( Photo: Heather MacDonald )
Alternatives to typical skin care treatments, such as prescription pills and topical creams, range from laser procedures to chemical peels to microdermabrasions. Many companies that offer these treatments say there is very little difference between what their clinics offer and what a dermatologist office offers.
Sachit Shah is a family physician with a special interest in cosmetic medicine and the owner of BC Laser and Skincare Clinic. The clinic employs four laser technicians and an esthetician.
The only difference between his office and a dermatologist’s office, he said, is that people come to the clinic without referrals from other physicians.
Alifiya Sadikali, a medical therapist at Ottawa skin care company Dermis, said a dermatologist can prescribe drugs and topical prescriptions available at a pharmacy, which she, and the other medical therapists on site, cannot.
“However, there are treatments that can be done that are as aggressive as a prescription drug would be,” she said. “Most people believe that a doctor’s word is the last word. They don’t want to look beyond that. Unfortunately, then you are limiting your options as to what you can do.”
Instead of applying a topical cream, she said she often recommends chemical peels to individuals with serious acne concerns.
Sylvia Lapointe, the owner of Facial Angle, said there is “no difference” between her office and a dermatologist’s office.
Lapointe employs aestheticians at Facial Angle.
“We’re aestheticians,” she said, “but I followed my course in chemical peels with dermatologists.”
She said there are four or five places in Ottawa that perform chemical peels, and if they have a dermatologist on staff, it is an assistant – and not the dermatologists – who actually do the peels. However, dermatologists have one more peel available to them that is a little more in-depth than the ones aestheticians have.
COMPARED TO PRESCRIPTION TREATMENT
It is impossible to compare results of prescriptions to peels, said Lapointe.
“Prescription pills, for example Accutane, which is the prescription that is most commonly used, work at completely shutting down the activity of the oil glands,” she said. “[Chemical peels], however, work on the upper layers of the skin. They do not work internally at all.”
She said there is no comparison between Accutane, and other pills, and chemical peels.
“If you’re looking at treating acnes, Accutane is something that treats acne. If you’re looking at completely eradicating acne, it does that. With a lot of side effects,” she said. “The chemical peels work on the upper layers of the skin, cleansing the pores.
“You can’t even compare the results because you’re not working on the same thing.”
Sadikali said she doesn’t recommend prescription treatments unless there is something she and the other medical therapists on staff really cannot fix.
“We’ll recommend a person to a dermatologist if I can’t diagnose [their skin condition], or I see that this is not something in my realm to fix,” she said. “But most people are veering towards more serious skin care because a dermatologist appointment is a year away in Ottawa so most people are looking for something to do in meantime.”
She said less intensive procedures, like a facial at a spa, are very superficial.
WHAT TO EXPECT:
Many companies offer a variety of “peels,” aimed at improving and smoothing the texture of the facial skin using a chemical solution that causes the skin to blister and eventually peel off. The regenerated skin is usually smoother and less wrinkled than the old skin.
Unlike many other procedures, peels are not relaxing, said Sadikali. Instead of dimming the lights for a more soothing experience, the lights are left on during a peel procedure. This way, if the skin is reacting negatively, the person administering the treatment can respond right away to rectify the situation.
However, she said they are not painful.
“They feel warm and tingly on the skin. For some, it is more intense than for others,” she said.
The results are always great, she said.
“I am a fan of peels. I really like them.”
Laser procedures can also have an element of discomfort, but they are not dangerous, said Shah.
“Mostly people complain that the laser treatments should not be done because they are done badly. Anyone can buy a laser and do a treatment,” he said. “We do them only for those conditions which we know we can get results. We do not provide treatments for conditions that cannot produce results.”
Laser treatments are very effective, Shah said.
Pre-cooling is an important step in the laser process, Sadikali said.
“You are cooling the skin’s temperature enough so that the laser’s heat is felt less on the skin,” she said. “It’s for patient comfort and it’s also to protect the skin.”
THE “STEAMING AND CREAMING” APPROACH
“At Dermis we don’t use the steaming and creaming approach anymore,” said Sadikali. “It’s on its way out. It’s not a trend that’s in any more.”
To get the results most clients want, she said a more intensive exfoliant is required.
“Any kind of acidic exfoliations with glycolic acids or lactic acids or more of a chemical peel process is the way to go if you really want to see the dramatic results that most people are looking for these days,” she said. “Unless your skin has sensitivities, that is the way to go if you really want to see results.”
Shah said his company does not do any steaming and creaming either.
“It is more spa-like and we are not a spa,” he said.
Lapointe said that in terms of results, the steaming and creaming process is on the way out.
“People who are just going to a place where all they get is steam and a layering application, are probably not getting a great procedure,” she said.
However, she said it definitely still has its place.
She said it is important not to forget that people often come in for relaxation, as well as a facial.
Steaming and creaming is a very relaxing part of the procedure, compared to having the products that sting and having a lot of extractions, she said.
You have to take that into consideration, she said.
The age of the clients is also important.
“If you have a lot of clients over the age of 75, they may not really go for all these chemical procedures,” she said. “They just want to come in to have a good face and skin care treatments.”
PRODUCTS
Sadikali suggested that everyone invest in a cleanser, an exfoliant and a moisturizer.
A toner is an added benefit, she said, because it will help products penetrate into the skin better.
Many people who suffer from dry skin may notice that the products they are using do not work. This is because they haven’t had an exfoliation in a long time, Sadikali said.
“Exfoliation is the key to keeping your skin healthy, because nothing you put on your skin is going to work if the dead skin cells are just sitting there,” she said. “If you get into a good exfoliation regime, your dry skin will react and feel better with time.”
She suggested avoiding a low-grade exfoliant made up of very jagged grains.
“These create micro-scratches on the skin that you don’t see,” she said. “I recommend something that has a little bit more of a chemical approach.”
A chemically-based exfoliant sits on the skin, performs its duties, and does not scratch at the skin, she said.
Lapointe said soap is probably one of the worst things people can use on their skin because it removes the skin’s natural acid balance.
If someone is on a soap and water regime, Sadikali said she would suggest that they invest in a couple of products before scheduling a treatment.
“Your skin needs to be prepped to have intensive treatments done,” she said. “Otherwise it’s almost like pouring water on a rock – nothing really penetrates.”
SUNSCREEN:
Sadikali said investing in a good sunscreen is one of the most important things someone can do to protect their skin.
For the summer, she said she recommends SPF 40 and over.
“It doesn’t matter how expensive your other products are,” she said.
“If you don’t invest in a good sunscreen, nothing really works out.”
Both Lapointe and Sadikali said they suggest a mineral-based sunscreen over a chemically-based sunscreen.
“It has to be chemical-free with natural and mineral ingredients so you know you are putting something pure on your skin,” Sadikali said. “There can be very clogging ingredients in regular, normal sunscreen.”
Lapointe said she recognizes the importance of sunscreen, but takes a very difference stance on its use.
Because sunscreen works by blocking UV rays, she said it also blocks production of Vitamin D.
“We’re not getting a lot of the Vitamin D in this hemisphere,” she said. “There have been some links to MS because we are not getting enough Vitamin D and also to some bone deterioration.”
Shah said sun damage, caused by not wearing enough sun block, is actually usually the most common skin problem he encounters.
He said sun exposure and tanning are horrible for skin, but people seem to continue doing anyway.
“They should never do it,” he said.