Family Practice

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

An Update on Medical Therapies for Chemical Exfoliation

Chemical exfoliation has been used for decades to reverse the signs of aging skin and provide a cosmetic benefit. This article reviews various peeling methods and strengths, and their therapeutic potential.

Actinic Keratoses

The best approach is a pragmatic one. The patient with few AK lesions is most conveniently and cost effectively treated with a destructive technique (cryosurgery or curettage with light desiccation). Those with many AKs are candidates for medical therapy (such as 5-fluorouracil, imiquimod or diclofenac).
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Trifarotene: A New Topical Retinoid for the Treatment of Acne Vulgaris

A new topical retinoid, trifarotene, the first fourth-generation retinoid, is now available in Canada for the treatment of moderate facial and truncal acne.
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Sun Protection Using Sunscreens

There are benefits and risks to sunlight exposure of the skin. This article covers a variety of topics, including the effects of UVA and UVB, vitamin D, skin tone, skin cancer risk, and SPF.
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The Role and Topical Management of Staphylococcus aureus in Atopic Dermatitis (Family Practice)

Atopic dermatitis (AD), or eczema, is a common, chronic, relapsing, genetically determined inflammatory skin disorder. This article discusses the role of Staphylococcus aureus (S. aureus) as a factor to consider.

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.

Optimizing Topical Acne Therapy

Acne vulgaris is a disease of the pilosebaceous follicle characterized by non-inflammatory (open and closed comedones) and inflammatory lesions. Its pathogenesis is multifactorial - the interplay of hormonal, bacterial, and immunological (inflammatory) factors results in the formation of acne lesions.

Onychomycosis Diagnosis and Emerging Therapy

Onychomycosis is a common nail disorder for which successful treatment can be clinically challenging. Diagnosis, treatment, and management using various modalities are discussed.
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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.

Tips for Maximizing the Effectiveness of Topical Acne Therapy

Successful treatment of acne with topical therapy can be achieved with patient education, patient engagement in treatment selection, and counseling on aggravating factors.

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...

Scaly Rashes of the Feet: Could It Be Fungal?

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

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.
Chronic Urticaria Practice Guidelines

Chronic Urticaria: Following Practice Guidelines (Family Practice)

Recently updated and revised international guidelines suggest a step-wise approach to the management of chronic spontaneous urticaria. These guidelines suggest that first-line therapy should be second-generation non-impairing, non-sedating H1-antihistamines such as bilastine (BLEXTEN®).
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.

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.

Atopic Eczema

Eczema diagnosis, treatments, and management techniques are discussed. Diagnostic features, treatments both topical and oral, infection control, and a note on calcineurin inhibitors.

Androgenetic Alopecia: A Review of Topical Agents for Hair Growth Promotion (Family Practice)

Hair loss is a common dermatological problem that affects a large segment of the population both physically and psychologically. This article focuses on androgenetic alopecia (AGA) or male pattern hair loss, as well as the common treatments, Minoxidil and other topical treatments.

Topical Efinaconazole in the Management of Toenail Onychomycosis

Onychomycosis is a fungal infection of the nail caused by dermatophytes, yeasts, or non-dermatophyte molds. Here we discuss using topical Efinaconazole in the management of toenail onychomycosis.

Head Lice: A Review of Topical Therapies and Rising Pediculicidal Resistance

Head lice infestations (Pediculosis capitis) are a worldwide problem with prevalence estimates typically ranging between 1-3% in elementary school aged children. Although this obligate parasite is a nuisance, infestation does not pose a health risk.

Topical Acne Therapies: Optimizing Patient Adherence

Adopting a comprehensive approach that takes into account individual preferences, properties of available treatments, and disease severity can encourage patient adherence and lead to improved treatment outcomes. The key to gaining adherence, is the attention devoted by physicians to establishing effective communication with the patient.

Hormonal Agents Approved for Treatment of Acne

Hormonal agents are important, effective therapeutic options for women across the spectrum of acne severity. The three preparations approved in Canada for this indication have safety profiles similar to conventional oral contraceptives.

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: 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.
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.

Management of Unwanted Facial Hair

Unwanted facial hair is a common, frustrating condition that affects up to 25% of women. This article review impact on patient QOL, treatment options ranging from shaving, waxing, threading, and bleaching to electrolysis, and laser therapy.

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.
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.

Efinaconazole in the Treatment of Onychomycosis: Managing Patient Expectations and Promoting Compliance

Onychomycosis, also known as tinea unguium, is a progressive fungal infection of the nails resulting in discoloration, nail plate thickening, and onycholysis. Efinaconazole 10% solution is an effective and convenient topical antifungal treatment for onychomycosis, with toenail mycological cure rates between 53.4% and 55.2% and complete cure rates between 15.2% and 17.8%.

A Summary of Approved Topical Treatments for Rosacea

Today, diagnosing and treating rosacea remains a challenge. More studies are necessary to provide additional insight on drugs currently available as well as possible future agents. The ultimate goal is to provide each patient with a treatment regimen best suited for his or her individual needs.

The Health Controversies of Parabens

Parabens are preservatives used in a variety of personal care, cosmetic, pharmaceutical and food products. Discovery of parabens in the breast tissue of patients with breast cancer has raised public concern over their use. This article discusses the controversy, research, regulations, and possible alternatives.

Actinic Keratosis: A Practical Overview

Actinic keratosis (AK) is a prevalent skin condition that warrants 5.2 million office visits in the US each year. Various treatments for AK, both local and field therapy, and their appropriate use are discussed in this article.

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.
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.

Common Bacterial Skin Infections

Recognition and appropriate treatment of these common bacterial skin infections, while at times challenging, can be very rewarding for both the physician and the patient. Selecting the right therapy from the beginning should help minimize complications, reduce the number of hospitalizations, and may also help reduce the climbing incidence of bacterial resistance.
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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.
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.

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.

Adherence Optimization in Acne Management

Acne is a common dermatological condition found in about 85% of adolescents and young adults. Acne can have significant psychological, social or physical impacts. This article delves into the importance of patinet adherence and therapeutic strategies.

Rosacea: An Update on Medical Therapies (Family Practice)

Rosacea is a common, chronic cutaneous condition that affects the face. This article reviews a variety of treatments for treatments for rosacea, including topical and systemic therapies.

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