“Three months after taking these tablets, she was 80 per cent better—without the risk, expense and everything that went with those procedures.”

“It is life-changing for a lot of patients, and it has been a real practice changer for me.”

What if one of the most effective treatments for melasma isn’t a topical cream or laser—but a low-dose oral medication?

In this episode of JCMS Author Interviews, Dr. Kirk Barber speaks with Vancouver dermatologists Dr. Vincent Richer and Dr. Allison Sutton about their article, “Low-Dose Oral Tranexamic Acid as a Standard Treatment for Melasma: Are We There Yet?”, published in the May/June issue of the Journal of Cutaneous Medicine and Surgery.

Dr. Richer and Dr. Sutton explain why oral tranexamic acid has become a practice-changing treatment for many of their patients. They discuss its effectiveness compared with topical treatments and laser procedures, including cases in which patients have experienced dramatic improvements after only a few months.

The conversation also addresses the questions surrounding longer-term use. Because melasma is a chronic condition that frequently returns when treatment stops, should oral tranexamic acid be continued beyond the three-to-six-month period typically studied in clinical trials?

Drs. Richer, Sutton and Barber examine dosage, patient screening and the risk of thrombosis, as well as considerations involving oral contraceptives, hormone replacement therapy, pregnancy and sun exposure. They also explore the continuing role of sunscreen, hydroquinone, botanical brighteners and laser therapy in a comprehensive treatment plan.

A practical and potentially practice-changing discussion about treating melasma safely, effectively and for the long term.

Dr. Vincent Richer is a clinical faculty member in the Department of Dermatology and Skin Science at the University of British Columbia. He practises at Pacific Derm in Vancouver, with a focus on medical and cosmetic dermatology, laser surgery and pigment disorders.

Dr. Allison Sutton is a clinical faculty member in the Department of Dermatology and Skin Science at the University of British Columbia and the founder of West Dermatology in Vancouver. Her practice focuses on cosmetic and aesthetic dermatology.

Dr. Barber and his guests do not receive any financial reimbursement for the production of this podcast.

For more great CDA podcasts check out Dermalogues, our Residents podcast hosted by Dr Kerri Purdy. New episodes are coming out in October 2026.

To learn more about the work of the Canadian Dermatology Association, please visit our website at dermatology.ca

This podcast is produced by David McGuffin and Graham McGuffin of ExploreProductions.ca

“With artificial cognition, we have the ability to outsource the entire thinking or reasoning process itself. And that’s what we call cognitive surrender: the adoption of AI outputs without verification, without much internal engagement at all.”

What happens to clinical judgment when physicians begin relying on artificial intelligence—and what happens when that technology is taken away?

In this special Editor’s Choice episode of JCMS Author Interviews, Dr. Kirk Barber speaks with Canadian academic Steven Shaw, assistant professor of marketing at King’s Business School, King’s College London, and formerly of the Wharton School at the University of Pennsylvania.

Shaw introduces the concept of “cognitive surrender”: accepting AI-generated conclusions without independently reasoning through or verifying them. They examine what this could mean in medicine, where incorrect or unchallenged answers can have serious consequences.

Their conversation explores emerging evidence of deskilling among experienced clinicians who use AI-assisted diagnostic tools, as well as the risk of “never-skilling” when medical trainees outsource parts of the learning process before developing their own expertise.

They also consider how AI is changing the doctor–patient relationship. Can AI scribes create more time for meaningful conversation—or does being recorded inhibit trust and disclosure? What happens when patients arrive with their own AI-generated diagnoses? And when a physician’s judgment differs from an AI recommendation, which one is more likely to be trusted?

A timely discussion about AI, medical education and how clinicians can benefit from new technologies without surrendering the critical judgment on which good medicine depends.

This episode is supported by an educational grant from Sun Pharma Canada through the CDA Corporate Supporter Program.

Dr. Barber and his guests do not receive any financial reimbursement for the production of this podcast.

For more great CDA podcasts check out Dermalogues, our Residents podcast hosted by Dr Kerri Purdy. New episodes are coming out in October 2026.

To learn more about the work of the Canadian Dermatology Association, please visit our website at dermatology.ca

This podcast is produced by David McGuffin and Graham McGuffin of ExploreProductions.ca

“There’s probably a whole field that’s been affected by the sun and the resulting DNA damage.”

An actinic keratosis may appear to be an isolated lesion—but it can also signal a much larger field of sun-damaged, precancerous skin.

Dr. Kirk Barber speaks with Dr. Steven Feldman about field cancerization and how its size should influence the treatment of actinic keratoses.

They discuss the difference between treating individual lesions and an entire field, the role of topical therapies, and whether approved treatment limits reflect the much larger areas of precancerous change dermatologists encounter in clinical practice. They also consider how clinicians balance cancer prevention against treatment discomfort, patient age, overall health and the relatively low risk of an individual actinic keratosis progressing to skin cancer.

Their wide-ranging conversation explores the difficulty of clinically defining a field, the cumulative effects of sun damage, the potential cosmetic benefits of field therapy and the need for a more nuanced approach to sun protection.

The conversation is based on the JCMS article “The Characterization of the Relationship Between Field Cancerization and the Number of Actinic Keratoses.”

Dr. Steven Feldman is a professor of dermatology, pathology, social sciences and health policy at Wake Forest University School of Medicine in North Carolina. He also leads the Center for Dermatology Research.

For more on the treatment of actinic keratoses, listen to Episode 82 of JCMS Author Interviews, featuring Dr. Christopher Chew and an Australian perspective on managing the condition.

Dr. Barber and his guest do not receive any financial reimbursement for the production of this podcast.

For more great CDA podcasts, check out Dermalogues, our residents podcast hosted by Dr. Kerri Purdy.

To learn more about the work of the Canadian Dermatology Association, please visit our website at dermatology.ca

This podcast is produced by David McGuffin and Graham McGuffin of ExploreProductions.ca

Reports of ticks are surging across Canada as blacklegged ticks expand into regions once too cold or dry to support established populations. What is driving their spread—and what does it mean for the risk of Lyme disease and other tick-borne illnesses?

In this special Editor’s Choice episode, Dr. Kirk Barber speaks with Dr. Katie Clow, one of Canada’s leading researchers in tick ecology and tick-borne disease. They discuss how climate change, migratory birds, wildlife and changing habitats are reshaping the country’s tick populations. Dr. Clow explains how ticks find and attach to their hosts, how the bacteria responsible for Lyme disease moves from a tick’s gut into its saliva, and why removing a tick promptly can reduce the risk of transmission.

The conversation also examines striking regional differences in infection rates, the emergence of anaplasmosis and Rocky Mountain spotted fever, the challenges of controlling ticks in the environment, and the potentially alarming arrival of invasive species such as the Asian longhorned tick in North America.

Dr. Clow is an associate professor at the University of Guelph’s Ontario Veterinary College, where her research explores the connections between human, animal and environmental health.

This episode is supported by an educational grant from Sun Pharma Canada through the CDA Corporate Supporter Program.

Dr. Barber and his guests do not receive any financial reimbursement for the production of this podcast.

For more great CDA podcasts check out Dermalogues, our Residents podcast hosted by Dr Kerri Purdy.

To learn more about the work of the Canadian Dermatology Association, please visit our website at dermatology.ca

This podcast is produced by David McGuffin and Graham McGuffin of ExploreProductions.ca

“I don’t think we can keep patients hostage to the failings of our healthcare system.”

— Dr. Stefanie Green

Medical assistance in dying may not seem like an obvious subject for dermatologists—but nearly one in five Canadian dermatologists surveyed has been approached by a patient about MAID.

Dr. Kirk Barber speaks with Dr. Stefanie Green, founding president of the Canadian Association of MAID Assessors and Providers, and dermatologist Dr. Mark Kirchhof about Canada’s MAID system and the role dermatologists may play within it.

They discuss eligibility and informed consent, the distinction between patients whose deaths are and are not reasonably foreseeable, and the difficult questions that arise when severe skin disease causes intolerable suffering. They also explain how dermatologists can contribute as treating physicians, expert consultants or MAID assessors—and what happens when available treatments have been exhausted or remain inaccessible.

The conversation is based on the JCMS article “Medical Assistance in Dying in Canada: A Review for Canadian Dermatologists.”

Healthcare professionals can learn more about MAID assessment, clinical guidance and training through the Canadian Association of MAID Assessors and Providers (CAMAP).

Dr. Stefanie Green is a clinical professor at the University of British Columbia and the University of Victoria. She is the founding president of the Canadian Association of MAID Assessors and Providers and author of the bestselling memoir This Is Assisted Dying.

Dr. Mark Kirchhof is Division Head of Dermatology at the University of Ottawa and The Ottawa Hospital and the outgoing president of the Canadian Dermatology Association.

Dr. Barber and his guests do not receive any financial reimbursement for the production of this podcast.

For more great CDA podcasts check out Dermalogues, our Residents podcast hosted by Dr Kerri Purdy.

To learn more about the work of the Canadian Dermatology Association, please visit our website at dermatology.ca

This podcast is produced by David McGuffin and Graham McGuffin of ExploreProductions.ca

"The same medication, the same dose—but given at bedtime improved efficacy by 150%."

Does the timing of a medication influence how well it works?

In this episode of JCMS Author Interviews, Dr. Kirk Barber speaks with Dr. Elena Netchiporouk, Assistant Professor of Medicine at McGill University and attending dermatologist at the McGill University Health Centre, about the emerging science of chronotherapeutics.

Dr. Netchiporouk explains how the body's circadian rhythms influence inflammation, immune responses, skin barrier repair, and wound healing. She discusses evidence suggesting that timing therapies to coincide with these biological cycles may improve treatment outcomes for inflammatory skin diseases, including atopic dermatitis, psoriasis, and chronic spontaneous urticaria.

The conversation explores practical implications for commonly used therapies such as methotrexate, cyclosporine, JAK inhibitors, and topical corticosteroids, while highlighting an exciting and underexplored area of dermatology that may help clinicians optimize both efficacy and tolerability.

Read the article: "Time-Driven Strategies for Inflammatory Skin Diseases: A Circadian Approach" in the Journal of Cutaneous Medicine and Surgery.

Dr. Barber and his guests do not receive any financial reimbursement for the production of this podcast.

For more great CDA podcasts check out Dermalogues, our Residents podcast hosted by Dr Kerri Purdy.

To learn more about the work of the Canadian Dermatology Association, please visit our website at dermatology.ca

This podcast is produced by David McGuffin and Graham McGuffin of ExploreProductions.ca

“Most dermatologists hate to see these patients. But we must not hate to see them because they need help—and they need the dermatologist.”

— Dr. Marcelo Nico

In this 100th episode of JCMS Author Interviews, host Dr. Kirk Barber reflects on a milestone for the podcast before welcoming Dr. Marcelo Nico, Associate Professor of Dermatology at the University of São Paulo and a leading expert in psychodermatology.

Over the past 100 episodes, JCMS Author Interviews has connected listeners with authors, researchers, and clinicians from around the world, bringing the pages of the Journal of Cutaneous Medicine and Surgery to life through conversations that advance dermatologic knowledge and patient care. Kirk and his team are proud of the community that has built up around the podcast and want to send a specials thank you to everyone involved, especially our guests and you, our listeners.

Dr. Nico joins the podcast to discuss his article, “Dermatitis Artefacta: A Study of 42 Patients With Management Considerations.” Drawing on decades of clinical experience, he explains why dermatitis artefacta should be viewed as a distinct clinical diagnosis rather than a diagnosis of exclusion, and shares his compassionate approach to caring for patients whose skin disease is intertwined with underlying psychiatric illness.

The conversation explores the importance of trust, long-term follow-up, and recognizing the role of insight in psychodermatologic disorders. Along the way, Dr. Nico offers practical lessons for clinicians navigating some of dermatology’s most challenging patient encounters.

Dr. Marcelo Nico is Associate Professor of Dermatology at the Medical School of the University of São Paulo in Brazil. His work focuses on inflammatory and autoimmune skin diseases, oral mucosal disorders, and psychodermatology.

Dr. Barber and his guests do not receive any financial reimbursement for the production of this podcast.

For more great CDA podcasts check out Dermalogues, our Residents podcast hosted by Dr Kerri Purdy.

To learn more about the work of the Canadian Dermatology Association, please visit our website at dermatology.ca

This podcast is produced by David McGuffin and Graham McGuffin of ExploreProductions.ca

How can dermatologists better understand—and improve—the lived experience of patients with vulvar disease?

In this episode of JCMS Author Interviews, Dr. Kirk Barber speaks with Dr. Marlene Dytoc about her article, Evaluating the Impact of the Vulvar Quality of Life Index for New Patient Dermatology Assessments, in the Jan/Feb 2026 issue of the JCMS. Together, they explore how the Vulvar Quality of Life Index (VQLI) helps capture the often-overlooked burden of vulvar conditions and can strengthen communication between physicians and patients.

The conversation also highlights the surprising impact of expert-led virtual support groups for patients with lichen sclerosus. Dr. Dytoc discusses how peer support, education, and structured quality-of-life assessments can improve patient confidence, satisfaction, and disease management—often after just a single session.

Looking ahead, she shares new research examining diagnostic delays in lichen sclerosus and the factors that may contribute to missed or delayed diagnoses, including stigma, examination gaps, and limited awareness among both patients and clinicians.

Dr. Barber and his guests do not receive any financial reimbursement for the production of this podcast.

For more great CDA podcasts check out Dermalogues, our Residents podcast hosted by Dr Kerri Purdy.

To learn more about the work of the Canadian Dermatology Association, please visit our website at dermatology.ca

This podcast is produced by David McGuffin and Graham McGuffin of ExploreProductions.ca

Guest Bio

Dr. Marlene Dytoc is a Clinical Professor of Medicine at the University of Alberta and Medical Director of the University of Alberta’s Vulvar Dermatology, Occupational Hand Eczema, and Psychodermatology Clinics. She is internationally recognized for her work in vulvar dermatology, psychodermatology, and patient-centred approaches to chronic skin disease.

In this episode of JCMS Author Interviews, Dr. Steve Feldman returns to discuss his three recent publications in the Nov/Dec 2025 issue of the Journal and what they reveal about modern dermatology practice.

The conversation moves beyond the research to explore bigger themes: how patients perceive care, why empathy matters more than efficiency, and whether technology—from dermatoscopes to AI—actually improves outcomes or simply reinforces trust.

Dr. Feldman also shares practical insights on patient behavior, telemedicine, and the surprising limits of large healthcare databases.

Dr. Steve Feldman is a professor of dermatology, pathology, and social sciences & health policy at the Wake Forest School of Medicine. He is a leading researcher in dermatology and directs the Center for Dermatology Research. His primary clinical focus is psoriasis, and his work has significantly shaped understanding of patient adherence, quality of life, and real-world treatment outcomes.

Dr. Barber and his guests do not receive any financial reimbursement for the production of this podcast.

For more great CDA podcasts check out Dermalogues, our Residents podcast hosted by Dr Kerri Purdy.

To learn more about the work of the Canadian Dermatology Association, please visit our website at dermatology.ca

This podcast is produced by David McGuffin and Graham McGuffin of ExploreProductions.ca

Pediatric hand eczema is more common than we think — and it’s not simply “adult hand eczema in smaller hands.”

In this episode, Dr. Kirk Barber sits down with Dr. Sonja Molin to explore why pediatric hand eczema deserves its own clinical lens. From COVID-era handwashing to slime exposure, allergic contact dermatitis, and patch testing strategies, this conversation unpacks the real-world triggers affecting children today — and how to manage them effectively.

They discuss practical treatment pearls, when to patch test, steroid strategy, non-steroidal options, emerging topical JAK data, and how to empower kids and parents in long-term skin care management.

If you treat eczema — or live with it — this episode delivers clinical insight with heart.

This conversation centers on Dr. Molin's article in the July/Aug Issue of the Journal of Cutaneous Medicine and Surgery: Patterns of Pediatric Chronic Hand Eczema: A Systematic Review With Focus on Causes and Management.

Her co-authors are: Dr. Katie Yeung, Dr. Joshua Lowe, Dr. Jessica Ho.

Sonja Molin, MD, PhD is a dermatologist specializing in eczema, allergic contact dermatitis, and chronic hand eczema.

She is Professor of Dermatology at Charité – Universitätsmedizin Berlin and former Chair of Dermatology at Queen's University, Kingston.

Dr. Barber and his guests do not receive any financial reimbursement for the production of this podcast.

For more great CDA podcasts check out Dermalogues, our Residents podcast hosted by Dr Kerri Purdy.

To learn more about the work of the Canadian Dermatology Association, please visit our website at dermatology.ca

This podcast is produced by David McGuffin and Graham McGuffin of ExploreProductions.ca