FAQS

It’s been awhile since I’ve given you guys the basic skin run down. I’m feeling nostalgic coming off a vacation and excited to talk skin. I couldn’t pick just one topic today so I thought a good old fashioned round-up would be nice. Below are my most frequently asked questions.

Q: What’s a good sunscreen?

A: Any sunscreen that has at least a 30 SPF, water resistant, broad spectrum and either zinc oxide or titanium dioxide in the ingredients. Drugstore options I use are Pacifica or bare republic. High end options I use are SkinMedica TD&R(if you didn’t guess that you don’t read my blog enough) and Elta MD.

Q: What make-up won’t make me break out?

A: A mineral based powder foundation. Sorry you gotta ditch that thick creamy stuff. Some say talc and silicone are ingredients that trigger acne. Try Jane Iredale if you like high end. That’s what I use when I want full coverage. A good drug store option is physicians formula.

Q: Does Latisse work?

A: Yes. That’s all, yes it has been scientifically proven to lengthen, thicken and darken lashes.

Q: When Botox wears off do your wrinkles come back worse?

A: No. I mean I’ve never let mine wear off enough to find out personally (I’m addicted) but logically speaking, no. As a matter of fact one treatment of Botox will make wrinkles better than never getting it at all because for those 3-4 months you weren’t etching lines deeper into your skin with muscle movement. Think of it like working out. If you exercise once a week you won’t be in As good of shape as if you work out everyday but it’s better than not working out at all that week. Botox once per year will result in less wrinkles at the end of the year than if you never had it but getting it 3-4 times per year will have the BEST results.

Q: Do fillers hurt?

A: It’s a needle, not a massage. I would love to tell you absolutely no pain whatsoever is involved but that’s just not true. The truth is that it’s just not a big deal. Hurts less than getting your blood drawn in my opinion. Just like beauty, pain is in the eye of the beholder. Some say it doesn’t hurt, some say it does but NO one has ever not had it again because it hurt too bad.

Q: Can I tan before my vacation so I don’t burn?

A: No. Benefit does not outweigh the risk. A tan gives you an SPF of 4 so guess what? You will still burn. Plus you will be at increased risk of getting melanoma(a cancer that kills) because of your tanning bed use.

Q: what is a good lotion?

A: Vaseline for the body. YASSSS! I like to put mine on in the shower and let hot water run over it then after pat dry rub it all over warm and soft. I use HA5 for my face and recommend it for you if you want a super moisturizer that erases lines within 15 minutes and has anti-aging benefits. I recommend a plain equate, cetaphil or cerave to my acne prone teens for face.

Q: Where do you get your sun protective clothing?

A: I was shocked how many people asked me this at the beach!!! Pale really IS the new tan! Www.theseea.com and www.cabanalife.com and www.swimzip.com and I will use the athletic section at Target as swim wear sometimes too.

Q: How can I not get sun during the Summer when I do so much outdoors?

A: You inevitably will get some but be smart. I spend a lot of time at the lake, my kids love pooltime and the beach. I take my kids to the waterpark frequently. I spend a lot of time in the sun but I am sunsmart. I seek shade. Avoid the hottest parts of the day outdoors. Wear sun protective clothing including hats and sunglasses. I always wear sunscreen and reapply appropriately.

Q: What skincare should I use that doesn’t cost an arm and a leg?

A: Sunscreen every morning and retinol every night. Those are my must haves. Splurge on the retinol so that you can use it successfully. The SkinMedica retinol is $82.31 with tax. That will last you 3 months. Without having to buy any other products, you’re saving. Go right now and pull out all your skincare products from your bathroom that gave you little to no results. Guarantee you it’s WAY more than you realized you were spending. Be smart when you invest in your skin!

Q: Are you a doctor?

A: No. I am a licensed health care provider practicing in Dermatology for the past 5 years. I’m trained by board certified dermatologist and work very closely with them, they are literally steps away at JD. I know my limitations. If I don’t have the answer I will try my hardest to find it for you. I love Dermatology, I love skin, I love cosmetics, I love my community and most of all, I love my patients. Thank you to all my patients who have trusted me and let me do what I love every day. It’s not work to me, it’s fun.

If you have any other questions you would like to ask me shoot them in the comment section or better yet on JD snapchat (jdermatology). Currently we are reviewing sunscreens on snapchat in a sunscreen series. Thank you  so much for reading my blog, it means the world to me. My successes and happiness are because people like you believed in me, trusted me and then came along for the ride.

Life is good, skin is Skintastic, keep it that way,

Nina

 

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Hairy Situation?

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Look who’s back! Back again! Dermatologist are experts on hair, skin and nails. Dr. Sandy was nice enough to write a guest post all things hair. Here it is:

As a dermatologist, I love skin, hair and nails.  As an Italian, I know how important hair is to your image.  Most people want healthy beautiful hair on our scalps.  Some men want beards.  Most women do not want facial hair.  Some cultures want body hair.  Other cultures do not want body hair.  Hair, or lack thereof, often defines us as much as our skin color and skin hygiene.  Aside from dermatologists and hair dressers, there  are so many people and companies who “specialize” in helping people grow more hair or diminish hair. In the July issue of the Journal of Drugs in Dermatology, Drs DiMarco and McMichael attempted to debunk some hair loss myths.  The article is really good.  I plan to restate some of their truths and add a few of my own.

 

Telogen effluvium affects most people sometime in their life.  It is hair shedding that lasts a few months after a physically or emotionally stressful event…most commonly after having a baby.  It usually resolves on its own but can persist especially if you have low iron, thyroid issues, chronic stress or take certain medications.

 

Studies show that by age 50 years, 50% of men and women will suffer with some hair loss.  Topical minoxidil treatment is one of the most studied and recommended treatments for hair loss.  Unfortunately, a few people may actually have some hair shedding in the first few weeks of starting minoxidil…this can be frustrating but it is temporary.  Also frustrating is that it can take up to 12 months of daily minoxidil use to see benefit.

 

There are so many natural remedies and supplements touted to grow hair.  One should consider their research and financial claims.  Biotin and iron have been studied to help hair growth.  Biotin helps if you are low in biotin.  I don’t usually test for this.  I was taught that your iron stores (ferritin) need to be at least 90ng/ml for optimal hair growth conditions.  I often check this. Onion juice and rosemary oil have also been shown to have some benefit in clinical trials.

 

Since hair grows from the “stem” cells in the scalp, typically whatever you do to your hair will not affect how hair grows. Traumatizing your hair with wearing tight braids, vigorous hair brushing, hair pulling, excessive heat or chemicals will lead to hair breakage and subsequent hair loss however.

 

Thankfully there is research being done in maximizing the hair on our head.  There are clinical trials being done for new medications to treat alopecia areata as well as hair cooling devices to decrease hair loss due to chemotherapeutic agents as well as hair loss due to aging.  Studies looking at platelet rich plasma, PRP, for hair loss are very promising.

 

All of that deals with not having enough hair on the scalp.  As for having too much hair on the body;  one can shave, tweeze, wax, sugar, pluck or laser.  On a personal note, laser hair reduction is one of the best things I have done for myself and I highly recommend it.  Please remember that in the state of Arkansas, any laser is considered a medical treatment and MUST be performed by a physician or supervised by a physician.

 

“Hair”  is to a skintastic day for everyone. Dr. Sandy

Dr.Sandy Talks Derm

Being a dermatologist is skintastic. The skin is the largest organ of the body. Everyone has skin. Skin is our window to the world. Helping people to have more beautiful skin and to love the beautiful skin they have been given is my favorite. Treating diseased skin is so rewarding. However, it is so frustrating when we are not able to help patients with their skin when they are suffering. Fortunately, medical breakthroughs are occurring at an incredible pace. When I started twenty years ago, we had very few treatments for psoriasis. Now, I can’t watch a television show or read a magazine without seeing an ad for a new treatment for psoriasis—it is so exhilarating that we have so many options. It is also exciting that people are becoming aware (albeit through advertising) that there are treatments for their conditions. It is also so exciting because we have been involved with the research for some of these medicines. At Johnson Dermatology, we are performing clinical trials (and offering not yet available medicines) for acne, rosacea, warts, psoriasis and eczema. I love my job.

Recently, two patients really touched my heart and have renewed my energy and zeal for skin. For convenience, I will refer to both of them as women in their mid-forties since I was totally able to relate to both of them on so many levels. The first patient suffered with eczema her entire life. She was always itchy and was treated with so many topical and systemic (by mouth) steroids that her entire body has side effects. She participated in one of our clinical trials and for the first time in her life had clear “normal” skin. She was able to sleep normally. It was amazing to watch her skin and personality transform. It really was similar to watching a butterfly emerge out of a cocoon. Simply breathtaking. Now, that product is available for everyone and she is able to continue using this medicine. She is a new person. Seeing her suffer for many years without having many options for her was extremely frustrating. Being able for her to participate in a clinical trial and get better was so rewarding for her and me. She taught me to always smile through adversity and never give up. She inspires me.

The other patient who touched my heart recently suffered with debilitating TMJ or jaw pain for a few years. She was so depressed from the pain. She said she had seen a variety of dentists and doctors to no avail. She had tried numerous and various treatments to no avail. She was considering surgery as her last resort. One of her friends talked to her about Nina and me injecting Botox. She did not know that botox injections were an option but made an appointment to talk. She decided to be injected with botox. She called 2 weeks after her injection to let us know that she was “without pain for the first time in a long time”. She returned recently because she noticed the pain was returning and wanted another treatment. She said she slept better and felt better about life. She taught me to always appreciate life and not to take good health for granted.

There are many other patients who inspire me and teach me. Every patient teaches me something. I am thankful and grateful for every patient who trusts the JD team for their care. I hope we always exceed your expectations.

Have a skintastic day,
Sandra Marchese Johnson MD, FAAD
Johnson Dermatology

Filler Crash Course

I’m giving you the break down. This is a basic, beginners crash course on different “filler” options.

1. Sculptra-not immediate, needs to be drawn up prior to day of injection. Needs to be massaged by patient to prevent nodules. Not immediate results. Best results 2 months after injection day. Lasts about 2 years but can’t win the fight against voluma so we don’t use much (if any) in our clinic anymore.
2. Restylane family-tends to be lumpy and have more swelling and bruising IMO (and SJ) plus only lasts 6-9 months so we don’t use this a lot in our practice.
3. Radiesse-Not a hyaluronic acid so it can’t be dissolved. It’s calcium hydroxyapatite. It is what we use in the hands-one syringe per hand lasts about a year.

Now let’s get to the good stuff……. The Juvederm Family

1. We love that the Juvederm fillers are by Allergan so people can use Brilliant Distinction points to get discounts with SkinMedica products, Botox and Kybella.
2. The vycross technology means lasts longer, less swelling initially. These are Voluma, Vollure, Volbella (that’s thickest to thinnest).
3. Not in a vycross technology are Juvederm Ultra Plus and Juvederm Ultra. We almost always use the first(Ultra Plus) because it is a little thicker and gives us more robust results.
4. The thickest of the family is Voluma-it lifts. If you have someone that complains of “sagging” or volume loss/ “hollows” then Voluma is your #1 lift power filler. It is immediate and lasts 2 years! However, we will not be 29 those entire two years as we continue to age we will continue to drop and be 31 in two years so patient needs to be seen every 6 months to assess for need of touch-up.
5. Vollure-thinner than Voluma, thicker than Volbella. It’s right in the middle of Voluma and Volbella and that’s how we use it. Someone with deep etched in lines around the mouth that are too deep for volbella but too shallow for Voluma will get Vollure. This lasts 18 months! That’s longer than any other FDA approved filler for nasolabial folds. It’s target is 20-30 year olds that don’t have the “sagging” but starting to get the nasolabial fold. Results we give them with Vollure are treating deep etched in lines, nasolabial folds and for some candidates even lips. Not to put her on the spot but check out what we did for Honey with Vollure next time you see her in clinic!

6. Volbella-The thinnest vycross technology filler. It is FDA approved for lip lines. Great for people that want lines treated but no plumping of the lips. Great for small etched in smile lines. This product doesn’t tyndall (look blue when put very superficial) so we use it in the tear troughs and fine superficial lines. Great for someone who wants very subtle lip definition. Lasts about a year. Call and make an appointment for a cosmetic consult with Dani and check out her volbella enhanced lips!
7. Juvederm Ultra Plus-Our go-to product for lips. It’s great for plumping the lips, treating deep lip lines and redefining the lip border, cupids bow and philtrum. Lasts about a year.

To simplify: voluma is like silly putty, Vollure is like pudding and volbella is like icing. Juvederm Ultra plus is different because it isn’t a vycross technology so it’s like jello. It plumps stronger than pudding does but it’s just a completely different substance.

Any questions please feel free to ask me…..
At the clinic! Immediately because I love talking beauty, refreshing and injecting!

We have a few Vollure coupons left so call today to snag your appointment before they are gone!

Do you watch our videos on Facebook? Follow us on snapchat? Let me know what you want to see in the comments!

Stat Skintastic

xoxo, Nina

Sunscreen for Kids

What sunscreen should I use for my kids? This has to be the number question I get as of late. What better time to answer it than right here, right now? First of all I must say it’s great to be a parent. Happy Fathers Day to all the great Dads out there! One of the magical things about parenting is we are the dictators. Although there may be a place for democracy in the family setting, as a Mother I get to say “because I said so” and “do it or go to time out”. I get to essentially force my children into doing things. Why? Because they can’t survive on Oreo cookies and cherry slurpies and someone has to keep them alive. After survival, I would also like to raise productive, good citizens into our world. So when my kids say they don’t want to wear their swim shirt or sunscreen I pull the Mom card, trump them, and they do it anyway. Since UV damage to the skin is a carcinogen much like cigarettes I encourage all you parents out there to do the same for your children. Teach them how to be healthy.

But, before sunscreen give them sunprotective clothing. Make sure they wear a wide brim hat, sunglasses, swim shirts and pants (yes pants). If you take this simple step, sunscreen for your kids will be so much easier!

Then pick a sunscreen:

Just like for adults you want broad spectrum, at least 30 SPF, water resistant and a physical blocker. To find a physical blocker look for one of these two ingredients: zinc oxide or titanium dioxide. If your child’s sunscreen hits all 4 of these requirements and doesn’t irritate their skin you’re golden. Here are a few other tips:

For sensitive skin children, find a fragrance free physical blocker.

Look for less than 10 ingredients.

Some good brands are Bare Republic, Kiss My Face, Elta MD and the BOB.

Grab a stick sunscreen for around the eyes to avoid sunscreen in the eye.

If using a spray make sure to rub it all over with your hands for good coverage. A “spray and go” technique will leave areas of skin without protection.

If it leaves a white residue that’s a good thing. It allows you to see where you have good coverage. It’s hard enough to lather a two year old in sunscreen so I’m all about what makes it easier on me.

I’m glad to hear you’re all lathering your kids up this Summer. Now if we can all just work on taking care of ourselves as good as we take care of our children. That’s the real struggle.

Hope this helps you protect those little angels. Just think about how many brown spots, wrinkles and possibly even skin cancers you are saving them in the future! I guarantee you when they are young adults, they will be forever grateful to you for it!

Happy Fathers Day to all the Dad’s out there!

Nina

JD Laser Toolbox

Sometimes people ask me how I got to JD. I had always worked in Intensive Care Units and Emergency Rooms. I traveled in this setting from California to Florida and I loved my job. So after 7 years of that how the heck did I land in derm? The PDL laser, that’s how.

Dr. Sandy and Dr. Brad had just opened their practice in Fort Smith and Dr. Sandy had a booth at the FSPD health fair to spread the word. Jarrard(my cop husband) stopped by her booth and informed her he was always red but knew she couldn’t help him with that problem. Never tell Dr. Sandy she can’t do something. She very quickly informed him he had Rosacea and she had a laser that would semi-permanently solve his problem. This was life changing. My husband was on the news regularly as the public information officer and people commonly asked him why he was so red. Was he mad, nervous or anxious? He wondered why as well and always felt frustrated to not have answers. It was a nuisance on top of an embarrassment. That’s the thing about the skin, it’s very difficult to hide your condition. He could very easily keep his high blood pressure, high cholesterol and heart stents a secret (if it wasn’t for me being his wife). He could never hide his rosacea. So monthly he went and saw Dr. Sandy for her to personally laser him. She changed his life and attitude with that laser. So much so that he made me go with him to his future treatments so I could see how amazing Dr. Sandy and her laser were in person. I saw what results she achieved and it was much more than the redness on his skin. That’s where my love for Dermatology began. Fast forward 10 years and here we are at JD with 4 laser rooms and 10 devices with a variety of results we can achieve. We have the largest laser center in the River Valley so I asked Dr. Sandy to write a blog about our lasers and here it is…….

 

As the granddaughter of a carpenter and a concrete man, I was taught the importance of having the right tools for the job. They taught that just because you have a hammer, not everything is a nail. As a child, I wanted to enter the family concrete business….I was denied and was told I needed an education. Reflecting on this, I am grateful because I love treating skin so much. Also, it may be that because they let me play with their tools as a child I now like to have so many tools in our armamentarium in our family business of Dermatology. My favorite tools in the clinic are the toys/tools that I and our well trained and physician supervised laser techs get to play with daily.
I love lasers and was fortunate to be trained by experts at UAMS and Harvard. I was honored to use some of the latest technology when I was on faculty at UAMS. I learned to respect lasers and what they can do when I served on the Laser Committee for the Arkansas State Medical Board. These experiences early in my career further enhanced my desires to have a lot of laser tools as well as my desires to provide the highest level of patient outcomes and experiences.

So now at Johnson Dermatology, if you tell us what you would like to enhance, we can tell you if we have a tool or tools for that. As Alice, one of our lasers techs, likes to say…”we have the most comprehensive laser center and the best trained team to use those lasers”.

Acne…we can treat with the Blu light, PDL or sublative

Acne scars…we can treat with PDL, sublative, YAG, IPL or subcision

Red marks, spots, birth marks, facial redness, or broken blood vessels…we can treat with PDL, KTP, IPL

Psoriasis…we can treat with PDL

Excess hair…we can treat with YAG for patients who have very light colored skin to very darkly colored skin. We can also treat with the motif for a more comfortable treatment experience

Loose skin…we can treat with YAG, sublative, PDL or velashape

Stretch marks…we can treat with PDL, YAG, sublative, velashape

Want 32% fat reduction that is permanent and painless…we can do that with velashape and ultrashape power

Unwanted tattoos…we can rid those with PicoSure or ATV

Brown spots…we can treat those with creams, peels, ATV, PicoSure, PDL, IPL
Yes, we have a lot of toys and we have fun playing with them for the benefit of our patients. The PDL and YAG were the first lasers we purchased for Johnson Dermatology in 2006. The V-beam perfecta we use now is the third version of the PDL I have used; and is still my favorite laser of all time. One of my favorite patients of all time was a sweet guy with a tattoo on his arm that he wanted gone before his baby was born. He challenged me and we accomplished his goal with the laser. Together our laser team has more than 40 years of experience and countless stories of these success stories. We are so thankful to every patient who has trusted us for that past 11 years and for every patient who will trust us in the future.

I would like to take this opportunity to offer Congrats to Dr. Bise on his retirement after a very successful plastic surgery career. I also want to thank him for trusting us with his PicoSure and KTP lasers…the latest tools we have added to our laser toolbox. We will do our best to make him and his patients satisfied.
Stay skintastic!

Skin Tips for Mom

Happy Mothers Day. I dread the day that I don’t have two little girls running around (mine are 2 and 4). Whoever said “the days are long but the years are short” was exactly right. There are some  skin tricks every Mom should know in my opinion. Let me share them with you.

  1. Laser hair reduction. I’m a pretty hairy chick. By the time I got done shaving my bikini line, legs, abdomen, underarms and feet(yes, I might be from the shire) in the shower my kids had enough time to destroy at least two rooms, maybe three. Laser hair reduction is once monthly for 3-5 months and boom daily time saved approximately 20 minutes.
  2. Sleep deprivation. It’s part of motherhood. First they don’t sleep through the night, then they are scared of the dark, then they just don’t want to be alone, then they have first love problems, it just goes on and on and you never sleep again. Keep those eyes looking fresh with Botox cosmetic for crows feet and to lift the brows and upper lids. I also love sublative for around the eyes. It’s radiofrequency that tightens the skin. Try keeping your under eye cream in the fridge. The cold will decrease swelling that accumulated while you slept and the moisture will create a smoothing effect.
  3. For the kiddos. Keep over the counter hydrocortisone handy. Use it on bug bites, sunburns(no judgement, just job security) and “poison ivy”. Keep Vaseline for cuts and scrapes to prevent infection.
  4. Use sun protective clothing on you and the kiddos. Who has time to grease down an entire wiggly 2 year old with sunscreen every two hours while outdoors? Long sleeve swim shirts, pants and wide brim hats. Cut the sunscreen to only areas of the body that can’t be covered with clothes and you’ll get better sun protection and save those precious minutes moms live for, you know when you get to pee alone.
  5. Basic skincare. All you really need is a sunscreen every morning and a retinol every night. The other stuff is extra. Use sunscreen to prevent damage to your skin and retinol to reverse any damage your skin might receive. Keep it simple for you because keeping up with your kids’ schedules is complicated enough.

May is skin cancer awareness month and we are celebrating with a sunscreen special. In the month of May, if you buy a brush on block you get a free refill. That’s a $17 value. The BOB is everyone’s favorite sunscreen for reapplication because it’s a clear powder that goes on invisible and dry. If you haven’t tried it, now is the time.

 

See you at the clinic this week, stay Skintastic Moms!

Xoxo, Nina

Fort Smith

Doesn’t it feel good to get home after a vacation? There is something about sleeping in your own bed that can’t be explained. Or your own shower. You sure do get used to your own shower head, don’t you? If you follow us on snapchat (jdermatology) then you saw some of my beach vacation. I am relaxed, recharged and ready to make my mark on Fort Smith. I personally chose Fort Smith as my home. After being born, raised and educated in Fayetteville it wasn’t a far leap from home but sure felt like a different planet when I moved here in 2006. I absolutely love my life here. Good food, great boutiques, booming downtown and the best people around. Dr.Sandy has chosen Fort Smith as her hometown too. We both were encouraged by our husbands to chose Fort Smith but I admire how she has made her own mark on The River Valley. We enjoy being a part of Fort Smith and serving all your skin needs. Listen to what Dr. Sandy had to say in a recent journal article she wrote about Fort Smith.

Life is worth living in Fort Smith.  This was the motto of our former mayor Ray Baker.  I believe it.   I also believes what goes around comes around.  After all, 1980’s hair and clothing are hip again.  Anyway, in the very distant past, Fort Smith was the mecca for health care. But then, corporate America took hold of health care and that changed….for the worse.  Doctors left Fort Smith in record numbers. We don’t need to harp on that era.  It was during this dreary period however that my husband wanted to move back home and open a Dermatology practice together.  My husband loves his hometown and he was unaware of the downturn in the medical community when he insisted we move to Fort Smith (Greenwood actually) to open our Dermatology practice after his derm surgery fellowship in 2006.  After all, he insisted, if there are not many doctors we should be busy.  (I love him and how he always look at the bright side.) He was right.  Even though Fort Smith was not my hometown, it is now.  I love it here.  I love the community.  I love that it is family oriented and is a great place to raise our children.  I love it so much that I love to give back to our community.  I love being a part of Leadership Fort Smith, the local Chambers of Commerce and various committees.  Life is worth living in Fort Smith (and Greenwood).

 

Fast forward to present day and Fort Smith is thriving again.  Many physicians are moving here and enjoying it.  Our Chamber of Commerce even started a New Physician reception a few years ago.  In fact, even we were able to recruit a wonderful Dermatologist who joined us last year.  For those of you interested, we (Johnson Dermatology) are still recruiting as are the hospitals and other groups in town…for all specialties.  There seems to be a new Mercy clinic with new primary care physicians opening every month.   There is actually a lot of collaboration occurring between the local hospitals…at least in my opinion.   We have an impressive Good Samaritan Clinic.  The UAMS West AHEC wins many awards.  The residents who rotate at our clinic from UAMS West are the best and brightest.  IM Well clinics started in Fort Smith about 10 years ago with forward thinking physicians and has grown tremendously with far reaching benefits for employers, employees and communities.  Health and Wellness programs are thriving.  We are fighting the good fight and we are winning.

 

The first class of medical students will start in a few months at our new medical school.  I was overwhelmed by the facility, technology, faculty and campus of the Arkansas College of Osteopathic Medicine.  I was told there were thousands of applications for the about 100 positions and the average MCAT score was 3 points higher than the national average.  The people behind the medical school are working with other community leaders and have big plans to help our health care system and health care education in many ways to help our community for years to come.  I think this collaboration is an important part to the improved health and health care situation of our community.  Don’t get me wrong, there are still naysayers and people who belittle and don’t play well in the sandbox.  But in general, the situation continues to improve.  Our trails continue to lengthen.  We have had a marathon for 3 years.  We have impressive bike races.  Our economy is steadily growing.  Physicians are serving on multiple organizations.  Our university, UAFS, is thriving in athletics and acadmeics. Health care, education, family values, quality of life—what else does one want or need?

 

In summary, life is worth living in Fort Smith.  If you don’t believe me or would like me to show you, let me know.  You can reach me by phone, email, website, Facebook, Instagram, twitter, Snapchat, or even snail mail….we have all of those in Fort Smith.  Even if you do not make it to Fort Smith, I hope your life is worth living wherever you are.

Stay Skintastic.  Dr. Sandy

We have so many exciting things coming to Johnson Dermatology. Hope you guys make it out to see us soon! Have a great rest of your week! Nina

 

 

Skin Cancer Awareness Month

Did you guys miss me this weekend? I missed you too. I totally forgot to post because I was busy celebrating. My youngest turned 2 and I turned 29 again. I have lots of blog posts stocked up from Dr. Sandy and myself so get excited for the future of “the skinny on skin”. This week our newest Dermatologist at JD, Dr. Nelson is guest posting. He specializes in skin cancer surgery and is the perfect addition to the JD team. He has a beautiful wife, Ashley and two little, little ones. Did you see the newborn picture of his son Grant on our facebook? Want to meet him in person? Now is the time to call the clinic and let Dr. Nelson do your skin cancer check. It’s a great way to get to know him and welcome him and his family to Fort Smith. Plus, what better way to celebrate Melanoma Awareness Month than with a full body skin exam? While you’re here ask him what skin care products he uses, his skin is JD flawless. (#Brotox) Here is what Dr. Nelson has to tell us all about skin cancer…..

May is Skin Cancer Awareness Month. This month is dedicated to educating the public about the importance of skin cancer prevention, diagnosis, and treatment.

 

Skin cancer is the most common form of cancer in the United States, with 3.5 million new cases diagnosed yearly. Approximately 1 in 5 people will develop skin cancer during their lifetimes.  There are three major types of skin cancer:  Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC), and Melanoma.

 

BCC and SCC are the two most common types, and have a very good prognosis if detected early. Left untreated, they will continue to grow and possibly spread.  Our clinic diagnoses and treats over 2,500 of these skin cancers in our community per year.

 

Melanoma is the 3rd most common type of skin cancer, with about 140,000 newly diagnosed melanomas per year.  Melanoma is the type of skin cancer that can spread and cause death.  We diagnose approximately one new patient with melanoma per week.

 

Some of the most common risk factors for skin cancer include exposure to ultraviolet radiation from the sun or tanning beds, a history of sunburns, and having light-colored skin. Thankfully skin cancer can be prevented in many cases by protecting their skin; this includes avoiding tanning beds, avoiding the mid-day sun, wearing wide brimmed hats, broad-spectrum sunscreens, sunglasses, and sun-protective clothing.

 

Dermatologists are the experts in skin cancer detection, diagnosis, and treatment. Every patient is unique, and treating their skin cancer treatment must be individualized.  Our team is highly trained in all aspects of skin cancer management and offer a full range of treatment options.

 

In May, dermatologists across the country will be offering free skin cancer screenings in their community. In the River Valley, Dr. Sandy Johnson and I will be offering free skin cancer screenings on May 1st and May 4th in conjunction with the Reynolds Cancer Support House.  You can contact the Reynolds Cancer Support House at 479-782-6302 for more information.

 

If you are unable to come to one of the free screenings, we would still encourage you to contact our office at 479-649-3376 to schedule your yearly skin cancer screening.

 

Garrett Nelson, MD

Board Certified Dermatologist

Fellow of the American Academy of Dermatology

 

Like This?

Haven’t we all wondered why there is no “dislike button” on Facebook? I can only assume it’s because disliking something feels mean and gives negative connotation. I guess that’s a vibe Facebook doesn’t want. They want a place of happiness, positivity and (most importantly) all are welcome here.

Even if we don’t want to admit it we all feel the need to be liked. Last night at 8:30 PM as I was checking out at the grocery store my 2 and 4 year old daughters were climbing all over the carts and pulling at me and being toddlers. The woman behind me said “oh they are so sleepy, huh?”. If I responded truthfully I would have told her how they never go to bed before 9 on weekdays and 10 on weekends. How they climb all over the place and act more like apes than humans most public places. Explain that they only mind other people and my voice goes directly in one ear and out the other. But that’s not what I said. I wanted her to like me and think I was a great Mom not a terrible Mom that had her hooligan toddlers out past bed time. So, I just laughed and explained how they took their time at the restaurant for dinner so we were out later than expected and my sweet innocent kid’s were just worn out and ready for bed. Not a lie, but the truth twisted into a way this random stranger would still like me.

This need to feel liked drives us to act a certain way. It’s why I sometimes avoid product reviews on my blog. I don’t want the people that sell the product or make the product or use the product to not like me. I have realized this is a disservice to my readers. I don’t recommend things based on feelings, money or friendships. I recommend products and procedures based on science. I have a masters degree in the science of nursing. I am literally specifically trained to practice evidence based (scienctifically founded) nursing. So since Bridgett and I have been reviewing products on snapchat we have had multiple requests for the Rodan and Fields review. I thought it was more fitting to put it in a blog but if you want a quick review on any product whatsoever, just snap us (@jdermatology) and we will shout it out.

The unblemish regimen was most requested so that’s what I’m going to address today. If you like this review and want to learn about another regimen they offer just ask me in the comments.

According to the Rodan and Fields website the Unblemish regimen is $120 before shipping. Here are the products/steps with my review.

  1. Sulfur wash. I think sulfur wash is a fine wash for acne treatment. This one however has 40 ingredients (I counted) and one of them is alcohol which is drying. Another is red dye which can trigger perioral dermatitis. And then there is fragrance (yuk) which can irritate and inflame the skin. I would pass.
  2. Second step is a toner. I generally do not recommend toners. No offense to this specific toner I just find them to be more drying and irritating than helpful. I pass on all toners without prejudice to any specific toner.
  3. The third step of the regimen is the “dual intensive acne treatment”. Its active ingredient is benzoyl peroxide 5%. Benzoyl Peroxide is an ingredient that I recommend all my acne patients use if they have never had an intolerance before. Here’s the thing about this specific one- it’s got over 40 inactive ingredients that are unnecessary in my opinion. Number one inactive ingredient is water, number three is benzyl alcohol. This is 2 chambers of 0.76 ounces. Now here is my real problem. Go to Wal-Mart and get equate brand benzoyl peroxide gel 10% and it only has 6 ingredients! Simple basic- gets the job done for $3.13 in a 1 ounce package. I mean….. you pick.
  4. The final step in the regimen is an oil control lotion broad spectrum SPF 20. Now that just annoys me. If this is a truely dermatologist made brand then why only SPF 20? The American Academy of Dermatology recommends an SPF of at least 30 and most derms agree. I’m thinking in my head “girl if derms really put their minds into this, they at least would have gotren the sunscreen right!”….. c’mon sunscreen is like the peanut butter to our jelly, the fries to our cheeseburger, get it together!

Overall I do like that this regimen has a benzoyl peroxide and that it is only 4 steps. I don’t like that there is no retinol. Any derm expert will tell you that after benzoyl peroxide you should be on a retinol or prescribe you a retinoid if you have acne and aren’t pregnant or breastfeeding. I also don’t like the price point. In my opinion you can get the same active ingredients MUCH cheaper. I don’t enjoy talking about products I don’t recommend. It makes me feel like I am gossiping behind people’s back. But I consider all my readers my friends and I am just giving you my opinion. I follow the American Academy of Dermatology guidelines for treating acne which is evidence based. There are lots of opinions out there and I hope mine doesn’t hurt anyone’s feelings. I must say that particular sunscreen hurt my feelings though. I do hope that my opinions help someone’s skin. Someone who might read my blog and go to wal-Mart and get some equate BPO and have less acne for $3.13. If I help just one person, then it’s worth the few that may not like me. We do everything with a purpose, right? Sometimes it can’t just be so that you like me.

Happy Easter, hope you’re hoppy with this blog, Nina