Nuceiva is the newest neuromodulator on the market for the treatment of glabellar frown lines. Whereas Botox is referred to as abobotulinumtoxin A, Nuceiva is referred to as prabotulinumtoxin A.

Similar to other brands such as Botox, Xeomin, and Dysport, Nuceiva™ works to smooth out creases in the face by decreasing muscle contraction.

It has been approved by Health Canada and the FDA.

Marketed as Jeuveau by a company called Evolus in the United States, it originated with a South Korean company called Daewoong. Nuceiva™ was authorized for sale by Health Canada in August of 2019 and was subsequently officially brought to the Canadian market by Clarion Medical Technologies in October 2019. It is also available in the European Union.

Nuceiva™ usually lasts about 3 to 4 months although this varies from person to person. A study published in Dermatologic Surgery in 2019 showed similar efficacy to Botox.

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Bleach baths are a controversial therapy for patient with atopic eczema, also known as atopic dermatitis (AD). In recent years, there has been an increase in the use of bleach baths to decrease the severity of the eczema. However, a recent review showed that while bleach baths did seem to decrease the severity of atopic eczema, it was no more effective than water baths alone. There has been a lot of research into the effect of bleach baths on Staphylococcus bacteria and it seems like the concentration of bleach used in bleach baths may not be high enough to kill bacteria. There may be other anti-inflammatory properties that have yet to be discovered.

With all of the conflicting data out there, the best summation is probably what was stated in the latest Canadian consensus statement on pediatric atopic eczema: “bleach baths have not been consistently shown to improve outcomes in AD and may be used at the discretion of the treating health care provider.”

Reference:
Lansang P et al, Approach to the Assessment and Management of Pediatric Patients With Atopic Dermatitis: A Consensus Document. Section IV: Consensus Statements on the Assessment and Management of Pediatric Atopic Dermatitis.

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Pulsed dye laser (PDL) is a very effective treatment for redness of the face due to enlarged blood vessels. It has proven to be very safe and effective. However, there is some discomfort from the laser pulses and while most patients have no difficulty tolerating treatment without any anesthetic, some patients do find it difficult to tolerate. Topical anesthetic can be used to decrease the discomfort of laser treatments but there has always been the question of whether the vasoconstrictive properties (i.e. constriction of blood vessels) of the anesthetic might have an adverse effect on outcome if you are trying to get rid of blood vessels.

A recent study by Chunharas et al in April of 2020 (Lasers Surg Med. 2020 Apr;52(4):307-314) demonstrates that topical anesthesia with lidocaine and tetracaine do not interfere with the efficacy of pulsed dye lasers. This is great news for those who want to receive treatments with pulsed dye lasers.

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Thank you for your patience! As Phase 2 is set to open on June 12, 2020, we are happy to announce that we are reopening as well! We have been following the Chief Medical Officer of Health instructions and have therefore not been able to see any of our patients since March 16, 2020, except for skin cancer patients and those with urgent needs.

We are happy to announce that we will be booking appointments for all those we had to cancel over the last few months, as well as accommodate those on our wait list. We look forward to see you back again! We thank you for your patience and understanding as we ourselves need to go through our phased approach to booking.

Sincerely,

Dr. Nakatsui

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Prabotulinumtoxin A

In 2002, Botox (onabotulinumtoxin A) was the first botulinum toxin to gain FDA approval for the “temporary treatment of glabellar lines in adults.”  A recent study published in Dermatologic Surgery reviewed two Phase 2 randomized, multicenter, double-blind, placebo controlled trials with 2100 patients showed that a new version called prabotulinumtoxin A had a similar onset of action, duration of action, and adverse event profile as compared to Botox. On the market currently, we have Botox, Dysport, and Xeomin for the treatment of lines and wrinkles. We may see another agent available soon.

 

References:

1. Dermatol Surg. 2019 Dec;45(12):1610-1619

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Temporary Closure

On Monday, March 16, 2020, the Nakatsui DermaSurgery Centre decided to take a leading initiative and temporarily close operations to help mitigate the spread of COVID-19. This was not an easy decision. In the end, we are confident that this was the best decision to protect our patients, our staff, and our community. We have stopped all non-essential services and are in the process of contacting patients who were scheduled to see us in the next two weeks to let them know what is happening. We will do our best to reschedule everyone as soon as possible once the situation improves. For our current patients who have more urgent medical needs, Dr. Nakatsui will make himself available to see you.

It is important to remember we should not panic as this infection will be well managed for the vast majority of those affected. However, we must assist our health care system by “flattening the curve” and preventing the exponential rise in COVID-19 and reducing the number of serious cases.

We will still be answering our phones and responding to emails for the time being. If you have any questions and concerns, please feel free to contact us at 780-482-1414 or via email at info@nakatsuiderm.com.

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Ohhhh the Weather outside is frightful, but the fire is so delightful, and since we have places to go, I want my skin to look aglow look aglow!

Yes!  The Merriest time of year is upon us.  Family dinners, work Christmas parties, and having friends over for the evening is all part of this festive season!  The truth of the matter is, is that we want to look our absolute best at these events.  We want to have smooth skin, amazing eyes, and a body that fits perfectly into that cocktail dress.  How we look at the end of the evening is a different story!

At the Groot DermaSurgery Centre, we offer various treatments that help fine-tune and tweak the little things.  Don’t like the wrinkles around your eyes whenever you smile?  Botox Cosmetic can be used to help treat crows feet so that when you’re smiling for photos, the wrinkles around your eyes will not steal the show.  What about your skin?  You want it to be flawless in those selfies.  HydraFacial MD can help cleanse the skin and reintroduce important compounds back into the skin that have been lost due to the harsh summer weather. 

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A recent study on SPF published in the Journal of the American Academy of Dermatology (JAAD, 2018; 78: 902-910) demonstrates that higher sun protection factor sunscreens really do provide additional benefit. This study evaluated skiers in a double-blind, split-face, randomized study. In this study, skiers in Vail, Colorado wore SPF 50 on one side of the face and SPF 100 on the other side of the face. They were allowed to do their normal activities and were then evaluated the next day to see if there was any evidence of sunburn erythema. The SPF 100 sunscreen side was found to be significantly more effective in protecting against sunburn.
The study supports our belief that if you are going to be out in a lot of sun, the higher the sun protection factor, the better! Another factor that may be important is that many of us apply far less sunscreen than we should, so you might think you are getting an SPF 50. However, you might be applying such a thin layer that you are only getting the equivalent of SPF 20! Consequently, make certain you apply enough sunscreen to provide adequate protection and if you decide to go to a higher sun protection factor,

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Scar treatment can be challenging and requires a multi-dimensional approach in order to be successful. A scar can be the centre of attention but can also be a source of annoyance. For some individuals, scars are a part of who they are, whereas for others they are intrusive and cause insecurity. They can be caused by a variety of reasons such as acne scarring, trauma, and surgery.

Some individuals have thickened keloid scarring, where a scar becomes raised and discoloured. In order to treat the thickened aspect of the scar, many times cortisone injections will be utilized to reduce the thickness of the scar.

On the opposite end of thickened scars, people may get pitted scars where the skin sinks in various regions. These types of pitted scars can be tricky to treat; however, with improvement in technologies and techniques, pitted scars can often be improved. In some cases, Dr. Nakatsui will use an ablative laser to smooth out the skin and reduce the harsh edges that cause shadowing.

A new approach is to promote collagen re-growth in the region.  Through the use of a technology called Percutaneous Collagen Induction (PCI), many tiny needles create tiny holes in the skin. The creation of these tiny holes stimulates collagen formation to help fill in the areas of depressed scarring.

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For many men and women, a nose that fits the symmetry and dimensions of their face can be an important aspect in their lives.  The nose is the most central and prominent aspect of a persons face and it is able to bring together all of the features of a person’s face like beautiful symphony.

Dermal fillers such as Juvederm and Restylane offer fantastic options to help augment portions of your cheeks, lips, nose, and chin! Dr. Nakatsui, dermatologist and Medical Director at the Groot DermaSurgery Centre, is able to use dermal filler, such as Juvederm, to augment portions of the nose.

Through careful and precise injections, Dr. Nakatsui is able to correct minute bumps, imperfections, and even enhance your nose bridge.  Dermal filler nose augmentation is a great non-surgical option for those wanting to address certain issues they have with their nose with minimal downtime.  It is also a great treatment for those who already had a previous rhinoplasty procedure and would like to correct minuscule imperfections.

If you have any questions or you would like to book a complimentary consultation with Dr. Nakatsui, please contact our clinic at (780) 482 – 1414.

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May is Melanoma Awareness Month

Did you know that in 2017, approximately 7,200 Canadians were diagnosed with Melanoma?  Melanoma is the most dangerous form of skin cancer that has been on the rise in Canada and across the world.  If melanoma is diagnosed early, there is a high probability of successful treatment and curability!  Staying vigilant and examining all lesions on your body regularly can help you stay on top of our skin health.

Here is a case example of melanoma with Dr. Nakatsui.

One of Dr. Nakatsui’s patients presented this mole to him and when presented this mole (above). Dr. Nakatsui had a strong suspicion that this oddly shaped mole could be something sinister. Through a diagnostic biopsy performed by Dr. Nakatsui at the Groot DermaSurgery Centre, the results confirmed that the mole was indeed a malignant melanoma, the most worrisome form of skin cancer.

What made Dr. Nakatsui concerned about the mole? We can look at the ABCDE’s of mole checking.

A – Asymmetry: The mole is asymmetrical in shape. If you draw a line through the middle,

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