Healthy Skin Expert Dermatology Advice

Weddingbells.ca - Editor’s Note, November 2009

While this order of business may not be topping your to do list, it should, especially if you want to look like the fairest of them all on your wedding day.

The business of skincare is what I’m talking about. While yes, beautiful skin is something you want everyday, but most definitely for your wedding day. If you’re anything like me (and most women I know), when your stress levels sky rocket and you’re not eating and sleeping right, you become reacquainted with that old high school buddy you’d rather forget: Mr. Pimple.

He and I seem to have been spending too much time together in the last few months with my skin going through an unrelenting breakout, the likes of which I haven’t seen for years. I have been busy; I have been travelling; I have been out of my routine; and I have experienced more than a few off the charts stress days trying to meet deadlines at work. When my tried-and-true home care routine wasn’t remedying the situation, I knew it was time to call in the pros—my dermatologist Dr. Lisa Kellett and her team of skin saviors at Toronto’s DLK On Avenue.

My diagnosis: stress and hormone-related breakouts. The remedy: a series of microdermabrasion treatments and a simple home regime of Dr. Kellett’s own acne-busting line of products (they are amazing and you can buy them online at clearclinical.com). Within days of my first treatment my skin was already starting to clear. I’m moving on treatment four this month and my skin is back on track and quite frankly has never looked better.

Being the busy bride-to-be that you are, I venture you, too, are probably experiencing an increased number of breakouts that might be driving you ‘round the beauty bend. While you might not need to consult a dermatologist, at the very least you should be sure that you are working with a skin pro to ensure you are doing all you can to take the very best care of it. Nobody wants spots, especially on your wedding day, so with the right planning you can ensure Mr. Pimple doesn’t RSVP to your party.

From Weddingbells.ca, November 2009 - Written by Alison McGill

MORE STYLE – The Truth About Botox

To freeze or not to freeze, that is the question…

Most women I know are either pro-intervention (and plan on raging against their drying collagen in every way possible) or have no intention of messing with the effects of Father Time.

Whether you fall into one of these categories, or instead have adopted a laisez-faire, never-say-never attitude using Botox, everyone has an opinion on the world’s most poplar cosmetic treatment.

As a result, there’s a lot of misinformation out there, even though Botox is hardly new on the scene - it was approved for medical used by Health Canada in 1990, and cosmetically in 2001. To date, more than 16 million North Americans have been treated with it.

A little Botox 101: While it does create a smooth, unlined surface, it is not wrinkle filler. The sterile, lab-created botulinum toxin works by “softening” the action of dynamic muscles, such as the ones between your eyebrows that get exercise when your teenager comes home with a new tattoo.

The most common concern about using Botox are that it’s unsafe or that you’ll look frozen. And, of course, there’s needle phobia.

This past January, Health Canada concluded that Botox use came with a “very rare” risk (less than 10,000) of distant toxin spread - when the toxin moves beyond the targeted muscle into other areas of the body, potentially causing muscle weakness, difficulty breathing or pneumonia. However, there has never been a medically confirmed case of distant toxin spread reported in Canada nor a fatality associated with its cosmetic use.

If you want good results, you’ve got to go to a license physician. And make sure she makes it her business to inject Botox all day long. The procedure demands and understanding – and appreciation - of facial structure and underlying muscles. Even though everyone is working with the same material, the results can differ widely (just compare Nicole Kidman’s face to Virginia Madsen’s).

Jean Carruthers, an ophthalmologist in Vancouver (who, along with husband Alastair, is credited with Botox’s cosmetic discovery) says women should avoid environments such as Botox parties. “In the middle of a roaring get-together are you really going to have a meaningful conversation with a person treating you?” she asks. “I don’t think there’s such a thing as informed consent if alcohol is involved.”

Carruthers, who jokes that’s he hasn’t frowned since 1987, advises finding a dermatologist on the same aesthetic wavelength as you are. Ask him if he uses Botox on himself, a sure sign that he believes in its results and safety.

Botox is used most frequently on the upper third of the face: crow’s feet, forehead and frown lines between the brows. But many dermatologists are getting more creative with the product, using it “off label” to give knees, the nose, the stomach, and even breasts a lift. It’s also good for delicate changes, such as lifting the eyelid by a few millimeters, which can be tricky with surgery.

Caveat emptor: Botox isn’t a cheap habit to break if you decide to dabble - it costs at least $350 per session to treat the lines between your brows. And what happens if you stop? Will you suddenly look as if you’ve aged 10 years?

“Definitely not,” says Dr. Lisa Kellett, a cosmetic dermatologist in Toronto. “Although people will start asking why you look so cranky,” she adds with a laugh. Botox wears off gradually over three to six months, and when it’s gone, “your face simply returns to the way t it looked before.” Of course, when you’ve become accustomed to seeing a wrinkle-free surface, that might not be so easy to deal with.

The effects of long-term use of Botox remain under debate. California-based Pamela Rae, who founded the beauty brand Solvaie, has some reservations. She thinks it can end up making your face look more saggy. “If you continually paralyze a muscle, over time that atrophy will cause your face to appear asymmetrical,” she says. “It’s hardly the glow of natural aging.”

Yet Beatrice Wang, a cosmetic dermatologist in Montreal, disagrees, citing recent MRI studies showing that, unlike bone and collagen, facial muscles don’t atrophy with age the way we once thought. In her opinion, sagging is more a result of heredity and UV exposure.

Finally, one of the more prevalent myths about Botox is that it builds up in the body. But although its effects last for several months, the product doesn’t accumulate. “Once it’s injected, it’s actually broken up and excreted within several minutes,” explains Carruthers. “The reason it lasts is because of the chemical effect on the neuron, which takes three to six months to repair itself. There can be no cumulative effect.”

And now for a news update: After dominating derms’ offices, Botox may soon have a competitor. The FDA in the United States recently approved Dysport, another botulinum toxin, which has been used in Europe for years. That’s good news for consumers, as it could bring prices down, although we’ll have to wait for Health Canada to give it the once-over first.

Ultimately, if you’re going to try Botox, keep your expectations realistic. It isn’t going to make you look 10 years younger. But used appropriately, it can make you look like a more relaxed, well-rested version of yourself.

From More Magazine, November 2009 - Written by Beauty Editor Vanessa Craft

More Men Seeking Cosmetic Treatment

As the Botox-infused needle pierces the skin around Howard Lende's left eye, the resulting wince produces the furrows he has earned over 46 years.

Slowly, the needle's clear liquid contents empty into the Toronto real estate agent's face in a ritual that is becoming increasingly common among men of a certain age anxious to smooth out the wrinkles.

"I haven't slept in 10 years," says Lende, a top agent specializing in downtown luxury homes.

"It's seven days a week, full speed. The eyes tell the story."

The pursuit of age restoration, once the exclusive realm of beauty-seeking women, is now a distinctly unisex endeavour.

Lende sits in the bull's eye of the male cosmetic procedure demographic: Mid-40s, successful and in an industry where appearance – especially youthfulness – is essential to success.

Indeed, real estate agents are among the leading group of male Botox-seekers, experts say.

"Presentation is part and parcel of the industry," says Lende. "If you're happy with your face it gives you more energy and vitality. It's not always inside out. It's often outside in."

Achieving the new 30 when you're in your 40s comes with options.

There are creams and toners. There is full-on cosmetic surgery. And then there is the kind of middle ground: Clinical, non-surgical treatments that plump, smooth, brighten and lift.

"We're not going to do anything drastic, just make you look like a better version of yourself," says Diana Phillips, the cosmetic nurse at the DLK on Avenue clinic where Lende sought the fountain of youth.

The process included a "soft lift," microdermabrasion and a photo facial – words and phrases not previously part of the male lexicon.

The soft lift is achieved by injecting a combination of Juvederm (which promises to restore volume in hollowed-out cheeks and smooth out folds around the nose and mouth) and Botox (designed to turn back the clock on frown lines and crows feet).

It's not cheap.

The Juvederm filler treatment rings in at $600 and up for a single treatment requiring a touch-up every six to nine months.

Botox treatments, which must be repeated every three or four months, cost $350 and up for each session.

Lende's youthful transformation also included intense pulse light (IPL) photo facial treatments in which a technician zaps uneven skin tone and broken capillaries (three to six treatments every two to four weeks; $350 and up for each treatment) and diamond microdermabrasion to suck up dead skin, exfoliate and brighten (three to six treatments every two to four weeks; $150 and up each).

"Men are slowly starting to realize there are options out there that will not drastically change their looks; rather, just make them look and feel younger," says Dr. Lisa Kellett, the Toronto dermatologist who owns the DLK clinic. "The benefit is that there is no surgery so, therefore, no downtime and more reasonable cost than surgery."

The before and after pictures tell the story. Weeks after his procedures, Lende does appear more rested and even youthful.

"I thought it was a subtle but distinct transformation," he says. "It's not a matter of wiping years off your face. But stress and exhaustion do dissipate. It's kind of like Photoshopping your face." 

Vika Goodale, owner of Yorkville's Vikaspa, says there are days now when she sees more men than women.

"Men absolutely love facials and pedicures," she says. "When you have younger and younger and smarter guys coming in looking for your job, grooming is a big way of keeping up."

Plastic surgery, a more dramatic aesthetic approach that our fathers and grandfathers would have eschewed with a dismissive wave of the hand, is also on the rise among contemporary men.

"It's a cultural change," says Dr. Nicholas Nikolov, a Beverly Hills plastic surgeon who has recorded a 30 per cent increase in male clients over the past three years.

"The perception is that people who are energetic and capable look youthful. Patients want to look younger so that the outside matches their enthusiasm and vigour inside."

From the Toronto Star - Healthzone.ca, October 7, 2009 - Written by Robert Cribb

Stretch It Out - Fade Away Stubborn Stretch Marks With the Latest Treatment Options

You’ve had your first baby, and while you’ve managed to lose the baby weight, you haven’t been able to shake the telltale aftermath: stretch marks. You might think you’re destined to never wear a tummy-baring bikini again. Not true. While you may not be able to completely banish stretch marks, the latest treatment options—from lasers to creams, peels and microdermabrasion —can help fade them away.

Stretch marks are caused when the skin is pulled to the limit, whether due to pregnancy, weight gain or a rapid growth spurt. “The skin literally stretches too quickly and the tissue breaks down,” says Dr. Sachit Shah, a cosmetic physician with the BC Laser and Skin Clinic in Surrey, B.C. Some people are more prone to suffering from these skin mementoes than others. “Some women never get stretch marks, post-baby,” says Dr. Greg Pugen, medical director at the Bellair Laser Clinic in Toronto. “For others, it’s related to heredity.”

Stretch marks most commonly surface as red, purple or silvery-white scars, and each kind is treated differently. Red marks, the sign of early-stage scarring, are usually treated with a vascular laser that removes the redness, says Shah. This form of treatment requires three to four sessions, at a cost of $200 to $400 each. Shah says pigmented scars are easier to treat, and “the sooner you get to them, the quicker they heal.”

Silver scars, which are late-stage stretch marks, are more stubborn. They require several treatments with a fractionated resurfacing laser known as the Fraxel. The Fraxel hits the damaged tissue in a grid-like pattern, causing little injuries in the skin that encourage healing. Expect to pay $1,200 to $1,500 per treatment, and for best results, you’ll need four to six sessions. Shah says you can expect 60 to 70 percent improvement in the appearance of abnormal texture. Post-treatment, some swelling and redness is normal, but there is no downtime. Shah cautions against any sun exposure during treatment, as tanned skin treated with a laser may become permanently discoloured or heal unevenly. As well, people with naturally darker skin may need to use a skin-bleaching cream containing ingredients such as hydroquinone before treatment in order to prevent permanent darkening of the skin.

If you’re looking for something a little less costly, treatments such as microdermabrasion and chemical peels can offer a short-term fix. “If you have [an important event, such as a] reunion coming up and you want your stretch marks to look better, these treatments can temporarily plump up the skin,” says Dr. Lisa Kellett, a dermatologist at DLK on Avenue in Toronto. And what about all those creams on the market? “No stretch-mark cream gets rid of stretch marks,” says Kellett. “But they might temporarily reduce their appearance.” A prescription-strength vitamin-A cream, however, may help improve scarring. “It’s the only thing that’s been shown to actually cause collagen regeneration in the skin,” she says. But the jury’s out on whether it’s safe to use during pregnancy. Err on the side of caution and check with your doctor.

Most importantly, when it comes to treating stretch marks, it’s best to have realistic expectations. “It’s not like a tattoo; we can’t guarantee it’s going to be gone,” says Kellett. “It’s a matter of saying: ‘I’m always going have it, how can we make it look better?’”

From Elevate Magazine, November/December 2009 - Written by Kristen Vinakmens

New Psoriasis Treatment - Health Specialist Laura DiBattista talks to the first person in the world to receive the treatment.

Dr. Lisa Kellett appeared on CityNews and discussed a new treatment for Psoriasis. To view the segment please click here or click on the image below.