A third floor in Fitzrovia, and a rig that has not moved since 2019.

A piano warehouse, which turns out to be an excellent clinic.

Pellier Street was built in 1932 to store and season upright pianos, which meant deep floors, thick walls and enormous north-facing windows — a room designed to keep temperature and humidity stable and to be worked in by daylight. It is difficult to imagine a better accidental brief for examining skin.

We kept the windows and the floor and put everything else back. The waiting area has no product wall, because a product wall is a shop and we would rather you did not buy anything here you could buy cheaper elsewhere.

Five rooms, each set up for one kind of work.

Room 1

Consultation and mapping. The camera rig, the Wood's lamp, the dermatoscope. North light through the original warehouse window, which is the one thing in the building we did not choose.

Room 2

Acne and minor procedures. Extraction, TCA CROSS, and the three-weekly reviews that make a course work.

Room 3

Peels and pigment. Also the scalp clinic, because trichoscopy wants the same steady light.

Room 4

Laser. Door interlock, blackout blind, eyewear rack, and one list a week on Thursdays.

Room 5

Recovery and barrier work. The quiet one, with the reclining chair and no screen on the wall.

Six rules, and what each one costs us.

1. 01

   No injectables on a first visit.

   Diagnosis and treatment on the same day is how people pay for the wrong thing twice. It costs us the patients who wanted it dealt with today, and we have made peace with that.

2. 02

   No packages and no pre-payment.

   A pre-paid course is a bet that you will keep coming. It also makes it socially awkward for a clinician to tell you to stop at session three, which is precisely when they should be able to.

3. 03

   No treating a mole we have not photographed under dermoscopy.

   Removing a lesion for cosmetic reasons without recording it first destroys the evidence. If it turns out to have mattered, nobody can go back and look.

4. 04

   No before-and-after that moved the lights.

   Changing the lamp angle, the lens distance or the white balance between two frames can manufacture an improvement out of nothing. Every image we show is the same rig, same settings, same seat.

5. 05

   No laser on Fitzpatrick IV and above without a patch test.

   Seven days ahead, 1cm square, free. It costs us slots every week. It is the single most effective thing we do to prevent post-inflammatory hyperpigmentation.

6. 06

   No downtime quoted at its best case.

   Quote three days and deliver six and you have cost someone a week they planned around. Every number on this site is the slow version.

Nobody here is paid on what they sell.

Clinicians are salaried. There is no commission on treatments, no target on products, and no bonus attached to conversion from consultation to booking. Roughly a third of first consultations end with a recommendation cheaper than the consultation was, and nobody's pay moves when that happens.

We stock nine products in total, at list price, and will tell you which of them have a cheaper equivalent at a pharmacy. Four of them do.

• Opened2014
• RoomsFive, one lasered
• CliniciansFive
• Consultation£180

Third floor, and the lift is behind the stairs.

22 Pellier Street, Fitzrovia, London W1T. Two minutes from Goodge Street, five from Tottenham Court Road. The entrance is the black door between the framers and the sandwich shop; the buzzer is marked Clavel — 3. There is a lift, it is small, and it is behind the staircase rather than in front of it, which nobody finds on the first attempt.

Open tue–sat, 8.30am–6.30pm, closed Mondays. Step-free access throughout the third floor; tell us when you book and we will meet you at street level.

reception@clavel.example · +44 20 7946 0188