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OK. So welcome to eat. Move. Think the show about optimal wellness brought to you by my can I let's practice it. OK, ready. Welcome. Welcome to the show about optimal optimal wellness brought to you by again. Yeah, that this is extremely good. Thank you. OK, Chris, I got to say it's weird timing because I just noticed a new pimple and we're talking about acne today but it happens from time to time and you know what? It actually is really, really common. It seems like something that happens at the worst time possible. It's true. Yeah, it's just unpleasant, it's something to deal with and it's not really like super straightforward to get rid of it. It's one of the just facts of life that one of the most unpleasant parts of adolescence actually doesn't stop. In adolescence. It just keeps going. Yeah, like acne is the most common skin condition in Canada. All right. Well, let's talk numbers. Ok. Almost 20% of adults have acne. That's 5.6 million people and 75% of those are women are women. Of course, of course. But finding out the cause of your acne and how to prevent. It can still be really tough. Yeah, you don't know necessarily where those underlying causes are, it could be hormones, it could be stress, it could be just a new product you're using or maybe even something you ate. So how do you know if you just need to drop a product from your routine or if you need to go see a doctor? These questions and more we're exploring in this episode. I'm Jasmine Ratch. I'm Chris Shulgin, where the producers of Eat Move Think. And in this episode, we have medan refined dermatologist, Dr Jennifer Tran to help you get answers to your biggest adult acne questions. Refined episodes are fun and this is the first time that we've had Dr Jennifer Tran on the podcast. She's going to be breaking down the potential reasons behind your breakout, how to prevent acne and the fastest way that you can get rid of a pimple safely. She's got lots of great little tips that can hopefully help you to clear up your acne problems or at least clear up some of your questions. Exactly. Good one. All right. Well, let's get to it then. Here's refined dermatologist, Dr Jennifer Tran. Hi, Doctor Tran. How's it going today? Hi. Good. How are you? I'm great. It's your first time on Eat. Move think. And we're so happy to have you. Thanks for having me. So I'm going to get you to introduce yourself first. Why don't you tell the listeners a little bit about who you are and what you do here at Medan. OK. So I am a dermatologist. I just joined actually last September. So I'm pretty new to the Medan family and I practice medical and cosmetic dermatology here at Medan. More cosmetic dermatology I would say, but happy to see all things skin related. Awesome. And can you give our listeners just a brief overview about what refine is? Yeah. So Refine is our dedicated dermatology clinic on the main floor of the building and it is pretty much your one stop shop for all your skin needs. We have several dermatologists who can deal with, you know, things that may not be serious, you know, like a little rash here and there, but also kind of more complex medical dermatologic problems. We deal with cosmetic dermatology, Botox fillers, injectables and then we have a huge team of laser and skin care consultants who can talk to you about procedures and different things that you can do to improve the quality of your skin. So when it comes to things you're hearing about from your clients at Refine, how often does adult acne come up in conversation? I think it is like an everyday thing that I see now. It definitely became more common during COVID with mask wearing. You may have heard the term mask. It affected me too. But I think it's something that I probably encounter every day in my practice every single day. So what are people asking you when they're asking about acne? So patients come in with a range of how severe their acne is. It can be mild to very, very bad. They might have developed it newly or might have had it years. And everyone wants to have solutions and they want to have options for their solutions. They want to see what can they do, lifestyle wise, diet wise that can help what can be done over the counter, what procedures can be done and then what medications can be considered to help their skin. There are so many treatments out there for acne that it can be overwhelming. I think that there's too many options and especially if you've tried a few and none of them have worked. It can feel kind of hopeless to navigate on. Yeah, I agree with that. There is you walk into the pharmacy, the drug store and it's an entire aisle of things that you can do or Sephora and it can be really overwhelming. Every product claims to be able to fix your acne. But what really does work? How long do you have to use it for? How do you use it properly? Most of these things cause irritation. How do you avoid that? So it can be a lot. So what do you think would surprise listeners most about your conversations about acne or refine? I think what people find surprising is we can definitely fix it. We have patients who come in, they've already suffered for many, many years and many patients have kind of accepted that maybe this is just their skin, they have to live with it. But honestly, like even in the most severe cases of acne, I'm pretty confident that we can really, really help. So I think that's a surprising thing. And many times patients come in saying I've used everything under the sun, but there's always more, there's always new stuff like just this year two new topical prescription acne medications are going to be released. So there's always new stuff being researched. That's exciting. I'm very hopeful too. So with that, then let's get into some of the most common questions about acne that you hear from your clients, first of all and maybe most obviously, how can I get rid of acne? Yeah. So usually I kind of walk through the different aspects of treatment pigment. So behavioral changes, what foods you can avoid good cleansing techniques, what moisturizer to use? And then we really get into the details of prescription medications if the patient's interested. And that can range from topical treatments to oral antibiotics or hormonal therapies or ISOtretinoin, which is otherwise commonly known as Accutane. Talk me through what's happening beneath the surface when you get a pimple. Yeah. So it's very multifactorial and oddly complex. So it all begins in what's called the PLO sebaceous unit, which is kind of like your hair follicle and in that hair follicle or pore, we have a hair, we have a sebaceous gland, which is your oil gland. We also have a muscle that touches the hair and kind of makes it give you goose bumps or not when you're cold. And what contributes to acne is a few different things. One is inflammation in that PLO sebaceous unit. One is oil production from the oil gland. One is bacteria which is called ku bacterium acnes and all of those things as well as the hormonal influence in the background can cause you to form a commodo. A commodo is like a white head or a black head and it's like the little baby that's going to become a big pimple. And if you continue to get accumulation of dead skin cells and oil and inflammation that will grow and then it becomes something more inflamed like a pimple. A nodule assist what we try to pop when we see it on our faces and that can lead to scarring. So it's this whole kind of cycle of life that all is from, I would say the inflammation, the oil production, the bacteria and the hormonal influence. OK. Great. And then I've seen these viral videos of these skin masks or the black charcoal nose strips that you put on. And then when you remove it like these long bits of, I don't know, gunk come out are those real where a lot of those videos are definitely fake. But you know, I've tried those nose strips. I do think that they remove a little bit of debris from your pores. But it doesn't, again, it doesn't treat the root cause so it can get rid of what we call open combos or blackheads. So, cosmetically, short term, it will look nice but it doesn't address all of the other factors that can contribute to acne. And so I guess that the treatment depends on maybe the different type of acne or the cause. Can you talk me through? What are the different kinds of acne that you can get? Yeah. So the most common types of acne that we see is basically we can describe it by the cause. So sometimes women will come in with hormonal acne. And that's a very common thing that we see at medan, you can have nodular cystic acne, which is the kind that gives you really painful boils. It can leave scarring in the face that can actually happen, not just on the face but on the chest and the back and all over the body as well. There's really mild acne as well like Commodo acne, which is the kind that gives you tiny little bumps that can be caused by wearing a headband or wearing a hat or putting oils in the scalp that can contribute to that as well. Is there a difference between the acne that you experience as a teenager? And then the acne that you're getting in your thirties, forties, fifties, but hopefully not behind. Uh Yeah, I think, you know, most people get acne as a teenager, all with the hormonal changes that happen and then later in life, it may not be due to that. So the cause can be a little bit different, it can look a little bit different. But at the end of the day, honestly, the treatments are very similar regardless of when in your life you get, it is acne hereditary. It can be but not always. Ok. What are some of the other things that could cause your acne? Definitely hormonal changes in terms of food. There is a little bit of evidence that certain foods can cause acne and they might be surprising to some people, for example, whey protein, which a lot of people take that can cause acne. I was thinking pizza because you think of greasy foods in general when you think of what causes acne. Yeah, there's no evidence that greasy foods cause acne. There is a little bit of evidence when it comes to the dairy and sugar story. So if you're going to have dairy, it's actually better to have high fat dairy. So with your coffee have **** milk rather than skim milk, that's better. So go for the high fat options with dairy. A little bit of evidence that high glycemic index foods are bad for your skin. Um But you know, you got to live your life and you know, enjoy life. So I think if you're really motivated to change your diet, it may have a positive impact, but you don't have to, we can try other things as well. Yeah. And so what are some of the other ways that you can prevent acne before it even happens? That is tougher. So I think it's good to have a good skin care regimen. Um Definitely you want to cleanse. You don't need to over cleanse. I usually recommend just before bed unless you did something where you were sweating a lot like a workout. Then you want to wash after that in your cleanser. You can have some active ingredients that prevent acne like benzoyl peroxide or salicylic acid. And then you can actually preventatively use the treatments for acne. So you can preventatively use an acne cream in the morning or at night, depending on the one and that can help prevent acne from coming up. Are those the same type of creams that you use directly? Like all in a pimple when you have one? Yeah. Oh, interesting. And you can use them preventatively. Yeah. My big tip is always think of it as field treatment like treat the whole area that is prone to acne rather than spot treatment because if you just treat the spot, you have to wait for the acne to come first and then treat it reactively rather than if you treat the whole area, you're less likely to get the pimple in the first place. So say you do have a pimple on your face. Is it ever OK to pop it? What's the deal with that? Well, they did make a huge show called Dr Pimple Popper. So honestly, I think it's really hard to resist and I think once it gets to that point done in a safe way, yes, you can do it, for example, clean it, use something sterile like a sterile needle gently poke it. Don't apply a lot of pressure. You don't want to cause more harm than good. So you don't want to get inflammation in the area because that can lead to more scarring. But in general, we don't recommend popping pimples as the way to treat acne. Then you're waiting for the pimple to come in the play. We'd rather nip it in the bud. That's a great idea. Great suggestion. So what about acne scars are acne scars permanent and can you prevent them from happening if you get pimples? So it's definitely easier to try to prevent them. Once you get the acne scars, it can be difficult to remove them. But there are a lot of options. Even topical creams now really can help with acne scarring, especially if they're not too old. And there's a lot of procedures that can be done. For example, you can do chemical peels, you can do resurfacing procedures, micro needling, microdermabrasion and all of those can help a little bit and all of those are offered at refine. Yeah, they're all offered at refine. I would encourage patients to get a consultation with one of our skincare consultants for that, especially because it depends on your skin type. So certain procedures are not safe. You know, if you've had recent Accutane use or if you have skin of color, then you want to make sure you see an expert and get the right treatment for your skin type. And so refund you're talking to the clients before they're going through these treatments to make sure that they're the right fit for those treatments. Yes. OK. So you mentioned before a couple active ingredients that were useful in treating acne like cy acid and benzoyl peroxide. I nailed it. And are there any ingredients that you should avoid when you have acne? You want to treat your acne? So you want to avoid really comic occlusive products. What does that mean? So for example, like really thick greasy things can clog your pores, which is why sometimes when people put oils in their hair, we notice that you can get acne along the hairline. So that should be avoided beyond that. Probably not. I think we have to be careful with things that irritate the skin. So it's very trendy right now to use a lot of actives in your skin. You'll hear about retinol vitamin C glycol acid, all of that. If you use too much of it, then it will cause more harm than good. So really, I always recommend it when you're introducing a new active to your skin care regimen, just do it once a week or spot test first and see how your skin reacts to it and then build up the frequency as tolerated by your skin and maybe only introduce one new active at a time. Yeah, you can kind of cycle through them. So do one a week kind of thing and see how your skin goes with it. OK. More on products. Are there any products that treat both acne and acne scars at the same time? Yeah. The big one would be a retinol. OK. Um That can definitely address both issues. Another good product is Azal Laic acid. Both of these can be available over the counter or prescription. Azole acid is nice because it more targets the hyperpigmentation piece of the scarring. OK. On the retinol note, I know that there are a lot of important things to know when you're adding retinol to your routine. Can you give me a bit of a crash? Of course on retinol? Yeah. So if you've never used it before, definitely ease into it, only use it at night and that's because it is actually inactivated by daylight. So you should use it at night for it to have its best impact. I often talk about the sandwich technique where you put a little moisturizer sandwich So moisturizer, first thin layer of retinol, then moisturizer again, um only do it once a week to start, build up gradually as tolerated. If once a week is even too much for your skin. For those with really sensitive skin, then you can do short contact. So you can just apply it for half an hour, then wash it off. And so other than for treating acne or preventing acne, what other benefits come with retinol? Well, I think this has blown up over tiktok recently because it's like the next best thing since Swiss cheese. So it really does help the quality of your skin improves fine lines. It prevents wrinkles long term, it kind of exfoliates your skin and so you can get rid of discoloration and irregularities. It's good, but certain patients definitely should not use a retinol. For example, it's not safe in pregnancy and breastfeeding. Ok. Good to know. And does it also make you? I heard it's extra important to wear SPF on your face while you're using retinol, it does make you more sun sensitive. But even a aside from that, honestly SPF is probably one of the best things you can do to prevent wrinkles in the first place. So, very good to do both. Ok. Good suggestions. And what about those new trendy pimple patches? Some of them are in a little star shape. What's the deal with those? Are they really effective? I think they can help? I haven't personally tried them. But I think if you had the odd pimple here or there, I think it probably would help clear it a little bit faster. But again, it doesn't really treat the root cause of the acne. It doesn't really prevent acne from coming up. So I don't think it should be the cornerstone of your treatment plan. No, I also know it's effective for you. If you have a hard time not picking the pimples, it covers up your pimples, you won't be picking at it. Hopefully. What about someone who's experiencing hormonal acne? Maybe because of PC OS and they're not seeing any results with the treatments that you just mentioned. Is there anything that specifically treats hormonal acne? Definitely. So a new cream will be coming out in the next few months. So talk to your dermatologist about that. It's a topical cream that is excellent for hormonal acne. In addition to that, there's a pill you can take, which is called spironolactone. This is actually a blood pressure pill that happens to work well for hormonal acne. Really great. There's various birth control pills. You can take other hormonal pills, but I would say probably the most commonly used one is Spironalactone. Ok. And talk to me about the type of people who are most likely to experience hormonal acne. Are there certain demographics or is it kind of random? So it's usually women in their thirties, I would say typically and one clue as to whether or not it's hormonal is the distribution. So if it's in the chin and the jawline area, chest or back and shoulders, it tends to be more hormonal. It also can be triggered by a certain medication. So a lot of people have the Mirena IUD like a progesterone only IUD and that can actually cause acne, hormonal, acne. Interesting. So Dr tr say I have a big event coming up or some thing important is coming up and I have this new unsightly pimple on my face. What are your recommendations for me to get rid of it as fast but as safely as possible. So this is like a true der emergency. It is, this happened to one of my best friends the night before her wedding and she called me and she said that she had a huge pimple on her chin and I said, come see me right away. So really the fastest thing you can do is inject it with steroid. Don't do that yourself at home. Go see your dermatologist to do that. It is something that is not a good long term solution for your acne. But if you have like a pimple emergency, we can inject it with a steroid and it will go down within 24 hours. Wow, that's good to know. So hormones can cause acne. I know that stress can cause acne. What are other lifestyle things that can cause acne, you know, we're all about making lifestyle changes at eat, move things. So, talk to me a little bit about the D OS and the don't of lifestyle choices when it comes to Acne. Yeah. So the research is not clear, we don't have a lot of clear answers as to what specifically can trigger it. But I definitely agree with you. I think H bones contribute to acne. I think stress contributes to Acne. Um I think it's always good to try to live a healthy lifestyle as much as possible. So you want to eat good food, well rounded diet. You want to exercise regularly, which kind of, I think can indirectly help acne because it just makes you feel good. You will encourage blood flow to your body to your skin, but just make sure you wash your face after and sweat cause acne, it can trigger acne a little bit, especially if you're wearing, you know, like a headband or workout clothes and then you don't rinse afterwards. It can definitely cause irritation of the hair follicles which can lead to acne. What are some of the biggest misconceptions that people come to you with? A lot of people think that the only cause is a diet which I don't agree with. I think sometimes, you know, you're just prone to acne and you were going to get it just by luck of the draw despite diet. So I never recommend a very restrictive diet or anything like that to fix acne. I think one of the biggest misconceptions that I see day to day is being fearful of the medications. Ok. I don't think that people need to take medications if they're mild, but they really, really can help patients and I always offer it to patients if they're interested because they really can change your life. Um, they are very, very, very effective and given properly with the right monitoring. I think that they're very safe to take. It's again, very hopeful for people who have been dealing with something like acne their whole lives. And in honor of September being Acne Awareness Month. Are there any resources or products that you can recommend? Yeah, certainly if you look online, like all of the main associations were DMAT. So the Canadian Dermatology Association and our clinic in particular were releasing promotional videos about educating the public about acne in terms of products. We do have a very nice product right now from skin soles that you can consider if you're interested. Um just drop by and our skin care consultants would be happy to talk to you about the different products that we have available or the procedures that we have. And then of course, if it's something that is requiring medications and come see us in dermatology and we'd be happy to help as someone who's experienced acne in my life, you know, it can really affect you a lot like it's not something as serious or debilitating as a lot of the conditions we talk about on this podcast. But it's something that you will remember for your whole life if you had acne growing up, if you have it as an adult, and that's a big deal. So it's really helpful to know that you can come to refine and they will be able to help your acne. Yeah, I completely agree with you. It's something that maybe in the medical world gets dismissed because, you know, it's just skin, it's just acne. But at the end of the day, the whole world sees your face, you know, that people can see it and many patients become very self conscious about it and it has an impact not only on your day to day confidence, but sometimes it can even affect, you know, are you you willing to go to school that day? Do you want to pursue this career that you're thinking about? Like will it change the trajectory of your life and your decisions because of how you feel about yourself? And because of the way that you look. So honestly, in dermatology, that's one of the reasons I enter dermatology. Like we just want to help as a dermatologist. How does that feel to help a client fix something that they've been dealing with their whole life? I mean, we take skin very seriously, obviously. So I think even when it's something as mild as acne, for example, or eczema or psoriasis it can really have a big impact on someone and you don't know that impact until you talk to the patient. So that's one of the things that is really, really rewarding in dermatology is being able to have the tools in our tool belt to be able to help patients with those concerns. That's awesome. Can you talk to me about your experience with acne? Yeah. So as a teenager, I definitely had acne, It was never so severe that I had to go on Accutane, but I did go on all of the creams under the sun. Proactive rings, a bell. I remember proactive and two different antibiotics. And you know, it, it was pretty bad. And then, and then during COVID, I had acne again leading up to my COVID wedding and you know, when you're a dermatologist and you're covered in acne, you're like this can't be right. I got to do something. So I did fix it and I had clear skin for my wedding, which was nice. Um That's kind of been my personal journey with it. So Dr Tran, this has been a really helpful chat. There's been lots of useful information out there for listeners dealing with Acne. So thank you so much for being here. Thank you for having me. That was Dr Jennifer Tran Dermatologist at Refine Medan's Dermatology Clinic to book an appointment with a refined dermatologist or aesthetician email. Refine at medan dot com. You can follow Medan on Twitter and Instagram and youtube at Medan Live. Well, and follow Refine on Instagram at Refine by Medan. We'll post episode highlights and other links you can visit on our website eat move think podcast dot com and say hello and send us a tip or a suggestion by emailing us at info at eatin podcast dot com. Eat Move Thinkk is produced by Ghost Bureau. I'm Jasmine Ratch, managing producer, social media and strategy support is from Chantel Girton, Andrew, Imax, Emily Bozic and I'm executive producer Christopher Shogen and we will be back soon with another episode examining the latest in health and wellness. 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