Expert: What I Know About … Skin
Everything there is to know about the thing that holds us all together.
Photography by Adam Goudreau
Who: Melody Cheung-Lee
Job: Dermatologist and clinical lecturer
Experience: Skin is the largest organ we have, and everything from our genetics to the environment can affect how it looks and feels. How to keep skin healthy and supple can sometimes be a mystery – that’s where Dr. Melody Cheung-Lee comes in. She’s a dermatologist and FRCPC (Fellow of the Royal College of Physicians of Canada). Cheung-Lee completed a bachelor of medical science, medical school and her dermatology residency, all at the University of Alberta. She’s currently a clinical lecturer, in addition to running her own private dermatology practice in the Westgrove Professional Building. She can keep your skin in tip-top shape, but don’t mistake her for a facialist – she doesn’t do a lot of cosmetic dermatology. Cheung-Lee focuses on medical dermatology, checking patients for skin cancer and treating rare and unusual skin conditions.
– “Many patients believe their skin condition is directly caused by allergies or reactions, especially to foods, personal-care products, or environmental elements. While true skin allergies and reactions do exist, a large portion of skin conditions have little to do with external factors. Most are a result of a complex interplay of intrinsic or host factors, like genetics, that may sometimes be triggered or worsened, but not directly caused, by what is in the environment.
– “A common myth is that acne is caused by eating greasy foods and not cleaning the skin enough. Acne is a complex condition caused by multiple factors, including genetic predisposition, hormonal stimulation, and a certain “normal skin” bacteria found within the pores of the skin, to name a few. There have been studies linking milk and milk products to acne, but it’s still controversial and more research is needed in this area.
– “Not every skin type has the ability to tan. Tanning is a result of the skin’s natural built-in mechanism to increase melanin production as a protective mechanism against damaging UV rays. Think of it as a type of built-in sunscreen system. However, it is neither immediate nor sufficient enough for complete protection in most people. UV damage caused by sun exposure still happens.
– “The three most common skin cancers are basal cell carcinoma, squamous cell carcinoma and melanoma. The former two are generally slow-growing, ‘mild’ skin cancers that usually do not spread to other distant sites and can be easily cured, for the most part. Melanoma is a potentially deadly type of skin cancer. The most common site of melanoma in women are the legs. For men, it is the back. For all three of these common skin cancers, both genetics and environmental factors play a role, particularly the sun.
– “Psoriasis is a fairly common chronic, complex condition of the skin that can affect almost any age and ethnic group. The most common form of psoriasis presents as well-demarcated red plaques covered with varying thickness of silvery-white scales, typically located on trauma-prone areas of the skin, such as the elbows, knees, knuckles and ankles. Psoriasis can involve other body parts including the joints and nails. Psoriasis is thought to be associated with inflammation of multiple other body tissues as it is associated with an increased risk of high blood pressure, heart disease and diabetes.
– “The skin can provide very valuable information to an individual’s internal health, that might not otherwise be easily diagnosable. The presence of certain skin conditions are associated with internal cancer and, in some instances, the underlying cancer may not be present until much later.
– “One of the most life-threatening and serious skin conditions in dermatology is called Toxic Epidermal Necrolysis [TEN]. The top layer of the skin and mucous membranes (eyes, mouth, genitalia) undergo extensive and generalized detachment from the lower layers of the skin. It is like a total-body burn and can be rapidly progressive. Patients must be admitted to the burn unit for intensive medical care. Thankfully, it is a rare condition. It’s the result of reactions to certain medications (the most common are certain antibiotics and anti-seizure medications), but only in predisposed individuals. There is a high mortality rate.”