10 Things Your Dermatologist Says You Shouldn't Do

Here are 10 things I would never do as a dermatologist.

1. Go in a tanning bed… EVER. They are a type 1 carcinogen shown to significantly increase risk of deadly melanoma. And tanning of any kind is just a bad idea. And it should go without saying that any tanning is bad. Contrary to the notion of a “healthy tan” a tan is indicative of DNA damage within the skin.

2. Skip sunscreen - Of course this is on the list but unless you are completely avoiding the sun then sunscreen is essential to protect skin from harmful UV that can cause premature aging and skin cancer.

3. Get injectable treatments from a provider who isn’t a specialist. You run the risk of results you aren’t happy with as well as more serious complications. Unfortunately I’ve seen too many patients regret a decision to go to the lowest cost provider who doesn’t have the necessary expertise.

4. Remove a skin growth at home. This is a definite no. Aside from the potential of infection and scarring, there is risk of improperly removing (or partially removing) a dangerous skin cancer without having it properly diagnosed first

5. Pick, poke or pop (your skin). While it can be incredibly tempting, it’s best not to pop pimples and pick at your skin. This can increase inflammation, swelling and redness, but it also increases your risk of scarring.  In general it is best to keep your hands off your face.

6. Use Neosporin or Polysporin. Yes we all were told to use it growing up but the reality is that it can cause allergic reactions and you are better to just use Vaseline for general wound healing. If the skin is truly infected then a prescription antibiotic such as fucidin or bactroban could be considered

7. Sleep with makeup on. No matter how tired you are, it is best to clean your face of makeup, dirt and oil at night especially if you are acne prone.

8. Pull hair tightly, especially when wet. Regularly wearing a tightly pulled hairstyle can lead to hair breakage and loss. Over time it can lead to permanent hair follicle damage and a condition known as traction alopecia.

9. Give up on your skincare too quickly. We know that skincare and “active” ingredients take time to affect change, so don’t give up after a few days of use.  For most skincare you need at least a few weeks to start to see change and for more therapeutic ingredients like retinol it can take several weeks.  

10. Forget to do self skin checks. It is estimated that 1 in 5 people will develop skin cancer in their lifetime but when caught early, skin cancer is highly treatable. If you notice a spot that is different from others, or that changes, itches or bleeds you should have it examined.

Skincare Labelling: What You Should Know

Finding the right skincare products can be tough and labeling can sometimes make things more, not less, confusing. The FDA and Health Canada have some differences in how they regulate personal care products but overall similar approach and points here would apply in both . 

The first point of distinction is drugs vs cosmetics. Cosmetics are intended to clean or improve the appearance of the skin, whereas drugs are used to treat a medical condition. Generally drugs must be pre-cleared by regulators and have a defined use and benefits. Only drugs are permitted to make therapeutic claims but some cosmetic marketing toes (or crosses) this line. 

Cosmetics generally do not need approval prior to being sold to consumers and responsibility lies with the manufacturer for product safety and determining how products are marketed. However, there are laws and regulations in place to ensure products are safe for consumer use. But when it comes to marketing, many cosmetic labeling terms are not legally defined so they can essentially mean whatever a manufacturer decides. These terms include “clean”, “natural”, “hypoallergenic”, “for sensitive skin”, “dermatologist tested / recommended” and more. 

One study found that of 187 tested products that were marketed as “hypoallergenic”, “dermatologist recommended” or “fragrance free” 89% contained at least one common contact allergen.

The trend toward labeling products as “free of…” can also be a bit of a red herring as it draws attention away from everything that is contained in a product to highlight something that is not. And even “free of” claims that would seem to be straight forward may not be. For example, if a fragrance additive is used for another purpose (e.g. as a moisturizer or a preservative) then it may legally be included in a product labeled as “fragrance free.”

My take-aways when it comes to cosmetic skincare: take marketing labels with a grain of salt, use ingredient lists if you have a known allergy or sensitivity, find sources of information you trust for recommendations, and try things for yourself! 

Review of Facial Aging and Common Treatments

In this post I want to address a problem that we all must face (yes pun intended): Facial aging. Two of the primary culprits responsible for aging of the face are fat loss and bone loss, which start to become increasingly visible as early as your 30s! Over time, volume loss, sagging of the skin, and formation of deep lines and wrinkles begins to occur.  This is why early prevention is key.

The images below show how internal fat loss and gravitational changes present over time. You can see the fat and bone structure at age 35 vs 55.  

Fat pads are what give our face volume. With age these fat pads start to shrink in size and move down the face. The first signs of this tend to occur in the malar fat pad or cheek (pictured). This causes separation at the lid-cheek junction, which results in the appearance of a tear trough or under eye hollow. At the same time, bone resorption causes structural changes to our face. Loss of bony support, along with volume loss from fat pads can cause the skin to sag, as it has lost the underlying support structures. Skin elasticity also degrades as we age. Aging occurs in a downward and medial direction, which is why you can see heaviness in the nasolabial fold and jowls.

That may sound like a lot of bad news, so what can we do? … 

A comprehensive treatment plan (and the earlier the better) may be able to slow the sands of time using non-invasive treatments. Neuromodulator injections (e.g. Botox) can soften dynamic lines, fillers can replace lost volume and skin treatments such as Thermage and Ultherapy can help stimulate collagen synthesis and tighten the skin.

If you are interested in learning more about what treatments may be right for you please contact my office to book a consultation.

Skin Care at Every Age

Healthy skin habits start at a young age, as my son Jacob has shared in his videos. As every dermatologist will tell you, the most important thing for all ages is to protect your skin from sun damage! Beyond that there are obviously different concerns that tend to arise at different points in our life and while everyone’s skin is unique I wanted to share some general tips for skin health as you age.

For those of you in your 20s if you haven’t already established a skin care routine now is the time. Prevention is key at this age. A gentle cleanser, moisturizer and sunscreen are the key elements. You may also want to consider an exfoliating product to help turn over the skin cells. Many people in their 20s may still be dealing with acne as well so if you are having flare-ups and don’t have a treatment that works well for you, be sure to talk to a dermatologist. While most people at this age haven’t started to develop wrinkles, I do see some younger patients for “preventative botox” as there is evidence that use of neuromodulators can actually prevent the formation of wrinkles down the road.

In your 30s is when you will likely start to notice more changes to your skin. For the most part, the routine you established in your 20s is still relevant (especially the sunscreen part - seriously, wear it every day!) Loss of collagen is a big one and this is the perfect time to introduce retinoids to your skincare routine. Hyaluronic acid is another ingredient that I recommend to help hydrate the skin and soften the appearance of fine lines. In terms of in-office treatments, depending on the condition of your skin you may consider starting laser or light-based treatments to help even out the skin tone and stimulate collagen.

For most people the 40s is when you start to see more signs of aging. Women in this age group may experience the onset of peri-menopause and the increased hormonal activity can wreak havoc on your skin. Adult acne may even be a problem and I often encourage the use of a retinoid for both anti-aging and acne concerns.  It’s a great time to incorporate an antioxidant like topical vitamin C into your routine as well.  

50s and beyond - yes I know there are a lot of years beyond the 50’s and everyone’s skin is unique at every age but especially as we age our needs differ. Unfortunately I’m running out of space for this post, but in brief, with age the skin dries out so hydration and a good emollient is key. In addition to the above, incorporating a growth factor could also be considered!  At this age and beyond one of the biggest problems is volume loss. Hyaluronic acid based fillers like Juvederm or Restylane can be helpful to lift the tissue, soften the folds and minimize the appearance of the jowls and sagging skin.  

No matter your age it is important to develop a treatment plan that is right for you and work with a doctor who can help to evolve that plan as you age to keep you looking and feeling vibrant!