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Skin Cancer Top Priority for Dermatologists

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T he second-hardest thing any dermatol-ogist has to do is deliver a diagnosis of melanoma cancer to a patient. The hard-est thing to watch, in a minority of cases, is one of our patients perishing from the

disease in spite of treatment.Skin cancers as a group — basal cell carcinoma, squa-

mous cell carcinoma, and the most serious, melanoma — represent the most common form of all cancers. About one in three new cancer cases in Canada is skin cancer.

Skin cancer on the riseThe incidence of melanoma in Canadians has almost doubled since 1985, from 8.7 to 15.9 cases per 100,000 people. Outdoor workers are particularly at risk — having

an estimated 2.5 to 3.5 times greater risk of skin cancer.Ironically, as our understanding of the dangers of

skin cancer increases, we have adopted new behaviours that put us at greater risk. Witness the annual march to tanning salons as high school students get ready for prom.

The great tragedy hidden behind these facts is skin cancer is highly preventable. We do not simply have to sit back and despondently accept the toll it takes on society. We just need to change our attitude, in much the same way that we have changed with regards to smoking.

Educating the publicFor dermatologists, the number one priority is slowing and possibly reversing the toll of skin cancer through education. Every year, we mount a sun awareness cam-

paign in early June. A survey conducted for last year’s campaign shows efforts like these are having an impact. People understand and retain the messages.

However, there is still work to be done. Putting on sun-screen, covering up in the sun, avoiding sun exposure during peak hours, seeking shade, implementing work-place sun safety measures — should all be second nature.

When we see friends or family members exposing themselves to unnecessary risk from the sun, we need to encourage them to change. In order to reverse rising skin cancer numbers, we must make sun safety a mat-ter of social responsibility that all of us carry.

Vince Bertucci, M.D., FRCPC, President,Canadian Dermatology Association (CDA)

YOUR SKINPERSONALHEALTHNEWS.CA

CDA’s Sun Awareness Week

June 6–12, 2016

Robert Lavoie remembers his mother tanning outside, covered in oil and holding a reflective aluminum board. While this practice used to be the norm, the President of Dermtek Pharma says that with our growing understanding of how UV rays harm the skin, the dawn of a new era of sun protection is upon us.

“Effective urban sunscreen is vital in today’s world,” says Lavoie. And, according to dermatologist Dr. Julia Carroll, it is and should be used daily. “If you can see your hand in front of your face, there’s enough sun that you should have sunscreen on — so really, every day,” says Dr. Carroll.

The sun’s wrathNot only can the sun cause painful burns, but chron-ic exposure can also make skin look older due to thinning, pigmentation, and wrinkles, explains Dr. Carroll. The sun’s UV rays are also the cause of 9 out of 10 cases of melanoma, according to the Canadian Cancer Society, which describes the disease as one of the most preventable forms of cancer.

An SPF 30 or higher broad-spectrum sunscreen is the best way to prevent damage, says Dr. Carroll. “You only have one set of skin, and you need to look after it.”

Urban damage Since UV rays can travel through glass, experts say sunscreen is just as important in buildings as it is on the beach.

“We know what sun does to furniture through win-dows, it fades with time,” explains Lavoie. “The skin is subjected to the same treatment.”

Commuting in the car or working in an office still offer the opportunity for sunshine, meaning that even city-dwellers need sunscreen.

“There’s cumulative damage that’s always happen-ing,” says Dr. Carroll, “So, if you’re only wearing sun-screen when you’re on the beach or playing sports, you’re missing the majority of time that your skin is ac-tually exposed to the sun.”

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Jennifer Beecker M.D., FRCPC, National Spokesperson, Chair, Sun Awareness Program, Canadian Dermatology Association (CDA)

Here are some reasons why you may want to consider microdermabrasion:➊ To brighten your skin complexion for a healthy glow.

➋ To remove whiteheads/blackheads or clogged pores.

➌ To improve the appearance of skin tone or discolouration.

➍ To improve the texture of skin, from acne scars or wrinkles.

➎ You have concerns about skin on your face, chest and hands. T here is a common myth that a tan

implies being healthy and out-doorsy, and can make you appear more attractive. Some people are even tempted to forego the sun-screen, at least for a little while, to

get that healthy tan.What exactly is that healthy glow? It’s an in-

crease in skin pigment called melanin, and it is a sign of skin damage. Evidence suggests tanning greatly increases your risk of developing skin can-cer. And, contrary to what many Canadians may believe, getting a tan does not prevent sunburn or other skin damage. The extra melanin in tanned skin provides a sun protection factor (SPF) of about 2–4; far below the recommended minimum of 30.

Risk of tanningThe tan you get from a salon is no healthier, and is particularly dangerous for young people. It’s esti-mated that sunbed use before the age of 35 increas-es the risk of melanoma, the most serious form of skin cancer, by 35 percent.

Sunburn is the next step in skin damage if we don’t protect ourselves properly. Sunburn is the skin’s short-term response to ultraviolet (UV) radiation that penetrates the skin and harms the

DNA within the cells of its structure. With repeat-ed, unprotected exposure the damage caused by UV radiation may result in sun-induced changes such as wrinkles, mottling of skin colour, and skin cancer — not attractive or outdoorsy at all.

Protecting your skinDermatologists suggest protecting your skin any-time you plan to go outdoors, especially between April and September when the UV Index is typ-ically higher than three. Use sunscreen labelled broad-spectrum and water-resistant with an SPF of at least 30, and apply generously. Seek shade, or bring your own, for example an umbrella. Wear a wide-brimmed hat and clothing that covers as much skin as possible. Do not go to a tanning salon, and don’t forget to protect your eyes by wearing sun-glasses or prescription glasses with UV protection.

Foregoing the unhealthy glow this summer will help reduce your risk of skin cancer and is likely to mean your skin remains attractive for many years to come. And remember, if you see un-usual changes to our skin — see your physician as soon as possible. Catching skin cancer early is critical to reducing risk.

Dr. Jennifer Beecker

AN UNHEALTHY GLOW

For individuals looking for a non-invasive way to freshen the appearance of their skin, microdermabrasion is a popular cosmetic procedure.

Microdermabrasion gently lifts off the top layer, the stratum corneum, of the skin to reveal a youthful, healthier appearance. At the same time, microdermabrasion also stimulates collagen production. Medical grade microdermabrasion uses a vacuum suctioning process which gently exfoliates the skin, where sun-damaged, older, or dead skin cells reside, while improving elasticity beneath the skin’s surface. This process provides an all over inner and outer skin renewal effect.

Over the years, microdermabrasion has grown in popularity due to its many benefits. It is known as the lunchtime facial because of its quick and effective treatment time. Microdermabrasion can be used on any skin type, and will provide immediate results with no downtime. Once the dead skin cells are removed, new skin cells regenerate and come up to the surface. Any creams or serums will have enhanced absorption into the skin and penetrate deep into the multiple layers of the skin; therefore, microdermabrasion maximizes the value of your expensive facial products. Laser treatments, like photo-rejuvenation will be more effective with a microdermabrasion enhanced barrier to light. Patients notice smoother feeling skin, brighter complexion, and the clearing up of skin impurities after treatment.

The newest advances in microdermabrasion include at home use treatments, the use of diamond tips over crystals, and the ability to adjust vacuum levels.

Dr. Stephen Mulholland, Plastic and Reconstructive Surgeon, SpaMedica

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➊ Use a cleansing brush when washing your face — day and night. Cleansing brushes remove dirt and debris from fine lines that often makes them look deeper than they are, exfoliate dead cells quicker, which helps stimulate collagen production and gradually helps you get tighter skin. Plus, the deep clean allows your anti-aging products to penetrate deeper in to the skin so they work better.

➋ Wash your face for at least two minutes. Just like brushing your teeth, to get real results with your skin, you need to put in the time.

➎ Protecting your skin from the sun is so important all year round, no matter the weather, especially since the most harmful rays aren’t even the ones you get on a hot sunny day between 10 a.m. and 2 p.m., they’re the ones you get the rest of the day, even when it’s cloudy. Applying SPF as the last part of your routine is the way to ensure its efficacy. So, if you’re applying foundation, concealer, powder, blush, or highlighter — wait, and then apply your SPF overtop.

➍ Try oils that supplement the skin’s natural oily layer and increase moisture retention. A cleansing oil helps put lost oils back into your skin instead of stripping it. Or try an overnight oil to hydrate skin while you sleep.

➌ Next, you need to choose a moisturizer that’s best for your skin type or main concern, and then apply liberally. Most moisturizers contain ingredients that prevent moisture from escaping the skin and protect your skin from exterior damage, which is why they work well on top of serums to get better results.

Understanding Scars & Stretch MarksNo one likes the appearance of scars and stretch marks. Dr. Paul Cohen, a Dermatologist at the Rosedale Dermatology Centre in Toronto, tells us the difference between the two and the best ways to make them disappear.

Mediaplanet What are stretch marks and where do they most commonly form?Dr. Paul Cohen Stretch marks are a form of scaring on the skin caused by the tearing of the middle layer of skin. Stretch marks are often the result of stretching of the skin through rapid body growth or sudden change of weight, which can be a result of pregnancy, hormone replacement therapy, body-building, and puberty. They commonly form where there is a growth of skin or a larger amount of fat stored on the body. Some of the commonly affected areas of the body are on the stomach, breasts, lower back, inner and outer thighs, abdomen, and buttocks.

MP What is the difference between a scar and stretch mark?PC Stretch marks occur in the dermis, the middle layer of the skin. Scars occur when there is damage to the skin, usually a result of an acute injury, where certain cells grow too quickly. A scar can be raised, depressed, red, or white depending how old they are.

MP What are the best treatments for scars and stretch marks?PC The best treatment for scars and stretch marks is simply taking a lubricated finger and massaging the affected area. Done every day, this treatment will help prevent the scars from becoming raised. Finding the right over-the-counter product is important, such as an oil or moisturizer.

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Anti-Aging Skin Care Tips with 5Chantel Guertin

QA

Chantel Guertin Bestselling author and beauty expert on The Marilyn Denis Show. Connect with her @chantelguertin

Fine lines, wrinkles, age spots, and lax skin — oh the joys of aging! And, while you cannot turn back the clock, you can follow a few easy tips to repair and prevent further damage.

PERSONALHEALTHNEWS.CA COMMERCIAL FEATURE

D espite the vast array of skin care products on the market, it’s relatively easy for people to take care of their skin, and seeking the advice of a professional is the first thing you should do.

“Skin care professionals understand the physiology of skin and are able to make the right recommendation for optimal skin health

and appearance,” says dermatologist Dr. Shannon Humphrey, who practices in Van-couver. “Drug and department store staff are trained to be sales people and typically don’t have the scientific and medical background that skin professionals do.”

Three easy steps to better skinAccording to the experts, there are three things you can do to help maintain healthy skin: use an appropriate skin cleanser, moisturize your skin, and protect yourself from the sun.

“Luckily there are many non-surgical options,” says Dr. Kristina Zakhary a Calgary facial cosmetic surgeon, who has been practicing for more than a decade. “Obagi Nu-Derm skin care system is very effective, because it contains medical grade ingredients. They also have a nice line of products, including sun protection.”

Forget that tan. It’s not good for you. Dr. Zakhary adds that you should use sun protection products of at least 30 SPF.

Skin care professionals prefer Obagi Nu-Derm because it is easy to use, people can do it at home, and it gives a healthy lustre to the skin — speeding up the turnover of skin cells.

Beauty Is Skin Deep

DATE: 2016-05-19REVISION (DATE): 2 (2016-05-19)PRODUCT: Obagi Medical (Macleans HALF page)COMPONENT: Magazine AdVALEANT CODE: N/A COUNTRY: CanadaOPERATOR: EBCOLORS :

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Why should we take care of our skin? Our skin is our largest organ, covering about 20 square feet. If we ignore our skin there are a number of serious implications — including permanent damage, premature aging, and cancer.

By Ken Donohue

Obagi Nu-Derm® Healthy Skin Protection Broad Spectrum SPF 50

Clear + Brilliant

“It’s an easy treatment that can be done at least once a year as part of regular skin care maintenance,” says Dr. Humphrey. “People shouldn’t wait a long time to improve the health of their skin.”

The performance of the Obagi line is clinically proven. Thanks to potent ingredients and unique delivery systems, it addresses a wide range of concerns including uneven skin tone, aging, and acne.

The advantage of good skin careWhile good skin care is about ensuring good overall health, there are a lot of person-al reasons why we should take care of our skin. “It will not only make you feel and look better, but it can also give you a competitive advantage professionally,” says Dr. Michael Weinberg, a Toronto plastic surgeon, and Division Head of Plastic Surgery at Trillium Health Centre. “I love the wide-range of Obagi products and so do my patients.”

Another non-surgical option that is backed by research and clinical studies is Clear + Brilliant, a laser treatment system that will leave your skin feeling smooth-er, younger, and give you that radiant glow that comes from healthy, youth-ful skin. “It’s gentle, and with a series of treatments you will see a nice con-sistent improvement,” says Dr. Hum-phrey. “This is great for people wanting a natural looking outcome with minimal intervention.”

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Research Reveals More Canadian Women (and Men) are Embracing Injectable Cosmetic Treatments for Natural-Looking ResultsToday, more than ever, Canadian women and men are turning to cosmetic injectable treatments to soften the signs of aging. A recent report reveals one in four women use or are considering using cosmetic injectable treatments. In fact, 75 percent of these people consider injectable treatments to be a part of their personal care routine.  Interestingly, more men are turning to aesthetic cosmetic procedures too, with dramatic increases seen in both surgical and non-surgical options over the past five years and a 43 percent increase overall.

Research is showing how important the role your face and facial expressions play in helping people to communicate effectively with others. And, for men and women, your face says a lot about who you are and how you’re feeling. But for some, frown lines, deep wrinkles, and sagging can make people look tired or annoyed when this is not how they feel. “People at every age

want to look as good on the outside as they feel on the inside and this is driving demand for injectable treatments,” says Dr. Vince Bertucci, Dermatologist and President of the Canadian Dermatology Association. “The women I see in my office feel empowered and are looking for treatments that give natural looking, subtle results. They don’t want to look like celebrities, but rather a more refreshed version of themselves.” 

JUVÉDERM® is the #1 doctor recommended facial filler in Canada and worldwide and for people interested in previewing treatment options, please visit www.juvederm.ca or download the JUVÉDERM® Virtual Mirror App, available free of charge at the App Store. The app helps users experience a virtual makeover by seeing potential treatment results in real time via a digital mirror.

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BEFORE AFTER †

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Non-invasive anti-aging procedures administered by cosmetic dermatologists are helping aging Canadians look the way they feel.

Look the Age You Feel

“I always tell my patients it’s as important who is holding the needle as what’s in the needle.”—Dr. Julia Carroll, Founder of Compass Dermatology

† Actual treatment results may vary. In addition to JUVÉDERM®, the model received another cosmetic

injectable to eye area and forehead.

oronto dermatologist Dr. Julia Carroll regularly hears frustra-tions from her patients about how their outward appearance doesn’t match how they feel on

the inside, despite the use of expensive beauty creams. “She feels like a 35-year-old woman,” Dr. Carroll says of a patient. “She still sees herself with that same amount of energy and drive but to the outside world she looks tired, almost invisible. She doesn’t look like herself.”

For noticeable, immediate results, Dr. Carroll advis-es patients to try a non-invasive anti-aging procedure. For her youthful client in the 50s, Dr. Carroll used a small amount of an injectable cosmetic treatment — also known as a filler — around her mouth for a nat-ural-looking improvement. “I showed her the mirror immediately afterward and she said ‘Wow, I don’t have that sad face anymore!’”

Safe and effective yet non-invasiveMany dermatologic anti-aging cosmetic treatments are effective, safe and yet non-invasive. Dr. Anatoli Frei-man, Dermatologist and Medical Director of the Toron-to Dermatology Centre, says treatments like injectable soft tissue fillers can last for up to 18 months with min-imal downtime. “It’s a much quicker lunchtime proced-

ure as opposed to going under the knife,” Dr. Freiman explains. “[Fillers are] very safe. They’ve been around for many years and when used properly by experienced injectors they last for quite a long time.”

Choosing practitioners wiselyIf you’re thinking about improving your appearance through cosmetic treatments, Dr. Carroll advises you to select your physician wisely. “I always tell my patients it’s as important who is holding the needle as what’s in the needle.” She recommends booking consults with a few doctors to gather information, view before and after photos and find out more about those patients’ experiences to see if a doctor is a good fit. “You really want a physician who shares your treatment goals.”

Andrea Yu

A SPECIAL INTEREST SECTION BY MEDIAPLANETPERSONALHEALTHNEWS.CA

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M ost Canadians aren’t aware there are specialists in the field of preventing and treating wounds, but the Can-adian Association of Wound Care (CAWC) continues to ensure patients

have the information and specialists they need to keep their skin healthy and to heal hard-to-treat wounds.

Diabetic foot ulcers are one type of wound that is very common but often difficult to manage. These types of ulcers can be prevented, but when they occur and are not appropriately treated they can lead to disability, amputation, and even death. The good news is people with diabetes who are aware of their risk can incorporate daily habits that can prevent injury — saving their limbs and lives.

Education and resources are available for health care professionals, patients, and their families alike to help manage diabetic foot ulcers and other types of wounds effectively. The PEP Talk: Diabetes, Healthy Feet and You program is an example of a CAWC peer-led, patient-fo-cused program that provides supportive and educational sessions on diabetic foot care. It is delivered by people liv-ing with diabetes for people with diabetes and their family members. This setup gives patients an opportun-ity to ask clinical questions of the provider while learn-ing from the lived experience of a peer educator.

Members of the Canadian Association of Wound Care

to Reduce Diabetes-related Foot ProblemsMichelle was thrilled to have found the perfect pumps to match her mother-of-the-groom dress for her son’s wedding. Several guests commented on how beautiful they were as she danced the night away. The next day she noticed blisters on the toes of both feet. But, because they didn’t hurt, she stuck some bandages on and didn’t worry about them again. Two months later, at a regular visit with her doctor, she mentioned that her toes had still not healed. After an examination of her feet, the doctor told her she had a bone infection and might need to have several toes amputated to prevent the spread of the infection, which if left untreated, could endanger her life.

Michelle was horrified and couldn’t understand because her toes hadn’t hurt her at all. Her family doctor explained that because Michelle has diabetes, along with a condition that often accompanies diabetes called peripheral neuropathy, she had lost sensation in her feet. As a result, she had difficulty feeling pain or other sensations designed to alert her to foot problems. It was the reason she didn’t think to seek help for the damage that wasn’t healing. The doctor referred her to a diabetic foot clinic where she received care from specialists who were able to heal her wounds and prevent amputation.

5 Easy Steps for Preventing

Diabetes-Related Foot ProblemsStep ➊ Make positive lifestyle choices, such as eating healthy and exercising daily to help maintain your blood sugar within a normal range.

Step ➋ Examine your feet daily to make sure there is no redness or injury to your skin.

Step ➌ Wash and dry feet daily, use a moisturizer for dry skin, avoid extreme temperature changes, and always check water temperature with your hand — not your toe.

Step ➍ Wear shoes and socks that fit and protect your feet at all times; shake your shoes before putting them on to clear any foreign objects.

Step ➎ Identify members of your foot care team, such as an MD, podiatrist, chiropodist, or specially trained nurse to keep your skin and nails healthy and well-groomed.

PATIENT STORY

MEDIAPLANETA SPECIAL INTEREST SECTION BY MEDIAPLANET

Read more online at personalhealthnews.ca.

tchy, flaky skin has driven psoriasis patients into hiding, but new treatments are bringing profound improvements to chronic sufferers.

As Canadians are swapping coats and sweaters for shorts and tees, there’s one segment of the population that wants to

stay covered up. To avoid unwanted attention and em-barrassment, sufferers of psoriasis typically hide the unpleasant symptoms of their skin condition. “Psoria-sis is a chronic, non-contagious skin disease,” explains Edmonton-based dermatologist Dr. Perry Grewal. “It re-sults in patients getting thick, red, flaky, itchy, painful plaques on various parts of their body.”

Dr. Grewal says about three to five percent of the population suffers from psoriasis which typically affects the elbows, knees, scalp, and lower back. Those suffering from milder forms of psoriasis may only have one or two patches of affected skin while severe psoriasis may cover larger parts of the body. Psoriasis not only manifests it-self in the skin but can also be associated with heart dis-ease and inflammatory bowel disease. Psoriatic arthritis also affects about one third of psoriasis patients.

Psoriasis misconceptions lead to stigmas Much of the stigma that has evolved around this psor-iasis is due to misconceptions of the general public. “If you’re in the same pool or if you shake hands with some-one with psoriasis, it doesn’t mean that you’re going to get psoriasis,” says Dr. Grewal, emphasizing the dis-

ease’s non-contagious nature. Summer is an especial-ly challenging time for psoriasis sufferers as trips to the beach or pool become stressful occasions. Dr. Richard Langley, Professor of Dermatology at Dalhousie Medic-al School, has witnessed the profound negative impact psoriasis has on his patients’ quality of life. “I think of children who are teased at school, like one kid who was called ‘Alligator Boy’,” Dr. Langley says. He explains how his patients cover up and hide to avoid drawing atten-tion to themselves. “Because of this we see higher rates of depression, divorce, suicide, and alcoholism.”

For milder cases of psoriasis, typical treatments in-clude topical creams with steroids, salicylic acid, or char-coal. But, according to the Multinational Assessment of Psoriasis and Psoriatic Arthritis Survey, conducted in part by Dr. Langley, the majority of psoriasis sufferers weren’t aware there are more effective treatment options out there. “More than 80 percent of patients that had severe psoriasis were still only on creams,” Dr. Langley explains. “Many of those patients had given up and they had not sought additional therapies because they weren’t aware of them, they were concerned about the safety of them or their physicians were not prescribing them.”

Tremendous advancements in psoriasis treatmentsMore effective therapies for psoriasis include photother-apy, which is a medical-grade UV treatment, injectable drugs called biologics, and new oral pills. “There have

been tremendous advances in our understanding of the causes of psoriasis, and because of that, the treatments for psoriasis,” says Dr. Langley. “While in the past we had difficulty controlling the disease, there are many new op-tions available now that have an excellent benefit-risk profile. We’re able to control the majority of patients now with severe psoriasis in a safe manner.”

With effective treatment, psoriasis patients have enjoyed dramatic improvements not only in the clear appearance of their skin but in the lives they lead. “I had one patient that was living in the basement play-ing video games all day — his parents were upset that he wouldn’t go out and get a job or make friends. He was becoming reclusive,” explains Dr. Langley, who saw the patient emerge from hiding and reintegrate back into society. “When you remove the disease, it allows psoriasis patients to have normal lives again in every facet that you can imagine.” Andrea Yu

Effective Psoriasis Treatments Bring Long-Time Sufferers out of Hiding

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