Family Practice

Read articles from the family practice edition, focused on helping family practitioners about various dermatological conditions.

A Physician's Guide to Treating Acne

A Physician’s Guide to Treating Acne

Acne is among the most common dermatological conditions seen in primary care. In this article, we provide a guide to address a growing need by primary care physicians to have a logical and practical approach to treating various forms of acne.
Malassezia Infections of the Skin

Malassezia Infections of the Skin

Malassezia are lipophilic yeasts that are normal commensals on the skin surface. There are seven species of these yeasts, which were previously called Pityrosporum. The conditions described in this article are either caused by the Malassezia itself or from some kind of immunological or toxic reaction to the organism.

Diagnosis and Treatment of Lip Conditions for Family Practitioners

Skin conditions are commonly found on the lips. Surrounding skin and mucosal surfaces may be involved, and hair problems may be present. Lesions can be single or multiple. Conditions can be localized or diffuse, with other features found upon physical examination that help to make a diagnosis.

Chemical Depilatories

There is a growing demand for the removal of unwanted facial and body hair in both men and women. This article reviews chemical depilatories and other modalities, their method of action, characteristics, advantages and disadvantages.

A Practical Approach to Classification and Treatment of Scars

This paper focuses on a comprehensive and practical approach to classifying and managing scars in terms of colour and texture, and discusses topical treatments accessible to family physicians in more detail.
Oral Therapy for the Treatment of Rosacea

Oral Therapy for the Treatment of Rosacea

Novel uses of old medications and new formulations of systemic medications have broadened the therapeutic armamentarium for treating rosacea patients. It is of primary importance to offer patients safe and effective therapies for this chronic and incurable condition, improving both the clinical and psychosocial consequences of rosacea.
A Clinician’s Guide to Treating Acne

A Clinician’s Guide to Treating Acne

In this article, we provide a guide to address a growing need by primary care physicians to have a logical and practical approach to treating various forms of acne.

Non-Pharmacologic Management of Atopic Dermatitis

Atopic dermatitis (AD) or eczema is a chronic, relapsing skin condition that can lead to xerosis, pruritus, and patches of dermatitis. Coping with the physical and emotional aspects of AD can significantly impact the quality of life. It is most common in childhood, as many patients seem to outgrow the condition by adulthood.
pic for New Canadian Guideline for Acne Treatment

The New Canadian Guideline for Acne Treatment

Physicians will be particularly reassured if the suggested guidelines are supported by scientific evidence. This new Canadian clinical guideline for the treatment of acne was developed taking into account new data published up to March 2015, as well as expert opinion and clinical experience.
The Treatment of Cystic Acne

The Treatment of Cystic Acne

Cystic acne is characterized by the formation of cysts enclosing a mixture of keratin and sebum in varying proportions. It is the most severe of the four main types of acne, which are comedonal, papular, pustular, and cystic. Identification and treatment options are discussed.

Topical Management of Recalcitrant Psoriasis and Eczema

Psoriasis and eczema, especially atopic eczema, are two of the most common cutaneous conditions seen by family physicians and dermatologists. This article discusses the etiology of psoriasis and eczema, immunologic abnormalities, and the role of immune mediators.

Atopic Dermatitis: A Practical Guide to Management

A group of dermatologists with extensive experience in managing pediatric and adult patients with atopic dermatitis developed practical recommendations for the management of atopic dermatitis based on expert consensus opinion and the best available medical evidence.

Delivery Vehicle Advances in Dermatology

This article review the newer vehicles which include gel, foam, and spray preparations. The newer topical delivery agents have the potential to limit the progression of cutaneous disorders requiring oral systemic therapy, which can expose the patient to greater risk for adverse side-effects.

Scaly Rashes of the Feet: Could It Be Fungal?

This article will deal with the diagnosis and treatment of common eruptions on the feet.

The Role of Cosmeceuticals in Anti-Aging Therapy

As baby boomers get older, they have shown an increasing interest in maintaining a youthful appearance. As a result, there has been a corresponding increase in topical antiaging formulations, which are commonly referred to as cosmeceuticals.

Therapeutic Moisturizers in Eczema and Xerosis Management

Psoriasis and eczema, especially atopic eczema, are two of the most common cutaneous conditions seen by family physicians and dermatologists. This article focuses on corticosteroids of varying strengths and their suggested indications.
Non-melanoma Skin Cancers

Management of Non-melanoma Skin Cancers in Canada

A summary of the most comprehensive and up to date guideline for treating non-melanoma skin cancer in Canada. Background, primary prevention, actinic keratosis, managing basal cell carcinoma, and squamous cell carcinoma, are covered.

Seborrheic Dermatitis: New Formulations for Treatment

Seborrheic dermatitis is a common cutaneous disorder occurring in at least 3%–5% of the population. We discuss new treatment formulations and protocols.
Adapalene/Benzoyl Peroxide image

Advances in Understanding Atrophic Acne Scarring and the Role of Adapalene/Benzoyl Peroxide

There have been important advances in our understanding of acne scarring. Acne scars can resolve, and their evolution is determined by a balance between matrix repair and degradation. Timely, effective management of acne can minimize risk of subsequent acne scarring.

Hyperpigmentation and Its Topical Treatments

Post-inflammatory hyperpigmentation, and melasma are common problems that dermatologists see. Various bleaching options are considered.
What's New in Acne Treatment in Canada?

What’s New in Acne Treatment in Canada?

Acne vulgaris is the most common skin disorder affecting children and young adults in North America. This article discusses combination therapy, and simplifying treatment plans in order to increase patient adherence, which is often a critical problem in treating acne.

Management of Recalcitrant Acne

Acne treatment success involves a comprehensive approach that addresses diagnostic confounders, appropriate therapeutic options and patient adherence. Ongoing education and counselling will assist in meeting patient expectations and establishing a favourable rapport that promotes adherence.

Update on Topical Approaches for Managing Scalp Psoriasis

Patients suffering from scalp psoriasis frequently seek medical care because of the persistent discomfort and social embarrassment caused by the visible flakes that are shed onto clothing. However, the presence of hair makes it challenging to apply medication to the scalp.

Chronic Hand Dermatitis: Case-based Approaches to Management

Practical guidelines for the management of Chronic Hand Dermatitis were published in the Skin Therapy Letter, Family Practice Edition (October 2016). This series of cases using Alitretinoin (Toctino®), is a follow on to that publication to put the guidelines into context.

New Science to Support 50 Years of Colloidal Oatmeal Use in Dermatological Practice

Colloidal oatmeal has been used for centuries in skin care as a soothing agent to relieve itch and irritation. Its use, efficacy, and mechanism of action are discussed.
Acne Clindamycin/Tretinoin Preparation

Management of Acne Using a Fixed Dose Clindamycin/Tretinoin Preparation

The focus of this review is to delve deeper into the use of Biacna® Gel, a fixed-dose clindamycin/tretinoin combination product, for the treatment of acne.

Acne in the Post-Adolescent Patient

For the purposes of this article, the focus will be on the topical treatment of post-adolescent mild to moderate acne. A selection of over-the-counter and prescription based topical treatments are discussed below.

Psoriasis of the Scalp

Psoriasis remains a therapeutic challenge. Involvement of the scalp can be minimal (“dandruff”) or more significant and difficult to manage. Gentle treatment, reducing trauma, and treating the inflammation and pruritus will improve therapeutic results.

Atopic Dermatitis: The Skin Barrier and the Role of Ceramides

This paper examines the pathogenesis of atopic dermatitis, the skin barrier, and the role that ceramides can play in therapy.
image for actikerall actinic keratoses

Actikerall™ (5-Fluorouracil 0.5% and Salicylic Acid 10%) Topical Solution for Patient-directed Treatment of Actinic...

Actinic keratosis, a common cutaneous lesion with the potential to transform into squamous cell carcinoma. Recently, a topical formulation Actikerall, combining 0.5% 5-fluorouracil with 10% salicylic acid (5-FU-SA) has been made commercially available in Canada. We discuss their merits.

Chronic Idiopathic Urticaria: Treatment with Omalizumab (Family Practice)

Chronic idiopathic urticaria (CIU) is a common autoimmune skin condition characterized by spontaneously recurring hives for six weeks or longer. We review the mechanisms of action of omalizumab, efficacy, cost and potential side effect profile for treating CIU.

Topical Management of Rosacea

This article reviews the various subtypes of rosacea, their clinical presentations, and the considerations in choosing the optimal therapeutic options. The importance of tailored treatment is discussed as well as topical therapies.

Adjunctive Skin Care for Acne

Acne vulgaris (AV) is among the most common dermatological disorders seen by dermatologists. Emerging evidence suggests that acne is associated with epidermal barrier impairments, and this article reviews the role of moisturizing, sun protection, and patient specific skincare advice for acne patients.

Review of Conventional Systemic Therapies for Severe Psoriasis

Psoriasis is a chronic inflammatory cutaneous disorder that can significantly affect patient quality of life (QoL). This article discusses immunologic abnormalities, immune mediators, and the possible pathogenesis of psoriasis.

Diagnosis and Management of Atopic Dermatitis for Family Physicians: A Clinical Review

Atopic dermatitis (AD) is a chronic and pruritic inflammatory disease that affects a wide age range of patients causing significant impact on their quality of life. There has been a recently updated consensus paper on the treatment of mild-to-moderate AD published by an expert panel of dermatologists and pediatricians. Family physicians are well equipped to manage...
Fucibet Cream image, doctor applying cream

Fucibet®: What’s Old Is New

Fusidic acid/betamethasone 17-valerate cream (Fucibet®) is a cosmetically acceptable, well tolerated cream which is hydrating and improves the TSS dermatitis score in secondarily infected dermatitis. In addition, it clears bacteria in infected dermatitis better than vehicle suggesting that improving the dermatitis with a steroid might be synergistic, perhaps through a reduction in bacterial load.
Hormonal Treatment of Acne in Canada: Clinical Update

Hormonal Treatment of Acne in Canada: Clinical Update and Case-Based Treatment Approaches

Evolving understanding of the role of hormones in acne, along with a growing body of data from clinical trials, calls for a reappraisal of the role of hormonal therapy for acne.
toenail onychomycosis transungal treatment image

Toenail Onychomycosis – A Canadian Approach with a New Transungal Treatment – a Podiatrist...

A recently published clinical pathway for Toe Onychomycosis is used as the basis for the management strategy presented here, and follows a pathway reflective of the therapeutic options available in Canada.

Management of Unwanted Facial Hair (Reprint from FP 7.2)

(Reprint from STL FP 7.2) Facial hair can be a distressing, chronic problem for many women. This article discusses assessment, treatment options, side-effects, and costs. Combination therapy and its benefits are also covered.

Ceramide-based Moisturizers as Treatment for Pediatric Atopic Dermatitis

Atopic dermatitis (AD) is a chronic inflammatory, xerotic and pruritic skin disease of increasing prevalence affecting 15-30% of children and 2-10% of adults. AD and its associated health consequences present significant challenges to patients, particularly children and their families.

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