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The Home of Expert Advice for Skin Care

Skinlibrary.com is an online medical resource addressing various concerns, issues and questions pertaining to the overall skin health with information on Dermatology, Dermatological Conditions, Skin Treatments, Skin Care Products, tips on Sun Protection, and even an inside look at Celebrity Skin.

Discover how to improve common skin conditions like Adult Acne, Dry Skin, Enlarged Pores, Aging Skin, Brown Spots, Rosacea, Sun Damage and Wrinkles with Dermatological Treatments and cosmetic procedures like Botox®, Thermage, lasers and much more.

At Skinlibrary we look forward to assisting you in optimizing your skin’s health and appearance.

About Skinlibrary:

The Skinlibrary network of dermatology, medical and health experts was founded to assist the pursuit for healthy skin with each expert offering unique advice, insight and knowledge in a certain aspect of the dynamic of healthy skin. It provides comprehensive information for the public, for dermatology patients, researchers, physicians and media about the skin, its care and various skin conditions and treatments.

All content is reviewed by an independent Board of Dermatology Advisors to ensure that the information is accurate, unbiased and current. This information is not intended to replace a consultation with your own dermatologist or physician.

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The Doctor Is In: Eye Care - Treating the sensitive skin around the eye area

When skincare brands launch a line in Canada, there’s always a separate product to apply around the eye area? Why is this? Why don’t regular moisturizers work in this specific area of the face? This month we ask our resident dermatologist Dr. Lisa Kellett to shed some light on this sometimes confusing subject.

Cosmetics Magazine: How is the skin different around the eye area from the rest of the face?
Dr. Lisa Kellett: The skin in the eye area has less subcutaneous tissue under it and is thinner than on the rest of the face. To put this into perspective understand that the average thickness of the skin on the back and soles of our feet is 4 mm. That thins to about 2 mm on the scalp and forehead. And it thins even further to less than 1 mm on the eyelids and around the eye.  So you see, you are working with a much finer thickness of skin that is very fragile and delicate.

Cosmetics Magazine: Why is it that many dermatologists recommend using an eye cream?
Dr. Lisa Kellett: Some moisturizers contain actives that are too irritating around the eyes. You may need a formula that is much milder.

Cosmetics Magazine: What are the main concerns around the eye area?
Dr. Lisa Kellett: Crows feet and dark under eye circles are the most concerning to clients. Fine lines and wrinkles tend to show up in this area first because there is less subcutaneous tissue to support it.

Cosmetics Magazine: What causes dark circles under the eyes?
Dr. Lisa Kellett: Dark circles are actually blood vessels under the eye. With age they often worsen because they become more obvious when you loose fat around the eye. However, for some people they are genetic and can occur at a younger age.

Cosmetics Magazine: Does the under eye area of ethnic skin differ from Caucasian skin?
Dr. Lisa Kellett: It definitely can. Some ethnic groups are more prone to getting certain skin conditions under the eye such as dermatosis papulosa nigra.

Cosmetics Magazine: We know the importance of using broad spectrum sunscreen in preventing premature aging. But can sun damage show up around the eye?
Dr. Lisa Kellett: Good question. Yes, definitely. Sun damage under the eye usually shows up as a loss of elasticity, but it can also manifest as brown spots and even skin cancer. It’s another good reason to use sunscreen every day.

Cosmetics Magazine: What ingredients should you look for in an eye product?
Dr. Lisa Kellett: Look on the back ingredient list of algae extract, vitamin A, vitamin E, rice bran oil, and glycerin.

Cosmetics Magazine: Does stress affect the eye area?
Dr. Lisa Kellett: Yes, stress can affect all of the skin including the eye area

From Cosmetics Magazine, July-August 2008
By Dave Lackie

SKIN CARE: SMART GUIDE - Your A-Z Beauty Handbook

From golden skin and custom foundation to injectable fillers and lush lashes, here’s what you need to know for the summer.

FAT FREE

Muffin top, spare tire, love handles- cute names, yes, but the real thing isn’t. There’s hope for those hard to tone deposits of fat around the midsection. UltraShape and Synergie offers a two step non-invasive cosmetic procedure that melts and drains away fat to about 2 to 3 centimeters, or one pant size smaller. “First, a focal ultrasound – UltraShape- targets the fat cells, breaks them open and releases the fat,” explains Toronto-based Dr. Lisa Kellett, the first cosmetic dermatologist in Canada to offer the procedure. Discomfort is minimal – a gel is place on the area and you’ll feel merely a tingly sensation. Then, the “free” fat is metabolized by the liver and liquefied.

Says Kellett: “Synergie – lymphatic massage – is then used to stimulate the lymphatic system and drain the fat away from the area.” She also qualifies that the procedure reduces fat, not weight. Cost: $800 to $1,000, depending on the surface area. Dlkonavenue.com

INJECTABLES

JUVEDERM & RADIESSE These two hyaluronic acid-based injectable fillers both correct facial folds and crease – results for the former lasting 6 to 12 months, the later, 4 to 6 – and deliver similar results. Juvederm is currently being use to build volume in lips, cheekbones and chin. “It’s preferred over a chin or cheek implant because it’s noninvasive – there’s no major surgery,” says Toronto-based cosmetic dermatologist Dr. Lisa Kellett. “We use what’s considered a deeper form of Juvederm, injected along the bone to help build up the shape.” Cost: $400 and up.

BOTOX

Now six years on the market, Botox is still the gold standard treatment for banishing – for at least up to four months, anyway – expression lines on the brow, forehead or around the mouth. “ You can’t beat it for filling in lines,” says Kellett. “Unless you do something to sop the contractions of the muscles, those deep folds will still occur.” Botox’s new calling card: turning a frown upside down. “A lot of people don’t like that the edges of their mouth naturally turn downwards,” says Kellett. “Botox can now be used to lift those turned-down areas.” Cost: starts at around $325 for eyes; more for larger surface areas. Dlkonavenue.com

THERMAGE

Using radio-frequency technology to tighten facial skin (primarily around the jaw-line) and increase collagen production, thermage is close to bumping Botox off the top of the list of most popular cosmetic procedures. Using a shallower, FDA-approved tip, thermage can now firm and even lift your upper lip, eyelids and the area underneath the eyes, “You won’t see a huge difference,” notes Toronto-based cosmetic dermatologist Dr. Lisa Kellett, “but it’s subtle enough for the customer to notice.” Best suited for people in their 30s to 40s who aren’t comfortable with surgery to fix dropping skin. Cost: Starting at $2,500 you can perk up your eyes for a mere 30 minutes, and your entire face for around $3,500. But it doesn’t stop there. You could say bye-bye to cellulite by undergoing one round of the new ThermaTip CL. “ By reaching and heating the deeper tissues in the skin, it helps rebuild collagen connective tissues and improve blood flow to these tissues,” says Kellett. The results are said to be immediate and can continue to improve for up to six months. Cost depends on the size of area.  Thermage.com

VANISHING VEINS

Wrinkles aren’t the only lines we don’t like to see. “Crossing the legs, standing for long periods, the hereditary factor and blunt trauma to the vein are the main causes of varicose veins ,” says Dr. Lisa Kellett, a cosmetic dermatologist in Toronto. The most common treatment for getting rid of varicose and spider veins is sclerotherapy. A salt-dextrose solution is injected into the vein, irritating the walls and causing them to shrink - a procedure that takes 20 minutes. The main side effect is bruising. Befriend the compression stocking for a few weeks. “Avoid anything that will put pressure on the vein, such as crossing your legs, but you can still remain active,” says Kellett, who also recommends undergoing sclerotherapy in the winter or early spring to tallow for four months of recovery. Cost: $250 and up.

Published by the Toronto Star - Friday, June 27, 2008

WHAT’S IN YOUR BAG? - VOULA AMPAS ANSWERS THE PROVERBIAL MAKE-UP QUESTION

Years ago I remember this question was asked of many woman, “if you were stranded on a desert island what make-up product would you want with you?  Are you a mascara or lipstick type?”

This question sums up the possible contents of the make-up bag.

Since most of us most likely won’t be stranded on a desert island sometime soon, the question now is what’s in your make-up bag?  What do you leave at home and what can’t you do without?   We all have our own particular needs for sure.  I’ll leave the interpretation of our choice to the therapists!

To determine what we choose to be in our bag we must first know the make-up bag basics. 

A good concealer or two are high on the list of priority.  One should be a hint lighter than your skin tone for those casual days you don’t wear foundation.  And the other should be 1-2 shades darker than the foundation for the days you do wear foundation.  Concealer is a must on any day because they act as a reflector of light.  Of course it can also act as a highlighter on the brow bone and on eyelids when you’re not wearing eyeshadow.

Foundation is another basic.  Once again you may opt to have two.  For the casual days use a tinted moisturizer or sheer textured foundation and a fuller coverage for your polished look.  Whichever you do use choose the correct colour.  Swatch your options on the side of your jaw and don’t be shy to take a mirror into daylight to determine the correct match.  Please don’t use your wrist! 

Powder is one of those necessities and one of the most feared products.  Too much can add years to skin.  Choose a loose translucent type for home use and a compact for touch-ups.  The colour should be a hint lighter than your foundation.  And even though the matte look is in this season don’t overdue it.  After your initial application touch-up only the forehead, nose and chin areas.  Avoid the under eye area.

Mascara is a must for many.  With the vast choices out there how does one decide?  From full and volumous to thick and separate, our lashes can have a different mood every day!

Whichever works for you, use a round brush or mascara comb to get rid of those clumps.  Apply, comb, apply and comb again.  A tip for bottom lashes is to tissue off the excess mascara first. 

Lipstick, lipgloss, lipbalm are top ranked in the ‘what I can’t live without’ category.  And we see this in the numerous options out there.  It’s eye candy!  And the beauty of all this choice is we don’t have to choose just one!  So go for it and use texture and colour to portray your mood of the moment.  And as summer is approaching consider using a sunscreen as well.

Blush has become a must for many in recent years and is getting a boost this season.  The choice of colour depends on the look you want to create.  If it’s your choice for that deserted island than opt for a colour that gives you a healthy glow.  Maybe one with a sheen rather than a matte texture.  A smile will show you where the correct placement should be.

Shadows are always in the make-up bag.  Ones for the soft, romance look in earthy tones to the intense darker, smokey colours for impact.  How many does one woman really need?!  But many we have I’m sure.  Create your ‘look’ based on what you feel comfortable wearing and add a new colour or texture to update your look for the season.

In the meantime keep any make-up that you don’t often use in the fridge to prolong its lifespan.

So the best advice is this…if you haven’t used it in a year, think about giving it to a friend.  Maybe it’ll be her ‘can’t live without it’ colour for that deserted island!

Written by Voula Ampas of The Artist Group

Self Tanning Creams Give Differing Results - From CityNews Toronto, Monday June 9, 2008

We all know sitting out in the sun and getting as brown as a baked potato isn't good for you. But what about those tanning creams? Do they actually work and should you use them?

To find out, CityNews took a guinea pig in the form of one of our interns and spread all kinds of the lotions at strategic places where a tan would look best. Among the products tested: Clairins Delicious Self Tanning Cream, the most expensive at $40, Biotherm's $30 Sun Tan, a $15 self-tanning lotion and Life brand's ultra-cheap $11 Bronze Up.

The results: the most expensive product appeared to do the best job at least for the subject in this case.

"The most expensive one was the best because of the way you applied it," explains Amanda, our patient zero. "It was really smooth ... You don't see any streaks."

The others were either streaky or too close to compare.

But either way, Amanda wasn't completely impressed. "It's really difficult to tell," she admits. "All I know is I wouldn't tan this colour ...  They're all a little bit too dark and orange for me."

As to how to prevent looking like a carrot, one expert suggests first using a test spot that won't show so you can see what you're in for. "It's important to find something that is great for your skin colour," advises dermatologist Dr. Lisa Kellett. "Most people who are very fair do very well with it. It's more like a blank canvas but other people have to be careful."

That's one of the drawbacks of the creams, no matter what kind you use. But it's not the only one. Don't get the idea most of them can properly protect you from the harmful rays of the blazing sun.

"Even though you're getting a glow to your skin with it, it is not protecting your skin," warns the doctor. "So you do need to use some sort of sun block with it."

There are self-tanners that come with suntan lotion. Just make sure it's an S.P.F. 30 or higher. Otherwise, you may have to apply a sun block separately, ironically so a real tan never gets in the way of your fake one.

This is article is based on a story that appeared on CityNews in Toronto whereby Dr. Kellett as a spokesperson for the Canadian Dermatology Association discussed Self Tanning Products

Written by CityNews.ca Staff

How to Guard Against the Sun’s Rays - Knowing the whats, wheres and whys of sunscreen means you’ll be able to enjoy the brilliant days of summer safely

1. DOUBLE-DOSE IT
For weekdays at the office, a moisturizer or foundation with SPF 15 is probably enough, says Dr. Paul Cohen, a Toronto dermatologist. But if you’re outside in the summer, wear at least an SPF 30. If your foundation’s SPF doesn’t go that high (most don’t), slather on sunscreen before applying your morning makeup. If your fair-skinned or have a history of cancer, go higher.

2. BUY THE NUMBERS
“SPF 30 gives approximately 97 percent protection, while SPF 45 gives approximately 98 percent, so the one percent makes, on a practical level, little difference,” says the Toronto derm Dr. Lisa Kellett. But we tend not to use enough sunscreen, so it’s a good idea to wear a higher number as insurance since spreading sunscreen too thinly diminishes its SPF factor. It takes about half a teaspoon of sunscreen to cover your face and neck and at least an ounce or shot glass of lotion to cover an average-sized body. Apply it at least 15 minutes before sun exposure. If you’re outside, sweating or swimming, you need to reapply every couple of hours.

3. UVA VS. UVB
SPF rates a product’s protection against UVB rays, but UVA rays are damaging, too. They cause cancer, are just as damaging, wrinkle-wise, and penetrate glass. Broad-spectrum sunscreens protect against both types, although how much they guard against UVA rays is not measured. We say that it’s better to be safe than sorry, so look for these broad-spectrum creams, gels and sprays, especially if you are an outdoors or beach lover and your sun exposure tends to be long and intense.

4. BEST BETS
Alcohol-based sprays are best if you have oily skin or are spraying in hairy areas such as your guy’s furry chest or legs, says Kellett. Creams are ideal for drier skin types. Look for Mexoryl, Tinosorb and oxybenzone, effective ingredients approved by Health Canada. They help provide photo-stability, which helps the sunscreen’s UV filters last longer. But check the expiration date on your sunscreen and, most importantly, make sure your bottle has a drub identification number (DIN), which means it is registered with Health Canada.

5. POP A PILL
Alternative ways to get protection are in the works. The Canadian brand Isomers is coming out with a body wash later this year with SPF in it: Use it in the shower and SPF remains. Available in the U.S., but still pending approval by Health Canada, is St. Ives cleanser with similar SPF technology. Researchers are also working on sunscreen vitamins. For now, there’s Heliocare, a pill that combines green tea, beta carotene and a natural fern extract. It’s supposed to help prevent sunburns by boosting your body’s natural ability to battle the sun’s rays.

From Chatelaine, June 2008 - Text by Doris Montanera

Saving Face - A Guide to Sensitive Skin: The simple answer to healthy skin-minus the jumble of jars, tubes and pots

We’ve all been there. Roaming the aisles of the department store, lured by a bevy of potions and lotions, each another promise of reclaimed youth and everlasting beauty, dressed up in packaging that actually seduces you with thoughts of being as pretty as it- an inanimate object! But what we can often forget when in the throes of beauty counter passion is that what works greats on your sister, best friend, or colleague with the glowing complexion won’t necessarily work for you. As we continue to slather on more and more products (usually without proper guidance), our skin is fighting back. In fact, complaints of sudden outbreaks of sensitive skin are becoming the hottest topic at your local dermatologist’s office.

“Patients who complain of sensitive skin are very common,” says Toronto dermatologist Dr. Lisa Kellett. “As the number of products available on the market increases and there is a greater use of products, there is a higher probability of reaction.”

Generally characterized by itching, burning, and/or stinging, with patches of redness and dry spots, truly sensitive skin can be hard to define. Technically, a condition of subjective hyper-reactivity to cosmetics, soaps, sunscreens, and environmental factors like harsh weather, Dr. Lisa Donofrio, Associate Clinical Professor of Dermatology at Yale University School of Medicine, emphasizes the importance of recognizing the spectrum of conditions, which range from just dry skin to skin that is actually allergic. “Patients don’t really know the difference and tend to feel it is all just ‘sensitive skin’.

Kellett says that while overusing beauty products can lead to sensitive skin, doctors can’t make a proper diagnosis just by looking at you. In addition to redness, breakouts or other symptoms you can see, others, such as itching, burning or stinging, are not visible symptoms.

From Lush Magazine, Spring 2008 - Text by Bonnie Mallot

Cellulite - 7 myths and truths

Do cellulite treatments work? Can you reduce cellulite or remove it and say goodbye to it for good? Separate fact from fiction about that dimpled skin on so many women's butts and thighs.

You glance over your shoulder at the mirror and your brow furrows in disapproval. All that time you spent at the gym and even though your thighs may be smaller, the cellulite seems to be staying for good. You're not alone.  According to SmartSkinCare.com, an independent skin-care information portal, 80 to 90 per cent of women live with the troubling, dimpled, "orange-peel" skin known as cellulite.

Cellulite is a nuisance for many women and you can find it on the thighs, buttocks and abdominal areas of postadolescent women. Despite the multitude of products and treatments that promise to get rid of this stubborn skin nuisance, it still exists and is not clearly understood. Here, three dermatologists debunk common myths with tried and tested truths on how to remedy your cellulite woes.

1. Fact or fiction: Tanning hides cellulite Fact, but tanning also worsens cellulite. "Tanning will only conceal the appearance of cellulite in the short term," says Dr. Mariusz Sapijaszko, medical director of the Western Canada Dermatology Institute in Edmonton. "[Over the] long term, ultraviolet radiation will weaken and thin the skin, exacerbating the look of cellulite."

According to Dr. Lisa Kellett, dermatologist at DLK on Avenue in Toronto, there are benefits for some who choose to tan, and skin-saving alternatives for others. "For fair-skinned people, tanning can improve the appearance of cellulite," she says. "But self-tanner is highly recommended."

2. Fact or fiction: Loofahs reduce the appearance of cellulite
Fiction: Regular use of a loofah can increase circulation and exfoliate the superficial layer of skin; however, it has a limited effect in dealing with cellulite. Dr. Paul Cohen, dermatologist at the Rosedale Dermatology Centre in Toronto, explains that loofahs do not reach the deep tissue required to affect cellulite, but the exfoliation may help the exterior layer of the skin look smoother. "It is an inexpensive method that anyone can use to improve the surface layer of skin," says Dr. Kellett, "but it won't cure cellulite."

3. Fact or fiction: Exercise can help banish cellulite
Fiction: Since poor lymphatic drainage in fat cells underneath the skin contributes to the formation of cellulite, exercise and drinking lots of water would seem like a surefire solution. Despite this assumption, experts believe weight and cellulite are not directly related. "Exercise can help the physical appearance of cellulite in that it will decrease fat volume and prevent its further deposition," says Dr. Sapijaszko. "But it has a mild effect on the appearance of cellulite."

4. Fact or fiction: Only plus-size women get cellulite
Fiction: Cellulite it is often associated with problems relating to obesity. "The biggest myth is that people who are really thin don't have cellulite," says Dr. Kellett. "I've seen women in my practice who are in top physical form and they still have cellulite!"

Dr. Cohen agrees that even if you're at an ideal weight, you can still have cellulite. "Cellulite does not distinguish between thin or overweight people. It's more a function of how fat is distributed throughout the body," says Dr. Kellett.

5. Fact or fiction: Creams with natural products can reduce the appearance of cellulite
Fact: Some natural creams are proven to be more effective than others. "Topical vitamin A acid derivatives such as retinol, tretinoin, adapaline and tazarotene have been shown to have a beneficial effect on the appearance of cellulite," says Dr. Sapijaszko. "These creams work by increasing the collagen content, thereby firming the skin."

Retinol refines the top layer of the skin and helps with fine lines but it won't penetrate the fat layer necessary to treat cellulite. There is no lack of products on the market that claim to cure cellulite but consumers should be discerning.

"Often, those who are conducting the research have a vested interest in the product," says Dr. Sapijaszko. "There is a need for more objective data with sustained results." Speak with a professional about your options.

6. Fact or fiction: Cellulite can be "cured" by plastic surgery and other noninvasive procedures
Fact and fiction: Plastic surgery is seemingly the closest option to a cure for cellulite, yet it has not been proven effective by any objective source. Liposuction works as a healing mechanism; as the skin swells and gets firmer, the appearance of cellulite diminishes.

Some studies have shown that subcision -- whereby a needle is inserted under the skin to detach the fibrous bonds that cause cellulite -- can be beneficial in treating cellulite.

Dr. Cohen says that there have been some positive results from endermology, a noninvasive process using massage, rolling and manipulation of the tissue, causing swelling or edema and temporarily masking the appearance of cellulite.

UltraShape, a new noninvasive way to treat cellulite, has also shown dramatic results. Soon to be approved by Health Canada, UltraShape liquefies fat through a focal ultrasound.

Most of these procedures are temporary and do not offer a long-term solution to cellulite.

7. Fact or fiction: Cellulite is genetic
Fact: While eating right, exercising and using the right products can help to a certain degree, genetics, hormones and gender play a central role in the formation of cellulite. According to Dr. Sapijaszko, women in the same family have similar degrees of cellulite. "Much of what causes cellulite is not within our control. There is a definite genetic component involved," says Dr. Cohen.

From Homemaker.com, Spring 2008 - Text by Sarah Snowdon