin C, iron, zinc, copper and enough protein. Established physiology: severe deficiency, as in scurvy, stops it. Whether a milder shortfall, such as low iron stores, means less collagen from the same treatment hasn’t been measured. My view: it’s worth finding and fixing a real deficiency for its own sake, and it may help your results. I can’t promise that it will.

The grades on this page: Strong good randomised trials agree. Mixed few, small, short, unblinded or conflicting trials. Observational: a link, not proof of cause. Mechanistic the biology makes sense but hasn’t been shown to change outcomes in people. None no usable evidence. Practice expert, guideline or coaching practice, not trial-tested. Established physiology: textbook biology where the deficiency disease is documented in people (scurvy; vitamin K deficiency bleeding).

What we assess

What I check, and what the evidence says

Vitamin C
Rate-limiting cofactor for prolyl hydroxylase — the enzyme building the collagen triple helix. Severe deficiency stops collagen forming properly. Established physiology. In a trial in 88 people with pressure ulcers, high-dose vitamin C didn’t speed healing compared with a low dose (ter Riet 1995). It hasn’t been tested in aesthetic procedures.
Zinc
Required for collagenase enzymes remodelling existing collagen and for the matrix metalloproteinases involved in wound healing and tissue remodelling. In UK survey data, girls and women eating less than 40 g of red meat a day were more likely to have zinc intakes below the lowest reference level, though their blood markers didn’t differ (Derbyshire 2017). Observational. Blood zinc is a rough guide in one person (King 2016).
Ferritin (Iron)
Required for prolyl hydroxylase alongside vitamin C. That’s laboratory biochemistry; whether low iron stores change the result of an aesthetic procedure hasn’t been measured.
Low iron stores can be missed when the full blood count looks fine. In anaemic patients, a ferritin of 30 µg/L (30 ng/mL) or less picked out iron deficiency far more reliably than the old cut-off of 12 µg/L (12 ng/mL) (Mast 1998). The British Society of Gastroenterology reads a ferritin below 30 µg/L (30 ng/mL) as low iron stores (BSG 2021).
Oestrogen and progesterone
Skin has oestrogen receptors, and skin collagen falls after the menopause. Women treated with hormone implants had more skin collagen than untreated women (Brincat 1985). Observational. But in a four-year randomised trial, HRT didn’t change facial wrinkles or skin rigidity compared with placebo (KEEPS, Owen 2016). Hormone testing can explain symptoms and inform a conversation with your GP about HRT. It hasn’t been shown to make aesthetic results last longer.
Cortisol (via DUTCH)
Long-term high cortisol thins skin and slows the cells that make collagen; that’s well known from steroid medicines. Mechanistic for everyday stress. Whether stress hormones change aesthetic results hasn’t been studied.
CRP
CRP is a general marker of inflammation. Its standard risk tiers (below 1, 1–3 and above 3 mg/L; below 0.1, 0.1–0.3 and above 0.3 mg/dL) are for heart disease (Pearson 2003), not skin. A raised CRP has many causes and is worth repeating and understanding. In the lab, inflammatory signals activate enzymes that break down collagen. Mechanistic I found no study showing that it makes filler break down faster or shortens results.
Targeted Assessment Service
DH Pre-Procedure Nutritional Assessment
Blood chemistry · Hormonal context where relevant · Written report · A plan for the weeks before your course
What's included
Blood chemistry — ferritin, zinc, vitamin D, CRP, fasting glucose/insulin
Hormonal context — oestrogen/progesterone pattern via DUTCH Plus where indicated
Dietary protein and collagen precursor adequacy assessment
Written interpretation report specific to your procedure type
A written plan: what to correct, what to raise with your GP, and whether any supplement is worth it for you, graded the same way as this page
If CRP is raised: what may be driving it and whether to retest
What you'll know
Whether you have iron deficiency (ferritin, in µg/L and ng/mL, with the full blood count)
Whether zinc or vitamin D are low, read with the limits of a single test
Your hormone pattern, where relevant, and whether it’s worth a GP conversation
Whether CRP is raised and what might explain it
What the evidence does and doesn’t support, so you don’t pay for things that haven’t been shown to help
Assessment fee
£345
Lab costs additional where applicable.
Book a free 20-minute call →
Evidence

How strong is the evidence?

ClaimGradeMain source
Microneedling increases collagen on biopsyObservational (uncontrolled; 20 people biopsied)Aust 2008
Microneedling improves scars and wrinklesMixed review notes weak methodsRamaut 2018
Collagen synthesis needs vitamin C and ironEstablished physiology—
Low iron or zinc means a weaker procedure responseNone untested—
HRT reduces facial wrinklesStrong no effect, one 4-year RCTOwen 2016
Sex hormones go with more skin collagenObservationalBrincat 1985
Low red meat goes with low zinc intake in UK girls and womenObservational (intake, not blood status)Derbyshire 2017
Inflammation or CRP makes filler break down fasterNone found—
Cortisol raises “neurotoxin requirement”None—

Sources

  1. Aust MC et al. Percutaneous collagen induction therapy: an alternative treatment for scars, wrinkles, and skin laxity. Plast Reconstr Surg 2008;121:1421–9. PMID 18349665. doi:10.1097/01.prs.0000304612.72899.02
  2. Brincat M et al. Long-term effects of the menopause and sex hormones on skin thickness. Br J Obstet Gynaecol 1985;92:256–9. PMID 3978054. doi:10.1111/j.1471-0528.1985.tb01091.x
  3. Derbyshire E. Associations between red meat intakes and the micronutrient intake and status of UK females. Nutrients 2017;9:768. PMID 28718824. doi:10.3390/nu9070768
  4. King JC et al. Biomarkers of Nutrition for Development (BOND): zinc review. J Nutr 2016;146:858S–885S. PMID 26962190. doi:10.3945/jn.115.220079
  5. Snook J et al. British Society of Gastroenterology guidelines for the management of iron deficiency anaemia in adults. Gut 2021;70(11):2030–51. PMID 34497146. doi:10.1136/gutjnl-2021-325210. Below 15 µg/L: absent iron stores; below 30 µg/L: low iron stores; up to 100 µg/L can still mean iron deficiency in active inflammatory bowel disease.
  6. Mast AE et al. Clinical utility of the soluble transferrin receptor and comparison with serum ferritin in several populations. Clin Chem 1998;44:45–51. PMID 9550557. PubMed
  7. Owen CM et al. Effects of hormones on skin wrinkles and rigidity vary by race/ethnicity: four-year follow-up from the ancillary skin study of KEEPS. Fertil Steril 2016;106:1170–5. PMID 27393520. doi:10.1016/j.fertnstert.2016.06.023
  8. Pearson TA et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice (CDC/AHA statement). Circulation 2003;107:499–511. PMID 12551878. doi:10.1161/01.CIR.0000052939.59093.45
  9. Ramaut L et al. Microneedling: where do we stand now? A systematic review of the literature. J Plast Reconstr Aesthet Surg 2018;71:1–14. PMID 28690124. doi:10.1016/j.bjps.2017.06.006
  10. ter Riet G et al. Randomized clinical trial of ascorbic acid in the treatment of pressure ulcers. J Clin Epidemiol 1995;48:1453–60. PMID 8543959. doi:10.1016/0895-4356(95)00053-4
Further reading

The clinical evidence behind this service

Clinical Essay
What Your Aesthetics Clinic Isn't Telling You
Clinical Essay
The Bioidentical Hormone Conversation Nobody Is Having
Clinical Essay
Before Your Operation: What Nutrition Can and Can’t Do
Test
Blood Chemistry — The Markers That Matter

I sell testing and consultations, including this assessment, so I declare an interest: the grades on this page apply to them too.

I don’t sell supplements. I recommend them, choosing the supplier on quality, dose, ingredients, value and what’s in stock. One supplier pays me a commission on its own brand, which I don’t always choose, and my resources page has a few Amazon affiliate links. Neither decides what I recommend.

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