Under The Skin
With a childhood defined by a very bad case of acne, world-renowned cosmetic dermatologist Michael Gold understands the misery that can be brought about by skin conditions. Now he works to help others feel better about themselves.
“I can reverse the aging process. I can fix scars and imperfections. I can make people look happy.” World-renowned cosmetic dermatologist Michael Gold does not mince his words.
He has a good reason for his faith in the powers of cosmetic dermatology. In his entire 25-year career, Dr Gold says, he has encountered only two patients with cases of acne worse than what he himself endured as a child. The condition defined his childhood. But he still remembers the day a dermatologist took him into a back room and offered him two jars of treatment he had developed. “That day changed my life.”
Today, Dr Gold is one of the world’s foremost experts on dermatology and aesthetic skincare, and the founder of the Gold Skincare Centre in Nashville, Tennessee. He is a Clinical Assistant Professor at Vanderbilt University, and has published over 300 scientific articles and 15 text book chapters, as well as playing an integral role in the development of new medical devices and cosmetic technologies.
When I catch up with him at Persona Med-Aesthetic Centre in Ta’ Xbiex, he is in Malta for the first congress of the Dermatology and Aesthetic Surgery International League, of which Dr Gold is president, and which brings together 200 delegates from 35 countries, with presentations by some of the world’s leading authorities.
Despite his high-profile, Dr Gold remains first and foremost a skin doctor. The job requires him to be a Jack of all trades, incorporating medicine, surgery, and pathology. “If a patient comes to me with a rash, that could be the sign of a liver disease, or some other wider problem and I need to be able to recognize that.”
His work comprises two different aspects: medical and cosmetic. The cosmetic aspect, he says with a laugh, is definitely the more enjoyable, but he firmly believes that the two are not entirely distinct. “If you look bad, you’re going to feel bad, and that’s going to impact your health. When we change the way people look, we can change their psyche.”
The demand for cosmetic procedures has exploded in recent years. A new report by iData Research suggests that by 2017, the market for cosmetic surgery, facial aesthetics and medical lasers will have doubled in size, exceeding $3 billion. And the stigma that once surrounded the issue is all but gone: a result of increased standards and affordability, as well as the prevalence of celebrity culture. Add to that the effect of an aging population, and Dr Gold is not at all surprised. “In the 1950s and 60s, people lived to be 70. Now we live to 80 or 90. My mother is 85 and still takes cosmetics, because she doesn’t want to look 85. And people who are 30 or 40 don’t want to look 30 or 40.”
But there is a dark side to the increasing normalization, Dr Gold regularly encounters what he calls ‘cosmetic junkies’, people who become addicted to cosmetic procedures and begin to seek them out irresponsibly. In these cases, he says, doctors have a duty to just say “no”. “There is an extreme, and you don’t and to cross that point.”
Dr Gold, in fact, has set himself strict limits as to what he will and will not do. His approach hinges on keeping a natural look, “I don’t want people to come up to you and ask what you’ve had done. I want you to look the best you possibly can, but the work I do should be invisible.”
In the world of modern cosmetic dermatology, the old stereotype of a plastic surgeon unscrupulously chopping and changing couldn’t be further from the truth, “Today procedures are becoming a lot less invasive; as doctors, we reach for the scalpel less and less”, he says. “Just by taking care of the skin we can knock years off. I can show you pictures of people at 40 and then the same people at 50 after 10 years of light procedures, and they actually look younger.”
Lasers and light treatments can today be tailored to tackle a wide variety of common complaints, from red spots and brown spots to scars and tattoo removal, and opening up a world of possibilities. Resurfacing lasers, for example, allow cosmetic dermatologists to remove the skin in little pieces, making healing faster, safer, and more complete that if whole chunks had to be removed surgically, as in the past.
The most popular procedures, meanwhile, are those utilizing toxins such as Botox and Bocouture and fillers such as Restylane and Juvederm. Toxins are used to relax the muscles, for example reducing frown-lines by relaxing the muscles responsible. Fillers, on the other hand, can reduce lines and wrinkles, as well as tackling defects of volume which occur as the skin ages and loses plumpness.
But for all these advanced techniques, it is sometimes the simplest that can be most effective. “You can do every procedure in the book, but if you don’t take proper care of your skin, you’re wasting your time,” says Dr Gold.
Even something as simple as sun-block can do a world of good, and not just cosmetically. Dr Gold tells me that although awareness is increasing, he is amazed at how many people don’t realize the importance of sun-block in a climate as sunny as Malta’s. “Telling a 30-year-old they have a melanoma with a 5 percent survival rate is no fun. If you don’t take care of your skin, you increase the risk of skin cancer.” Today, there is a whole range of next-generation skincare products available on the market, with new active ingredients and innovative ways of delivering those ingredients to the skin.
The world of cosmetic dermatology continues to revolve and Dr Gold is at the forefront of that evolution. “I sometimes say that dermatologists are the most fortunate group of doctors. The patients we encounter are usually not that sick and we can make a big difference in their lives.” It is the chance to make that difference that keeps him going, whether it’s an 85-year-old woman dreaming of younger days, or a little boy with a bad case of acne.
Dr Gold was in Malta for the first annual congress if DASIL (Dermatological and Aesthetic Surgery International League), of which he is president. Live workshops in liposuction, Smartlipo, vein therapy, Botox and fillers was held at Persona med-Aesthetic Centre in Ta’ Xbiex.