Dermatology has a sexy reputation — skin-smoothing lasers, cheek-chisling microcurrents, et cetera. But it was inflammatory conditions, not sex appeal, that drew board-certified dermatologist Dr. Brenda LaTowsky to the field. “My dad is a farmer, and he has severe psoriasis and psoriatic arthritis,” she shares, tucking a strand of sunshine-hued hair behind her ear. “That’s what made me interested in the field.”
The doctor and I met at a large dermatological convention in Chicago; as we chat, we’re sitting on the outskirts of a noisy exhibit hall. Dr. LaTowsky’s voice is yoga-teacher-calm, and among the raucous chatter, it seems pleasantly out of place. Perhaps her demeanor is a product of mothering three young children while simultaneously cultivating not one, but two successful dermatological practices in Arizona. Such success can’t have been easy — but in a way, her fate seems to have sprouted from a deep seated understanding.
As a child, the Nebraska native understood how skin conditions could affect the entirety of a person; in her father’s case, right down to their livelihood. “[My dad] had to retire from farming because of his severe psoriatic arthritis,” she says. Today, the mother of three practices in Scottsdale, Arizona, where she treats patients affected by psoriasis and other inflammatory conditions.
Oftentimes, treating these conditions crosses into the glitzier side of dermatology — lasers, lights, gadgets. Of course, medical and aesthetic dermatology are not mutually exclusive. In fact, Dr. LaTowsky reckons most of her work these days is aesthetic-only treatments. In addition to treating the visible manifestations of inflammatory skin conditions, like redness, she uses lasers to revive skin that’s speckled with dark spots and/or laden with fine lines.
Below, Dr. LaTowsky shares her favorite procedures to perform; plus, the man of “humble beginnings” who inspires her, and why she’s always up for an adventure.
Spotlyte: Your father’s condition made you acutely aware of psoriasis from a young age. Did you also always know you wanted to become a doctor, specifically a dermatologist?
Dr. Brenda LaTowsky: When I started college, I got really interested in biochemistry, and I was doing lab research and really enjoying that. [Initially], I actually thought that I would become a genetics counselor [advising families and individuals at risk of disease]. But, I ended up enjoying the human aspect of medicine and how it makes a direct impact on someone's life. So, I was able to become a physician and do the research part of it, but also interact a lot more with people.
Spotlyte: Were there any moments where you questioned your decision to pursue medicine?
BL: Giving up was never really an option for me. I never really had a plan B where I was thinking, "Oh, if this doesn't work out, I'll do something else." I have always known in my heart that it was the right thing for me.
Spotlyte: Did you ever have a mentor in your life? Either in dermatology or otherwise?
BL: If I had a mentor, I would say it would be my grandfather. He had very humble beginnings. His dad committed suicide when he was very young, and he dropped out of high school and became the man of the family. He farmed for many years — and then, eventually, he became very successful in business. His story helped me realize that anything is possible.
Spotlyte: You mentioned that your father was affected by psoriatic arthritis. Do you treat many patients who have similar conditions?
BL: I definitely do. I also do research on psoriasis and psoriatic arthritis.
Spotlyte: What is the biggest misconception about these conditions?
BL: One of the biggest misconceptions is that the conditions are only skin deep. [In reality], these conditions can really affect the whole patient — not just their skin — from their internal organs to their overall feeling of well-being to their psyche. It’s important to treat the patients to improve all of that.
Spotlyte: You’ve studied rosacea, too. What do you wish more people knew about the condition?
BL: Rosacea is a very challenging condition. It definitely has a hereditary component to it, but it is also environmental. There are several different types of rosacea, but the most common type is one that makes [areas of] the face red. It [can] get worse over time and worse with sun exposure. I see a lot of rosacea in Arizona, mainly because of the sun.
Spotlyte: Do you find that rosacea is largely misunderstood?
BL: Absolutely. A lot of patients come in and tell me they don't like the redness in their faces — and they don't even know they have rosacea. [Since they don’t know they have it], they may not be aware of the triggers, which can make it get worse a lot faster. So I would love there to be more knowledge about rosacea out there. Treating rosacea is very rewarding, because it can help people feel better about themselves and more confident.
Spotlyte: Switching gears a little bit: How much of your work is aesthetic dermatology? Do you do a lot of injectables, lasers, and other treatments?
BL: I do. I would say the majority of my work now is [aesthetic] dermatology. Medical dermatology is still very important to me, but I also have a really, really deep love for aesthetics.
Spotlyte: What's your favorite procedure to perform?
BL: At this point in my career, I love doing almost everything. I do a lot of injectables — so I do fillers and a lot of [injectable wrinkle reducers]. I also do a lot of lasers, especially for acne and rosacea.
Injectable wrinkle reducers temporarily smooth the look of moderate to severe wrinkles in certain areas of the face, including the forehead, frown lines, and crow’s feet; they should not be used more frequently than every three months. Injectable filler is a temporary treatment that adds volume to areas of the face such as the lips, cheeks, and laugh lines. Like any medical treatment, both injectable wrinkle reducers and injectable fillers have potential risks and side effects. Talk to a licensed provider to see if they’re right for you.
Spotlyte: What is your favorite laser for rosacea?
BL: I use a laser called a pulsed dye laser in my practice. It specifically focuses on the red component of [skin] conditions, which means it works really well for rosacea.
Spotlyte: What are the mechanisms behind the pulsed dye laser?
BL: It uses a narrow wavelength of light to go into the skin. And that narrow wavelength of light is selectively absorbed by the blood in the blood vessels. When the light is absorbed, it turns into heat. The heat heats the blood vessels; the hope is that the blood vessels clamp closed, or at least become much smaller. [When the blood vessels are shrunken], the face becomes less red, and patients are less prone to flushing or blushing.
Spotlyte: It’s interesting that heat can oftentimes cause rosacea to flare up — yet in the case of this laser, heat is beneficial.
BL: An aggressive setting can actually flare a patient's rosacea. [The key is that the laser is] targeted and sent in a controlled fashion. So, knowing the proper settings to use is part of the skill set you need to have to treat a patient.
Spotlyte: How do you maintain a work-life balance?
BL: That's a very good question. I'm not sure it exists. But I like to think of it as just kind of something that I'm always working toward. I have a wonderful husband and three kids. My kids are five, seven, and nine. They're really fun. I try to spend as much time with my family as possible. We love traveling. We love adventures, so we're always trying to come up with a neat new adventure, and learn by traveling, and learn by doing things.
Spotlyte: Any recent adventures that are forever emblazoned in your memory?
BL: I have a staff member who got into an accelerated nursing program in Manchester, New Hampshire. I practice in Scottsdale, so my kids and I decided to visit him. We took another staff member and her boyfriend along with us. That was definitely an adventure.