Healthy Skin Expert Dermatology Advice

Understanding Water - WATER PLAYS A CRUCIAL ROLE in good skin care.

We asked our resident dermatologist Dr. Lisa Kellett to explain how water works within the skin.

Cosmetics: To start, what role does the water play in the skin health? What functions does it perform?
Dr. Kellett: Water is a vital to our physiological functions including those of the skin.

Cosmetics: At what levels of the skin is water’s role most crucial?
Dr. Kellett: Water is crucial for all skin levels.

Cosmetics: Many people confuse the level of oil on the skin with the amount of water in the skin. Can you explain both for us?
Dr. Kellett: Sebaceous (oil gland) function acts to coat the skin to prevent the skin from drying out. It is unrelated to the amount of water on the skin.

Cosmetics: What role does a good moisturizer perform?
Dr. Kellett: A good moisturizer will prevent transepidermal water loss in the sin. Moisturizers have evolved to be less mineral oil-based so that acne breakouts are less frequent.

Cosmetics: What is the latest scientific research you’ve seen regarding skin hydration?
Dr. Kellett: The most interesting studies we’re seeing now is looking at how to repair damaged skin cells and how to reduce the amount of moisture lost through the skin.

Cosmetics: Why is it that drinking lots of water doesn’t necessarily boost moisture levels in the skin?
Dr. Kellett: There is no scientific evidence-based medicine that supports the notion that intravascular (blood) volume boots moisture levels in the skin. Drinking enough water is good for overall health as is proper diet and exercise.

Cosmetics: Is dry skin more susceptible to sun damager?
Dr. Kellett: Yes, dry skin can lose some of the intrinsic barrier function that normal skin possesses and therefore be more susceptible to sun damage. That’s true.

Cosmetics: Should the skin always be damp when applying a moisturizer?
Dr. Kellett: Yes, absorption of topical agents is increased if the skin is wet.

Cosmetics: What is the most important point readers should know about the skin’s relationship to water?
Dr. Kellett: That water intake and skin dryness can be unrelated and that you can get a sun burn in a swimming pool. Believe it or not, many people think that as long as you are under water you can't burn.

From Cosmetics Magazine - November/December 2009

Ask a Dermatologist - Decoding Wrinkles

Tackling wrinkles is a priority for many Canadian consumers. Our resident dermatologist, Dr. Lisa Kellett offers a crash course in understanding wrinkles

Cosmetics: To start, what are embryonic wrinkles and how do they form?
Dr. Lisa Kellett: Fetal wrinkles commonly known as embryonic wrinkles occur during development in the uterus. They are seen in areas of natural folds such as the neck and palms.

Cosmetics: What are permanent wrinkles and when do they usually form on the face?
Dr. Lisa Kellett: Permanent wrinkles can be fetal or they can occur as a result of skin laxity (eg. Nasolabial folds) or frequent movement (crow’s feet). They are usually seen more often in patients over the age of 30 and become more pronounced with age.

Cosmetics: What are reversible wrinkles?
Dr. Lisa Kellett: They are expressive wrinkles that can be treated with Botox to cause a decrease in expressive muscle movement resulting in softening of wrinkles.

Cosmetics: We know that Retinol is a great anti-aging ingredient. But can you tell us about the variations on the molecule?
Dr. Lisa Kellett: There are many forms of Vitamin A including tretinoin, isotretinion, and Retinol. Retinol is better tolerated as it is not as irritating as its cousins above.

Cosmetics: We’ve all heard about wrinkles that occur from repeated muscle contradictions like laugh lines. Can these be prevented?
Dr. Lisa Kellett: These are called expressive wrinkles and occur at sites of repeated muscle contraction. Good examples of are the lines between the eyes, forehead, and crow’s feet. If you want to treat them, the best method is Botox cosmetic which softens the muscles of facial expression.

Cosmetics: What effect do UV rays have on wrinkles?
Dr. Lisa Kellett: Most of skin aging (including wrinkles) found in humans is a result of sun exposure rather than intrinsic factors.

Cosmetics: What effect does smoking have on wrinkles?
Dr. Lisa Kellett: Smoking has a number of detrimental effects on the skin including skin aging. It definitely contributes to wrinkle formation.

Cosmetics: Does a mild exfoliant help with reducing the look of fine lines?
Dr. Lisa Kellett: Exfoliation will remove some layers of the stratum corneum (the upper level of the skin) and might temporarily improve the appearance of the top of the skin.

Cosmetics: What is the best way to treat wrinkles without visiting a dermatologist?
Dr. Lisa Kellett: The most important treatment is prevention…with an SPF Sunscreen of 30 or higher as well as using a hat and avoiding the sun. The second step is using a product with 1% Retinol or higher.

From Cosmetics Magazine - July/August 2009

Ask A Derm - Is mineral makeup good for my skin?

Question: Is mineral makeup good for my skin?

Answer: “There is no evidence to support the claim that mineral make up is any better for your skin or that it allows your skin to ‘breathe’ more than conventional makeup,” says Dr. Lisa Kellett of DLK on Avenue “The term ‘mineral makeup’ is not regulated, thus it’s a case of ‘Buyer beware.’ However, mineral products that contain titanium dioxide can double as an effective sunblock. Look for one that offers SPF 30.”

From ELLE Canada - May 2009

Beauty News - Fine Lines

Expert Dr. Lisa Kellett, dermatologist

Q: I’m noticing fine lines around my eyes. How can I prevent them from getting worse?

A: “When you’re outside, always wear a hat and sunglasses to prevent squinting,” says Dr. Lisa Kellett of DLK on Avenue (www.dlkonavenue.com). “Wear a face cream that has an SPF of 30 or higher all year long, and use an eye cream that contains either vitamin A or C- both are antioxidants that fight sun damage.

Professionally, Botox injections can be used to relax the muscles that lead to crow’s feet.; results last about four months.

For longer-lasting results, a derm can perform Thermage, a procedure that uses radio frequency to tighten the collagen around the eyes, or use an erbium laser to gently burn off the lined skin and firm the eye area.”

From Elle Canada, October, 2007

Beauty News: Enlarged Pores - From Elle Canada

Expert Dr. Lisa Kellett, Dermatologist at DLK on Avenue, Toronto
 
Q: HOW CAN I GET RID OF ENLARGED PORES?

A: “You can’t get rid of enlarged pores, but you can make them appear smaller,” says Dr. Lisa Kellett of DLK on Avenue (www.dlkonavenue.com). “Pores are hair follicles into which oil glands empty. These areas become dilated because of excess oil and lack of collagen surrounding the pores. Using products with vitamin A – which promotes collagen regeneration – will support the pore walls, keeping them tight and small. Salicylic acid will also remove pore-clogging bacteria. A dermatologist can perform a diamond peel or treat the skin with lasers, using heat to regenerate collagen.”

From Elle Canada, September, 2006

Elle Body Special: Hot Legs

Expert Dr. Lisa Kellett, dermatologist                        

What's new? "UltraShape is the only treatment that liquefies fat per­manently," says Kellett. (Fat is broken down the same way that focal ultra­sound blasts kidney stones.).

Who's it for? People who are fit and healthy but who have stubborn areas of fat. For best results Cut carbs and fat for about a week before and after. Eat high-protein foods and lots of vegetables and fruit, and drink eight glasses of water a day.

Downtime: None

Duration and cost: Derma­tologists recommend three one-hour sessions over a period of a month, for a total of $3,000.

Other op­tions: Thermage uses radio frequen­cies to boost collagen production and appears to tighten the skin. Spas offer the Accent and Vela Smooth cellulite treatments, which tempor­arily smooth the skin. Accent uses unipolar and bipolar radio frequen­cies, while Vela Smooth uses bipolar radio frequencies, infrared light and a vacuum action.

Topical options: Caffeine-infused creams, gels and patches cause blood vessels to di­late. This results in swelling, which temporarily improves the look of the dreaded "orange peel" skin.

You're so vein

What's new? Sclerotherapy and EndoVenous Laser Treatment (EVLT).

Who are they for? Anyone with visible superficial or deep veins. These treatments are not for people with leaky valves (valve insufficien­cy) or for pregnant women .

How do they work? With sclerotherapy, a medicine is injected into small varicose veins, capillaries and spi­der veins, causing them to swell and then close down. EVLT is used on larger varicose veins.

• For best results don't tan before or after either treatment. When a laser is used on tanned skin, some of the light is deflected from the blood vessel and absorbed by the melanin in the skin. A tan also makes the skin more prone to pigment changes and burns from the laser.

• Downtime from none to bruising for up to a week

• Duration and cost on average, sclerotherapy costs $200 for a 10-minute session. EVLT is slightly more costly, aver­aging around $300 for a 20-minute session. (It depends on the number of veins treated.).

Topical options:

• Support hose can help prevent vis­ible leg veins.

• Tinted moisturizers and self-tanners diminish the look of spider veins.

From Elle Canada, July, 2007

Chicken Pox and Acne Scars

Expert Dr. Lisa Kellett, dermatologist

Q: How can I get rid of chicken pox or acne scars?

A: “Scars can be improved-by up to 95 percent-but not removed,” says dermatologist Dr. Lisa Kellett of DLK on Avenue (www.dlkonavenue.com). “Treatments remodel the collagen in the skin, making it smoother. For raised scars, ND-YAG lasers and steroid injections work best, whereas for depressed scars, Intense Pulsed Light (IPL) and Erbium lasers are ideal. Levulan, a new topical photosensitizer, makes any laser more effective. Prescription vitamin A cream also helps diminish scars. Over-the-counter scar treatments are available, but they are less effective and can take up to 12 weeks to show results. Lasers offer the quickest results.”

From Elle Canada, April  2006.

Beauty News - Sunburn Facts and Remedies

Q: I WAS AT THE BEACH ALL DAY. HOW DO I TREAT A SUNBURN?

A: “If you are sunburned, it means that you have had strong UV exposure,” says Dr. Lisa Kellett of DLK on Avenue (www.dlkonavenue.com). “This is dangerous because these rays are thought to affect DNA, which could result in skin cancer. The first thing to do is get out of the sun and apply a cold compress to the damaged areas to decrease redness and swelling. Taking an Aspirin or other anti-inflammatory may help, as long as the drug is not contraindicated with other medicines you are taking. To further decrease redness and swelling, a dermatologist can prescribe a strong topical steroid. If you have blisters, cover them with an antibiotic ointment.”

From Elle Canada, August 2006.

Beauty News: Self Tanner Secrets

Expert Dr. Lisa Kellett, dermatologist

Q: WHAT’S THE BEST WAY TO TONE DOWN SELF-TANNER STREAKS WITHOUT AGGRAVATING MY SENSITIVE SKIN?

A: “Take a bath, and use a body scrub to exfoliate the darkened skin cells,” says Dr. Lisa Kellett of DLK on Avenue (www.dlkonavenue.com). “A scrub with large particles is best, but if you have sensitive skin, use any exfoliant that doesn’t irritate you. After your bath, go for a moisturizer that contains alpha-hydroxy or beta-hydroxy acid to further slough the skin. Follow this routine twice a day for about two weeks. Professional crystal or diamond micro-dermabrasion treatments can also do the trick.”

From Elle Canada, June, 2007

Beauty News - Varicose Veins

Expert Dr. Lisa Kellett, dermatologist

Q: WHAT ARE VARICOSE VEINS, AND WHAT IS THE BEST WAY TO GET RID OF THEM?

A: “Varicose veins can be anything from very small and threadlike to bulging and blue,” says Dr. Lisa Kellett of DLK on Avenue (www.dlkonavenue.com). They are a result of genetics, giving birth, standing for long periods of time or trauma to the legs.  They occur when the valves in the veins fail, causing a backflow of blood.  To prevent them – or to stop them from worsening – wear compression stockings and do frequent calf raises, both of which put pressure on the legs and stop this backflow.  However, professional treatments work best.  Sclerotherapy uses injections of a vein-irritating substance to close off the veins, and lasers are being used to heat up blood vessels to seal them shut.

From Elle Canada, May, 2007

Q: WHAT ARE VARICOSE VEINS, AND WHAT IS THE BEST WAY TO GET RID OF THEM?

A: “Varicose veins can be anything from very small and threadlike to bulging and blue,” says Dr. Lisa Kellett of DLK on Avenue (www.dlkonavenue.com). They are a result of genetics, giving birth, standing for long periods of time or trauma to the legs.  They occur when the valves in the veins fail, causing a backflow of blood.  To prevent them – or to stop them from worsening – wear compression stockings and do frequent calf raises, both of which put pressure on the legs and stop this backflow.  However, professional treatments work best.  Sclerotherapy uses injections of a vein-irritating substance to close off the veins, and lasers are being used to heat up blood vessels to seal them shut.

From Elle Canada, May, 2007