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ERIN LUKAS

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Ninty percent of teens and 30 percent of adults at one point experience acne. While for some people, this may mean an occa-sional or mild breakout, for others se-vere acne a ects their self-esteem and daily lives. Education and proper treat-ment of the common skin care prob-lem is essential in obtaining clearer skin and gaining con dence back.

What causes acne?A major myth surrounding acne is that people develop it due to poor hy-giene. While people with acne tend to have oilier skin and have increased bacterial growth related to that, there are various factors that can cause and trigger acne, explains Dr. Benja-min Barankin, Dermatologist, Found-er and Medical Director of Toronto Dermatology Centre.

In reality, hormone levels in women and teens and a persons gen-etics play a major part in oil produc-tion and in turn, acne development. Other causes can aggravate acne in-cluding diet, particularly dairy, like skim milk, as well as stress.

The importance of proper treatmentWhile the severity, length, and point in life when someone is a ected will vary, a healthy skin care routine along with treatment and consulting with a dermatologist is crucial in preventing

scarring and discolouration. Most im-portantly, it will help make patients feel con dent and look good. A problem I see a lot is people who have bad acne trying various over-the-counter prod-ucts thinking they can x it themselves, while in the meantime not only are they spending a lot of money, they are developing scarring which is painful, expensive to repair, and your skin will never be the same, says Dr. Barankin.

How to treat acneDr. Barankin recommends a standard routine of cleansing once or twice a day followed by moisturizing and SPF, and exfoliating once or twice a week. If you experience occasional, mild break-outs or early acne, prescription topical creams and gels that include any of the following ingredients: Benzoyl Perox-ide, Retinol, Salicylic Acid, or Glycolic Acid can help heal breakouts.

For deep, hormonal acne, Dr. Baran-kin suggests prescription-grade top-ical products with higher concentra-tions of ingredients that are available in topical creams and gels in combina-tion with antibiotic pills, birth control for some women, and Accutane or Iso-trentinoin in severe cases.

In adjunction with topical creams, gels or prescription pills, treatments like microdermabrasion, laser treat-ment, chemical peels, photodynamic therapy, facials, and extractions can speed up healing.

What is antibiotic resistance?Antibiotic creams and pills may aid in calming acne, but if taken for long periods of time, there is risk of the bac-teria being treated, building a resist-ance to the antibiotic and in turn, no longer responding to the medication. Not only will a patients acne not clear up but instead of P.acnes, the bacteria that causes acne, other important bac-teria the body needs will be killed.

After seeing a recent rise in anti-biotic resistance, Dr. Barankin says that, weve tried over the years to use less antibiotics or combine them with things like Benzoyl Peroxide. The typ-ical course of antibiotic treatment would be two to three months after which we would reassess your case and could potentially extend it to six months. Combining Benzoyl Perox-ide with antibiotic treatments wont guarantee that antibiotic resistance will be avoided, but its a precaution-ary step for patients to combat acne without sacri cing their health.

Take actionWhile there is no way to predict the future health of a persons skin, it is important to manage acne and be aware of the available treatment op-tions in order to keep skin clear and eliminate the chance of scarring and discolouration.

Clearing up the confusion about acne

Know the factsRosacea is most prevalent in people over the age of 25, and in those who are fair-skinned and from Celtic or Scandinavian ancestry. Women are also three times more likely to suf-fer from the chronic skin condition than men are.

In mild cases, the condition may simply cause redness and ushing, but if it gets more advanced, it can take on an acne-like appearance, says Dr. Jason K. Rivers, Clinical Pro-fessor of Dermatology at the Univer-sity of British Columbia and Found-er of Riversol Skin Care Solutions Rosacea is distinguished from acne, though, in that there are no black-heads or whiteheads associated with the disorder.

It should also be noted that, like other chronic skin conditions, ros-acea can have a significant impact on a persons self-esteem and men-tal wellbeing.

Causes and triggersSpicy foods, alcohol, emotional stress, sun exposure, exercise and ca einated or hot drinks can all trig-ger rosacea symptoms. But scien-tists still dont completely know the underlying causes of the skin dis-ease. There are a number of di erent principles on the genetics of the dis-

ease though, one of which points to the outbreak of rosacea being linked to the immune system, explains Dr. Rivers.

The immune system is regulat-ed in a way that we dont completely understand, he says. Its believed that the immune system of a rosacea su erer may overact, causing an in- ammation of the skin that then feeds on itself.

Currently, there are no su cient ways to test for rosacea; the only diagnosis is a clinical examination, which means a patient has to have a visible outbreak before they can conclusively diagnosed.

Managing the conditionThere are a number of di erent ros-acea treatments, all of which are generally quite e ective, says Dr. Rivers. The rst step in any treat-ment is prevention, and that means identifying and avoiding your per-sonal triggers. It can be quite par-ticular for some people, says Dr. Rivers. Somebody a ected may be

ROSACEA: Shedding light on the chronic skin condition

Rosacea is an in ammatory skin condition that a ects an estimated two million Canadians and 45 million people worldwide. It is characterized by redness, visible facial blood vessels, and pimple-like bumps and blemishes in the central part of the face.

CONTROL BREAKOUTSThere are treatment options that can clear your complexion .

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CYNTHIA NIXON, STAR OF SEX AND THE CITY, SAYS DIAGNOSIS IS KEY TO HELPING CONTROL ROSACEA

Despite starring in one of the most popular TV series of the 90s, Cynthia Nixon suffered at times from low confidence due to rosacea flare-ups. In her 30s, the Sex and the City star noticed a chronic redness on her face, which resembled acne. The flare ups were often triggered by spicy foods, red wine, and hot baths.

My facial redness used to a ect my confi dence on set and at big social occasions and I struggled to man-age what I thought was a recurrence of acne, like I had when I was a teen-ager, she says. So it was a relief when

my dermatologist told me I had ros-acea as it has transformed the way I can manage my symptoms and better understand my triggers.

Two million Canadians affectedNixons self-consciousness in her ap-pearance isnt unique for those who have the skin condition. Surveys show that rosacea can take a toll on people emotionally, from how they feel at work, to how they feel in social settings and in their relationships. The good news is that rosacea is a treatable and common skin condi-tion. Over two million Canadians and around 40 million people worldwide are a ected by it.

Visiting a dermatologistThe key to managing rosacea is get-ting a diagnosis. Those who are left undiagnosed face challenges on-ly about one in ten su erers receive a formal diagnosis from a doctor or dermatologist. Those who do are twice as likely to manage their symptoms.

It is important to ask your doc-tor about ways to manage these symptoms, otherwise they will get worse, says Nixon. Redness is a challenge, but you can get it under control. Dealing with rosacea on a day-to-day basis is tough. And sometimes I used to start my day off on the wrong foot just by look-ing in the mirror.

Keeping it under controlThese days, Nixon is more confi dent, thanks in part to learning how to manage her skin condition. She rec-ognizes her triggers, such as extreme heat and humidity, and gets the help she needs.

Symptoms can be managed and its important not to let them get worse, Nixon says. Rosacea might always be on your mind but it doesnt have to be on your face.

ELIANNA LEV

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ease though, one of which points to the outbreak of rosacea being linked to the immune system, explains Dr. Rivers.

The immune system is regulat-ed in a way that we dont completely understand, he says. Its believed that the immune system of a rosacea su erer may overact, causing an in-fl ammation of the skin that then feeds on itself.

Currently, there are no su cient ways to test for rosacea; the only diagnosis is a clinical examination, which means a patient has to have a visible outbreak before they can conclusively diagnosed.

Managing the conditionThere are a number of di erent ros-acea treatments, all of which are generally quite e ective, says Dr. Rivers. The fi rst step in any treat-ment is prevention, and that means identifying and avoiding your per-sonal triggers. It can be quite par-ticular for some people, says Dr. Rivers. Somebody a ected may be

SEX AND THE CITY STAR CYNTHIA NIXON SAYS DIAGNOSIS IS KEY TO HELPING CONTROL ROSACEA

Symptoms can be managed and its important not to let them get worse,Rosacea might always be on your mind but it doesnt have to be on your face.

In mild cases, the condition may simply cause redness and fl ushing, but if it gets more advanced, it can take on an acne-like appearance.

able tolerate white wine but not able to tolerate red.

People with rosacea are also ad-vised to use mild cleansers to re-move dirt and reduce infl ammation on the skin, and to always apply sun-screen in the summer time. Medica-tions can be topical, in the form of creams and gels, or oral, which are often anti-infl ammatory doses.

There is a new topical gel treat-ment that came onto the Canadian market about a month ago which can reduce redness in the face for up to 12 hours, says Dr. Rivers. However, it doesnt have any e ect on the course of the disease itself.

If you think that you may be a ect-ed by rosacea, dont continue to suf-fer without professional advice and treatment. It could make a massive di erence to your life. A trip to your doctor could be your fi rst step on the road to beating rosacea.

ERIN LUKAS

editorial@mediaplanet.com

-Cynthia Nixon

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ADVANCES IN THE TREATMENT OF NAIL FUNGUS: NEW OPTIONS AVAILABLE

PATRICK BISSETT

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Fungal nail infections (onycho-mycosis) are often mischar-acterized as purely cosmetic. However, if left unchecked, onychomycosis can cause ser-ious problems particularly among those with pre-existing medical conditions.

In the early stages, infections present as a form of mild discolouration often at the edges of the nail bed. In-fection can arise for a number of rea-sons such as trauma to the nail, other skin infections (like athletes foot or nail psoriasis,), and poor circula-tion. Those most at risk from com-plications due to an infection are the elderly (40 percent of elderly patients have onychomycosis) those who are immunocompromised (such as HIV patients or those on immunosuppres-sive medications,) smokers, and most especially those with diabetes.

Nail fungus characteristicsDr. Aditya Gupta is a dermatologist and describes the characteristics of onychomycosis. Nail fungus can be quite gradual. People often mistake it as part of the natural aging pro-cess, particularly the elderly, which can cause serious problems down

the line. Infections can become pain-ful, and can spread to other people. In some rare cases the fungus can spread to other sites on the body such as from the toes to the groin or fi ngers and in those who are severely immunocompromised. It may even travel through the blood stream. Not only do nails become discoloured, but they can also be-come brittle and disintegrate. If left untreated infected nails can actually separate from the nail bed.

According to Dr. Gupta recogniz-ing risk factors as well as early de-tection is key to e ectively treating the disease. The sooner a diagnosis is made, the sooner treatment can begin and the less likely complica-tions become.

Treatment optionsThere are two main types of treatment for nail fungus topicals, which are ef-fective for mild to moderate conditions, and oral treatments, which are typ-ically stronger and work on moderate to severe infections. Lamisil is the oral drug most often used for severe infec-tions and works in almost 70 percent of patients. Lamisil is prescribed for ap-proximately three to four months with results in 48 weeks. Jubilia is a new top-ical solution and the fi rst advance in onychomycosis treatment in a decade. Jubilia works by penetrating through the nail to fi ght the infection. Treat-ment is daily and lasts for 48 weeks; the long period of treatment is correl-ated to the length of time required for healthy nail tissue to grow.

Social stigmaNot only is onychomycosis a serious condition it can also have a nega-tive psychological impact. There is a stigma attached to the condition , absolutely, says Dr. Gupta. Those who have nail fungus, particularly on their fi ngernails may fear social interaction and many are too em-barrassed to seek help. But to those people I say, the sooner you seek treatment, the sooner you can get rid of the problem.

Nail fungus, unfortunately, is a re-curring problem but there are steps that patients can take to minimize re-infection. Keep feet dry and clean and regularly sanitize or replace shoes and socks. Wear sandals in public spaces like swimming pools, keep nails trimmed, and regularly apply mois-turizer to dry skin.

If you think you have a fungal nail infection, talk to your doctor today about the right treatment options for you.

Above are two examples of fungal nail infection.

The sooner a diagnosis is made, the sooner treatment can begin and the less likely

complications become.

Find yourself constantly excessively sweating? Skip the sweat this summer.

You may be su ering from hyper-hidrosis a condition that defi nes in-dividuals who sweat more than the body would normally need to main-tain optimal temperature.

While hyperhidrosis a ects ap-proximately 950, 000 Canadians, only 38 percent of hyperhidrosis su erers talk to a health care pro-fessional about their condition. People rarely seek help because many are unaware that excessive sweating is a treatable medical disorder.

Two types: Focal hyperhidrosis, also known as primary hyperhidrosis, has an un-known cause. This type of hyper-hidrosis is localized to one or more of the following areas:

Underarms (axillary hyperhid-rosis)

Hands (palmar hyperhidrosis) Feet (plantar hyperhidrosis) Face (facial hyperhidrosis)

Although this type of hyperhidro-sis has an unknown cause, the way it a ects su erers appears to be re-lated to over-activity of the central nervous system thereby causing an overactive stimulation of local sweat glands.

Generalized hyperhidrosis, al-so known as secondary hyper-hidrosis is actually caused by an-other underlying condition (e.g. endocrine disorders, menopause, obesity, nerve damage, and rare-ly, some types of drugs). This type of hyperhidrosis generally occurs over the whole body and is usually treated by addressing the under-lying condition.

Many treatment options: Topical treatments There are

a variety of topical agents that can be used to treat hyperhidrosis, a common one being Drysol.

Iontophoresis Is the passage of an electrical current onto the skin.

Botulinum toxin type A A neurotoxin injection that blocks the cholinergic stimulus of eccrine sweat glands.

Surgery Endoscopic Thoracic Sympathectomy (ETS) is a surgical procedure that can eliminate sweat-ing in the hands and underarm.

In order to find the best treat-ment for you, speak to a derma-tologist or sweat management specialist.

DONT MISS

CANADIAN DERMATOLOGY

ASSOCIATION

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One day you wake up and the mirror looks back at you and everything is not the way it once was. You start to wonder if you might feel and look a lot better, with just a little help.

A lot of people have never done anything like this but suddenly they feel they look aged or tired and want to do something, says Dr. Fred Weks-berg, owner of the Weksberg Centre for Cosmetic Dermatology.

Rejuvenation is a process that goes beyond the odd wrinkle to deal with your whole face: the shape, texture, elasticity, and how it all works together.

Theres been an evolution in the last 10 years of not just treating lines and wrinkles but treating the face three-dimensionally the volume of the face, says Dr. Weksberg.

enhance shape and volumeWhen were younger we have an up-side-down triangle, where the cheeks are the base of the triangle and it goes down to a point at the chin, says Dr. Weksberg. As we age, the triangle re-verses.

Cosmetic dermatologists use fill-ers to return the face to its youthful shape. By injecting fillers we can fill in lines, grooves, and improve scars. And very importantly we can improve the three-dimensional appearance by replacing volume that has been lost by the aging process, says Dr. Weksberg.

Some 90 percent of fillers in use today are hyaluronic-acid based. Hyaluronic acid is one of the main components of skin, explains Dr. Weksberg, so by using a filler made of the same material you can

avoid reactions, and enable the fill-er to blend in very naturally with the skin. There are very few cases of inflammation, he says, because its doesnt stimulate the immune system. These products are revers-ible, predictable, and reliable which makes them very safe, he says.

Fillers typically last up to a year, and some newer products last up to two years.

I prefer not to inject permanent fill-ers, I find they are less predictable as you age, says Dr. Weksberg, because, as you continue to age, the shape of your face will change, however perma-nent fillers will not change to its shape. This could result in a distorted look.

smooth lines and wrinklesStatic lines form between the nose and the mouth, the cheek, around the lips and jaw line; while dynamic lines come from your muscles, i.e. crows feet, frown and forehead lines.

Fillers smooth the static lines, says Dr. Weksberg, while neuro-modulators deal with the dynamic lines. The neuromodulator binds itself to the nerves that fire the muscle. It actually affects the direct connection between the nerves, re-sulting in a weaker muscle contrac-tion. Once this happens the lines begin to fade he says.

This technology has been used for over 20 years, and approved in over 80 countries, he says. The days of uncer-tainty are over. Mainstream in medi-cine, its uses extend to stroke victims, children, migraine therapy, and re-ducing sweating.

Current trends are leaning to-

Dermatology is a medical spe-cialty that focuses on the skin, hair, and nails, but its not a superficial specialty by any stretch. There are around 3,000 known skin diseases, ranging from the very com-mon to the very rare. Acne affects a large proportion of people (85 per-cent), whereas vitiligo (patchy loss of skin pigmentation) occurs in less than 1 percent of the worlds population.

Skin specialists see everything from autoimmune disease, such as lupus and scleroderma, to sexually transmit-ted infections, such as genital warts and syphilis. In fact, dermatology intersects with a host of other medic-al specialties, including immunology, endocrinology, oncology, surgery, and psychiatry. This intersection occurs as many skin conditions reflect early

problems occurring in a patients in-ternal organs. The dermatologist de-tective can use skin clues to detect in-ternal problems before these problems cause harm to the patient.

For example, about one-third of people with diabetes will develop some form of skin disease, such as fungal and bacterial infections. An itchy blistering rash or canker sores may sometime be the only obvious signs of Celiac disease.

it happens to everyoneAt some point in our lives, most of us will develop some skin condi-tion, be it a rash, chickenpox, or dan-druff. Some skin conditions are fleet-ing, like hives. Others are chronic and marked by symptoms that either per-sist or are episodic, such as eczema. Some skin conditions grab the media spotlight more than others like skin cancer and wrinkles. But there is a lot more to dermatology than biopsying suspicious moles and filling in laugh lines. Although many skin conditions are not life-threatening, the majority carry a heavy social and physical bu-rden on effected patients.

More than skin deepBesides visible skin changes, most skin diseases have a definitive psychosocial component. Vitiligo, psoriasis, and ros-acea, for example, can cause social em-barrassment and the associated emo-tional stress. Skin diseases can be so-

cially limiting and isolating, they can affect employment opportunities, and they can severely affect an individ-uals quality of life. A study in the Brit-ish Journal of Dermatology reported, for example, that the levels of social, psychological and emotional prob-lems related to having severe acne were comparable to people living with chronic diseases such as asthma, epi-lepsy, diabetes, back pain or arthritis.

innovations on the horizonThe good news is that exciting innov-ations in therapy continue to trans-form dermatology, allowing derma-tologists to treat skin diseases more

successfully. Immune-modifying bio-logics have revolutionized the treat-ment of psoriasis, while Mohs sur-gery has made it possible to accur-ately excise non-melanoma skin can-cers while sparing healthy skin tis-sue. More innovations are on the hori-zon such as artificial bioactive skin to treat burns without skin grafts, and stem cell therapies that will speed up wound healing. Such promising new therapies will help millions of pa-tients with skin diseases, so they can put their best face forward.

UnDeRSTAnDIng THe PROCeSS OF ReJUVenATIOn

ward smaller doses to reduce muscle movement while maintaining a nat-ural appearance no more frozen-face look. The treatment lasts about four months, and Dr. Weksberg says its safe because doses are small and injected locally.

tighten skin elasticityAs we get older, the skin loses elasticity. Radiofrequency or ultrasound energy can be used to tighten the collagen fib-ers and stimulate new collagen forma-tion, making skin less saggy.

improve colourBrown spots that commonly appear on the skin as we age can be improved dramatically with topical treatments and creams, chemical peels, lasers, and Intense Pulse Light or liquid nitrogen treatment, says Dr. Weksberg.

resurfacingHow your skin feels is just as import-ant as how it looks. Skin thats soft to the touch can be achieved by chemical peels and microdermabrasion, or by resurfacing with a fractionated laser.

the big pictureTheres no one-size-fits-all approach to rejuvenation. Consulting with a cosmetic dermatologist or specialist to find out whats best for you is the first step towards a youthful and fresh appearance.

Dr. Fred weksbergOwner, weksberg center fOr cOsmetic dermatOlOgy

Theres been an evolution in the last 10 years of not just treating lines and wrinkles but treating the face three-dimensionally; the volume of the face.

Dr. David ZlotyPresident, canadian dermatOlOgy assOciatiOn

Kimberley Fehr

editorial@mediaplanet.com

Dr. DaviD Zloty

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six steps for Beautiful summer skin

Great summer weather doesnt have to mean weath-ered skin. Dr. Fred weksberg call him Dr. w. for short is a leading toronto-based cosmetic Dermatologist with some tips for radiant skin that lasts all summer long.

Use a broad-spectrum spF 30 sunscreenYoull want a broad-spectrum sun-screen which protects from both ultraviolet A (UVA) and ultraviolet B (UVB) light. The shorter UVB rays make the outer skin burn, while the UVA light penetrates more deeply in-to the skin and can cause premature aging and skin cancer. The sun-pro-tection factor (SPF) should be 30 or higher, recommends Dr. Weksberg.

the right skincare regimen for youDr. W suggests that all the new in-ventions we have nowadays like retinols or Vitamin As, antioxi-dants, and growth-factors can make your skin radiant.

every person is unique, and every program he advocates is specific-ally tailored for each individual. Talk with a dermatologist about whats best for you. generally, a pH-balanced, moist cleanser thats not going to irritate the skin is ideal, but not everyone needs a moisturizer every day. For people with a natur-ally moist skin, its not helpful.

Gentle exfoliation exfoliation also doesnt need to happen every day, says Dr. Weks-berg. gentle exfoliation, using sali-cylic acid with a cleanser, is ideal. Some people may need more exfoli-ation because they have a lot of dead skin cells that build up.

Mole check Youre exposed to a lot of sun dur-ing the summer. Start the season off right with an annual mole check with the doctor.

take care of your skin issuesSun can aggravate skin conditions like acne, rosacea, eczema, and psor-iasis, so its important to take great-er care in the summer, and also treat acne and rosacea properly to pre-vent scarring. Fully removing your make-up at the end of the day can help avoid problems.

Balanced nutrition The media is often hyping one food or another for skin health, says Dr. Weksberg, but really a balanced diet is the most helpful. Foods that are high in antioxidants can also help reverse DnA damage and pre-form-ing skin cancers, he says.

SUMMER SKIN TIPS

Kimberley Fehr

editorial@mediaplanet.com

Dr. weksberg administers a filler injection to a patient, showing the non-evasiveness of the procedure.PHOTO: Weksberg CenTer fOr COsmeTiC DermaTOlOgy

The science of skin

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It is the season for summer sunshine that we have all been waiting for. Before fl ocking to the beach, it is important to understand the dangerous e ects the sun has on your skin, and how you can protect yourself from damage.

Play it safe this summer

Dr. Marla Shapiro Shares how you can play it safe this summer and still have fun outdoors.PHOTO: CTV NEWS

With us in the long-awaited summer months, it is timely to remember sun safe-

ty! Every day we are exposed to UV rays and we should be sun safe in every season. The amount of ultra-violet rays depends on two factors: the amount of time you spend in the sun as well as how strong the suns rays are. Environment Canada has a UV index that ranges from zero to 11. A rating of zero to two is ranked as ex-treme.

Be sun smartAs the Canadian Cancer Society points out, a UV index of three translates to moderate exposure and that is when we need to be more vigilant. Peak ex-posure is between 11 am and four pm so it makes sense to spend less time in the sun during these hours.

If you are not avoiding the sun, then you can reduce your exposure by covering up. Protect yourself with clothing, a wide brimmed hat and sunglasses. Use a sunscreen with an SPF of 30 or higher and make sure it is labeled as protecting against UVA and UVB. If you are swimming use a waterproof sunscreen. Dont forget to protect your lips as well! While sunscreen is important to apply and re-apply start 20 minutes before you go out it cannot o er you as much protection as avoidance. Lead by example and teach your chil-dren to look for the shade. Children under one should be kept out of dir-ect sunlight.

Addressing misconceptionsThe Canadian Dermatology Society points out that as much as 80 percent of the suns rays can penetrate mist, fog, and light clouds. Sunlight also re-fl ects from the sidewalk concrete and sand. While sun safety is critical for all of us to practice, remember that tan-ning beds and sunlamps use UV radia-tion then can cause skin damage and skin cancer. It is a myth that a tan of any sort protects you from the sun! As is pointed out by my dermatology colleagues, a tan means you have al-ready put yourself at risk with dam-age to your skin. Many of us had sun exposure during early childhood and the most harmful e ects started then!

The power to protect yourselfSkin cancer is on the rise and it is up to us to turn that tide around. The most common cause of skin cancer in Can-ada is basal cell carcinoma, and while it is the least dangerous, it does re-quire treatment. Frequent severe sun-burns during childhood increase our risk in adulthood. The next most com-mon form of skin cancer is squamous cell carcinoma and can not only can

this grow but it can spread to other parts of our body. These cancers must be removed and some require radiation therapy. Malignant melanoma is a very concerning and dangerous form of skin cancer. It is the eighth most common cancer in Canada and the incidence continues to grow. In addition, there is a growing death rate due to melanoma. In 1930, the risk for this cancer was 1 in 1500. The risk for men is now 1 in 74 and for women is it 1 in 90 according to the Canadian Dermatology Association. Again the greatest risk is UV radiation from the sun and tanning beds.

Early detection is criticalMake sure to watch for any change in birthmarks or moles. Changes in size, colour, shape and surface should all be brought to the attention of your phys-ician. Any new growth, lesions that will not heal or lesions that bleed al-so should be checked. All of us should check our skin regularly and have those hard to see areas (back of neck, ears, leg etc) looked at by someone else.

DONT LET THE SUN GET UNDER YOUR SKIN

PREVENTION

Stay out of the sun between 11 a.m. and 4 p.m.

Cover arms and legs with lightweight clothing

symmetry: One side of the mole looks different than the other

order: Blurry or jagged edges

olour: Multiple shades or colours

iameter: Larger than an eraser on the end of an HB pencil (~6mm)

volution: Watch for changes in size,colour, or shape over time

Wear sunglasses with a UV protection rating of 400Use a broad spectrum sunscreen with an SPF of 30 or higher

Never use tanning beds. Exposure to UV can be up to 4x that of the Sun

EARLY DETECTIONFOLLOWING THE ABCDES OF EARLY DETECTION WILL HELP YOU

DETERMINE IF YOU SHOULD HAVE A MOLE OR NEW SPOT CHECKED BY A PHYSICIAN

PRACTICING SUN SAFETY WILL REDUCE THE CHANCES OF YOU BEING DIAGNOSED WITH SKIN CANCER

ABCDE

Wear sunglasses with a UV protection rating of 400

volution: Watch for changes in size,

Over 90% of skin cancers are preventable and yet it is the most common form of cancer worldwide.

DR. MARLA SHAPIRO

editorial@mediaplanet.com

It is a myth that a tan of any sort protects you from the sun!

Source: Canadian Skin Cancer Foundation

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Chicken pox is a common concern for children, but the virus behind this disease does not disappear along with its characteristic red spots. In-stead, the varicella zoster virus remains in nerve roots and can reactivate later in life, this time, as a painful rash called shingles.

Shingles can put a persons life on hold. It can be extremely painful and can last for months, says Canadian Skin Patient Alliance president Bar-bara-Anne Hodge. Understanding the disease and who is most at riskin some cases can even prevent it.

Who is at risk?Anyone who has had chicken pox can develop herpes zoster, or shin-gles, but this disease typically af-fects people 60 and older, or those with a weakened immune system, and can be prompted by stress, in-jury, or certain medications.

Though researchers have identifi ed the chicken pox virus as the cause of shingles, there is not yet a way to pre-dict if or when the varicella virus will reactivate. There are other risk fac-tors, but you never know when youre

going to have it, explains pain expert Dr. David Lussier, who su ered from shingles in his 30s.

In Canada, there are an estimated 130,000 cases of shingles each year and these numbers appear to be in-creasing. Humans are the only reser-voir of the chicken pox virus and as we age, our immune system ages too and therefore we are all at risk of having shingles, explains family physician and CTV health consultant Dr. Marla Shapiro.

A real painNerves are what allow us to feel and when varicella reactivates in the nervous system, it can be excruciat-ing. This neuropathic pain can make everything from putting on a shirt to receiving a hug, painful and for some patients, the pain does not fade with the rash.

While the bumps and blisters from shingles typically last a couple weeks, some patients experience prolonged discomfort that can last months or even years. This complication, known as post-herpetic neuralgia, is the most common neurologic disability of the elderly and occurs in an estimated 20 percent of adults with shingles, according to Can-adas Public Health Agency.

The most important thing is to get treated if you have shingles, says Dr. Lussier. If you wait too long, then the risk of having pain later is that much higher.

Give healing a shotSince the reactivation of the varicella virus cannot be predicted, the only way to protect against this disease is to get the vaccine, says infectious disease

specialist Dr. Julie Bestman-Smith.The vaccine boosts our immune

system so even if the virus reactivates, now we have the antibodies that are able to reduce its replication, ex-plains Bestman-Smith.

The herpes zoster vaccine has been available in Canada since 2009 and though it is recommended to every-one over the age of 60, Canadians 50 to 59 can also request it. The vaccina-tion cannot guarantee that patients will not get shingles, but if they do, it can reduce the severity of the infec-tion and any long-term e ects, such as post herpetic neuralgia.

In addition to getting the vaccine, experts also recommend watching out for signs of shingles.

Knowing the symptoms and see-ing your doctor quickly when you suspect you may have shingles can help greatly speed up recovery, says Hodge. Speak with your doctor to learn if you are at risk and take steps to learn what you can about shingles.

ISHANI NATH

editorial@mediaplanet.com

ISHANI NATH

editorial@mediaplanet.com

For many, chicken pox is an illness that comes and goes with childhood, but for a growing number of Can-

adians, like Sue Rosenthal, this dis-ease can resurface without warning as a painful rash called shingles.

Rosenthal was playing the French horn in a community concert when she fi rst felt symptoms.

Because of the pain in my shoul-der, the entire concert was excruciat-ing and I could barely concentrate on the music, she recalls. Even carrying her gear from the car to the venue had caused incredible discomfort.

DiscomfortThe next morning, the pain was un-bearable so 48-year-old Rosenthal went to a walk-in clinic. The doctor listened to her story, examined the small rash on the left side of her neck which she had previously thought to be a couple of mosquito bites and diagnosed her right away. Rosenthal had shingles.

She experienced chicken pox as a child and now, 43 years later, the varicella virus had reactivated along a nerve on her left side. Her case was relatively mild, but Rosen-thal still required painkillers to manage her condition.

I generally dont like to take any-thing if I can help it, but nerve pain is unlike any other and I couldnt

cope without medication, she says.There is no way to predict if or when

shingles, or herpes zoster, will fl are up but researchers have noticed that patients tend to be 50 or older or have a weakened immune system, such as with cancer patients, and it can be triggered by stress, injury, or certain medications. It was this potent com-bination that caused my mother, Vee-na Nath, to get shingles after her last round of chemotherapy.

It started with pain in my lower back and right thigh but I just fi gured it was from my chemo, she recalls. Soon after, she noticed spots on her thigh and hip. They could be bug bites, she thought, or possibly an allergic re-action, but something didnt feel right. A visit to her doctor confi rmed that the spreading rash was, in fact, shingles.

I didnt know anything about shingles, didnt know what they looked like and never ever thought that I would get shingles, she says. But being 55 with a weakened im-mune system from chemotherapy and a sizeable amount of stress from her battle with cancer, she met the criteria.

She was prescribed antiviral medi-cation to battle the infection and painkillers to manage the burning, shooting type of pain that she was experiencing on her right side.

After a few weeks, the blisters

faded to red patches, but to my moth-ers surprise, the pain remained. Her doctor advised that it would likely take between fi ve to six weeks for the neuropathic pain to subside.

As my mother continues to heal, her advice to others is to be vigilant when it comes to shingles.

I never would have thought to even ask about it, she says, but I think its worth having the conversa-

tion with your physician and fi nding out about your risk factors and your eligibility for the vaccine so hopefully you can avoid shingles, or at least the severe pain that it can cause.

An unwelcome surprise: patients share their stories

SHINGLES: WHAT YOU NEED TO KNOW

For those of you that have had chicken pox as a child, the shingles virus already lives inside you and can become active unexpectedly which can be seriously debilitating and painful. The best way to prevent this experience is to visit your doctor and fi nd out if you are at risk.

Understanding Rare Skin Conditions: A look into Vitiligo:

Vitiligo is a skin condi-tion in which the skin loses melanocytes, the cells that produce melanin, the pig-ment responsible for skin, hair, and eye colour. As a result, irregularly shaped, smooth white patches ap-pear on different parts of the body. Usually, the disorder is progressive, meaning that over time the white patches will spread to other areas of the body.

Breaking the stigmaVitiligo is neither dangerous nor contagious. The condition seems to run in families and occurs more often among people who have cer-tain autoimmune diseases. Stud-ies suggest that these di erent autoimmune diseases probably share at least some predisposing genetic or environmental causal factors, although these mostly re-main unknown.

An up-and-coming model and Toronto native Chantelle Young-Brown is on the upcoming cycle of Americas Next Top Model. Chantelle, who has had vitiligo since she was very young, is a face to be remembered as she sets strides to break social stigmas for those that feel isolated for having vitiligo and often feel ashamed of their appearance. Her confidence and determination to pursue her dreams in the spotlight has made her an emblem of true beauty.

Reaching out for supportChantelle is a role model and spokesperson for those that have vitiligo and often feels stigmatized and socially isolated. Although viti-ligo is a rare skin condition, that on-ly about 0.5 to 1 percent of the gen-eral population has, it is important not to feel alone and build a better understanding of this condition.

Vitiligo does not impact a per-sons overall physical health: how-ever, if the white patches are in a prominent place (e.g., hands or face), it may result in feelings of self-consciousness, embarrass-ment, depression, or anxiety. In these situations, psychological counselling can restore self-confi -dence and positive self-image.

Vitiligo support groups can al-so be a useful forum for sharing concerns and coping strategies. Associations such as Vitiligo Sup-port International and the Na-tional Vitiligo Foundation (NVF) can provide additional informa-tion. By increasing public under-standing of this rare skin condi-tion, we can decrease the social stigma and create a network of support for those affected.

GOING DEEPER

SOURCE:

CANADIAN SKIN PATIENT ALLIANCE

editorial@mediaplanet.com

Look out for Canadian Model Chantelle Brown-Young, who goes by Winnie Harlow, on the upcoming cycle 21 of Americas Next Top Model, premiering this August, 22.PHOTO: POTTLE PRODUCTIONS

The appearance of shingles is similar to that of hives or blisters.PHOTO: DERMNET

Knowing the symptoms and see-ing your doctor quickly when you suspect you may have shingles can help greatly speed up recovery.

Did you know?One in three Canadians 50+ will experience Shingles in their lifetime and the risk increases after the age of 50

Photo of Sue RosenthalPHOTO: ROBERT KETCHEN

Look out for Canadian Model Chantelle Brown-Young, who goes by Winnie Harlow, on the upcoming cycle 21 of Americas Next Top Model, premiering this August, 22.PHOTO: POTTLE PRODUCTIONS

If you had chickenpox

THE SHINGLES VIRUS IS ALREADY INSIDE YOU

ZOSTAVAX II does not protect everyone, so some people who get the vaccine may still get shingles. However, if you develop shingles despite being vaccinated, ZOSTAVAX II can help reduce the intensity and duration of pain.

ZOSTAVAX II is indicated for the prevention of herpes zoster (shingles) and for immunization of individuals 50 years of age or older. ZOSTAVAX II cannot be used to treat existing shingles or the pain associated with existing shingles. If you get shingles even though you have been vaccinated, see your healthcare provider promptly.

ZOSTAVAX II should not be used if you: are allergic to any of the components of the vaccine, including gelatin or neomycin; have a blood disorder or any type of cancer that weakens your immune system; have been told by your doctor that you have a weakened immune system as a result of a disease, medications, or other treatment; have active untreated tuberculosis; are pregnant.

Women of childbearing age should avoid pregnancy for 3 months following vaccination. Like all vaccines, ZOSTAVAX II can have side effects. In studies, the most common side effects were at the injection site and included redness, pain, swelling, hard lump, itching, warmth, and bruising. Headache and pain in the arm or leg were also reported. Additional side effects reported with ZOSTAVAX II include allergic reactions, which may be serious and may include difficulty in breathing or swallowing, and fever. If you have an allergic reaction, call your doctor right away. Talk to your doctor or pharmacist for a more complete list of side effects for ZOSTAVAX II.

It is estimated that nearly 1 in 3 people will experience shingles in their lifetime and the risk increases after the age of 50.

Drug Identification Number (DIN): 02375516

VACC-1104498-0000-E-CDN-MAR-15 Registered trademark of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc. Used under license. 2014 Merck Canada Inc., a subsidiary of Merck & Co., Inc. All rights reserved.

www.zostavax.ca

Talk to your doctor or pharmacist about vaccination.

SHINGLES:HELP PROTECT YOURSELF

BY GETTINGVACCINATED

The only vaccine indicated for the prevention of shingles in individuals 50 years of age or older.

(zoster vaccine live, attenuated [Oka/Merck], refrigerator-stable)