1 in 3 Canadians think dangers of sun exposure are exaggerated: What to know about skin cancer risk, sunscreens & more

Nearly a quarter of Canadians believe you need to burn before you tan — but is it true?

Canadians are becoming less concerned about skin cancer risks, and misinformation about sun safety is growing, according to a new survey by the Canadian Dermatology Association (CDA). The CDA, in collaboration with Ipsos, has released its 2023 Sun Safe Behaviour Survey, highlighting key trends and perceptions about sun exposure among Canadians.

Tanning, cloudy weather, skin cancer risk & more

According to the CDA, concern for the risk of skin cancer has reached an “all-time low” among Canadians, despite skin cancer cases being on the rise. While the exact reasons for this decline are unclear, the report suggests that people underestimate sun exposure risks.

And, misinformation is on the rise. Despite the well-documented dangers of UV exposure, Ipsos noted more Canadians now believe “the dangers of sun exposure are exaggerated (32 per cent),” and there is “no need to use sunscreen when it is cloudy (32 per cent).”

A whopping 23 per cent of Canadians believe getting a sunburn is the first step to getting a tan.

While most Canadians acknowledge that using sunscreen is important, there’s a decline in other protective behaviors (like seeking shade or wearing UV-protective clothing). “Over two in 10 Canadians always employ the top three sun protection behaviours, while around one in ten never use them,” the report said.

The survey also revealed that only “about a quarter of Canadians can correctly identify the difference between UVA and UVB rays.” It pointed out that a third mistake one for the other and “the proportion who say they don’t know increased to [40 per cent].”

Meanwhile, concerns about sunscreen’s environmental impact have decreased, but the importance of choosing the right sunscreen remains high.

The survey said “Canadians view all characteristics of sunscreen as important, but to varying degrees.” It’s become important to choose sunscreen that is “hypoallergenic or has a low potential for skin irritation and is non-comedogenic.”

What Canadians really need to know about sun exposure

To debunk the misinformation that nearly a third of Canadians believeYahoo Canada spoke with Dr. Benjamin Barankin, a renowned Toronto dermatologist and founder of the Toronto Dermatology Centre, and Dr. Katie Beleznay, a clinical instructor at the Department of Dermatology at UBC.

Here’s what you need to know.

Risks of UV exposure

Barankin explained that increased sun exposure can cause:

  • painful sunburns
  • freckles and melasma
  • cold sore reactivation

In the long-term, it can cause:

  • brown sun spots (lentigines)
  • redness and burst blood vessels
  • wrinkles
  • most importantly: skin cancers

Sun protection and sunscreens “have immediate benefits” of preventing these impacts.

“While Caucasians benefit the most from sunscreen, all skin types in fact receive various benefits from minimizing UV radiation,” Barankin said in an email.

Do you need sunscreen year-round, even in cloudy weather?

“Sun protection is obviously most important in the summer months, and at times of the day when your shadow is close to you (sun directly overhead),” Barankin explained, adding that’s usually between 10 a.m. and 4 p.m.

However, we still get about 80 per cent of the UV rays through cloud cover, he said, and UV can bounce off of snow and water and windshields.

“A dark and rainy day does not require sunscreen; that said, I’ve seen a number of patients who didn’t bother with sun protection because it was raining, and then a couple hours later, the weather improves, and they end up getting a sunburn and unnecessary UV radiation.”

Beleznay added most dermatologists recommend using sun protection year-round to minimize these risks.

What’s the difference between UVA and UVB rays?

According to Beleznay, UVA and UVB are both types of ultraviolet radiation emitted by the sun.

UVA rays are the primary cause of premature aging of the skin, including wrinkles, fine lines, and age spots, but can also contribute to the development of skin cancers,” she explained.

UVB rays are the main cause of sunburns and play a key role in the development of skin cancers, including basal cell carcinoma, squamous cell carcinoma, and melanoma.”

Barankin said UVA rays (“aging rays”) can pass through window glass, whereas UVB rays (“burn rays”) are blocked.

How to use sunscreen properly

What sunscreen to use?

Both experts recommend using sunscreen that is at least SPF 30. Those who are going to sunny and hot places, and those who have a photosensitizing medication or condition (like lupus or rosacea), are advised to use even higher SPF (SPF 60).

It’s also important to use a broad spectrum sunscreen that protects from both UVA and UVB rays.

Don’t forget SPF on your lips!

– Dr. Benjamin Barankin

Barankin said people who have dry skin could opt for a cream sunscreen, whereas gels are good for oily or hairy areas. SPF sticks are good for the face, and sprays “need to be rubbed in, shouldn’t be used near smoke or flames, and shouldn’t be inhaled.”

He added that sunscreens mixed with insect repellant “should not be used,” as sunscreens should be “generously applied and reapplied,” and insect repellant “used sparingly and less frequently.”

According to Beleznay, the most important thing is “to find a sunscreen that you like and will use.”

How much sunscreen is enough?

Beleznay said when it comes to sunscreen, “the biggest problem is under-application.” Here’s a good rule-of-thumb to follow:

  • a quarter to a half of a teaspoon for your face and neck
  • one ounce for your entire body

It’s also recommended to reapply every two hours, or after swimming (even with water resistant sunscreen).

Other sun protection

In addition, Barankin added, big sunglasses and broad-brimmed hats “are terrific add-ons.” He said the sun can cause cataracts (20 per cent of global cases) and skin cancers around the eye. Sun protective clothing with a UPF rating is also a great option for those who don’t like reapplying sunscreen.

Credit: By Karla Renic, Yahoo! Life

Stress acne is a thing

Flat woman face with skin diseases. Rashes, acne or dermatology problems. Dermatologist or cosmetology doctor with magnifier glass examining huge female head with facial dermatitis, redness or pimples

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 sunscreenmosquito protection and healing dry skin.

And now, acne.

Article content

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.

Try unscented and soap-free cleansers
(check out the ESC’s Seal of Acceptance
products for guidance).
Overuse soaps with harsh detergents and perfumes;
these are often irritating to the skin.
Give your skin a break from over-cleansing.
Only use soaps when necessary.  
Rely on scrubbing or exfoliating ‘tools’ such as rough
washcloths or loofahs, which often make eczema worse.
Test any new products on a small patch of
skin to ensure they are safe and non-irritating.
Forget to ask for samples! Ask to try before you buy
– whether at the store or your doctor’s office
Avoid jewelry or clothing that contains
potential irritants such as nickel or itchy wool.
Expose yourself to extreme temperatures (both hot
and cold) – this includes hot baths and showers! Try
washing with warm – not hot – water, and wearing
loose-fitting clothing made of natural materials
like cotton instead.
Take some time for yourself and focus on
being calm and relaxed.
Stress (if you can avoid it). Seek activities that bring
joy and inner peace, and share your feelings with
someone you trust.
Keep your fingernails short (try carrying a
cardboard nail file to manage snags on the go).
Scratch that itch! Resisting the urge to scratch can
be next to impossible, but scratching can lead to
broken skin, make flares worse, and lead to
infection. Try applying a moisturizer or cool wet cloth instead.

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

Our very own expert dermatologist Dr. Benjamin Barankin was recently interviewed by GoodTimes magazine about skin tags, what causes them, and if and how to remove them. 

Read here.

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.

black birthmark on skin

More than half of patients can now survive a deadly skin cancer that was considered untreatable just a decade ago, say UK doctors.

Ten years ago only one-in-20 patients would live for five years after being diagnosed with late-stage melanoma. Most would die in months.

But drugs to harness the body’s immune system mean 52% now live for at least five years, a clinical trial shows.

Doctors said it was an extraordinary and rapid transformation in care.

How hard is melanoma to treat?

Melanoma is the fifth most common cancer in the UK and kills nearly 2,300 people each year.

If it is caught in the early stages then the chances of survival are good, but as the cancer becomes more aggressive and spreads throughout the body (known as metastatic cancer) then survival plummets.

“In the past, metastatic melanoma was regarded as untreatable,” said Prof James Larkin, a consultant at the Royal Marsden NHS Foundation Trust.

He said: “Oncologists considered melanoma different to other cancers, it couldn’t be treated once it had spread.”

People tended to live between six and nine months after diagnosis.

What did the trial show?

The trial investigated two immunotherapy drugs which are designed to enhance the immune system and let it attack cancer.

There were 945 patients in the trial, a third were given nivolumab, a third were given ipilimumab and a third were given both.

Doctors then looked at the five-year survival rate – the proportion of patients still alive after five years.

The results showed:

  • 26% were still alive on ipilimumab alone
  • 44% were still alive on nivolumab alone
  • and 52% were still alive when given both.

“It’s been an amazing surprise to see so much progress in such a short a period of time,” Prof Larkin told BBC News.

He said: “It’s been the most extraordinary transformation from a disease that was regarded, among all the cancers as the most difficult to treat, the most serious prognosis.

He said there is now “the possibility that 50% of people with stage four melanoma are alive five years after having immunotherapy treatment.”

The findings have been presented at a meeting of the European Society for Medical Oncology and published in the New England Journal of Medicine.

What do patients say?

Pam Smith, 67, from Royal Tunbridge Wells, started on the trial in January 2014.

She was “devastated” when she was told her cancer was untreatable and says she “wouldn’t have stood a chance” without immunotherapy.

She had treatment once every two weeks for four months, but the drugs gave her such severe diarrhoea as a side-effect that she could no longer continue.

Her tumour halved in size after treatment and has not grown since. Pam now feels “brilliant”.

She told the BBC: “I might not have seen my grandchildren.

“It’s just over five years now since it happened and my youngest grandchild was six at the weekend.

“I wouldn’t have seem him grow up and the other grandchildren as well.”

Are these patients cured?

Saying cured is always difficult in cancer, but five-year-survival is a hugely significant milestone.

Some patients taking the drugs are in total remission with no sign of any abnormality on scans.

Others like Pam still have a tumour inside their bodies, but they are no longer growing.

Out of the patients that survived, three-quarters no longer need any form of cancer treatment.

How does immunotherapy work?

Immunotherapy is Nobel Prize-winning science that is making the untreatable treatable.

The field is one of the most exciting in cancer treatment.

The immune system constantly patrols our body, fighting off hostile invaders such as viruses.

It should attack cancers too – but cancers are a corrupted version of healthy tissue and can evolve ways of evading the immune system.

Ipilimumab and nivolumab both stop some cancers from hiding and allow the immune system to attack.

They interrupt the chemical signals that cancers use to put the brakes on the immune system.

Nivolumab blocks the off-switch on white blood cells called PD-1. Ipilimumab blocks a similar switch called CTLA-4.

It is described as taking the brakes off the immune system.

“By giving these drugs together you are effectively taking two brakes off the immune system rather than one so that the immune system is able to recognise tumours it wasn’t previously recognising and react to that and destroy them,” Prof Larkin said.

Are there side-effects?

Yes, the drugs are changing the way the immune system works inside the body and that can have consequences, such as fatigue, skin rashes and diarrhoea.

Some are severe enough that patients like Pam cannot complete a full course of treatment.

However, even a brief spell of immunotherapy had a lasting benefit on the immune system and on patients.

This is in stark contrast to other cancer treatments such as chemotherapy which stop working the moment the treatment stops.

Although this lasting changes means side-effects could continue to emerge as patients get older.

Are these drugs available?

Yes, earlier results from this trial led to these drugs being made available around the world – including on the UK’s National Health Service.

The decision to approve the drugs for melanoma was one of the fastest in NHS history.

And they are also being used in other cancers such as lung and kidney.

What do experts think?

Prof Charles Swanton, chief clinician at Cancer Research UK, said the progress in melanoma had been “incredibly fast”.

He said: “I’m inspired seeing the advancements being made in the development of immunotherapies, and their potential to transform the outlook for some patients, giving them time with friends and family they never thought they would have.

“And now work continues to make sure more people with different types of cancer can also benefit from these innovative treatments.”

Credit: James Gallagher, bbc.com

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