Acne & Acne Scarring

Acne is the most common life long skin disorder affecting all ages and ethnicities. Acne ranges from severe cystic acne involving multiple areas on the body (face, chest, back) to milder non cystic acne involving only the face. But, no matter the severity or the regions affected, acne can have profound impact on things like self esteem. As a rule of thumb, severe cystic acne (often in young men) needs to be aggressively treated medically usually with isotretinoin ( very strong form of vitamin A) Milder acne can be treated with either topical or oral antibiotics with good results. Often a recommended skin care plan is also recommended to avoid products which might clog pores and worsen acne. The key to success is to treat the entire face early and to be consistent with treatment.

Acne Scarring

Acne scarring can be softened with a few options. As long as the acne is not active, using a dermal roller of at least 0.02 length plus vitamin A and Vitamin C can soften the scars. Deeper scars might require laser treatments. Ice pick scarring is the hardest to address. I would be very happy to discuss which option might be the best option for your skin! Book an appointment with the “book now” button and ask for a skin care consult. This is covered service under the MSP plan and so is no cost to you.

>> Treatments

I am happy to chat about which options would work best for your skin—this might be topical antibiotics, oral antibiotics, or other skin care products. We are also proud to offer Rodan and Fields Spotless (for those under 21) and Unblemish (for those over 21). Dr Rodan and Dr Fields are Stanford trained dermatologists who developed Proactiv for the treatment of acne. All Rodan and Fields products offer a 60 day empty container guarantee if you are not happy with the results.

Fine Lines & Wrinkles

Did you know that 80% of the factors that age your skin are preventable? Sun exposure, smoking, polluted environments, use of sun beds, etc. all prematurely age the skin. Only 20% is genetic. Erasing the marks of time is both a skill and an art. At SIMA, we specialize in facial and neck rejuvenation. We would love to chat with you about which options would be the best choice for you. We take into account your budget and your lifestyle. Make an appointment to chat with us about whether the best option is physician designed skin care products, or botox, or fillers, or a combination. We are also happy to chat about laser and other light therapies and how these might fit into your treatment plans.

Brown Spots & Pigmentation

Dark spots on the skin can arise from sun exposure or diseases such as melasma or chloasma (pregnant mask). The vast majority of dark spots are harmless — the average person has at least several dozen spots over their body. Some spots can be moles which need to be checked carefully. As physicians, we are trained to look for and identify moles which need a biopsy done. Part of our service is educating you on what to watch for with moles. The treatments for brown spots and pigmentation can vary from physician designed skin care products to ablative options (laser and IPL). We are happy to advise you to discuss your options so you can make an educated decision on treatment.

Uneven Skin Texture

Over time, the damaging effects of the sun lead to skin irregularities such as uneven pigmentation, sun spots, brown spots, scaly patches and uneven texture. All of the above can be treated with various methods—either physician designed skin care which is tailored to your individual skin care needs or microdermabrasion (a gentle resurfacing option). We can also discuss the role of laser or of IPL/BBL as potential treatment options.

Jowls or Loose Jaw Lines

As we age, we lose collagen in our skin which leads to a softening along the jawline. There are various options to treat collagen loss. Dermal rolling stimulates collagen and over time will lead to firmer skin. We sell dermal rollers and will train you in their use and care. Other options might involve filler which can be placed in several areas to help lift jowls. And sometimes, the best option is a referral to a plastic surgeon for a face lift. We are happy to discuss the pros and cons of each option and to make recommendations individualized for each patient.

Loss of Lip Volume

The mouth area is a region that is often a cause of unhappiness for both men and women. The upper lip can develop vertical lines (these are often worse in smokers), the outer edges of the mouth can start to turn downwards, and the lips can seem to narrow and vanish. Deep lines may develop between the nose and the edges of the mouth or from the edge of the mouth downwards towards the jawline. Options for treatment of lips vary from a few units of botox in the upper lip (a lip flip) to filler placement. Botox lasts for 2 to 3 months in the lips whereas filler will last from 12 to 18 months. We always aim for a natural look. We are happy to meet with you and create a detailed individualized plan that works for your budget.

Excessive Sweating

Hypderhydrosis (excessive sweating) can occur in some patients.  This is most common in the axillae (under the arms) but can also occur in the hands and feet.  (We do not treat feet in our clinic but can refer you to a VAncouver clinic ).  It is important to rule out medical conditions that might need to be treated first (over active thryoid, drug reactions etc.).

 Botox works extremely well to eliminate sweating for a year after injection.  This is considered a medical use of botox and is tax deductible as a medical condition but is also sometimes covered by extended health.  We are happy to chat with you about this as an option. 


Rosacea is a chronic inflammatory skin disorder. Rosacea can vary from mild episodes of facial blushing or flushing to permanent red facial skin. Individuals with fair skin, particularly those of Scottish, Irish or Celtic descent, are more predisposed to rosacea, although dark-skinned individuals are not spared. Anything that causes the face to flush – sun exposure, alcohol, heat, cold weather, wind, cosmetics, exercise, spicy foods, medication – can worsen rosacea symptoms.

Treatment can vary from topical medication, physician designed skin care and light therapies.  Our doctors can discuss with you which would be the best approach for you.