Rosacea

This bothersome skin condition is characterized by areas of redness that typically appear on the forehead, cheeks, nose, or chin. Rosacea may get progressively more severe, eventually manifesting as small bumps or a permanent rough texture. Patients experience some or all aspects of this condition which can include easy flushing, papules or pustules, small vessels or capillaries or less commonly rhinophyma (the red bulbous nose associated with W.C Fields).

While the cause of rosacea is not definitively understood, certain factors can increase your risk. These include:

• A family history of rosacea
• Long-term, unprotected sun exposure
• Light-colored skin
• Diet

At your appointment, Dr. Wismer will take a detailed history to see if trigger factors or current products can be identified. There have been many promising advances in the treatment of Rosacea in recent years. Dr. Wismer will help you determine which is best for your condition based upon the presentation. Depending on the severity of your rosacea and the underlying conditions that may be contributing to it, Dr. Wismer may recommend topical or oral medications, or intense pulsed light.

Acne

If you are struggling with acne, you should know you are not alone; it is one of the most frequent conditions seen by doctors. We use the term acne to refer to black heads, white heads, pimples and more troublesome cysts and it occurs when hair follicles become clogged with sebum, dirt and dead skin cells. Almost everyone will experience acne at some point in their lives, most often during puberty though adults do experience outbreaks. We recognize that the emotional and psychological impact of acne can be devastating, impacting self-confidence, causing poor body image and resulting in depression. We treat the full patient, not just the symptoms and never minimize the impact of this condition.

Acne is characterized as mild, moderate and severe. While mild cases will typically self-limit, moderate to severe acne if untreated can result in scarring. Early intervention is considered the best way to prevent long term scars. A number of factors can cause flare ups, including cosmetics, sweat, medications, hormones or irritating existing pimples by squeezing or over washing. There are studies referring to diet as a potential culprit, including high glycemic foods and low fat dairy. 

Dr. Wismer will discuss with you the factors that are influencing your skin and devise a treatment plan that may include oral and or topical medications, or potentially intense pulsed light, or red light therapy.

Skin Cancer

Dr. Wismer offers screening, diagnosis, and treatment of skin cancers, including basal cell carcinoma, squamous cell carcinoma, and melanoma. Patients trust Dr. Wismer’s careful attention to diagnosis and treatment.

A detailed examination is taken which includes dermoscopy (a non-invasive skin examination using a high level magnifier) and digital photography. Dr. Wismer has the experience and ability to detect and diagnosis very early melanomas which can be life-saving. She is also a strong proponent of patient education and self-examination. Dr. Wismer recommends conducting a self-check of your body once monthly to monitor new or changing moles, freckles, or lesions. Do not neglect areas such as your scalp, soles of your feet, and backs of your legs. If you notice a new lesion or a lesion that appears to be changing, please see your family physician for referral.

According to Health Canada, one-third of new cancer diagnoses each year in our country are skin cancer. Tanning bed use, multiple sunburns, chronic outdoor tanning exposure, skin type and family history all contribute to increase life time risk. By taking simple precautions to protect yourself from excessive sun exposure and seeking care if you notice any changes, you can do your part to minimize your risk of invasive skin cancer.

Psoriasis

There have been exciting and important advances in the understanding of and treatment of psoriasis in recent years. Patients no longer need to accept partial or insufficient treatment of this disease. We now understand the pathways involving the immune system which may cause psoriasis and in past years a number of new biologic agents have been indicated for use.

Dr. Wismer can also help to explain other conditions which have known associations with psoriasis including psoriatic arthritis, heart disease, and even depression and obesity. She can help you to understand the importance of lifestyle factors such as diet and exercise known to benefit treatment outcomes. While plaque psoriasis is the most common form of this condition, accounting for about 90% of cases, Dr. Wismer offers treatment for less-common variations, including inverse psoriasis and guttate psoriasis. Topical, oral, or light-based therapies – or a combination of these – are typically the preferred treatment options for psoriasis. Injectable or oral medications are indicated for more severe forms of psoriasis. These medications include the newer biologic therapies, or older therapies such as methotrexate or acetretin.

Atopic Dermatitis

Commonly known as eczema, atopic dermatitis often shows up in infancy but can develop or worsen at any age. It typically presents as a red, itchy rash that can cause great discomfort and distress. It is most characteristically found on the face and neck, hands, and in skin folds. Although we know that atopic dermatitis is influenced by environment and heredity, there is a growing understanding of the abnormal immune and barrier function of the skin in patients with Atopic Dermatitis.    Management includes proper education of factors that may worsen atopic dermatitis such as stress, sweat, clothing irritation and use of every-day products which may be causing a secondary reaction. If indicated, patch testing can help to identify agents that may be triggering an allergic contact dermatitis. Topical prescription creams of corticosteroids, and calcineurin inhibitors are beneficial, as is narrow-band UVB light therapy. Daily moisturizing is a key part of management. Severe atopic patients may be prescribed oral agents such as cyclosporine or methotrexate. Coming soon, in Canada, is the awaited approval of a new biologic therapy (Dupilumab) indicated for this condition.