What Is Bakuchiol, Natural Skincare’s Answer to Retinol? | Healthyish

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I was once in a meeting with a beauty brand when a publicist—one I know pretty well, to be fair—reached over and brushed a few flakes off my cheek.

“Sorry,” she said. “I couldn’t help it.”

I shrugged, replying, “I’ve been using retinol.”

Everyone nodded. They got it: Errant flakes are just one unpleasant side effect of retinoids, a form of vitamin A that can otherwise do lots of good, like increase cell turnover, spur production of collagen and elastin, and fight acne when applied topically to skin.

“Retinoids commonly come with uncomfortable side effects, including increased redness, dryness, and peeling of the skin,” says Y. Claire Chang, MD, a cosmetic dermatologist at Union Square Laser Dermatology. For those with sensitive skin or prone to eczema and rosacea, the risk is even higher. That’s why bakuchiol, a plant-derived ingredient and mainstay in Ayurvedic medicine, has recently caused the skincare obsessed and retinol naysayers to lose their collective minds. On its own, bakuchiol has an impressive resume. “It’s an antioxidant that protects the cell from oxidative stress by regulating the mitochondria,” says Dendy Engelman, MD, a dermatologist at Medical Dermatology & Cosmetic Surgery in New York City. (That oxidative stress, by the way, causes cell damage that leads to premature aging.) It also mimics vitamin E in its ability to heal and hydrate the skin.

What makes bakuchiol so unique, though, is that research has found that it can provide the same anti-aging results as retinol—but without the annoying side effects. The theory is that bakuchiol activates a receptor in cells similar to those of retinol, explains Raja Sivamani, MD, a professor of dermatology at UC Davis who published a paper on it in the British Journal of Dermatology. Comparing the two ingredients, the study found the same results both in the reduction of wrinkles and improvement in hyperpigmentation. The only difference? The retinol group experienced more facial scaling and stinging.

“Other studies have also reported improvement in lines and wrinkles, pigmentation, elasticity, and firmness with bakuchiol,” says Jennifer Chwalek, MD, a dermatologist at Union Square Laser Dermatology. That explains why bakuchiol has snagged a starring role in recent skincare formulas, like Biossance Squalane + Phyto Retinol Serum, which boasts impressive clinical results (like a 48-percent improvement in skin firmness), and OleHenriksen Transform PLUS Goodnight Glow Retin-ALT Sleeping Crème, which boosts its effects with a gentle blend of acids. It also makes quick work of crows’ feet in Alpyn PlantGenius Line-Filling Eye Balm, which might be the most genius place for it, seeing as retinoids are typically too harsh for the delicate eye area.

Still, the research on it is relatively new—and a few derms I contacted didn’t think there’s enough data in human skin to celebrate just yet. But it’s definitely promising, especially if retinoids have been a no-go for you in the past. “Since bakuchiol seems to be less irritating than retinoid, it’s a good alternative for patients with sensitive skin or anyone who has experienced redness, burning, and scaling with topical retinoid,” Chwalek says.

Plus, it eliminates the headache of trying to pair retinoids with other ingredients. “There are instances where you should avoid specific products when using a retinoid, such as exfoliators, toners, and benzoyl peroxide, as they can cause irritation,” she says. “However, due to bakuchiol’s natural composition, it’s safe to use with other products in your skincare regimen.”

But its biggest advantage might be its overall compatibility—whether or not it’s stacking up to or replacing retinoids entirely. “Bakuchiol works as an anti-inflammatory and an antioxidant, so it’s ideal for those who suffer from dry or sensitive skin,” Engelman explains. “[And] its antibacterial properties also mean that it’s great for those with oily or acne-prone skin.”

For all the similarities between bakuchiol and retinoids, the difference between the two—that lack of irritation—might make the former worth a shot. And maybe the best reason of all to try it: You won’t have to worry about your face peeling in public.

Buy it: Biossance Squalane + Phyto-Retinol Serum, $78. Olehenriksen Goodnight Glow Retin-ALT Sleeping Crème, $55.

All products featured on Healthyish are independently selected by our editors. However, when you buy something through our retail links, we may earn an affiliate commission.

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The big questions Doug Ford will have to answer in 2019

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This time last year nobody was predicting Doug Ford would become Ontario’s premier in 2018, so accurately predicting what will happen in provincial politics in 2019 can’t possibly be as difficult.

Can it? 

Not being blessed with a crystal ball, and knowing that Ford did several unexpected things in his first six months in power, I will refrain from predicting exactly what he will do this year. Instead, I’ll pose the questions that Ford will have to answer as 2019 unfurls. These themes will frame much of Ontario’s politics this year.

1. Can Ford help defeat Trudeau?

Ford says frequently that beating Kathleen Wynne was just the first step, and beating Justin Trudeau’s federal Liberals is up next. Ford will undoubtedly play a key role in a growing coalition of conservative premiers who intend to stir up anti-Trudeau sentiment in their provinces to the benefit of Andrew Scheer’s Conservative Party of Canada. 

Ford’s hope is to help Scheer’s party take the Ontario swing ridings that carried the PCs to power provincially, particularly the 905. Ford has explicitly attacked Trudeau on such issues as carbon pricing, steel tariffs, and asylum seekers, Expect that much of Ford’s politicking in 2019 will take the form of swipes at Trudeau. 

 

2. How deeply will the PCs cut the deficit? 

Ford and Finance Minister Vic Fedeli say the Liberals left the province $15 billion in the red. Fedeli’s mini-budget in November took a mini bite out of the shortfall, now clocking the 2018-19 deficit at $14.5 billion. The cuts were not as deep as some Ford opponents feared they would be, but it left them asking: how much deeper will the cuts be this year?

The answer will come whenever the PCs deliver their first budget, sometime in the next few months. Ford has set himself an onerous task: promising to balance the budget without layoffs. It’s left the government trying to find savings by trimming around the edges: cutting landline phones at Queen’s Park, reducing the use of paper, offering early retirement buyouts to provincial employees, none of which can add up to the billions that the PCs need to find.

The budget will force the PCs to answer one financial question they have been refusing to answer since before they were elected: when do they aim to get rid of the deficit? By law, every deficit budget must show a timetable for getting out of the red. 

3. What will Ford’s health care reform look like?

In a memo this week to Ontario’s 60,000 public servants, Ford identified « delivering better health care » as one of his three top priorities. He said this will involve « embracing change and innovation, deploying technology more effectively, and committing to new models of collaboration and patient care. » 

People who work in Ontario’s health care system are wondering what those words will mean in practice. 

Ford says delivering better health care is one of his three top priorities in 2019, along with jobs and balancing the budget responsibly. (Samantha Craggs/CBC)

It’s also not totally clear who will be the architect of Ford’s health care reform. Health Minister Christine Elliott is officially in charge and has delivered speeches about transforming the system. But sources in the bureaucracy say the driving force for change is Rueben Devlin, former CEO of Humber River Hospital, who chairs the Premier’s Council on Improving Healthcare and Ending Hallway Medicine.

It’s not a stretch to say that unless Devlin and Elliott find ways to spend the province’s $61.7 billion health budget more efficiently, it will be all but impossible for Ford to balance the budget without layoffs (see question 2). 

4. Will hydro rates come down?

One of the PCs’ key election promises was an additional 12 per cent cut in the cost of electricity for residential and small business customers. The party platform said this would cost in the neighbourhood of $800 million a year. About half of that would come from the government’s Hydro One share dividends, and half from the tax base.

But again, refer back to question 2. Keeping the hydro rate promise by spending $800 million a year will not make it any easier to keep the promise to balance the budget.

Ford frequently says he has an all-star cabinet, but some of his ministers, including Attorney General Caroline Mulroney, left, have taken a back seat to Ford on key issues in their portfolios. (Chris Young/The Canadian Press)

5. Will Ford’s style of governing change? 

The PCs did things at a frantic pace in their first 100 days in power, and they didn’t take their foot off the gas until the Christmas break.

Ford has fulfilled some of his central campaign promises: cancelling cap and trade, scrapping the Liberal sex-ed curriculum, getting rid of the Hydro One CEO and board. So, will he settle into the more sedate pace of having a majority government. Or, after 15 years of Liberals running Ontario, does Ford feel he has so many changes to make, that he cannot slow down?

In the same vein, how will Ford handle the inevitable bumps along the way? His appointment of his friend Ron Taverner to head the OPP is on hold pending an investigation. His move on the sex-ed curriculum is being challenged in court. And no one can predict what other controversies will emerge in the months to come.

Ford had a tremendous 2018, winning all his big battles: the PC leadership, the election campaign, the legal fight over slashing Toronto city council. A significant test of his mettle as a politician will come if he loses a big battle in 2019.

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Justin Trudeau says RCMP trying to answer ‘a lot of questions’ about Liberal MP Raj Grewal

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OTTAWA—Prime Minister Justin Trudeau acknowledged Wednesday that there are still “a lot of questions” surrounding Brampton East MP Raj Grewal that the Royal Canadian Mounted Police are trying to answer, as opposition MPs demanded to know when he first learned of the troubled politician’s gambling debts.

Responding to questions in the House of Commons, Trudeau said he first learned of the Liberal MP’s situation at some point last week.

Raj Grewal announced last Thursday that he would step down as MP for Brampton East, but as of Wednesday Elections Canada said he hadn’t.
Raj Grewal announced last Thursday that he would step down as MP for Brampton East, but as of Wednesday Elections Canada said he hadn’t.  (Adrian Wyld / THE CANADIAN PRESS FILE PHOTO)

“We know there are still a lot of questions on which the RCMP is working to get answers,” the prime minister said in French. “We have confidence the RCMP will do the appropriate work to fully understand what happened.”

Grewal announced last Thursday that he will step down as MP for Brampton East, citing undisclosed “personal and medical reasons.” The Prime Minister’s Office admitted the following day that Grewal would resign after informing them he had a gambling problem and had incurred “significant personal debts.”

After Elections Canada confirmed Grewal still hasn’t officially stepped down as of Wednesday, Conservative MP Peter Kent called for his immediate resignation. He pointed to a Globe and Mail report about Grewal’s actions when he sat on the House of Commons finance committee earlier this year. He said the report suggests Grewal was “asking self-serving questions” about money laundering to high ranking officials.

This comes after the Globe and Mail, citing unnamed sources, reported Fintrac, the government agency responsible for tracking money laundering, tipped off the RCMP about Grewal’s gambling activities.

Fintrac declined to answer questions about Grewal from the Star, saying federal law prevents it from “commenting on compliance enforcement actions that may or may not have been undertaken.”

According to a transcript of a finance committee meeting June 20, Grewal asked officials from the Finance Department: “Would there be a scenario in which a financial institution would provide what they think is a suspicious transaction to Fintrac, Fintrac would launch an investigation, but the individual account holder would never know that this was taking place?”

The responding officials said Fintrac passes “suspicious” information to relevant law enforcement or tax authorities, and that the agency is careful “not to tip off a person on whom they are filing a suspicious report, because down the line it could lead to an investigation.”

In mid-September, Grewal was shuffled to the health committee.

Mark Holland, who oversees committee assignments for the Liberals as chief government whip, said the move had nothing to do with questions about Grewal’s gambling habits or alleged police investigations.

“We make changes all the time to committee and obviously the reasons are confidential but I can confirm that it had nothing to do with the matter that is before us,” said Holland.

Holland said he had no indication at the time that Grewal may have been under investigation.

“There’s a bunch of different reasons why someone might change committees. There’s internal machinations that we don’t discuss, but it was of that ilk,” he said.

Meanwhile, The Canadian Press reported Wednesday night that word of Grewal’s gambling debts came to the attention of the Ontario Provincial Police during a broader investigation into potential money laundering and drug money that was to be transferred to an extremist group in the Middle East. Citing an unnamed source, the report said Grewal’s gambling debts were mentioned in conversations captured on police wiretaps.

Grewal is also subject of an investigation by Parliament’s Conflict of Interest and Ethics Commissioner, Mario Dion, who is looking at how the MP invited the chief executive of a Brampton construction firm to hobnob with cabinet ministers and high-ranking government officials during Trudeau’s trade mission to India last February.

Grewal’s ethics disclosure with Dion’s office shows he has received “employment income” from that firm, ZGemi Inc., since he was elected in 2015. Grewal has said his “business relationship” with the chief executive was cleared by the ethics commissioner.

Trudeau’s office said last week that it is aware of RCMP inquiries into the matter.

With files from Bruce Campion-Smith

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Is it strep throat? Pharmacies say they could give you the answer and maybe save a trip to the doctor

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‘Tis the season for colds, flu and sore throats. And anguishing over whether you — or your child — need to go to the doctor. Maybe it’s better to stay in bed — but what if it’s strep throat and antibiotics are required?

In three Canadian provinces (B.C., Alberta and Nova Scotia), you can walk into some pharmacies and get a rapid « point-of-care » strep throat test.

The pharmacist takes a throat swab, and within a few minutes, tells you whether it tested positive or negative for group A streptococcus — the bacteria that cause strep throat.

Now pharmacy owners want that test to be available across the country.

It’s a quick and easy way, they say, to confirm whether a sore throat is caused by strep bacteria or by a virus.

That’s important because only about a third of sore throats in children between five and 15 years old are caused by strep. The rest of the time it’s usually a virus, in which case antibiotics won’t do any good and shouldn’t be prescribed. 

So if the test comes back positive for strep, the pharmacist will advise you to go to the doctor and get the appropriate prescription. In Alberta, you could get the antibiotic right away, as pharmacists have prescribing authority in that province.

If the test comes back negative, « you may just need fluid and rest, which a pharmacist could advise you on, » said Sandra Hanna, vice-president of pharmacy affairs for the Neighbourhood Pharmacy Association of Canada and a pharmacist in the Toronto area.

« In the majority of cases, an antibiotic … would not be required, because it’s a viral sore throat, » she said.

Since about two-thirds of sore throats are viral and antibiotics shouldn’t be prescribed, ruling out strep infections in a pharmacy setting can help save patients unnecessary trips to the doctor’s office, says Sandra Hanna, vice-president of pharmacy affairs for the Neighbourhood Pharmacy Association of Canada and a practising pharmacist. (Neighbourhood Pharmacy Association of Canada)

The test, which costs patients about $15, allows people « to determine whether they need to go to the doctor or not, » Hanna said.

That, in turn, could help prevent the unnecessary antibiotic prescriptions which contribute to antibiotic resistance, she said.

For all those reasons, the association, which represents pharmacies (including chains such as Shoppers Drug Mart and mass merchandisers with pharmacy services such as Costco and Walmart), says strep point-of-care testing should be available across the country, and is currently lobbying to start it in Ontario.

Sounds great, right?

Not so fast, say infectious disease specialists.

When it comes to kids, point-of-care tests (also called rapid antigen tests) shouldn’t be used on their own to rule out strep throat, said Dr. Jeffrey Pernica, head of the Division of Pediatric Infectious Disease at McMaster University in Hamilton, Ont.

« These tests that they’re talking about don’t work well enough to be reliable in children. And children are the ones who are the most at risk from complications of strep throat, like rheumatic fever. And they’re the ones who get strep throat the most, » he said.

(For adults, strep throat is less common.)

When doctors suspect a patient has strep throat, they usually do a throat swab and send it off to a lab for a « throat culture test, » where the sample is left for a day or two to see if it grows into strep bacteria.

Dr. Jeffrey Pernica, head of the division of pediatric infectious disease at McMaster University, says he understands the appeal of rapid strep tests, but they shouldn’t be used in isolation when it comes to ruling out strep throat in children. (McMaster University)

That’s the « gold standard diagnostic test » for strep throat, according to the U.S. Centers for Disease Control and Prevention.

It’s also the accepted medical guideline for treating strep throat in children, said Dr. Jonathan Gubbay, a Toronto pediatrician specializing in infectious disease, as well as a medical microbiologist for Public Health Ontario.

Gubbay actually uses a point-of-care test in his clinic when he suspects a child has strep throat because he can get the result back in five or 10 minutes. If it’s positive, he can start antibiotic treatment right away.

But if it’s negative, he sends a sample to the lab for the culture test to make sure the point-of-care test wasn’t a false reading.

It’s important to make sure a strep diagnosis isn’t missed in children, Gubbay said, because although rare, it can progress into an invasive form of the disease or heighten the risk of rheumatic fever, which can damage the heart and joints.

« The sensitivity [of rapid tests] isn’t as good as we’d like, » he said.

So how reliable are they? It depends on who you ask.

The Neighbourhood Pharmacy Association says the point-of-care tests are accurate more than 90 per cent of the time. But both Gubbay and Pernica say that’s unlikely.

Dr. Jonathan Gubbay, deputy chief of medical microbiology at Public Health Ontario and a pediatric infectious disease physician, says a comprehensive physical exam of a child with a sore throat can sometimes rule out strep throat without requiring a swab at all. (Public Health Ontario)

Although studies that show such high accuracy do exist (including those cited by test manufacturers themselves), the doctors say a broader look at the research puts the number closer to 70 per cent.

Dr. Lynora Saxinger, an infectious disease specialist at the University of Alberta, also questions whether point-of-care tests are as accurate as they claim to be.

« There are lots of tests that are licensed and the packages always tell you that they’re fantastic. In the real world, they vary a lot, » she said.

Both Saxinger and Gubbay also point out that diagnosing strep goes beyond the throat swab — regardless of how the results are processed, because physicians and nurse practitioners do complete physical exams. In many cases, they’re able to rule out strep throat without even doing a swab — a level of diagnosis they’re not sure all pharmacists are equipped to provide.

But Hanna said in the provinces where point-of-care tests are in place, pharmacists do have comprehensive conversations with patients — and also guard against missed strep diagnoses.

« Tests that show a negative result in patients where the pharmacist strongly suspected them of having strep throat, based on their symptoms, were referred to a physician for further evaluation, » she said.

The manufacturers of point-of-care tests, including those for strep throat, ‘always tell you that they’re fantastic. In the real world, they vary a lot [in accuracy],’ says Dr. Lynora Saxinger, an infectious disease specialist at the University of Alberta. (University of Alberta)

The in-pharmacy tests could also save the health-care system money, the Neighbourhood Pharmacy Association says, citing a study published in the Canadian Pharmacists Journal in August. It concluded the pharmacy-based treatment saved an average of $12.47 to $24.36 per patient.

However, the study did not account for the fact that patients pay about $15 out-of-pocket for the strep test — and it was funded by Loblaw Companies Limited, which runs pharmacies and owns the Shoppers Drug Mart chain.

That raises questions for Pernica about how impartial the findings are.

« There’s a clear incentive for the drug stores to get people [in], » he said. « Because if they have strep throat, they’ve done them a service. If they don’t have strep throat, they’re still there. And I think that people will be walking out of those drug stores with cough and cold remedies. »

Regardless, Pernica said he understand the appeal of the pharmacy-based tests for patients.

« Pharmacists will make a good point in saying that sometimes it’s hard to get in to see your doctor or nurse and it’s sometimes easier for people to access pharmacies. I completely agree with that, » he said.

But he’s not convinced there’s enough independent research to back up the claims that false negatives aren’t happening — or even that there’s a cost-saving to the health-care system.

« I’m not sure of the data yet, » said Pernica. « Will people actually get treated more appropriately faster? Will the overall costs be lower? I think these are answers we don’t have yet. »


This is an excerpt from Second Opinion, a weekly roundup of eclectic and under-the-radar health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.

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