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These skin conditions, which can flare up during cold weather, may need a doctor’s help

Dry, itchy skin is a common winter companion when the humidity drops, especially as we get older.

“The oil-producing glands that lubricate skin shrink and don’t work as efficiently,” says Amy Kassouf, M.D., a dermatologist at the Cleveland Clinic. And that dry winter skin can certainly be uncomfortable.

Some people with find relief with self-help measures, over-the-counter products, or medication. Here are some strategies for three common dry-skin conditions: eczema, psoriasis, and rosacea.

Soothing the Itch of Eczema

More than 30 million Americans have eczema, or patches of red, thick, scaly, itchy skin.

Older adults are at higher risk for asteatotic eczema, which often causes intense dryness and itchiness on the lower legs.

Eczema crops up often in people with asthma or hay fever, but stress, dry heat, allergens, and fragrances and dyes in household products can set it off, too, says Jonathan Silverberg, M.D., director of the Northwestern Medicine Multidisciplinary Center for Eczema at Northwestern University in Chicago.

DIY care: Moisturize several times per day, and run a humidifier when the heat is on at home. Use detergents and soaps that are free of scents and dyes, and wash new clothes and bedding before use.

Occasional use of over-the-counter hydrocortisone cream can also help calm the itch.

See a doctor if you see little change after several weeks of self-care or you have severe itching or patches that blister or ooze.

He or she might prescribe a steroid cream or, in severe cases, an oral immunosuppressant for the itch.

Photo­therapy, which uses ultraviolet light to tame ­inflammation, is an option, too.

Easing the Discomfort of Psoriasis

An estimated 6.7 million Americans have this chronic condition, marked by flaky, itchy, slightly ele­vated patches covered with silvery skin cells.

These “plaques” develop when skin cells grow too rapidly, flaring up when “something triggers the immune system to become overactive,” says Ronald Prussick, M.D., of the National Psoriasis Foundation.

Triggers can include stress, skin injury or infection, allergies, and certain medications.

And “scratching an itchy spot can create new psoriasis in that area,” says Jessica Krant, M.D., a dermatologist on Consumer Reports’ medical advisory board.

DIY care: To ease itching and loosen dead skin, soak for 15 minutes in a lukewarm bath to which you’ve added baby oil, oilated oatmeal, or Epsom salt.

A shampoo or an OTC cream that contains salicylic acid can soften plaques; one with coal tar can ­reduce discomfort.

You can also subdue itching with OTC hydrocortisone cream.

See a doctor if self-care doesn’t help. Your doctor might prescribe a biologic drug for inflammation, methotrexate to slow skin-cell growth, or phototherapy.

Coping With Rosacea

A chronic condition that’s more common after age 30, rosacea can lead to redness, bumps, and pustules, usually on the face.

Some people with the condition may also experience dryness, stinging, itching, and burning.

“The skin of rosacea patients is very sensitive,” says John Wolf, M.D., chairman of dermatology at the Baylor College of Medicine in Houston.

Triggers include cold or hot weather, ­indoor heat, stress, sun, wind, alcohol, hot baths, vigorous exercise, and spicy food.

DIY care: Use a gentle facial cleanser and moisturizer before bed, and wear broad-spectrum sunscreen for sensitive skin with an SPF of at least 30.

See a doctor if your symptoms don’t resolve with DIY care or if rosacea causes physical discomfort or distresses you.

Prescription treatments might include a topical anti-­inflammatory cream or an oral antibiotic for more severe inflammation and redness. Laser or light therapy can also be used to reduce redness.

Keeping Dry Winter Skin Healthy

Whether you have eczema, psoriasis, or rosacea, these strategies for dry winter skin can also help.

Turn down the thermostat a few degrees. “It may keep the air from drying out as much, and cooler air is less likely to aggravate your itch,” Silverberg says.

Bathe briefly, and only in tepid water. The hotter the water, the more skin oils are stripped away.

Moisturize after bathing while you’re still slightly damp. Use a product that’s fragrance-free, hypo­allergenic, or made for sensitive skin.

Run a cool-mist humidifier. Or place pans of water near heating vents to moisten indoor air. Humidity should be 30 to 60 percent (40 to 50 percent if you have ­allergies or asthma).

Stick to fragrance-free soaps. Also use detergents made for sensitive skin.  

Credit: consumerreports.org, by Catherine Winters

woman face lifting skin tightening

Unlike many clinics, Toronto Dermatology Centre doesn’t tend to jump on the “latest and greatest” train when it comes to technology. We do a ton of research, seminars, peer suggestions & discussions with technology & laser gurus from around the world, and trials of our own before committing to a new device for our patients. We do NOT use our patients as guinea pigs; ever!  One area we had been looking into for several years was skin tightening. But we didn’t want just any device. We needed something that was tolerable (pain) for the patient, didn’t require the patient to come in every month for the rest of their lives, and was at an affordable cost with little-to-no downtime. A very high satisfaction rate is also super important to us as is our reputation.

We also wanted to look into the field of merging not only RF (Radiofrequency) with microneedling but also to develop combination treatments that would allow the patient quicker results with less down time and fewer clinic visits.

After many years, we have found the perfect combination of “wants and needs” from our wish list. Introducing Inmode Forma and Morpheus 8, with additional Lumecca handpiece to compliment the other services for an all-over impressive rejuvenation experience.

Fractora (we thought it was good, but knew something better was coming) has made an excellent name for itself in the time it has been in both Canada and the USA. The Morpheus 8 is the newest version of the Fractora with advanced application of treating both face and body through RF (radiofrequency) and microneedling. With the ability to treat texture, scars (especially acne scarring), lines and wrinkles, colour, tone and tightening for the face and body, without discomfort or downtime, the Morpheus 8 can be combined with Lumecca to deal with sun damage or the Forma to advance skin tightening starting in one application. Although each patient is unique, and depending on your goals, less treatments are required overall and results come sooner.

For those who have healthy skin but may have some volume loss or loose skin, either on the face or the body, the Forma can provide excellent results. Unlike most RF devices, the Forma is not painful. It feels like a hot stone massage and many patients even fall asleep during the treatment. Results are immediate and no downtime is required. Its really something to behold.

The Lumecca is a more powerful (3x) IPL (intense pulsed light) device that can be used to enhance the results of both the Forma and the Morpheus 8 and can be performed on the same day. By adding the Lumecca, the patient can treat sun damage (vascular and brown pigmented lesions) and increase collagen production while treating for their other concerns at the same time, reducing downtime and visits to the clinic.

This is really a major victory for us at Toronto Dermatology Centre. We have spent years trying to find just the right device for our patients; we were simply not interested in lackluster results or too much pain or too much cost or downtime for our patients. The Inmode trio (Forma, Morpheus 8 and Lumecca) fulfills all of our wish list requests and we can’t wait to share our victory with you.

~ Sheri Roselle, Medical Esthetician at Toronto Dermatology Centre

Hands holding a credit card using laptop computer and mobile phone for online shopping .

I just finished watching a video from CBC Marketplace that one of our dermatologists recommended to me. A portion of the episode was dedicated to shopping online and mistakenly buying fake products. What an eye opener!!!

Now, I can admit, I LOVE shopping online!!  Me in my jammies and a hot cup of my favourite specialty coffee checking out the deals…. that’s as good as it gets. But, while you and I may know that buying designer products online is a big no-no, did you know that buying many things from a third party, in many cases, is often fake?

The episode had a panel of 3 experts in the field of fraud including a lawyer who specializes in fraud and fake products. They were introduced to a selection of accessories and make-up as well as your basic skin care lines such as Biotherm. These items were sold on EBay, Wish, Amazon, AliExpress and Walmart. In most cases, the audience was polled and felt the items being shown were real, but in almost every case, the item was a fake.

I guess for me, I don’t trust big item or high-cost products to be real, so I avoid them. And of course, I have always known that medical-grade products are typically fake, as they can only be sold by medical retailers. I think what startled me the most was that even basic items like Urban Decay eyeshadow or items from cheaper lines could also be fraudulent.

While I have never trusted AliExpress or Wish, and I know some retailers on EBay and Amazon are known to sell fake purses and accessories, I kinda thought Walmart, with its naturally lower priced lines would have no reason to sell imitation products. Walmart was the only company of those five mentioned to deny fraud, but the experts didn’t buy it. And the other companies say they are working hard to eliminate third party sellers when they have been tipped off to the unfair sales. But this has been going on for a long time, and I don’t think it is possible for some of these sites to ever completely be on the up and up due to the way their items are sold by individuals all over the world. It would be impossible to prevent all fraud, I would think.

There are some sites that sell legitimate products and have been proven to be on the up and up. But those sites are dealing directly with the manufacturers, not a third-party seller.

So, while you and I are at home in our jammies, shopping online and relaxing, pay attention to the details. Know what can and can’t be sold online. Or, if you want to be really sure your hard-earned money is going to the purchase you THINK it is going to, buy direct. Reputable companies like Toronto Dermatology Centre have websites and will often sell their products online, especially now that most of us aren’t able to get out to shop. Be assured that when you buy direct from companies like ours, you are getting what you pay for and not some cheap or even dangerous knock off. Our clinic has been in business for over a decade and plans to be around for a very long time. Our reputation is everything, so you can always count on the most effective medical-grade skincare products at the best price possible. When it comes to skincare, the last thing you want to do is put something on your face that isn’t what it says it is, doesn’t have enough or any of the key active ingredients, or which is long-expired!

If you have purchased an item you suspect to be a fake, you can contact the Canadian Anti- Fraud Centre, located in North Bay and dedicated to eradicating illegal sales. Without tip- offs though, they won’t be able to help us feel safe with our purchases. And remember, try to buy direct from the stores or clinics when purchasing skincare as well as most other items. When this is not possible, do your research, read reviews and be as knowledgeable as possible so you won’t suffer from buyer’s remorse.

~ Sheri Roselle, Medical Esthetician at Toronto Dermatology Centre

Woman sitting in a cafe drinking coffee and working on a computer

Recently Dr. Barankin asked me a question regarding iron oxides in sunscreens. I have to admit I had never really thought about that particular ingredient. This week, while being my usual skin geeky self, I came across a recent study about iron oxides. So, of course my curiosity got the best of me and I have to say I was surprised and impressed by what I learned.

In the Journal Of Cosmetic Dermatology November 18, 2020,  the results of an in-vitro study showed that sun protection products containing iron oxides provide extra protection against high energy visible light (HEV). Consumer electronics such as your Smartphone or computer emit HEV. Many studies have now proven that HEV contributes to aging skin in multiple forms such as increased wrinkles, skin laxity and pigmentary damage.

The study shows that iron oxides can protect against the HEV light whereas titanium dioxide and zinc oxide give us UVA and UVB protection, but provide a limited protection when it comes to HEV. Even antioxidants that provide protection from free radicals can’t prevent blue light melanogenesis. Therefore, the addition of iron oxides may protect patients who struggle with melasma or are more prone to hyperpigmentation (especially those with darker skin).

Dr. Eric F. Bernstein, M.D. one of the researchers for this study and a highly respected cosmetic dermatologist had this to say: “My entire career has been laser-focused on the use of lasers in medicine and the study of sunlight. One thing I’ve learned all too well is that sunlight causes a range of problems for our skin including fine lines and wrinkles, enlarged pores, redness, pigmentation, skin sagging and skin cancer. Visible blue light is the most energetic, and therefore the most damaging light, to reach our skin and penetrates more deeply than ultraviolet rays. I have been interested, for many years, in ways to protect skin against all wavelengths of light. This research is important because it shows that skin care products formulated with iron oxides, combined with mineral sunscreen actives and other ingredients, effectively shield skin against harmful, high-energy, visible wavelengths.”

You can read the full study here

As we continue to find better products to amplify the health of the skin and to protect it against the signs of aging, cancer and pigmentation, and with continued studies being conducted providing concrete results, it is possible to slow down deterioration of the skin and to be able to age gracefully. Ask us about which sunscreen products have iron oxides (unfortunately not many!); we’ve made it a point to carry sunscreens with this important ingredient.

~ Sheri Roselle, Medical Esthetician at Toronto Dermatology Centre

female doctor nurse wearing protective gear of surgical mask and face shield, protection against contagious corona virus disease COVID-19, health care worker in hospital diagnosing patients

We have a very busy clinic (multiple dermatologists and a plastic surgeon all working on 2 floors spread over 13,000 square feet) and we get a lot of phone calls. One recurring query has me wondering what is going in this industry, especially in Toronto. Every step of the way along this confusing and yet somewhat defined protocol for COVID, Toronto Dermatology Centre has adhered to the standards and regulations set forth by our governing parties (and additional precautions to protect you and our staff as well).

We have had to call and unfortunately cancel some services during different phases since returning to work at the end of May. And, like any other business in the city, or in the world for that matter, turning away business hurts. However, with that said, there is a reason these regulations have been put in place, and it is for the safety of our patients and our staff, for their friends and family and to continue to help stop the spread of this unrelenting virus.

So when I hear patients getting upset with us and telling us that other clinics are still doing the treatments that have specifically been added to the restricted list, it makes me wonder where their priorities are at.  Is it worth it to book a patient for a treatment that has been restricted and possibly take the chance of spreading a virus? If that does happen, not only are they now adding to the problem, but that clinic will then have to close down for 2 weeks. The patient won’t be aware immediately that they have been infected, and the vicious cycle continues.

So, when I hear this, instead of getting upset or mad, I simply tell the patient to consider whether or not they want to hand over their face (or body) to a clinic that ignores health standards in order to make a few bucks. Do they have your best interest at heart? Do they have the health of their staff as a main priority? Have they even been following what is going on in the city? The province? If a clinic or medispa chooses to ignore the standards set to keep us safe, are you willing to have a treatment performed at that clinic, wondering what other protocols are not being adhered to?

Update:  When I started this blog, it was before the Toronto/ Peel region modified lockdown.  Now that our circumstances are more restricted, it is imperative that all clinics adhere to their local and provincial rules and regulations. At Toronto Dermatology Centre, our dermatologists, the only true skin experts, are considered essential. Medispas, unfortunately, at this time may have to close down temporarily and some will close permanently as this longer than expected situation continues. Thankfully, we can guarantee that we will not be going out of business. We have spent the past few days calling and cancelling some further services, but still have the right to treat some patients under stricter guidelines. We are also here to consult medical patients who have been here to see one of the dermatologists on the medical side of the clinic, and to help patients with products and potential services in the future.

We will continue to serve our patients in the safest, most effective ways throughout this unusual time. But, we will always choose the safety of our patients, our staff, and our families first. Please do the same for you and yours and always choose wisely.

~ Sheri Roselle, Medical Esthetician at Toronto Dermatology Centre

Just in time for the holidays!

Starting December 14, 2020 we are offering one daily special exclusive at Toronto Dermatology Centre. Follow us on Facebook, Instagram or Twitter to enjoy terrific savings on a range of medical-grade skin care and esthetic treatments. 

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Wearing a mask can be hard on your skin
Gentle skin care can prevent your mask from causing skin problems.


Masks play a vital role in reducing the spread of the coronavirus. Masks can also be hard on your skin, causing problems that range from acne and peeling skin to rashes and itchiness. To help prevent skin problems from developing under your mask, board-certified dermatologists recommend these nine tips.

1. Cleanse and moisturize your face daily. Gentle skin care can prevent skin problems. When washing your face, use a mild, fragrance-free cleanser and follow these steps, Face washing 101.

Dry skin is a common face mask skin problem. Applying moisturizer adds a protective layer that can reduce dryness.

You want to apply moisturizer immediately after washing your face. To get the most benefit from a moisturizer, board-certified dermatologist Carrie L. Kovarik, MD, FAAD, recommends using a moisturizer with one of the following ingredients:

    • Ceramides
    • Hyaluronic acid
    • Dimethicone (which can also create a barrier that helps reduce irritated skin)

You can prevent breakouts from your moisturizer by using a moisturizer formulated for your skin type. When selecting moisturizer, follow this guide:

    • Oily skin (or when weather is hot, humid): Gel moisturizer
    • Normal or combination skin: Lotion
    • Dry to very dry skin: Cream

If you have acne or tend to break out, you can still use a gel moisturizer.

2. Protect your lips by applying petroleum jelly. Dry skin and chapped lips are common face mask skin problems. You can prevent chapped lips by applying petroleum jelly to your lips:

    • After washing your face
    • Before you put on your mask
    • Before bed

To prevent breakouts, take care to apply the petroleum jelly only to your lips.

3. Skip the makeup when wearing a mask. Beneath a mask, makeup is more likely to clog your pores and lead to breakouts. If makeup is necessary, use only products labeled “non-comedogenic” or “won’t clog pores.”

4. Avoid trying new skin care products that can irritate your skin. Wearing a mask for even a short time can make your skin more sensitive. To reduce skin problems, avoid trying harsh products, such as a chemical peel, exfoliant, or retinoid, for the first time, says board-certified dermatologist Daniela Kroshinsky, MD, MPH, FAAD.

5. Use less of certain skin care products if your face becomes irritated. When you cover your face with a mask, some skin care products that you’ve used in the past may irritate your skin. If this happens, Dr. Kroshinsky recommends cutting back on products that can irritate your skin, such as:

  • Leave-on salicylic acid
  • Retinoid you apply to your face
  • Aftershave

6. Wear the right mask. To reduce skin problems, look for masks that offer the following:

  • A snug, but comfortable fit
  • At least two layers of fabric
  • Soft, natural, and breathable fabric, such as cotton, on the inside layer that rests against your skin

Wearing a mask that offers a snug, but comfortable fit helps to protect you and others from the coronavirus. You want a snug fit across your nose, on the sides, and under your chin.

A snug, comfortable fit also reduces skin problems. If the mask feels too tight or slides around on your face, it can irritate your skin. You’re also more likely to adjust a poorly fitting mask. When you touch your mask, you can transfer germs to your mask and your face.

The fabric is also important. Avoid synthetic fabrics, such as nylon, polyester, and rayon on the the layer that rests against your skin. These are more likely to irritate your skin and cause breakouts.

For more tips on selecting a face mask to prevent the spread of COVID-19, visit the Centers for Disease Control and Prevention at CDC.gov/coronavirus.

  1. Take a 15-minute mask break every 4 hours. Health care workers on the frontlines of the coronavirus pandemic have found that this helps save their skin. Of course, only remove your mask when it’s safe to do so and after washing your hands.Safe places to remove your mask include:
    • Outdoors, when you can stay at least six feet away from people
    • Inside your car when you’re alone
    • At home
  2. Wash your cloth masks. Many health care organizations now recommend that you wash a cloth mask after each use. Washing it also removes oils and skin cells that collect inside the mask, which could lead to a skin problem.You can wash a cloth mask in a washing machine or by hand. Both ways remove germs and other particles. Just be sure to:
    • Follow the washing instructions on each mask.
    • Wash the masks in hot water unless the instructions say otherwise.
    • Use a fragrance-free, hypoallergenic laundry detergent.

After washing your mask, check its shape. If a mask no longer fits snugly (and comfortably), it is less protective.

  1. Continue the treatment plan that your dermatologist created for you. If you have a skin condition, such as acne or rosacea, it’s especially important to follow your treatment plan. This can help keep the condition under control.

If you develop a face mask skin problem

Life gets busy. Sometimes, it’s hard to care for your skin as planned. If a skin problem develops under your mask, you may be able to treat it yourself. See what dermatologists recommend at, Face mask skin problems: DIY treatment.

 

Credit: Americian Academy of Dermatology Association

This year we’re giving back even more by extending our annual Customer Appreciation Day to one full week – happening November 9-13, 2020. Enjoy the same great savings & amazing deals VIRTUALLY! There will also be many great raffle prizes to be won!
Follow us on   to receive first-access updates & full details about our VIRTUAL Customer Appreciation Week.

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The first new retinoid molecule approved in over 20 years is now available in Canada.

Sudden breakouts – an unexpected outcome of living through the COVID-19 pandemic – aren’t limited to your face. Trunk acne, which refers to acne on the back, shoulders and chest, affects approximately 52 percent of people who have facial acne, and is becoming increasingly common as we spend more time at home.

“We’ve certainly got acne flare ups around the mouth from wearing masks,” says Dr. Benjamin Barankin, dermatologist and medical director at the Toronto Dermatology Centre. With a dark, warm and humid environment comes increased inflammation and bacterial overgrowth, inviting “maskne” (mask + acne) – the term referring to the unsavoury consequence of preventative mask-wearing – into our vocabulary.

The same idea applies to our bodies. “As far as trunk acne, it’s possibly worse just from occlusion. If we’re sitting at a chair doing work from home and Zooming, we’re not getting up and around as much,” says Barankin. In addition to reduced movement, lack of sleep and increased stress levels are leading to a decline in the quality of our skin beyond our face. “There’s a lot of stress related to COVID, whether people realize it or if it’s subclinical, it’s there.”

Trunk acne is generally harder to treat than face acne, according to Barankin. Though it’s less visible, it tends to be more inflammatory, as the skin is thicker and oil glands are deeper. It’s also worth mentioning that we tend to pay less attention to our backs and chests when cleansing. “We’re not seeing it every day so it’s not top of mind,” he says. “We also know that a little bit of sunlight helps acne, and you’re more likely to get that on your face than on your trunk.” Consequently, those with trunk acne are more likely to seek a prescription in order to effectively treat it. “We often forget that it’s not just that it doesn’t look good,” says Barankin. “A surprising amount of suffering that occurs with acne even though it’s not a deadly condition, so to speak. It’s a visible condition. If you have high blood pressure or high cholesterol, nobody knows. You can keep that to yourself. When you have acne, the whole world sees it.”

Enter Akleif, the first prescription body medication to be specifically studied for trunk acne and the newest generation of topical retinoids. “It specifically targets the retinoic acid receptor gamma, which is the most common retinoic acid receptor found in the skin,” says Barankin. “I think the reason that we’re seeing nice results with this product is that you’re covering more areas of the skin that are going to be responsive to this product than to other retinoids because there’s more receptors there to bind this product.”

“This new approval marks an important milestone in effectively treating acne in Canada, especially truncal acne,” says Dr. Melinda Gooderham, a dermatologist and Medical Director at the SKiN Centre for Dermatology and the SKiN Research Centre in Peterborough, Ontario. “The clinical evidence demonstrates that Akleif reduces inflammatory lesions on the face, back and chest while delivering low systemic levels. This ensures efficacy, safety and tolerability which makes Akleif particularly useful for the treatment of acne lesions that appear on large surfaces of the skin, like the back and chest of some acne patients.”

When should you consider a prescription to treat acne? “When the acne is mild and early on, start treating it using a gentle cleanser and moisturizer, along with over-the-counter products that have things like salicylic acid, benzoyl peroxide and glycolic acid,” says Barankin. “If you’re finding after three months or so of doing that, that you’re seeing scarring, or the acne is affecting you psychologically – like it’s affecting how you dress whether you’re going out or seeing friends – then definitely you want to come on in and see your physician and consider prescription therapy.”

Credit: Melissa Perdigao, ellecanada.com