Stress acne is a thing

Dr. Benjamin Barankin is a dermatologist practicing in Toronto and is the medical director and founder of the Toronto Dermatology Centre. Often skin care lines have an in-house dermatologist to talk about their respective brand but Dr. Benjamin Barankin is brand agnostic. He has shared best practices for picking sunscreen, mosquito protection and healing dry skin.

And now, acne.

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Between physical makeup stores and pharmacies and the seemingly endless supply of beauty brands online, it’s hard to decipher which skin care products could work for you. When it comes to acne, there are all sorts of underlying causes.

It’s so interesting and incredible how connected the mind and body are — aside from when our minds are stressed and then we get acne. Way to kick us when we’re down, bodies. But turns out, we’re not imagining things. Stress acne is a thing.

Also, why do we get acne on our chests and backs? Or “trunks,” as dermatologists call them. We learned a bit of the profession’s jargon, how to treat acne and fun (not fun) facts like adult acne is more common in women.

Q: What causes acne?

A: Acne is due to many factors including stress, diet and genetics, but ultimately there is a hormone-mediated drive resulting in increased sebum(oil) production, as well as plugging up of pores, inflammation and C. acnes bacteria.

Q: Do adolescence and adult acne have the same cause?

A: Generally speaking. Adult acne is much more common in women and is typically due to hormonal factors.

Q: Can you treat adolescent and adult acne the same way?

A: Treatment is similar, except that adult skin tends to be less oily and more sensitive and more often hormonal.

Q: What are the differences between face and body acne in terms of cause and treatment?

A: Face and trunk are similar.

Q: How do you prevent acne?

A: Prevention includes gentle cleansing, avoiding picking and popping and minimizing exfoliating of the skin. A low-glycemic diet and reduced dairy (skim milk especially) are helpful for some people. A benzoyl peroxide body wash can be quite useful for those with body acne. Keeping athletic gear (e.g. hockey or football equipment) clean and washing right after sport is important for body acne prevention.

Q: How do you treat acne?

A: The type of acne (e.g. hormonal, comedonal, inflammatory etc.) and extent of acne (face only, or also trunk) are important determinants of treatment options. 

Over-the-counter (OTC) options mainly include benzoyl peroxide and salicylic acid-based products, although retinol, tea tree oil, glycolic acid and azelaic acid or other acids are available and great places to start.

(Benzoyl peroxide helps treat acne by killing the bacteria that cause the skin condition. It also helps by removing excess oil from the skin. You can get OTC products in benzoyl peroxide strengths from 2.5 per cent to 10 per cent. Often the 2.5 per-cent-strength option works just as well as more potent options, so start with a lower concentration to manage side effects. Of course, read the instructions of any product before you use it, but general side effects could include dry, irritated or stinging skin.

Salicylic acid unclogs pores and breaks down oils, like sebum. It also decreases how much skin produces sebum, which can reduce future acne.)

Q: What if OTC treatment isn’t working?

A: If acne is not responding sufficiently to OTC options or the acne is severe or scarring, or having an impact psychologically or socially, then best to see your doctor and ideally a dermatologist for expert skin care and prescriptions, which include topical or oral antibiotics, combination creams and gels and/or hormonal therapies or isotretinoin, chemical peels or lasers.

If acne affects much of the chest or back, or scarring is present on the trunk, then generally one requires oral therapies such as antibiotics, hormonal treatments in women (oral contraceptive or spironolactone) or isotretinoin. Photodynamic therapy may also be considered.

Credit: By Randi Mann, National Post

Kids have more sensitive skin than adults and should be treated with care — bathing too much or for too long can lead to future issues.

How often we shower (and when) can be a hotly contentious issue, especially when kids are involved.

But there’s good reason for the debate, doctors tell the Star, as under or overdoing our bathing routines can lead to problematic skin issues or foster fungal growth.

Studies show young kids have softer, thinner and more sensitive skin than adults, which can be easily irritated and prone to moisture loss — putting them at greater risk of skin issues like eczema, which over-showering can exacerbate.

Experts previously explained how, for most people, showering every other day could result in healthier skin. Here’s what they recommend for our kids.

How often should my kids be showering?
While every child is different, as a general rule, bathing or showering once every two to three days is fine — at least, it is before they hit puberty, said Dr. Benjamin Barankin, the medical director and founder of the Toronto Dermatology Centre.

After puberty, which hits around the ages of 12 to 18, “daily bathing is worthwhile for most people due to more oil secretions and bacterial overgrowth, particularly in the armpits and groin,” Barankin explained.

If your child is physically active and sweating regularly, it’s worth showering daily, he continued. Additionally, if young ones haven’t completed toilet training yet, they should be bathing daily — “or at least washing the groin area.”

This is because frequent showering — especially long, hot and soapy sessions — can erode the skin’s natural oil barrier and lead to irritation or damage, he said.

Dr. Renée A. Beach, an assistant professor of medicine at the University of Toronto and founder of Toronto’s DermAtelier on Avenue, notes that daily showering makes sense — just so long as they’re not overdoing it.

Not showering enough could lead to bad body odour and even health conditions like folliculitis or fungal growth, Beach explained.

“However, the frequency can depend on the teen, their body chemistry, menstrual cycle, the amount of hair they grow in the armpits and genitals” and more, she added.

How long should kids be showering?
Overlong showers can damage our kids’ skins and even spark medical conditions like eczema, or make pre-existing skin conditions worse, Beach noted.

It’s a common belief that “a longer shower means you are ‘more clean,'” she said. Not so — a 10 to 15 minute-long shower will usually suffice.

“Staying in longer may feel good, but (it can do) your skin damage in the form of trans-epidermal water loss — a factor for eczema,” she said. That’s especially true for kids under 10, who have skin more permeable to water.

Barankin agreed, recommending a length of five to 15 minutes as “sufficient for most.”

He added that water temperature is also an important factor, warning against hot showers which can “strip some of the skin’s natural oils.”

Avoid natural soaps in the shower — use this instead
As children have thinner, more fragile skin, they are especially sensitive to chemical irritants — meaning it’s wise to pay attention to the products we use in the shower.

Because our skin is naturally slightly acidic, we should take care to avoid basic cleaning products like natural soaps, which are made using lye. So too should kids avoid fragranced products, which can cause allergic reactions, Barankin explained.

“Use a gentle cleanser or moisturizing soap bar, rather than a shower gel,” he recommended.

Afterward, pat-dry the skin to minimize damage, and ideally, apply a cream or balm to lock in the moisture, Barankin said. It’s doubly important to moisturize during the dry winter months or “in kids prone to dry skin,” he continued.

Credit: By Kevin Jiang, Toronto Star

Our very own Dr. Benjamin Barankin’s expertise has once again been sought regarding new and innovative treatments in dermatology.

Read here.

Here’s when to worry about varicose veins, plus why they appear and how to treat them.

When it comes to caring for the health of our legs, a common concern is varicose veins. Often blue and bulging, these pesky veins can seemingly appear out of nowhere, obfuscating the once pristine canvas of our gams. But what are varicose veins? Why do they appear? Do they pose a health risk? And what can be done to get rid of them?

What are varicose veins?

Benjamin Barankin, a Toronto dermatologist, medical director and founder of Toronto Dermatology Centre, explains that varicose veins are superficial, enlarged, bulging and twisted veins that mainly develop in the legs. They’re dark purple or blue in colour and can cause aching, itching or discomfort. Their cousins, the spider veins, are a milder form, consisting of much smaller red or purple veins that are closer to the skin’s surface.

Why do they appear?

Varicose veins are due to weak or damaged valves in the veins that help to control blood flow towards the heart. When they’re not functioning properly, blood can pool in the veins, resulting in the veins stretching or twisting. There are several reasons why weak or damaged valves lead to the development of varicose veins, and unfortunately, they’re not necessarily something you can control. Barankin says the risk of weak or damaged valves is more common in women and potentially increased by pregnancy, menopause and possibly birth control pills. Age also plays a factor, thanks to wear and tear on the vein valves over time, as does being overweight, having a sedentary lifestyle, standing for long periods of time and having a family history of them.

When should you worry about them?

Varicose veins aren’t necessarily cause for medical concern. Barankin says that, for most patients, leg veins are nothing more than a cosmetic blight. However, “those with varicose veins are at higher risk of ulcers, bleeding—burst vein—and blood clots,” he says, recommending that anyone experiencing persistent leg pain and swelling seek medical help.

Is it possible to prevent them?

Before they appear, there are some ways to reduce the risk of developing varicose veins. Barankin says that the best prevention is exercise and maintaining a healthy weight. Other tips include raising your legs when sitting or lying down, eating a low-salt, high-fibre diet, changing your sitting or standing position regularly and avoiding wearing high-heeled shoes and hosiery. “There isn’t much data on alternative medicine, but some have reported improvement with horse chestnut, butcher’s broom, grab—leaves, seed and fruit—and sweet clover,” he adds.

Other preventative measures may be a bit more pleasant, if not downright blissful. At the Park Hyatt Stillwater Spa in Toronto, the Detox + Revive Body Ritual focuses on circulation and fluid retention. “The ritual’s physical, mechanical body work, in conjunction with the products, aids the body in getting the accumulated blood and lymph fluid moving again throughout the body,” says spa director Kerry Werner.

What are the treatment options?

When you notice the early appearance of varicose veins, there are some strategies to help prevent them from getting worse. Barankin says compression stockings are the main therapy in early stages. “Wear compression stockings during the day, and apply a good moisturizer at night to reduce itching and dry or cracked skin,” he says. “Avoid salt to reduce leg swelling, wear more comfortable low-heeled shoes to work the calf muscle to pump more, and avoid tight clothing around your waist, legs and groin so as not to impede blood flow.”

What about removal options?

For those looking to have varicose veins professionally removed, there are a few different options. Sclerotherapy is a solution or foam, such as a sale-solution, that’s injected into the veins. It costs roughly $200 to $400 per session and may require three to six treatments every other month for results. Post sclerotherapy, compression socks for one to two weeks to fully optimize results, and contrary to what some people have heard, airplane travel is totally safe post-treatment.

Another option is vascular lasers, which can be used on spider veins or endovenous laser ablation for larger varicose veins. And finally, there’s surgical vein stripping—a minor surgery where one or more varicose veins are removed. This would likely be an in-and-out procedure with recovery at home for a few days following the operation, depending on how many veins are removed.

Ultimately, the decision of how to treat varicose veins is personal. Unless they are causing persistent pain or swelling, varicose veins are something that can be lived with.

Credit: Caitlin Agnew, Best Health Mag

Eczema is a chronic skin condition marked by flares – episodes of red, itchy and aggravated skin. Preventing flares is key to achieving control. A good skin care routine and using topical medications to manage inflammation will help to keep your eczema under control.

Here is are some simple Dos and Don’ts to help identify and avoid common culprits of eczema flares.

A full list of approved products and more information can be found on the Eczema Society of Canada’s website at  www.eczemahelp.ca.

Toronto Dermatology Centre is back!

Our doors have reopened and we are working hard to contact all patients whose appointments were cancelled due to COVID-19. If you had an appointment before but was cancelled, please feel free to give us a call back. We look forward to helping you.

We have implemented extra sanitary precautions and preventive measures while maintaining high-quality care in our office. If you, or someone in your family, has exhibited flu-like symptoms such as fever, cough, shortness of breath, severe muscle aches, shaking chills, diarrhea or recent loss of taste or smell, DO NOT ATTEND the appointment. Please contact us at (416) 633-0001 or [email protected] for rescheduling options. 

Your health, safety and well-being are of the utmost importance to us. If you have an upcoming appointment, please note the following: 

All patients and accompanying persons must wear a face mask covering mouth & nose; upon arrival and for the duration of your visit. Patients must use hand sanitizer before entering & upon leaving the clinic. Only patients with an appointment are allowed in the clinic. The patient can be accompanied if they are a child or have difficulty ambulating; family members can wait outside the clinic. Patients entering the clinic will be required to stand/sit 6 feet apart from one another in the waiting room. This will apply in clinic rooms, waiting areas and hallways.   Physicians, nurses and staff will be wearing personal protective equipment. Avoid handshaking or any physical contact with any of our staff. When paying for private/Non-OHIP procedures, contactless payment preferred (debit or credit card).   Check Out Our New Screening Process: Click here to learn more about new patient & visitor guidelines.