Congratulations to our esteemed Dr. Anatoli Freiman and Dr. Benjamin Barankin on their well-deserved recognition as top dermatologists in the annual “Top Doctors in Toronto” by Post City Magazine. These doctors are nominated by other respected physicians in Ontario who highly recommend them to patients and families. Curious if your doctor made the list? Check it out here.
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Our very own Dr. Benjamin Barankin was recently quoted in the National Post discussing the powerful benefits of retinol.
If you have a skincare problem or concern, chances are there is a product or more specifically an ingredient to combat it, you probably just don’t know it.
Over the past few years, there has been much more transparency around skincare ingredients, however, the information presented is often very surface-level. Retinol is one of those ingredients that is known to be great for the skin, but why is that and what does it do?
I had a chance to ask Dr. Benjamin Barankin, a Toronto dermatologist, Medical Director & Founder of Toronto Dermatology Centre just this and based on his answers I’ve learned that retinol or retinoids are “the best studied topical therapy for anti-aging”. “It causes faster turnover of the skin’s cells and boosts collagen resulting in reduced fine lines and wrinkles,” he said. Apart from the anti-aging benefits, the ingredient is also beneficial for preventing and treating acne and acne scars. Additionally, it is beneficial for evening out skin tone, pigmentation and smoothing the skin’s texture and giving it a nice glow.
While this all sounds great and enticing and according to Dr. Barankin, most people will benefit from retinol, there are some limitations to using this ingredient, which Dr. Barankin breaks down in our Q&A below. Now, if you do fit the criteria for being able to add this into your routine, make sure to check out our top retinol products before running to the store.
Q&A with Dr. Benjamin Barankin
Q: What is retinol?
A: A retinol or retinoid is a vitamin-A-based product. It can be found over the counter (retinol), “medical-grade” strength retinol at dermatologist offices, and/or stronger versions by prescription (retin-A/tretinoin/adapalene/tazarotene/trifarotene).
Q: What does it do?
A: It is the best-studied topical therapy for anti-aging. It also treats and prevents acne, improves acne scars and gives the skin a nice glow. It causes faster turnover of the skin’s cells and boosts collagen resulting in reduced fine lines and wrinkles. It also helps even out skin tone and pigmentation and smoothens skin texture.
Q: Can everyone use it?
A: Most people will benefit from a retinol/retinoid, but the selection of which product and concentration is used should be carefully guided by your dermatologist, otherwise there can be dryness, irritation, redness and peeling to deal with. We generally advise to not use these products during pregnancy or breastfeeding because we know the effects of oral retinoids on a fetus are dangerous, and so out of an abundance of caution, we advise skipping the topical usage as well during pregnancy.
Patients with sensitive skin or rosacea should either avoid or use the mildest form possible. We often use it at night (since it can make the skin more sensitive to sun) and advise sun protection/sunscreen/hat in the mornings. We generally wouldn’t bother using it below age 10, but then for acne treatment and prevention and scar and pigmentation reduction during the teenage years, followed by anti-aging benefits starting in your 20s and pretty much for your entire life would be worthwhile. Over time, you want to try to increase the strength where possible to get even better results, while being careful to avoid irritation (just take a break for one to three days or be better about moisturizing).
Q: Is there a limit on how much should be used?
A: A thin layer should be applied, and in some cases (winter, people prone to dry skin or eczema or sensitive skin), we advise applying moisturizer underneath or on top of the retinoid to improve tolerability.
Q: Is it only effective while using, or does it carry continued benefits even after using?
A: It is beneficial while you use it and for a few weeks or sometimes months after as far as acne and anti-aging, although there can be long-term benefits when treating hyperpigmentation or melasma, as well as for acne scarring.
Credit: By Sidra Sheikh, National Post
Canadian dermatologists assess benefits of new treatments
A new biologic for psoriasis and a new tyrosine kinase-2 inhibitor for psoriasis, the long-term safety of
an IL-17 to treat pediatric patients with psoriasis, the availability of a new laser to treat acne, more options for atopic dermatitis (AD) patients, and expanding the use of deroofing in the management of
HS, are all advances that are highly encouraging to Canadian dermatologists.
Click here to read the full article.
Minocycline foam formulation minimizes systemic absorption of antibiotic
Emerging options in novel retinoids, new antibiotics, as well as agents that challenge the hormonal pathways in acne, and innovative energy devices are all on the acne radar for Canadian dermatologists who treat patients with the condition.
Click here to read the full article.
Everything you need to know (and more) about this popular skincare ingredient.
If you ask any dermatologist, aesthetician or skincare junkie what their favourite skincare ingredient is, there’s a pretty high chance it’ll be retinol—and for good reason. Part of the larger retinoid family, this Vitamin A derivative is known as the gold standard for its anti-ageing properties as it speeds up your cell turnover rate to exfoliate the top layer of your skin.
“Retinol and other Vitamin A-based products can help treat and prevent acne and acne scarring, reduce hyperpigmentation and blemishes, reduce fine lines and wrinkles, and improve the glow and texture of the skin,” says Dr. Benjamin Barankin, a Toronto dermatologist and Medical Director of Toronto Dermatology Centre.
One drawback to retinol? Its quickened cell turnover process can also lead to a fair amount of dryness, flakiness and irritation, which can turn people off of using this anti-ageing ingredient. With this in mind, Biossance produced a powerful, yet gentle, Squalane + Retinol Night Serum that is ideal for both novices and more experienced users. Alongside retinol and retinal (a more potent retinoid), its key ingredient is squalane, a soothing, plant-based emollient that is proven to effectively deliver the retinoids while simultaneously providing moisture and minimizing the dryness and irritation that can happen when you first try this powerful ingredient. Its blend of rosemary and saffron also provides antioxidant protection and help support overall skin health and aging.
While anti-ageing skincare products used to be viewed or even reserved solely for those in their 40s and up, taking care of your skin proactively, starting as early as your 20s, is becoming increasingly common and even recommended by dermatologists. Using products, such as Biossance’s Squalane + Retinol Night Serum, gives you the preventative power to keep fine lines and wrinkles at bay for longer before they even appear. To sum it up: It’s never too early or too late to start using retinol and taking care of your skin.
We connected with Dr. Benjamin Barankin to get his best retinol tips for every age and stage.
If you’re in your 20s
First of all, kudos on being proactive and setting positive skincare habits early. Whether you’re trying to treat acne, pigmentation, texture or proactively get rid of any fine lines, Barankin recommends taking it lower and slower early on in the process. “Pick up the lowest concentration product and use it two nights per week, and increase the frequency by 1 night per week each month,” he says. “Once you can tolerate it nightly, increase the concentration of the retinol and repeat.”
For those with sensitive skin or well-controlled rosacea or eczema, start even slower at once a week at a low dosage and work your way up. If you have oily skin, which is more common at a younger age, Barankin also recommends starting with a mid-level retinol (0.025% – 0.04) and working up to a higher strength (0.1%) over top of a moisturizer.
If you’re in your 30s
If you’ve just started your retinol journey, make sure to follow the beginner notes above. If you’ve already been using retinol for a few years, you’ve probably developed a good tolerance at this point in your skincare journey. If you feel your results have plateaued, try increasing your dosage or frequency as needed (don’t skimp out on the moisture and sunscreen). If you feel your skin is thriving, maintain the routine you currently have.
“The higher the concentration you can ultimately tolerate, the better the results you’ll have,” says Barankin. “For your 20s and 30s, it’s important to work your way up with a retinol as the plan is to use them for life.”
If you’re in your 40s
For both our retinol novices and pros in their 40s, hydration and sun protection are more important than ever. While dermatologists recommend wearing sunscreen (another anti-ageing gold standard) every day and at every age, it becomes even more important at this stage because retinol will make you, even more, sun sensitive and vulnerable to burning. Plus: UV rays have a drying effect on the skin and may make you more prone to irritation.
“In your 40s onwards, we’re starting to get drier, and so applying a moisturizer first before the retinol will make more sense,” says Barankin. “If you get too dry or red or peeling or irritated from retinol, simply take a break for two to three nights, moisturize only, and then resume using it. Our skin will typically get used to the products over time.”
If you’re in your 50s and beyond
If retinol’s been a part of your skincare routine since your 20s and 30s, you’re a superstar and we can all learn from you. According to Barankin, at this point, your skin has probably “retinized” and you’re already able to tolerate higher concentrations of retinol and are able to increase your potency (with a lot of moisturizer and sun protection, of course).
For those in their 50s or 60s and just starting their retinol journeys, it’s important to be extra gentle with your skin because, as you know, it is going to be a bit thinner, dryer, and more sensitive than it was in your 20s or 30s. Make sure to always wear SPF and to start with the lowest potency of retinol paired with “more and/or thicker moisturizer, cream or balm.” From there, you can slowly work your way up as needed.
Note: Your skin may be even dryer during the winter, so either double up on the moisture or take breaks when needed.
Credit: Chatelaine.com
Stepping outside during those bone-chilling winter months is already a whole to-do. It would be nice if we could skip the sunscreen step in the getting-ready routine. The good news is, we can save a bunch of money on body sunscreen.
We connected with Dr. Benjamin Barankin, Toronto dermatologist and medical director of Toronto Dermatology Centre, to find out if we should be wearing sunscreen during the colder months.
We first connected with Dr. Barankin to find out which sunscreens we should be using in the first place — here are his recommendations.
So when it comes to winter, do we need to wear sunscreen? “Yes. Mainly if out and about for more than 30 minutes, and just for the face/neck,” said Dr. Barankin.
“We still get sun/UV damage, although the sun is weaker and thus takes much much longer to burn the skin,” explained Dr. Barankin. “Although impact on wrinkles, brown spots and skin cancer are still present.”
And if you’re planning on skiing or enjoying the mountains, it’s even more important to ensure you’re applying sunscreen. “The sun is stronger and can [even] reactivate cold sores,” said Dr. Barankin. “Sun/UV will bounce off of water, ice, windshields and snow and hit us, so it’s important for anti-aging and anti-skin cancer effects to wear SPF when outdoors in the winter, too.”
Same goes for fall and spring: if you’re outside for 30 minutes or more, make sure you apply SPF to stay protected on any area exposed to the sun.
Here are some of Dr. Barankin’s face/neck sunscreen recommendations:
- Aveeno Sun Aveeno Protect + Hydrate Face Moisturizing Sunscreen SPF 50
- La Roche-Posay Sunscreen Lotion, Anthelios Ultra Fluid Face Sunscreen SPF 50+ Broad Spectrum
- La Roche-Posay Body and Face Sunscreen, Anthelios Lotion Sunscreen Broad Spectrum SPF 60
- Neutrogena Suncare Neutrogena clear face Sunscreen SPF 50
Credit: Randi Mann, nationalpost.com
When mouth guards fail, are injections the answer?
With the pinch of a needle, cosmetic dermatologists such as Michele Green can make forehead wrinkles disappear and deep-furrowed crow’s-feet puff back out like yeasted dough. Botox is totally magic, a little unsettling, and very in demand: Green’s New York City practice has been swamped as Americans seek to give themselves a “post-pandemic” glow-up. But these days, many of her patients aren’t after eternal youth and sex appeal. When Green reviews her schedule for the week each Monday morning, she told me, “I’m just like, Oh my god.” At least a quarter of her Botox appointments are for people with a different motive entirely: They can’t stop clenching their jaw and grinding their teeth.
Across the country, patients dealing with the meddlesome condition are now turning to Botox—yes, Botox. “It’s a very popular treatment” for people who grind and clench their teeth, Lauren Goodman, a L.A.-based cosmetic nurse, told me. Bruxism, the official term encompassing both behaviors, is an involuntary action that tends to happen when people are sleeping at night, for reasons including alcohol and tobacco use, sleep apnea, and stress—perhaps why the condition has soared in the United States during the pandemic. The condition is a tolerable nuisance for many people, but the symptoms can get very real: With bruxism on the rise, dentists are reporting more chipped and cracked teeth in patients, along with jaw pain and facial soreness. In the most severe cases, patients can suffer debilitating headaches and jaw dislocation. The most common treatments, such as mouth guards and lifestyle changes, only sometimes help get rid of symptoms.
That’s what makes Botox so appealing for the recent flood of teeth grinders. Jaw injections relax the chewing muscles that clench and grind with up to 250 pounds of force—potentially relieving pain and preventing dental issues in the process. It’s not as though every teeth grinder in America is hotfooting it to their nearest Botox clinic, but the procedure seems to have blown up since the start of the pandemic. Five dentists and cosmetic experts told me they’d noticed an increase in teeth grinders and clenchers getting Botox. People who have exhausted more traditional routes are “really just committed to alleviating their pain,” said Samantha Rawdin, a prosthodontist in New York City. “If that means getting a needle to the face, so be it.”
But even if Botox has some upsides, it’s hardly the permanent, sure-thing solution that dentists and patients have long searched for. That’s been the narrative all along with bruxism: Because there are so many possible causes, treatments are an educated dice roll—and none of them is universally effective. “I don’t tell my patients I can treat them,” Gilles Lavigne, a dentistry professor at the University of Montreal, told me. “I tell them I can help them manage their condition.” So, how do we still not always know how to handle this incredibly common ailment?
Botox has been creeping onto the teeth-grinding stage since long before the pandemic. Although it has gained noticeable traction over the past few years, research on the efficacy of Botox stretches back to the late 1990s. In the years since, researchers have also discovered that the injections, which temporarily paralyze the masseter muscles responsible for grinding and clenching, can reduce the frequency and intensity of bruxism. It’s one of a slew of non-cosmetic Botox uses that have been identified since the drug hit the market in 1989: Injections also treat issues such as excessive underarm sweating, acne, and migraines.
Botox for bruxism hasn’t been FDA approved, so it’s still considered off-label—but anyone with a Botox license can legally inject a willing teeth grinder. And at least in theory, Botox has some advantages over other bruxism treatments. Night guards might prevent you from gnashing your teeth into smithereens while you sleep, but they can be ineffective at stopping the behavior and can even make it worse—especially if you have sleep apnea, Jamison Spencer, a dentist and sleep-apnea expert based in Boise, Idaho, told me. Minimally invasive regimes such as yoga, meditation, cognitive behavioral therapy, and physical therapy are hit or miss. Muscle relaxers can be helpful for some patients, but those aren’t universally popular among the dentists I spoke with, some of whom cited America’s opioid crisis as a concern.
When less invasive treatments don’t work, Botox might be “the next frontier,” Leena Palomo, a professor at New York University’s College of Dentistry, told me. Grinders and clenchers seem to be learning about the injections from a variety of sources. Rita Mizrahi, an oral surgeon in New York who offers Botox for bruxism, told me that her patients are typically referred by their regular dentists. Others discover jaw Botox in online forums such as Reddit and the beauty network RealSelf, where often anonymous discussions of the procedure abound. And some are reading mainstream-media testimonials or hearing about it from friends or family—particularly as more and more Americans embrace Botox for cosmetic purposes.
At its best, the procedure can really help certain teeth grinders: Studies have indicated that Botox can decrease pain levels. One RealSelf reviewer described trying night guards, stress relief, and cutting out caffeine before getting jaw injections. “Thank goodness for something like Botox to come along in this day and age,” they wrote four months after getting the procedure. Injections come with some cosmetic changes too: Grinding and clenching all night can be a workout, which might lead to enlarged chewing muscles and a square, boxy face. Botox slims the jawline for many patients, giving it “more of a V-shape,” Green said.
But Botox has some real downsides—and plenty of dentists are still hesitant to recommend it. For starters, it’s expensive and impermanent. The procedure typically costs at least $1,000; is not covered by medical or dental insurance; and usually won’t last for more than four months. “This isn’t a onetime thing and you’re good,” Mizrahi said. And like most of the other treatments available, jaw Botox attacks teeth-grinding and clenching symptoms, but not the cause. Because people still need to chew, the masseter muscle isn’t totally immobilized—meaning that patients “will just grind with less power,” Lavigne said.
And all of the risks associated with the cosmetic use of Botox apply here too, such as bruising at the injection site, headaches, allergic reactions, and less desirable changes in facial expressions due to misplaced Botox. One RealSelf reviewer experienced no improvement in jaw pain but the unfortunate onset of a creepy grin that resembled a “chucky doll smile.” Another said that their headaches disappeared after the procedure, but so did their cheeks: “I couldn’t recognize myself in the mirror and looked like I had aged 10 years within a couple of months.”
That grinders and clenchers are more frequently turning to Botox is hardly a pure success story. Early mentions of teeth gnashing exist in the Bible, yet we still don’t really understand how to make it stop. I know firsthand how frustrating that feels. In January, after trying (and failing) to open wide enough for a crispy chicken tender, I was finally motivated to see a dentist—who gave me a night guard so I’d quit slamming my teeth together. I meditate like it’s my job, I don’t have sleep apnea or take medications of any sort, and yet I still gnaw on that hunk of plastic like it’s gristle. My jaw doesn’t lock anymore but it’s still tense most mornings. I’m priced out of getting Botox—so, like many teeth grinders, I’m stuck in medical purgatory.
Teeth grinding isn’t like a broken arm, where cause and effect are obvious and fixable. “Because the origin of [jaw] pain is not singular, you have to attack it from various modalities,” Mizrahi told me: “All the things that potentially contribute to the pain have to be addressed,” and that can involve fields far outside dentistry. Even dentists themselves aren’t always equipped with all the information: “We get virtually no bruxism education” in dental school, Spencer, the sleep-apnea researcher from Idaho, said.
With all these roadblocks, many patients never find out why they’re clenching or grinding, says Alan Glaros, an emeritus professor of dentistry at the University of Missouri at Kansas City, who’s been researching the issue for more than 40 years. That’s partially because it’s a difficult problem to not only treat, but also study. Bruxism’s many causes intersect “a lot of disciplines,” such as dentistry, sleep health, and psychology, which muddies the research process. Each field is studying the behavior, but the results will only ever tell part of the story. “People act as if this is all solved, but it’s not,” Glaros told me.
So for now, mouth guards, meditation, and Botox are what we have. The treatment, in all likelihood, isn’t going anywhere. “As people get to know others who have responded well, I predict that we’re going to see an uptick,” Palomo said. Grinders and clenchers will keep chomping on their plastic night guards or forking up thousands of dollars a year for temporary injections, all in a maybe-successful attempt to quell their pain. If only Botox could banish bruxism like it does stubborn wrinkles.
Credit: Article by Ali Francis, from thealtanic.com
If you have some form of Psoriasis or know someone closely affected by it, why not show your support over a cup of coffee?
The Canadian Association of Psoriasis Patients (CAPP) has teamed up with Sparkplug Coffee to raise funds for its programs. The fundraiser is open until November 6, 2022.
Enjoy a variety of different coffees and support our community in the process:
- CAPPuchino (Kenyan Blend)
- PsoDark- PsoMedium
- PsoLight
- PsoDecaf
Check out the available coffees here and help support people in Canada living with psoriasis and psoriatic arthritis! Tell your friends!
What is Hyperhidrosis?
Hyperhidrosis (also referred to as HH) is defined as excessive sweating, which can affect any part of the body. “In fact, we see many patients in our practice with this condition.” It is a disorder of excessive sweating due to the over-stimulation of cholinergic receptors on eccrine (sweat) glands.
Hyperhidrosis is inappropriate sweating, so sweating while reading or watching TV, as opposed to appropriate sweating when we’re nervous or exercising.
For many patients, it can be embarrassing, frustrating, even debilitating and impairs social interactions. In fact, it has been shown to have a significant impact on patients’ quality of life, resulting in social and work impairment and emotional distress.
Where does it occur?
The most commonly affected areas are the armpits/underarms as well as the palms and the bottom of feet. Excessive sweating can also occur in other areas of the body as well.
Why do we sweat?
- Sweating is important for our health, providing pheromones for sexual attraction, and thermoregulation so we don’t overheat in hot weather or with exercise, and so we can grip and grab better with our hands.
- Hands & feet sweating, sometimes called “emotional” and can be due to stress or anxiety which is odor-free.
- The smell of sweat occurs when skin bacteria overgrow and feed on excess moisture, typically in the armpits and groin, but also the chest.
HH treatments
- Topical antiperspirants are generally considered as first-line treatment for palmar (hands), plantar (feet) and axillary (underarms) Hyperhidrosis (HH) because of their ease of application, high efficacy and safety, and low cost. As a first-line treatment, if properly planned, topical therapy can eliminate the need for time-consuming or expensive therapies such as iontophoresis and Botox injections. Unfortunately, for some patients, topical antiperspirants only provide temporary, short-acting relief of sweating and tend to be most effective for mild or moderate cases of HH.
- Aluminum chloride (main topical treatment ingredient) is thought to work by physically obstructing the pore of the sweat gland and/or by causing atrophy of the secretory cells. In Canada, the over-the-counter antiperspirant preparations contain a maximum concentration of aluminum chloride of 6.25%, 12%, 20–25%.
Drysol™ an over-the-counter clinical strength antiperspirant
- Drysol™ – contains Aluminum Chloride Hexahydrate, which is a unique maximum-strength topical antiperspirant. ACH has a 98% proven efficacy in controlling sweat and a 30% reduction in sweat volume.
- Drysol™ 20% passed the HRIPD test and meets the criteria of The Canadian Dermatology Association’s Skin Health Program. The product does not contain specific ingredients that can cause irritation and negative reactions to the skin.
Drysol™ topical treatment is an effective choice to help your HH condition or excessive sweating.