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All Posts in Category: Health Basics

An Aesthetic Provider’s Guide to Identifying the Brown Spots You WANT to Treat: SKs!

Learn How to Identify, Treat, and Become Profitable When Addressing SKs

A board-certified dermatologist is a medical doctor who specializes in the diagnosis and medical and cosmetic treatment of skin, hair and nail conditions. However, many of the same patients who visit Dermatologists are the same patients that walk through the doors of a medical spa or plastic surgery practice. As an aesthetic medical provider, especially one who treats other skin conditions or offers cosmetic procedures, it’s critical to know the difference between Seborrheic Keratoses (SKs, raised brown spots or age spots) and potentially harmful skin conditions. With nearly 80% of the patients who walk through your door affected by SKs, it’s also an exciting opportunity to offer a new treatment which can reduce or remove the appearance of brown spots or age spots.


SKs are common, benign skin growths that can occur anywhere on the body. Although anyone can develop SKs, they’re typically more prevalent with age. SKs, more commonly known as raised brown spots or ‘age spots’, can vary in size, appearance and coloration although they tend to have a waxy, stuck-on-the-skin appearance. SKs may also look like other common skin growths including warts, actinic keratoses (which are generally dry and/or scaly growths and can become harmful), moles, and of course, melanoma. If you have any question as to whether a spot is an SK or another type of skin condition, it’s always recommended that you send your patient to a board-certified dermatologist.1


SKs typically occur in middle age or later and may appear in anyone (or any skin type) at any time. They’re most commonly found on the chest, back, scalp, face and neck although they can appear almost anywhere on the body, with the exception of the palms of the hands and the soles of the feet.1  


The number of SKs found on a patient tends to increase with age, but the exact cause of SKs is unknown.1


In a recent study, 73% of participants said they were mostly or slightly bothered by the appearance of SKs around their face, neck or hairline2. With this becoming a more popular (or widely-discussed) skin condition, many patients look to remove their visible or irritated SKs. In-office options for removing SKs include cryotherapy (freezing), electrosurgery or curettage (electric currents or scraping), topical treatments (hydrogen peroxide), and laser treatments, all of which have the risk of scarring and/or infection.1


Until very recently, providers have not had access to a painless topical solution that has proven to successfully clear SKs. ESKATA, developed by Aclaris, is the first and only FDA-approved topical treatment indicated for SKs. With fewer side effects and better outcomes, it is quickly becoming a popular treatment not only in Dermatology practices, but in other types of aesthetic medical facilities.  As ESKATA can be administered by both physicians and mid-level providers, it offers a unique opportunity to provide a solution to a large portion of aesthetic patients with a 2:1 return (better than injectables).

To learn more about the clinical and financial benefits of using ESKATA, please contact us at or visit us here. Members receive a 15% quarterly rebate on ESKATA purchases.  

Reference 1: American Academy of Dermatology. Seborrheic Keratoses. 2018
Reference: 2. Data on file. Aclaris Therapeutics, Inc. 2018.

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vaginal laxity

Vaginal Laxity. The Frequent Problem That’s Infrequently Addressed.

This past month we recently launched a partnership with the newest device to enter the women’s health space in the USA.  Although the efficacy of several women’s health devices is debatable at best, the most important aspect of these technologies lies in what manufacturers claim to treat vs. what they actually treat.

We’ve done extensive research into what the most common concerns are regarding women’s health and statistics show that vaginal laxity, post-childbirth, appears to be the most frequent, yet “under-addressed” issue that women have today.  As many patients won’t discuss or more than likely can’t define vaginal laxity and related symptoms, we felt it was relevant to pull an excerpt from a well-written article about vaginal laxity.

Although the basis for this article is set in explaining why pelvic physiotherapy can be a great treatment addition to mitigate the effects of vaginal laxity related to child birth, it acts as a great tool to describe the symptoms of vaginal laxity and why advanced technologies may be even better options for patients seeking improvement.

Vaginal Laxity and Childbirth: Is a “Loose Vagina” Common? Treatable?

Following childbirth new mothers can feel distressed about the changes they see in their bodies. The majority of these changes go away naturally, but some changes can persist. One commonly held belief is that childbirth permanently stretches and thereby “loosens” the vagina. Is a “loose vagina” a common consequence of childbirth, and if so, is it treatable?

In this blog post Lindsay, with the help of our Pelvic Physiotherapist Katie, discusses vaginal laxity following childbirth: its prevalence, causes, risk factors, and treatment options.

Can vaginal birth really cause a “loose vagina”?

For some women the answer appears to be yes. Vaginal delivery can result in persistent feelings of vaginal laxity. This laxity can reduce vaginal sensation during intercourse and diminish sexual satisfaction of both partners, which can in turn lead to decreased sexual self-esteem and a drop in sexual intimacy.

How common is this complaint in mothers?

Vaginal looseness is a subjective and self-reported sexual health concern. There are no objective measures of it, and so there are few good statistics on the prevalence of vaginal laxity following vaginal childbirth.

When it is investigated, vaginal laxity is typically lumped in with other female sexual dysfunctions. One recent Australian study of FIRST-TIME mothers found that some form of female sexual dysfunction was reported in 58% of mothers ONE YEAR after childbirth (ref 1). The main complaints included insufficient lubrication, abnormal vaginal sensation, vaginal laxity, vaginal tightness, pain with intercourse and incontinence during intercourse.

An earlier (but perhaps less reliable) survey of 25 to 45-year-old women with at least one vaginal birth, reported that approximately half of women expressed concern over vaginal looseness (ref 2). It has also been reported to be the most common physical concern discussed with OBGYNs after vaginal childbirth (ref 3).

So vaginal looseness appears to be a rather common complaint, or at the very least, a meaningful concern for many women following vaginal birth.

How could vaginal birth cause vaginal “looseness”? Am I at risk?

The walls of the vagina contain an elastic muscle that is normally folded up, holding the vagina closed tightly. During sexual arousal and childbirth hormones cause the muscle to relax. The vagina is designed to be able to relax and re-tighten repeatedly, without any loss of tone or tissue elasticity.  Accordingly, regular sexual activity does not loosen the vagina. But there are limits to the elasticity of this muscle and associated tissues, and a few risk factors are known to contribute to chronic feelings of vaginal looseness.

Risk factors that contribute to vaginal laxity:

  1. Age. Vaginal laxity can occur naturally with aging in some women, the result of a gradual weakening and atrophy of the vaginal muscles and tissues over time.
  2. Multiple vaginal births. Evidence suggests that having multiple vaginal deliveries can increase the chance of vaginal fatigue and incomplete recovery of pre-pregnancy vaginal tightness.
  3. Trauma during vaginal childbirth or other event. This category includes damage to muscles of the pelvic floor which surround and help maintain the position and shape of the vagina. Varying degrees of musculoskeletal trauma occur commonly with vaginal delivery, and so this is likely to be a common occurrence.

So in broad terms, a young mother with an uncomplicated vaginal delivery will usually fully recover vaginal tightness within the first 6 months of having her first child. Whereas women having children later in life, having multiple vaginal births, or having more significant injury during childbirth, are at a greater risk of experiencing chronic vaginal laxity that lasts beyond the first 6-12 months.

Are there other options for treating vaginal laxity besides physiotherapy?

Surgery for vaginal tightening

Reconstructive surgery can be used to shorten and/or change the shape of the muscles and tissues around the vagina, and fat transplantation can be used to increase the fullness of the tissue. These and other surgical approaches can be very effective at increasing vaginal tightness in patients. However, surgery is invasive, and has associated risks including the potential for nerve damage and loss of vaginal sensitivity.

Surgical approaches are typically only recommended for patients with vaginal laxity that appears unresponsive to pelvic physiotherapy. If you are considering surgery, please discuss your candidacy and your options with your family doctor.

Creams, pills and ointments for vaginal tightening

There does not appear to be any creams, pills or ointments with actual clinical data to back up their claims of improving vaginal tightness.

Non-prescription creams and pills are not medical products, and are not held to the same regulatory or efficacy standards as actual medical treatments. The claims made on such bottles often have no clinical data to support them. Nor are there any compelling reasons to believe that these products would work, especially as a long term solution for vaginal laxity.

Some of these products may also pose a safety concern, causing vaginal irritation, infection, and allergic reaction. In general, I would say that these products should be avoided. If you feel compelled by the claims made by the manufacturers of these products, please discuss them with your family doctor before trying them out.

Radiofrequency thermal therapy for vaginal tightening

Another product on the market directed towards vaginal tightening is radiofreqency thermal therapy. This is basically a device that can warm the vaginal tissue without burning the surface of the skin. The idea behind this product is that local heating of the tissue will stimulate collagen formation in the vaginal tissue and thereby re-tighten the tissue at the opening of the vagina. The commercial leader in this space appears to be the Geneveve product by Viveve.

Join the educational webinar on March 23rd, “New Treatments in Sexual Dysfunction and Vaginal Laxity”

Click here for the full original article.

References from the original article:

  1. Durnea C.M., Khashan A.S., Kenny L.C., Tabirca S.S., O’Reilly B.A. The role of prepregnancy pelvic floor dysfunction in postnatal pelvic morbidity in primiparous women. Int Urogynecol J. 2014;25:1363–74.
  2. Millheiser L., Kingsberg S., Pauls R. A cross-sectional survey to assess the prevalence and symptoms associated with laxity of the vaginal introitus [abstract 206]. Presented at: ICS Annual Meeting; Toronto, Ontario, Canada. August 23-27, 2010.
  3. Pauls R.N., Fellner A.N., Davila G.W. Vaginal laxity: a poorly understood quality of life problem; a survey of physician members of the International Urogynecological Association (IUGA). Int Urogynecol J. 2012;23:1435–1448.
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