Category: Our Blog

There is a very common misconception that laser treatments can’t be performed during the summer months. As many know, doing a laser on tanned skin can lead to burns, which, for lighter skin can leave a temporary discolouration. On darker skin, sometimes even on a light olive skin, the burn could lead to permanent skin discolouration.

However, there are ways around this issue. For starters, wear sunscreen! Seriously, it really is as easy as that. No one is expected to stay inside all summer. It is short enough as it is, we certainly want you to get out and enjoy the beautiful weather. But a proper application of sunscreen either all over (preferred) or at least on the area to be treated, will prevent the skin from changing colour. Remember that sunscreen should be reapplied during the day if you are outside every 2-3 hours; hats, sunglasses, and clothing also offer good protection, as does shade.

All laser treatments can be performed on a residual tan. For example, let’s say you went south in April and got a pretty good tan, but you haven’t tanned since. It is now July, and you can still see the tan as darker than the rest of your skin. Well, that is ok. The laser treatment won’t be affected by an older tan and the skin won’t burn. Each laser has a specific time frame that is preferred for the skin to be tan free. For instance:

 

BBL or IPL (Photorejuvenation)

• Used for vessels, redness or flat brown spots ; 4 weeks tan free to be safe

Light Sheer Duet Diode Laser

• Used for hair removal; 2 weeks tan free

KTP 532nm Laser

• Used for veins, sun damage, port wine stains; 2 weeks tan free

NdYag 1064nm Laser

• Used for hair removal, leg veins; 2 days only out of the sun!

For example, let’s say you are doing laser hair removal for your legs, which is done about every 8 weeks. You can still be out, even get a tan, but for two weeks before your next session, be sure to wear sunscreen. We can adjust the settings accordingly and still treat in a very safe way, and you don’t need to get off course at all. For the face, which is done every 4 weeks, it is best to wear sunscreen all the time (for so many reasons!) but if you have been in the sun and feel that there may be a slight tan on your skin, we can treat you with the NdYag, providing you have been sun free for only two days or more.

Of course if we are treating your face for brown spot removal, which is caused by the sun in the first place, sunscreen is needed every day, and all year round, to avoid more damage. It doesn’t make a lot of sense to try to get rid of sun damage if you aren’t going to wear sunscreen or practice other sun safe behaviours.

Although we do see a lot of people at this time of year who are considering laser treatments for a variety of reasons, it is important that the patient is able to comply with the mandatory guidelines to avoid a burn or to avoid new sun damage. Some of my consults who haven’t started treatments yet choose to delay beginning their sessions until the fall. That is ok too.

For me, I always wear sunscreen, and therefore have no qualms about doing any laser treatment during the summer. I have also done chemical peels, microdermabrasion and other medical esthetics during the summer, with no repercussions. The choice is yours. I believe that being smart about it and knowing my priorities is the first step in choosing when to treat. If I have a consult come to see me who I can tell will not be able to remember to cover up or apply their sunscreen as needed, I will suggest for them to wait until the fall. By the time the next summer comes around, and their skin looks so good by then, they will have no problem remembering how to protect their skin from then on.

If you are considering some sort of laser treatment, but aren’t sure if you are a good candidate for it, come in for a consult (no charge!). We will let you know what you need to do, what to avoid and whether or not we feel you are best to start now or wait until the fall to begin. An informed, educated consultation is always the first place to start. And from there, together we can make a plan that suits not only your skin condition, but your lifestyle as well.

~ Sheri Roselle, Medical Esthetician at Toronto Dermatology Centre

Recently we’ve noticed a number of cases of patients with chronic itchy skin and rashes and have determined that it was caused by their body wash. If you have such problems, consider switching to Dove Sensitive Skin Soap and see if the rash/itch go away.

Until recently, sclerotherapy has been the first line of defense against small to medium sized leg veins. Inserting a needle directly into the vein with a solution of saline and sugar helps the vein to collapse. Sclerotherapy, although ideal for veins large enough to get a needle into, is not a great option for very small spider veins.

With the addition of an Nd:Yag 1064 laser to our cutting edge clinic and new, improved techniques with the laser, it is fast becoming the first line of action against smaller veins. A recent study with both sclerotherapy and the Nd:Yag laser was conducted with both resulting in an over 70% clearance. Unfortunately there is no 100% guarantee with either treatment option.

Patients with numerous varicose and spider veins are not good candidates for the laser, and reticular veins, although considered appropriate to treat with laser, are often too difficult to reach with enough heat to successfully erase the vein entirely. The Nd:Yag penetrates deep enough to be absorbed by hemoglobin and is unlikely to be absorbed by melanin, therefore greatly reducing the chances of post-inflammatory hyperpigmentation, even on dark skin types.

The KTP 532 laser was also tested and was efficient with smaller, superficial veins, usually pink or red. The energy from the KTP penetrates fast, but not deep. The KTP is attracted to melanin as well, therefore increasing the chances of post-inflammatory hyperpigmentation and cannot be used with darker skin types. I find that for my patients, the KTP is invaluable for treating veins on the face where the vessels are small, red and superficial. I have not found the KTP to be efficient on legs or other body areas and tend to eliminate using it at all other than directly on the face. With that said, I have found the KTP laser to be incredibly effective with blue veins around the eyes, whereas no other laser even comes close.

Although no compression is required after laser vein removal (unlike after sclerotherapy where it’s a great idea), wearing compression garments for up to 2-3 weeks following each treatment may improve response. It is suggested to avoid blood thinners prior to any form of vein treatment, and avoid any form of strenuous exercise directly after treatment. We recommend looking into compression garments prior to treating leg veins, unless the treatment area is small. 

At Toronto Dermatology Centre, we work with the Cutera Excel V laser which houses both the Nd:Yag and the KTP lasers and with just a touch of a button, we can maneuver easily back and forth as needed. It is important to assess the treatment area, treat each vessel according to its size and colour and watch to see an endpoint for each vein. Our patients are told that, although the vein may appear to disappear immediately during treatment, the vein may come back smaller within 2-4 weeks. As well, some vessels that may appear to not disappear during treatment may completely dissolve before the next treatment. We suggest treatments at 4-week intervals, and often only a few appointments are necessary. Discomfort is modest and bearable.

So for those who have tried sclerotherapy and didn’t like it or didn’t get sufficient results, or for those with a needle phobia or those with smaller veins, don’t give up hope. With the newer long pulsed Nd:Yag laser available at our clinic, we are giving our patients great clearance with the best in laser technology. And although bruising is always a potential side effect with any vein treatment, we have seen a significant decrease in bruising with the Nd:Yag compared to sclerotherapy. Come in for a laser consult today to see if you are a candidate for this type of leg vein removal.

~ Sheri Roselle, Medical Esthetician at Toronto Dermatology Centre

Dr. Barankin recently published a case blog on psoriasis in the International Journal of Clinical & Medical Imaging.
Follow the link below to read the journal article:

Case about plaque psoriasis
Leung, A.K.C. and Barankin, B. (2015) Plaque Psoriasis. International Journal of Clinical & Medical Imaging. Volume 2 (Issue 4) 1000317

Dr. Barankin recently published in the International Journal of Clinical & Medical Imaging two cases blogs on basal cell cancer (BCC), the most common cancer in the world.

Follow the link below to view the journal articles:

Case about sclerosing basal cell carcinoma

Wong, A.H., Leung, A.K.C. and Barankin, B. (2015) Sclerosing Basal Cell Carcinoma. International Journal of Clinical & Medical Imaging. Volume 2 (Issue 4) 1000315

Case about superficial basal cell carcinoma

Wong, A.H., Leung, A.K.C. and Barankin, B. (2015) Superficial Basal Cell Carcinoma. International Journal of Clinical & Medical Imaging. Volume 2 (Issue 4) 1000316

It seems like everyone has the episode of Sex and the City where Samantha gets a chemical peel engraved in their memory forever. Yep, it is a pretty funny scene, but it does evoke fear in the minds of patients who come in looking for a solution to their skin problems. The good news is that all peels are different and the peel Samantha had was probably a deep phenol or high percent TCA peel. In almost all cases, superficial or medium depth peels are the norm for any medical clinic. 

So, what are chemical peels and what can you expect to achieve from having one done? Well, they are all different in what they help to control or fix, but they have some things in common too. A chemical peel is a chemical reaction between the product going on the skin (the peel) and the skin itself. Depending on what acids are in the peel, what buffers are or are not added, the percentage of the actives and the pH balance, the effect of a chemical peel is that the skin will peel. It may peel microscopically, which means you don’t actually notice the peeling process, or it might peel visibly, either mild or more pronounced.

Chemical peels may be able to help with acne, papulopustular rosacea (rosacea with pimples), fine lines, wrinkles, pigment (sun damage, melasma) dull skin or dehydration. Some of the stronger peels (but not necessarily a high percentage) will help with textural problems such as acne scars or other forms of scarring and even help stretch marks to some degree. What I like about chemical peels is that they are practically the only treatment that works on acne and acne scarring at the same time, which is great for my patients who have lost their patience!

Chemical peels containing either salicylic acid or TCA will tend to frost on the skin when applied. The skin turns white, which helps the practitioner determine the endpoint for the peel. As well, any area that has blanched or frosted will definitely peel, probably more so than areas that haven’t changed colour. Using a cotton square to work the peel into the skin in certain areas allows us to control where we want the skin to peel from and where we want the skin to be less affected. 

Areas that have blanched are likely to turn brown just before the peeling begins, often the second or third day after the treatment has been performed. It is necessary to apply moisturizer, wear sunscreen and not pick at the loose skin as it begins to shed. Peeling can last from two days to a week, so don’t plan any big events around the time of your peel.

Although peels can technically be done every two weeks, I prefer to book them at least 1 month apart. It allows for better healing and gives the patient a break from peeling all the time. A few days of peeling once a month is well worth the results. For those whose skin is in good shape, but just need a pick-me-up for their skin, I like to do the peels quarterly, or once a season.

Chemical peels are one of the most versatile services for the skin. They take about half an hour to perform, have minor heat associated for a few minutes, and depending on the depth of the peel, have minor to moderate downtime. Once any peeling is done, the results are immediate.

Although you will not look like Samantha post peel, it is best to speak with your medical esthetician to determine which peel suits not only your skin concerns, but your lifestyle as well. Note that “salon/spa” peels are not nearly as effective as medical-grade chemical peels at a dermatology clinic. Although we can’t predict whether you will peel or not, we do know which peels are more likely to do so and to what degree.

If you haven’t tried a professional medical-grade chemical peel from Toronto Dermatology Centre, book a consultation now and get on the road to better skin. 

~ Sheri Roselle, Medical Esthetician at Toronto Dermatology Centre

The latest issue of Canadian Skin recently published an excellent article by our very own skin expert Dr. Anatoli Freiman called “5 Essential Skin Care Tips from a Dermatologist.” A must read!

Click here to view now.

At Toronto Dermatology Centre we have been treating a plethora of skin imperfections with the Dermaroller, a minimally invasive micro-needling cosmetic procedure. Results are impressive, although it does take patience and understanding of how skin works to repair itself for the patient. We also have the e-Dermastamp, specific to treating scars, both acne and surgical as well as stretch marks. By creating more trauma to the area, more evenly distributed, and considerably more comfortable, we are able to get a more dramatic improvement for our patients with fewer treatments.

The e-Dermastamp is the next evolution of skin-needling. Dermaroller has spent an extensive amount of time perfecting this new system. It’s shown within their studies that less needles on the tip (not more) proved greater in perforation, and (unlike the competitor) resulted in no dragging, tearing or scratching. Since then the needle design has dramatically changed along with a whole new tip design. The e-Dermastamp is combined with a motor, not found in the hand piece, it is separated. This separation has given the system stronger motor and quicker perforations into the skin. With the competitor, holes are created 50 times per second; the e-Dermastamp can perform with more than triple the penetration at 150 times per second.

The e-Dermastamp effectively promotes Scar Reduction Therapy using an automated, stamp-like motion with micro needles. This technology has been shown to aid in the treatment of deep wrinkles and scarring, and can effectively treat hard-to-reach places like the nose and upper lip. Unlike the needles on the Dermaroller, the needles on the e-Dermastamp have a vertical delivery. The needles can also easily penetrate isolated scar tissue. The micro needles enter the skin 50-150 times per second. For a fraction of this time the needle tips push the epidermal scales aside and enter into the skin. This tissue intrusion is sensed by the nerve sensors and, in return, they signal to other cells in the vicinity of 1 to 2 mm around the channel that a “possible” injury has taken place. The nerve signals trigger a wound healing response and cell proliferation occurs.

This is not to supersede the Dermaroller, as studies have proven that by rolling we create a “static” field of electrical signals needed to trigger regeneration mechanisms. The skin’s conductivity increases, while the skins electrical resistance decreases, allowing the cell to release growth factors which are received by dermal stem cells, creating up to 1000 times more collagen from just one treatment. Both modalities are a powerful duo and can be used together in the same treatment to achieve maximum results – using traditional Dermaroller for maximum Collagen stimulation and the e-Dermastamp to focus on scars, deep lines and stretch marks.

The e-Dermastamp uses a unique spring-loaded “stamp” with changeable needle tip cartridges. Identical to the Dermaroller the sterile needles are for single-use only. This astute design permits the user to change the needle tip cartridge after each use. The controlled precision of both the Dermaroller and e-Dermastamp demonstrates a non-ablative technique which does not damage the skin nor is the epidermis removed. Furthermore, with no thermal heat, clients experience minimal downtime. The e-Dermastamp also introduces the skin to instant hyaluronic acid infusions. This instantly makes the skin hydrated, smooth & glowing! Wait to see it with your own eyes; it’s the only way to be convinced.

~ Sheri Roselle, Medical Esthetician at Toronto Dermatology Centre

The latest issue of Canadian Skin recently published a good article called “Your skin and your immune system.” Click here to view the article.