Category: Our Blog

Our very own Dr. Benjamin Barankin was recently invited to lecture at the 52nd Annual Scientific Assembly of the College of Family Physicians of Ontario. His topic was Dermatology Review, and he covered new developments and treatments for such conditions as: acne, rosacea, eczema, psoriasis, melasma, and hyperhidrosis. In addition, he spoke about the uses of neuromodulators such as Botox and Dysport for dynamic wrinkles and other problems, fillers such as Juvederm and Restylane, and the latest in laser treatments.

Acne can range in severity from the occasional breakout to the ongoing eruption of painful, swollen nodules or cysts—and as any sufferer of severe acne knows, it can be debilitating. Fortunately, advanced light-based technologies are making the battle against blemishes easier for those who have not seen results from conventional therapies.

Whether caused by genetics, hormonal shifts, excess oil production or other factors, the best way to fight stubborn forms of acne is to attack it at the source. An acne lesion forms when bacteria (called P. acnes) and sebum mix with dead skin cells, resulting in a “plug” in the hair follicle and inflammation. Accordingly, the most effective acne treatments target bacteria and the painful swelling it causes.

Until recently, prescription antibiotics and the oral medication, isotretinoin (“Accutane”), have been considered the best options for treating inflammatory acne (also known as pustules, papules or cysts). However, concerns over these medicines’ long-term effects have prompted some patients to pursue other courses of treatment, like light-based therapy. Similar to their laser predecessors, professional light-based therapies work to target both bacteria and resulting inflammation. 

A combination of blue and red light therapies has been proven effective at treating acne without the high price tag of laser treatments or the side effects of oral medications. The distribution of blue light over the skin’s surface targets acne bacteria, while short wavelengths of red light work to reduce inflammation inside the pore. Red light may also offer the additional benefits of reducing redness in rosacea patients and decreasing fine lines and wrinkles.

Light-based therapies can reduce acne blemishes in a series of several treatments. You may experience slight redness or swelling after treatment, though downtime is typically minimal.

Applications include a Broadband light combo done 7-10 days apart for 4-6 sessions, Laser Genesis, a 1064nm wavelength, which also stimulates collagen, reduces scars and has virtually no down time, and Photodynamic therapy (PDT) with Metvix. PDT is used in conjunction with a topical medicine that is applied and left on the skin for up to 3 hours prior to light application. The skin may appear red for a few days following the treatment, but generally only 2-3 treatments are required and results are substantial. 

If you have tried other methods without resolve, or simply don’t want to use medical products to relieve the skin of acne, then light based therapies may be best for you. To consider your options, consult your dermatologist or medical esthetician at Toronto Dermatology Centre.

Excessive sweating or hyperhidrosis is a very common problem, particularly amongst teenagers. It affects about 3% of the population, and can affect the armpits most commonly, as well as the hands, feet, scalp, face, groin and other areas. It has a big impact on quality of life, even though it is not dangerous to your health. In most cases, there is no clear cause of hyperhidrosis. There is both generalized (widespread), and more commonly localized (e.g. 1-3 areas) hyperhidrosis, of which localized is the most common and typically begins in adolescence, but sometime even in childhood and it does not occur during sleep. Some of the best treatments for localized hyperhidrosis include Botox injections, topical gels applied at night time (e.g. Hydrosal, Drysol), pills (e.g. anticholinergic such as oxybutynin), iontophoresis, and uncommonly surgery. Sometimes blood work can be helpful just to make sure there are no underlying problems such as thyroid problems or diabetes. It is best to speak with your dermatologist, experts in treating hyperhidrosis, to find out the best options for treatment for your condition.

Pearly penile papules (PPP) are common, 10-30% of men are affected and it is more common in uncircumcised men and black persons. They present usually as flesh-colored (or pearly) bumps in 1-3 rows at the base of the tip of the penis (glans).; they are typically 1-2mm in length and there are no symptoms. They are particularly common in young adults, and most men present around puberty or during their teenage years with concerns about these lesions. While some people may mistake them for genital warts in appearance, they are not infectious or contagious, but rather a cosmetic nuisance. Dermatologists are the best in diagnosing and treating this common problem, and the best treatment is typically electrodessication or laser, less common liquid nitrogen or application of special acids. At Toronto Dermatology Centre, we have treated hundreds of men successfully and painlessly with pearly penile papules from all over North America. Best to speak with one of our highly trained dermatologists about the best treatment options for you.

Rosacea is a condition affecting typically middle-aged persons, often with fair skin and British or northern European backgrounds. It is characterized by sensitive skin, easy flushing, persistent redness or blood vessels, and/or pimples and pustules, and sometimes nose swelling (rhinophyma) or eye involvement (ocular rosacea). 

A new study published in the Journal of the American Academy of Dermatology by a group out of the U.S. shows that patients with rosacea have higher incidence of embarrassment, social anxiety, depression and a reduced quality of life compared with the rest of the population. It also showed that adequate treatment of symptoms results in improvement of quality of life in these patients. It suggests that new treatments such as Onreltea gel and newer lasers that reduce redness likely improves the psychological impact of this frustrating condition.

A recent evidence-based unbiased study by Ibrahimi entitled “Who are the pioneers? A critical analysis of innovation and expertise in cutaneous non-invasive procedures” has shown the following findings:

– In 5 out of 5 categories, Dermatologists rank as #1

– Dermatologists are the #1 scientific innovators

– In particular, with Botox for wrinkles and fillers such as Juvederm, Restylane, Perlane, Voluma, Radiesse), dermatologists are clearly far more considered the experts than plastic surgeons or ENTs.

It bears repeating, that for the best cosmetic care of the skin, the best outcomes and best safety, trust the skin experts: dermatologists. Ibrahimi notes that “the results are very very clear…the overwhelming majority of innovation and pioneering research in neuromodulators (e.g. Botox, Dysport) and fillers (e.g. Juvederm, Restylane, Radiesse) has been done by dermatologists. They are the leading experts for facial injectables.” 

The summary of this scientific study was “Dermatologists are the best specialists for non-invasive facial injectables.”

• Over 6 million Canadians suffer from cold sores?
• Cold sore is a common recurring infection caused by a virus?
• 60% to 90% of adults are infected?
• 20% to 40% of those adults will experience recurrent outbreaks?

 

 

 

Triggers: What causes cold sores?

Once you are infected, here are the possible triggers that will cause cold sore outbreak:

Tackle your problem: it can be treated

It is optimal to treat cold sores early at the “tingling stage”, where pain, burning and itching are experienced. The majority of cold sore patients tell us they prefer a topical cream to an oral medication for continuous cold sore prevention. 

A new prescription cream for cold sore sufferers is now available, considered to be the most effective topical therapy on the market.  It is called Xerese (5% acyclovir with 1% hydrocortisone cream). It has been shown to shut down the development of cold sores, decrease the size of the lesion and speed up healing time. This is the first and only treatment to help prevent cold sores progression that combines both an antiviral and anti-inflammatory agent. Finally, most private insurance plans do cover the cost of this product.   

If you are one of the 6 million Canadians suffering from cold sores, ask your physician about the available treatment options.

Did you know that our very own Dr. Barankin had his dermatologic expertise quoted in the Nov-Dec issue of Elevate magazine? In this article, he discusses the importance of year-round sun protection, the importance of not lip licking, and more. Click here to view article!