Acne occurs when pores in the skin get blocked by dead skin cells, and sebum — oil produced by skin glands — accumulates in the pores. Bacteria in the pores can contribute to pore clogging and inflammation. Acne can occur on the face or body — usually the back, chest, and shoulders.


How common is acne? And who gets it?

Acne often starts around puberty, with about 90% of adolescents being affected. But it can be a problem for many older people too, especially women. About 1 in 5 adult women suffer from the condition — often due to hormone fluctuations.

In all, acne affects about 20% of the population in Canada — about 5 million people. Acne can have significant effects on wellbeing. And having other people dismiss it as a teen rite of passage or as vanity doesn’t help.

Acne can evoke feelings of low self-esteem, depression, and thoughts of self-harm. It's especially important to treat acne if it's making you or your adolescent child experience significant psychological distress. If you treat acne early, it is less likely to develop into a more severe form, and less likely to lead to scarring.



What causes acne?

There are many factors involved in the development of acne:

  • Blocked pores
  • Oil production
  • Hormones
  • Inflammation
  • Genetics
  • Bacteria

Note that poor personal hygiene is not on that list! Acne is not caused by infrequent washing. In fact, washing too often or too vigorously can irritate the skin and make acne worse. 

Acne can fluctuate in severity over time, and different people have different triggers that can make their acne flare up. These include:

  • Physical pressure – Bra straps, headbands, or tight clothing can trigger an outbreak in the area of skin under pressure.
  • Cosmetics – Look for products labelled oil-free, non-comedogenic, or non-acnegenic to avoid contributing to pore clogging.
  • Sweat – Especially if trapped under damp clothing.
  • Medications – Corticosteroids and contraceptive pills with progestin can be triggers in some people.
  • Menstrual cycle – Some women and girls find they get premenstrual flare ups.
  • Picking or squeezing – This can spread the oil and bacteria to the surrounding skin, causing more swelling and redness.
  • Food – Reducing dairy intake and a diet with a lower glycemic index might help, although the evidence for a connection is weak. (There is no evidence that chocolate or greasy foods cause flare ups.)
  • Washing too often or vigorously – Gently wash your face once or twice a day with an acne cleanser.

What non-medication treatment is there for acne?

Regular washing and removing make-up – Gently washing your face every day helps remove oil, dead skin cells, and bacteria from the surface of the skin. Acne isn’t caused by infrequent washing, but regular washing can help keep it under control, especially if you use a cleanser that is designed for acne.


Reducing stress – Stress can increase the production of certain hormones that cause increased oil production. Practicing relaxation techniques may help reduce your acne flare ups.


Changing pillow cases/sheets – Hair products, for example, can transfer to your pillow case, and then end up as residue on your skin. Change your pillow cases frequently and, if you have long hair, consider wearing your hair up at night.


Dietary changes – There is some weak evidence that a low glycemic index diet, and eliminating dairy can help.


Laser and light treatment – The idea is that certain kinds of light can deactivate the bacteria in the pores. But there is not yet enough evidence to recommend this treatment.


What non-prescription medications are available for acne?

First, try a non-prescription topical (applied to the skin) medication. Look for creams, gels, or cleansers with either of these active ingredients:

  • Salicylic acid
  • Benzoyl peroxide

These medications treat acne in one or more of the following ways:

  • Removing dead skin cells and excess oil to help unclog the pores
  • Killing bacteria
  • Reducing inflammation

Benzoyl peroxide can make your skin more sensitive to the sun, so reduce your exposure, and make sure you use sunscreen.


Tretinoin - A derivative of vitamin A, this is available over-the-counter in various concentrations. It causes the outer layer of the skin to grow more quickly and to be replaced with new skin cells, which helps to reduce the formation of pimples


Azelaic acid - It works in part by stopping the growth of skin bacteria that cause acne, and by keeping skin pores clear.


Use caution

More isn't always better. Just because these medications are available without a prescription doesn’t mean that they can’t have side effects. Some of these medications can cause significant skin irritation. So it’s safer to start with a weaker dose and move up to a stronger dose only if necessary.


Any acne treatment requires a couple of months to see improvement — and the treatment may temporarily make your acne worse. So give it some time! If you don't notice improvement after six to eight weeks, see your doctor.


Prescription medications for acne

If the non-prescription medications don’t work for you, talk to your doctor about which prescription medication you should try using next to treat your acne.

There are topical products with the same ingredients as above, but in stronger concentrations, which are available only with a prescription.


Topical antibiotics - For mild to medium acne, doctors often prescribe gels or creams containing clindamycin, erythromycin, or sulfacetamide to destroy acne bacteria.


Oral antibiotics - These may be prescribed in cases of severe acne. There are a number of different antibiotic pills that may be prescribed:

  • doxycycline (which also has anti-inflammatory properties)
  • erythromycin
  • clindamycin
  • tetracycline
  • minocycline
  • trimethoprim
  • azithromycin

Antibiotic treatment should be restricted to a few months to prevent antibiotic resistance developing.


Corticosteroids - Synthetic versions of a hormone made in the body. Topical applications reduce inflammation.


Combined oral contraceptives - Can help improve acne for women by regulating hormones.


Spironolactone - This hormonal treatment reduces the levels of male hormones (testosterone, in particular) that are responsible for increased oil production in the skin.


Topical retinoids - Derived from vitamin A, these medications (including tretinoin, adapalene and tazarotene) help reduce pore blockage and lessen inflammation.

Retinoids can irritate your skin if used too often or if the dose is too strong.


Oral isotretinoin - Oral isotretinoin is the only oral retinoid indicated for acne. It is reserved for severe acne that is not responding to other treatments. It has many effects that improve acne, including unblocking pores and reducing oil production.


Questions about acne medication?

If you have questions about acne medication, ask your doctor or pharmacist. 

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Sunshine Vitamin

Vitamin D is sometimes called the “sunshine vitamin” because it’s produced in your skin in response to sunlight. It’s a fat-soluble vitamin in a family of compounds that includes vitamins D-1, D-2, and D-3.


Your body produces vitamin D naturally when it’s directly exposed to sunlight. You can also get it through certain foods and supplements to ensure adequate levels of the vitamin in your blood.


Vitamin D has several important functions. Perhaps the most vital are regulating the absorption of calcium and phosphorus, and facilitating normal immune system function. Getting a sufficient amount of vitamin D is important for normal growth and development of bones and teeth, as well as improved resistance against certain diseases.


If your body doesn’t get enough vitamin D, you’re at risk of developing bone abnormalities such as soft bones (osteomalacia) or fragile bones (osteoporosis).


1. Vitamin D fights disease

In addition to its primary benefits, research suggests that vitamin D may also play a role in:

  • reducing your risk of multiple sclerosis.
  • decreasing your chance of developing heart disease.
  • helping to reduce your likelihood of developing the flu.

2. Vitamin D reduces depression

Research has shown that vitamin D might play an important role in regulating mood and warding off depression. In one studyTrusted Source, scientists found that people with depression who received vitamin D supplements noticed an improvement in their symptoms.

In another study of people with fibromyalgia, researchers found vitamin D deficiency was more common in those who were also experiencing anxiety and depression.


3. Vitamin D boosts weight loss

Consider adding vitamin D supplements to your diet if you’re trying to lose weight or prevent heart disease. 

In one study, people taking a daily calcium and vitamin D supplement were able to lose more weight than subjects taking a placebo supplement. The scientists said the extra calcium and vitamin D had an appetite-suppressing effect.

In another study, overweight people who took a daily vitamin D supplement improved their heart disease risk markers.


Few foods contain vitamin D naturally. Because of this, some foods are fortified. This means that vitamin D has been added. Foods that contain vitamin D include:

  • salmon
  • sardines
  • egg yolk
  • shrimp
  • milk (fortified)
  • cereal (fortified)
  • yogurt (fortified)
  • orange juice (fortified)

It can be hard to get enough vitamin D each day through sun exposure and food alone, so taking vitamin D supplements can help.


The Institute of Food and Agricultural Sciences reports new recommendations based on international units (IUs) per day. IUs are a standard type of measurement for drugs and vitamins. IUs help experts determine recommended dose, toxicity, and deficiency levels for each person.


One IU is not the same for each type of vitamin. An IU is determined by how much of a substance produces an effect in your body. The recommended IUs for vitamin D are:

  • children and teens: 600 IU
  • adults up to age 70: 600 IU
  • adults over age 70: 800 IU
  • pregnant or breastfeeding women: 600 IU
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Arthritis Awareness Month

6 million Canadians struggle with the pain and disability of arthritis. There are over 100 different types and it is the most expensive chronic disease in Canada, costing the economy an estimated $33 billion per year. Arthritis isn’t just about aches and pains. It is a serious, life-altering disease that impacts people of ALL ages. It can cut careers short, make daily life extremely challenging and lead to life-threatening complications like heart attack, stroke and hip fracture.  



The most common signs and symptoms of arthritis involve the joints. Depending on the type of arthritis you have, your signs and symptoms may include:

  • Pain
  • Stiffness
  • Swelling
  • Redness
  • Decreased range of motion


The two main types of arthritis — osteoarthritis and rheumatoid arthritis — damage joints in different ways.



The most common type of arthritis, osteoarthritis involves wear-and-tear damage to your joint's cartilage — the hard, slick coating on the ends of bones where they form a joint. Cartilage cushions the ends of the bones and allows nearly frictionless joint motion, but enough damage can result in bone grinding directly on bone, which causes pain and restricted movement. This wear and tear can occur over many years, or it can be hastened by a joint injury or infection.

Osteoarthritis also affects the entire joint. It causes changes in the bones and deterioration of the connective tissues that attach muscle to bone and hold the joint together. It also causes inflammation of the joint lining.


Rheumatoid arthritis

In rheumatoid arthritis, the body's immune system attacks the lining of the joint capsule, a tough membrane that encloses all the joint parts. This lining (synovial membrane) becomes inflamed and swollen. The disease process can eventually destroy cartilage and bone within the joint.


Risk factors for arthritis include:

Family history. Some types of arthritis run in families, so you may be more likely to develop arthritis if your parents or siblings have the disorder. Your genes can make you more susceptible to environmental factors that may trigger arthritis.

Age. The risk of many types of arthritis — including osteoarthritis, rheumatoid arthritis and gout — increases with age.

Your sex. Women are more likely than men to develop rheumatoid arthritis, while most of the people who have gout, another type of arthritis, are men.

Previous joint injury. People who have injured a joint, perhaps while playing a sport, are more likely to eventually develop arthritis in that joint.

Obesity. Carrying excess pounds puts stress on joints, particularly your knees, hips and spine. People with obesity have a higher risk of developing arthritis.

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​It is probably one of the easiest ways to prevent millions of cases of cancer each year—sunscreen. However, most of us still forget to slather on the sunscreen. Canadian men and women regularly forget to put sunscreen on their faces and other exposed skin before heading outside for more than an hour.

So, what do you need to know about protecting your skin from the sun? 



Here are 10 tips to keep in mind as you finish out the summer.

  1. Use sunscreen everyday even if it’s cloudy outside.
  2. Apply at least one ounce of sunscreen (enough to fill a shot glass) at least 15 to 30 minutes before going outside. Also use a lip balm or lipstick that contains sunscreen with a sun protection factor (SPF) of at least 30.
  3. Choose a broad-spectrum sunscreen that protects against both UVA and UVB radiation. Make sure it is water resistant and has a SPF of 30 or higher. Other sunscreens may help keep you from getting sunburned, but they won’t protect against skin cancer.
  4. Reapply sunscreen every two hours. Reapply every hour if you are swimming or sweating.
  5. Be extra careful around water and sand. These surfaces reflect the damaging rays of the sun, which can increase your chance of getting a sunburn.
  6. Keep babies younger than 6 months old completely covered and in the shade.
  7. Limit the amount of time you’re in the sun between 10:00 AM and 4:00 PM. This is when the sun's rays are the most intense. Practice the shadow rule: if your shadow is shorter than you, the sun's rays are at their strongest, and you should find shade.
  8. If possible, wear a long-sleeved shirt and long pants. Dark clothing with tightly woven fabric blocks more sun than white or loosely woven fabrics. For additional protection, look for clothes made with special sun-protective materials.
  9. Accessorize with a hat that shades your face, neck, and ears and a pair of sunglasses. Sunglasses with lenses that have 99% to 100% UV absorption provide optimal protection for the eyes and the surrounding skin.
  10. Be even more cautious if you are taking medications that may make you more sensitive to the sun. These include specific types of antibiotics, anti-inflammatories, antifungals, blood pressure medications, and chemotherapies.



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Ashley Resnik
September 14, 2021
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