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Q. My mother had terrible trouble with leg veins and had them stripped and injected. I am only in my late 20s but already starting to see big veins popping out on my calves. Should I be starting treatment this young? C.R. A. One of the big misconceptions is that varicose veins are a condition of old age. Quite the opposite is true. There is an old saying that ‘varicose veins are caused by the improper choice of grandparent’. In other words, this is an inherited problem and will often present in very young life, even early teenage life. The most important thing, if you have a family history and are seeing big veins, is to have a proper evaluation of your veins which includes a physical examination and ultrasound examination, both of which I do in my offi ce. Then, if there are faulty veins, we can lay out a treatment program for you which may just be keeping a watch on the veins or may require treatment. Treatment for varicose veins has come a long way and is much more precise than it was 20+ years ago so you should not be fearful of checking your veins out. Just call for a vein consultation at my office to have this done.
Q. I am in my 50s and, like my Mother, I am starting to get a lot of loose skin under my chin and neck. This is driving me crazy as it makes me look so old. I keep wearing clothes with high necks or scarves to hide it. Is there anything that can be done for this? A. This, unfortunately is always a difficult area to treat as the skin on the neck is so thin that many of the tightening procedures that we use cannot be safely used on this skin for risk of injury. There are special Botox injections that we do that can improve the wrinkles. PRP (Platelet Rich Plasma) injections, which use your own blood products, can create slight improvement. One of the most exciting things, short of surgery, is NeckTite. This is a brand new technology which I have just obtained, which uses radiofrequency to tighten the skin. The results are quite dramatic and are much easier than surgery. The recovery time is minimal but can expect a little swelling or bruising for a few days.
Q. The pores on my face are huge, or at least I think so. Especially over my nose and cheeks. I am even getting some small white bumps forming on the pores. Can anything be done about this? C.S. A. Large pores are usually due to inherited skin type. We see this more in fair skin of Celtic or Northern European heritage. Although you can’t change your genes, we can improve the appearance of the pores. Intense Pulse Light (IPL) is a type of light wave energy that is particularly good for reducing redness and brown spots on the skin. At the same time, it will decrease pore size to some degree. A more aggressive way of managing this is fractional or full field resurfacing. This has a bit longer recovery time but can make a very significant difference to the quality and appearance of the skin and is particularly good at reducing pores. Ongoing skin maintenance at home, after the treatment, will consist of an exfoliating agent such as a glycolic acid cleanser or a retinoic acid cream in the Dermalogica or Skin Tx line available at The Canmore Medispa.
Q. You keep talking about the difference between sunscreens and sunblocks but I am not sure that I have really been able to understand the difference. I have always used a day cream with SPF 15 that I put on in the morning. Is this not good enough? A. At least you are doing something to protect your skin from early aging effects from the sun. Blocks and screens work differently. Sunscreens include chemicals that help the skin to absorb the damaging effects of the sun, particularly UVA. They should, however, be applied at least 30 minutes before sun exposure to work into your skin and need to be reapplied about every 2-3 hours to maintain their effect. Sunblocks contain
Q. I saw your answer last week about the sunblocks and sunscreens. Where do I get sunblocks as I don’t see them that often in stores besides the shelves full of sunscreens? A. Many years ago, sunblocks were quite popular because they looked like ‘war paint’. That was the white stuff that people would apply to their nose or other parts. Then they came out with wild fluorescent colours. Then, that died. This, though, was zinc oxide cream which worked well but nobody wanted to walk about with a solid white face. The mineral blocks then came out from some of the high end makeup companies. They used special techniques to disguise the whitening effect and are applied like a makeup to the face. The good ones require colour matching to your skin tone. But, even for men, when applied with a brush and sprayed, it is completely inconspicuous yet gives great protection. That is what I wear in Mexico or on the golf course. So, you will have to find them in a high end salon or medical spa.
Q. I am in my fifties and noticing a lot of brown marks on my face and many fine wrinkles on my cheeks and around my mouth. I don’t want to have surgery. Is there anything else that can help? J.S. A. Sometimes, if the damage is severe, surgery is the only option. However, we can improve the skin significantly with laser resurfacing. By breaking the laser beam up into smaller beams, resurfacing can give great results in the colour and texture of the skin with a much shorter downtime. This is called fractional resurfacing. But, because it only treats a ‘fraction’ of the skin, it may require more than one treatment. For more severe wrinkles, like those that we get around the mouth and eyes, we can still do full resurfacing which does give beautiful results but has more
Q. Now that I have been out in the sun a bit, I am noticing that I am getting more and more brown spots as the years go by. Do I have to live with these as they do make my skin look older than I feel? M.H. A. Summer is great. We all feel the benefit of the warm sun’s rays but, of course, there is the downside of sun damage causing skin aging that comes along with it. Those brown spots are a sign of sun damage and are usually not harmful but can be cosmetically unappealing. At the end of Summer, you want to think about treating your skin with IPL (Intense Pulse Light) as this is usually very effective at treating not only the brown
Q. I am in sales, so my hands are always on display. I am 48 and healthy, but my hands just look old. I have tried all sorts of creams but nothing seems to improve the wrinkly looking skin. What can I do? M.E. A. There’s a saying that, if you want to know a woman’s age, look at her hands. Often we neglect our hands as we are not seeing them in the mirror all the time but we can treat the hands the same way as we do the face. Discoloration is common on the hands due to sun exposure so, removing the uneven brown and red spots with IPL (intense pulsed light) can remove the sun damage. If the skin is still wrinkled and thin, then we can improve this with a resurfacing laser or with the injection of fillers which plump up the tissues a bit. We can use fillers like Juvederm or Selphyl, (the vampire lift product), both of which can give very nice results. Let me see your hands and I can advise you on the best approach.
Q. I have quite a lot of brown spots on my body but one of them seems to have grown bigger recently. Should I be concerned and what should I do? K.T. A. The quick answer is HAVE THEM CHECKED. The more moles or brown spots that you have obviously increases the likelihood of one of them changing into a form of cancer. Melanoma, the most frightening of the skin cancers, can be very sneaky in that it can occur in a pre-existing brown lesion or can start from fresh. Also, it need not be only in a sun exposed area so even places like the feet or the groins need to be watched. Any skin lesion that changes size, shape or colour should be considered suspicious and must be checked. This can be done by a Doctor with experience in examining these lesions and this is often improved by using special tools such as a Dermascope, that allow much more accurate assessment. If there is any doubt, a biopsy will be taken for pathological examination. So, again, HAVE THEM CHECKED!
Q. I hear a lot of talk about facial SKIN PEELS. Can you give me a bit more information on what they are? L.S. A. Neat question as I have just written an article on peels in my newsletter. Peels can be very mild with low concentration fruit acid peels such as glycolic acid (often called a ‘lunchtime peel’). With this, you don’t actually peel, rather exfoliate some of the surface dead cells so there is very little recovery. Slightly stronger peels are amazing for treatment pigmentation and acne and will cause some flaking and peeling and possibly slight swelling for about 48 hours.
Q. How can I improve the tone and quality of my skin? I use good products regularly, cleansers and moisturizers, but my skin still looks flat and dull. I am in my early 40s. A. As we get older, because of aging and sun damage, the dead cell layer thickness on our skin gets thicker. This has the effect of refracting the light when it hits our skin, instead of reflecting it as in young skin. You can improve this with the regular use of a glycolic or retinoic (vitamin A) cream but sometimes you have to be more aggressive. We can help with facial chemical peels or microdermabrasion. Intense Pulse Light (IPL) treatments have the added effect of repairing deep sun damage. Also, Micro Laser Peels (MLP) can significantly improve the quality of your skin. All these procedures can be explained to you in a (free) skin consultation in our office. Call for an appointment.
Q. I recently had an IPL (Intense Pulse Light) treatment and I am very pleased with the result. What is the best way for me to look after my skin so that I can make the most out of my investment? A. IPL can make your skin look and feel significantly younger. After, you want to protect your skin from the sun’s damage as much as possible – try a good quality mineral make-up such as Jane Iredale. Dermalogica (one of our line of skin care products) provides exfoliants and moisturizers that will also
Q. I’ve been hearing a lot about Fractional Lasers for treating acne scars and wrinkles. What’s it all about and are the treatments successful?
Q. I hear a lot of talk about facial SKIN PEELS. Can you give me a bit more information on what they are? L.S. A. Neat question as I have just written an article on peels in my newsletter. Peels can be very mild with low concentration fruit acid peels such as glycolic acid (often called a ‘lunchtime peel’). With this, you don’t actually peel, rather exfoliate some of the surface dead cells so there is very little recovery. Slightly stronger peels are amazing for treatment pigmentation and acne and will cause some flaking and peeling and possibly slight swelling for about 48 hours.
Q. I have quite bad arthritis in my left knee. I have had injections of Durolane which can help but I have been reading about PRP. I have heard that this is something that you do. Can you tell me about it? A. PRP is short for Platelet Rich Plasma. This treatment uses your own blood but separates the cells in the blood. We use the platelets as they encourage growth and healing. PRP has been used in surgery for about 20 years but recently has gained interest as a stand alone treatment for various injuries and also for treating arthritis. The platelet rich part of the blood is drawn off and this is what is injected into the area of concern, in your case the knee. Unfortunately, to date, there are no studies to assess the outcome so we can never guarantee the outcome. Many people have gained significant benefit from PRP injections. I do offer this treatment in the MediSpa, often using ultrasound to guide accurately in to certain joints like the shoulder for rotator cuff injuries. It is not for everyone but it is
Q. I injured my Achilles tendon 3 months ago and it is still giving me pain. A friend said to me that I should try PRP injections. What’s this all about? D.B. A. PRP is short for Platelet Rich Plasma. This is a process where we take some of your own blood and centrifuge it in a special gel that separates the blood cell layers. We then draw off the layer that contains the platelets, stem cells and other healing cells. This is then injected in to the site of injury. What this does is it stimulates a strong healing process at the site of injection. It can be used for many types of injuries such as knees, ankles, shoulders as well as possibly helping for arthritis. This is a relatively risk free procedure which received media coverage recently when used by Tiger Woods and a couple of the Pitssburgh Steelers players, Hines Ward and Troy Polamalu. It is certainly worth considering for slow healing injuries.
Q. I really look forward to Spring and Summer BUT I also hate it because of my underarm sweating! I have to be so careful what I wear as my clothes quickly get quite wet and will stain from my antiperspirants. I have heard that Botox can help this. Is that true? S.E. A. Absolutely true S.E. This is a problem that I see a lot of in my Office. Heavy sweating, also known as hyperhidrosis, is a surprisingly common problem but can be very embarrassing. Fortunately, a few simple tiny injections of Botox into the underarms can relieve this heavy sweating for often 9-12 months. This can literally change some people’s social lives. The other nice thing is, for most people with extended health benefits, the cost of the Botox can be covered! You can’t beat that. The treatment only takes a few minutes for months of dryness.
Q. I have an embarrassing problem of sweaty armpits and wet hands. What can you tell me about the Botox treatments for this? A. Botox is a wonderful treatment for excess sweating or hyperhidrosis. This condition can cause serious social and psychological problems.
Q. I really look forward to Spring and Summer BUT I also hate it because of my underarm sweating! I have to be so careful what I wear as my clothes quickly get quite wet and will stain from my antiperspirants. I have heard that Botox can help this. Is that true? S.E. A. Absolutely true S.E. This is a problem that I see a lot of in my Office. Heavy sweating, also known as hyperhidrosis, is a surprisingly common problem but can be very embarrassing. Fortunately, a few simple tiny injections of Botox into the underarms can relieve this heavy sweating for often 9-12 months. This can literally change some people’s social lives. The other nice thing is, for most people with extended health benefits, the cost of the Botox can be covered! You can’t beat that. The treatment only takes a few minutes for months of dryness.
Q. I am in my early thirties and noticing already that I am getting strong frown lines on my forehead. I would love to do Botox but I’m a bit nervous about starting so young and also about the side effects. D.V. A. Botox has been in the news a bit because of side effects. These side effects relate to large doses that are used for treating muscular conditions like cerebral palsy or back muscle spasm. Cosmetic doses are very small and very safe. Many people are now starting to use Botox earlier in life to prevent wrinkles forming. There are published studies of people who have used Botox over more than 13 years with absolutely no side effects and reducing the effects of aging (studies on twins). In short, Botox is a safe product that can give lovely cosmetic results short term and long term.
Q. I have an embarrassing problem of sweaty armpits and wet hands. What can you tell me about the Botox treatments for this? A. Botox is a wonderful treatment for excess sweating or hyperhidrosis. This condition can cause serious social and psychological problems.
Q. I’m in my twenties and have a bump on my nose that I do not like. I am a bit nervous about having surgery. Do you have any other suggestions? C.S. A. Surgery on the nose can be very successful but, you’re right, many people are reluctant to make that step. Fortunately, we can make some changes to the shape of the nose with fi llers. The newer fi llers such as Juvederm, can be used on the nose to make changes to the shape. Bumps or bends can effectively be reshaped to give the nose a more natural contour. This treatment is very quick to do, causes very little discomfort and has
Q. You recently did some fillers into my lips which now look really nice. BUT now I have noticed that my teeth are not very white. Can you do anything for that or should I see my Dentist? A. Your Dentist has definitely got options for whitening your teeth and there are also products available in the pharmacy. Many of these can cause some irritation in the mouth from the peroxide. We have a very new product called Liquid Smile that is a peroxide that you just paint on your teeth at night and there is almost no irritation. The staff at the Canmore MediSpa have been using this product on trial for the last two months and notice a significant difference in their teeth colour. Come by the MediSpa to obtain your kit.
Q. A friend of mine was talking about something called Voluma and a Soft Lift. She had it done and looks great. Can you tell me something about it? J.S. A. First off, Voluma is a relatively new hyaluronic acid filler from Juvederm. What makes it different is that it is a denser product so it supports tissues well (and likely will last longer too). The Soft Lift is a term employed when we use fillers to restore volume to the face. The fillers are injected in the anatomical fat pads of the face which tend to fall with aging due to the effects of gravity. By restoring the volume, you take the shape of your face back to your younger look naturally giving a soft, natural appearance. Now, Voluma allows an even better lifting effect which should last
Q. Last week, on CTV, I saw a program about a procedure to fix nose shape with fillers. I don’t like the bump in my nose so I was wondering if this can be done and where I can get it done. A. Dr. Steve Mulholland in Toronto, pioneered this procedure that he calls the ‘5 minute nose job’. Actually, it takes a little longer than 5 minutes but it is quick and quite easy, using fillers like Juvederm to change the shape. This creates a very pleasing change to the shape of the nose and can correct bumps or hollows very nicely. Unlike surgery, this is minimally invasive but, of course, shorter lasting with a duration of about 2 years. As for where you can get it done, I am pleased to say that I have done Dr. Mulholland’s training course and I can do that for you in my office in Canmore. Call today to schedule a complimentary skin consultation to discuss this procedure.
Q. I hear a lot of talk about facial SKIN PEELS. Can you give me a bit more information on what they are? L.S. A. Neat question as I have just written an article on peels in my newsletter. Peels can be very mild with low concentration fruit acid peels such as glycolic acid (often called a ‘lunchtime peel’). With this, you don’t actually peel, rather exfoliate some of the surface dead cells so there is very little recovery. Slightly stronger peels are amazing for treatment pigmentation and acne and will cause some flaking and peeling and possibly slight swelling for about 48 hours.
Q. A friend of mine was talking about something called Voluma and a Soft Lift. She had it done and looks great. Can you tell me something about it? J.S. A. First off, Voluma is a relatively new hyaluronic acid filler from Juvederm. What makes it different is that it is a denser product so it supports tissues well (and likely will last longer too). The Soft Lift is a term employed when we use fillers to restore volume to the face. The fillers are injected in the anatomical fat pads of the face which tend to fall with aging due to the effects of gravity. By restoring the volume, you take the shape of your face back to your younger look naturally giving a soft, natural appearance. Now, Voluma allows an even better lifting effect which should last
Q. I have some quite shallow acne scars on my cheeks. My friend told me that I could get rid of these with microdermabrasion. Will that help? A. Microdermabrasion has been around for a long time. Before microdermabrasion, ordinary sand paper was used to reduce the skin layer to help improve rough texture and spots. Microdermabrasion allowed a gentler, more controlled way of doing this. There are two types of machine – one which uses crystals and the other which has a diamond tip. With both, the treatment involves the removal of the surface layer of the skin. The limiting feature of microdermabrasion is the depth of penetration. This will only allow the removal of 2-5 microns of the skin. This leaves the skin feeling very nice and, with repeated use, will improve the skin texture and tone significantly. We recommend treatments about every 2 weeks and there is no recovery time with this treatment. Unfortunately, most acne scars are deeper than microdermabrasion can treat. That is why we usually use lasers for this, as lasers can go much deeper with their treatment, creating a much better result in the appearance of the scars.
Q. I hate it!!!! I’m female and 19 and my face is covered in pimples. I have tried Proactive and other things that are supposed to help but aaaagh! – they’re still there. What can I do? R.B. A. First off, R.B., realize that you are not alone. Acne affects a large percentage of the population, male and female. Although teenage acne is more common in males, this changes as we get older and many women have frustrating acne well into adult life. Of course, your menstrual cycle plays a big part in this and can Fortunately, there are treatments that are effective at treating acne from topical creams, antibiotics, peels, microdermabrasion
Q. I’ve been hearing a lot about Fractional Lasers for treating acne scars and wrinkles. What’s it all about and are the treatments successful?
Q. I get a lot of questions about general skin care – what to use for a cleanser, toner or moisturiser and what is the difference between one brand or another. So, I am bunching all these questions together here. A. First off, we don’t all have the same skin. Our skin type tends to relate to where our forefathers lived in relation to the Equator. People living in the Northern latitudes have pale, red skin which tends to be thinner and dryer skin. The closer to the Equator, the darker the skin gets and the more natural oil glands. Even those two skin types require different skin care. Then we throw in all the other factors such as environment, lifestyle, diet and mixed genetic factors and you can understand why one skin cream does not work for all. In Alberta, we have a harsh climate with long, often dry winters but quite different summers. So, even for the same skin, what is good for the summer months may not be nearly good enough for the winter months. You can arrange a complimentary consultation at our MediSpa to talk with Leslie about proper skin care for your type of skin. We can explain the difference between store bought products and cosmeceuticals (therapeutic level cosmetics). We also have many samples that can be used to help you decide what you like before you buy. Don’t lose out – get that advice today – it could save you in the long run. Q. I have always wanted long eyelashes. Mine are kind of puny. I have heard about Latisse but I don’t know anything about it. Is it safe and does it work? A. Latisse is a lovely product and YES, it most certainly does work! The chemical in the Latisse eyedrops is used IN the eye for glaucoma. People started to notice that when they were using it, they often ended up having to cut their eyelashes as they were rubbing on their glasses! Now, the same drops are used but NOT IN THE EYE. They are used like eyeliner on the skin of the upper eyelid only. After applying for a few weeks, the lashes grow in length, thickness and often darker in colour. Some people will get a bit of skin irritation but this usually goes away after a few applications. As the drops are not being put in the eye, they are risk free. The only side effect apart from irritation that has been noticed rarely, is pigmentation of the skin where it is applied. Most women do not mind this as it just looks like an eyeliner. So, to answer your question, they do work and they are safe. As this is essentially a prescription item, it must be obtained through a Doctor’s offi ce with consultation first.
Q. I have really short eyelashes which don’t look much better even with mascara. I’ve heard about a product called Latisse that can make your lashes longer. Is this right? K.N. A. This is absolutely right! Latisse is a prescription only product that does what it claims. It stimulates the growth of the eyelash, making it thicker, longer and usually darker. Because it is prescription, you can only get it from a Doctor’s clinic. During that time, we advise you how to use it properly.
Q. You keep talking about the difference between sunscreens and sunblocks but I am not sure that I have really been able to understand the difference. I have always used a day cream with SPF 15 that I put on in the morning. Is this not good enough? A. At least you are doing something to protect your skin from early aging effects from the sun. Blocks and screens work differently. Sunscreens include chemicals that help the skin to absorb the damaging effects of the sun, particularly UVA. They should, however, be applied at least 30 minutes before sun exposure to work into your skin and need to be reapplied about every 2-3 hours to maintain their effect. Sunblocks contain minerals like iron, titanium, zinc and others that block the sun’s rays from your skin. They don’t need to be applied early and will usually last on your skin a lot longer. They also protect against the damage from UVA and the sunburn effect from UVB. So, it is a matter of personal choice, but we recommend the mineral blocks for superior protection.
Q. I saw your answer last week about the sunblocks and sunscreens. Where do I get sunblocks as I don’t see them that often in stores besides the shelves full of sunscreens? A. Many years ago, sunblocks were quite popular because they looked like ‘war paint’. That was the white stuff that people would apply to their nose or other parts. Then they came out with wild fluorescent colours. Then, that died. This, though, was zinc oxide cream which worked well but nobody wanted to walk about with a solid white face. The mineral blocks then came out from some of the high end makeup companies. They used special techniques to disguise the whitening effect and are applied like a makeup to the face. The good ones require colour matching to your skin tone. But, even for men, when applied with a brush and sprayed, it is completely inconspicuous yet gives great protection. That is what I wear in Mexico or on the golf course. So, you will have to find them in a high end salon or medical spa.
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