Psoriasis vs. Eczema

Psoriasis vs. Eczema: what are they and how do they differ?

As we battle through winter, when skin is especially sensitive, it’s important we keep an eye on any changes to the body. Below, we break down the key characteristics of each condition and how to go about treating outbreaks.

The average person probably couldn’t tell the difference between psoriasis and eczema. What’s understood is that both skin conditions are uncomfortable and visually unpleasant for those who suffer from them. Generally speaking, they look similar—red, rash-like, and inflamed—however, the symptoms and treatment options differ.

Psoriasis

According to Dr. Kirk Barber, a certified dermatologist practicing in Calgary, Alberta, psoriasis affects approximately one million Canadians and 125 million people worldwide. Although it manifests on the surface of the skin, its impact is profound. Dr. Barber says that about 30% of people with the condition will develop an arthritis related to their psoriasis. Psoriasis has been linked to other chronic diseases like diabetes and cardiovascular disease. Most patients have their first episode in adulthood, yet it still affects about one per cent of children.

While the exact cause remains unknown, researchers believe it to be a combination of genetic, environmental, and immune factors.

Signs and symptoms
Psoriasis speeds up the production of skin cells, which results in itchy and sometimes painful lesions. These patches are well-defined, red, and elevated, often with flaking silvery scales. Affected areas look dry, cracked, and inflamed. The most common sites for psoriasis are the elbows, knees, scalp, chest, and lower back. Outbreaks can be triggered with increased stress, infection, injury to the skin, smoking or heavy drinking, and certain medications. Depending on the patient, an episode of psoriasis often subsides within a few weeks or months.

Treatment options
There are a variety of treatment options available to patients with psoriasis. These vary based on the level of severity, how large the lesions are, and patient preferences. For mild to moderate cases, creams or ointments, such as corticosteroids, vitamin D or vitamin A derivatives, or coal tar may be helpful. When the affected area is large, and it is not practical to apply creams or creams have not been effective then light therapy, oral medications or injections may be recommended.

Quick tips:

  • Exercise frequently and manage your stress
  • Avoid extreme temperatures
  • Moisturize every day, particularly after bathing/showering and hand-washing

How bad is your psoriasis?

  • Mild: Affects less than 3% of skin
  • Moderate: Affects 3 to 10% of skin
  • Severe: Affects more than 10% of skin

For more information about psoriasis, visit the Canadian Dermatology Association’s website.

Eczema

Approximately 15 to 20% of Canadians suffer from eczema. Around 17% are diagnosed with the most common type, atopic dermatitis (AD). AD is hereditary and is often linked to asthma and/ or hay fever. While most cases of AD occur before the age of five, some experience their first outbreak in adulthood, which is known as adult-onset atopic eczema.

The other common form of eczema is known as contact dermatitis, and it comes in two forms: allergic and irritant. Allergic is caused by a delayed immune reaction, whereas irritant is caused by repeated exposure to substances that damage the skin.

Like psoriasis, the cause of eczema is unclear; patients either develop or are born with an impaired skin barrier function, which means they’re more susceptible to external allergens and bacteria. Again, there are a variety of genetic, environmental, and immune factors at play.

Signs and symptoms
Eczema consists of dry skin and inflammation, and is generally more itchy than psoriasis. Infected areas look red and swollen, sometimes with fluid-filled bumps. Whatever the state, eczema is not contagious. Flare-ups may occur in different areas of the body based on one’s age. For instance, babies tend to experience eczema on their scalp and face, whereas adolescents tend to have flares in the crooks of the knees and elbows. In addition, everyone, adults included, may also find patches on the ankles, wrists, neck and hands.

Treatment options
Eczema is kept under control by a variety of remedies. Treatment is primarily based around minimizing recognizable irritants, like soaps and detergent based body washes and avoiding them. Coarse fabrics and wool clothing may cause significant irritation. In severe cases, and especially when infection is present, certified dermatologists will recommend antibiotics, corticosteroids, topical calcineurin inhibitors, or light therapy. Regardless of its state, moisturizing is essential and will minimize itchiness, which can be the most aggravating symptom of all.

Quick tips:

  • Avoid harsh products and fabrics that cause irritation
  • Bathe daily or every other day (or even less frequently, depending on what works best for you), using lukewarm water
  • Moisturize every day, particularly after bathing/showering and hand-washing

Other types of eczema:

  • Dyshidrotic Eczema
  • Lichen Simplex Chronicus
  • Nummular Eczema
  • Seborrheic Eczema
  • Stasis Dermatitis

For more information about eczema, visit the Canadian Dermatology Association’s website.

The skin is the body’s largest organ, and as such, it’s important we protect and take care of it, regardless of genetics or skin condition. In some circumstances, like those noted above, skin requires a little extra care. Book regular appointments with your certified dermatologist to minimize discomfort and damage to the skin.

 

The Canadian Dermatology Association along with Novartis and the Canadian Association of Psoriasis Patients developed a public service announcement to raise awareness of psoriasis and the emotional and physical impact it has on the 1 million Canadians who live with it.

The information in this article has been reviewed by a certified dermatologist.


Food and your skin

Food and your skin: The inside out story

Nowadays, just about every skin care product contains some sort of exotic fruit, from coconut to kiwi. Likewise, scroll through any beauty magazine and you’ll find lists of household items like oatmeal and egg whites, recommended for DIY facials. Are they truly beneficial or just a silly marketing scheme? On the opposite end, how much does the food we consume have an impact on how our skin looks and feels?

Keep reading as we sink our teeth into this issue.

Skin care remedies that taste oh so good

While celebrities, beauty bloggers, and skin care aficionados have long raved about the benefits of using food products on the skin to boost its appearance, others suggest approaching with caution.

Dr. Jason Rivers, a Vancouver-based certified dermatologist, says that while almost every vegetable or fruit has been attributed with skin health benefits, there’s very little data to support these statements.

“Tannins in tea may help to soothe and reduce swelling under the eyes. Tea tree oil may diminish acne lesions but only in relatively mild disease. Oatmeal lotions applied to the skin or oatmeal powder used in the bath water may reduce itch, soothe and moisturize the skin. Alpha hydroxy acids—found in apples and other citrus fruits—used in relatively high concentrations (35-50%) may produce a visible improvement to the skin.  However, anything applied to the skin for a prolonged period may also cause skin irritation,” says Dr. Rivers.

The bottom line is everyone’s skin will react differently to various skin care remedies, whether found in the fridge or bought on the shelf. For instance, while some swear by using mayonnaise in the winter months to help hydrate scaly skin, others find it causes acne breakouts given it’s primarily fat and oil. Likewise, while cinnamon is alleged to be an effective exfoliant, for many it can cause rashes and blisters.

Dr. Rivers says the best way to determine whether a product or ingredient will work for your skin type is to apply a small amount of the substance to an area of the face the size of a postage stamp, once daily for a week. If redness and scaling develop, it’s best to avoid it. Depending on the patient, some areas will be more prone to reactivity than others.

“You are what you eat!”

You might remember this phrase as something your parents used to help stop you from a chips and candy binge, probably with limited success; maybe it was whispered to you from a concerned friend who insisted that eating chocolate and other junk food causes pimples. Regardless of where you might have heard it, does you are what you eat bear any truth?

Certain foods play an important role in the health of our skin, just like they do to any other organ in the body, says Dr. Rivers. Too much of a something in our diet can be just as harmful as too little.

“Vitamin deficiencies may lead to conditions such as scurvy (vitamin C) and pellagra (vitamin B).  Mineral deficiencies can result in acrodermatitis enteropathica (zinc deficiency), and hair loss (iron deficiency).  The development of drug and food allergies can manifest as rashes and urticaria (hives). The skin truly is a window to our inner selves,” says Dr. Rivers.

Sadly, no single kind of food will cure it all. For the most part, a balanced diet can prevent skin diseases, infections, and general irritation. Dr. Rivers also suggests limiting alcohol and caffeine while increasing water intake, and always remembering to wear sunscreen.

If you’re looking for some healthy additions to your diet, start with the list below:

  • Say yes to nuts and seeds. Walnuts, chia, and flax seeds contain a high amount of omega-3 fatty acids, which can reduce inflammation and dryness, common in skin conditions like eczema and psoriasis.
  • Stock up on oily fish and yogurt. Salmon, mackerel, and herring are all good sources of omega-3 and omega-6 fats.
  • Dairy has been anecdotally associated with an increase in acne breakouts, though there is a lack of strong evidence proving causation. However, switching to non-dairy alternatives may prove beneficial for some people’s skin.

Like all matters in life, there are lots of opinions about what’s best for the health of your skin—some of it useful, some of it harmful.  Make sure to schedule regular appointments with your dermatologist to avoid confusion and to better understand how food affects the skin—whether it’s what you’re putting on your body or what you’re putting in it.

The information in this article has been reviewed by a certified dermatologist.


How to keep fresh in the winter

How to keep fresh in the winter, from head to toe

Winter brings with it many great things: holiday cheer, gifts, snow, and eggnog, but it also has a knack of leaving our skin and hair completely dehydrated. This season, though, we’re going to help you avoid that.

Dry hair no more

Brittle, crispy, straw-like—these are all descriptors we commonly used to describe our hair in the winter. Dr. Jeff Donovan, a Vancouver-based certified dermatologist and hair transplant specialist, says it’s harsh outside temperatures and dry indoor heating that causes damage—not to mention, friction from hats, headbands, and other outdoor gear.

So, what can we do to fight back? Here are a few tips and tricks to get you started.

1. Hold back on heavy-duty styling
As much as you may be yearning for the beach-bred wavy hair in the winter months, Dr. Donovan suggests holding off from using direct heat on your hair. If you can, put down your flat iron, hair dryer, and curling iron for at least a few days a week. When it’s imperative to use heated tools, make sure your hair is 70 per cent dry before styling.

2. Put a mask on it
Dr. Donovan encourages patients to use conditioner with every wash; it will help tame those pesky flyaways, which are a key sign of dryness. On top of that, enrich your hair with a weekly leave-in conditioner or hair mask to protect the cuticle and amp up the silkiness. For minimal interference on your daily routine, use a night serum—just remember to designate a pillowcase for this, as it can get messy!

3. Push it an extra day
Although it might seem undesirable, try to add another day to your hair wash cycle. Instead of shampooing every day, make it every two; instead of every two, make it every three. Shampoo strips your hair of its natural oils, which naturally moisturize your hair. If you’re worried about looking conspicuously unkempt, try using a dry shampoo.

4. Scalp care
There’s nothing quite as off-putting as seeing a flurry of white specs cascade onto your desk as you run your hand through your hair. Most people experience some version of this, especially as the cold weather hits. Surprisingly, an oilier scalp leads to clumping and shedding of dead skin cells. So, the easiest and most effective way to control your itchy scalp is by shampooing frequently. If that doesn’t work, opt for a dandruff treatment shampoo. Now, you may be thinking this goes against the advice noted above but it’s about finding a balance. If you’re not seeing improvement, talk to you doctor and consider asking for a referral to a certified dermatologist; there are many conditions that can mimic dandruff, and as such, won’t improve with anti-dandruff shampoos.

5. Line with satin or silk
As noted above, friction is a big problem in the winter months. Wool, cotton, and other coarse fabrics rubbing against your strands can cause major breakage, especially for those with wavy or curly hair. These materials absorb moisture—the opposite of what we’re trying to achieve. Dr. Donovan recommends buying hats with a silk or satin lining, or using a scarf as shield. Anti-frizz products can be used in tandem to combat the damage done.

6. Regular trims and natural colour
We can all get a bit fixated on hair care remedies, but sometimes all it takes is a simple trip to the salon to liven up your do. Freshly chopped strands can bring back the bounce and help your hair grow. Dr. Donovan suggests a trim every six to eight weeks. In addition, keep your colour treatments to a minimum, and try to resist the platinum look; bleaching your hair only adds extra strain.

Oh, how she glows

Just like hair, skin is vulnerable to serious damage in the winter. It’s sometimes thin, fragile, and generally bears the biggest brunt when it comes to daily activities—not to mention it’s the part of our body most exposed to the outdoors, whether it’s the beating sun or freezing temperatures. Just like in the summer months, we need to take the necessary precautions to protect our skin in the winter.

Let’s dig into it.

1. Stock up on lotion
Moisturizing is a critical step to ensure your skin looks and feels vibrant. Once you step out of the shower, gently pat yourself down with your towel and apply lotion to your body and face—this way you’ll lock in as much moisture as possible. The type of lotion will depend on skin type and where it’s being applied to the body (i.e. products used on the face should be lighter than those applied to other parts of the body, where oil build-up isn’t as common). While some people swear by natural or organic products, Dr. Melinda Gooderham, a certified dermatologist and assistant professor at Queen’s University School of Medicine, says they’re not for everyone. In some instances, they can prove to be highly allergenic; read what Dr. Gooderham has to say about natural health products and other healthy skin myths here.

2. Wear sunscreen
Most people put away their sunscreen when autumn rolls around, and don’t dig it out until spring or summer. Well, it’s time to change that habit! Dr. Gabriele Weichert, a certified dermatologist practicing in Nanaimo B.C., says the sun’s ultraviolet (UV) rays can still cause permanent damage to the skin in the winter. In some cases, they’re more threatening at this time of year because of how they reflect off snow and ice. If you plan to be at higher altitudes—say on the ski hill—you’ll need to be extra cautious. For every 1,000 metres in elevation, exposure to UV rays increases by 10%. Dr. Weichert strongly recommends applying a minimum of SPF 30 broad-spectrum (UVA and UVB) sunscreen before embarking on any outdoor adventure. For a list of recognized sunscreens and skincare tips, check out the Canadian Dermatology Association’s website.

3. Scrub it down
While moisturizers, lotions, and creams are imperative to maintain hydration, they aren’t nearly as effective if they’re applied to dead or dry skin. This is why exfoliants are critical for winter skin care. Whether DIY or bought in-store, find something that’s gentle and soothing. The exfoliant you use on your face should be less intensive than what you use on your body—and remember, too much of anything is bad, so schedule it into your nighttime routine twice a week.

4. Hot and cold
We’ve all come home from a winter trek or a long day on the ski hills and thought, ‘I cannot wait for a nice, long, hot shower.’ While it makes total sense in our heads—most of the time we’re chilled to the bone—sadly science says NO; hot water, just like cold water, dries out the skin. Get the water lukewarm and try to limit shower time to about 10 minutes or less. For those with already dry skin, aim for five.

So there you have it. No more flaky skin, brittle hair, or sad scalp. You can glide into winter knowing you’re equipped with the right tools and tactics to tackle the harsh conditions the weather throws your way. Hair and skin may take a serious beating from the outdoors, but these tips will help you feel and look your best.

The information in this article has been reviewed by a certified dermatologist.


Challenging some long-standing myths around healthy skin habits

"But I got it from the health food store!" Challenging some long-standing myths around healthy skin habits

These days, most of us go online as a first point of reference when we’re looking for answers about our health. Sometimes, we get good ones—there’s plenty of information available from respected sources. The trouble is, there’s also a lot of questionable advice.

When it comes to healthy skin habits, there are misconceptions that persist—both online and off. So, we spoke with skin expert Dr. Melinda Gooderham, a dermatologist and Assistant Professor at Queen’s University School of Medicine, to try and debunk some of the myths and misunderstandings that people have about taking care of their skin.

Myth #1

Natural products are better

“Many people assume that, if a product is labelled ‘natural’ or ‘organic’, it’s automatically healthy for your skin,” says Dr. Gooderham. “but that is not always true for everyone.” One of her patients was cleansing her skin with baby wipes, resulting in an allergy causing an itchy rash, so Dr. Gooderham advised her to avoid using them. Six months later, the patient came back with the same symptoms. Why? “She had switched to wipes from a natural food store, thinking they were fine,” shares Dr. Gooderham. “In fact, they contained lavender, a natural product that also happens to be highly allergenic.”


Myth #2

If I use SPF 60, I can stay out in the sun twice as long as with SPF 30

The truth is, no matter what level of SPF you choose, you will need to reapply your sunscreen often to stay protected. “Some people don’t like to use chemical sunscreens because they are absorbed through the skin,” says Dr. Gooderham. “We have no evidence to show that they’re harmful, but to avoid absorption, you can choose a physical sunblock like zinc or titanium oxide if you prefer.”

Another solution is to wear protective clothing and stay out of the sun at peak hours. “One thing I know for sure is that sun damage to your skin does cause cancer. Protecting yourself from the sun is an absolute must,” advises Dr. Gooderham.


Myth #3

Indoor tanning is safer than natural sun

“I have a lot of snowbirds who still think that getting a ‘base tan’ before they head south for a holiday helps protect their skin,” says Dr. Gooderham. “Sun beds use only UVA light, which tans the skin. Without the UVB that causes your skin to burn, a tanning bed is like a poisonous gas that has no smell. You’re doing damage but you don’t have the burn to warn you that something bad is happening.”

Her advice?
“Just don’t do it. A tan is sun damage. End of story.”


Myth #4

Makeup is bad for acne

Dr. Gooderham sees many young women struggling with acne. “I hope this one will solve a few mother/daughter arguments,” offers the doctor. “There are many non-comedogenic make up products that teens can use to cover acne.” Boosting confidence is so important for young people. A non-comedogenic product doesn’t clog pores, and won’t make acne worse. “Mineral-based powders are effective, but always read the label to make sure it won’t clog your pores.”


Myth #5

My body absorbs everything I put on my skin

Your skin is a protective barrier. Some things stay on the surface, others are absorbed. How much depends on these factors:

  1. The size of the molecule in the product—if it’s small enough, it can penetrate through or between your cells.
  2. The vehicle that the molecule is in—a spray may work differently from a cream.
  3. The amount, and how often you put the product on your skin.
  4. Where you use the product on your body. Your eyelids are your thinnest skin, while your lower back skin is the thickest.
  5. Some skin diseases, like eczema, can make your skin break down so the barrier isn’t as intact or as good as it could be, which will also affect absorption.

“Absorbing things through your skin is not necessarily a bad thing. Many topical medications work this way,” says Dr. Gooderham.


While these are the ‘big five’ that Dr. Gooderham comes across in her daily work, we also asked her to share some of the ‘home remedies’ that people swear by. With a bit of a chuckle, she offered these up:

  • Mouthwash to treat toenail fungus
  • Apple cider vinegar to remove a skin tag
  • Toothpaste for clearing pimples

“These are unproven and unlikely to help. In some cases, they may make things worse,” says Dr. Gooderham. “It’s always best to get advice from a health professional.”

Many thanks to Dr. Gooderham for helping clear up some of the myths around healthy skin habits. As she mentioned, if you have concerns, please consult a family physician or certified dermatologist. You’ll also find some more (dependable) information on the Canadian Dermatology Association’s website.