GCW

Gratitude Celebration Week. GCW. My favorite week of the year at Johnson Dermatology.  We spend the entire month of November at JD trying to show an attitude of gratitude. We tell each other and our patients what we are grateful and thankful for and focus on our blessings. The week  of Thanksgiving we thank all our patients that trust us with their skin throughout the year with 20% off all cosmetic products and procedures. So today I want to tell you what you need to hurry in and stock up on this week!

  1. Laser hair reduction package. Other than just the savings, laser hair reduction is safest when done without any tan or color from the sun. Since most people need 3-5 treatments once a month, now is the perfect time to start. Be ready for Summer without a razor!
  2. Jane Iredale magic mitt. This is everyone’s favorite stocking stuffer. It’s a very gentle make-up removing cloth. Come in and stock up for the perfect stocking stuffer or small gift to give all your gal frands!
  3. Botox. We all know botox is valued by the hands that it is in. Never have Dr. Sandy and I offered $8/unit Botox from our hands. Normally $12/unit, this week it is $10/unit and for elite members it’s $8/unit. It would be near impossible to find EXPERT hands letting Botox flow out of their needle at this low of a price. All I can say is, if you snooze you lose.
  4. PRP. This is a procedure Dr. Nelson does for hair loss. He draws your blood, spins it down and injects the good stuff into your scalp. Initially you need 4 treatments and then you need maintenance treatments every 3-6 months. My advice? Get your initial treatments at a discount! Come in this week for 20% off! Without that initial sticker shock start up will be easy and maintenance treatments a breeze.
  5. TNS essential serum. I call this stuff the breast milk of skin care products, no formula can exactly replicate it. These growth factors will give your skin life again. The antioxidant side will not let your skin go dry and dull this winter. It’s also the highest priced item I recommend for skin care. That’s why you should get it now, while it’s 20% off. Get the new larger size for even more savings! It’s a skinvestment you won’t regret. Glow girl!

Dont know where to start? Overwhelmed with what to do for your skin with all these options? No worries. I got you covered. E-mail Dani@johnsondermatology.com or Margaret@johnsondermatology.com for a free consult and let us get you to your skin goals!

Thank you so much to each and every one of you for taking time out of your day to read my blog. I’m so grateful for you all.

Happy Thanksgiving, Nina

 

 

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Want the upper hand?

Having the upper hand usually means having an advantage in a situation. Unfortunately in skin, aging of the hands usually doesn’t have the upper hand. Many of my patients complain their hands look much older than their true age. This might be because we are better at applying skincare products to our face than hands. It might be because we drive frequently putting our hands in the sun’s harmful rays while our faces stay shaded. Protruding veins and tendons tend to develop over the years as we lose the fat layer in our skin and our skin thins. Luckily, we have great treatment options for the hands. Here are some of my favorites.

  1. Creams, serums, lotions. If you apply good skincare to your face pump it into the back of your hand first and apply from there. Whatever product you have left over on your hand just rub it in. SkinMedica total defense and repair sunscreen is a great hand option because it prevents premature photoaging and has antioxidants that repair Brown spots.
  2. IPL. While not a true laser, the intense pulse light device is one of my favorites for hands. It has great results with treating brown spots and it helps to tighten the skin as well. We recommend 3-5 treatments for optimal results.
  3. Radiesse. This is a filler that lasts 6-12 months in the hands. If your concern is crinkly skin and protruding veins and tendons then this is the option for you. It’s a quick in office procedure with immediate results and no real downtime.
  4. ATV. This laser is great for specific brown spots that are driving you nuts. Great for people who don’t need the entire hand treated but just one or two spots. Very effective in results and cost.
  5. Chemical peels. Although I do have this tool in the JD toolbox, in my opinion the lasers and devices we have are more controlled and offer the best results for the hands. I will commonly use a TCA peel for actinic keratosis on the arms and hands which need to be treated for medical reasons rather than solely cosmetic. This brings us to the point of how important it is to have your skin evaluated by a dermatologist before cosmetic procedures.

Don’t neglect those pretty hands. E-mail Margaret@johnsondermatology.com for your free consult ASAP because our Gratitude Week Celebration is coming up and all the procedures and products discussed here will be 20% off!

Feeling grateful, thankful and blessed, Nina

 

Are you ready for Botox?

When should you start considering Botox? When are you too young? When are you too old? Can you be too old or too young? These are good questions I am frequently asked. Today I’m going to try to answer them.

To know when it’s time for you to skinvest in Botox you first need to understand how it works and what it achieves. To understand how Botox works you need to understand what makes wrinkles. The wrinkles that we soften with Botox are lines in motion. That means when you squint repeatedly over the years crows feet develop around your eyes. When you scowl and pull your eyebrows closer together and down, over the years “11’s” develop. Years of muscles repeating the same motions basically etch those lines into the skin. In other words, lines in motion become lines at rest. Botox is a medication we inject into the muscle, not the skin. The Botox relaxes the muscle enough that it can’t etch those lines into your skin. When done by an expert injector, the muscle is not frozen but relaxed naturally resulting in softer lines at rest. Back to the original question, when should you start injections? In my opinion, this age varies from person to person. I believe you should get your Botox at the first sign of a line in motion becoming a line at rest. Don’t wait until you have a deep line at rest. The first sign, make a consult with an expert injector. Although the theory of prevention of lines with Botox is out there I feel it may not be necessary. Why relax muscles that haven’t even started to etch a line in when you can wait until the very first sign of an etched in line and get Botox resulting in no line? Yes, of course if you start now you will never get that line but save your money and start a good medical grade skincare line until you’re ready for Botox.
The difficulty lies in knowing what the first sign of a line a rest developing looks like. I assess skin everyday. I could tell every single person I see everyday if, in my opinion, they would benefit from Botox. Unfortunately most people don’t have that assessment skill. And why should you? That’s not your topic of expertise. That’s why it’s important to have a dermatologist. The only medical specialty that is specially trained in skin. No offense to the pyramid scheme skin care line you are using but Dermatology is where the experts in skin reside. Remember that and make an appointment. Let someone you trust with your skin assess you and let you know where you should be putting your skinvestment money. I have 20 year olds with deeper lines than some of my 30 year olds. I don’t have a particular age number for you as the answer to when to start Botox, but I do have the assessment skills and the knowledge to tell you when you’re ready. So be proactive. Go get a consult. Take control of your skin. The answer isn’t on the Internet. It’s at a dermatology office near you(insert wink emoji here).

Can’t wait to see you at the clinic this week. Gearing up for our Gratitude celebration in November and it’s going to be great!
Stay Skintastic, Nina

Drug Store Picks

I am often recommending to you medical grade skincare. Injectables, lasers and topical anti-aging products are all skinvestments that I feel are game changers in taking care of your skin over the years. However, there are also drug store skin care items that I use regularly and save a buck or two. Here are my money saving skin care finds.

  1. Vaseline. If you’ve followed me for any length of time you know I use this as my body emollient straight out of the shower. Game changer. Winter is approaching, get you a jar.
  2. benzoyl peroxide. This is an acne medication found over the counter. I saw a gel at Target this weekend for $3.49. If you have acne prone skin this is a great starting point for you. I pair it with my retinol at night since I’m a dewy acne prone kinda gal.
  3. Albolene moisturizing cleanser. $5.56 at wal-mart. People ask me how I remove my make-up. This is it. It’s only 5 ingredients: mineral oil, petroleum, paraffin, ceresin and beta-carotene. Put some in your hand or on a cotton swab and it will melt your eye-make-up off for 1/4 of the price of those expensive make-up melters. I then use a cleansing cloth to wipe it all away.
  4. Cetaphil cleansing cloths. I use them to wipe away make-up(see #3) at night or when I need a quick cleanse. Not like a bird bath cleanse or anything. But after a work-out before running to the grocery store. Or washing my face after falling asleep on the couch while walking to my bed. They are gentle and non-irritating. Must haves for the working Mom or teenagers on the go.
  5. Maybelline super stay matte ink. This lipstick is not for the faint of heart. I swear I apply this stuff at 6am before work and it’s still perfect at 4:30pm with no re-application and more eating than any lips should have to endure(#whatsadiet). It’s not terribly drying although I do a dose of HA5 to my lips in the am before application to boost my moisture level. I recommend color heroin for a popping red that is great for Summer and can take you into the holidays. This isn’t a must-have unless your name is Nina Copeland and you can’t go without a lip color at all times. All times.

Go hit the drug store and try out some of my money saving faves. Let me know what you think. Leave a comment, tell me on our Facebook page or our Instagram. Or you could send me a snap!

Love to hear from y’all! Keep it Skintastic, Nina

Dermatology Saves Lives

For those of you that don’t know my background, I started as a nurse aide on OB/GYN unit at Washington Regional Medical Center In 2000. As a very young child I always wanted to be a plastic surgeon. I joined the healthcare academy in high school and that’s how I got involved in nursing. One of my very first mentors professionally was a nurse who taught at my high school. She helped me get my CNA license. I then worked through college at an outpatient surgery center and immediately after graduating became an ICU nurse. I worked as an ICU nurse from California to Florida. I only cared for people who did not know if they would live or die that day. I recovered open heart surgery patients and neurology patients. I took care of people on life support after traumatic injuries. Some of the medications I gave people would be keeping them alive. If I made a mistake it could literally kill someone. I loved that work and I was successful in that field. When I graduated with my Nurse Practitioner license I was offered jobs by neurosurgeons, cardiologist, cardiovascular surgeons, emergency rooms and hospitalists. All doctors who had learned to trust me and had seen my skill set over the years. So when I took a job in Dermatology you can imagine what some of my colleagues said. “Why are you going to waste all your knowledge in Dermatology?” Or “Have fun popping zits all day” and maybe the most annoying “You will be so bored there”. But I knew in my heart the reasons I wanted to be in Dermatology with Dr. Brad and Dr. Sandy as my mentors (I had only met Honey  briefly at that time but she has become one of my biggest supporters and mentors me still daily). I knew that I wouldn’t have to wonder if those people who moved out of ICU ever lived a fulfilled life. I knew that I wouldn’t be shocking hearts into normal rythym but that I would be changing lives. I knew that I would be working for a company that cared about their patients more than their numbers. I knew that I would be valued as a provider. I knew that I would get to know my patients and learn what was important to them and be able to help them reach their skin health goals. I made the right decision. I have never looked back. I am blessed. One of my beautiful patients wrote something to talk about how Johnson Dermatology and the medication dupilimab for atopic dermatitis has changed her life. Here is her story. I hope you read it and all understand how Dermatology saves lives.

By the time I was 2 weeks old my parents started to notice my skin was a little different. They never imagined this would be the beginning of a very long road.
It started with patches and cracks , from there it began to get infected. After months of trying to find therapies that healed my skin I was officially diagnosed with Atopic Dermatitis ( Eczema). Mine was considered severe, so I was started on steroids very young. At that time that really was the only treatment they could offer. Due to my severe case I was on a strong steroid called prednisone 2 to 3 times a month after I was a year old. This therapy was after trying betamethosone and topical steroids. I was also kept on antibiotics to help keep the infection down. I had a very strict regimen of 20 minute baths to soak my skin . I would then have to be covered from head to toe in steroid ointments and creams. By morning my skin would be dry so we would have to repeat this. This has been my life since I was born. Not only was this emotional for me but for my parents, sister, and family. These treatments were so painful because my skin was open. My parents told me as I got older I used to scream everytime we had to apply medicine. I remember it felt like my body was being lit on fire. I was prescriped atarax and benadryl to help me sleep and comfort the pain . This treatment did end up being unsuccessful because it caused night tears. I continue to use benadryl as a treatment when needed for itching .
As I got older I started to really realize how different I was . No one else had to pay attention to their skin like I did. No one my age felt pain like I did or had to have help from my parents in the morning opening their arms or legs. This was due to pus from my skin being cracked open and scabbing over. The creases in my arms and legs behind my knees would stick together. These were daily struggles for me that no one could sympathize with . There were times I felt very isolated and had to hide my skin from embarrassment. Due to my eczema being so severe I also developed severe Asthma. This led to more medication and years of trying to find inhalers that controlled it. I honestly felt like I was always sick and missed out on so much as a kid .
After years of being made fun of and constantly being asked “ what’s wrong with your skin?” I started to accept myself and realized this is a strength , not a weakness. I started to take real interest in my disease instead of despising it. I quit wearing hoodies to hide it and started being okay with explaining what I have. I started to explain to people that my disease does not make me ugly and that yes it hurts but I will not let it get the best of me .
Eczema not only affects your skin and body physically it is an emotional disease. It has caused me alot of anxiety especially with bad flare ups. It has made me feel alone. It made me worry no one would ever want to hold my hand or accept that my body was covered in this rash. There has been alot more to my eczema than I ever thought imagineable .
I was diagnosed with an allergy to the cold weather. I have grown up with severe allergies specifically pollens and grasses, dust and animals. I also had food allergies to eggs and peanuts. I was prescriped an Epi-Pen for my peanut allergy because of anaphylaxis . needless to say I was no stranger to allergies. But…. this was definitely new to me. How could you be allergic to the weather? Well I am . The cold really started to affect me. My legs were covered in so many hives you could see them through my clothing . My hands swelled so bad I could not make a fist. My joints started to be affected as well . These were new symptoms to my eczema I had never experienced. After moving to New York with my husband I started to experience severe joint pain . My hands started to curl up to the point I could not use them . This was the most difficult experience I ever had with my eczema. I never had to deal with this much pain.I went through multiple tests from rheumatology and dermatology I kept getting the same answer, “we have never seen this with eczema”. It was really discouraging and exhausting. I’m a very athletic person. I am optimistic. I was in school to become a nurse and help others. This was very discouraging . It was hindering my career, my life . For once my skin was stopping me. I continued to be told that it was environmentally induced. This gave me hope that when we moved back to Arkansas my skin would get better. I would stop having the severe joint pain . We did eventually move home and my skin did not get better. This was probably the lowest point for me. I didnt know how I was going to continue my life like this . I was in so much pain. I am a nurse so it was affecting me at work as well not being able to use my hands. I could barely walk due to my severe bone pain in my feet and ankles. I finally decided to start a medication called cyclosporine in hopes this would help. This and prednisone did help for about a month . After that month I started to get severe infections. It was one after another for about the next 6 months . I finally decided I could not take the cyclosporine . I was told there were no other treatments for me at that point. I was truly so sad. My skin was at its worst and there was no hope. I had so many cracks in each knuckle my gloves at work were inbedded every time I tried to take them off. My back was so raw my scrubs stuck to it every time I got up. I had a severe staff infection on my scalp . I never could have imagined I would be this bad.
I finally got a glimpse of hope soon after all of this . I was told there was a new drug being approved called Dupilumab . It was an injection for people suffering from eczema and asthma. In trials people had experienced great success. I was so happy and could not wait to try this medication. I ended up being apart of a clinical trial for this through Johnson Dermatology . I have always wanted to use my Eczema to help others with research and I was finally getting a chance to do that. After just a month my skin started to improve with Dupilumab. This meant so much more to me than just my skin looking better. This treatment and the support I received from Johnson Dermatology gave me quality of life back I had been hoping for. This injection gave me the hopes that I could have a successful pregnancy in the future. This treatment was and is a true blessing .
If I can say one thing about my eczema its that it is a gift. It has taught me so much and continues to teach me about my self and others. It has given me the strength I need to be a compassionate daughter, sister, wife, and nurse . When people ask me now “ what’s wrong with your skin?” I proudly say I have eczema. I am not ashamed. Its something I have to live with every second of every day. I still have a strict regimen every night and every morning. Our skin is our largest organ. Most people do not even think about it daily. My skin is different, it is dry, scaly and cracked . I have to really take care of it but it makes me who I am . I have learned I am not alone, I am not isolated, I am not ugly . I am strong. I am a person, beautiful inside and out.

Thank you so much for this inspirational story from our JD patient. I thank God that I was a patient in that clinic that day and she was my nurse. As soon as we met, I knew she was a perfect candidate for the clinical trial. This is how Dermatology saves lives. If you or someone you know is interested in participating in a clinical trial then e-mail study@johnsondermatology.com

Stay Skintastic and don’t let anyone talk you out of your dreams or tell you that what your choices and missions are in life are less than theirs. Always go change lives the way you know you should. Nina

Specializing in Skin Cancer while Providing Comprehensive Skin Care

Dr. Sandy has done it again. I absolutely love when she guest posts on the skinny on skin. This blog makes you go hmmmmm. Then makes you want a skin cancer full body exam. Go ahead, you’re intrigued, read on……
October is Breast Cancer Awareness Month. This is important since breast cancer affects 1 in 8 women.
Did you know however that skin cancer affects 1 in 5 people (men and women)?
Did you also know that melanoma is the most common form of cancer in women ages 15-29 years?
Did you know that one American dies approximately every hour from melanoma?

Whether or not you already knew all of this, you may find more about skin cancer and other skin cancer statistics on our website www.johsondermatology.com as well as the American Academy of Dermatology’s website www.aad.org. You will also find other helpful information about prevention and treatment of skin cancer. We take skin cancer prevention and treatment seriously at Johnson Dermatology. We still hold true to the vision that Dr Brad and I created when we opened the clinic in 2006 “Specializing in Skin Cancer while providing comprehensive skin care”.

Time for more questions—
Did you know that Dr Brad was the first fellowship trained skin cancer dermatologic surgeon in the region—including Ft Smith and NWA?
Did you know that every year since we opened in 2006, we have offered and will continue to offer free skin cancer screenings?
Did you know that Dr Nelson joined the JD team in 2016 because he also believes in our mission and vision and wants to offer the highest quality care to patients, especially patients with skin cancer?
Did you know that the number of patients with skin cancers and melanomas seen at our clinic have steadily increased in the past few years?

Here are some more sobering statistics about skin cancer at Johnson Dermatology.

The following are how many patients at our clinic were diagnosed with melanoma
In 2014, 35 patients were diagnosed with melanoma.
In 2015, 48 patients were diagnosed with melanoma.
In 2016, 48 patients were diagnosed with melanoma.
In 2017 (January through September), 47 patients were diagnosed with melanoma.

The following are how many specialized skin cancer surgeries with frozen sections were performed at our clinic for the same time periods.
In 2014, 1220 surgeries were performed at JD.
In 2015, 1339 surgeries were performed at JD.
In 2016, 1612 surgeries were performed at JD.
In 2017 (January through September) 1364 surgeries were performed at JD.

These specialized skin cancer surgeries are performed under local anesthesia at our clinic by Drs Brad and Nelson. They cut out the skin cancer with the smallest amount of normal skin around and under the tumor then gives that tissue to our amazing in clinic lab team who processes the tissue into frozen sections that Drs Nelson or Brad look at with the microscope. If they got all of the cancer cells then they close up the surgical wound as skintastically as possible. If there is a small piece of cancer left anywhere, they go back and remove some more tissue from that area and repeat the process until there are no more visible cancer cells. It is because of this tenacity that Mohs surgery has cure rates of 95-99% as compared with 90% with excision. Because we specialize in skin cancer, we offer not only Mohs surgery but we also offer excision, electrodessication and curettage (ED&C), creams, photodynamic therapy, chemical peels, laser, etc for skin cancers and actinic keratosis (pre cancers). When looking for a skin cancer surgeon, training and experience of the surgeon as well as of the lab team is important. Lisa, who now manages our lab team of 6 full time people and some helpers, has been working in the lab for more than 10 years. She and the team are skintastic and work extremely closely with Drs Brad and Nelson as well as with Dr Amy. Dr Amy is a board certified dermatopathologist extraordinaire on the JD team with more than 20 years of experience.

I know if you are reading this, then I am probably preaching to the choir. However, an ounce of prevention is worth a pound of cure. Get your birthday suit checked by your dermatologist at least yearly. Do self skin exams monthly. There is research that shows that having a significant other who helps do your skin exams also helps to catch skin cancers early. Also please try to prevent skin cancers and premature aging by using a sun block with antioxidants that is also broad spectrum against UVA/UVB/IR daily; using retinol nightly to reverse the damage caused during the day; wearing your sun hat, sun glasses and sun protective clothing; seeking shade; avoiding the peak sun hours of 10 AM to 4 PM; and if want to take it a step further consider taking Heliocare or Niacin. Email samira@johnsondermatology.com. Samira will help you schedule you an appointment to have your spot(S) checked and/or to have your entire skin checked.

In summary, the skin is the largest organ of the body and your window to the world. Protect your tatas but also protect your skin.

Stay skintastic, Dr.Sandy.

Botox isn’t Botox

When I found out I was pregnant I had no idea who to choose for a pediatrician. I called other mothers to find out who took good care of their children. I asked other doctors I knew who took the best care of babies. I called to see who had nurse practitioners or who sent acute illnesses to the ER. I did NOT however call to see which pediatrician was cheapest. On the other hand, when I found the hair dryer I just had to have all I cared about was the cost. I checked every on-line site I could find to get the cheapest price of the same hair dryer. Because no matter which online site I bought the hair dryer from it would come to my door step exactly the same. Now that hair dryer in my hands never could fix my hair exactly like my hair dresser (Caroline Mackey at Roots) could fix my hair. Who knows the feeling? Your hair looks so good when your hair dresser does it so you buy the same curling iron, shampoo, conditioner and hair spray but then when you use all the same tools your hair looks completely different! Never as good.

Botox is a tool. Just like that Hair dryer. If you take every single injector in the United States and take their Botox vials and set them on a counter they all come from Allergan (the company that makes Botox cosmetic)exactly the same. However, in whose hands that vial is placed makes all the difference. The injector may mix it any concentration he/she chooses, place it to lift the brows or drop the brows, make a smile symmetrical or make it crooked, shelf the cheeks around the eyes or open the eyes up youthfully and naturally. Good and bad results can come from a vial that once looked the same sitting on a counter. Just like that hair dryer that I searched all over the Internet for the best deal. Once it was in my hands I got okay hair-do results but once placed in my hair dresser, Caroline’s hands, I had the best hair I could possibly have. If it was placed in the wrong hands I could have my hair singed off.
That’s why Botox isn’t Botox. That’s why when you shop around for Botox you should be shopping for an injector, not a price. Shop for Botox like I shopped for my pediatrician, not my hair dryer. Ask a friend who you think looks great where she is injected. Call the clinic and ask what type of experience the injector has, did the injector train at an 8 hour course on a free weekend or was he/she trained by dermatologists or plastic surgeons? Ask how much they inject, 10 people a month or 100? Ask what awards they have won. Ask the person you’re talking to on the phone if they have had it done and why they trusted their injector. Johnson Dermatology offers Botox at $9-$12/unit depending on what program you’re in with our clinic. So I hope you know I don’t make these suggestions because we are expensive(we are competitively priced with other expert injectors) and I want to validate that. I make these suggestions because Botox may come in a bottle the same but I promise it goes out of the needle differently. I often joke that our clinic could run an episode of “Botched” from all the corrections Dr. Sandy and I perform. It’s not a funny joke. It’s scary and sad and I would love to prevent it from happening, even if it means the patient spends a few extra dollars. Thank you for trusting Dr. Sandy and I as your injectors. If you would like to come interview us in person because you’re interested in injections, then come this Friday, September, 29th and watch us inject live. We are going to have a lunch and learn at noon that day. Please RSVP to Dani@johnsondermatology.com or margaret@johnsondermatology.com if you plan to join the fun!
Have a Skintastic week , Nina

Derm Conference Fun Facts

I’m at a conference the rest of the week learning ways to improve the care I give to my patients. I feel so blessed to have patients that trust me with their skin. I take that honor seriously and enjoy learning and improving all the time. Thank you to Dr. Brad and Dr. Sandy for opening a dermatology practice in Fort Smith that continues to “deliver efficient, quality, compassionate, comprehensive, patient-centered skin care” (JD mission statement) and for allowing me to be a part of the team. With that being said, I am fairly certain the pearls I pick up at conferences are more exciting to me than most but here are a few from today I thought my readers would enjoy!

  1. One study showed that adding one tablespoon of peppermint oil to your Vaseline decreased “itch” 50% more than plain Vaseline.
  2. Lexus windows do the best filtering UV rays. (Currently considering a clear UV tint for my windshield found at California Customs in Fort Smith)
  3. Patients prefer white coats over suits and scrubs. How do you guys feel about patterns, leopard as a neutral and chokers? Asking for a friend.
  4. Chlorine Dioxide wash is highly effective for the hard to treat condition Keratosis Pilaris (red sand paper like bumps often found on upper arms). Fine it at www.asepticmd.com for about $20.
  5. A good alternative to my eczema patients who dislike the bleach baths idea is a tablespoon of apple cider vinegar added to moisturizer. Y’all know I love a good organic option!
  6. Rogain helped NAILS grow 0.5 mm more than placebo. Why didn’t I think of that?
  7. Low risk products for sensitive skin according to Dr. Zirwas the contact dermatitis expert: Cerave cream, Certain Dry antiperspirant, cleure toothpaste and Wella Koleston innosence hair dye. Has anyone heard of those last two? Anyone?
  8. New topical out for excessive arm pit sweat coming this year!
  9. New topical for removing Seborrheic Keratosis(brown crusty age spots) coming in December!
  10. It’s only 10 AM who wants another post this week?!?!?!

Please make sure you guys call the clinic soon and get on our schedule September 29th for cosmetic day! Discounted Botox, skincare travel kits free, lunch and learn and live injections! Don’t miss out! See you there!

Stay amazing, happy and skintastic! Nina

P.S. The conference is at the Hilton New Orleans Riverside (amazing location) so follow our snapchat and I will try to get some local photos for ya! Jdermatology

Eczema vs Psoriasis

With Dr. Google and all the awesome free information online sometimes it’s easy to diagnose ourselves at home. Often times patients tell me what they think they have, often times I agree. Sometimes I disagree. Dr. Sandy has been gracious enough to explain the differences between eczema and psoriasis. These are two very commonly confused diagnoses among patients and sometimes even health care providers.

superman

It’s a bird. It’s a plane. It’s superman. Sometimes that is what it feels like in clinic. It’s psoriasis. It’s eczema. It’s a rash. It’s a job for Super-dermatologist. Really though, most people don’t know or care to know the differences between eczema or psoriasis or any other rash. Most people just know they have a rash and they don’t want to have a rash. Well as dermatologists, we care about what kind of rash you have and what the best way to treat that rash is. Most people are fortunate and only develop self-limited rashes that resolve over a few days, weeks or months. Other people however develop rashes that last a long time. We call those long lasting rashes “chronic” and the two most common are eczema and psoriasis. A simple way to differentiate between the two is this chart

 

Eczema Psoriasis
Age when rash starts Usually first 5 years of life Usually after first 5 years
Where on body Usually  “flex” areas—bends of elbows and back of knees Usually “extensor” areas—backs of elbows and front of knees. Involves nails
Appearance Moist and eroded, “wet” Thicker skin, white scales, “dry”
Associations Asthma, allergies, itchy eyes Arthritis, obesity, metabolic syndrome

 

ps

sj

Above are 2 pictures taken from the internet to compare and contrast the 2 rashes. The top photo of psoriasis shows the well demarcated thick red silver scaled plaques on the elbow of an adult. The bottom photo of eczema shows the wet lichenified (accentuated skin lines) patches on the back of the leg of a young person.

Some of the treatments for the different rashes are the same but some are different and specific for the specific rash. I have been blessed in my careering many ways. One way is that I got to be involved with the research for the first “biologics” for psoriasis more than 20 years ago. Now, the Johnson Dermatology research team and myself, got to and continue to get to take part in the clinical trials for the first “biologic” for eczema, dupixint. We are also researching other treatments for both eczema and psoriasis. Since these treatments are not yet available to the general public to learn about them you get to (sounds better than have to) email Crystal who leads our research team at study@johnsondermatology.com.

Crystal will probably want me to also mention that we are also researching treatments for warts, acne, rosacea, and itch in addition to psoriasis and eczema. We are also researching treatments for kids who have acne, warts and psoriasis. I love clinical research which makes my inner nerd happy. I would be remiss if I didn’t also admit that I love cosmetic dermatology which makes my inner artist happy. It is truly a blessing to be able to work with an amazing group of people and be able to use both the left side (nerd) and right side (artist) parts of my brain.

Since Nina let me write a blog, I would like to take this time to brag on both Nina and Honey. The three of us have worked very closely together for more than 5 years. We practice very similarly. However, Honey is definitely more left brain. She excels in treating patients with complicated rashes. She is even recognized nationally for her approach to treating patients with psoriasis. Nina is definitely more right brain. She is so artistically gifted especially when it comes to helping people who feel “botched” (no I have not watched that show but I hear about it often) by someone who is offering a sale or does not fully love the skin as much as we love the skin. Nina appreciates symmetry, proportion and the natural look. The 3 of us make a great team. Adding in Dr Amy as our board certified dermatopathologist, my husband Dr Brad as a dermatologic surgeon, and Dr Nelson as both a dermatologist and a dermatologic surgeon—we have a complete skin care provider team. Together with the rest of the JD team—the entire team is needed–we are here to keep you skintastic.

Make-up 101

I frequently get asked what a good make-up is for skin. Unfortunately this is a complicated question. Just like I don’t treat all acne EXACTLY the same there are some general rules I always follow for everyone. I thought it might be helpful for you guys to know some of my make-up rules.

  1. Sunscreen in make-up is not important to me. There’s rarely ever a high enough quality sunscreen in it and no one is going to re-apply their make-up every 2 hours while out doors so you’re going to need a sunscreen anyways. Try the BOB, a brush on powder sunscreen that won’t budge your make-up. I keep mine in my car and apply on the way to work. Throw in purse for during the day, doesn’t melt. No mess, no wrinkles, no brown spots, no problem.
  2. If you have acne prone skin use a mineral based make-up. There are powder foundations that will still get you full coverage! Don’t believe me? Make an appointment with Margaret on September 12th as part of our Millenial Madness Month and get some specials and free make-up application including color match. E-mail Margaret@johmsondermatology.com before slots fill up.
  3. On the other hand, if you have dry skin a BB cream may be a good option for you. More mature skin really needs a good moisturizer before any make-up application. I recommend HA5 because it will plump the skin and make your make-up go on much smoother.
  4. Avoid the fancy-shmancy- gimmicky stuff. If it promises something you’ve never seen make-up do before, it’s probably a gimmick. If it has tons of fragrance and colors and additives it might irritate the skin flaring acne, rosacea, redness and worsening fine lines and dullness.
  5. Avoid high alcohol content make-up removers. They tend to dry the skin out and cause irritation. Especially around the eyes where the skin is very thin and already easily irritated. Try some Vaseline or lotion on the eyes then wipe away with a gentle wipe like Cetaphil cleansing cloths.
  6. Prep lashes with a moisturizer. Mascara can dry out lashes. I use the Jane Iredale PureLash. It’s a moisturizer in a wand that you just swipe on before mascara. It keeps my lashes happy and doubles as an extender. Winning.
  7. More mature lips should go for satins or creamy lip sticks and lip glosses. The newer matte lip stick fad is cute but the drying affect of some of the matte liquid lips will make lips appear more wrinkled. The teenagers have it all don’t they?
  8. Make-up will always be better with good skincare. Want to hide enlarged pores? Redness? Acne? Rosacea? Blackheads? Let us treat your condition first and then make-up won’t be doing the job alone. You will enjoy make-up more when you are enhancing your skin, not just covering it up. There is a difference.

We arent a spa but we sure have a great aestitician. Margaret is excited to be my new cosmetic coordinator and her years of experience at JD make her the perfect fit to the cosmetic team. Be sure you make it in September 14th so you can enjoy make-up, get to know her, get a free skin care consult and maybe even save some coin!

Have a great week skintastic followers, Nina