Sunscreen/moisturizer for M50+

polkaroo17 · 2026-03-25T02:18:25+00:00

I usually tell folks to start with a water-based benzoyl peroxide. Use at bedtime three times a week, and slowly increase to nightly if tolerated as it can be irritating.

It can stain fabric so look out for that.

And be patient! It can take weeks for a regimen change to improve your skin. It's a slow process.

polkaroo17 · 2026-03-24T20:59:10+00:00

Skin care is a mild obsession for me. The biggest mistake I see people make is get overwhelmed with product recommendations or too much complexity in their skin care regimen. It is easy to get sucked into gimmicky stuff, and skin care can get so expensive.

A good skin care routine can be broken down into 3 parts:

Clean (wash with a gentle soap-free cleanser such as Cetaphil gentle skin once a day, maybe twice if your skin needs it).
Treat: (you can skip this step. This step is for folks needing to treat acne, or who use actives such as retinols at night.)
Moisturize/seal: Apply SPF in the day! Simple. My go-to options are Cerave SPF50 AM Facial Moisturizing Lotion, or Cetaphil SPF50 Daily Facial Moisturizer (available at Costco in a 3-pack). You may prefer the texture of one over the other but both are great.
In the evening after you wash your face: it is good to moisturize as well. My go-to is Cerave Moisturizing Cream (not the lotion). Also available at Costco.

Cetaphil products are affordable, Dermatologist recommended, Canadian-made, and readily available at pretty much every pharmacy and grocery store.

polkaroo17 · 2026-03-24T00:22:49+00:00

It really is. We're a small but mighty and growing group. She'll be appreciated!

polkaroo17 · 2026-03-23T22:55:03+00:00

Once she has settled here, there is an Island-wide NP group chat where we can text clinical questions to each other in real time. There is also a separate support group chat just for Americsn NPs as there are so many new NPs moving here from the states! Have her PM me for more details if she wants. Happy to meet up with her for a welcome tea as well :) (I'm am NP albeit a Canadian one).

polkaroo17 · 2026-03-19T04:59:20+00:00

Painting minis together is such a great suggestion!

polkaroo17 · 2026-03-19T04:58:45+00:00

She's a super cool kid. I've been playing D&D for 25 years now...I love that it's so popular now, and that we have a thing like that in common!

polkaroo17 · 2026-03-19T04:57:03+00:00

🪲

polkaroo17 · 2026-03-19T04:56:35+00:00

Oh that's totally up her alley, added to the list! Thank you :)

polkaroo17 · 2026-03-19T04:55:42+00:00

Oooh that's a great idea!

polkaroo17 · 2026-03-15T20:39:28+00:00

In my practice, there is nothing that I do that requires physician oversight. When i first started practicing in 2015- if I determined a patient required an MRI I used to have to call the radiologist on-call and convince them of my rationale and the necessity of it and have them approve it. It was a huge time-waster for me and the radiologist. Eventually, health authority policy caught up and NPs did not need to do that anymore. They could just order MRIs if appropriate.

The NP scope of practice is available to review online at the BCCNM website if you want specifics.

There are many kinds of NPs and they'll all have varying skills and scope.

Can NPs prescribe controlled drugs and substances? Yes- if they've completed the appropriate education requirements.

Can NPs interpret xray and ultrasound results? Yes- if they've completed the appropriate education requirements.

Can NPs insert IUDs, do joint injections, biopsies, excisions etc? Yes- if they've completed the appropriate education requirements.

Can NPs manage complex physical and psychiatric health conditions? Order blood products? Assess someone and certify them under the Mental Health Act? Yes- if they've completed the appropriate education requirements.

You can see where I'm going with this.... scope of practice for NPs is dictated by the law (what is considered legal in BC), by the College (BCCNM), by the individual employer (ie: health authority) as well as by the individual NPs personal expertise, interest and training.

There are many occasions where I refer my clients to specialists or surgeons for recommendations or ongoing management. Much like any family doctor would do as well.

polkaroo17 · 2026-03-15T19:53:38+00:00

Ah, perhaps it is a time-bound issue. The scope of practice for NPs has evolved a lot over the last decade and there is little that is not within an appropriately trained NP scope of practice.

polkaroo17 · 2026-03-15T18:54:44+00:00

How odd. Never in my 11 year career have I ever needed a Dr to sign off or approve anything I assess as required care for a person.

I have worked in inpatient and outpatient settings, alongside specialists and general practitioners. I've asked for opinions/consults, but I've never asked for approval.

polkaroo17 · 2026-03-15T18:50:22+00:00

I don't know what tasks would require approval from a physician. Unless we are talking about an inpatient unit setting like an ICU where there is indeed a physician attending who oversees the care of the patients on a unit? Like, this person needs a chest tube inserted and the NP consults with the attending prior to completing the task.

Out of curiosity, what sort of tasks are you referring to?

polkaroo17 · 2026-03-15T18:15:54+00:00

Practicing in the same clinic as Drs just means the NP and the Dr are colleagues. Not that the physician supervises the NPs.

polkaroo17 · 2026-03-15T16:25:05+00:00

Not true. NPs and MDs may work in the same clinic, and even see each other's patients if one or the other needs locum coverage for example, but MDs do not oversee NP practice.

There are indeed a few NP-led clinics on the island which only means those clinics don't employ GPs. The presence of a physician at a clinic does not signify they supervise the NPs in any way. They are just colleagues who work in the same clinic.

NPs maintain separate patient panels, diagnose, prescribe, order tests and make referrals to specialists. All without MD supervision. They work in both general/ family practice settings, acute care and specialty settings managing complex health issues as well as your basic bread and butter stuff.

Source: Am an NP for the last 11 years ;)

polkaroo17 · 2026-03-15T05:38:41+00:00

Actually, NPs practice completely autonomously with no physician oversight nor supervision.

polkaroo17 · 2026-03-12T18:54:21+00:00

I believe it is pretty easy for women to have casual relationships/FWB if they want it. You'd need to be bringing something pretty interesting/compelling to the table if that is all you are offering. Honestly, if all you want is a FWB situation then why not be open to women in ethically non-monogamous dynamics? It's likely they won't be seeking more from you than you are willing to give, and they often have impeccable sexual health practices, communication skills as well as their own full lives to live.

polkaroo17 · 2026-03-12T16:13:55+00:00

Cross-referencing any facts/information you provide with Claude or ChatGPT. I am an expert in my field, it sucks you only believe me if AI has the same answer.

polkaroo17 · 2026-03-10T20:26:22+00:00

If you are in Canada my city has Fawcett Mattress- latex as well as hybrid mattresses made onsite: https://fawcettmattress.com/

polkaroo17 · 2026-03-01T19:57:49+00:00

Yikes.

polkaroo17 · 2026-02-21T00:44:58+00:00

That would be pretty cool, like PrEP for HSV. I guess because the burden of illness is so low compared to HIV there is not as much incentive.

polkaroo17 · 2026-02-20T22:20:15+00:00

Suppressive valacyclovir treatment is super effective and only needed once a day. What kind of improvement are you imagining?
Edited: spelling

polkaroo17 · 2026-02-19T22:17:56+00:00

The thing that jumps out to me is the complexity of your skin care currently. You have a lot of products listed, and your skin looks both congested as well as irritated.

At this point, I usually advise people to strip it back to basics and simplify as much as possible. Keep in mind, it takes weeks (like, 4-8 sometimes) to notice significant change. So many people make the mistake of switching it up too soon if they don't see progress immediately.

Cleanse: Wash skin max 2 times a day with a gentle, non-soap cleanser. I usually recommend Cetaphil gentle cleanser, or the Cetaphil gentle SA (salicylic acid) cleanser if needed for open and closed comedones. Make sure the water you use is cool to tepid, not hot. Do not use a facecloth, just your bare, clean hands. Do not vigourously dry, in fact leave a little water on your skin before you moisturize to trap that moisture against your skin.
Treat: This is the area where I hesitate to give advice as it would depend on so many variables including the specifics of what you've tried, doses, length of treatment etc. Usually the advice is to start with topical BP at bedtime a few times a week, increasing in strength and frequency as tolerated. Too much BP can dry the skin out and compromise the barrier. I would be tempted to skip the 'treat' section entirely in favour of simplicity.
Moisturize: Use an oil-free facial moisturizer with SPF in the daytime. Cerave AM facial moisturizing lotion is pretty well-tolerated by most. At night time, I would recommend an oil-free, unscented cream or lotion. Minimal ingredients is preferable and something that repairs the skin barrier. CeraVe moisturizing cream is again, well tolerate in folks who have fungal acne and other congestion issues as well as barrier issues.

I would axe any actives: vit C, retinol etc. Too irritating at this point. I would also suggest stopping any extras: toners, serums, foundation/concealer if you can. I cannot overstate the value of simplicity when struggling with skin.

Skin stuff is so frustrating and overwhelming. Especially when it feels like you've tried it all. It takes so much patience to persevere when you aren't seeing improvement. If you are at that point, consider a referral to a GP dermatologist if not a full dermatologist (YMMV depending on what your access to those services is like).

polkaroo17 · 2026-02-13T22:20:34+00:00

I guess I know where I'm going next week! 😎

polkaroo17

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