One of the words we hear most often at consultation is "dull", and it can mean three quite different things. Treating the wrong one is how people spend money on a treatment that was never going to help.
This is how we tell them apart, and where PRP, skin boosters and anti-wrinkle injections each fit.
Three things "dull" usually means
The first is the surface. Skin looks bright when light reflects evenly off it. Rough texture, enlarged pores, fine scarring and a build-up of dead cells scatter that light, and the skin reads as flat.
The second is the quality of the skin underneath. Skin that has lost hydration, thickness and elasticity, through age, sun or both, looks thinner and more tired even when the surface is smooth. Around the eyes, this is often what people mean when they say they look tired.
The third is not the skin at all. Loss of volume under the eyes or in the mid-face creates shadow, and shadow reads as tiredness. No skin treatment fixes a shadow.
Most faces have some of each. The assessment is about working out which one is doing most of the work.
Before any treatment
Some things no treatment replaces, and they are worth saying because they cost little: sunscreen every day, whatever the weather; not smoking; enough sleep; and a simple routine your skin tolerates. Clinic treatments work better on skin that is looked after between appointments.
Feeling tired and looking tired can also share a cause. If your skin has changed noticeably in a short time, or you feel as tired as you look, see your GP before you see us. Thyroid problems and low iron, among other things, can show in the skin, and no aesthetic treatment will fix them.
Where PRP fits
PRP, platelet-rich plasma, is prepared from a small sample of your own blood, spun to concentrate the platelets, and injected back into the skin or worked in with microneedling. It prompts the skin to repair itself and make new collagen.
It works on quality and texture rather than shape: finer, more even, healthier-looking skin over time. It is a course rather than a single session, usually three sessions about a month apart, and three to six months is the fair timeline for judging the result. Expect some redness for a day or two afterwards. Because the material is your own, allergy is not a concern in the way it is with an introduced product.
PRP suits people who want gradual, natural change and are happy to wait for it.
Where skin boosters fit
Skin boosters are injectables that improve skin quality without changing the shape of the face. Profhilo is hyaluronic acid that spreads through the tissue, hydrating the skin and prompting it to make collagen and elastin; it suits skin that has lost firmness and bounce. Polynucleotides (we use Plinest and Vitaran) work on the cells that make collagen and calm inflammation, and are where we lean for thin, crepey or sun-damaged skin, especially under the eyes. Sunekos combines hyaluronic acid with amino acids to much the same end.
All three are given as a course. The first change usually shows around four weeks in, and the full effect around three months after the last session.
Microneedling
Microneedling works from the surface: controlled micro-injuries that trigger the skin's repair response, useful for rough texture, enlarged pores and mild scarring. It is often combined with PRP. Expect two to three days of pinkness afterwards.
Where Botox fits, and where it does not
Anti-wrinkle injections (Botox) relax the muscles that crease the skin. They soften frown lines, forehead lines and crow's feet, and because a deep frown line reads as tired or cross, softening it can make a face look more rested.
What they do not do is change the skin itself. They will not add hydration, improve texture or brighten a dull complexion, and we would not recommend them for dullness on its own. Where lines and skin quality are both part of the picture, the two are often combined: a skin treatment for the skin, and anti-wrinkle injections for the lines.
When tired-looking is a volume problem
If the tiredness is mostly shadow under the eyes or flattening in the cheeks, the answer is structure, not skin. That may mean tear trough or cheek filler, used conservatively, and hyaluronic acid filler can be dissolved if it ever needs to be. Often the better plan is skin quality first and a small amount of filler afterwards, which usually means less filler, not more.
What we do not offer
We do not offer chemical peels, laser resurfacing, HydraFacials or other facials. If pigmentation or sun spots are your main concern, those treatments are worth looking at with a practitioner who specialises in them.
Common questions
How long before I see a difference?
With skin boosters, usually around four weeks after the first session, with the full effect about three months after the course. PRP is slower, at three to six months. Anti-wrinkle injections work within days and settle at around two weeks, but on lines rather than on dullness.
Can PRP and skin boosters be combined?
Yes, and it is often a sensible plan, because they work in different ways. The order and spacing are decided at your consultation.
Is Botox worth it for tired-looking skin?
Only if lines are part of what makes you look tired. For a frown that makes you look cross or worn, it can make a real difference. For dullness, texture or dehydration, a skin treatment is the right tool.
What does it cost?
Skin boosters start from £250 a session and PRP from £300 a session, with a lower price per session for a course. Every price is on our pricing page, and the consultation itself is free.
Book a consultation
If your skin looks tired and you are not sure why, that is exactly what a consultation is for. Dr Haroon will look at texture, skin quality and structure separately, tell you which is doing most of the work, and recommend the least that will make a real difference, including nothing if that is the right answer. The clinic is at 3 Holmesdale Road, Reigate, one minute from the station, and we see patients from Redhill, Dorking, Banstead, Leatherhead, Horley and across Surrey. Book a consultation.
About the author
Dr Haroon Ashraf is a GMC-registered doctor (GMC 7645907) and the founder of Mindful Aesthetics in Reigate, Surrey. He qualified in medicine at St George's, University of London, in 2019, works in aesthetics full time, and has been a senior clinical trainer at Derma Medical since 2021, where he has taught over 1,000 doctors, dentists and nurses. Every treatment at Mindful Aesthetics is carried out by him personally.