1. What is dermatology?
Dermatology is a specialized field of medicine, which includes the diagnosis and treatment of diseases/conditions of the skin, hair, nails, mouth and genital surfaces.
2. What is a Dermatologist?
A dermatologist in Canada is a medical physician who after completing medical school, successfully completes a five year dermatology residency program as set out by the Royal College of Physicians and Surgeons of Canada, and passes the very rigorous fellowship examination in dermatology. A dermatologist has the initials "MD FRCPC" after their name. By definition, a dermatologist is a physician who is a recognized expert in the diagnosis and treatment of diseases of the skin, hair and nails. A dermatologist receives five years of specialized medical training that includes training in all age groups and skin types, and learns everything from immunologic to infectious to cancerous conditions of the skin. As well, a dermatologist receives extensive training in surgical, cosmetic, and laser care of the skin. Procedures that dermatologists are trained in include: Botox treatments, filler injections, laser and light treatments, chemical peels, microdermabrasion, skin tightening & fat reduction, hair transplantation, skin cancer surgery, & much more. Thus, for all skin related conditions & procedures nobody knows the skin better than a Dermatologist.
3. How do I choose my doctor?
The Dermatologists on staff at the Toronto Dermatology Centre participate in education, research, and patient care. A Dermatologist will have the letters "MD FRCPC" after their names to connote their extensive training and accreditation by the Royal College of Physicians & Surgeons of Canada. Your doctor should hopefully be involved in teaching students and other doctors about dermatology which reflects qualities of a life-long learner and educator, thus ensuring top notch care for you.
4. Do I need a referral to see the dermatologist at Toronto Dermatology Centre?
All medical skin conditions (e.g. acne, eczema, rosacea, psoriasis, warts, skin cancer) require a referral letter from your family physician or walk-in clinic. Cosmetic skin concerns (e.g. Botox, fillers, lasers, chemical peels, microdermabrasion) do not require a referral.
5. Is the Toronto Dermatology Centre accepting new patients? Do you treat children?
We are always accepting new patients into our practice and typically can see new patients within a few weeks, and often much sooner. We also make a special effort to squeeze in emergency patients within 48 hours. We also keep a waiting list for patients if cancellations occur prior to your scheduled appointment time. We treat anyone and everyone with skin!; we treat men and women, children, elderly, pregnant patients, and all skin colours and skin types.
6. What is the difference between a dermatologist and a plastic surgeon?
A Dermatologist is the foremost medical specialist dealing with the skin and the person to consult for any significant problem affecting the skin, hair and nails. A Dermatologist receives training in pathology, infectious diseases, allergy and immunology, skin cancer surgery, lasers, botulinum toxins and Injectable fillers and thus are uniquely qualified to diagnose and treat a wide variety of dermatologic conditions, both medical and cosmetic. Dermatologists are also the experts in caring for normal skin, and in the prevention of skin diseases, skin cancer, and sun damage.
7. I have questions about my skin condition and wonder how much your different treatments cost?
It is best to make an appointment with one of the dermatologists at Toronto Dermatology Centre. Your skin condition or concern requires a visual in-office assessment to best provide you with the correct diagnosis and treatment plan. As with any treatment, costs vary depending on the scale and severity of the condition, as well as the treatment method selected. There are often various treatment options that can be selected to fit your budget. If you have a medical problem affecting your skin, hair or nails, then a referral is required from your family physician/GP or walk-in clinic. For cosmetic concerns (e.g. BOTOX, fillers, lasers, chemical peels, microdermabrasion, sclerotherapy), a referral from a physician is not required and you can contact us directly by phone to make the appointment.
8. What creams, lotions, shampoos and products should I be using on my skin?
Every skin type is different, so speaking to your Dermatologist is always an excellent idea to receive a personal assessment, recommendation, and sometimes a prescription. Generally speaking, protecting yourself from the sun through sunscreens, hat, sunglasses and sun avoidance during mid-day hours is one of the best things you can do to minimize sun damage, aging, and risk of skin cancer. Moisturizing your skin with a non-comedogenic cream for the face is important, and exfoliating once or twice a week depending on your skin type is also beneficial. Cleansing your face with a mild soap, or more preferably a cleanser (e.g. Alyria, Revaleskin, SwissTec, Spectroderm/jel, Cetaphil, Toleriane etc) is a great way to wash your face without irritating or overdrying it; once a day is usually sufficient, although if you're oily or do lots of sports/sweating, then twice a day is recommended. Acne-prone skin benefits from face washes or products containing salicylic acid, benzoyl peroxide and/or sulfur, though prescription treatments from your Dermatologist are often required as an adjunct. Various anti-aging preparations are available and beneficial, including: glycolic acid, vitamin C, vitamin A/tretinoin (retinoids), matrixyl, coffeeberry extract etc. At Toronto Dermatology Centre, we offer physician-grade products to our patients that have been extensively studied for efficacy and safety, as well as prescription creams that can be beneficial.
9. Do I really need to take care of my skin?
Definitely since your skin is the largest and most visible organ of the body. Our skin acts as a shield protecting our insides from external stresses such as infection, allergens, temperature change and environmental factors (e.g. sun, pollution), and can show manifestations of underlying health problems. Our skin is an important part of our appearance as it can reveal age, sun damage and overall health.
10. How can a Dermatologist help me with my skin?
A dermatologist can help you care for your skin in many important ways:
Diagnosis - Dermatologists diagnose skin disease quickly and effectively by noting your symptoms and checking your skin. They sometimes will perform biopsies, blood tests, or other tests to determine the diagnosis. They then give you options for treatment based on the risk/benefit balance and what fits your budget.
Prevention - Dermatologists can also help you prevent unnecessary damage to your skin through education and by showing you how to examine your skin for signs of skin cancer or other skin problems.
Surgery - Dermatologists are trained and skilled in skin surgery. They often perform surgery on the skin to prevent disease or treat skin cancer, or improve how the skin looks.
Cosmetic Procedures - Dermatologists can improve the appearance of skin damage caused by genetics, aging, sunlight or disease. Various treatment modalities are employed depending on the problem, and can include: cryotherapy, electrosurgery, Botox, fillers, lasers and light devices, chemical peels, microdermabrasion, or removal of skin growths, discoloration or unwanted veins.
11. Does Toronto Dermatology Centre treat any famous people?
We treat many famous people including well-known actors, musicians, athletes, and politicians. Unfortunately, for privacy reasons, we are unable to disclose the names. For the patient requiring particular discretion, this can be arranged by speaking with our staff.
12. Can I be treated at Toronto Dermatology Centre even if I am not a Canadian resident or don't have an Ontario health card?
Yes, although there is a little extra paperwork.
13. Do the dermatologists typically run on time?
The dermatologists at Toronto Dermatology Centre appreciate that everyone's time is important. We make every effort to stay on time, but due to circumstances that are not always in our control, there may be occasional delays. Our staff will make every effort to keep you abreast of any delays and patients are welcome to reschedule their appointment if necessary.
14. Do you have a cancellation policy?
If it becomes necessary to cancel your appointment, it is important to call our office (Phone: 416-633-0001) 24 hours in advance so that we can offer that appointment to others on our waiting list. There is also a no-show fee for not showing up or not cancelling within 24 hours of your appointment.
15. What do I do in case of an emergency?
If your skin emergency occurs during work hours, give our office a phone call and we will try to accommodate you as quickly as possible. Outside of office hours, it is best to either see your family doctor, walk-in clinic, or nearest Emergency room.
16. What changes are taking place in the field of dermatology?
Dermatology is constantly advancing, and in the past few years, our treatment options for acne, rosacea, eczema and psoriasis have had significant advancement. As well, cosmetic dermatology is booming with newer, more effective treatment options for enhancing and rejuvenating our skin. Talk to our dermatologists to see what is new and exciting, and what is coming down the pipeline.
17. My skin is very oily, do I still need to use a moisturizer?
Yes, even those with oily skin need a daytime moisturizer with a minimum of SPF 15 and a non-oily nighttime moisturizer. A deficiency of moisture will typically lead to an overproduction of oil which can worsen your condition.
18. At what age is it recommended to introduce daily skin care products?
Adolescence is a great time to begin a daily skin care regimen. The introduction of a gentle cleanser, sunscreen moisturizer in the morning and nighttime moisturizer will assist in maintaining healthy skin, preventing the onset of certain skin conditions and helping to form beneficial habits, such as daily SPF/sunscreen application.
1. I've been going to a skin "specialist" person for my acne, do I need to see a dermatologist instead?
There are sadly many individuals purporting to be skin care experts or specialists without the necessary training to back it up. The only true, recognized skin expert/specialist is a Dermatologist, recognized by the Royal College of Physicians & Surgeons of Canada as having the qualifications necessary to treat the skin, hair and nails safely and effectively; remember to look for or ask that the person treating you be a licensed Dermatologist who has an "MD FRCPC" after their name.
2. My child has a birthmark that my pediatrician has been following. What is the risk of cancer in this lesion?
Small pigmented birthmarks ("congenital nevi") are fairly common and usually of minimal medical significance. As with any mole, it should be monitored for signs of changing in size, color, or shape. It is really only the very large birthmarks that are quite rare that are considered to have a higher risk of skin cancer (melanoma). You should consider measuring the birthmark and/or photographing it so you can monitor it more accurately for change. A birthmark growing more rapidly than would be considered normal for a child's normal growth rate should be assessed and/or biopsied.
3. I have been prescribed an antibiotic pill for my acne. My pharmacist tells me that because I am on an oral contraceptive pill, that the birth control will be less effective as a result of adding the antibiotic. Is this true?
The number of birth control failures presumably due to antibiotics is extremely low. In fact, the birth control pill itself is only 92-99.7% effective as a contraceptive and the reduction in efficacy as a result of antibiotic addition is minimal at best. If you are concerned, then a second form of birth control (e.g. condom) can be added while on the birth control which would also be protective against sexually transmitted diseases.
4. After recently having my baby, I began experiencing hair loss. Will I go bald?
Following pregnancy, surgery, illness or other significant stress to the body, accelerated hair loss called "telogen effluvium" can occur and can last for several months, but fortunately this is typically reversible and going bald from this would be incredibly rare.
5. My doctor diagnosed me with hives but nobody is able to tell me what caused it. Please help.
Unfortunately, the cause of hives is not often found which we term "idiopathic." Hives or urticaria of less than 6 weeks duration is considered acute, and may be due to a recent infection or medication which if stopped will resolve or will resolve regardless. Hives that go on for longer than 6 weeks are termed "chronic urticaria" and can be quite frustrating as an identifying cause is seldom found. Blood tests are occasionally helpful as would be seeing an allergist. Using various antihistamines throughout the day can be very beneficial and safe until the body's immune system calms itself down and the hives resolve.
6. Are tanning beds a safe way to tan and get my vitamin D?
There is no such thing as a safe tan other than a fake tan from a bottle. The ultraviolet-A (UVA) light that is used in tanning beds actually is able to penetrate the epidermis and dermis to a deeper level than UVB light and contributes significantly to the aging process as well as being cancer causing. UVB light is required for vitamin D synthesis by the body and so a tanning bed is not helpful for this either. An oral supplement of vitamin D is the best way to increase your vitamin D intake, rather than increasing ultraviolet light exposure.
7. How high of an SPF do I need in my sunscreen?
The sun protection factor (SPF) is a measure of UVB protection, and doesn't describe well the protection from UVA light. For the average person, a daily application of an SPF 15 or greater sunscreen is often sufficient, though reapplication every 3 hours is suggested as the sunscreen breaks down. For persons who are very fair and burn easily, for those who work outdoors, are on photosensitizing medications (e.g. tetracycline, accutane) or have photosensitive diseases (e.g. rosacea, lupus or Porphyria), higher SPF values can be beneficial. Note that sunscreen is not a complete sun block and people will tan even with sunscreen on, so wearing a hat, sunglasses and avoiding mid-day sun are also important elements of sun protection. Your dermatologist can help you select the best sunscreen or sunblock for your skin.
8. Is my acne caused by the food I eat?
Acne is caused by a number of factors including: hormones, bacteria, and genetics. Diet does not appear to play a major role in acne, although there is increasing evidence in the last few years that a low glycemic diet and reduced dairy intake may be beneficial for some patients. If you notice that eating certain foods consistently aggravates your acne, then reducing intake of these foods makes good common sense.
9. Will I outgrow my acne?
Approximately 90% of teenagers will develop acne and most will outgrow their acne, but some acne can persist into adulthood or even develops in an adult with no previous history. Our dermatologists can assess your acne and determine what treatment plan would be most beneficial for you. Your options include non-prescription products and if necessary, topical and/or oral medications such as antibiotics, oral contraceptives, or isotretinoin (Accutane). Various procedures may speed improvement, such as microdermabrasion & silkpeel dermalinfusion, chemical peels, Blu-U or laser/light therapy.
10. Is there a treatment for rosacea?
Rosacea is a condition that is sometimes hereditary and is more common in people of Celtic and Eastern European background. It is most common in middle-age, and typically involves any of: persistent redness, dilated blood vessels, pimples, and pustules. Topical and oral antibiotics can be helpful for the pimples and pustules, and reduce redness slightly. Laser and light devices (e.g. IPL or BBL) are particularly effective for the redness and blood vessels aspect of rosacea.
11. My child has dry, rough and sometimes itchy skin, how can I help him?
Childhood eczema is a common problem (~ 20% of the population) often starts with very dry skin that is sometimes itchy. If your child scratches long enough, dry red patches may develop. The best way to treat your child's skin is to make sure they take a warm (not hot!) shower or bath every day using a mild cleanser or moisturizing soap. This is followed by pat-drying (not rubbing!) the skin with a towel, and then immediately applying a bland (fragrance-free) moisturizing cream or ointment to their damp skin. Controlling dry skin reduces the risk of eczema developing or flaring, but for red itchy areas, a medicated cream (steroid or non-steroid options) from your dermatologist is often required.
12. Does Botox really work for excessive sweating (hyperhidrosis)?
One of the many uses of Botox®, beside the cosmetic improvement of wrinkles, is to control excessive sweating (hyperhidrosis) of the underarms, hands and feet, and the forehead. This safe treatment has been used for many years in millions of people, and the effect can last anywhere from 6-12 months. Most drug plans will pay for this treatment.
13. Do you have any general tips for sun protection?
A. Apply a broad-spectrum water-resistant sunscreen of at least SPF 15, and reapply every 3 hours or after getting wet or sweating.
B. Sunscreen should be applied even on cloudy days and in the winter (on the face).
C. Wear sun-protective clothing, hats, and sunglasses
D. Seek shade; remember that the sun's rays are strongest between 10 a.m. and 4 p.m. Do your outdoor exercise early in the morning or in the evening.
E. Remember that water, snow and sand all reflect damaging ultraviolet rays
F. Avoid tanning beds -
G. Vitamin D is best obtained through vitamin D rich foods and enriched foods (e.g. milk), or through a vitamin supplement rather than by increasing sun exposure.
14. My doctor has sent me for patch testing. What exactly is this?
There are two main types of allergy testing involving the skin. Skin prick testing, typically performed by an allergist, involves placing drops of solution of various allergens using a series of scratches or needle pricks on the forearms. If the skin develops a red, raised itchy area (wheal), then the person is felt to be allergic to this substance. Skin prick testing typically tests for environmental or oral allergens such as dust mite, trees, animals, eggs, wheat, milk. The results can be interpreted immediately.
Patch testing on the other hand is more commonly performed by dermatologists, though some allergists do this as well. This type of testing typically takes place on the patient's back, and involves applying patches containing allergen solution with tape (no needles). This form of testing is to assess whether you may be allergic to something you are physically in contact with, such as an allergy to: metals (e.g. nickel), fragrances, preservatives, sunscreens etc. Patch testing can take 2-3 visits to the doctor and is used to detect allergic contact dermatitis.
15. My doctor has referred me for Mohs surgery for my skin cancer. What is Mohs surgery?
Mohs Surgery or Mohs Micrographic Surgery is an advanced surgical technique for skin cancer that offers the highest possible cure rate for many skin cancers and simultaneously minimizes the sacrifice of normal tissue. It is typically performed for skin cancers on the face, particularly for basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). This treatment requires highly specialized physicians (usually dermatologists with special training) that serve as surgeon, pathologist and reconstructive surgeon. The microscopic analysis of tissue that is removed allows the surgeon to track the removal of the cancer and ensure the complete elimination of all tumor roots.
The cure rates for Mohs Micrographic Surgery approach 99% for most primary (untreated) cancers with a slightly lower cure rate for secondary or recurrent (previously treated) cancers. While limiting the sacrifice of uninvolved tissue, this specialized procedure preserves the greatest amount of normal tissue resulting in the least amount of scarring or disfigurement. In Toronto, patients are typically treated by Mohs surgery at Women's College Hospital.
1. Who will be performing my BOTOX or filler injections?
Dr. Benjamin Barankin and Dr. Anatoli Freiman believe that it is critical for safety and optimal results that only someone trained and skilled in anatomy, surgery, and anesthesia be allowed to inject the face with botulinum toxin and injectable fillers. Thus, all of these injections are performed by the Dermatologists themselves, always!
2. A local clinic/spa offers laser hair removal for cheap, should I go there? Aren't all lasers the same?
All lasers are not created equal, nor are the people using lasers on you. Medical-grade lasers (e.g. Diode or Nd:Yag) are typically far more effective and safer as compared to a spa or esthetician employed laser equipment. There are many clinics out there with poorly trained personnel and without a commitment to ongoing training for their staff. As well, many clinics hook in clients using very cheap prices for inferior quality treatments that can either take many more treatments than a more powerful laser, and more importantly can be riskier as far as potential side effects such as burns and discolouration of the skin.
Laser hair removal is best performed using a Diode (used by Toronto Dermatology Centre) or Nd:Yag laser, which are safe in all skin types. Many salons & spas offer IPL for laser hair removal (often found on group buying sites like groupon) - this device is far more painful, less effective, and can lead to side effects and should be avoided. Your skin health and appearance is not worth a false savings of a few dollars.
3. What is the difference between BOTOX and restylane/perlane/juvederm?
Botox is a purified protein injected into the skin and used to relax muscles that cause wrinkles ("dynamic wrinkles"), while restylane, perlane, or juvederm are hyaluronic acid injectable fillers used to fill out wrinkles or enhance facial volume or plump up lips.
4. Are Injectable fillers such as restylane, perlane or juvederm safe?
These fillers are made up of "Hyaluronic acid" which is a normal component of the skin which unfortunately breaks down as we age. Thus the fillers are bio-compatible and safe, and do not require allergy testing.
5. Is Botox safe?
Botox has been used for over 20 years in millions of people and is considered a very safe treatment, especially when performed by specialist physicians such as Dermatologists.
6. How often will I need Botox?
Most people find BOTOX lasts anywhere between 3-6 months. With repeated treatments, BOTOX treatments will often last increasing amounts of time.
7. How often will I need fillers such as Restylane or Juvederm?
Depending on the area treated and how much is injected, fillers can last anywhere from 4 - 12 months. Fillers in the lips last the shortest amount of time, while fillers in the cheek bones or tear trough area last the longest amount of time.
8. How can I improve the vertical lines around my lips?
Effective measures include stopping smoking, not drinking from a straw, and wearing sunscreen around the lips and applying chapstick with SPF. Various treatments such as Botox, injectable fillers, and chemical peels are particularly helpful in softening these lines, though they are hard to get rid of completely.
9. How do you treat large broken blood vessels in and around the nose?
One of the best ways to treat large, dilated, blood vessels on the face is with a laser or light device (e.g. Intense Pulse Light - IPL or Broad Band Light - BBL). This is generally well tolerated, effective with a few treatments, causes minimal down time, and does not scar. For a few broken blood vessels, electrosurgery can also be very beneficial and may require a few treatment sessions.
10. How do I improve my dull complexion?
Various prescription or physician-grade creams can be somewhat helpful, though for better results, chemical peels, microdermabrasion, or intense pulse light (IPL) are required.
11. Do lasers work on all skin tones?
In the last few years, major improvements have been made to laser technology. Lasers used to work best on people with lighter skin and dark hair, but these days there are options available for women and men of all skin tones and colours. With the help of modern technology and the cutting edge technology offered at TDC, our Dermatologists can select the laser technology that is both safe and effective for each patient, or sometimes recommend other options such as chemical peels, microdermabrasion and fading creams as adjuncts to improving skin tone.
12. My doctor told me I have age spots on my hands and face. How can these be removed?
"Age spots" or "liver spots" are called "lentigo" or "lentigines" by a physician. They are sometimes related to age and genetics, and can also be due to chronic sun exposure. Although they are harmless, they can be unsightly and can be safely lightened or removed using various techniques that your dermatologist can discuss with you. Laser or light devices, cryosurgery, chemical peels, and some creams may be employed.
13. What are the benefits of ProFractional Laser Resurfacing?
The ProFractional laser device offers a number of benefits for men and women who are noticing the premature signs of aging, are recovering from acne, and those who may have severe scars from an injury. The procedure can reduce skin imperfections and help create a smoother, more uniform appearance.
Some of the top anti-aging benefits of the ProFractional laser include:
Can be used on both the face and body
Laser can be administered on all skin types
Can be combined with other treatments, including skin tightening procedures and micro laser peels
Helps reduce or eliminate acne scares
Can reduce or eliminate skin pigmentation
Helps reduce or eliminate fine lines and wrinkles
Can help keep acne under control
Improves the texture and tone of the skin
Evens out skin discoloration
Eliminates or reduces the effects of sun damage
14. What are the benefits of Silkpeel DermalInfusion?
If you are looking for a skin treatment that delivers immediate results, won't take hours out of your busy schedule, and will leave you with noticeably better skin in under 30 minutes, then SilkPeel™ Dermalinfusion™ is one of the best procedures offered today. Similar to microdermabrasion, The SilkPeel™ Dermalinfusion™ System combines non-invasive exfoliation with deep delivery of patient-specific solutions directly to the skin without the use of crystal or other chemical exfoliants.
SilkPeel™ is exclusively offered through facilities with medical directors on staff, and isn't available at a typical day spa or salon. The procedure is non-invasive and even soothing; delivering the results you want without harsh chemicals or uncomfortable treatments. When you get a SilkPeel™, you won't have any downtime, and don't have to worry about dealing with irritated or inflamed skin. Within about 30 minutes, SilkPeel's wet exfoliation leaves your skin silky smooth, hydrated, bright, and full of the youthful, healthy glow that we all desire.
15. What are the benefits of LightSheer Laser Hair Removal?
Men and women alike can now make unwanted facial or body hair a thing of the past and forget about painful waxing, electrolysis and razors. The Light Sheer hair removal system delivers 21st century technology for the treatment of this distressing problem. The Light Sheer system presents a revolution in hair removal. Using technology beyond that of other lasers, the Light Sheer can disable hundreds of hair follicles in less than one second. The procedure is computer-guided and promises permanent hair reduction. An 800 nm high-power, long pulsed diode laser with contact cooling provides safe and effective reduction of pigmented hair in patients with a variety of skin types.
16. How do LightSheer treatments compare with electrolysis?
Electrolysis is a tedious, invasive and painful process that involves inserting a needle into each hair follicle and delivering an electrical charge to destroy them one at a time. Electrolysis often requires years of treatments at regular intervals. Light Sheer delivers light energy non-invasively to hundreds of hair follicles simultaneously. So, in a few minutes, Light Sheer can effectively treat an area that would take over an hour with electrolysis, and causes only minimal discomfort.
17. Are the creams & other products that Toronto Dermatology Centre sells any better than what I can buy over the counter?
Most certainly yes. The creams, lotions, and other products sold at Toronto Dermatology Centre are physician/medical grade and not available over the counter. They have been rigorously reviewed and selected by our Dermatologists. The concentrations of various antiaging ingredients (e.g. glycolic acid, vitamin C) and their delivery system is superior to over the counter products, and we provide sunscreens and other products that are the least likely to cause irritation or allergy, and at various price points to fit your budget.
18. Do you offer free shipping?
Yes, we offer free shipping on orders $250.00 or more.
If you have a question which is not listed below, please contact us with your questions or concerns.