By Anjum Choudhry Nayyar
For women, looking good is always part of their daily routine, that’s not news. What is news to some South Asian women is that our skin has special needs and may need specialized treatment when it comes to many medical skin issues. According to Dr. Davindra Singh, an award-winning dermatologist specializing in ethnic dermatology, many skin conditions present themselves differently in ethnic skin.
“When you look at different ethnicities, there are different structural changes in the skin and hair,” said Singh. “Acne presents itself differently in people with ethnic skin. The darker you are, the more likely it is that the acne appears as non-inflammatory lesions which then end up leaving dark marks. So, most people that are darker or Indian will complain of the dark marks that are left behind. They call it scarring but it’s not scarring it’s just hyperpigmentation.”
Dr. Singh’s says that most people believe that darker skin is more resilient than its Caucasian counterpart; however nothing could be farther from the truth.
“From a medical perspective, things are just different when you have to diagnose or treat dermatology conditions in ethnic skin. They appear differently , they have to be treated differently, and there are more risks to treatment especially with cosmetic procedures.”
That’s where the “ethnic dermatology” specialization comes in. As a practicing dermatologist, Singh observed two voids in dermatology care that hit particularly close to home. Firstly, it was evident that Toronto, the most multicultural and ethnically diverse city in the world, was not well equipped to handle the dermatological needs of patients with ethnic skin. Secondly, access to dermatologists was limited and waiting times were exceedingly long, especially in areas just outside the Toronto core. He opened AvantDerm in Toronto to effectively fill these voids. AvantDerm is home to Canada’s first ethnic dermatology centre and Rapid Access Clinic, in addition to offering medical and cosmetic dermatology services.
“I’m getting a lot of referrals for laser hair removal. Laser treatment is like shining a flashlight on your skin that targets one of three things: blood, water or pigment. If you had blood vessels causing the problem, you target blood. If you wanted to tighten the skin you would target water which is in collagen.”
“The ideal person would be someone with fair skin and dark hair, so that when you shine the laser on the skin it would target the pigment in the hair, heat it up and destroy the hair follicle resulting in reduced hair growth,” said Singh. “The problem with people that have pigmented skin is that you can mistakenly target the pigment in the skin before the laser reaches the pigment in the hair follicle. This could result in heating of the skin, leading to blistering or burns. This is why a lot people are turned away from laser hair removal treatment or if they’re not turned away, they end up being treated with the wrong machines or the wrong settings. The machines that we have can penetrate deep to the hair follicle and we prevent burning by cooling the top layer of the skin.”
Dr. Singh’s medical career began in the small, rural, Northern Ontario town of Iroquois Falls. He spent eight years practising as a family physician, emergency physician, and sole physician of a nursing home. He spent his final years there as Chief of Staff. Dr. Singh decided to pursue his passion and returned to the University of Toronto to complete a residency in dermatology. While doing so, he continued to dedicate time to his patients in Northern Ontario, providing care until a replacement could be found.
To gain further knowledge and skill in managing patients of different ethnicities, Singh spent several months in India and various multicultural cities in the United States, including Howard University in Washington, DC. He worked with world-renowned experts in order to comfortably bring proven techniques and equipment back to Canada.
He points out that part of the problem is that most research and textbooks on dermatology focus predominantly on lighter skin.
“The textbooks most dermatology residents learn from show white people and most of the skin conditions look red. However, if you start looking at black or brown people then all of a sudden the skin with these medical conditions starts to look purple.”
“Eczema is good example of a skin condition where symptoms often appear very purple in ethnic skin,” said Singh. “I would look at conditions like that initially and think they might be cancerous and so I would biopsy them a lot.”
For patients looking to visit with a dermatologist, AvantDerm is the first clinic of its kind in Canada to offer a Rapid Access Clinic (RAC), which offers a unique service that combines the immediate access of a walk-in clinic with specialty care by a team of fully-qualified dermatologists.
“I’ve opened a rapid access clinic and it allows me to see a patient the next day after a referral from their family doctor. There’s such a shortage of dermatologists and the waiting lists are long. We can now treat every skin type safely in a timely manner.”
Award-winning dermatologist, Dr. Davindra Singh, was born and raised in the quiet city of Peterborough, Ontario. He possesses a wealth of experience based on almost fifteen years as a practising physician and he has always been dedicated to providing medical care to patients in under-serviced communities.
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