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Dear Patients and Friends,
I want to personally thank all of you for your continued support and trust in us!
To my patients who have followed me in the last decade and a half, thank you, once again, for allowing me to remain in your service. It has truly been my honor to learn from you. We are so grateful that you are in our lives. To my new patients, welcome to our family. My team and I look forward to discovering your personalized skin care journey with us.
As I reflect, we have so much to be grateful for and look forward to. We hope to continue to bring to you cutting edge technology, premium skin care and new treatment options for various dermatologic conditions. The pandemic has not slowed down the new advances which are coming down the pipeline. We are excited to share them with you!
We wish you many happy moments with those you love. Life is precious – enjoy every moment of it!
Happy Valentine’s Day!
Sincerely,
Alison Young, MD PhD
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Procedure of the Month:
Photodynamic Therapy
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Photodynamic therapy (PDT), is a form of phototherapy involving light and a photosensitizing chemical, used in conjunction with molecular oxygen to elicit cell death. PDT is selective for skin cancer cells. PDT also has proven ability to kill microbes, including bacteria, fungi and viruses. PDT with blue light is used in treating acne.
Heme is synthesized in all cells, with aminolevulinic acid synthase (ALAS) as the rate limiting step. By loading exogenous (topically applied) aminolevulinic acid (ALA) and bypassing the rate limiting step, protoporphyrin IX (PPIX) which is an endogenously produced photosensitizer, accumulates selectively in skin cancer cells. PPIX absorbs light energy and transfers this energy to oxygen, generating reactive oxygen species, which then lead to cell death. This is the basis of PDT. PDT is used both in cancer diagnosis and treatment.
Actinic keratoses (AK) are the most common pre-cancerous lesions, affecting more than 58 million Americans. 1 in 5 Americans will develop skin cancer in the course of their lifetime. In up to 10% of patients with AK, individual AK lesions, including subclinical AK, progressed to squamous cell carcinoma (SCC) within an average of 2 years. According to recent studies, treating AKs delays the development of SCC. Because we cannot predict which AK will eventually develop into SCC, they should all be treated. This is the concept of field therapy.
I recommend PDT for treatment of actinic keratoses because it is an effective field therapy that prevents non-melanoma skin cancers (including squamous cell carcinoma and basal cell carcinoma). Afterall, prevention is better than cure!
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How Effective Are Oral Hair Growth Supplements?
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In the last year, I have seen an increased number of patients with hair loss concerns. A frequently asked question is: Do oral hair growth supplements actually work?
In a recent review published in the International Journal of Dermatology, the authors reviewed 20 popular over-the-counter oral supplements taken for hair loss, including vitamins, minerals, plant derivatives, and nutraceuticals. While the authors identified no clinical evidence supporting the use of vitamin A, vitamin D, biotin, niacin, selenium, ashwagandha, curcumin, and capsaicin for treatment of hair loss, they found that mild evidence exists for the use of vitamin E and zinc in hair loss conditions, in addition to mild evidence for horsetail and methylsulfonylmethane as complementary management for skin and hair health. Some evidence exists for the use of pumpkin seed oil and saw palmetto as additional options for androgenic alopecia. Also, marine complexes have shown positive effects on hair health. As oral supplements are not regulated by the FDA as drugs, larger peer-reviewed clinical studies are needed to determine the safety and efficacy of the oral supplements discussed in the article.
Because there are many causes of hair loss, my advice is that if you are experiencing hair loss, please allow us to perform a thorough evaluation and examination as soon as possible, to determine the most appropriate treatment for your condition.
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Dr. Young is excited to partner with Fullscript to give her patients access to high quality supplementations from the safety of their own homes. Look out for the Cyber Monday sale coming soon.
Fullscript is a smart, easy way to access supplements and meet wellness goals – from anywhere. You can pick your favourite supplements from your preferred device, and supplements get shipped right to your front door. Plus, getting started is completely free! It’s that simple.
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Dr. Young's Tip of the Month
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Longer-Term Exposure To High-Energy Blue Light May Increase DNA Damage And Possibly Photoaging
Blue light is emitted visible light between the wavelengths of 400 to 500 nm. The main source of blue light is sunlight, but digital screens, light‐emitting diodes (LEDs), and fluorescent lighting are additional sources. In the past decade, concerns about the negative effects of blue light on the skin have increased significantly.
Depending on the intensity and wavelength, blue light can be both harmful and beneficial to the skin. Studies have shown that while low‐energy and low exposure times to high‐energy blue light can help prevent skin diseases, longer exposure to high‐energy blue light can increase the amount of DNA damage, cell and tissue death, and injury, eye damage, skin barrier damage, and photoaging.
To protect from the negative effects of long term blue light exposure on the skin, here are my recommendations:
1. Tinted broad spectrum sunscreens containing 2-3% iron oxide, block visible light in addition to UVA and UVB, while non-tinted sunscreens which are formulated to be invisible on the skin, block UVA and UVB.
2. Antioxidants (my favorite is vitamin C serum) are non-negotiable as they neutralize free radicals generated by visible (and UV) light, thus reducing cell damage and photoaging.
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