What happens when you stop

3.6.1The fear, and where it comes from

People commonly ask whether their skin will look worse if they stop, and often report having been told, or having inferred, that it will. The belief is understandable. It arises from the general anxiety about cosmetic treatments creating dependency, and it is reinforced by a maintenance schedule presented as a requirement.

There is no mechanism by which a material that is cleared from the tissue leaves it in a worse state than before, and we are not aware of evidence of a rebound effect. The more likely explanation for people feeling that their skin looks worse after stopping is straightforward: they became accustomed to the treated appearance, ageing continued in the meantime, and the comparison being made is against a remembered recent state rather than against the pre treatment baseline.

3.6.2The baseline problem

This deserves more attention than it gets, because it affects the whole way people assess cosmetic treatment over time.

Facial change with age is slow and continuous. Nobody perceives it accurately in themselves, because the comparison is always against a recent memory rather than against a fixed point. If you have treatment over a year, stop, and then assess your face against how you looked six months ago, you are comparing against a treated face and against a face that was six months younger. Both differences will register as decline attributable to stopping.

This is exactly why standardised photographs before you start matter, and why they should be taken under consistent conditions and kept. They are the only fixed point you will have. A clinic that takes them and gives you copies has given you something more valuable than most of what you will be sold.

3.6.3How the fade is likely to look

Gradual rather than sudden. There is no cliff edge, no point at which something is withdrawn. The material clears over weeks, whatever effect it was producing diminishes over the same period, and any subsequent change is the ordinary process that was happening before.

People who stop generally describe not a deterioration but a slow return of what they had been noticing before. That description is consistent with both explanations for how the treatment works, which is why it does not settle anything, but it is at least reassuring about the specific fear.

3.6.4Dependency, properly considered

There is no physiological dependency here in any meaningful sense. The material is not psychoactive, there is no withdrawal, and the tissue is not being suppressed in a way that rebounds.

There is, however, a real behavioural pattern worth naming, and it is not unique to this treatment. Cosmetic treatment can shift attention onto features that were not previously a focus. Regular appointments create a rhythm of assessment in which a face is examined critically every few months by someone whose work involves identifying things that could be treated. Some people find that helpful. Others find that the thing they came in for is resolved and three new things have been identified.

Noticing that pattern is not a criticism of practitioners, most of whom are responding to genuine questions. It is worth naming because the decision to stop is often harder than the decision to start, and understanding why makes it easier.

3.6.5Stopping well

A few practical points for anyone deciding to stop.

• You do not need permission and you do not need to explain. A decision to stop an elective cosmetic treatment requires no justification to anybody.
• If you have paid for a course you have not used, ask about the position on unused sessions. Do this in writing.
• Take a standardised photograph at the point you stop, so that you have a second fixed reference.
• Give it several months before assessing anything. The first few weeks after a final session tell you nothing.
• If you feel pressure to continue that goes beyond information, that is worth noticing. Professional guidance on cosmetic practice is explicit that patients should not be pressured and that time to consider is part of proper consent.

3.6.6Restarting later

Nothing about stopping prevents starting again. There is no evidence of a diminishing response with repeat courses and no evidence of a cumulative problem, though there is also no long term data on repeated courses over years, which belongs in the not known column rather than the reassuring one.

If you do restart, the same questions apply as the first time, including whether the product, practitioner and area are the same and whether your circumstances have changed. Medical history changes. Medication changes. A consultation you had two years ago is not a consultation you have had now.