10 Things Your Dermatologist Says You Shouldn't Do

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

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

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

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

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

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

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

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

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

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

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

Skincare Labelling: What You Should Know

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

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

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

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

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

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

Dealing with Dandruff? Here's What To Do

Dandruff is a common and harmless scalp condition in which small pieces of dry skin flake off. Here is a quick breakdown on what you need to know about dandruff and flaky scalp.

Malassezia, a yeastlike fungus that lives on the scalp, is thought to be a primary cause of dandruff. Flaking of the scalp however may be caused by a number of things, including dry, irritated skin, conditions such as eczema and psoriasis, and sensitivity to hair care products (contact dermatitis).

One way to treat and control dandruff is to use over the counter dandruff shampoos. There are a variety of active ingredients that may help. Some will work better for certain people so it may require a bit of trial and error. Popular ingredients to consider are: Zinc Pyrithione , Selenium Sulfide, Ketoconazole, Salicylic Acid, and Coal Tar.

It is important to leave shampoo on for enough time to be effective (generally 5 minutes). It is also a good idea to rotate your dandruff shampoos so that your scalp doesn’t get used to a particular active ingredient. If you continue to have symptoms after using a dandruff shampoo, consult a board-certified dermatologist.

5 Surprising Uses for Botox

Most often when we think about Botox it is for cosmetic use. However, Botox has many uses in medicine that people are often unaware of. Botox was first approved for medical use in the treatment of two eye muscle disorders more than 30 years ago. It was during use for treating eye conditions that the power of Botox for cosmetic reasons to minimize wrinkles was accidentally discovered. Botox is currently FDA-approved for 11 therapeutic indications and used “off label” for a number of other conditions.

Here are five uses of Botox you may not have known:

Chronic migraines - Botox injections are believed to interrupt pathways of pain transmission that cause headaches and migraines. Treating migraines generally requires multiple injections in the forehead, temple and neck. You should get this type of Botox treatment from a doctor who is trained in placement for best effect.

Hyperhidrosis - Excessive and often unpredictable sweating. People with hyperhidrosis may sweat even when the temperature is cool or when they are at rest. Botox is approved for use in the axilla (armpits) and is used off label in other areas, most commonly the palms. It can significantly reduce sweating and typically lasts 6-12 months.

Cervical dystonia - A painful condition in which neck muscles contract involuntarily causing the head to turn to one side. Botox injections to these muscles can relieve these muscle contractions.

Overactive bladder - Botox injected into the bladder can help relieve urge incontinence or overactive bladder symptoms (involuntary loss of urine).

Depression - Of the 5 mentioned this is the only one that is not currently FDA-approved and has been the subject of much debate. There are several theories as to how Botox may help, one of the most popular being the “facial feedback hypothesis” which has roots all the way back to Charles Darwin and rests on the idea that by reducing frowning (through botox injections or otherwise) you can reduce negative emotions.

There are a number of other uses beyond these, in addition to of course helping to deal with unwanted wrinkles. In 2017 Botox made the Time Magazine cover as “The Drug That’s Treating Everything.” It is one of the most well-researched medicines in the world with an amazing list of current and potential future benefits!