of skin cancers - Canadian Dermatology Association

Dangers
of indoor
tanning
SUMMER 2013
+
Choosing
the right
sunscreen
+
Your guide
to summer
skin health
A CANADIAN DERMATOLOGY ASSOCIATION PUBLICATION
EXCESSIVE
PHOTOAGING
Prevent and treat
deep wrinkles
and other effects
EARLY
DETECTION
You’ve been
diagnosed with
skin cancer.
Now what?
T
H
G
I sun
S
N
I w the your
Ho affect
s
can eye 6)
e
g
(Pa
Sun care
The best of UVB-UVA protection
*
This product is recognized by the
Canadian Dermatology Association
SENSITIVE SKIN
•
•
•
•
•
INTOLERANT AND ALLERGIC SKIN
A stable UVB-UVA photoprotection with long-lasting efficacy
A potent antioxidant
Photo-aging protection
Water-resistant
Avène thermal spring water provides soothing and softening properties
* The Skin Cancer Foundation recommends the tinted compact SPF50 as an effective UV sunscreen
summer 2013
A message from the president
Welcome to our
premier issue!
The Canadian Dermatology
Association is pleased to provide you with this magazine,
designed to keep Canadians informed about sun safety.
Our publication coincides with the 25th annual Sun
Awareness Week, held this year from June 3 to June 9. The
goal of the week, and the aim of our National Sun Awareness Program, is to reduce the incidence of skin cancer in
Canada.
Skin cancer is the most common type of cancer in
Canada, with more than 74,000 new non-melanoma skin
cancers found each year. More than 5,000 Canadians are
expected to be diagnosed with melanoma in 2013, with
more than 900 dying from it. The number of people with
a skin cancer diagnosis has been rising since the 1960s,
and now those born in the 1990s have a two to three
times higher risk of skin cancer than those born 30 years
earlier.
Luckily, both melanoma and non-melanoma skin
cancer are highly preventable. Prevention begins by getting informed about the dangers of excessive exposure
to ultraviolet radiation, whether from the sun or tanning
beds, and incorporating sun safety into your daily routine.
In the following pages you will find important advice
on how to protect yourself from the sun and why you
should do so. You’ll also find a list of sunscreens recognized by the Canadian Dermatology Association,
information about what medications may make you more
sensitive to the sun, tips on how to have great skin this
summer and much more.
Be sure to visit our website at www.dermatology.ca for
more information on healthy skin, including fact sheets
on common skin issues and even colouring pages to help
children learn about the importance of sun safety.
As president of the Canadian Dermatology Association,
I would like to wish you a happy and safe summer.
Dr. Gordon Searles
President, Canadian Dermatology Association
Proud partners of my skin magazine
A Canadian Dermatology Association publication
18
What’s inside
4
Summer skin health
6
Sun and vision
8
Excessive photo aging
Six easy tips will keep your skin looking great
this summer
Sunglasses don’t just keep you looking cool –
they protect you from serious eye issues
Learn how to prevent - and treat - the signs
of photoaging
12
The dangers of indoor tanning
14
Early detection of skin cancer
18
Sun and medications
20
How to choose a sunscreen
22
Final word
With significantly more UV radiation than the
sun, tanning beds are a dangerous risk
12
6
Learn the signs of skin cancer so you can seek
treatment if needed
Your medications may make you more
sensitive to the sun
Choose a sunscreen that offers the protection
you need
One woman’s story of the dangers of tanning
beds
22
A publication of the Canadian Dermatology Association, my skin is produced
in co-operation with RandallAnthony Communications Inc. and Globe Edge, a
division of The Globe and Mail’s Custom Content Group.
Inquiries: Jennifer Scott, Communications Director, [email protected];
Richard Deacon, National Business Development Manager,
[email protected]
Points of view expressed in this publication are each author’s own work. Information
contained in articles should not be considered complete and should not be used in
place of a visit, call or consultation with, or advice of a dermatologist.
SUMMER 2013
my skin 3
up front
1
Embrace
your natural hue
Ditch your plans to get a tan. A
tan is evidence that your skin
has been damaged: your skin
changes colour as a response
to injured DNA in the skin cells.
Over the years, all that harm will
produce wrinkles, fine lines, dark
spots, visible blood vessels and
even purplish splotches.
Some people also get sun
blisters or cold sores after a day
out in the sun. This is because
covers the back of your neck
and choose clothing that covers sun-exposed areas. Select
clothes in dark or bright colours
(colours that reflect some UV
light) and that are made of
densely woven fabric. Wear
sunscreen on all exposed areas
of skin, including your hands
and lips (see tip 3 on how to
pick your sunscreen).
Take extra care if
you’ll be spending time near
(SPF) of 30 or greater, are broadspectrum, hypoallergenic, nonirritating, non-comedogenic
and low in fragrances.
A broad-spectrum sunscreen
protects against both types of
harmful ultraviolet rays: UVA and
UVB. UVA rays penetrate deeper
into the skin, interfering with
your body’s immune system
and causing premature
aging of the skin.
6
Six tips
for great skin
this summer
By Dr. Ian Landells
Protect
your skin
2
There are a few simple rules to
follow to protect your skin. Wear
a hat with a wide brim that
4
SUMMER 2013
my skin
water, where the UV rays can be
reflected back onto your skin.
3
Pick
the right sunscreen
On page 21 and on the Canadian Dermatology Association
(CDA) website, you will find a
list of sunscreens recognized by
the CDA. All these sunscreens
have a sun protection factor
5
Hydrate
and moisturize
Your skin is always thirsty. Make
sure you drink enough fluids to
replace moisture lost through
sweating and to keep your body
hydrated. A moisturizer will help
prevent your skin from drying
out and is best applied when
your skin is moist, such as after a
shower or bath.
The summer months are
a great time to show
off your skin. Follow the
six tips below to look
your best both now and
in the future.
too much exposure to the sun
can affect the body’s immune
system, leaving it susceptible
to infection. For great skin now
and in the future, protect it from
the sun.
enough sunscreen. You’ll need
two to three tablespoons for
your body and a teaspoon for
your face. Remember to reapply your sunscreen regularly,
especially after swimming or
sweating – sunscreen can’t
protect your skin if it stays in the
bottle.
UVB rays affect the upper layers
of skin and are the primary
cause of sunburn. UVB rays are
blocked by glass (like your car
window), but UVA rays are not.
Overexposure to either UVA or
UVB rays can cause skin cancer.
4
Apply
sunscreen correctly
Many people don’t apply
Maintain
a healthy lifestyle
Your skin benefits from any
habits that improve your overall
health. Eating a balanced diet,
exercising, refraining from
smoking, managing stress and
getting enough sleep will all
contribute to glowing skin. Exercising increases the blood flow
to your skin, bringing nourishment and oxygen with it, and
sweating helps flush out impurities in your skin. Keeping your
skin clean is also important,
and washing your face every
morning and before bed with
a gentle non-irritating cleanser
will keep it looking fresh.
Dr. Ian Landells is the Clinical
Chief at the Division of Dermatology for Eastern Health, Clinical Associate Professor of Medicine and
Paediatrics with the Faculty of
Medicine at Memorial University
of Newfoundland, Medical Director of Dermatology at Nexus Clinical Research, and past president
of the Canadian Dermatology
Association.
Heads up from CDA
Misleading marketing claims, inaccurate product information and public
perception can make it confusing to select over-the-counter skin health
products. That’s why the Canadian Dermatology Association is launching a program to help
consumers make better and more informed decisions.
In the coming months, we’ll be introducing a new program to the public that we believe
will effectively fill the need expressed by consumers and industry for evidence-based information – reflecting the most recent dermatological science – to help Canadians navigate
the variety of skin care products on the market.
Our Skin Health Program will be led by an Expert Advisory Board of objective medical
specialists who will review product formulations and independent laboratory testing to provide Canadian consumers with reliable, unbiased guidance when selecting healthy skin care
products for themselves and their families.
Since 1925, the Canadian Dermatology Association has remained dedicated to providing Canadians with information about maintaining optimal skin, hair and nail health. Now
we’re going a step further by empowering Canadians with the knowledge they need to make
informed choices about the dermatological products they use.
Our experts are looking out for your family’s health.
advertisement
Step inside a Shoppers and explore
sun safety through to August
When summer finally arrives in Canada,
Canadians celebrate with afternoons in the
park, days at the beach, hikes in
the woods – every manner of
outdoor activity. It’s great for our
health and our spirits, but it also
brings the danger of sunburn,
and with it, risk of skin cancer.
Skin cancer is the most common form of cancer in Canada
– more common than breast,
prostate, lung, and colon cancer
combined, says Victor Wong, a
Shoppers Drug Mart pharmacist
and owner-operator in Toronto.
Unfortunately, while the
incidence of skin cancer
is rising, it can be prevented, he stresses.
“There are no safe
UV rays, but effective sun protection
can be achieved.”
Wong says the answer is found in just a few
simple steps:
1. Cover up. Hats, sunglasses and
clothing are a must. Darker clothing and denser weaves are proven
to provide the best protection;
clothing with built-in UV protection
is also available.
2. Seek shade. Avoid the sun between the hours of 10 a.m. and
4 p.m., even on cloudy or hazy days.
Remember that UV rays can pass
through windows.
3. Apply sunscreen. Always apply
generously 30 minutes before going
out and reapply each two hours or
immediately after swimming or
excessive perspiration.
“The most important
thing to do when choosing a sunscreen is read
the label,” he advises.
The SPF number stands for Sun Protection
Factor. SPF 30 means you will get the same
amount of UV rays in 30 minutes that you
would in one minute without protection.
Also important is UVA protection against
aging, which means looking for “broadspectrum protection,” advises Wong. “For
example, at Shoppers, we offer Canadian
Dermatology Association-approved Life
Brand Sunthera3 broad spectrum products,
which offer protection against both UVA
and UVB.”
To help ensure Canadians have the
sun protection they need, Shoppers
Drug Mart is offering a Sun Safety
Pharmacy campaign from June 1st
to August 9th. “If you are planning
on being out in the sun, we’re here
to help with tips and advice on sun
safety,” says Wong.
SUMMER 2013
my skin 5
up front
Sunglasses offer important sun protection.
Remember your eyes
By Dr. Paul Rafuse
W
e all know
about sunscreen and
other protective measures to keep our skin
safe, but what about our eyes?
Sunglasses keep our eyes safe
from the sun and can protect us
from many eye issues.
There are many reasons to
wear sunglasses outside, on
both bright days and those with
cloud cover. Ultraviolet (UV)
light easily penetrates clouds,
particularly in the summer
during midday or at altitude.
progress to squamous cell malignancies, have a preference for
the corners of the eyelids.
The cornea, the clear domeshaped window of the eye, can
get enough of a “sunburn” that
dry eye symptoms can be generated or greatly aggravated. An
extreme example of this is the
snow blindness suffered by skiers who forget their sunglasses
or goggles. The shorter UVB
wavelengths are responsible for
the formation of pingueculae,
small fleshy nodules at the junction of the cornea and sclera
70s or 80s who develop nuclear
sclerotic cataracts. The damage
probably starts in childhood.
The number one cause of
blindness in Canada is agerelated macular degeneration,
which is caused by a number
of genetic and environmental
factors. One of the alleged
modifiable risk factors is UVA
and, perhaps, blue light. The evidence isn’t conclusive, but these
wavelengths can be filtered to a
large extent with sunglasses.
Good general-purpose sunglasses don’t have to be expen-
useful for reflected light from
the road, water or snow. The
colour of the lens should be
grey or a brownish green.
Sunglasses should be large
enough to cover all the lightsensitive structures of the eye.
Large wrap-around styles, or
sport goggles, are the best
choices for those who work or
play outdoors, and a broadbrimmed hat is a good idea
too. Don’t forget your children –
since much eye damage begins
at a young age, children should
protect their eyes from the sun
Given our cumulative exposure to UV
radiation over our lifetime, even
low levels of UV radiation have
the potential to affect almost
all structures of the eye and its
surrounding tissues.
Your eyelids have some of the
thinnest and most delicate skin
on your body. They are subject
to the same risk of cancer as any
other sun-exposed skin surface:
basal cell, squamous cell and
melanoma. The lower eyelid
is particularly prone to basal
cell carcinoma. Pre-cancerous
actinic keratoses, which can
(white of the eye) at
the three and nine
o’clock positions. Pingueculae
can grow across the cornea
as a pterygium, which can be
cosmetically unacceptable and
lead to visual distortion.
Clouding of the natural lens
(nuclear sclerotic cataract) is
a normal effect of aging, but
cortical cataracts are associated with exposure to UV light
without proper eye protection.
These typically occur at a much
younger age (to people in their
40s and 50s) rather than the
usual age group of those in their
sive. However, they should filter
60 to 92 per cent of visible light
and UVA rays, and 95 to 99 per
cent of UVB rays. They should be
dark enough to be comfortable
in bright light, but not so dark
to reduce your vision.
Winter enthusiasts, such
as alpine skiers, often carry a
selection of tints for various
lighting conditions. Photochromic lenses, which darken with
increasing light intensity, may
be adequate for moderate conditions, but may not get dark
enough for very bright light.
Polarized lenses are particularly
by wearing sunglasses as soon
as they venture outside.
6
SUMMER 2013
my skin
Dr. Paul Rafuse is the President of
the Canadian Ophthalmological
Society and an Associate Professor in the Department of Ophthalmology and Visual Sciences,
Dalhousie University, Halifax,
Nova Scotia. He is a past President of the Canadian Glaucoma
Society and chaired the Expert
Committee authoring the Canadian Ophthalmological Society’s
Clinical Practice Guidelines for the
Management of Glaucoma in the
Adult Eye.
Voted #1
Best Feeling
Sunscreen
by Canadian Dermatologists
*NEUTROGENA® sunscreen voted brand with best texture by Canadian dermatologists. 2012 data on file. © Johnson & Johnson Inc. 2013
1
2
3
5
6
8
SUMMER 2013
my skin
4
Feature
It takes more than great genes to keep
your skin looking good as you get older.
All those visible signs of aging that
you hear about on cosmetics ads – the
fine lines, pigmented spots and loss of
skin tone – often have more to do
with sun exposure than they do genetics.
The lowdown on
photoaging
T
wo factors determine how our skin
ages. First, there is
chronologic aging,
or aging caused by
the natural passage of time and to
some extent our genetics – and there
isn’t much you can do about that. Then
there is photoaging, the aging of the skin
caused by sun exposure – and there are
ways to both prevent and treat this type
of skin aging.
“Photoaging is often described as
premature aging because of excess sun
exposure, and it’s usually responsible
for the deep wrinkling, pre-cancerous
By Lola Augustine Brown
lesions, leathery appearance and dryness
that you see on some people’s skin,” says
London, Ontario dermatologist Dr. Denise
Wexler. “With chronologic aging you
won’t get the same extremes, and consequently those who have had a lot of sun
exposure will look older than their age.”
Prevention is Key
Although there are several ways that you
can help improve your skin, there is no
way to completely undo the effects of
photoaging. What you can do is make
sure that you prevent any further sun
damage by wearing a hat, sun-protective
clothing, sunglasses that have UVA and
UVB protection (and preferably ones
that wrap around
your face to protect as
much of your eyes as
possible) and, of course,
sunscreen (one that is broad spectrum
and at least SPF 30).
Although we all know that we should
wear sunscreen, it isn’t simply a case of
applying a little bit at the beginning of
the day and thinking you are protected.
Wexler says that when applying sunscreen, the average adult needs to use
two to three tablespoons of sunscreen,
and they need to reapply it every two to
three hours. “Especially if you are at the
beach, in and out of the water, or doing
a sports activity where you are sweating
The deleterious effects of the sun are responsible for up to 90 per cent of skin aging. Pictured opposite, some early signs of
photoaging include: (1) sun-related keratosis; (2) pigmented spots; (3) deep wrinkles; (4) freckles; (5) age spots; (6) solar lentigines.
SUMMER 2013
my skin 9
Sunburn
What is it? How do you treat it?
Sunburn is the skin’s short-term response
to ultraviolet (UV) radiation that penetrates the skin and harms the DNA within
its cells. With repeated and unprotected
exposure, the damage caused by UV
radiation may result in sun-induced
changes such as wrinkles, mottling of skin
colour and skin cancer.
Signs of sunburn typically include
redness and swelling, tenderness and/or
irritation, skin that feels hot to the touch,
and varying degrees of pain, which are all
proportional in severity to both the duration and intensity of exposure. In severe
cases, a person may experience blistering,
second-degree burns, chills and fever,
dehydration, electrolyte imbalances and/
or a secondary infection.
Sunburn treatment aims to provide
relief from discomfort. This can be achieved
with the use of analgesics (painkillers), cool
baths, aloe vera lotions and moisturizers.
• Hyperpigmentation
What is it? How do you treat it?
Hyperpigmentation is the darkening of an
area of skin or nails due to excess production of melanin caused by sun damage,
inflammation or other skin injuries,
including those related to acne. People
with darker skin tones are more prone to
hyperpigmentation.
Dermatological laser procedures can
sometimes induce hyperpigmentation,
which is why it is important to ensure the
person performing these procedures is a
physician, or working under the guidance
of a physician, with a greater understanding of the skin, its structure and the
implications of laser use on the skin.
To treat hyperpigmentation, a physician
may prescribe hydroquinone, topical
retinoids, topical corticosteroids, glycolic
acid and other fruit acids, azelaic acid and
L-ascorbic acid.
Skin resurfacing using chemical
peels, laser, intense pulsed light (IPL)
or dermabrasion may be effective, but
unfortunately risks further damage to the
epidermis and formation of more pigment. Cautious cryotherapy to small areas
of post-inflammatory pigmentation can
be effective but may potentially cause a
permanent loss of pigment.
10
SUMMER 2013
my skin
While the effects of photoaging like the
freckles pictured here cannot be completely
undone, dermatologists can apply
topical treatments and services to improve
skin health.
a lot, then you really need to reapply.”
It is also important not to assume that
because you are wearing sunscreen, you
are totally protected and can stay out
in the sun all day. “Seek shade,” advises
Wexler, “and avoid being out in the sun
between 11 a.m. and 3 p.m., when the UV
rays are strongest.”
Treating Photoaging
When it comes to repairing the damage
done by the sun, a number of options are
available. Usually the first course of action
is to apply some sort of cream to the skin
(known as a topical treatment). There
are a huge number of creams available
in drugstores that contain active ingredients that have been proven to reverse
?
What’s the difference
between
UVA and UVB?
“UVB is the shorter wavelength, and
these rays burn the skin and are
responsible for the development of
photoaging and skin cancers. UVA
penetrates a lot deeper, but these rays
are deceiving because they don’t burn
the skin, but probably cause even more
damage in terms of photoaging and
melanoma development,” says Wexler.
This means that even if you aren’t
visibly getting a sunburn, UVA can still
be damaging your skin. “For example,
if you are using a tanning light that
only has UVA waves, you may not have
visible sunburn, but you may still be at
risk of damage.”
photoaging in some way, and if you
visit a dermatologist, you can also obtain
prescription-strength creams that will
have a much more noticeable impact. “The
creams that are available over the counter
are not thought to be as strong, but probably do have some effect,” says Wexler.
Several different ingredients are used in
these products. “Topically, retinol, vitamin
C, glycolic acid, tretinoin and peptides like
matrixyl are useful things one can apply
to the skin,” says Dr. Benjamin Barankin, a
Toronto dermatologist and medical director of the Toronto Dermatology Centre.
(In over-the-counter preparations, these
ingredients may be listed under different
names – for example, Retin-A is a form of
tretinoin – or they may be listed as antioxidants.)
In basic terms, these creams work by
lightening the skin and stimulating the
creation of healthy new skin cells while
preventing the build-up of dead cells.
Photoaging breaks down collagen, the
stuff that gives skin its strength and holds
it taut, and these treatments help build up
collagen in the skin.
Beyond using creams, other photoaging
treatments can have a very positive effect
and help reverse sun damage. “We can
also perform treatments using lasers and
light-based devices, as well as medicalgrade chemical peels and microdermabrasion,” explains Barankin. By consulting with
a dermatologist, you can find out which
course of action will best suit you and
provide the best possible results.
“It is hard to completely undo the
effects of photoaging, but the topical
treatments and services that dermatologists use can definitely improve the skin
significantly,” says Barankin. “Going forward,
the best anti-aging thing anyone can do
is to minimize sun exposure and wear a
good sunscreen properly.”
Lola Augustine Brown is a freelance writer living in Halifax, Nova Scotia. Her articles have
appeared in Flare, Fashion, Canadian Family,
Today’s Parent and various other magazines
in North America.
CAPITAL SOLEIL
PRESERVE THE YOUTH
AND BEAUTY OF YOUR SKIN
HIGH UVA-UVB PROTECTION
Long-lasting UV protection with our photostable
filtering system, featuring Mexoryl®, a patented filter
most recommended by Canadian dermatologists.1
ULTRA-COMFORTABLE TEXTURES
New Bare Skin Feel Lotion SPF 45/60 with
dry-touch, non-greasy, non-comedogenic and
fast-absorbing textures – so comfortable, they
feel like your daily skin care.
For a personalized diagnostic and advice,
visit vichy.ca/capitalsoleil
1
Reference: FIFG, 2012 Canadian study among Canadian dermatologists.
* AC Nielsen, pharmacies, sales in $ in Canada, 2011.
** With other filters in products: Capital Soleil SPF 60 XL cream, SPF 60 XL
face stick, kids SPF 50 lotion, SPF 30 XL cream, SPF 30 XL ultra-fluid lotion
and SPF 20 XL lip protection stick.
NEW
YOUR # 1 BRAND IN CANADA* EXCLUSIVELY IN DRUGSTORES
feature
Some advertisers suggest it’s sexy – but it’s not.
The dangers of
indoor tanning
By Dr. Cheryl Rosen
True
or
False
Having a tan
means I’m healthy.
False: A tan is evidence
of damage done to the
DNA of skin cells. Not all
of this damage can be
repaired, and it can lead
to mutations that can
ultimately result in skin
cancer.
I can safely get
a tan by using a
tanning bed.
False: There is no such
thing as a safe tan. Tanning beds may emit 10 to
15 times more UV radiation than the midday sun,
which is why your skin
tans in brief sessions.
Indoor tanning
can give me all the
vitamin D I need.
False: Taking a vitamin D
pill and eating food that
contains vitamin D are
far safer ways of getting
enough vitamin D, so skip
the tanning bed. Most
people get enough UVB
radiation from incidental
sun exposure in the spring
and summer.
12
SUMMER 2013
my skin
D
o you look better
with a tan? Many
Canadians seem to
think so, particularly
when attending celebrations
such as proms and weddings.
Although many Canadians seek
a tan because they believe it
enhances their appearance,
they are risking their health in
their quest.
Some people are aware of
the devastating side-effects
from using indoor tanning beds,
but seem to be willing to accept
the risk. Others remain unaware
of the possible side-effects of
tanning and do not know that
a tan is actually a response to
damage to the skin.
The direct link between skin
cancer and ultraviolet (UV)
radiation is undeniable. But did
you know that indoor tanning
equipment can emit 10 to 15
times more UV radiation than
you would be exposed to when
outdoors in the afternoon sun?
Not only is the tanning industry
misleading its customers into
believing that using artificial
tanning equipment is beneficial,
they are marketing their efforts
directly to our children.
Industry advertisements
encourage people to believe
that a good “base tan” will help
prevent sunburn. However, the
facts remain that skin is damaged when obtaining a “base
tan,” which only provides you
with a sun protection factor
of two to four. This certainly
cannot compare to the effective
sun protection found in a highquality sunscreen.
The ads are directed towards
the youth market for good reason. Indoor tanning is very common among teens and young
adults, with over 70 per cent of
Canadian females between the
ages of 15 and 18 having used
tanning beds. Forty per cent
of female tanners between the
ages of 11 and 18 have used
tanning beds more than 10
times in the past year.
In 2009, the World Health
Organization reclassified tan-
ning equipment as category-1
“carcinogenic to humans.”
Tobacco, arsenic and plutonium
also hold court in this category.
Indoor tanning before the age
of 30 increases the risk of melanoma by 75 per cent. Yet young
people still use tanning beds in
spite of the risk. Discount multitan packages, flashy advertising
and the still common belief that
a tan makes you look healthy
can be very persuasive.
Let’s convince tanners
that no tan is sexy. Talk to the
tanners you know, encourage
them to skip the tan and be
happy with the skin colour
they were born with. Indoor or
outdoor, no tan is worth the
risk to your health.
Dr. Cheryl Rosen is the Chair of the
Canadian Dermatology Association’s National Sun Awareness
Program, Head of the Division of
Dermatology at Toronto Western
Hospital and an Associate Professor in the Department of Medicine
at the University of Toronto.
advertisement
Skin care treatment
lightens dark spots
caused by sun exposure
Whether we’re young or old, we’re
all seeking clear, smooth complexions.
But dark spots on the skin – sometimes
called age spots, liver spots or hyperpigmentation – are common, especially as
we age.
Age is not a primary cause, however.
Dark spots can often be prevented, and
when they occur, effective treatments are
available.
The two main types of hyperpigmentation are lentigines (“sun freckles”),
caused by prolonged, repeated
exposure to the sun throughout life, and
melasma or chloasma, which can be
triggered by either prolonged sun exposure or hormonal changes (pregnancy,
hormonal treatments or while taking
oral contraceptives). Melasma is usually
intensified by sun exposure. Chloasma is
sometimes called the “pregnancy mask,”
and causes dark, smooth spots, often
with uneven edges, to appear on the
forehead, cheekbones and cheeks.
Hyperpigmentation can also be
caused by skin inflammation, such as
rashes or acne, says Dr. Adam Natsheh,
a Toronto dermatologist. In other cases,
“certain medications can cause photosensitivity, which makes the skin more
prone to solar damage.”
But the biggest factor is sun damage,
he says. “Practicing safe sun habits
can prevent or reduce hyperpigmentation. That means limiting sun exposure
between 10 a.m. and 4 p.m., covering
your head with a hat, wearing light,
breathable clothing and using a broadspectrum sunscreen on any exposed
skin.”
It’s also important to consult your doctor when dark spots occur as a result of
hormonal treatments, as well as to treat
-81%
Before
After 3 months
81% less pigmentation on average, validated by
the dermatologist (DPGA score)
rashes early to minimize long-lasting
damage, he advises.
For existing spots, treatment recommendations depend on the depth of the
pigmentation, says Natsheh. For those
on the surface of the skin, he recommends topical treatments, such as the
D-Pigment Dark Spot Lightener by Eau
Thermale Avène.
The D-Pigment line lightens dark spots
and prevents new ones from appearing, evening out skin tone. It combines
three complementary, synergistic active
ingredients: melanyde, a de-pigmenting
agent derived from the Scots Pine; retinaldehyde, a retinoid (vitamin A), which
stimulates cell renewal to help remove
excess melanin; and pre-tocopheryl, a
precursor of vitamin E that slows melanin
production through an anti-oxidizing
action. When applied daily, the product
has been proven to reduce hyperpigmentation by 81 per cent over a period
of three months, with visible effects after
just one month.
For deeper hyperpigmentation, options include using prescription medication, chemical peels, microdermabrasion
and laser treatments to remove the dark or damaged
skin, says Natsheh.
Meanwhile, preventing sun damage
in the first place is critical, he advises,
noting that planning ahead is an effective strategy. “People often find that they
get caught outside unexpectedly. Many
come in with sun damage that has
resulted from chronic sun exposure while
driving, even if they’re just spending a
lot of time commuting.”
Being aware that sun damage can
occur even through closed windows
and keeping an Eau Thermale Avène
very high protection tinted compact SPF
50 in the car can help, he says. “There
are also lots of great moisturizers that
contain sunscreen. Apply it every morning before you leave the house, even if
you don’t plan on spending a lot of time
outside.”
Equally important, especially for teens
and young adults, is avoiding sun beds,
he stresses. “That tan may look great
now, but it is causing a lot of damage that will appear over the years to
come.”
feature
Although it is the most common cancer in Canada, skin cancer is
largely preventable, detectable and curable. You can protect your
health by taking steps to prevent skin cancer, learning what skin
cancer looks like and taking action if you find something unusual.
big
e
th
skin
cancer:
C
Early identification
is of critical importance
By Dr. Richard Langley
I
t is estimated that one in five North
Americans will develop a skin cancer
over the course of their lifetime. The
incidence of melanoma, the most
dangerous of the skin cancers, has increased
almost threefold over the past three decades.
Despite these staggering statistics, if
detected early, skin cancer can be successfully treated. Melanoma, if caught in its
early stages, is curable, or, when minimally
14
SUMMER 2013
my skin
invasive, highly curable; whereas people
with melanoma that has metastasized to the
brain have an average survival rate of only
four months. This underscores the critical
importance of early diagnosis and prompt
excision of malignant skin cancer.
The most common form of skin cancer,
basal cell cancer, rarely metastasizes. Still,
even for this form of cancer, it is important
to diagnose it early as it can be locally
invasive and cause significant morbidity in
patients.
Why is prevention important?
Skin cancer is largely preventable. The most
important risk factors for melanoma include
light skin colour, red or blond hair, a history
of sunburns (particularly blistering sunburns),
a family history of melanoma in at least two
first-degree relatives and a prior history of
ANTHELIOS XL
The advanced UVA-UVB protection
most recommended by
Canadian dermatologists*.
OF SKIN CANCERS
DETECTED EARLY ENOUGH
CAN BE CURED**
Use our interactive mole checker
to monitor your moles at:
In the
lightest
textures
FRAGRANCE-FREE.
PARABEN-FREE.
*Canadian Study, IFOP 2012
**Source: French Syndicate of Dermatologists and Venereologists, 10th March 2008.
feature
melanoma. Some of these risk factors, such
as sun exposure, can be minimized, particularly sunburns and blistering sunburns.
We also know that for the most common
skin cancer, basal cell carcinoma, the most
significant risk factor is chronic sun exposure.
Over 80 per cent of all basal cell skin cancers
occur on the head and neck, occurring in
areas of maximum sun exposure.
Solar radiation has been identified as a carcinogen by the World Health Organization,
Self-detection works:
over 50 per cent of all
melanomas were selfdetected by patients.
and its clear link in epidemiological studies
of skin cancer underscores the importance
of prevention. In general, we recommend
that patients avoid the midday sun (from
11 a.m. to 3 p.m.), wear a sunscreen with an
SPF of at least 30, wear sun-protective clothing and avoid artificial forms of radiation.
These precautions have been shown to
reduce the formation of skin cancers and
are an important step that we can all take to
prevent skin cancer.
AppearanceLocationCauses
Who’s at risk?Treatment
Basal Cell
Fair-skinned people
with blond or red
hair and skin that
usually burns are
most at risk.
Depends on
tumour size and
location, as well as
the patient’s overall
health.
Incidence increases
as people get older,
especially over the
age of 50.
Therapies include:
photodynamic
therapy, immunemodulating creams
or surgery for large
recurrent lesions.
A firm, flesh-coloured or reddish bump, often with a pearly
border.
Classification:
Skin Cancer
A sore or pimple-like growth
that bleeds, crusts over and
then reappears.
Sun-exposed areas,
most commonly
on the face and
neck, but also on
the trunk, arms and
legs.
Frequent severe
sunburns and intense sun exposure
in childhood.
More men get basal
cell cancer than
women.
Organ transplant
patients whose immune systems are
compromised.
Squamous
Cell
Thickened, red, scaly bumps or
wart-like growths.
Grows quickly over a period of a
few weeks.
Classification:
Skin Cancer
Chronically sunexposed areas such
as the head and
neck, arms, back of
the hands and legs.
Frequent sun
exposure.
Areas of particular
concern: the rim of
the ear and the lip.
Malignant
Melanoma
Can be a new mole or frecklelike spot, or develop in an
existing mole.
Classification:
Skin Cancer
Usually dark in colour – brown
and black, and can sometimes
include blue, grey and red.
For men: commonly on the back.
For women: commonly on the legs.
In darker-skinned
people, it can appear on the soles
of the feet, toenails
and palms of the
hands.
Red, rough, scaling spots.
Spots may sting or itch.
Classification:
Pre-Cancer
16
SUMMER 2013
Sun-exposed areas
such as the face,
ears, balding scalp,
back of the hand,
forearm and leg
People over 40
who’ve had a lot
of lifetime sun
exposure.
Organ transplant
patients whose immune systems are
compromised.
Excessive exposure
to UV from the sun
or sunbeds.
A history of severe
sunburns.
Fair, sun-sensitive
skin that burns
rather than tans,
and people with
freckles and red or
blond hair.
If confirmed by
biopsy, excision or
surgery is required.
People with more
than 50 moles or a
close family history
of melanoma or a
personal history of
melanoma.
Excessive exposure
to UV from the sun
or sunbeds.
A history of severe
sunburns.
Fair-skinned people.
People over 40
who’ve had a lot
of lifetime sun
exposure.
Outdoor workers.
my skin
Surgical excision,
radiation therapy or
Mohs micrographic
surgery.
Outdoor workers.
Can also appear
on the arm, scalp
or face.
Actinic
Keratosis
Fair-skinned people.
Treatments
include cryosurgery
(freezing of the
lesion with liquid
nitrogen), surgical removal and
creams.
big
e
th
C
What are the signs of skin
cancer, and what do I do if I find
something?
What happens if I am
diagnosed with skin cancer?
Look for new or changing skin lesions,
monitor them and get them assessed if you
are concerned. Sustained change over the
course of weeks or months is a significant
risk factor for skin cancer.
For melanoma, a helpful mnemonic is
the ABCDEs:
• A: Asymmetry in the shape or colour of a
pigmented lesion
Remember that most skin cancers are curable or highly curable. Your treatment options
depend on the type of skin cancer you have been diagnosed with.
If you have a basal cell skin cancer or squamous cell skin cancer, these can typically
be cured by surgical removal of the tissue along with a minimal amount of surrounding
normal skin. Certain types of basal cell skin cancers (basal cell cancers around the eyes,
certain locations on the nose or a specific type of basal cell cancer called morpheaform)
may require specialized surgery known as Mohs surgery. This type of surgery will remove
the cancer in several stages to ensure that all of the cancer cells have been removed.
For melanoma, the stage of the cancer will determine your best treatment option. Most
melanomas are either in the outer layer of the skin (epidermis) or have just penetrated
into the skin. In this case, the thickness of the tumour (how far it penetrates into the skin)
will determine how wide a margin of normal skin you need to have removed. Patients
who have thicker tumours may also require a specialized biopsy of a node called a sentinel lymph node biopsy.
Although skin cancer is the most common cancer, the prognosis is excellent if the
cancer is diagnosed early and treated appropriately. Keep in mind that many skin cancers
can be prevented by minimizing exposure to the harmful rays of the sun.
As we all enjoy the warmth of summer, it is important to remember that we need to
enjoy the sun in a safe and responsible way.
• B: Irregular or jagged border
• C: Variegation in colours, such as shades
of brown, black, red or white
• D: A diameter greater than 6 mm
• E: Evolution or change in a lesion as
noted above
Self-detection works: over 50 per cent of all
melanomas were self-detected by patients.
If you identify a suspicious lesion, it is best
to bring it to the attention of your family
physician. If he or she is concerned, they
may do a biopsy (remove the lesion) or refer you to a dermatologist for examination.
Dr. Richard Langley is a professor and Director of Research in the Division of Dermatology,
Department of Medicine, Dalhousie University, and President-elect of the Canadian
Dermatology Association. He has received numerous awards for teaching, research, clinical
practice and volunteer activities.
sun care
+ ACTIVE NATURALS® oats, clinically
proven to hydrate and nourish
sun-exposed skin
+ broad spectrum UVA/UVB protection
+ #1 pediatrician recommended brand
in Canada*
+ waterproof, sweatproof
trusted
protection
for baby and mom
that’s the beauty of
nature+science
© Johnson & Johnson Inc. 2013
*Data on file.
Feature
W
hen taken as
prescribed,
medications can
help address
illness and relieve pain and discomfort. Many drugs also have
side effects, however, and with
some, you may find that your
skin is more sensitive to the sun.
This means that when the drug
is in your body, it reacts to exposure to ultraviolet light, causing
a sunburn or skin rash. Your skin
can burn in less time and with
less exposure to the sun, leaving
you at greater risk for skin cancer.
What happens if I take
these medications and go
out in the sun?
How your skin will react depends
on each individual. Some may
have severe reactions, while
others have a mild reaction or no
reaction at all. If your body does
have a reaction, it may respond
in one of two ways: you could
have a phototoxic reaction or a
photoallergic reaction.
A phototoxic reaction can
occur within hours of taking the
medication. It often looks like a
sunburn, and it appears only in
areas of sun-exposed skin. It may
or may not be itchy. In extreme
cases, blisters may break out.
Photoallergic reactions are
more rare. These appear later, up
to three days after being exposed
to the medication. The time lag
is because the immune system
needs time to ramp up an attack
against the combination of the
medication and sun exposure.
Photoallergic reactions resemble
eczema: watch for itching, red
bumps, scaling and oozing lesions. These reactions occur all
over the body – not just on sunexposed skin. Like other allergies,
photoallergic reactions tend to
happen in people who have
been exposed to the medication
before. They are most commonly
caused by topical medications
(creams or ointments) and ingredients found in cosmetics.
The important thing is to
be aware of the risk and take
precautions.
18
SUMMER 2013
my skin
A
&
Q
Are your
medications
making
you more
sun-sensitive?
By Dr. Gordon Searles
If I have a reaction, what
is the treatment?
Treatment depends on the
severity of the reaction. In
many cases, you can treat the
reaction using cold compresses
or a hydrocortisone cream to
reduce any pain or swelling.
Mild phototoxic reactions are
often resolved in a week or less.
It is best to discuss treatment
options with your dermatologist
or family doctor.
What kind of
medications bring on
this sun sensitivity?
A list of some of the common photosensitizing drugs is
included below. In clinical tests,
medications that include heart
medications, antidepressants,
antimalarials and the pain reliever ibuprofen have been found to
cause photosensitivity. Note that
herbal medications could also
cause photosensitivity. It is best
Drugs to pay attention to
The following drugs are some of the most common
medications that cause increased sensitivity to the sun:
Anti-inflammatories:
Naproxen (e.g. Aleve, Midol, Naprelan)
Piroxicam (e.g. Dolonex, Feldene)
Antibiotics:
Tetracycline (e.g. Panmycin, Sumycin, Tetracyn)
Doxycycline (e.g. Microdox, Vibramycin)
Nalidixic acid (e.g. Neggram, Nevigramon, Wintomylon)
Antifungals:
Voriconazole (e.g. Vfend)
Diuretics:
Hydrochlorothiazide
(e.g. Apo-hydro, Aquazide H, Dichlotride)
Antiarrhythmics:
Amiodarone (e.g. Cordarone, Nexterone)
Antipsychotics:
Chlorpromazine (e.g.Largactil, Megaphen, Thorazine)
Thioridazine (e.g. Mellaril, Novoridazine, Thioril)
to ask a pharmacist about your
medication to see if you need to
take extra precautions.
Is there really a heightened risk of skin cancer if
I am taking one of these
medications?
Researchers have found that
people on some photosensitizing medications had an
increased risk of non-melanoma
and melanoma skin cancers
compared to people not taking
these drugs.
Can I still go outside?
Yes, but if you are taking a photosensitizing medication, extra
care is needed. Be sure to follow
the basic precautions:
• Seek shade when possible and
avoid the sun from 11 a.m. to
3 p.m. when the sun’s UV rays
are at their strongest.
• Wear protective clothing. Slap
on a broad-brimmed hat and
pick clothes that have densely
woven fabrics for extra sun
protection.
• Wear a broad-spectrum
sunscreen with an SPF of 30 or
greater.
• Use enough sunscreen: about
two to three tablespoons on
your body and a teaspoon on
your face.
• Apply sunscreen approximately 15 to 20 minutes before
going outside to give it time
to properly absorb. Reapply
every two hours, or after swimming or sweating heavily.
Finally, be aware that you
could still be sensitive to the sun
after you have finished taking
the medication. Check with your
doctor or pharmacist about
how long you should be extra
vigilant about sun protection,
as this varies with each kind of
medication.
Dr. Gordon Searles is the President
of the Canadian Dermatology Association, Clinical Associate Professor of Medicine at the University of
Alberta and the Managing Director
of the Keystone Dermatology
Institute in Edmonton, Alberta.
Clim a tic a g g re ssio ns,
unsuit a bl e c osm e tics...
Skin
recovery cream
Helping my skin to protect itself
Skin Recovery Cream is now enriched with Parcerine, a patented ingredient
that decreases skin reactivity.
By rapidly soothing the irritation and restoring the hydrolipidic film, Parcerine
guarantees an efficient, long-lasting protection and comfort to the skin.
Eau Thermale Avène is the only brand that offers sterile cosmetics, the innovation that truly guarantees 0% preservatives, 0% paraben, 0% fragrance, and
0% alcohol for unequalled safety and efficacy for hypersensitive and irritated
skin.
PA R C E R I N E ®
SPECIFIC INGREDIENT
• Rapidly calms irritation
Everything about
sterile cosmetics
• Long-lasting protection
resource
Learning about key sunscreen features can help you make better
choices for staying safe in the sun.
Sunscreen 101:
Everything
you need to know
By Dr. Anatoli Freiman
W
ith one in six
Canadians
expected to
develop skin
cancer in their lifetime, skin
cancer is the most common
type of cancer. Yet it is also one
of the most preventable.
The primary environmental
cause of premature skin aging
and most skin cancers is ultraviolet (UV) radiation from sun
exposure. UV radiation is composed of three wavelengths:
UVA, UVB and UVC, of which
UVA (320-400 nm) and UVB
(290-320 nm) rays are specifically carcinogenic. Sunscreens
are an integral element for sun
protection since they work
by absorbing or reflecting UV
radiation.
There are two main types of
sunscreens: organic/chemical,
which absorb UV radiation,
and inorganic/physical (such
as titanium dioxide or zinc
oxide), which physically block
UV radiation. Many sunscreens
combine both chemical and
physical ingredients, and they
are available in a variety of
forms including lotions, gels
and sprays.
Learning about the following
key sunscreen features can
help you make the best choice
for staying safe in the sun:
20
SUMMER 2013
my skin
• SPF stands for Sun Protection
Factor and indicates sunscreen effectiveness against
UVB rays. There is incremental
protection with higher SPF,
and dermatologists typically
recommend using a sunscreen with an SPF of at least
30, which blocks 97 per cent
of UVB. SPF does not indicate
UVA protection or that the
sunscreen is broad spectrum.
• Sunscreens labelled “broad
spectrum” offer protection
against both UVA and UVB
rays and are therefore the
best choice. A critical wavelength of at least 370 nm is a
laboratory measure of broadspectrum protection.
• The photostability of sunscreens refers to their stability
upon exposure to sunlight.
• Water-resistant sunscreens
maintain their SPF protection
level after 40 to 80 minutes
of water immersion, as determined by laboratory testing.
• Sunscreens should ideally be
non-comedogenic (which
means they won’t block
pores), non-irritating, hypoallergenic and minimally or
non-perfumed.
The U.S. Food and Drug Administration recently adopted
more stringent regulations
about labelling sunscreens
!
Checklist:
My sunscreen
should...
1. Have an SPF of 30 or higher.
2. Offer broad-spectrum
(UVA/UVB) protection.
3. Be hypoallergenic and noncomedogenic so it won’t
clog my pores.
When in doubt:
look for the CDA Sun
Protection Program logo.
and establishing standards for
testing the effectiveness of sunscreen products. Health Canada
is also in the process of revising
its sunscreen monograph.
The Canadian Dermatology
Association (CDA) Sun Protection Program scientifically
evaluates sunscreens through
independent laboratory testing,
and Canadians are encouraged
to look for the CDA logo when
purchasing sunscreens.
The CDA recommends that a
broad-spectrum (providing UVA
and UVB protection) and high
SPF (30+) sunscreen be generously and evenly applied to
the skin approximately 15 to 20
minutes before sun exposure. It
should then be reapplied every
two hours, or more frequently if
you are swimming or sweating. In general, you will need
about two to three tablespoons
of sunscreen to adequately
cover the body’s skin surface,
and a teaspoon of sunscreen is
needed for the face.
Dermatologists encourage the use of sunscreen for
children older than six months,
while using other sun protective measures for younger
infants.
Keep in mind that sunscreen
is only one of the many ways to
ensure overall sun safety. Other
strategies include staying out of
the sun during peak hours from
11 a.m. to 3 p.m., seeking shade
and wearing sun-protective
clothing and sunglasses. Including sunscreen as part of your
everyday routine will not only
save you from painful sunburns,
it will, most importantly, reduce
your risk of developing skin
cancer.
Dr. Anatoli Freiman is Chair of
the Canadian Dermatology
Association Sun Protection
Program and Medical Director of
the Toronto Dermatology Centre
(torontodermatologycentre.com).
Earned recognition
The following sunscreens and other
products are recognized by the
Canadian Dermatology Association
Aveeno Active Naturals Protect + Hydrate SPF 30
Aveeno Active Naturals Protect + Hydrate SPF 45
Aveeno Active Naturals Protect + Hydrate SPF 60
Aveeno Active Naturals Sensitive Skin SPF 30
Aveeno Baby Sensitive Skin SPF 50
Aveeno Baby Sensitive Skin Mineral Sunscreen SPF 50
Aveeno Baby Sunscreen Lotion SPF 55
Aveeno Kids Sensitive Skin Mineral Sunscreen SPF 50
Aveeno Sensitive Skin Mineral Sunscreen SPF 50
Avène High Protection Emulsion SPF 40
Avène High Protection Lotion SPF 40
Banana Boat Baby Tear Free Sunscreen Lotion SPF 60
Banana Boat Kids Tear Free Sunscreen Lotion SPF 60
Banana Boat Ultra Defense Sunscreen SPF 30
Banana Boat Ultra Defense Sunscreen SPF 60
Coppertone General Protection Sunscreen Lotion SPF 60
Coppertone Kids Sunscreen Lotion SPF 60
Coppertone Oil Free Sunscreen Lotion SPF 30
Coppertone Oil Free Sunscreen Lotion SPF 60
Coppertone Sport Sunscreen Lotion SPF 30
Coppertone Sport Sunscreen Lotion SPF 60
Coppertone Sport Sunscreen Lotion Face SPF 60
Coppertone Water Babies Sunscreen Lotion SPF 60
Exact Cooling and Refreshing Clear Continuous Spray
Sunscreen SPF 45
Hawaiian Tropic Sensitive Skin Face Sunscreen SPF 30
Hawaiian Tropic Sheer Touch Lotion Sunscreen SPF 30
Hawaiian Tropic Sheer Touch Lotion Sunscreen SPF 45
Hawaiian Tropic Sheer Touch Lotion Sunscreen SPF 60
Hawaiian Tropic Sheer Touch Oil-Free Sunscreen SPF 85
IDC SPF 30
IDC SPF 50
La Roche-Posay Anthelios Dermo-Kids Velvet-Soft Lotion SPF 45
La Roche-Posay Anthelios Dry-Touch Spray SPF 45
La Roche-Posay Anthelios Melt-in Cream SPF 45
La Roche-Posay Anthelios Targeted Protection Stick SPF 60
La Roche-Posay Anthelios Ultra-Fluid Lotion SPF 60 Face
La Roche-Posay Anthelios XL Melt-in Cream SPF 60
La Roche-Posay Hydraphase UV SPF 30
Life Brand Sunthera3 Baby SPF 60
Life Brand Sunthera3 Kids SPF 50 Continuous Spray
Life Brand Sunthera3 Lip Balm SPF 30
Life Brand Sunthera3 SPF 30
Life Brand Sunthera3 SPF 30 Sun Protection Lotion Face
Life Brand Sunthera3 SPF 60
Life Brand Sunthera3 SPF 60 Continuous Spray
Life Brand Sunthera3 SPF 60 Sun Protection Lotion Face
Life Brand Sunthera3 Sunscreen Stick SPF 60 Face
Life Brand Sunthera3 Sport SPF 30 Continuous Spray
Neutrogena Age Shield Face Sunscreen SPF 60
Neutrogena Beach Defense SPF 30 Sunscreen Lotion
Neutrogena Beach Defense SPF 60 Sunscreen Spray
Recognized
Sun Protection
Reconnu
Protection solaire
Category:
Sensitive skin
Baby/Children
Sport
Neutrogena Beach Defense Kids SPF 60 Sunscreen Lotion
Neutrogena Healthy Defense Daily Moisturizer SPF 30
Neutrogena Healthy Defense Daily Moisturizer SPF 45 - Untinted
Neutrogena Pure & Free Baby Sunscreen Lotion SPF 50
Neutrogena Ultra Sheer Dry Touch Sunscreen SPF 30
Neutrogena Ultra Sheer Dry-Touch Sunscreen SPF 55
Neutrogena Ultra Sheer Dry-Touch Sunscreen SPF 70
Neutrogena Ultra Sheer Dry-Touch Sunscreen SPF 110
Neutrogena Ultra Sheer Face Sunscreen SPF 45
Neutrogena Ultra Sheer Face Sunscreen SPF 60
Neutrogena Ultra Sheer Water-Light Daily Face Sunscreen
Lotion SPF 60
Olay Complete Defense Daily UV Moisturizer Sensitive Skin
SPF 30
Ombrelle Face Cream XL SPF 30
Ombrelle Face Cream XL SPF 45
Ombrelle Face Cream XL SPF 60
Ombrelle Face Stick XL SPF 60
Ombrelle Kids Protection Milk XL SPF 60
Ombrelle Kids SPF 30 Lotion
Ombrelle Kids SPF 45 Lotion
Ombrelle Kids SPF 30 Lotion Sensitive Skin
Ombrelle Lip Balm Anti-Drying Transparent SPF 30
Ombrelle Lotion SPF 30
Ombrelle Lotion SPF 45
Ombrelle Extreme Lotion SPF 30
Ombrelle Multi-Positions Sport Clear Spray SPF 60
Ombrelle Protection Milk XL SPF 60
Ombrelle Sport Gel SPF 30
Ombrelle Sport Lotion SPF 30
Ombrelle Sport Lotion SPF 45
Ombrelle Sport Spray SPF 30
President’s Choice SPF 30 Sport Sunscreen Lotion
President’s Choice SPF 30 Sunscreen Continuous Spray
President’s Choice SPF 30 Sunscreen Lotion
President’s Choice SPF 50 Sunscreen Continuous Spray
President’s Choice SPF 50 Sunscreen Lotion
President’s Choice SPF 60 Kids’ Sunscreen Continuous Spray
President’s Choice SPF 60 Kids’ Sunscreen Lotion
President’s Choice Sunblock Lotion, SPF 30
RoC Soleil Protexion Invisible Touch SPF 30
RoC Soleil Protexion Invisible Touch SPF 45
RoC Soleil Protexion Sun Lipstick Velvet Moisture SPF 20
RoC Soleil Protexion Velvet Moisture Spray Lotion SPF 30
RoC Soleil Protexion Velvet Moisture Spray Lotion SPF 60
Vichy Capital Soleil Sun Protection Cream XL SPF 30
Vichy Capital Soleil Sun Protection Cream XL SPF 45
Vichy Capital Soleil Ultra-Fluid Sun Protection XL SPF 30
Vichy Capital Soleil Ultra-Light Lotion SPF 50
Vichy Capital Soleil Face and Body Lotion SPF 50
Vichy Capital Soleil Sunscreen Cream SPF 60
Vichy Capital Soleil Ultra Protection Sunblock Stick SPF 60
SUMMER 2013
my skin 21
final word
“I don’t recall
anyone at our
graduation who
wasn’t tanned.
I used tanning
beds every other
day for about
four years.”
A picture of health
J
ackie Connors, a
39-year-old nurse in St.
John’s, Newfoundland,
started using tanning
beds in her teens because “tans
were in and everybody was
doing it.
“I don’t recall anyone at our
graduation who wasn’t tanned,”
she adds. “I used tanning beds
every other day for about four
years. I went to two or three
different salons to get as much
22
SUMMER 2013
my skin
time as possible. It was definitely
addictive.”
At age 20, while at nursing
school, Connors learned about
the signs of skin cancer, including the most dangerous kind,
melanoma. A very dark, irregular,
raised spot on her leg that bled
after shaving rang alarm bells.
After the spot was removed,
the confirmed diagnosis of cancer was “completely devastating,”
says Connors. She underwent
further surgery to remove a
wide margin of skin around the
cancerous lesion.
The blond, blue-eyed mother
of one has since undergone
treatment for two more melanomas – one on her back, the other
on her neck.
Back at the dermatologist’s
office where she now works,
Connors looks for any opportunity to counsel parents and
teens against sunbed use and to
tell her story. “They can’t believe
what I’ve been through,” she says.
“I show them the scars.
“My own parents really regret
that they let me use tanning
beds, but no one knew much
about them then. Over the past
five or 10 years, knowledge
about the dangers of using tanning beds has really grown. It’s
important that people find out
the facts about indoor tanning.
Don’t learn the hard way.”
FEEL PROTECTED WITH
SUNTHERA3
™
Discover our line of sun care.
Life Brand Platinum Sunthera3 Face
protects with a broad spectrum sunscreen
that’s gentle and light enough to wear
on your face and neck every day.
Available in SPF 30 or 60 Lotion and
SPF 60 Continuous Spray.
All Sunthera3 ™ products are recognized
by the Canadian Dermatologist Association.
Only at
Protect
your face
and your
beauty.
NEW
Ombrelle Ultra-Fluid Lotion
Sunscreen SPF 60
Easy daily application
Ultra-light texture
✓ Ideal under make-up
✓ Non-comedogenic
✓ Vitamin E**
✓ For all skin types
* Canadian Dermatologists 2012 Survey. **Cosmetic ingredient: Vitamin E (tocopherol)
For women by Canadian dermatologists