By: Dr. Sharyn A. Laughlin, MD

During the height of the pandemic, cosmetic injectables and fillers actually declined in use, which was a big reversal of trends considering their surging popularity in these past few years.  During the initial lockdowns, most physician offices in Ontario but across the country and the world were closed for non-essential appointments.  Our Ottawa practice was completely shut down for almost 12 weeks.  Even when things began to open back up, people were hesitant to return to in-person visits. There was a lot of fear but also guilt in entertaining cosmetic or superficial considerations.  Virtual consults are always tricky for properly assessing patients when it comes to aging concerns but even other skin disorders.  The speciality of dermatology is one of the most high-touch specialities.  I spent most of my days inches away from people’s skin with my dermatoscope or magnifying loops looking and assessing their skin.  I found that most people just decided it best to defer their procedures until 2021.

Having said that, people were feeling the need for proper skin care and were becoming even more self-conscious of their aging concerns.  These were stressful times and people turned to self-care in the form of skincare to help manage anxiety.  They were also seeing themselves on camera more and more, and fixating on self-perceived issues, thanks to those pervasive Zoom meetings.  Wearing masks aggravated acne, rashes and rosacea.  A lack of socialization and exercise, poor nutrition and sleep all showed up in skin complexion and really emphasized the early signs of deterioration, deflation and descent - the 3 D’s as we like to call them in dermatology. 

Certainly, skincare and at home devices were helpful stop gaps for these past few months.  My daughter, the CEO of The Sunscreen Company™️, calls it “Stress Skin-caring”.  We’ve all heard the term Stress Eating but in this case, people had been going full throttle on their correction skincare routines, doing at-home peels or layering on multiple actives, less concerned about irritation or peeling because no one was going to see them out of their homes. Some of that furor will wane and people will stop ‘overdoing’ things.  Going forward, the hope is that people will have developed some good and useful skincare habits for the prevention of skin aging concerns but also maintaining procedures they receive in a medical office.  I think we’ve all realized their importance as necessary supportive and additive measures, but they do not replace what we achieve using injectables and laser medicine.  To put it in perspective, it’s reasonable to expect that really effective skincare can improve the look of the skin when it comes to texture changes, hydration, luminosity etc. by up to 30-35%. In short, a great skincare routine can bring real visible change.  If you’ve been diligent about your sunscreen and prevention routine then that 35% change is really impactful because you are not having to address large scale changes of the 3 D’s as we previously mentioned. If you know what we preach at The Sunscreen Company ™, then you also know that the quality of your sunscreen and the fact that you apply it daily is the most important. For us that means a highly protective sunscreen against UVA rays that uses 20-25% zinc oxide.  When you do start to see a lot of the 3D’s though, there is nothing like the procedures and interventions that we can do in a physician’s office to effect change.  Micro injectables (and some fillers) can still make a big impact, especially if done early on.  Certain light-based procedures like Foto-Facials (otherwise known as BBL treatments) if done regularly can have a compound effect where eventually you are seeing something like up to 50% or more improvement.  When we start to do more ‘penetrating’ treatments where we are actually drilling small targeted wounds into the skin like with the Fraxel, you can see improvements of up to 70% of the 3D’s and even things like acne scars.  Finally, fully ablative lasers are like erasers for the skin.  We are literally taking off or removing layers of skin giving you a new skin.  There is a lot of wound care involved and your physician needs to have expert knowledge in how best to do this and manage any  complications, although infrequent with the right expertise.  When done properly, you are resetting the skin and the face’s appearance by up to 20 years. I’ve always said that after the age of 40, it’s all about maintenance.

I do caution people when it comes to getting injectables while we are in the midst of vaccination roll-outs.  Vaccinations take priority- full stop.  Ideally, you want time between when you’re going to get your vaccine and any facial injectables.  Vaccines are designed to stimulate your body’s immune response.  For injectables, you want your body to be in a receiving or responsive mode and not ‘fight’ against the injectable so it settles and softens nicely.  I even used to caution people against getting the flu vaccine too close in terms of time to their facial injections.  If it happens that you’ve gotten injectables and then by surprise gotten called up to receive your vaccine, the take-away is to not panic.  The risk is relatively low for adverse effects.  If you have a choice though, the conservative and prudent approach would be to defer your injectable and get your vaccine. Not vice-versa!

For the short-term future, I think we are going to see a surge of people either returning to the full gamut of in-office procedures or even dipping their toe in if they had never done so pre-pandemic.  People are going to feel a little giddy or exuberant and want to celebrate a return to some normalcy.  I’ve seen in the past as part of my normal practice that people turn to these types of self-care as a form of consolation in times of grief.  It’s a physical way to feel like you are starting over or releasing emotional pain.  I think we’re starting to see the ways that people are going to prioritize their physical appearance with little things like wearing lipstick again or colouring their hair, getting their nails done.  The hope is we’re going to start seeing each other again and being with friends and family - we are going to want to start to feel like our ‘old’ selves.  I always tell people to go slow and not to go over-board.  Ultimately we are not looking to change the face that you were born with or conform to some cookie-cutter idea of beauty.  Love the face you have and find a professional to help you care for it.