Sudden and exaggerated hair loss? You may have Telogen Effluvium.

August 5th, 2017 | Conditions, Hair Transplant

Telogen Effluvium (Scalp Hair Thinning Due to a Shift in the Hair Cycle) The sudden loss of exaggerated amounts of scalp hair is quite a common complaint, particularly in women.  This shift in the hair cycle, creating a hair loss pattern called “telogen effluvium”, usually occurs suddenly.  This is not associated with isolated bald patches of the scalp, or with excessive crusting or infections of the hair follicles.  It may “unmask” male pattern hair loss in women, revealing thinning on the top of the scalp.  In these cases, treatment is required for both problems. NORMAL HAIR CYCLE When a scalp hair begins to grow in each individual hair follicle, it remains in the “growth phase” (anagen phase) for approximately three years.  This average growth phase for the scalp hair creates hair that will grow to approximately mid-back level.  Some people have a longer growth phase and can grow their hair until they can almost stand on it, while others with a shorter cycle, can grow their hair no longer than shoulder length.  This is an individual genetic variation.  After the growth people, the individual hair follicles, independent of each other, convert into a “resting phase” (telogen phase), and remain in …Read More

Crescendo at the Winspear

June 23rd, 2017 | General Info, Uncategorized

Crescendo Edmonton. Dr. Thomas and Melanie Nakatsui

Giving back to the community is so important to the members of the Groot DermaSurgery Centre! Dr. Thomas and Melanie Nakatsui support many initiatives, including the Royal Alexandra Hospital, the Edmonton Opera, McDougall House, and many others. Recently, Dr. Thomas and Melanie Nakatsui and the Groot DermaSurgery Centre were proud to have been one of the principal sponsors for Crescendo, a fantastic night of entertainment presented by the fabulous John Cameron Entertainment! It was a night in support of The Mental Health Foundation and the Royal Alexandra Hospital Foundation. Almost everyone’s lives have been touched by depression and mental health issues in some way and supporting Crescendo is one way each of us can help. If you were there, thank you, and we’re pretty sure you’ll agree with us that it was an amazing, outstanding event! For more information on the event and the important initiatives it supports, click on the links above. On a final note, as one of the speakers said, if you’re suffering from a mental health issue, “it’s okay to reach out for help…”

The Dreaded Man-breast

May 2nd, 2017 | Conditions, Treatments

You’re working out, eating well, and simply doing all of the right things.  You look in the mirror and see your abs toning up; your biceps getting bigger.  Things are going great… except, your just not satisfied with your chest because it still has some fatty deposits that make it appear like breasts.  Fatty deposits on the chest can affect many males and can be difficult to treat on your own no matter how strict you are with diet and exercise. In comes CoolSculpting, a non-invasive technology that freezes away stubborn fat.  An applicator is placed on the problem area, in this case the chest, and gently targets and cools unwanted fat cells in the selected area.  Millions of CoolSculpting Procedures have been performed worldwide with great success!  The Groot DermaSurgery Centre was one of the first clinics to offer CoolSculpting in the city! CoolSculpting can be effective in reducing the fat in the chest region of a man.  However, not all man breasts are simply fatty tissue.  A condition known as gynecomastia is when there is an excess of male breast tissue.  In this situation, CoolSculpting may not be an ideal treatment.  It is important to have a consultation …Read More

Something to be excited about!

April 19th, 2017 | General Info

Do you feel like you look sad, tired, or angry even when you’re not? If so, you are not alone. Some of the most common concerns patients have when they come into the Groot DermaSurgery Centre are that they look fatigued, upset, or depressed, even though they feel well rested, energetic, and happy. For many people, how they feel on the inside is not reflected on the outside. At the Groot DermaSurgery Centre, Dr. Nakatsui can help you understand the cause of your concerns, discuss those concerns, and help determine a game plan to revitalise your appearance.   As we age, skin elasticity is lost and the skin becomes less firm. Years of expression cause wrinkling to form around the eyes and forehead. Excess sun exposure causes changes in skin texture. The natural fat pads beneath the skin that give the face shape begin to shrink and shift, resulting in loss of fullness. Even our bone density diminishes around the cheeks, chin, and temples, resulting in a hollowed appearance. Weight loss causes areas of the face to become sunken and appear less full and youthful. All of these factors affect how we look.   Understanding these anatomical changes is important as it allows Dr. Nakatsui to …Read More

Did you know?

December 30th, 2016 | General Info, Treatments

Dr. Nakatsui Double Diamond award recipient from Allergan

Dr. Nakatsui is one of a small number of solo physician injectors to have received Diamond and Double Diamond status from Allergan, the makers of Botox and Juvederm. We are proud of having received this recognition but it is not essential to go to a Double Diamond provider to be certain you have an injector with expertise. When considering an injector, look for a practice that uses Botox and fillers every day. Ask about experience and training with Botox and fillers. Find out who your injector is–injectors are usually physicians, but can be nurses or pharmacists. At the Groot DermaSurgery Centre, Dr. Nakatsui personally performs all Botox and filler injections. Be aware that Double Diamond status can be achieved by multi-physician groups and multi-location practices where Botox is distributed to multiple physicians and injectors. Therefore, not all Silver, Gold, Platinum, Diamond, and Double Diamond providers actually use the same amount of Botox or fillers.

Dr. Donald Groot

December 21st, 2016 | Dr. Donald Groot

I, along with my associates, Dr. Linda L. Smith, Dr. Bruce Ramsey, and our staff, are deeply saddened by the passing of Dr. Don Groot, the founder of the Groot DermaSurgery Centre.  It gives us all great comfort to know that he passed away peacefully and surrounded by family. He was a mentor, a colleague, a friend, and someone who knew no bounds. His warmth, spirit, and dedication to dermatology will remain with each and every one of us. Please feel free to visit his obituary. Dr. Thomas Nakatsui Medical Director, Groot DermaSurgery Centre

What is Brilliant Distinctions?

December 2nd, 2016 | General Info

brilliant distinctions edmonton

Brilliant Distinctions is a program provided by Allergan, the company that produces Botox and Juvederm. This program allows patients to accumulate points from the use of Botox Cosmetic, Juvederm products, Belkyra, and Latisse.   Botox Cosmetic is used to treat wrinkles on the forehead, the angry lines between the eyebrows, the smile lines around the eyes, and other areas as well. Juvederm products can help bring back fullness to problem areas such as the nasolabial folds, marionette lines, cheeks, and lips that lose volume as we age or lose weight.   Belkyra is an exciting new treatment that can help reduce fat in the dreaded double chin zone and can help improve and contour your chin and jowl line. For longer and thicker eyelashes, Latisse can be used for lusher eyelashes.   Each of these treatments earn points that can be used towards the purchase of future Allergan products. For more information, please visit or

Party season is here!

December 1st, 2016 | Treatments


Ohhhh the Weather outside is frightful, but the fire is so delightful, and since we have places to go, I want my skin to look aglow look aglow! Yes!  The Merriest time of year is upon us.  Family dinners, work Christmas parties, and having friends over for the evening is all part of this festive season!  The truth of the matter is, is that we want to look our absolute best at these events.  We want to have smooth skin, amazing eyes, and a body that fits perfectly into that cocktail dress.  How we look at the end of the evening is a different story! At the Groot DermaSurgery Centre, we offer various treatments that help fine-tune and tweak the little things.  Don’t like the wrinkles around your eyes whenever you smile?  Botox Cosmetic can be used to help treat crows feet so that when you’re smiling for photos, the wrinkles around your eyes will not steal the show.  What about your skin?  You want it to be flawless in those photos.  HydraFacial MD can help cleanse the skin and reintroduce important compounds back into the skin that have to lost due to the harsh summer weather. How about the double chin …Read More

Hot Tub Blues

October 26th, 2016 | General Info


Hot Tub Itch There is nothing quite like slipping into a hot tub after a day of battling the winter elements. The positive memories of the experience can quickly fade if the event is followed by hot tub itch, medically known as pseudomonas folliculitis.  If an itchy rash consisting of elevated bumps, some pus filled, appears within 12 to 48 hours after a hot tub immersion then it is likely hot tub folliculitis. These bumps may develop into dark red, tender papules. What causes hot tub itch? A hot tub rash occurs when a bacteria known as Pseudomonas enters the pores of the skin causing an infection. Pseudomonas lives naturally and without consequence in the skin of about 15% of the population. If Pseudomonas is introduced into improperly treated and maintained hot tub water the bacteria will take up residence in it. Once this happens it is very difficult to ‘evict’ because the bacteria develops a slimy layer that protects it from recommended levels of hot tub disinfectants. Super chlorination may help to get rid of the problem but it might be necessary to drain and scrub the tub with bleach in order to ward off the infestation. The second …Read More

Fall is here!

October 6th, 2016 | Uncategorized

Portrait of beautiful girl with scarf in autumn nature

    Pumpkin spice everything, leaves falling, and sweaters everyday can only mean one thing:  Fall is here!  This beautiful and romantic time of year can also mean changes in weather and temperature which can affect your skin.  Everyday events that we take for granted, such as stronger winds, can strip away moisture from the skin.  When this moisture is stripped or there are irritants in the air, your skin can become itchy or even a rash can appear!  Here are some basic tips to help your skin retain moisture.  The following are only tips and does not replace seeing a qualified dermatologist. Shorten the time spent in showers and baths. Not only is it good for the environment to decrease the amount of water used, limiting the time spent in the shower will prevent your skin from losing its moisture barrier. Closing the bathroom door to keep moisture in the bathroom is a great way to keep your skin moist. Hot water can irritate the skin.  Try dropping the temperature to a warm setting. Use unscented soap products on your skin. Gently pat your skin dry with a towel. Immediately after drying your skin, apply a non-irritating moisturizer to …Read More

Party season is around the corner! Look your absolute best!

September 8th, 2016 | Treatments

party, drinks, holidays, christmas and people concept - smiling woman in evening dress holding cocktail over night lights and snow background

  With fall here, it can only mean one thing: Party season!  From Thanksgiving to work parties to Christmas and New Years, we have many functions coming up.  The truth of the matter is, is that we want to look our absolute best at these events.  We want to have smooth skin, amazing eyes, and a body that fits perfectly into that cocktail dress.  How we look at the end of the night is a different story! At the Groot DermaSurgery Centre, we offer various treatments that help fine-tune and tweak the little things.  Don’t like the wrinkles around your eyes whenever you smile?  Botox Cosmetic can be used to help treat crows feet so that when you’re smiling for photos, the wrinkles around your eyes will not steal the show.  What about your skin?  You want it to be flawless in those photos.  HydraFacial MD can help cleanse the skin and reintroduce important compounds back into the skin that have to lost due to the harsh summer weather. How about the double chin that is always there whenever you look back at photos?  Belkyra injections and ThermiTight can help eliminate fat and improve on the appearance of double chins!  That …Read More

Solutions for Dry Skin

August 31st, 2016 | Conditions

Dry Skin

Dry skin is particularly noticeable during the winter months due to low humidity and cold temperatures. Other contributing factors include overuse of harsh skin care products especially those containing perfumes and preservatives, aging, and yes, your grandparents (genetics).   To avoid dry skin try these options: Choose gentle cleansers that remove the superficial dirt and excess oil from your skin without stripping away all your natural oils. Gently exfoliate the skin with a gritty cleanser or for tougher jobs micro-dermabrasions. Apply a moisturizer which contains ingredients that draw moisture to the epidermis such as glycerine, urea and hyaluronic acid. Moisturizers are most effective when applied to the skin while it is damp. Apply a sunscreen daily with a sun protection factor (SPF) of 45 or more. Even though the winter sun seems harmless it’s UVA and UVB rays can still damage the skin as well as tending to exacerbate dry skin. Caution: Applying too much moisturizer to dry skin without proper cleansing may contribute to the development of seborrhoeic dermatitis, an inflammatory condition of the skin resulting in scaly, flaky, itchy, red skin. Written by Patricia Johnston

What Do You Do When Antiperspirants Don’t Work for Hyperhidrosis?

August 24th, 2016 | Conditions, Treatments


Despite the fact that sweating serves the very important function of cooling the body it is considered to be unacceptable in certain social settings. For example a sweaty palm during a handshake is often frowned upon whereas sweaty palms while exercising falls within most people’s tolerance level. Sweat marks under the armpits while dining at a restaurant is socially undesirable whereas arm pit sweat while working in intense heat would be considered understandable. For those socially awkward situations antiperspirants work for most individuals to control underarm sweating. However there is a condition known as hyperhidrosis where excessive sweating in any circumstance is a problem. The problem may be limited to the armpits, but often the palms of the hands and soles of the feet produce excessive amounts of sweat as well. Antiperspirants fail to work in individuals with hyperhidrosis. There is no cure for hyperhidrosis. The good news is that there are controls. Sweat inhibiting injections of Botox have proven to markedly reduce sweating for anywhere between 3 to 16 months (average of 6 months) after 1 or 2 treatments.  The injections have been approved by Health Canada for the treatment of excess underarm sweating. Topical applications of aluminum chloride …Read More

Eye Creams – Do They Work?

August 22nd, 2016 | General Info

Untitled design (17)

Eye Creams – Do They Work?  Knowledge is power – how is the skin around your eyes different from the rest of the skin on your face? The skin around the eyes does not differ from the skin on your face. This is a misnomer propagated by the cosmetic industry.  Aging of the skin around the eyes is caused by heredity, sun damage, muscle pull, fat loss and gravitational pull on the skin. Often wrinkles appear first around the eyes because of the dynamic movement of the muscles around the eyes and the breakdown of the building blocks of the skin due to sun damage.  Sun damage leads to wrinkles, pigment changes and vascular discoloration which contribute to the appearance of aging. It also leads to skin cancers which if left unchecked can damage the eye itself. Another little known fact about aging around the eyes is that the eyelashes become shorter and thinner. Are you wasting your money or do over the counter eye care products work? The skin around the eyes is just as susceptible to sun damage as the rest of the face therefore protecting the skin around the eyes from the sun’s rays is important. The …Read More

The Unwanted Double Chin

August 8th, 2016 | Uncategorized

belkyra treatment for double chin best non-surgical

  As we age, our skin begins to lose laxity to the point where we begin to notice areas of loose and dangling skin on areas such as our arms, abdomen, and neck.  One of the most commonly complained areas of excess skin and fat from our patients is around the chin and neck, also known as the submentum.  Because our face and neck are the most visible parts of our body that is seen the most, it can be the area that can be most bothersome, even though other areas may be affected. The typical treatments for tightening and removing excess tissue and fat around the neck and chin is a face and neck lift surgery.  This type of surgery is still the best option for overall improvement; however, many individuals do not want to go through with a surgery or cannot take the adequate time off after surgery.   In recent years, new or improved technologies and treatments have come through to help eliminate fat, or tighten the skin around the neck and chin. Belkyra is a new injectable medication that is approved for the treatment and reduction of excess fat under the chin on the upper neck.  In …Read More

Tips for Sensitive Skin!

July 30th, 2016 | Conditions

Applying moisturizer cream. Care for female legs isolated on white background

  Our skin is the largest organ we have.  It acts as a barrier between your surrounding environment and your internal organs.  Our skin is the first line of defence from the outside world and is constantly bombarded with various irritants in the environment such as dust, bacteria, and the effects of weather.  Many people suffer from sensitive skin and one of the most notable and common issues with our skin is eczema.  Eczema is inflammation of the skin usually due to dryness, irritation, and possible allergy. The ”Mayo Clinic Regime” is a guideline for sensitive skin for people suffering from eczema: YES: SOAPS – Use products that are soft and non-irritating to the skin.  This may take some trial and error to find the perfect soap for you. Use unscented laundry detergents. Wash all new clothes and linens five times before using White cotton gloves under vinyl or nitrile gloves for any activities where you anticipate your hands getting wet. Trim nails short or wear white cotton gloves full time.  Long nails are dangerous weapons to the skin.   NO: No HOT water (use lukewarm only).  Hot water can cause major irritation to the skin. No powders, rubbing alcohol, perfumes, colognes, after shave, or pre-shaves on any part of …Read More

The Art of Hair Restoration Surgery

July 7th, 2016 | Hair Transplant

Hair Transplant Grafts

The Art of Hair Restoration Surgery Hair transplant surgeries have become one of the most popular cosmetic procedures for men and a large number of women.  Much of what happens before, during, and after a hair transplant surgery is uncertain for many curious people.  Here is what the typical process for hair restoration surgeries look like from consultation to 1 year after the surgery with Dr. Nakatsui. Complimentary Comprehensive Consultation A prospective patient will come in to our clinic for a complimentary consultation with Dr. Nakatsui.  During this consultation, Dr. Nakatsui will obtain a thorough history of the individual.  When did the hair loss begin, what types of treatments they have tried in the past, and what is their family history for hair loss are among a few of the typical questions asked. Dr. Nakatsui then performs a thorough examination of the scalp to determine if there are any other medical factors that may contribute to the hair loss such as Alopecia Areata or Lichen Planopilaris.  These are conditions in which the body attacks its own hair and because of that, hair transplantation into these areas is not recommended.  Dr. Nakatsui then assesses the patient’s situation and expectations and determines if the individual is a good candidate for hair restoration surgery. Candidacy for hair restoration surgery …Read More

Hope for Ugly Toenails

June 28th, 2016 | Conditions, Treatments


Are you embarrassed to wear sandals because of your ugly toe nails – toe nails that are yellow, brittle and/or scaly? If so, it is possible that you have fungus of the toe nails (onychomycosis) – a condition that can be treated. Two options are available: medication and laser treatments. Lamisil, Soranox or Nizoral are examples of prescription anti-fungal medications that are taken by mouth for a period of 3 to 6 months. They work from the inside out (systemically) with about a 70% success rate.  A new medication to the market called Jublia  is a topical ointment that is applied directly onto the problematic nail. Lasers work from the outside in. Two treatments and the fungus is eradicated in 70% of cases. The success rate depends on how long you have had the fungus. If it has been left untreated for over a year then a combination of medication and laser treatments is usually required. If you are hiding your toes, call us at (780) 482-1414 to find out if one of these treatment options might work for you. Then go out and buy a pair of those cute little sandals that you have been coveting.

Fillers and Botox for cosmetic reasons: Truths and Misunderstandings

June 28th, 2016 | Treatments

Portrait of a young woman has a question is asking herself something. Question mark over her head.

  As we age, certain aspects of our appearance begin to bother us when we look in the mirror.  What we see in the mirror may not reflect what we feel on the inside.  The vivaciousness and energy that we carry may not be indicative of the bags under our eyes. As we age, certain aspects of our appearance begin to bother us when we look in the mirror.  What we see in the mirror may not reflect what we feel on the inside.  The vivaciousness and energy that we carry may not be indicative of the bags under our eyes. Botox cosmetic and dermal fillers such as Juvederm and Restylane have been around for many years.  They each have a specific role to play when dealing with facial rejuvenation.  Botox and fillers can often become mixed up in their perceived usage.  Many times when a celebrity with large lips is seen on TV, one of the common phrases is that she has too much Botox in her lips.  In all likelihood, that celebrity had a dermal filler treatment to enhance her lips. Botox (OnabotulinumtoxinA) is a substance that blocks localized nerve activity in the muscle.  This causes a temporary cessation of muscle movement.  …Read More

Golf, Ticks and Lyme Disease

June 8th, 2016 | General Info


The beauty of many of our Alberta golf courses is the tree lined fairways. I can attest to the fact that I have had up close and personal encounters with some of these trees while tromping through the underbrush in an attempt to find my ball. Having read an article written by Michelle Gagnon in the Rocky Mountain Outlook about Ticks and the risk of the Lyme disease I am more inclined to take the penalty strokes and leave the ball where it lies.   Lyme disease is caused by a bacterium called Borrelia burgdorferi. The bacterium is spread from small animals to humans by little biting arachnids called ticks. Ticks are like vampires – they attach to you and suck away, quite possibly and inadvertently leaving behind the bacterium called Borrelia burgdorferi. The name of the bacterium is not as important as the damage it can do if a person is unfortunate enough to be exposed to it. One of the first signs of Lyme disease is a bulls-eye rash around the site of the tick bite. Not all people get this rash so early detection may be missed. Other symptoms in the early stages are: fatigue; chills; headaches; …Read More