Category: Our Blog

It isn’t often that I will write about one particular product, but last week I experienced trying a new product that knocked my socks off. As we age, no matter how good we are with our skin and no matter how awesome our home care routine may be, there is no doubt that our skin starts to become duller, less plump, less youthful. Add to that, that personally I have an oilier skin and have to be careful not to use rich moisturizers and you can see how it can be difficult to maintain a proper hydrated, voluminous, healthy appearance.

SkinMedica recently released a new hydrator in Canada called HA⁵. It is a hydrator containing 5 different weights of hyaluronic acid. Hyaluronic acid (HA) is a molecule capable of retaining up to 1000 times its weight in water. It is the ultimate sponge, and the more we have, the better our skin will be.

As children, we are full of HA. When we see children and admire their beautiful, perfect skin, it is because they are loaded with HA. But as we grow and are exposed to the elements, environmental pollution, the sun, or things we put in our bodies, we are slowly depleting our system of HA. From dry, dehydrated skin to those suffering from acne, we all need as much HA as we can get. SkinMedica’s oil free, fragrance free hydrator is ideal for every skin type. It is non-comedogenic (doesn’t cause acne breakouts), light weight and feels amazing from the get go.

Hydrators and moisturizers are not exactly the same thing. A moisturizer is a cosmetic cream or lotion made with humectants or occlusives or a combination of both that prevent skin dryness. A hydrator is a cosmetic treatment product that promotes epidermal health by supporting the skin’s natural ability to replenish HA. For most of us, the HA⁵ would be applied directly before the moisturizer. For some, perhaps in the summer, the HA⁵ may work well alone.

Dry skin is a skin type, while dehydration is a skin condition. In both, the skin undergoes transepidermal water loss, or evaporation of water from inside the body. With this water loss, the enzymes that normally help the skin shed cells can’t function properly, resulting in a buildup of cells that makes the skin look rough and dry, contributing to the appearance of fine lines and wrinkles.

Dry skin can be genetic or a symptom of systemic disease. It is caused either by the inadequate production of oil, called sebum, or by an imbalance of fatty acids, ceramide, and cholesterol in the stratum corneum, the barrier layer of the skin. Age is also a factor in dry skin. As we get older, we experience a decline in a main hormone that triggers sebum production.

Dehydrated skin still produces sebum but is temporarily dry because of various factors, including environmental effects such as a dry climate or use of harsh detergents or products on the skin. It is caused by a temporary imbalance of fatty acids and ceramides in the skin’s barrier layer, resulting in a temporary spike in transepidermal water loss. Those suffering from acne and are on acne medications are often subjected to dehydrated skin. Thinking their skin is dry instead of dehydrated, these patients will often resort to using too rich creams or even worse, oils, to make the skin feel less dry. Of course this results in more acne as the pores are blocked with the wrong types of products.

I was given a sample of the HA⁵ that would last 4-5 days. Apprehensive due to my oily skin, yet informed enough to understand that HA doesn’t add oil to the skin; I was mildly excited to try this new product. I did everything else the same. I applied my regular serum in the morning, then the HA⁵, my moisturizer and then sunscreen. At night, I did the same, sans sunscreen. For the first few days, although I loved the feel of the product, I didn’t experience any change in my skin. By the 4th morning, even before I applied my skincare, I noticed my skin looking plump, juicy and yummy. When I went to work that day I had several comments from regular patients asking what I had been doing differently. So I told them. A few were so impressed they decided to try the product for themselves.

The next morning I was scraping the bottom of the barrel like a crazy addict. I am sure I have never done this before. I was actually laughing a little at how weird I was acting. This is one product I will be adding to my routine. I will probably use it morning and night in the winter and maybe just once a day in the summer. Experiencing results like this so quickly and having others notice, is a rare thing for me. I love SkinMedica products and I use a lot of their home care, but this is the first one to really knock my socks off. I have actually been at work during the day and caught myself thinking about putting it on when I get home! Seriously!!

If there is one new product you want to try this year, let HA⁵ be that product. No matter your skin type or condition, this is one of the best products I have ever used, and I imagine you will feel the same.

~ Sheri Roselle, Medical Esthetician at Toronto Dermatology Centre

 

This week a patient of mine told me that her nail girl told her to never have her underarms lasered because it causes breast cancer. Although I have often been asked if any radiation comes from our lasers (there is zero radiation from cosmetic lasers of any kind), I was curious as to where she got this false information. She said that the girl who does her nails knew a girl who had her underarms lasered and that person also had breast cancer.

The truth is that all cosmetic lasers, whether for hair removal, photo rejuvenation (e.g. IPL or BBL), skin resurfacing or anything else, has a wavelength in a safe zone, where there is no radiation emitted whatsoever. Each laser’s wavelength is attracted to a specific something, usually a colour. If it doesn’t see that colour, then it isn’t even absorbed into the skin. Yes, the skin, only the skin. In other words, the lasers can’t see the thyroid, the lymph nodes or any other part of the body that is more than skin deep. Dear nail girl: leave the facts to the professionals and keep your silly conclusions to yourself.

Here are some other myths about lasers:

Myth #1: Cosmetic lasers are a ‘new’ technology and still very much in the developmental and experimental stage.

The first dermal laser treatments were conducted by a dermatologist named Leon Goldman in 1962 for the removal of tattoos. Since then, cosmetic lasers have been successfully developed for the treatment of scars, varicose veins, birthmarks, wrinkles, hyperpigmentation, hair removal, and much more. There are thousands of clinical studies conducted on cosmetic lasers and their effective and safe use in many skin concerns has been proven many times over.

Laser treatments are developed through sound scientific principles to produce specific results while minimizing unwanted side effects. In hair removal treatments, for example, the energy from the laser is tuned to heat up and thereby deactivate hair follicles, thus preventing them from further activity. In the case of tattoo removal, the pigments in the tattoo ink are targeted, and the specific wavelength is designed to break up the pigments so they can be eliminated by the body’s waste systems. Provided a laser treatment is given within the specified guidelines and with the proper diagnosis of a trained expert, the results and side effects are almost always predictable and controllable.

Myth #2: Lasers are unnecessary because all their benefits can be achieved with skin care products.

Unlike store brand skin care products which may have all kinds of exorbitant claims, medical equipment such as cosmetic lasers are required by law to be thoroughly tested for effectiveness and safety. Laser machines cannot be marketed unless approved by the US FDA (or European equivalent CE mark) which sets stringent rules on claims that any equipment may make. For example, most hair removal lasers are not allowed to say that they give permanent hair removal, but only permanent hair reduction. This is because occasionally hair does regrow in an area after treatment, but it will be greatly reduced in quantity and appearance.

Skin care products on the other hand, are rarely required to prove their claims, so they can claim “better than Botox” or “as effective as laser” without repercussions. There are no skin creams or serums that can remove varicose veins, resurface and smooth out severe acne scars, reduce the appearance of birthmarks such as Port Wine Stains or help remove unwanted tattoos. Its simply not possible and doesn’t exist, nor will it ever.

 Myth #3: After one treatment, you can tell if lasers will be effective or suitable for you.

Every single person is different, and what works for 90% of the population may just not be right for the remaining 10%. Depending on different factors such as your skin sensitivity, pain tolerance, or even your lifestyle habits such as smoking, excessive sun exposure or usage of certain drugs or skin care products, you may respond differently to a laser treatment. That is why it is important for you to trust your doctor, and allow him or her to determine the course of your treatment and deciding if you need to change the settings from your previous procedure or not.

Myth #4: Having laser treatments causes the skin to thin out and become weak.

Lasers do not cause the skin to become weak and thin, in fact the controlled heating and wound action of a laser treatment actually induces the natural skin reaction of collagen and elastin formation to replace the damaged skin. Even repeated usage of lasers will not cause the skin to be damaged or weakened, provided your laser provider has a thorough understanding of the limitations of the equipment he or she is applying to the skin.

Myth #5: All laser equipment provide the same range of treatments.

Lasers are not a one size fits all, and most equipment is highly specialized and calibrated for specific purposes. There are two main types of lasers – namely ablative and non-ablative. Ablative or cutting lasers work by physically destroying the top layers of the skin, and are used in procedures such as laser resurfacing and scar revision.

Non-ablative lasers work by targeting specific depths or colors while leaving the top layer of the skin unharmed. Different laser modalities are calibrated for various uses including hair removal, skin rejuvenation, reducing excess pigment and tattoo removal. While a single machine can often be used to treat a range of different concerns, the wavelength and energy levels must be adjusted for each specific purpose.

Different laser machines are also calibrated differently and may have specific strengths, ie. Profractional laser is very good for acne scar revision and skin rejuvenation, but differs from the Cutera Excel V that targets hair and vein removal. Even rival hair removal lasers can differ in the skin / hair types which they are used for, so having a professional who knows the ins and outs of the equipment is essential for effective and safe treatment.

Myth #6: Lasers are all the same, no matter the companies who create them

Fact: Lasers may be an established and well understood medical tool, but just like a kitchen knife has the potential to be deadly, a laser in the wrong hands has the potential for serious damage. A laser that is unreliable and poorly engineered or poorly maintained is even worse, which is why you need to ensure the laser equipment you are being treated with is safe.

Major medical laser names such as Cutera, Sciton, or Lumenis are continuously being tested for quality and safety as well as efficacy. The lesser brands that sell to spas don’t have equivalent parameters to follow and therefore don’t need to be as effective.

Myth #7: Once you start using lasers, stopping treatments will cause your skin to rapidly deteriorate.

A laser treatment simply changes the conditions of your skin at the time of the treatment, and does not produce a dependency. For example, after an strong laser treatment such as a resurfacing procedure that vaporizes skin cells to encourage cell renewal, your skin will heal and become smoother, even, and more supple. You may need several treatments to achieve your end goal, but certainly there is no need to continually undergo treatments once you have solved the problems you wish to address. Eventually on-going aging and lifestyle factors will cause pigmentation, wrinkling or other problems to recur, which is when further treatments or a maintenance program may be necessary.

Myth #8: A laser treatment shouldn’t be painful and if it produces a severe reaction, it is a failure.

It is important to remember that a laser procedure is in fact a serious thing, and it is designed to cause controlled damage to induce the skin to heal and renew itself. A laser resurfacing procedure commonly produces a bronzing effect, as if you have had a sun burn, as the skin injury causes old and pigmented cells to die off and be replaced. Some swelling after the treatment may also be seen. Many doctors believe that although unpleasant, the more severe the reaction (tissue swelling, intense redness, flushing and sensation of heat), the better the results of the treatment. Other treatments such as hair removal may not produce as severe reactions, and any blistering or pus formation after a laser treatment is most certainly not desired. It is usually best to check with your physician or technician to determine if your post-laser reaction is indeed normal or if it needs attention, but bear in mind, a severe reaction is not necessarily a bad thing.

In conclusion, I wouldn’t ask my car mechanic how to do my plumbing, so it would only make sense to ask a professional in the required field of expertise that you are seeking answers for. Without the facts, you could be keeping yourself from achieving great results with cosmetic lasers that have proven themselves for many years to be safe and effective. When in doubt, ask  your dermatologist or your laser technician. They are the ones who work with the machines and they are the ones who have the proper education to answer your questions based on facts and experience.

 ~ Sheri Roselle, Medical Esthetician at Toronto Dermatology 

A recent study published in the respected JAMA Dermatology journal indicated that “women under 40 who started indoor tanning at a younger age and tanned more often have a higher risk of being diagnosed with melanoma”, a potentially deadly form of skin cancer. This helps underscore the importance of banning tanning salon use under age 18.

Who hasn’t pinched an inch here or grabbed a handful there? How many times have we looked in the mirror and thought “if I could just get rid of this bulge here, I would be happy”? How many of us have worked out, eaten healthy and finally found a good weight only to be stumped by that one area that won’t seem to get any smaller? Toronto Dermatology Centre, always at the cutting edge of skin beauty, has the answer to all of these questions and more.

We are beyond excited to offer Coolsculpting, a technically advanced way of actually eliminating fat cells in specific areas of your body without affecting other areas. Like liposuction but without the surgery, downtime, or potential side effects, Coolsculpting is able to kill fat cells and eliminate them from your body.

Scientists in the 60’s noticed that children that sucked on Popsicles frequently lost fat cells in the side of their cheeks. Fortunately children are resilient and they were able to replenish the cells without complication naturally. Over time scientists developed a technique called Cryolipolysis, a way of killing fat cells through slowly freezing the fat and without damage to the surrounding cells.

Cryolipolysis is based on the principle that fat cells are more vulnerable to cooling than surrounding tissues. A non-invasive applicator is attached to the targeted procedure area to slowly freeze the underlying fat tissue, while protecting the skin, nerves, muscles and other tissue. The cooled fat cells undergo apoptosis (controlled cell death) and are gradually eliminated, reducing the thickness of the fat layer.

With Coolsculpting, your initial consultation would include a full explanation of how Coolsculpting works, what you need to know before and after the treatment and a full treatment plan. We may mark the areas to be treated and decide how many sessions would be required for full benefits. For example, if you wanted to target the abdominal area and the love handles, you may want to tackle one area first and come back for the other area. Most areas require 1 session, but 2 may be required for a better sculptured appearance, depending on the amount of fat in the selected areas. As well the assessment will help to determine if you are a good candidate for the treatment.

Coolsculpting is targeted for the abdomen, upper, low and mid (for women), flanks (love handles), inner and outer thighs, arms and chin fat. Not all types of fat will work with Coolsculpting. For example, visceral fat, found below the muscles, cannot be treated. As well, if there is not enough fat to fit into the Coolsculpting treatment zone, the area won’t freeze properly and results won’t be as effective.

Although there is no downtime, some temporary side effects may include tenderness, swelling, redness, occasional bruising and a “pins and needles” feeling as the nerve endings begin to unfreeze. Results can be seen in as little as 3 weeks and full results seen in 2-3 months. You can resume your daily regime immediately after treatment. A compression garment is not required as it is with liposuction, but if treating the abdominal area, patients found that using one, even a mild form such as Spanx, decreased discomfort post treatment.

Today’s intelligent women and men are opting out of surgical procedures when it comes to improving their appearance. With the cost of liposuction, increased chances of serious side effects, downtime and scars, it doesn’t seem feasible that one would choose this more aggressive procedure over Coolsculpting; today’ s patient knows the best way to treat unwanted fat is only a few hours away.

Call for your complimentary Coolsculpting consultation today and get 2016 started with a happier, slimmer you.

~ Sheri Roselle, Medical Esthetician at Toronto Dermatology Centre

Read about the FDA ban on indoor tanning and the rise of skin cancers in young people.

http://www.teenvogue.com/story/fda-ban-teens-indoor-tanning

(Picture from/credit: TeenVogue.com)

As 2015 draws to an end, I look back on all the new or improved products and services Toronto Dermatology Centre has incorporated into our clinic this past year. As a medical Esthetician, I am always hungry for something better, something that will help my patients get the results that they want, faster, safely and with more success.

Towards the end of 2014, we started using our Cutera laser platform, which incorporated the Excel V and the Genesis lasers. Over the past year, we have been treating specific veins, port wine stains, pigmentary problems, leg veins and a multitude of other skin ailments with the Excel V. For skin tightening, collagen boosting, scar treatments and even nail fungus, the Genesis has proven itself to be one of the best laser technologies in existence.

We have gone full tilt with our chemical peels now, solely relying on Mesoesthetic from Spain for the best medical peels available in Canada. We dabbled with a few different lines for a time, but came to the conclusion that only Mesoesthetic could deliver the results that we wanted for our patients this year. From the same company, we have included the newest version of Dermamelan, which includes a pre-peel, two applications of the treatment mask and the home care necessary for the fastest, most comfortable recovery for pigment reduction available.

Our 1064nm NdYag laser for hair removal for dark skin has been pivotal in providing a safe, effective treatment for our darker skin patients. Although the Lightsheer is still our go-to laser for most of our patients, the option for dark skin, especially on the face, is just easier, even less painful and actually more effective.

Although we have been using our Dermaroller for some time now, we have been using the eDS (electric version) non-stop this past year. Results for scars, collagen induction and antiaging have never been so easy. With no downtime except a little pink hue to the skin for a few days, this treatment is less painful than lasers, results are just as fast, and for some scars such as ice pick scars, we find it more effective than resurfacing lasers. I just did my full face with eDS a week ago and tolerated the treatment with ease and already I’m seeing terrific improvements in my skin texture and tone.

This year we introduced the new Clarisonic Smart, a device that cleans the skin up to 30 times better than hand washing! SkinCeuticals and SkinMedica introduced some amazing new products as well. From acne to anti-aging and everything in between, I think we have cornered the market on the very best that home care products have to offer. They are great on their own and even better as a complement to our amazing services.

I am biting my tongue right now too because I have some incredible news for 2016, but I can’t let the cat out of the bag just yet; but stay tuned as I will be revealing something incredible in January. It is something that all of our estheticians and doctors have been crazy excited to add to our repertoire and I know our patients are going to flip for it. I have tried it myself and I can’t wait for you to hear my experience. Hint: bye bye fat.

As well even bigger and better news is coming late spring/early summer. Our entire clinic will be involved and it is going to take us from being the best Dermatology centre in Toronto to the best one in Canada (or are we already??). Toronto Dermatology Centre just keeps getting better and better and I am loving our journey so far. We are constantly growing and becoming better for our patients, so take advantage of us if you haven’t already. We are always happy to help.

Happy New Year to everyone, and may 2016 be even bigger and more thrilling!

~ Sheri Roselle, Medical Esthetician at Toronto Dermatology Centre

For those patients with psoriasis, check out these terrific real life stories – real struggles, real triumphs, real life, real stories…watch this beautiful 12 minute video called “Invisible Man”: https://www.reallifestories.ca

You’ve tried everything for your acne. It’s getting to the point where you are wondering if anything is going to help your skin to look better. Is there an alternative to medications when it comes to acne? Many years ago when I was growing up, the answer was simply no.

But now there are alternative methods that can clear up your acne either completely, or close enough to it. There are laser acne treatments, often offered with either a 1064nm Nd:Yag laser or a BBL device that, over several sessions, will alleviate bacteria growth and minimize the sebaceous glands. The results can last a year or sometimes indefinitely. Usually treated in 4-6 sessions 1-2 weeks apart, they require no medication, no downtime and you can start to see results by the 4th or 5th session.

Alternately, there is a treatment called Photodynamic Therapy (PDT). Photodynamic Therapy is widely known for treating Actinic Keratosis, or pre- cancerous cells. But, it is also an amazing treatment for acne. PDT is a treatment that generally requires 2 rounds of treatment, usually about two weeks apart, and occasionally a third treatment is required for severe acne. A medication called Metvix is applied to the affected areas, and is left on the skin for about three hours. This incubation process allows the medication to go deeper into the skin and look for the problem.

The medication by itself is not active, is painless and is only applied topically. To activate the Metvix, the use of our BBL device, using double wavelengths (blue and red) helps to destroy bacteria and alleviate inflammation. Because it is generally done over a two week process, results are quick and very satisfying.

During the first week after the initial application, a purge may happen. This means that the bacteria in the skin may come to the surface, resulting in a more severe breakout than normal. Although it doesn’t always happen, we do offer the patient the option of using an antibiotic for that week to lessen the purge, although it is not mandatory. A purge after the second application is rare, as most of the bacteria have been eliminated already. We do suggest not having any big plans during this time just to be safe!

PDT with Metvix is now widely known in the benefits/ insurance field, and benefit plans will cover most, if not all of the service. We provide a letter for you to give to your insurance company with all the necessary information that they will need to let you know whether or not you are covered.

If your acne is making a mess of your life and nothing else seems to be helping, or, if you are a person who would rather not be on medications such as birth control or antibiotics or accutane, PDT is an excellent alternative. It is big in the United States and has been gaining popularity here in Canada over the past few years. A quick, fairly easy way to finally treat your acne once and for all, PDT is an option you should look into.

To see if you are right for PDT for acne, be sure to come in to Toronto Dermatology Centre to visit your medical esthetician. She will determine if you are a good candidate, explain in full detail what the treatment requires, and book your treatment for you to accommodate your schedule.

~ Sheri Roselle, Medical Esthetician at Toronto Dermatology Centre

A new study suggests that smoking can trigger psoriasis in persons with a genetic predisposition. Yet another reason not to ever start smoking, or to stop!