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Skin Health
Your skin can tell you something is changing. Let’s find out what.
Acne, eczema, rosacea, rashes, pigmentation changes, scarring and other skin concerns can be frustrating — especially when you have already tried products, diets or treatments that did not give you the results you hoped for.
At Sage, we look at skin health in the context of the whole person while keeping the medical diagnosis and evidence-based treatment of your skin condition at the centre of care.
Your assessment may consider your symptoms, medical history, medications, skincare routine, nutrition, hormones, lifestyle and previous investigations. When appropriate, care may also involve prescription treatment, laboratory testing, nutrition support, procedures, or referral to a physician or dermatologist.
There is no single “Sage skin protocol.” The right approach depends on what is actually happening with your skin.
Skin concerns we help with
Skin problems can look similar but have very different causes and treatments. Sage can assess a range of skin-related concerns and, when appropriate, provide supportive or collaborative care.
Acne
Acne can affect teenagers and adults and may include blackheads, whiteheads, inflammatory pimples or deeper lesions. Treatment depends on the severity and type of acne and may include skincare, prescription medication, lifestyle and nutrition support, and management of contributing factors such as hormonal changes.
Acne scarring
Even after acne has cleared, scars or changes in skin texture can remain. Depending on the type of scarring, options may include skincare, medical treatment or procedures such as microneedling. Microneedling is primarily used for established acne scarring rather than active acne.
Eczema and dermatitis
Dry, itchy, inflamed or irritated skin may have several possible explanations, including atopic dermatitis, contact dermatitis or other inflammatory skin conditions. Identifying the type of skin problem matters because treatment can differ significantly.
Rosacea and facial redness
Persistent facial redness, flushing, burning, sensitivity or acne-like breakouts may be rosacea, but other skin conditions can look similar. Appropriate assessment is important before assuming that redness is simply “sensitive skin.”
Psoriasis and chronic inflammatory skin conditions
Sage can provide individualized supportive care for people living with chronic skin conditions, including attention to general health, nutrition, lifestyle and treatment-related concerns. Depending on severity and diagnosis, ongoing dermatologic care and prescription treatment may be essential.
Pigmentation and uneven skin tone
Dark spots, post-inflammatory pigmentation and changes in skin tone can occur for many reasons. Assessment can help determine whether the change is related to previous inflammation, sun exposure, hormonal factors, medications or another skin condition.
Skin texture, fine lines and other cosmetic concerns
For selected cosmetic concerns, Sage offers procedures such as microneedling and cosmetic/facial acupuncture. These services are different from medical treatment of an underlying skin disease and are considered based on your goals, skin health and suitability.
Hair and scalp concerns
Hair thinning or loss can sometimes be associated with nutritional deficiencies, hormonal changes, thyroid disorders, medications or other medical conditions. Where appropriate, assessment may include medical investigation and referral rather than assuming the problem is simply a nutritional issue.
If you have a new, rapidly changing, painful, bleeding or otherwise concerning skin lesion, you may need prompt medical or dermatologic assessment rather than a routine skin-health appointment.
Understanding what may be contributing
Your symptoms are the starting point — not the whole story.
Two people can both experience acne, itching, redness or hair loss for very different reasons.
That is why we do not believe every skin concern should be approached with the same supplements, elimination diet or testing panel.
The first step is understanding what you are experiencing and determining what information is actually useful for making decisions about your care.
For example:
That is why we do not believe every skin concern should be approached with the same supplements, elimination diet or testing panel.
The first step is understanding what you are experiencing and determining what information is actually useful for making decisions about your care.
Our approach
Individualized care, grounded in evidence
Your first appointment is an opportunity to step back and look at the bigger picture.
Depending on your concern, your practitioner may review:
- Your current skin symptoms and when they began
- Previous diagnoses and treatments
- Medications and supplements
- Skincare and cosmetic products
- Menstrual or hormonal history when relevant
- Nutrition and eating patterns
- Sleep, stress and lifestyle factors
- Allergies or relevant environmental exposures
- Previous blood work, imaging or specialist assessments
- Your goals and preferences
From there, we determine what needs to happen next.
Sometimes the answer is straightforward. Sometimes additional investigation is appropriate. And sometimes the most appropriate next step is referral to a dermatologist, family physician or another medical specialist.
That is part of good integrative care — not a failure of it.
Comprehensive care, without unnecessary testing
Testing can be useful when it answers a specific clinical question.
Depending on your symptoms and history, investigation may include:
Blood work
Blood tests may be considered when there is a reason to investigate issues such as thyroid function, iron status, nutritional deficiencies, hormonal factors or another medical contributor.
Condition-specific testing
Additional testing may sometimes be appropriate when the history suggests a specific allergy, inflammatory, infectious, hormonal or other medical concern.
Further medical investigation
Some skin concerns require diagnostic procedures or specialist assessment that are outside the scope of a naturopathic or primary-care skin-health visit. Depending on the situation, this may include dermatology assessment, skin scraping, patch testing, biopsy or other investigations.
Diagnostic imaging
Imaging is not routinely required for most skin concerns, but may be appropriate when a clinician identifies a separate medical question that requires it.
At Sage, testing should have a purpose. We do not believe in ordering expensive or specialized tests simply because they are available.
The goal is to gather the information that can actually help answer the clinical question and influence treatment.
One team. Multiple healthcare perspectives.
Skin health does not always fit neatly into one healthcare discipline.
That is one of the advantages of an integrated clinic.
Depending on your needs, care at Sage may involve:
Naturopathic medicine
Naturopathic doctors can assess your overall health and consider evidence-informed nutrition, lifestyle, botanical or other naturopathic approaches where appropriate.
Nurse practitioner care
Our nurse practitioners can provide conventional medical assessment, order and interpret diagnostic testing, prescribe medications and manage medical conditions within their scope of practice.
For some skin conditions, prescription medication is the appropriate treatment. Sage does not believe that choosing integrative care means avoiding conventional medicine.
Dietitian support
Nutrition can be relevant to some patients with skin concerns, but there is no universal “skin diet.” A registered dietitian can help determine whether nutrition changes are appropriate and develop a practical plan that does not rely on unnecessary restriction.
Lifestyle support
Sleep, stress, physical activity and other lifestyle factors may be relevant to overall health and, in some cases, to the management of skin symptoms. These factors are considered as part of the bigger picture — not as an explanation for every skin problem.
Collaboration and referral
If your concern requires dermatology, family medicine, allergy/immunology or another specialist, we can help coordinate the next step.
The goal isn’t to choose between conventional and naturopathic medicine. It’s to use the right tools for the right patient at the right time.
Meet Some of Our Practitioners
Dr. Rahima Hirji, ND
Doctor of Naturopathic Medicine
Dr. Deanna Walker, ND
Doctor of Naturopathic Medicine
Dr. Heather Robinson, ND
Doctor of Naturopathic Medicine
Dr. Emile Sabga, BSC (Hon), ND
Doctor of Naturopathic Medicine
Dominique Williams, MSW, RSW
Registered Social Worker
What might treatment look like?
Your treatment plan depends on your diagnosis, symptoms, severity, health history and goals.
Depending on the situation, treatment may include:
Evidence-based skincare recommendations
Prescription topical or oral medications when appropriate
Management of contributing medical conditions
Nutrition assessment and individualized dietary guidance
Lifestyle strategies
Selected naturopathic treatments
Targeted supplementation when there is a clear clinical rationale
Microneedling for appropriate cosmetic concerns, particularly acne scarring
Cosmetic or facial acupuncture for patients interested in these services
Collaboration with your existing physician or dermatologist
Referral for specialist assessment when needed
For example, acne treatment may involve topical retinoids, benzoyl peroxide, azelaic acid or other prescription therapies, while some patients may require oral medication. More severe or persistent acne may warrant dermatology involvement.
For eczema, treatment may include moisturization and prescription anti-inflammatory therapies, with more advanced treatments or specialist care considered for moderate-to-severe disease.
For rosacea, treatment may include trigger management, gentle skincare and prescription medications depending on the type and severity.
The important point is that treatment is not chosen because it is “natural” or because it is available at Sage. It is chosen because it makes sense for you.
What to expect at Sage
We listen.
We start with your concerns, your goals and what you have already tried — including what did not work.
We assess the pattern.
We review your symptoms, medical history, medications, skincare, nutrition and other relevant factors to determine what may need further attention.
We decide whether investigation is necessary.
If additional information could change your treatment plan, we may recommend appropriate laboratory testing or other medical investigation. If testing is unlikely to change management, it may not be necessary.
We build an individualized plan.
Your plan may involve one practitioner or several members of our healthcare team. It may include conventional treatment, naturopathic care, nutrition, lifestyle support, a procedure or referral.
We reassess and adjust.
Skin conditions can change over time. We monitor your response and modify the plan when needed rather than keeping you on a fixed protocol indefinitely.
Frequently Asked Questions
Yes. Sage practitioners can assess acne and help develop an individualized treatment plan. Depending on the type and severity of your acne, care may include skincare, nutrition and lifestyle strategies, naturopathic treatment and/or conventional prescription medication. More severe, scarring or difficult-to-treat acne may require dermatology care.
Not necessarily. Blood work is considered when your history or symptoms suggest that it could help answer a clinical question or change your treatment. It is not automatically required for every skin concern.
Not automatically. Skin symptoms alone do not mean that a person needs a food-sensitivity test or elimination diet. Your practitioner will first assess whether there is a reasonable clinical indication for investigating a food-related issue.
Depending on the condition and the practitioner involved, conventional prescription treatment may be part of your care. Sage’s nurse practitioners can diagnose, order and interpret diagnostic testing, and prescribe medications within their scope of practice. Your naturopathic doctor may also discuss conventional treatment and coordinate care with your physician or dermatologist where appropriate.
No. Do not stop a prescribed medication simply because you are seeking integrative care. Bring a list of your current medications and supplements to your appointment so your practitioner can consider them when developing your plan.
Nutrition can be relevant for some patients, but there is no universal diet for healthy skin. When nutrition is likely to be useful, guidance should be individualized around your symptoms, health history, nutritional needs and preferences. A dietitian may be involved when appropriate.
Sage can provide individualized supportive and integrative care for people living with chronic inflammatory skin conditions. Conventional medical treatment remains important, particularly for moderate-to-severe disease, and referral or collaboration with a dermatologist may be recommended.
Yes. Sage offers microneedling for selected cosmetic and skin concerns, including acne scarring, skin texture, pigmentation concerns, stretch marks and certain scars. Microneedling is not appropriate for everyone and is not a replacement for medical treatment of an active skin disease.
We will tell you. Good integrative care includes recognizing when another healthcare professional has the most appropriate expertise or treatment option. Depending on your symptoms, we may recommend seeing or continuing care with your family physician, dermatologist or another specialist.
Not necessarily. The best starting point depends on your concern. A free discovery call can help determine which Sage practitioner or service is most appropriate for your needs.
Your skin deserves more than another protocol.
If you are tired of trying one product, supplement or restrictive approach after another, the next step may be a better assessment — not another protocol.
At Sage, we bring together different healthcare perspectives so your care can be based on what you actually need.
Use the right tools. At the right time. For the right patient.
