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Ask your doctor

about topical
cold sore
treatments.
DERMATOLOGY
skinhealthawareness.ca
P
H
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T
O
:

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C
T

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N

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E
D
REFRESH YOUR VIEW
ON HEALTHY SKIN
Award-winning actress Cynthia Nixon shares how visiting a dermatologist
was the key to better understanding and managing her skin condition.
Featuring
LIVING WITH
COLD SORES
Know your options,
speed the healing
SKIN CANCER:
WE ARE ALL AT RISK
Innovations in
melanoma treatments
PREVENTING THE
PAIN OF SHINGLES
How to avoid this
unwelcome surprise
CHALLENGES
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2 SKINHEALTHAWARENESS.CA
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customers for our advertisers by providing
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A NEW REFLECTION
We all face challenges to clear skin.
Bad skin happens
W
ith the world watching,
Emma Stone, Kim Kar-
dashian,and Bill Clinton
sufered with the im-
pact of unhealthy skin.Acne, psoriasis,
and rosacea, all visible skin conditions,
can be physically and mentally debili-
tating for anyone famous or not.With
over 3,000 types of skin disorders,about
30 percent of Canadians struggle with
some kind of skin disease.
All of us at some point have been
bothered by a pesky rash,bump,pim-
ple, burn, or skin scrape. So it is not
surprising that over 40 percent of
our doctor visits are for a skin prob-
lem. Following a diagnosis, most pa-
tients see improvement within a
few weeks; however,what if the skin
prognosis is serious, worsens or re-
quires extensive treatment?
Beyond the surface
Millions of Canadians start their day
at the mercy of their skin disease,with
lengthy regiments of ointment appli-
cations, pills, countless medical ap-
pointments, and even the fear of be-
ing judged for looking diferent. Sim-
ply staring in the mirror can deate
ones willingness to leave their home.
Furthermore,some sufer from chron-
ic pain caused by their skin disease.The
majority of those living with a skin
condition feel self-conscious, embar-
rassed, frustrated, and unattractive,
which can lead to serious psychologic-
al repercussions and even depression.
Why are so many patients living with
these frustrations? Skin conditions
such as psoriasis, acne, and rosacea
often create a cycle of low expectations
and poor adherence to prescribed treat-
ments.Some live with the pain and dis-
comfort without realising the psycho-
logical burden that can set in.Other pa-
tients may not appreciate the necessity
to actively manage their skin condition
over the years, especially when other
factors like treatment side-efects,con-
venience, and costs add stress to their
life. Luckily, in Canada,we have access
to dermatologists and researchers spe-
cialising in skin issues seeking the best
solutions and treatments using the
latest science and technologies.
Expert advice
So,when is it time to see a dermatolo-
gist? If you feel your current treatment
is not working, if your skin is getting
worse, or if your skin is afecting your
self-esteem,ask your family physician
to refer you to a dermatologist.Derma-
tologists prescribe treatments that can
signicantly improve many chron-
ic skin diseases.You must ask for help
and not accept your skin disease as
something you should just live with.A
dermatologist has the experience and
knowledge of the latest treatment to
best treat your skin issue.
Also, partnering medical treatment
with a strong support system is key to
helping patients living with a chron-
ic skin condition. Skin illnesses have a
huge impact on the quality of life.Many
isolate themselves, skip opportunities
to gather in a social setting to avoid be-
ing seen, or they are simply too blue
and would rather not connect with
others. Some even lose their employ-
ment due to accumulating sick days
which can send patients into a negative
spiral, especially if medical insurance
coverage is consequently terminated.
Connecting with those who under-
stand can make a world of diference.
You are not alone
A skin disease is rarely just skin deep
profoundly afecting patients both
physically and psychologically, says
the Canadian Skin Patient Alliances
President, Barbara-Anne Hodge. The
Alliance is a non-prot patient group
that educates,supports,and advocates
for Canadian skin patients. Thou-
sands of Canadians are missing out
on life because they believe that they
need to tolerate their symptoms and
adjust their activities for the rest of
their lives, she explains.
Whether you or someone you care
about is living with a skin condition,
start the conversation today,get support,
trust your instinct, research your treat-
ment options, and be proactive about
caring for your skin.You are not alone.
DERMATOLOGY
FIRST EDITION, JUNE 2014
Publisher: Sonja Draskovic and Sara Pazin
Business Developer: Martin Kocandrle
Managing Director: Joshua Nagel
Production Manager: Laura Shaw
Lead Designer: Matthew Senra
Designer: Scott Dixon
Contributors: Patrick Bissett, Canadian
Dermatology Association, Canadian Skin
Patient Alliance, Canadian Skin Cancer
Foundation, Kimberley Fehr, Elianna Lev,
Erin Lukas, Ishani Nath, Sheri Pilon, Joe
Rosengarten, Dr. Marla Shapiro,
Dr. David Zloty
Send all inquiries to
editorial@mediaplanet.com
Distributed within:
The National Post, June 2014
This section was created by Mediaplanet
and did not involve The National Post or its
Editorial Departments.
Photo credit: All images are from
Thinkstock.com unless otherwise
accredited
How to manage your
psoriasis
PAGE 11
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SHERI PILON
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Sheri Pilon
ASSISTANT DIRECTOR, CANADIAN
SKIN PATIENT ALLIANCE
A skin disease
is rarely just
skin deep pro-
foundly afecting
patients both
physically and
psychologically.
New advances in the treatment of cold sores
Affecting an estimated six
million Canadians, cold sores
cause a burning or stinging
pain, skin sensitivity and can
lead to depression and social
isolation. But what causes
cold sores and what effective
treatments are available?
Causes and symptoms
Cold sores are caused by the Her-
pes Simplex Virus (HSV), an infec-
tion that the majority of Canadians
contract during childhood or ado-
lescence. Its the most common of
viruses and can afect individuals
of any age, explains Dermatologist,
Dr. Gary Sibbald. The rst infection
often occurs before the age of 14, and
up to 70 percent of the population
have had a past infection.
HSV is highly transmittable and
primarily passed on via intimate oral
contact with an active cold sore,shar-
ing kitchen utensils or asymptom-
atic shedding of the virus between
acute episodes. People who sufer
with recurrent cold sore eruptions
will normally experience between
one and six outbreaks per year.
Regular recurrences of a cold sore
will have less severe symptoms than a
primary outbreak, which can include
a period of fever, oral ulcerations, and
gingivitis. Intermittent cold sore
eruptions, also known as recurrent
herpes labialis, are characterized by
the appearance of small blisters on
the lip,which usually last for between
one and two weeks.
It is known that frequent recur-
rences are associated with a signi-
cant negative impact on quality of life.
Theres a common negative view that
a cold sore is something dirty, some-
thing bad, says Dr.Sibbald.That view
stops people from talking to others
about it or disclosing it to friends and
sexual partners.
Triggers
Although it may seem impossible to
avoid contracting HSV in the rst place,
realizing what triggers cause possible
outbreaks, and then doing whatever
you can to avoid them is essential. Al-
though in some cases,triggers are sim-
ply unavoidable. Cold sore triggers in-
clude: fever, sun exposure, other ex-
isting viral respiratory infections,
emotional stress, fatigue, trauma, iron
deciency, oral cancer therapy, im-
mune-suppressing chemotherapy for
cancer, oral and facial surgery, gastro-
intestinal upset, and menstruation.
UV rays are the number one trigger of
cold sores, says Dr.Sibbald.
Treatments
There is a common misconception
that cold sores cannot be proper-
ly treated and controlled. Its also
damaging for people afected, who
may be reluctant to seek treatment
if they take on this false information
as truth.
Most patients prefer a cream that is
applied directly on the cold sore lesion
area (a topical treatment).
Xerese is a new topical treatment
that has been shown to shutdown the
development of cold sores and prevent
cold sore progression.It decreases the
size of the lesion and speeds up heal-
ing time. Patients are recommended
to apply Xerese ve times a day for ve
days at the rst sign of burning and
stinging.
Xerese is a combination of acyclo-
vir and hydrocortisone, says Dr Sib-
bald. The acyclovir stops the viral
replication and the hydrocortisones
anti-inammatory action accelerates
the recovery stage. It may even pre-
vent the redness at the early stages of
the sore from ever occurring.
Valtrex is an oral treatment also
shown to shut down the develop-
ment of a cold sore. Patients are
recommended to take four pills at
the rst sign of burning and then
another four between four and 12
hours later. It works by interfering
with the enzyme thats important
for viral replication, says Dr. Sib-
bald Its one of the safest drugs that
weve got.
If youre one of the six million
Canadians that is afected by cold
sores, make sure that you visit your
doctor to discuss treatment options.
Make today the day that you start to
tackle the problem.
JOE ROSENGARTEN
editorial@mediaplanet.com
FIND EXCLUSIVE ONLINE CONTENT AT
SKINHEALTHAWARENESS.CA
MEDIAPLANETCA
KNOW THE FACTS
Left: HSV is highly transmittable
Right: Six million Canadians are
affected: Proper treatment and
control exists.
It is time to talk about our skin. Although it is not perfect,
there are ways to manage and treat diferent skin conditions to
improve overall comfort, appearance, and quality of life.
By starting
an open
dialogue about
psoriasis, more
suferers will
be encouraged
to shake of
their fears
and go see a
physician about
treatment.
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SKINHEALTHAWARENESS.CA 3
E
very year,as many as 60,000
Canadians are afected by
Basal cell carcinoma (BCC)
a type of non-melanoma
skin cancer.BCC is the most common
type of skin cancer,accounting for 80
percent.The cancer starts in the basal
cells,which produce new skin cells as
the old ones die of.
BCC most often develops on areas of
the skin that are most exposed to the
sun, such as the face and neck and is
believed to be caused by long-term ex-
posure to UV rays from sunlight.Given
that our skin is the bodys largest or-
gan, there is a lot of area to protect
from hazardous sun damage. But ex-
tensive, chronic exposure can lead to
BCC in damaged areas of the skin.
Symptoms to look out for with BCC
include: an open, bleeding or oozing
sore that doesnt heal; a reddish patch
or bumpy area; a shiny bump or nod-
ule thats pearly,translucent,pink,red,
or white in colour; a pink growth with
a slightly elevated rolled border and a
crusted indentation in the centre or a
scar-like area with poorly dened bor-
ders that isnt a result of injury.
Advanced Basel Cell Carcinoma
If caught early enough, BCC is curable
and can be treated with surgery or radi-
ation. However, one percent of BCC
cases tend to progress to advanced BCC
and these cases are not as manageable.
Advanced BCC is when the cancer has
spread beyond the skin and into the
lungs, the lymph nodes, or the bones.
Treatment with radiation and surgery
is not suitable or possible,and chemo-
therapy isnt considered efective.
People with advanced BCC tend to
have progressive disease and usually die
within 10 to 15 months, says Dr. Scott
Ernst,head of medical oncology at West-
ern University.The other type is locally
advanced BCC,when the tumour is still
in the skin but invades into the region
around it.So if they have it on their face,
for example,it means that it can extend
into the facial bones, nose, eyes, ear, or
skull bone, explains Dr.Ernst.
These cases of advanced Basal Cell
Carcinoma are rare, and until recent-
ly,have been incredibly challenging to
manage.If left untreated,BCC can prog-
ress to more advanced stages,resulting
in severe deformities and debilitat-
ing efects,and can even lead to death.
When BCC progressed to an advanced
state,up until now,has left this patient
population with no treatment options.
However, patients with advanced BCC
are being given hope since a new,non-
invasive medication taken daily as a
pill has been introduced.
New hope, new relief
Murray Thorimbert has lived with ad-
vanced BCC for almost 35 years and
received the non-invasive therapy as
part of a clinical trial.
Since my early 20s, I have had six
to seven surgeries each year to re-
move BCCs I even had part of my
scalp removed but the lesions just
kept coming back, says Thorimbert.
The continual procedures took a ser-
ious toll on me and my family. Since
I started the new therapy, my lesions
started to clear up and I felt like I
started to get my life back. I havent
had a single surgery since.
Having something now thats in
a pill form for cancer is pretty new
wave, says Kathleen Barnard,found-
er of the Save Your Skin Foundation.
In the earlier days, surgery was the
thing for advanced BCC. And now
to think that we dont have to cut?
Thats pretty amazing science.
The Hedgehog signaling pathway
tends to play a key role in regulat-
ing proper growth and development
in the early stages of life. Abnormal
Hedgehog signaling is connected to
more than 90 percent of BCC cases.
The pill blocks the pathway that is
driving the growth of the cancer cells.
Dr.Ernst agrees,saying its an encour-
aging development for treating rare
forms of BCC. Before patients would
have an uncontrolled tumour and now
within a few weeks its controlled, he
says. Weve been able to save peoples
eyes,noses,ears,and half their face.
After a long, brutal winter,
the arrival of warmer days
is a welcome relief. As
temperatures rise and
days get longer, beaches
and parks are crowded
with people eager to take
advantage of the sun and
our all-too-short Canadian
summer. However, a note of
caution is necessary.
Incidences of melanoma are rising in
the Canadian population. According
to the Canadian Cancer Society (CCS)
6,500 people will be diagnosed with
melanoma in 2014 with 1,050 dying
from the disease. The CCS estimates
that one in 59 Canadian men will
contract melanoma in their lifetime
with one in 73 women also develop-
ing the disease.
Six months to live
One such woman is Save Your Skin
Foundation founder, Kathy Barnard.
Doctors rst diagnosed Kathy in 2003
with early stage melanoma. Initial
treatment appeared successful but
soon after,Kathy experienced a major
recurrence and was given six months
to live.They found cancer in my liver
my bones,my lung and adrenal glands
I was full. However,Kathy was able
to take part in a clinical trial for a new
form of immunotherapy drug and ex-
perienced a dramatic turnaround.
Everything is gone, says Kathy.
There is no cancer left.
Immunotherapy treatments work
by arming the bodys immune sys-
tem to recognize and ght the dis-
ease, and as in Kathys case achieve
results that appear miraculous.
New treatments
Immunotherapy is not the only new
form of treatment available.With the
arrival of precision medicine (which
is an approach where a patients dis-
ease is analyzed at the molecular
level),and targeted therapies,doctors
can now exclusively target the can-
cer cells.Mutations in the BRAF gene
cause the gene to make an altered
BRAF protein that signals melan-
oma cells to grow and divide quickly.
One type of targeted therapy targets
this faulty BRAF gene.Melanoma tar-
geted therapies work by attaching to
cells with the faulty BRAF gene, in-
hibiting their growth, and causing
them to die.
Dr. Danny Ghazarian is the Mel-
anoma and Skin Site Group Lead-
er at Princess Margaret Hospital in
Toronto, and is excited at the new
wave of personalized medicine.The
combination of these therapies is
an amazing breakthrough. Before
2010, a patient with a metastatic
melanoma had about six to eight
months to live. Now we are seeing
patients above two years and with
an improved lifestyle. Using ther-
apies such as TILS (a form of therapy
where T cells are removed from the
body and infused with antigen re-
ceptors before reintroduction, thus
allowing greater recognition of can-
cer cells) and targeted therapies, we
are able to fully recognize and de-
stroy cancerous cells, says Dr.Ghaz-
arian. We are heading to a good fu-
ture. And, one of the most potent
weapons in the ght for a better fu-
ture is targeted therapy. Targeted
therapies can be used against mel-
anomas that are otherwise inoper-
able, and its very efective and of-
fering immense hope to patients.
Preventing melanoma
Yet the fact remains that UV expos-
ure causes 90 percent of all melan-
omas, a point that Annette Cyr of
the Melanoma Network of Canada is
keen to stress. This is preventable.
Dont over-expose yourself to UV
rays. Seek shade and use protective
clothing a lot of clothing has SPF
built in. Use a broad-spectrum sun-
screen and reapply regularly.Preven-
tion is better than cure.
Talk to you doctor if you are con-
cerned about skin cancer or melan-
oma; for more information and re-
sources, visit the Melanoma Net-
work of Canada or the Save Your
Skin Foundation.
ELIANNA LEV
editorial@mediaplanet.com
PATRICK BISSETT
editorial@mediaplanet.com
Groundbreaking treatments for melanoma
create new hope for skin cancer patients
Improving quality of life for Canadians diagnosed
with the most common form of skin cancer
Dr. Danny Ghazarian
MELANOMA AND SKIN SITE LEADER,
PRINCESS MARGARET HOSPITAL
Dr. Scott Ernst
HEAD, DIVISION OF
MEDICAL ONCOLOGY,
LONDON REGIONAL
CANCER PROGRAM
6,500 Canadians will be
diagnosed
1,050 Canadians will die from
melanoma
3,500 men will be diagnosed;
660 will die from it
3,000 women will be
diagnosed; 400 will die from it
MELANOMA IN 2014
SKIN CANCER AWARENESS
LEFT: 76,100 Canadians will be
diagnosed with non-melanoma skin
cancer. If you are concerned, visit your
doctor today.
RIGHT: Walking for awareness: Strides
for Melanoma Walk in 2013
PHOTO(RIGHT): SAVEYOURSKINFOUNDATION
Dont over-expose yourself
to UV rays; seek shade and use
protective clothing. Use a
broad-spectrum sunscreen and
reapply regularly. Prevention is
better than cure.
Kathy Barnard,
Save Your Skin Foundation
Asymmetry: Is the spot in ques-
tion an unusual shape?
Borders: Are the edges uneven or
scalloped?
Colour: is there a variety of col-
our?
Diameter: Is it greater than six
millimeters or the size of a pencil
eraser or larger?
Evolution: Has it changed in
size,shape,colour or height?
If you have any questions or con-
cerns, be sure to visit your doctor.
For more information, resources
or support on skin cancer,contact
the Melanoma Network of Can-
ada, Save Your Skin, or visit their
websites.
AWARENESS IS AS
EASY AS ABCDE
The key to preventing forms of BCC
is awareness. Theres a simple way to
monitor your skin for questionable
markings .

BE SUNSAFE. BE SUN AWARE. PROTECT YOUR SKIN.
STRIDES FOR MELANOMA: WALK FOR AWARENESS
JOIN US: SUNDAY, SEPTEMBER 28TH 2014
melanomanetwork.ca
Find out more:
Melanoma is a very serious and potentially deadly form of
skin cancer. Its not just skin cancer. In 2013 over 6,100
Canadians were diagnosed and over 1,000 died of
Melanoma. But, it doesnt have to be this way.
Join our walk for awareness across
Canada and help raise funds towards
melanoma research, education and patient support.
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SKINHEALTHAWARENESS.CA 5
Although it afects over one million Canadians, psoriasis is a disease that many
people have little or no knowledge about. This lack of awareness has a large
negative efect for suferers of the skin condition.
Changing your perspective on psoriasis
Symptoms and triggers
Characterized by thin,red,scaly patches
typically located on the elbows, knees,
and scalp, psoriasis is itchy and irritat-
ing,and sometimes so unbearable that
patients scratch themselves until they
bleed. Psoriasis is not just a skin-itch
condition afecting just under one mil-
lion Canadians. Its economic burden
is immense: almost two billion a year,
says Christine Janus, of the Canadian
Association of Psoriasis Patients.
Although there is currently no cure
for the disease,with the correct treat-
ments it can be efectively controlled.
There is a common belief that psoriasis
can be passed from one person to an-
other,but this is incorrect; psoriasis is
not an infection and is, therefore, not
contagious.
Scientists have yet to clearly de-
ne a cause of psoriasis, explains Dr.
Shaq Qaadri, family physician and
medical lecturer. We do know there
is a genetic component to the condi-
tion though, meaning that it can run
in the family, says Dr.Qaadri.
It is known,however,that environ-
mental triggers, such as trauma to
the skin, strep throat, stress, or ciga-
rette smoking can start the rst ap-
pearance or ares of the disease.
Suffering in silence
Psoriasis often causes just as much
psychological pain as it does physical
discomfort.Many suferers experience
embarrassment as well as low self-es-
teem and condence,which seriously
impacts their relationships,social life,
work,and interpersonal skills.
Janet English,23,has been sufering
with psoriasis for ten years, and she
often nds herself picking out clothes
that cover up the parts of her skin that
are afected.I work in a retail environ-
ment and sometimes customers come
up and ask whats wrong with me, she
says.They have a judgemental look on
their face that says should I be touch-
ing what shes touching?
A recent study showed that 94 per-
cent of suferers feel that the disease
afected their overall quality of life,
and 81 percent said that their work,
school, and leisure activities have
been significantly affected. People
with psoriasis also have higher rates
of depression and suicide.
A challenge with psoriasis man-
agement is the large gaps that often
occur between the start of the disease
and a diagnosis by a health care pro-
vider, which can sometimes take up
to 15 years.This delay in diagnosis can
further increase the impact of psoria-
sis on self-esteem and seriously afect
personal and professional relation-
ships, even after the disease is being
properly treated.
Raising awareness
Despite the physical symptoms and
psychological impacts, the lack of
awareness surrounding the condi-
tion leads to thousands of Canadians
suffering in isolation, afraid and
ashamed to speak out and seek help.
This needs to change, and by start-
ing an open dialogue about psoria-
sis,more suferers will be encouraged
to shake of their fears and go to see a
physician about treatment.
English thinks that its important
that the general public gains a better
understanding of psoriasis; she feels
that if people knew it wasnt conta-
gious,attitudes might begin to change.
If people knew more about it, I think
theyd be less judgemental, she says.
Hardeep Singh,48,feels that the per-
ception of psoriasis will change,but that
more public education is required be-
fore that can begin to happen.If every-
body knew that its just a normal dis-
ease,that cant be passed on if you shake
hands with somebody,people would be
more respectful to people with psoria-
sis, says Singh,who has been afected
by the condition since 2009.
It does seem as though things are
slowly changing, and this is reected
by a recent decision made by the
World Health Organization to adopt
its rst ever resolution on psoriasis,
recognizing the disease as a signi-
cant burden for people who, due to
their condition, face stigmatization
and discrimination.
A problem shared
Dr. Qaadri believes that suferers of
psoriasis should have access to advo-
cacy and support groups,places where
they can interact with others who
have experienced what theyre going
through. Theres nothing more com-
pelling for patients than hearing from
someone who is now a champion of
their disease, he says. Patients see
that they too can bounce back and
move forward with their lives.
Singh also feels that the introduc-
tion of support groups would be a
positive step. Its a great idea, he
says. We would be able to have dis-
cussions and share our feelings, it
would give everybody a morale boost.
Only when the stigma is gone
and those affected are confident
enough to open up to medical profes-
sionals will we see every single Can-
adian afected by psoriasis getting the
treatment that they need and deserve.
Pharmacist Carolyn Siauw comes
across many patients with the disease.
My job is to provide patients with the
best possible advice to make them feel
as well as possible and as soon as pos-
sible, she says,but this can only hap-
pen through open and frank dialogue
between patient and pharmacist.
Dr. Qaadri echoes the thoughts of
Siauw: recovery starts with the pa-
tients themselves, he says. If you
have itchy patches that dont go away
with your basic home remedies, you
need to go and see a doctor.
MANAGING YOUR PSORIASIS
Left: Ask your doctor about treatments
and available support groups.
Right: Plaque Psoriasis is the most
common form, characterized by
raised, red scaly patches.
PHOTOS: STALMANS
JOE ROSENGARTEN
editorial@mediaplanet.com

BE SUNSAFE. BE SUN AWARE. PROTECT YOUR SKIN.
STRIDES FOR MELANOMA: WALK FOR AWARENESS
JOIN US: SUNDAY, SEPTEMBER 28TH 2014
melanomanetwork.ca
Find out more:
Melanoma is a very serious and potentially deadly form of
skin cancer. Its not just skin cancer. In 2013 over 6,100
Canadians were diagnosed and over 1,000 died of
Melanoma. But, it doesnt have to be this way.
Join our walk for awareness across
Canada and help raise funds towards
melanoma research, education and patient support.
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AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET TO THE NATIONAL POST
6 SKINHEALTHAWARENESS.CA
ERIN LUKAS
editorial@mediaplanet.com
N
inty 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 afects 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 condence 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
treatment
While the severity, length, and point
in life when someone is afected 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
condent 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 acne
Dr. 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 sacricing their health.
Take action
While 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 facts
Rosacea 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 triggers
Spicy foods, alcohol, emotional
stress, sun exposure, exercise and
cafeinated 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 diferent
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
suferer may overact, causing an in-
ammation of the skin that then
feeds on itself.
Currently, there are no suf 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 condition
There are a number of diferent ros-
acea treatments, all of which are
generally quite efective, 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 afected may be
ROSACEA:
Shedding light on the
chronic skin condition
Rosacea is an inammatory skin condition that
afects 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 BREAKOUTS
There are treatment
options that can clear
your complexion.
CONTINUED ON NEXT PAGE
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SKINHEALTHAWARENESS.CA 7
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 afect my
condence 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 affected
Nixons 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 afected by it.
Visiting a dermatologist
The key to managing rosacea is get-
ting a diagnosis. Those who are left
undiagnosed face challenges on-
ly about one in ten suferers 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 control
These days, Nixon is more condent,
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
editorial@mediaplanet.com
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
suferer may overact, causing an in-
ammation of the skin that then
feeds on itself.
Currently, there are no suf 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 condition
There are a number of diferent ros-
acea treatments, all of which are
generally quite efective, 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 afected 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 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 inammation
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-inammatory 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 efect on the course
of the disease itself.
If you think that you may be afect-
ed by rosacea, dont continue to suf-
fer without professional advice and
treatment. It could make a massive
diference to your life. A trip to your
doctor could be your rst step on the
road to beating rosacea.
ERIN LUKAS
editorial@mediaplanet.com
-Cynthia Nixon
NEWS
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ADVANCES IN THE TREATMENT
OF NAIL FUNGUS:
NEW OPTIONS AVAILABLE
PATRICK BISSETT
editorial@mediaplanet.com
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 characteristics
Dr. 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 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 efectively treating
the disease. The sooner a diagnosis
is made, the sooner treatment can
begin and the less likely complica-
tions become.
Treatment options
There 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 rst advance in
onychomycosis treatment in a decade.
Jubilia works by penetrating through
the nail to 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 stigma
Not 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 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 sufering from hyper-
hidrosis a condition that denes in-
dividuals who sweat more than the
body would normally need to main-
tain optimal temperature.
While hyperhidrosis afects ap-
proximately 950, 000 Canadians,
only 38 percent of hyperhidrosis
suferers 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 afects suferers 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
editorial@mediaplanet.com
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O
ne 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 volume
When 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 ll-
ers to return the face to its youthful
shape. By injecting llers we can ll
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 llers in use
today are hyaluronic-acid based.
Hyaluronic acid is one of the main
components of skin, explains
Dr. Weksberg, so by using a ller
made of the same material you can
avoid reactions, and enable the ll-
er to blend in very naturally with
the skin. There are very few cases
of inammation, 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 ll-
ers, I nd 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 llers will not change to its shape.
This could result in a distorted look.
Smooth lines and wrinkles
Static 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-
D
ermatology is a medical spe-
cialty that focuses on the skin,
hair, and nails, but its not a
supercial specialty by any stretch.
There are around 3,000 known skin
diseases, ranging from the very com-
mon to the very rare. Acne afects 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 reect 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 everyone
At some point in our lives, most of
us will develop some skin condi-
tion, be it a rash, chickenpox, or dan-
druf. Some skin conditions are eet-
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 lling in laugh
lines.Although many skin conditions
are not life-threatening, the majority
carry a heavy social and physical bu-
rden on efected patients.
More than skin deep
Besides visible skin changes,most skin
diseases have a denitive 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
afect employment opportunities, and
they can severely afect 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 horizon
The 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 articial 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 elasticity
As we get older,the skin loses elasticity.
Radiofrequency or ultrasound energy
can be used to tighten the collagen b-
ers and stimulate new collagen forma-
tion,making skin less saggy.
Improve colour
Brown 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.
Resurfacing
How 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 picture
Theres no one-size-ts-all approach
to rejuvenation. Consulting with a
cosmetic dermatologist or specialist
to nd out whats best for you is the
rst step towards a youthful and fresh
appearance.
Dr. Fred Weksberg
OWNER, 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 Zloty
PRESIDENT, CANADIAN DERMATOLOGY
ASSOCIATION
KIMBERLEY FEHR
editorial@mediaplanet.com
DR. DAVID ZLOTY
editorial@mediaplanet.com
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 sunscreen
Youll 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 you
Dr. 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 specic-
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
of right with an annual mole check
with the doctor.
Take care of your skin issues
Sun 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: WEKSBERGCENTERFORCOSMETICDERMATOLOGY
The science of skin
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It is the season for summer sunshine that we have all been waiting for.
Before ocking to the beach, it is important to understand the dangerous efects 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: CTVNEWS
W
ith 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 smart
As 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 ofer 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 misconceptions
The 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-
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 efects started then!
The power to protect yourself
Skin 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 critical
Make 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 400
Use 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 DETECTION
FOLLOWING 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
A
B
C
D
E
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
I NSI GHT
AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET TO THE NATIONAL POST AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET TO THE NATIONAL POST
SKINHEALTHAWARENESS.CA 11
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 identied
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 sufered 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 pain
Nerves 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 shot
Since 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 efects, 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
F
or 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 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.
Discomfort
The 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 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 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 conrmed 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 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 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 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 stigma
Vitiligo 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 diferent
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 support
Chantelle 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-con-
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 Rosenthal
PHOTO: ROBERTKETCHEN
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 GETTING
VACCINATED
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)