When it comes to skin discolourations, we all know that prevention is the best medicine. You know the drill: Wear sunscreen, big hats, and seek shade whenever you can. And surprisingly, avoiding hot environments should also be part of the drill.
“Heat can often stimulate the pigment cells,” says our dermatologist Dr. Lisa Kellett. So those hot yoga classes may be doing more harm than good, at least for your speckled skin.
I learned this at my last consultation with Dr. Kellett about my own hyperpigmentation issues. During this conversation, we discussed the myriad of non life-threatening skin discolourations in-depth. Here’s The Skiny on what causes them and (what we all want to know) which clinical treatments are the gold standards.
Dr. Lisa Kellett: There are a number of “normal” discolourations and their causes and treatments vary. Some can’t be treated and will only, with any luck, fade in time.
• Melasma is also known as the mask of pregnancy and generally appears on the cheeks, forehead, nose and around the mouth, but it could turn up anywhere. The cause is a combination of hormones and the sun; no matter how much sun protection you use, you could still get it. The pigment cells are also heat sensitive, so if you go out in very warm weather, you’re at risk. It’s more common in pregnant women because they have high estrogen states, but it can happen to anyone. The treatment is a combination of light treatments and topical bleaching creams or agents, like azaleic acid, arbutin and hydroquinone. It’s often very difficult to remove. But it may fade in time.
Melasma
Check out the “Spotless” peel program at Dr. Kellett’s clinic, here. A pre-treatment at-home routine a month before with these lightening pads will improve results.
• Post-inflammatory hyper-pigmentation (PIH) is found in people who have darker skin types, after a burn, acne or any other trauma, even a scratch or irritation. The skin reacts by producing spots of dark pigment. In Caucasians, the skin can turn red. Treatment is usually bleaching creams and Lumenis Intense Pulsed Light treatments (light energy). Untreated, it can fade, but that might take months or years.
PIH
• Seborrheic keratoses are also known as liver or age spots and you see them on the back of your hands or your trunk. They start off as flat brown spots and become raised and quite warty. They can be burned off with electrodessication.
Seborrheic Keratoses
• Nevi (birth marks) are collections of mole cells, which develop in the fetal stage; it’s all pre-programmed. They’re usually flat, and they can be excised or lasered off.
Dysplastic Nevus
• Port wine stains are a collection of blood vessels. You might be born with it, or it might develop in infancy. These, too can be lasered off.
Port Wine Stain
• Lentigines or sunspots appear on the face, shoulders or back, hands and arms; anywhere exposed to sun. Simply put, it’s sun damage and, although they can removed or minimized significantly with lasers or light treatments, the best cure is prevention as they’re permanent.
Sunspots
Dr. Kellett is one of the few dermatologists in Toronto that has one of the most powerful photofacial (IPL) machines on the market today. This woman had just one session!
April 31, 2014. Two days after IPL treatment.
May 13, 2014.
Click here to find out more about this treatment for sunspots.
If you’ve been following my blog for a while, you’ll know that I’ve been struggling with hyperpigmentation since entering my thirties. My parents never put sunscreen on me as a kid, and though I was never a hardcore sunbather, admittedly, I spent several weeklong sun vacations slathered in Banana Boat tanning oil throughout my twenties.
In fact applying sunscreen every morning, rain or shine, and reapplying it throughout the day, has only recently become hardwired in my skincare routine.
That means that all of the current brown spots on my face (including this one I had on my lip that Dr. Kellett removed two and half months ago) are a result of three decades of cumulative UVA/UVB damage. Each time I show Dr. Kellett a new spot and lament “It came out of nowhere!” she reminds me that the damage I see today is from my past.
Yup my reckless past…
Regrets in this pic include eating chips for lunch, wearing no sunscreen and that bikini.
Getting lasers and Lumenis IPL treatments for the past year have certainly helped lighten the dark spots, however I’ve still got a splattering of light and dark brown spots, stubborn ones that no longer darken and then flake off like it should with IPL. The Ruby laser which I blogged about here, has helped shrink some but I need to wait another six to eight weeks for another session. Now that we’re heading into summer, which means more face-time outdoors with friends, I can’t afford too much downtime. Oh ya, and my wedding date is fast approaching: Aug 1! The medical aestheticians at my go-to skin clinic DLK on Avenue in Toronto have cautioned me about getting laser treatments so close to my date. You see, even with my not-so-new skin-savvy lifestyle (office job, commuter, religious sunscreen user, big hat wearer) I still need to be cautious because I have the skin type that is prone to hyperpigmentation from any kind of skin trauma – being from lasers, waxing, or even acne breakouts. This is due to a mix of factors, genetics and my previous exposure to the sun. (For skin nerds familiar with the Fitzpatrick scale, I am a IV.)
A safer treatment to try at this point in my pre-wedding program is a peel, particularly their Spotless Light Peel.
Why? According to Helen L., the ridiculously intelligent (and in-demand) senior medical aesthetician at DLK on Avenue, my pigmentation isn’t considered severe, though I think it is! Helen L. has been performing my laser treatments all year long so she knows my skin well.
The Spotless Brightening Peel treatment comes in two strengths: Regular ($1800), for severe cases such as melasma and Light or “Mini” ($1200), for mild pigmentation.
Other factors that made me a good candidate for the peel include:
I’m not on any medications.
I don’t have open lesions or cold sores.
I’m not pregnant or nursing. The peel has high levels of active ingredients that may make their way into the bloodstream.
I practice safe sun. I always have SPF 30 on, and I’m the square that drives with anti-sun gloves!
My skin has been adequately prepped for the peel because my home care products contain the key components that will improve the final results of the peel. My Kellett Polishing Gel cleanser contains a BHA, salicylic acid; my daytime antioxidant serum contains 20% vitamin C; my night time vitamin A serum contains 1% retinol;and I’ve been using a lightener in the form of the Kellett Luminate brightening pads for the past five months, which are soaked with salicylic acid and pigment inhibitors, arbutin and kojic acid. These products may have help lift the stubborn pigment cells, making it potentially easier for the peel to work. Pre-care is just as important as post-care with chemical peels!
So now that my skin is brighter overall compared to last year, it’s time to lighten the existing brown spots using with higher levels of these actives found in the clinical peels. I’m so ready! But before we start, let’s go over what a chemical peel is. As an aside, you might be amused to know that I’m currently taking a course at Canadian Beauty College on microdermabrasion and peels, just for fun. Some of the technical information below is plucked from my textbook, Peels and Chemical Exfoliation (Milady’s Aesthetician Series, 2nd edition) by Pamela Hill, R.N.
The Skiny on Chemical Peels
The intention of a chemical peel is to remove the outermost layers of the skin using chemical agents that cause controlled wounding with a predictable result. This wound healing process begins to regenerate necrosed epidermal tissues (dead skin cells that sit on the top layer of your skin and makes your complexion look dull) and promotes shedding of those glow-robbing necrotic cells. The predictable result is brighter more even-toned skin due to the sloughing off of damaged or dyschromatic (skin-speak for discoloured) skin.
Reddening is a normal response of the skin when an irritant is applied. That said, how red and for how long are associated with the specific peel solution applied, the time it is left in place, and the aftercare. The famous scene from SITC where Samantha looks like a burn victim after getting a peel on impulse is a gross exaggeration of what could happen when negligence on the part of a the technician and the client occur. Certain peels are not for everyone, and there needs to be full consultative process before any chemicals are put on your face. Health history, contraindications, your lifestyle — these are all important factors that need to be assessed thoroughly by the technician.
In terms of flaking, Kim, the medical aesthetician who did my peel on Thursday at DLK on Avenue, says that “the degree of flaking will depend on the skin; some people don’t even flake. Whether you flake or not, you will still benefit from the treatment internally.” For example, Kim says that just the penetration of the Spotless Light peel will reduce melanin in my skin.
Depending on their depth, peels have the ability to reduce damage caused by sunlight exposure, pigmentation irregularities, and fine lines. When the new skin replaces what has been removed, generally this will take about a week, the skin will be healthier and more youthful in appearance.
Peels are valuable for all skin types and have a long history of improving the quality of skin. Check it out:
The Egyptians were using lactic acid when they bathed in sour milk to smooth their skin.
Greeks used various facial peel combinations of sulfurs, mustards, and limestone.
It wasn’t until 1882 when German dermatologist Dr. Unna ushered in the modern era of chemical peeling with phenol, a corrosive acid made of carbolic acid, a derivative of coal tar; By the late 1900s phenol was used to treat acne scarring and later for gunshot wounds during War War I.
Today even with the advent of lasers, peels are still a valuable modality for skin rejuvenation because, they too, have evolved. In the treatment of hyperpigmentation, for example, not so long ago the controversial yet highly effective ingredient hydroquionone was the star player in many of the skin lightening peels in doctor’s offices. I learned that DLK on Avenue had long stopped using hydroquinone-based peels due to public health concerns.
Instead, their Spotless peels combine new-generation de-pigmenters such azelaic acid, arbutin (a hydroquinone derivative found in bearberries considered to be as effective as hydroquinone without side effects) and Kojic acid (derived from mushrooms) with proven exfoliating ingredients like salicylic acid and retinol, mixed into a stew of antioxidants and skin-soothing herb and fruit extracts like ginger and vitamin E.
Here is an actual DLK on Avenue patient who received the Spotless treatment.
My Experience
The actual procedure itself is super quick, less than 5 minutes. First, Kim removed my makeup with their most gentle enzyme-based cleanser, the Kellett Reflect Brightening Anti-Aging cleanser. She then prepared the pigment-busting potion, which is made up of: Ethoxydiglycol, 20.4% SD Alcohol 40-B, Water, Lactic acid, Azelaic acid, Benzyl alcohol, Phytic acid, Diisopropanolamine, Povidone and Laureth-4.
Kim then degreased my skin using a solution that had a bit of acetone, and then used a swab to spread the peel solution across my face. I didn’t feel any stinging. Kim watched my skin to see if I was getting red, I wasn’t. I was done. I was advised to wash my face at home in two hours using the Anti-Redness foaming cleanser in the all-important aftercare kit. The peel was clear so I was able to walk to my car and drive home without anyone knowing any better.
To make it easier to remember, Kim wrote down my get-thyself-to-a-sink time on my post-care card…
On the back of this card was a handy chart detailing exactly what to do today, tomorrow, and onwards. Since it’s a new skincare routine that I have to adapt to, I really appreciate this visual guide, so much so, that I taped it onto my bathroom mirror.
After schooling me on how to use the home care products properly, Kim sent me home with a tube of 5 products. Apparently post-care is where the melanin-busting magic happens, but I have to follow the instructions to a tee. I was kindly reminded that any side-step such as slacking on sunscreen use or using other products that are not included in the tube, can compromise my results or, in the worse case scenario, darken existing pigment and encourage more spots to come to surface. So let me show you what exactly is in the crucial post-care tube…
Ingredients: Water, Isopropyl palmitate, Cetearyl alcohol, Tetrahexyldecyl ascorbate, PPG-15 Stearyl esther, Ceteareth-20, Kojic dipalmitate, Penthlene glycol, Butylene glycol, Hydrogenated lecithin, Tocopherol, Sodium oleate, Oligopeptide-68, Glycerin, Rumex occidentalis extract, Evodia rutaecarpa fruit extract, L-Ergothioneine, Dimethicone, Magnesium Aluminum silicate, Steareth-2, Steareth-21, 1, 2, Hexanediol, Caprlyl gylcol, Allatoin, Potassium sorbate, Bisabolol, Zingiber officinale (ginger) root extract, Feruloyl soy glycerides, Hydroxypinacolone retinoate (Ginseng), Sodium metabilufite, Xanthan gum, Edetate disodium and BHT. Note: The medical aesthetician adds fresh retinol and arbutin into this cream at the time of your treatment to increase the lightening potential.
My Early Progress
It’s only been two days since my peel, so I don’t have a lot to report. Because this treatment is rather involved and requires strict adherence to a new home care regime (for at at least one month), I will be breaking up this post into parts. This first part was meant to review with you my hyper pigmentation history, give an overview of peels, and introduce you to the Spotless Light peel at DLK on Avenue.
So far, my face is doing well. One day after the peel, I had no redness nor flaking. I looked normal for much of the day and was able to wear light foundation…
Day 1
By the late evening though, I started to flake lightly underneath my nose and upper lip. Which is where I have a few unsightly dark spots and a general overall darkness that I blame on years of waxing. Remember, any kind of trauma, especially repeated heated trauma can stimulate pigment cells. By day 2, flaking is prominent around my mouth and nose.
I’m advised to stay out of direct sunlight for at least a week, which is doable since I’ve been feeling under the weather lately, fighting a cold for the past few days. Luckily the beau is away this long weekend, leaving me at home to tough it out by drinking lots of liquid, applying moisturizer to my face, and blowing my nose every hour. Yeah, I’m glad that he isn’t seeing me in this state of snot and slough! Here’s hoping by the time he gets home, this worse of this cold and flaking will be over. Stay tuned for my next pigment progress post!
Sunscreen. Vitamin C. Retinol. Treatments. What a difference one year of following Dr. Kellett’s skin gospel can make.
Just look at my before photo above taken last May. See all of those sunspot scattered across the bridge of my nose and my upper cheeks? Head north and you’ll also notice two large dark spots on my forehead. Even more frustrating is the fact that I was wearing thick foundation and concealer that day, and the spots still showed through.
To skin care experts, those marks on my forehead are “PIH” – skin-speak for Post Inflammatory Hyperpigmentation: pigment that occurs in response to skin injury. The trauma that caused the dark divot on the right side is the result of childhood chicken pox and the other divot is from a face-plant on the floor sometime during my preschool years. So I had these all of my life, and have become accustomed to covering them up with makeup in the morning. As for the dark band of sunspots across my nose and cheeks, well, those are just a result of aging, asian genes (we get brown spots faster and sooner than any other ethnicities) and plain old neglect (I never wore sunscreen growing up at all).
The after photo was taken yesterday, exactly two weeks after getting a specialty peel at Dr. Kellett’s clinic. Called the Depigmentation Peel at DLK on Avenue in Toronto this is by far the most effective and expensive peel I have ever done. At $1100, this melanin-busting treatment isn’t like those $150 lunchtime peels you can get at run-of-the-mill med-spas. The DLK pigment-busting peel is a customized formula of high levels of proven chemical agents combined with new-generation depigmentation ingredients (no hydroquinone). Note: They have many types of peels, and this is just one on the higher price point.
The peel that I had done contained lactic acid, an alpha hydroxy acid (AHA) derived from sour milk known for it’s smoothing and hydrating properties. AHAs work by melting epidermal cells, causing these dead skin cells to shed, providing the skin with a healthier texture. Also in the peel are azelaic and kojic acid, lightening agents derived from plants which target the pigment cells (melanocytes) that are located deep in the epidermis.
Very importantly, the peel I had done was administered under the care of Dr. Kellett, who is one of the most reputable derms in Toronto. Before even booking the appointment for the peel, Dr. Kellett screened me with questions about my health history, sun habits, and skincare regime, as if I were applying for a sure-shot at getting my dream skin.
Pre-Peel Care
After telling Dr. Kellett that I’ve been using her trifecta of anti-aging products at home (SPF 30, Vitamin C, and Retinol), and about my stagnancy with IPL, she suggested that I would be a good candidate for her depigmentation peel, which involved a few weeks of preconditioning my skin with a brightening product, these Luminate Pads.
$250 per container
Soaked with pigment inhibiting ingredients, arbutin and kojic acid plus salicylic acid, these pads have done wonders for my complexion in terms of texture, luminosity, and reduction in breakouts. I’ve been using them since December, and I’m currently on my third container and consider these an essential product in my skincare regime now. Note: Because these pads are hydroquinone-free, you can use them longterm.
The only bummer about these pads is that you can’t buy them online, as they must be freshly mixed at the clinic by a medical aesethetician to ensure potency of the active ingredients and that you are using them correctly. Trust me, you will be tempted to overuse them! After just one week of using the pads every other night, my skin looked so smooth that I wanted to use them every day, twice a day! But I had up build my skin’s tolerance to them slowly. When I returned to the clinic after two and half months to get another container of them, their senior aesthetician Helen L. suggested that I could amp up my usage to every night in order to really prepare my skin for the peel, as it could help lift the melanocytes closer to the skin’s surface making it potentially easier for the peel to whisk them off. Ok so fast-forward to the actual treatment.
The Peel
The procedure was super quick. The medical aesthetician, Kim, cleansed my face and then applied the clear solution using a large cotton swab. I was sent home with the peel still on, and was instructed to wash it off two hours later with the anti-redness foaming cleanser included in my post-care kit. My kit contained 5 products: the cleanser, a sunscreen, two soothing emollient creams to help my soon-to-be flaking face look normal, and a night cream enriched with depigmentation actives. Apparently, most of the melanin-busting magic happens with home care, so Kim spent a great chunk of time instructing me on how to use each product correctly. It’s not that different from any other skincare regime (cleanse, moisturize and protect), only with different products. If you’re forgetful, the kit comes with a handy reminder card with all the steps laid out, which you can tape on your bathroom mirror like I did.
The Peeling
As with most chemical peels, you can expect some redness and/or facial dandruff in the first week. I was warned that the sloughing would last 7-10 days, but for me the flaking didn’t subside until day 14, with major snake skin happening on day 5 and onwards…
No matter how much of the emollient cream I slapped on, the flaking around my mouth was visible, at least to me. Nobody really said anything unless I pointed it out, but then again, people are polite. I had to keep reminding myself that with clinical treatments, it always looks bad before it looks good.
My Results
I cannot believe how effective this peel has been for me. Not only is my skin softer and smoother (most likely due to the lactic acid and the fact that peels in general increase the moisture-binding qualities in the dermis), but most impressively, some of spots on the bridge of my nose have completely vanquished and some of the most stubborn spots on my cheeks are significantly lighter. Another noticeably lighter area is my upper lip, an area that has been getting progressively darker due to years of waxing my upper lip. Waxers, take note: Heat and trauma can excite melanin-making cells so ease off the waxing if you’re prone to hyperpigmentation. Here’s a pic of the area at it’s peak of dyschromia (skin-speak for discolouration)…
And now, look at how lighter and cleaner the area looks after the peel…
If I had to use an analogy to describe how this peel works, think of those rectangular white latex erasers. You know, the ones you had to buy separately and probably used in your high school algebra class, when we actually used pencils. I’m not talking about those hard rubbers on the end of cheap wooden pencils that did more smudging than erasing…
…I mean these guys…
The Depigmentation Peel at DLK on Avenue works just like those reliable (slightly expensive) erasers, gently rubbing off life’s little blemishes from your face. Worth every penny because it works.
Like most women, I have an insecurity that I constantly obsess over despite my better judgment. Beauty might only be skin deep but my skin suffers from hyperpigmentation, more specifically melasma, and I HATE it. Melasma is a skin discolouration caused by the stimulation of melanocytes (melanin producing cells). It is typically seen in women as it is triggered by the production of estrogen and progesterone. Unbeknownst to me, my birth control was causing my skin to darken on my forehead and cheeks every time I went in the sun!
Treating my melasma has been a frustrating journey with countless dollars wasted in the pursuit of erasing those dark spots. I have tried natural remedies, drugstore varieties, and the more expensive options offered in cosmetic clinics. Melasma is very difficult to treat and every case is different, but I can say that most of the products that I have used have shown minimal results. Despite their best efforts, I have tried and failed with the following brands: Clinique, Eminence, Obaji, Cosmelan, Neostrata and so many more that I can’t even recall their names! My main concern with certain products was the use of hydroquinone. In recent years, it has been linked to cancer and even banned in Europe. Due to this scary development, I took a 180-degree turn in my skincare regime by trying natural products. Unfortunately, after a few burns from too much apple cider vinegar and disappointing results from the all-natural lines, I gave up completely until I moved to Toronto and met Dr. Lisa Kellett.
Despite the marks on my face, none of my former dermatologists had informed me that I suffered from melasma. It wasn’t until I walked Dr. Kellett’s office a few years ago that she diagnosed me within seconds. I have trusted her ever since because her advice and product line has only shown me fantastic results.
When Helen blogged about the new Luminate pads by Kellett Skincare, I was the first one in line to get them! The main ingredient featured is Arbutin, which acts as the lightening agent. It is also the naturally occurring derivative of hydroquinone so I feel safe knowing that my vanity isn’t affecting my health (bonus!).
The only downside is that they are prepared at the clinic by a trained specialist so you can’t order them online. However, this means that they are freshly compounded on the spot so it hasn’t been sitting on a shelf.
I sat down with Lindsay at DLK to learn how to add the pads to my daily routine. I use them every night before my retinol serum to maximize my results. My skin was pink and a bit sore for the first few days but now I can use them daily without any tenderness.
I have recently finished up my first batch of 60 treatment pads and desperately need to get back to DLK to buy more. I believe that I have stopped the melasma from darkening any further, and it has lightened up. However, I still see it when I look at myself in natural daylight so I need to be more aggressive. I have decided to sign up for one for one of their Depigmentation Peel programs over the Christmas holidays when I have time to peel, flake and look a bit silly in the comfort of my own home. Hopefully this treatment will remove my dark spots enough so I can stop putting a filter on my photos.
Medical Aesthetician Lindsay holds a DLK peel kit. (Hope in a tube!)
Yes it’s a thing (for better or worse) and it’s #trending on your Facebook and Instagram feed. Newly engaged women posting close-ups of their adorned left hand as a way to announce their engagement. But in the spirit of the inter web, some people – namely the rich – are taking it to the next level of one-upmanship.
Industry watchers are saying that this trend has caused a rise in demand for “the hand lift,” a 10-minute injectable procedure that instantly transforms old hands into younger ones.
Have we entered a new vortex of vanity?
Well, not for the well-heeled. At $1200 per treatment, it’s not for the budget-minded bride-to-be. In fact, “it’s not new” according to our go-to cosmetic nurse Diana Phillips who says that a non-surgical hand lift is one of the most popular treatments at DLK on Avenue, the dermatology clinic where Phillips works. The clinic, located in the swish Yorkville area of Toronto, is perhaps the only spot in the city where women don’t bat a Latisse-enhanced eyelash at the price of a Hermès scarf.
Phillips injects the hands with either Juvederm or Radiesse, two types of cosmetic fillers that provide an immediate plumping effect. Juvederm contains volume-restoring hyaluronic acid whereas Radiesse is a gel with calcium-based microspheres that acts like a scaffold under the skin, providing more structure. Both products stimulate collagen production – that skin-plumping process that woefully declines with age.
“I inject these products with micro cannula, a very fine threading technique of distributing the product in the hands. The result is a restoration of crepey or sagging skin and a reduction of visible veins that can last up to a year. It’s an excellent procedure for all skin types and really anyone who is noticing changes in the integrity of their hands…and of course, for those who have beautiful diamonds to show off.”
Personally, this liquid hand lift isn’t for me as I’ve always had little girl hands. Small and dainty. But lately I’ve been noticing some volume loss and more veins and sunspots than I had a few years ago (see pic below). When I showed Phillips my left hand and asked her if I’d be a good candidate for the treatment, she kindly said no and that I had “fine hands.” My bank account sighed a sense of relief. Though in retrospect, she was probably just being nice, and based her decision on my modest ring.
And hey, that’s okay with me. I’ll stick to hand cream and manicures…for now.
Q: The veins on the back of my legs seem to be getting worse with age. They look more pronounced and are bulging more than ever. Is there anything I can do to get rid of them or, at least, improve the look of them? I don’t want to give up wearing shorts and skirts this summer. – Patricia, Vancouver, BC.
A: Varicose veins can be anything from very small and threadlike to bulging and blue. 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 such as injectables and lasers 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.
Spider veins vs. Varicose veins
Spider veins are like varicose veins but are smaller and are closer to the surface of the skin than varicose veins. Often, they are red or blue.
Did you know? Women are almost twice as likely to get varicose veins as men.
The last month of wedding planning can surely take a toll on your skin. Oh the planning – the endless to-do lists, the appointments, and table seating changes – it’s no wonder people hire wedding planners! When I arrived at my final treatment at DLK two days before my big day, my complexion was looking a little sallow, possibly due to my poor sleeping patterns for the past week. That seating plan always seemed to need midnight revisions, arg. Though my skin was in the clear in the acne department (thanks to diligent use of this) and line-less (thanks to her), there were still a few blackheads on the tip of my nose and my skin was lacking in the glow department. Apparently Dr. Kellett had foreseen this six months ago, when she planned my bridal skin prep plan and prescribed the final treatment to be a SilkPeel Dermal Infusion ($250 at DLK on Avenue). I was stoked when I saw this on the plan because I love this treatment! The SilkPeel was actually the first treatment I ever got at DLK several years ago and I remembered being blown away by how soft and silky smooth my face felt for days afterwards.
A SilkPeel is basically a super medical facial: A 2-in-1 treatment that combines the exfoliating benefits of a diamond-tipped microdermbrasion with deep infusion of pharmaceutical-grade skin serums. So while all that grim and dead skin cells are being sucked away, high quality glow-boosting nutrients are being simultaneously pumped into your skin. The result? A face that is camera-ready and smooth as a newborn’s butt.
In this video below, I take you into my appointment with medical aesthetician Kim (you may remember her as MC DLK) as she explains how a SilkPeel works. Want The Skiny? Skip to 3:52 to hear the short rap version.
How’s your summer going? I hope you’re wearing lots of sunscreen and reapplying as needed (every 2-3 hours). And if you’re wearing a hat, make sure it’s not a wimpy baseball cap – get a wide brimmed hat that covers the back of your neck, shoulders, and chest. Those are the areas that age fastest and also where skin cancer often pops up.
These are the lessons that my derm, Dr. Lisa Kellett, has taught me through the years. If you’ve been reading my blog then you’ll know she’s the doc who cured my cystic acne with her lasers and Clear line; and the doc who skillfully removed a suspicious mole on my lip back in the winter. Oh and, most recently, who created a customized 6-month bridal timeline plan for my wedding that happened on August 1 (pics to come soon).
Now is your chance to meet Dr. Kellett and her team and experience, for yourself, the incredible skin-saving toys she has at her Yorkville clinic. On the evening of Wednesday August 20, DLK on Avenue will be holding a Patient Appreciation and Open House – and I’ll be there along with my dear friend, Allana Mirza (MakeupLady.ca) who will be doing complimentary eye makeup touch ups.
Learn about the latest clinically proven ways to look hotter with age (without surgery). Get The Skiny on Botox, lasers, skin tightening Thermage, lip fillers, and the new buzz-worthy treatment for eliminating dark under eye circles: Redensity 2! You’ll be hearing a lot more about this innovative Swiss-made injectable as we’re working on editing the video. In the meantime, check out the teaser shot…
Amazing, ya?
It will be a fun and informative night full of treats including contest draws, discounts on Kellett Skincare and yummy grub from Fit Organix. For a full list of the sweet deals you can expect, visit the clinic’s site here.
Above all, whether it’s pimples, wrinkles, sagging skin, or scars, I promise you that after this event you will gain a powerful ally to help you win your own dermal dramas.
When you’re older, light doesn’t bounce off the skin as well as when you’re young. Faking young luminous skin with makeup is easy. Just venture into any mass-market drugstore, Sephora, or department store makeup counter and you’ll see just how ubiquitous light-reflecting foundation formulas are.
But for the discerning mature woman who prefers her beauty, bare-faced, slightly more permanent, and high-end, there’s a filler on the market that’s winning praise from the medical aesthetics industry.
“Redensity has been recognized as the Best Skincare Injectable product in the UK,” says Gina Da Silva, a sales rep for Clarion Medical, the Canadian distributors of Teosyal Redensity [I] and Redensity [II] which are made by Geneva-based cosmeceuticals company, Teoxane. That’s no a small feat, says Da Silva, considering its competitors – France, Italy, Germany, Portugal, Spain, the Orient, Dubai, Russia – are continually on the cutting-edge of medical aesthetics.
For 20 minutes, I watched Diana Phillips, the cosmetic nurse at DLK on Avenue, intricately and methodically prick the face of a fifty-something year old woman with a tiny needle, injecting Redensity [I], a youth elixir formulated with purified anti-aging ingredients – 8 amino acids, 3 antioxidants, 2 minerals, and hyaluronic acid (known as a moisture magnet).
A syringe of Redensity [I] (starting at $600) works to instantly hydrate the skin, promoting luminosity and even out blotchy skin tone caused by photodamage. Wrinkling, roughness, altered texture, and mottled hyperpigmentation – all that jazz that shows up on your face, neck and hands as years go by – can be erased, for at least 10 months, says nurse Phillips.
The patient, a skincare aficionado who is no stranger to Botox, laser resurfacing, and Thermage skin tightening, complained of dullness in her skin tone and wanted to try something different from what she had been doing for several years for age maintenance. Philips recommended Redensity [1] based on raving reviews from her other patients with similar concerns who have had it done since bringing on the product in the Spring. “I’m very impressed with the results, very natural with a predictable outcome,” she tells me.
Phillips starts the procedure by going around the thin skin around the eyes, working her way down to the upper lips, jowls, and finishing on the neck area where the woman’s sun-worshipping past revealed itself.
Our skin remembers everything, damn it.
Watching Phillips work –gently threading the needle to mend damaged skin – was like witnessing artistic aesthetics at its best. What was missing in that room was some Pavarotti playing in the background to set the mood.
To give a sense of how Redensity [I] works to fix the surface of the skin and why it is a great treatment to do in conjunction with other deep-penetrating modalities such as lasers and fillers, Da Silva uses the analogy of drywall.
“The skin is very similar to drywall. When someone is doing construction on a wall, the background of the wall needs structural support and for that we can use methods such as lasers, which penetrate deep or fillers to lift. After fixing the underneath, it is time to refine the surface.”
Much like the surface of a drywall, the skin may have lines, discolouring and blemishes, which will improve by lasers, but another major source needed to refinish the surface is hydration.
“To get rid of lines on a wall, you spread putty on it and smooth it, then sand it to achieve a solid complexion…for the skin, it is quite similar.”
“We use the Redensity [I] for redensification the dermis,” says Phillips, who explains that it hydrates, plumps up line, uniting them. Then you don’t have the shadow due to the synergy of the hydration; it unifies the line. So light will bounce off the skin, resulting in a smooth glowy effect. That’s why we call it a ‘Light Filling’ treatment.”
Redensity [I] compliments the results of any treatment, whether it’s just a new skincare cream, a laser treatment or even a facelift. “It works on the surface of the skin to promote radiance,” says Phillips.
Two weeks later, the patient returns to the clinic to take her after pictures. The mild redness and swelling experienced a day after the procedure had long subsided. A side-by-side comparison of her photos reveals a subtle yet significant difference that makes everyone in the room beam with delight: Her skin is much more radiant.
Luminosity restored.
Stay tuned for our next treatment coverage on Redensity [II], a denser injectable gel for eliminating dark under eye circles.
With every passing birthday after age 29, the already delicate skin around our eyes loses its tone and thickness. “Dark circles usually become a problem around age 35,” confirms our derm, Dr. Lisa Kellett, founder at DLK on Avenue in Toronto. “Dark circles are usually attributable to a vascular (blood vessel) bed beneath the skin, which make the area appear darker.”
To add insult to injury, as we get older we also lose fat in the under-eye area, which makes dark circles look even more prominent, says Dr. Kellett. The fat pads underneath the eyes disperse, forming hollows that houses shadows, accentuating the darkness and making us look perpetually pooped.
Other factors that can cause under eye flaws such as dark circles and puffiness include allergies, food sensitivities, lack of sleep, a poor diet and genetics. For instance, if you’re darker than Julianne Moore, you’re even more prone: “Certain ethnicities have an olive-based skin tone, which imparts a yellowish or brownish hue to the area and can get worse with sun exposure,” says Dr. Kellett.
In rare cases, dark and swollen under eyes accompanied by weight gain and excessive sweating can indicate an underlying health condition such as a thyroid or adrenal disorder, adds Dr. Kellett who sees every patient before having any cosmetic procedure at her clinic to ensure that they are fully informed.
I got a chance to watch someone get treated with Redensity [II], the latest filler for under eye circles at Dr. Kellett’s clinic when I brought in Bina, a reader who wrote in seeking help for her sunken-in circles. Video below.
What it is
From Swiss-based Teoxane Labratories, Teosyal PureSsense Redensity [II] is an injectable gel made up of hyaluronic acid, which replaces lost volume and retains skin hydration, mixed with reparative ingredients (amino acids, antioxidants, vitamin B6, and the minerals zinc and copper) to redensify eye circles, hallow tear troughs, and the horizontal groove under the eyes. Like other modern fillers, Redensity [II] has also contains Lidocaine (an anesthetic) in it to minimize patient discomfort. Bina was smiling throughout the procedure – hooray for Lidocaine!
Results
Phillips tells me that the cosmetic outcome of Redensity [II] is predictable and long lasting: “With any injectable we tell our patients that there is a risk of the product not settling well or that they may like more or perhaps less after they see the results. We always start with a less is more approach.” A clinical trial showed Redenisity [II] can last one year and 72% of this patient sample did not require touch ups after the initial injection – something that Bina can attest to. It’s been a month since the video was shot and she hasn’t felt the need to return to the clinic nor to smack on concealer on her under eyes. Here are Bina’s results taken one week after treatment. Not only are the dark circles significantly lighter, the hollowness is more elevated when touched.
Another rave review
After filming the treatment video, I sent out an Instagram about Redensity [II] and was pleasantly surprised to get a thumbs up emoji from a former colleague who I never suspected to be interested in this kind of stuff. So I prodded her via email for more details on her experience with it. She wrote back saying she tried Redenisity [II] last summer before her wedding to replace some lost volume due to weight loss. In her own words,
“What I loved about R is that I had dropped about five or ten pounds pre-wedding and some of the volume beneath my eyes had disappeared and I was touching bone (as gross as that sounds). Once it was injected beneath the eyes I had a renewed glow and subtle volume there that just made me look much more fresh and youthful. It was extremely subtle, no one would ever be able to put their finger on it, but I could see a noticeable difference, having examined my face in the mirror so intently as I lead up to the big day, HAHA!”
With two real testimonials and now having had witness the quick procedure myself (and not squirming too much from the sight of the cannula), I’m totally game for Redensity [II] when my own under eye circles grow big enough to have their own IG account.
Is your complexion looking listless? Click here to read about Redensity [I].
Toronto-based Dermatologist Dr. Lisa Kellett gives us The Skiny on skin tags.
What is a skin tag? Skin tags are an over growth of normal tissue. They tend to stick out above the surface of the skin. They are benign in nature; and can be permanent.
Where are skin tags commonly found on the body?
Anywhere that it is moist, covered, and folded. In other words, in areas on the body that are intertriginous, which means folded areas such as the neck, underneath the arm, breasts and groin.
Who gets skin tags?
Anyone of all ethnicities.
When is it common for people to get skin tags?
Generally they come with age and skin tags are very common after pregnancy.
How do you treat skin tags?
I do not recommend freezing them off as this can cause some blistering. I use electrodessication, which is the use of a tiny electric needle that heats it enough so that it falls off. Both the procedure and healing time is very quick. The patient leaves with a small bandaid on the spot and is told to apply Polysporin on the spot twice a day.
Dr. Lisa Kellett removing a skin tag from a woman’s underarm.
Skin tags do not cause pain but can get irritated when rubbed against clothing.
It’s Fall! Time to erase the signs of summer from our faces. Autumn is prime time for refreshing your complexion by removing age spots because sunlight hours are shorter, so there is less risk of compromising your clinical results with post inflammatory hyper pigmentation. However the autumn months are often the busiest for most people. How can you optimize your results in less time?
For me, a simple microdermabrasion won’t cut it. It’s too gentle. On the opposite end, photo rejuvenation, a.k.a. Intense Pulse Light (IPL) therapy which is the most popular clinical treatments for age spots is not gentle enough! I can’t handle the zap of IPL going over sensitive areas such as the upper lip, underneath the eyes, and around the temples. I always feel like jumping off the bed when the technician says okay tuck in your lips, I’m going to go over area now. Ahhh!
I love laser resurfacing (with numbing cream!), but my social calendar from now until Christmas doesn’t allow for much downtime (mild pinpoint bleeding and flaking is the norm).
So what’s a skin conscious though fragile, time-pressed gal to do? On Monday, I found out when I went in for my Fall appointment at DLK on Avenue. On the cosmetic menu for me was a 3-in-1 ResurFX Laser treatment. Under the supervision of our go-to dermatologist Dr. Lisa Kellett, her medical aestheticians created a customized program for me with the goal of improving on the results I have accumulated over the past six months – but in a much more time-efficient manner using DLK’s latest toy, the ResurFX M22 Laser. My triple treatment started off with topical freezing followed by a microdermabrasion, then IPL, and finished off with non-ablative fractional resurfacing.
It was my first time getting a combination of skin lasers in one day. You would think that my appointment would arrest my whole day and relegate me on laser lockdown for the next week, but the whole treatment took an hour and a half (including 40 minutes of numbing and paper work) and here I am back at work two days later looking unsuspiciously glowier. (Yes, I’m making that a word.)
What is ResurFX?
Though technically not a true laser, as the M22 is a multi-application platform that uses light energy to provide medical-grade IPL and non-ablative fractional resurfacing to make wrinkles and acne scars less visible without the typical downtime associated with true lasers such as the CO2 or ProFractional laser.
Dr. Kellett explains, “The settings are modified [different from the more intense CO2 laser] so there’s more rapid healing, less downtime for patients, and less risk for infection.”
Even as a beauty journalist, it can be dizzying to keep up with the evolution of skin lasers. Here’s how I’ve come to understand it. The goal of laser resurfacing remains constant: Boost collagen production in the dermis (the deep layer of alive skin beneath the epidermis where precious collagen and elastin fibbers reside) without creating too much visible damage on the upper layer of the skin (the epidermis). And getting heat into the skin via lasers and light therapies is the best way to jumpstart collagen-building, as Dr. Kellett once explained to me “Emitting targeted heat is what lasers do. When you produce heat in the skin, it stimulates cells called fibroblasts which generate new collagen.” The result is thickening of the dermis which manifests as plumper, more resilient, younger-looking skin. IPL on the other hand primarily targets dychromias (colour abnormalities like brown and red spots). Thinning the epidermis with exfoliation removes dead skin cells, encourages faster cell turnover which slows down after age 30, and it allows topical products to absorb better. So to recap, to keep your skin looking its best, you want to do things that thicken the dermis, thin the epidermis, and correct colour.
The ResurFX triple treatment combines three proven modalities that do all these things. The bonus is, you don’t feel a thing during the treatment because you’re nicely numb the whole time (huzzah!). Keep in mind that this was customized to what my skin needed, my 9-5 lifestyle, budget, and skin goals. Not everyone will want or even need all three treatments. It’s important to consult with a derm before starting a skin program.
My session with medical aesthetician Kim Whiteford started out like this:
Me: “Will it help with these?” I pointed to a band of brown spots speckled across the bridge of my nose.
Kim: “The IPL will help to lift them to the surface…but how long have you’ve had them for and what are you using at home?”
Me: I rattled on about my obsessive nightly habit of swiping the Luminate pads across my face and neck. I’ve always had sunspots but lately the eight to twelve brown blobs on the top of my nose where my glasses sit have darken. Most likely exacerbated from my recent Caribbean honeymoon, Kim theorized. Ah, true. Moving on to my other skin woes…
Me: “My T-zone feels slicker and clogged.” I point to the blackheads on the tip of my nose.
Kim: ”The microdermabrasion will loosen them up and the heat from the lasers will regulate my overactive oil glands.”
Me: Pointing to my right cheek, “This tiny red dot here popped out of nowhere!”
Kim: The combination of heat from IPL and resurfacing can help reduce facial redness problems such as broken blood vessels like this. “It deflates the vessels and breaks up the coagulated blood in the area.”
Me: “And my acne scars?”
Kim: ”The fractional laser should help to soften them.”
Here’s a step-by-step rundown of my ResurFX treatment:
#1 Diamond-tipped microdermabrasion
Purpose: “Topical exfoliation to clear the pores of any debris,” says Kim.
How it felt: Gratifyingfeelingthe gunk being gently scratched and whisked away.
#2 Intense Pulse Light
Purpose: “Heats up the tissue and starts the rejuvenation process – formation of new collagen.”
How it felt: Snappy but not as bad as other IPLs I’ve tried before. There’s a reason for that, said Kim: “unlike most varieties of IPL machines you can see the pulse of light at each pass, which can startle some people and make the sensation of the pulse feel worse. The ResurFX light is fragmented so there is less of a big burst of light. And because you’re numbed from a topical freezing cream, you don’t feel much at all.”
#3 Fractional Non-ablative Skin Resurfacing
Purpose: “The light creates microscopic heated channels in the skin, which helps to break up scar tissue, pigmentation, and re-texturizes the skin. And the heat further helps with boosting collagen.”
How it felt: Little squirts of warmth ushering into my pores.
Right after the treatment, Kim gave me two ice packs to place on my cheeks and forehead to reduce redness and swelling. She put sunscreen on my face and I left the clinic wearing my sunhat and sunglasses to protect my newly sensitized face. My face felt super smooth and tight, and looked slightly red for a few hours – as if I had just finished a hard workout – but nobody, including my husband could tell that I did anything at all (never mind three treatments in one go)! By the time I went to bed, I had actually forgotten I did anything to my face at all. There was zero discomfort. I give it cake status on my personal pain scale…
My Results
I don’t usually post treatment reviews so soon after because I’ve learned that it takes time to reap the rewards of non-invasive procedures. Results are usually very subtle and not that dramatic in photos, because well that’s the point, you’re not supposed to look “done.” However I feel compelled to post this now because just after two days, I’ve noticed a difference that have historically taken a week or so for me to notice with other laser treatments.
One day after: I have no signs of post-treatment redness. The blackheads on the tip of my nose and most of the brown spots that accumulated over the summer were gone. Not just faded but completely gone. My acne scars looked slightly less depressed. My skin is overall smoother and even in tone, negating any need for makeup.
Two days after: Skin feels cleaner, pores look smaller, and overall my whole face is more luminous, almost glass-like (glowier!). Some of the scars actually feel softer to the touch, which makes me think that the heat broke up some of the scar tissue (tough collagen) and is in remodelling mode now.
I’m reminded by Kim, who called the next day to follow up, that the results are both immediate and progressive so over the next few days my skin will continue to get better. I may or may not experience light flaking in the next few days and I should expect to see the treatments full benefits one month after. By then my skin will be ready for the next shakedown. Based on my rapid results and comfort level with the ResurFX treatment, she recommended that I do two more spaced one month apart to really optimize my results. For people whose time is of the essence, I think the ResurFX laser treatment is a perfect program option. In response to Kim’s suggestion, I shouted “sign me up!” into my iPhone with an ear-to-ear smile, dreaming about having an even glowier complexion for the holidays (accept the word, folks). Glow on!
As a writer I tend to overuse parentheses. They allow me to convey side thoughts, sarcasm (since you can’t hear my tone), and (sometimes funny) inside thoughts.
Though when it comes to our faces, parentheses (also known as smile or laugh lines; in skin-speak they are called nasolabial folds) are no laughing matter. These are the lines running from the corner of your nose to the corner of your mouth the can become deep and very pronounced with age.
Why it happens:
Over time skin becomes thin and slackens as facial volume and skin elasticity – the ability for you skin to snap back when pinched – are gradually lost, resulting in deeply etched skin depressions and saggy skin around the lower face. Blame it on a combination of sun exposure, genetics, and lifestyle choices.
Most women over the age of 35 are not happy about nasolabial folds, per recent recent. A 2013 survey conducted by Leger Marketing was done on 867 Canadian women between the ages of 30 and 60. The researchers asked the women which features made them look older than they felt, and one in five women said they were bothered by their smile lines.
Treatment:
Dermatologists inject hyaluronic acid (HA) right into lines to plump them, restoring facial fullness immediately. HA is a naturally occurring sugar molecule in the body that decreases after the age of 30. It holds water in the skin. In fact, HA is the jelly that lubricates our eyes and joints and it can hold 1000 times its weight in water (that’s why we refer to HA as a moisture magnet).
You can always count on a slew of new HA-laced products hitting store shelves in the Fall and winter months, as people anticipate the arrival of dry skin. However, topical application of HA is controversial, as many experts believe that it is not capable of penetrating the skin. Injecting it into the skin is more effective, they say.
Dr. Vince Bertucci, dermatologist and President-Elect of the Canadian Dermatology Association, says, “While anti-aging skin care products can address some of the signs of aging, like skin texture changes and fine lines and wrinkles, when it comes to volume loss and sagging skin, facial fillers are a better choice.”
I recently met with Dr. Vince Bertucci to get The Skiny on Volift with Lidocaine, the latest HA injectable by Juvéderm, an industry leader in facial fillers in Canada according to Medicard Financial, a company devoted to financing cosmetic procedures.
Currently, the Juvéderm Vycross collection consists of three HA gel facial fillers: Voluma for the upper face, Volbella for the lips, and the new Volift for the mid-face around the cheeks and mouth. All Juvéderm fillers contain numbness-inducing Lidocaine to ensure patient comfort.
The first thing Dr. Bertucci told me was that most real women do not want to look a cast member of the Real Housewives. Instead, “Women seeking non-invasive procedures want a discreet look. They want to look like themselves only less tired, less haggard. One of the biggest trends today is full facial rejuvenation. From cheeks to smile lines to lips, women want an overall refreshed, natural look. And fillers such as those in the Juvéderm Vycross collection allow us to treat multiple areas of the face together, and not in isolation.”
Dr. Bertucci describes Vycross technology as using “more efficient cross linking of long and short-chained HA molecules” which delivers the plumping effect with minimal swelling for the patient, and longer lasting results than the typical 3-6 months longevity of older facial fillers on the market. All three of the new-generation Juvéderm Vycross fillers last up to 12 months. The effectiveness of Juvéderm Voluma was recently hailed by Allure Magazine as one of the top Beauty Breakthroughs for 2014.
In terms of how each filler differs from the other, Dr. Bertucci explained that each Juvéderm filler simply has varying concentrations of HA. “Volbella has the lowest concentration as it’s used for the lips, a thin area. This results in less swelling and bumps. Voluma has the highest concentration of HA and the new Volift is a middle concentration.”
I visited our consulting cosmetic nurse Diana Phillips for her take on Volift. Like Dr. Bertucci, she is a full facial rejuvenation cheerleader and is revered for her natural-looking outcomes. Phillips is less prescriptive about where to use Voluma and Volift, stating that she customizes each treatment depending on the patient’s needs. I watched Phillips do a liquid facelift on a 52-year-old woman (who could pass for a 45 year old, no problem) using Botox and all three Juvéderm fillers. Phillips used Volift not only around the mouth but also to lift the woman’s eyebrow.
Juvéderm has, once again, created a versatile filler that will keep women smiling (without the parentheses problem).
Cost: One syringe starts at $650.
Download the Juvéderm Visualizer 3D app to see what you could like if treated with fillers. Free on iTunes.
When done properly Laser Hair Removal is an amazing procedure for permanent hair removal (no more ingrowns, yeah!). However, when preformed by someone untrained or on the wrong setting the treatment can cause painful burns in sensitive areas. Laser hair removal is an immensely popular procedure. Nearly half a million treatments were preformed by dermatological surgeons in 2011, according to The American Society for Dermatological Surgery.
There are an unknown number of procedures preformed by untrained professionals with minimal training. Laws vary from state to state on who can legally preform laser treatments. Only 26 states require on-site medical supervision and 11 states do not have any laws regulating it. The danger of this treatments lies in the hands of the operator. The operator is the one who chooses the settings for the laser which varies patient to patient depending on skin coloring, hair thickness and area of the body being treated. If an untrained provider chooses a setting too high for a particular patient this can lead to painful, permanent scarring.
Here are factors for you to consider for those considering laser hair removal:
Is the facility owned by a medical doctor and are they on-site during the procedure? Physician Assistants are the ones who preform the Laser Hair Removal treatments in my office, however there is always a physician on site.
Interview the person who is doing the treatment. Ask how long they’ve been doing the procedure, how often they perform the procedure and if they have experience with treating your skin color and the desired area.
Have a test spot preformed with the laser. If a small patch is tested with the laser at least 24 hours prior to the treatment we can observe if the skin has any side effects such as burning or blistering prior to treating an entire area.
Stay out of the sun. Having the procedure preformed while the skin is tan increases chances for burning and blistering.
Stay away from bargain Laser Hair Removal. That $99 groupon seems pretty tempting, huh? Bargain laser hair removal is usually too good to be true. Most of these deals are at medspas where there can be a lack of physician supervision. Choosing a board-certified dermatologist office will ensure a greater level of training.
This shouldn’t scare you away from this great treatment, only empower you to make an educated decision on who you choose to preform your treatments.
About the Author Erin Jensen PA-C is a practicing Dermatology Physician Assistant based in Southern California. She has a passion for both medical and cosmetic Dermatology and is skilled in the use of Botox, fillers and laser treatments. Visit her blog The White Coat Treatment.
Tired of looking tired, Rebecca decides to get a liquid facelift, a non surgical procedure that uses a combination of muscle immobilizing injectables such as Botox and Dysport plus hyaluronic acid facial fillers to lift sagging skin, minimize wrinkles and fine lines. Allergan, the makers of Botox and Juvéderm, call this popular treatment the ”Soft Lift” as it’s meant to provide a very soft natural-looking result. Depending on the type of products used and lifestyle factors, a liquid facelift can last about a year, with touch ups required every 3-4 months for Botox/Dysport because that’s how long neuromodulators last in the face for.
Watch this video to witness Rebecca’s jaw-dropping transformation.
Just for fun, we caught Rebecca’s sister’s reaction on camera and turned it into a suspenseful trailer. A sister never lies!
As much as we love lasers, peels, and fillers, there may come a time when these clock-turning tools might not be enough. When is the right time to consider plastic surgery? Dr. Sean Rice, a renowned plastic, cosmetic and reconstructive surgeon offers his insight.
Non Invasive procedures have become very common in the last few years, particularly as technology has advanced.
It is not uncommon for both women and men to begin their journey into cosmetic surgery by using fillers. Fillers are used to restore volume particularly in the area of the cheeks or lips. These are simple procedures that can be performed in a short time period with minimal downtime.
As the years go by, the quality of our skin begins to show our age. Another common procedure that we perform is laser skin resurfacing. The role of the laser is to remove damaged skin and stimulate new collagen growth. This brings back a freshness to the skin and can help in removing fine wrinkles and skin blemishes.
There are a variety of external skin tightening procedures that are available; the most common ones use a radio frequency to cause the skin to tighten. These tend to work well on slightly loose skin but require a maintenance program.
There comes a point in time where these non-invasive procedures don’t work anymore and one must consider plastic surgery or “going under the knife”. That point comes at different times for each individual. However, it really comes down to laxity of the skin and its facial structures.
Let’s say your jowls begin to droop or your eyelids hang down and people start to comment that you look tired or angry all the time. This is probably the time to consider plastic surgery. When your appearance is altered by loose skin, fillers or external skin tightening machines probably won’t work anymore. There is no “golden time” to consider plastic surgery. I have performed face lifts on people in their 40’s all the way to 80’s, everyone is an individual.
It is not uncommon that a facelift is done in combination with laser skin resurfacing; as one will tighten the skin and the other bring back a nice glow.
When considering surgery make sure you get an opinion from a qualified surgeon and know what is involved for both the surgery and the recovery time.
About the Expert Sean Rice, B.A. (Hons), M.D., M.S.c., F.R.C.S.C. is the founder of Rice Cosmetic Surgery in Toronto. Dr. Rice specializes in a comprehensive array of plastic and cosmetic surgery procedures including breast augmentation, breast lift, tummy tuck, liposuction, endoscopic facelift, body contouring after weight loss, laser tattoo removal as well as non-surgical treatments. Follow him on Twitter @dr_seanrice
We asked top docs for what was hot in 2014 and what will be hot in 2015. Here’s The Skiny from Toronto-based plastic surgeon Dr. Cory Torgerson…
Q: What treatment or skincare product was a game-changer for you in 2014?
Dr. Cory Torgerson: When it comes to products, there were two that stood out.
#1 Alryia Intense Hydrating Serum is formulated with high performance hydrating complexes (Hydroviton Plus and PatcH2O) and antioxidants (Vitamin B5) this new serum provides the skin an instant boost of hydration, soothing and protection.
#2 Neotensil is a breakthough invisible shapewear film that reduces the appearance of eye wrinkles and under-eye bags!
In the world of clinical treatments, Teosyal Redensity I and II are innovative hyaluronic acid injectables paired with collagen boosting vitamins and minerals to redensify the skin. These won the best dermal filler two years in a row (2013, 2014) at the Anti-Aging Medicine European Congress.
Q: Are there any treatments or innovative techniques that you are most excited about in 2015?
Dr. Cory Torgerson: Neograft is a new stealth hair transplant technology that eliminates the scar.
The Teosyal RHA injectable filler line uses new injectable hyaluronic acid technology that has been designed to move naturally with your face, bending and conforming with facial expressions while maintaining the volume and lift.
Teosyal injectable pen is a revolutionary injectable pen that allows uniform and seamless flow of injectable filler, providing the injector with perfect control and the patient with virtually painless treatment.
About the Expert Cory Torgerson, MD, PhD, FRCSC is a facial cosmetic surgeon in Toronto. Dr. Torgerson is renowned for providing his patients with a completely fresh and artistic approach to plastic surgery. Follow him on Twitter @drtorgerson
We asked the country’s top docs for what was hot in 2014 and what will be hot in 2015. Here’s The Skiny from plastic surgeon Dr. Cory Goldberg…
Q: What treatment or skincare product was a game-changer for you in 2014?
Dr. Cory Goldberg: This year has seen the take-off of nutraceuticals, which are taken by mouth, all natural, prescription strength, and immensely powerful for treating skin conditions and improving skin health. The concept of treating the skin with an ingestible product is well established in Europe and South America, and is now gaining acceptance in North America.
GliSODin Skin Nutrients is a line of products that contains all natural ingredients derived from food sources that have been proven to reduce inflammation of the skin and treat disorders from rosacea to acne to melasma, and improve overall quality and appearance of the skin. This line of products is a must-have for all my patients, whether it is for treatment of pigment disorders, anti-aging benefits, weight loss, or recovery from surgery.
Q: Are there any treatments or innovative techniques that you are most excited about in 2015?
Dr. Cory Goldberg: In 2015 we will see the first human studies in North America of human stem cells. These cells have the ability to reduce inflammation and regenerate tissue. This has many medical treatment uses, as well as cosmetic. Stem cells will be injected for facial rejuvenation, hair restoration, to reduce scars, and to improve healing after surgery. They will also be used to enhance, restore or reconstruct breasts, in combination with fat grafts from other parts of the body.
Tissue Regeneration Therapeutics is a company that produces high quantities of these cells, which are taken, purified, and grown from umbilical cords that are normally thrown in the garbage after a baby is born. Their cells will be at the forefront of growth for cosmetic use as well as medical uses in inflammatory and auto-immune disorders.
About the Expert Cory Goldberg, MD, FRCSC, FACS is a Toronto-based board certified plastic surgeon and medical director for Sanctuary Day Spas. He was one of a select few Canadian plastic surgeons to have undergone a fellowship as a Craniofacial Surgeon involving extensive additional training in reconstructive and cosmetic facial surgery.
We asked the country’s top docs for what was hot in 2014 and what will be hot in 2015. Here’s The Skiny from plastic surgeon Dr. Julie Khanna…
Q: What treatment or skincare product was a game-changer for you in 2014?
Dr. Julie Khanna: Fat injection, we have always used it, but it is becoming more common, and we are expanding our indications for it. It is the ultimate ‘au natural’ result for breasts, buttocks and facial rejuvenation.
Q: Are there any treatments or innovative techniques that you are most excited about in 2015?
Dr. Julie Khanna: In 2015, we are going to see more and more combination therapies of non-surgical and surgical techniques. Our ultimate goal, is plastic surgery with no tell-tale signs, by combining non-invasive therapies with plastic surgery. We are entering a completely new era of tailored procedures.
Photo: Skin-brightening ‘Luminate’ pads $250 at DLK on Avenue.
By Louise Hidinger, PhD
Having Asian skin means being extremely prone to hyperpigmentation, and once a hyperpigmented patches shows up, it is near impossible to get rid of. When I heard about Kellett Skincare Luminate pads, I thought they were definitely worth trying out.
Hyperpigmentation of skin can occur as a result of hormonal fluctuations and as a post-inflammatory response to acne, sun exposure, and other inflammatory skin conditions. These hyperpigmented patches may be seen as freckles, scars, solar lentigines (sun spots) and age spots.
The gold standard for skin lightening agents remains hydroquinone, a chemical which is a powerful inhibitor of the production of melanin, the compound responsible for pigmenting skin. However, hydroquinone is controversial: long-term use of high concentrations of hydroquinone may cause permanent disfiguration of the skin, known as ochronosis, and there is suspicion that hydroquinone is a potential carcinogen. Hydroquinone is banned for use in cosmetics in Europe and Japan, and in the U.S., the FDA proposed a similar ban in 2006 (although it continues to be available over-the-counter at concentrations of up to 2%). As a result, the hunt has been on for alternatives to hydroquinone that have less potential for harmful side effects.
Of the known alternatives, arbutin is the most promising, as it is actually a form of hydroquinone with a sugar molecule attached to it. In order for arbutin to become active in inhibiting pigment formation, the sugar portion must first be cleaved off by enzymes within the body to expose the hydroquinone portion of the molecule. This activation step acts as a safety valve that controls the amount of active hydroquinone that is present at any given point in time. Arbutin is naturally occurring in a number of plants, including mulberry, bearberry and cranberry.
Besides arbutin, kojic acid is another popular alternative to hydroquinone. Kojic acid is a naturally occurring compound, produced by certain species of fungi, particularly Aspergillus oryzae. It is the by-product of the fermentation of rice by these fungi in the production of sake (Japanese rice wine).
Both arbutin and kojic acid are much weaker than hydroquinone in terms of, their ability to inhibit pigment production, so changes in skin tone are much more gradual. To increase the rate of skin lightening, these ingredients are usually combined with an exfoliating ingredient such as salicylic acid or fruit-derived alpha-hydroxy acids (e.g. glycolic acid). The idea is to slough away the outermost layers of the epidermis which are more pigmented, exposing the less pigmented, more even-toned skin beneath.
The Luminate pads contain a powerful combination of active ingredients which act together to help even skin tone and lighten hyperpigmented patches. Luminate pads contain both arbutin and kojic acid, both of which act to inhibit pigment formation. Salicylic acid, a beta hydroxy acid, exfoliates and helps to accelerate exfoliation of pigmented skin cells, revealing more even-toned skin below.
In addition, the Luminate pads contain the antioxidants L-ergothioneine and Camellia oleifera (green tea) extract, and Evodia rutaecarpa extract, a traditional Chinese medicinal herb that has an anti-inflammatory effect. These ingredients act together to help to inhibit oxidative stress and calm inflammation, thus helping to limit pigment production and scarring that may occur in response to injury, hormonal fluctuations or sun exposure.
The Luminate pads are compounded on site at Dr. Kellett’s clinic, just before being dispensed to the patient: the active ingredients are dissolved in a water and alcohol base, and a set of 60 disposable pads is soaked in the resultant mixture. I was told that the pads can be stored at room temperature and they will gradually turn brown with time, but the colour change does not significantly affect their efficacy. However, the pads do need to be used up within 60 days of compounding.
My Experience
When I first received the Luminate pads, I used them daily as recommended. Unfortunately, they proved to be a little too powerful for regular use: after about 5 days of daily use, I started to break out on my cheeks and around my mouth, areas of my face which are the most sensitive to drying out and showing irritation (I suspect the alcohol content was a bit too irritating for my skin type). I switched to using them as a spot treatment. When I use the pads that way, I notice they have a noticeable effect in reducing post-inflammatory hyper pigmentation, especially when compared to Kellett Skincare Clear pads (discussed HERE) and other anti-acne treatments. What’s more, I noticed that the Luminate pads had a similar “zit busting” effect as the Kellett Clear pads. When used regularly for 4-6 weeks, the pads are expected to provide a noticeable improvement in skin tone.
About the Author Louise Hidinger, Ph.D., is a cosmetic chemist and founder of the blog INGREDIENTS. She splits her time between Toronto and New York City.
