Family Practice

Personal care in Canada is a $5 billion industry that offers thousands of competing products, many of which make skin care-related claims. Advertisers inundate us with messages about what their products can do for us, but how can we be sure that the products we buy will actually live up to their claims?

Recognition and appropriate treatment of these common bacterial skin infections, while at times challenging, can be very rewarding for both the physician and the patient. Selecting the right therapy from the beginning should help minimize complications, reduce the number of hospitalizations, and may also help reduce the climbing incidence of bacterial resistance.

For decades, skin care has primarily been considered to be the domain of women, but recently, an increasing number of men are involved. This article delves into similarities and differences in gender as it relates to skincare, and the complexities of skincare for men.

The National Advisory Committee on Immunization (NACI) recently released its recommendations for the use of the quadrivalent vaccine, which include: For use in females 9-26 years of age. The recommendations for the use of the bivalent vaccine will be available following its approval in Canada.

Mild to moderate atopic dermatitis (AD) is often controlled by behavioral measures such as skincare and avoidance of triggers in addition to topical treatments such as topical corticosteroids (TCS), topical calcineurin inhibitors (TCI), and crisaborole, a phosphodiesterase-4 inhibitor (PDE4-I).

Physicians will be particularly reassured if the suggested guidelines are supported by scientific evidence. This new Canadian clinical guideline for the treatment of acne was developed taking into account new data published up to March 2015, as well as expert opinion and clinical experience.

This article delves into new development and research into cosmeceuticals, their potential role, and the importance of educating patients on realistic expectations. Various potential benefits are discussed using an evidence based vantage.

Novel uses of old medications and new formulations of systemic medications have broadened the therapeutic armamentarium for treating rosacea patients. It is of primary importance to offer patients safe and effective therapies for this chronic and incurable condition, improving both the clinical and psychosocial consequences of rosacea.

Acne vulgaris is a chronic inflammatory cutaneous disease involving the pilosebaceous unit. This article discusses pathophysiology, sebum production, keratinization, and the role of P.acnes in acne formation.

Atopic dermatitis is a chronic inflammatory skin condition. It has a relapsing course characterized by flare-ups of acute eczema on a background of chronically dry skin. The association of atopic dermatitis (AD) with asthma and allergic rhinitis is referred to as the atopic triad.

The cosmeceutical industry has undergone phenomenal growth over the past decade. Acquiring a basic knowledge of the major classes of active ingredients that are found in cosmeceuticals will enable healthcare professionals to provide accurate and educational information to consumers.

Atopic dermatitis (AD) or eczema is a chronic, relapsing form of skin inflammation that is attributable to multiple pathogenic, genetic, and environmental factors, as well as a dysfunctional epidermal barrier. Immune responses involved in AD culminate in dry skin, pruritus, and IgE mediated sensitization to food and environmental allergens.

Hirsutism can cause embarrassment and lead to anxiety and depression. There are a limited number of treatments available that vary in efficacy, degree of discomfort and cost. It is very important to make sure that the patient is aware of all the available treatment modalities, since no one method is effective for all patients or body locations, and results from therapy may not always be satisfactory.

Parabens are preservatives used in a variety of personal care, cosmetic, pharmaceutical and food products. Discovery of parabens in the breast tissue of patients with breast cancer has raised public concern over their use. This article discusses the controversy, research, regulations, and possible alternatives.

Acne vulgaris remains a therapeutic challenge, in large part due to its multifactorial pathophysiology. Evidence for improved and quicker efficacy with safety and longer remission has been noted with combination therapies.

Evolving understanding of the role of hormones in acne, along with a growing body of data from clinical trials, calls for a reappraisal of the role of hormonal therapy for acne.

Hair loss is a common dermatological problem that affects a large segment of the population both physically and psychologically. This article focuses on androgenetic alopecia (AGA) or male pattern hair loss, as well as the common treatments, Minoxidil and other topical treatments.

The term “atopy” was first coined by Cooke and Coca in 1923, derived from the Greek word atopos, which means out of place and denotes an immune reaction that is “strange or eccentric”. Atopic dermatitis (AD) is a chronic, waxing and waning, often symmetric inflammatory eruption that is characterized by pruritus and xerosis.

In a small real-world patient case review study, dermatologists tested the efficacy, safety and patient preference of Enstilar®, a calcipotriol-betamethasone dipropionate (Cal/BD).

Patients often seek natural approaches to treating skin disease. Colloidal oatmeal has been used for decades to improve atopic dermatitis and soothe other pruritic and xerotic dermatologic conditions.

Almost everyone at some point in his or her life will be troubled with mild acne. It can be related to athletic activities, travel, cosmetics, or hormonal changes. Various treatment options are discussed.

For most patients, antiperspirants containing aluminium salts are the first-line treatments. Other therapeutic options, especially for those with hyperhidrosis, include botulinum toxin injection, systemic anticholinergics, iontophoresis and surgery.

This article review the newer vehicles which include gel, foam, and spray preparations. The newer topical delivery agents have the potential to limit the progression of cutaneous disorders requiring oral systemic therapy, which can expose the patient to greater risk for adverse side-effects.

A summary of the most comprehensive and up to date guideline for treating non-melanoma skin cancer in Canada. Background, primary prevention, actinic keratosis, managing basal cell carcinoma, and squamous cell carcinoma, are covered.

Acne vulgaris is a disease of the pilosebaceous follicle characterized by non-inflammatory (open and closed comedones) and inflammatory lesions. Its pathogenesis is multifactorial - the interplay of hormonal, bacterial, and immunological (inflammatory) factors results in the formation of acne lesions.

For many years, clinicians have expressed ongoing concerns about treatment adherence by patients, especially pertaining to those with chronic skin disorders. Although crucial to effective therapeutic outcomes, the issue of patient adherence has been largely ignored in dermatologic disease management until recently.

The new generation of sunscreens serve an important role in overall skin protection from the sun. However, they should be used in conjunction with other sun protection measures such as sun protective clothing, hats, and sunglasses.

Truncal acne refers to AV affecting the chest and/or back, a common presentation in acne patients. This article offers guidance in clinical differentiation of truncal acne from other acneiform diseases and provides management recommendations.

For the purposes of this article, the focus will be on the topical treatment of post-adolescent mild to moderate acne. A selection of over-the-counter and prescription based topical treatments are discussed below.

Patients suffering from scalp psoriasis frequently seek medical care because of the persistent discomfort and social embarrassment caused by the visible flakes that are shed onto clothing. However, the presence of hair makes it challenging to apply medication to the scalp.

Atopic eczema (or atopic dermatitis) is a common inflammatory skin condition that dermatologists, pediatricians, family physicians, and primary-care providers see on a daily basis. Treatments, mechanism of action, preventative therapies, and the skin barrier are discussed.

This article will deal with the diagnosis and treatment of common eruptions on the feet.

Psoriasis is a chronic inflammatory cutaneous disorder that can significantly affect patient quality of life (QoL). This article discusses immunologic abnormalities, immune mediators, and the possible pathogenesis of psoriasis.

There are currently no laboratory tests to diagnose rosacea; it remains a clinical diagnosis. The actual pathophysiology and etiology of rosacea also remain unclear; however, quite recently the spectrum of rosacea has been classified and standardized.

In this article, we provide a guide to address a growing need by primary care physicians to have a logical and practical approach to treating various forms of acne.

This article reviews the various subtypes of rosacea, their clinical presentations, and the considerations in choosing the optimal therapeutic options. The importance of tailored treatment is discussed as well as topical therapies.

Psoriasis and eczema can at times be recalcitrant to conservative topical treatment. This article focuses on corticosteroid strength and their appropriate uses for various presentations.

Chronic idiopathic urticaria (CIU) is a common autoimmune skin condition characterized by spontaneously recurring hives for six weeks or longer. We review the mechanisms of action of omalizumab, efficacy, cost and potential side effect profile for treating CIU.

Onychomycosis is a fungal infection of the nail caused by dermatophytes, yeasts, or non-dermatophyte molds. Here we discuss using topical Efinaconazole in the management of toenail onychomycosis.

The best approach is a pragmatic one. The patient with few AK lesions is most conveniently and cost effectively treated with a destructive technique (cryosurgery or curettage with light desiccation). Those with many AKs are candidates for medical therapy (such as 5-fluorouracil, imiquimod or diclofenac).