Monthly Archives: January 2014

Working Out and Your Skin

This is the time of year that a lot of people flock to the gyms. Some of those people will only be there a couple months while others work out year round. For those of us that have a workout routine in our lives we usually have a group of friends that keep us in that routine. Runners, cyclists, yoga folks, we all have our little group. For me, its a barre class.  If I miss a week I miss my little barre instructor and barre family. So this post is dedicated to them because if you work out with me you should have healthy skin, right?  And to all those people upping the ante on their workouts this month, take care of your skin too please!


No make-up and dolled up hair-do’s please. You know who you are. I’ve been guilty of it too, I must admit. Back in high school I may or may not have gotten up on that treadmill, hair done and make up on, beep boppin along as if to be acting out a scene from Baywatch. Not only was the residue from all that hairspray triggering back-ne but every time a piece of hair got in my face I would transfer all that bacteria and dirt onto my sweaty face while taking my hand and throwing my hair back over my shoulder. Plus if you wash your face before and after a work out (to get that make-up right) and in the morning and at night thats too much! That will irritate your pores causing inflammation and acne.


Antidandruff shampoo is your friend. Getting hot and sweaty is the point, thats good for you overall. But in skin creases such as the groin or under the breasts, yeast and bacteria love these hot and sweaty areas and can cause yeast acne or rashes. Try using antidandruff shampoo as a body wash after your workout. This will cut back on the normal flora that may try to over grow and cause problems for your skin. Be careful not to get 2 in 1 shampoo with conditioner. You don’t want conditioner residue on your skin.


What you wear matters. If not wearing make-up gets you down then wear some cute workout clothes to make you feel pretty at the gym and motivate you.  Choose something made of fabric that wicks the moisture off your skin. Wearing fabrics that lock all that moisture onto your body can also perpetuate yeast acne and rashes. Check out  It’s stylish stuff with lots of different fabrics. Also buy a good pair of shoes so that your precious skin doesn’t get any blisters.



Be cautious of what touches your face. Those towels at the gym can be rough, pat the sweat off, don’t rub that rough towel all over your face and irritate the pores. Try not to take the dirt and bacteria on workout equipment with your hands to your face. Take your gentle face wash to the gym showers. Don’t use that high fragrance, pore irritating shower gel because its convenient (I promise you won’t offend your gym).


Step up your skin care regimen too. For back acne thats hard to reach, try a spray. I like the Glytone back acne spray because you can spray it upside down and easily apply to your own back. The salicylic acid will help remove excess dead skin cells and  P. acnes bacteria that could be causing acne. Try a nano-silver infused soap like the one sold at  It can be drying to the skin but it is known to remove body odor and breakouts.  Warning though, its $54 bucks for a bar of soap.


Shower please. This seems silly right? Well we live in a busy world and everyone’s trying to get ahead. Don’t workout and then jump straight into getting the kids to school, errands, work, etc. etc. Take 10 minutes to take a shower and cleanse your skin immediately after your workout.


Got hyperhidrosis? No, that isn’t a deadly disease.  Simply said, it’s just a big fancy medical word that means “excessive sweating”.  It can be really bothersome after a workout when your arm pits just keep sweating for what seems like all day. We can inject Botox into your armpits to decrease sweating or you could consider prescription strength antiperspirant. Sometimes laser hair removal of the armpits decreases stinky, sweaty pits. Before you ask, the answer is NO. Stopping the sweating from your armpits will not make you overheat and pass out during your next workout.  You have plenty of other body surface areas from which to sweat.  You might want to make an appointment with a dermatologist to discuss your options and which one suits you best.


Working out is so good for body, mind and soul. I hope you all find happiness in a good workout like I do.  Just don’t forget your skin is the largest organ in your body and it deserves some love too so take care of it during your workouts this year!  Hope to see you all soon at the clinic!


Pregnancy and Your Skin

Your social media feeds are a dead give away to your age.  They are literally directly related. For example, my parents feed is recipe and quote shares and comments that only half make sense. My college attending step son has a feed full of party pic’s, concerts and things that at are now much too fun for me. My school age niece has #selfies of herself, her with her pets, her with her parents, etc. And then lastly when I roam my social media at the ripe old age of 29 I see pregnancy and babies. Almost everyday there is a new friend announcing they are expecting or a pic of their new angel. So this post is a shout out to all my social media friends, skin, pregnancy and babies.


Prescription acne meds while pregnant. For acne/rosacea you can’t have retinols/retinoids (the work horse topicals of acne) so your left with two gels that are considered generally safe in pregnancy. Finacea and Metrogel. Warning: don’t let the pharmacy change your metrogel to metronidazole cream. Although it is a more cost effective choice and both have the same medicine its the vehicle the medicine is in that helps your acne and rosacea. This is a good tip for those not pregnant as well. Also, in my personal experience the Finacea burned my skin so I kicked it to the curb. Maybe you will have better luck.


BLU-U blue light treatment- The BLU-U is a blue light that you sit under, usually twice a week and it kills the P. acnes on your face. P. acnes are the bacteria that play a role in causing acne. It’s not painful, it doesn’t burn. This is a treatment that we use often in non-pregnant patients with acne, and its safe while pregnant! I recommend this as a 16 minute relaxation time to sit quietly and enjoy your pregnancy in solitude.  The fact that it is good for your skin is the bonus!


Clarisonic. This is my daily skin massage. If you’re an exfoliator, scrubber, bead-using type of girl-STOP and get a clarisonic. It gently washes your skin without causing inflammation and irritation to your pores which can cause acne. If you’re acne prone, try the acne brush head, its gentler. They have lots of products to chose from including longer handles for “backne” and even one for the feet.


Stretch Marks– These are caused by a tearing of the dermis, the middle layer of the skin that helps give skin its shape. They are caused during pregnancy from hormonal changes and stretching of the skin. While your pregnant it is a good idea to use lots of moisturizer such as petroleum jelly or any thick plain white cream in a jar 3-4 times a day to help with prevention. After you have the baby you can consider laser treatments. We have two lasers at the clinic we use for stretch marks. The first is the YAG laser which, to make a long story short, helps you rebuild collagen, the structure of the skin. Think of the YAG laser as rebuilding the foundation of a building, so it will tighten the area. Second on the list is the PDL which will help with the red/purple color of your stretch marks. Stretch marks are scars so don’t expect them to disappear but their appearance will improve. Expect 3-5 treatments monthly. You may only need YAG or PDL or a combination for best results.


Mandelic Acid- This was my personal favorite while I was pregnant. It was the closest thing to replacing my retinol. I used the M2 high potency skin refinish (we sell it at the clinic) its a gel like serum. Its a combination of mandelic acid and malic acid that helps the appearance of hyperpigmentation, scars, pores, fine lines, wrinkles and acne. It’s naturally antibacterial. It also helps with the “pregnancy mask” your getting on your cheeks while pregnant. It helps with oil control too. I still use it after pregnancy as part of my AM routine. We also have a mandelic acid peel which is safe while pregnant and has awesome results. The nice thing about this peel is how gentle it is, no down time! Here are some before and after pics after three mandelic acid peels we did on someone at the clinic.





Lastly, for the littles! When your baby gets here I know you want him or her to smell like a baby but sometimes those fragrances can cause dry, itchy patches of skin on your sweet baby. Try to avoid washes and moisturizers that “smell like baby”.  Use plain, fragrance free, gentle wash on that baby smooth bottom. When you get the little sugar plum out of the bath try to moisturize within three minutes while baby is still a little damp to lock in all that moisture. Try to remember these things while living off of no sleep for the next few months and you’re a real hero!


Congrats on your pregnancy and new additions!

Follow the link to Johnson Dermatology to learn more about treatments discussed here.

Botox Expectations

We let expectations play a huge role in our happiness and satisfaction. If you go out to eat and order a cheeseburger, you expect a cheeseburger to arrive at your table. When the waitress brings you a cheese pizza you’re not happy. Why? You like cheese pizza, cheese pizza would curb your hunger. Why aren’t you happy about getting a cheese pizza? Because you expected to receive a cheeseburger. Even if the cheeseburgers at the restaurant aren’t quite as tasty as the cheese pizza you would still be more satisfied with the cheeseburger because its what you expected to eat for dinner. The same holds true with Botox (or any neuromodulator, I inject Botox, Xeomin and Dysport brands). If you expect your lines (no, we don’t say wrinkles) at rest to be erased with Botox then you’re not going to be satisfied after your money is spent on an injection. On the other hand, if you know what you’re paying for and that’s what you received it could be the best money you’ve spent all month. So here’s an effort to tell you what to expect from Botox so you can really enjoy all of its potential benefits. You can treat multiple conditions with Botox; migraines, twitches, hyperhidrosis, the list goes on and on but for the purpose of this post we are going to talk about what it’s famous for in dermatology-lines in motion.

Lines in motion versus lines at rest. It’s important to understand the difference between “lines in motion” and “lines at rest”.  If you stare into the mirror without expression and see “11” lines between your eyebrows (a region we call the glabella) these are lines at rest. Now, say you don’t see those lines but then you scowl or make a mean looking face and these “11” lines appear, those are lines in motion. Botox prevents your muscles from being able to make your mean face which is the motion that makes lines at rest.  Over time, if you keep up with your botox then you will see lines at rest soften. Soften, not disappear.  Expect lines at rest to stick around.  Expect lines in motion to disappear.  So remember, without botox lines in motion become lines at rest.  This is why we call botox health maintenance, preventative.

Botox lasts three to six months. In our clinic we usually say pray for six months but expect three months.  For some it could be more than six months and for others it could be less than three months.  Don’t expect one injection to be all you need in a lifetime.  That’s like going to the gym once and thinking thats all your body needs.  Sure it helps, I mean it’s better than never going to the gym, but we all know that one workout will not make you in good shape either.  Expect multiple treatments.

Botox  won’t freeze all expression. Don’t expect to get Botox and be completely expressionless.  While trying to talk my husband into some “bro-tox” he told me he was reluctant (in slightly different vocabulary) because he didn’t want to walk out into the sun and not be able to squint.  He feared he would walk outside and have to say “ouch my eyes, its so bright out here” and just look silly.  No this won’t happen.  Botox won’t unnaturally freeze you when used properly.

Botox has complications. Ask your injector for the full list of complications and make sure your injector has the resources to deal with complications.  When you choose a skilled healthcare provider complications risks are lower.  The most common problem is bruising. Some people never have had a bruise after botox while others get slight bruising every time they are injected.  Don’t plan to get Botox on your wedding day, expect a bruise.  What a pleasant surprise when you don’t have any bruising.

Botox can start working in 1-3 days but isn’t in full effect for two weeks.  Some people notice one area kicking in quicker.  It is what it is at two weeks.  Thats when to see your injector again if you’re not satisfied.  Another reason not to come in on your wedding day, expect two weeks for full effect.

Interested in Botox?  Have more questions?  Come see us at Johnson Dermatology!  I love doing cosmetic consultations.

Here are my before and after Botox pics:

Crow’s feet before…..



Crows feet after….. Yes Botox gives you (well me anyways) the confidence to post a selfie  on the internet!

New Year Skinolutions


It’s time to reflect on 2013 and be resolute in 2014. While pondering what I wanted my first blog post EVER to be, I tried to think of one thing I wanted my patients to do for their skin this year; quite honestly, what I wanted to do better for my skin this year. Well, I couldn’t think of just one so I’m going to suggest twelve. That’s right, I’m an over achiever and I expect the same from others. So this year, instead of doing one good thing for your skin, do one good thing each month. And here they are, in no particular order, the twelve months of Skin Resolutions.


1. Wear sunscreen. Its the most obvious so I had to make it first and get it out of the way. And for those of you that feel invincible to skin cancer, it has cosmetic benefits too! If I had a dollar for every time I’ve heard “no one ever told me about sunscreen back in my day”, well I’d be relaxing on a beach (in the shade) right now drinking a cool drink with an umbrella in it instead of working. So, here’s someone telling you right now please wear your sunscreen in 2014.


2. Number one isn’t enough sun protection. You need to avoid sun exposure during the sunniest times of the day and wear your sun protective clothing while outside. I’m a lake girl so I know it isn’t easy but in 2014, I can do better and so can you!


3. Unless you are pregnant, trying to become pregnant, or breastfeeding you should be using a retinol at night. They shrink your pores, even skin tone, prevent acne, prevent fine lines and much more. You need instruction on which one is right for you and how to use it or you might fail to reap its full benefits so check with your dermatologist.


4. Stop with the scrubbing and harsh exfoliators. Yes, its true those little beads are bad for your skin, contrary to some popular beliefs. So in 2014, don’t irritate and inflame your pores with scrubs and exfoliators, please!


5. Throw away your magnifying mirror. Sorry ladies, it’s not good for your skin’s self esteem. I mean if you need that thing to see a tiny imperfection does it really matter anyway?


6. Get a full body exam this year by a dermatologist. Your skin is the largest organ in your body so get it checked out this year. It’s only fair that if you get your blood pressure checked, you should also get your skin checked.


7. Start moisturizing your skin as soon as you finish showering. With what you ask? Good ole petroleum jelly.  It’s not as greasy as you expect after your skin sucks up all that moisture. Smooth like butter, aaahhhh.


8. Promise to never even look at a tanning bed again. The skin Gods say that every time you lay in a tanning bed you increase your risk of melanoma by 20%.  Actually it’s the Skin Cancer Foundation that said it so you should listen to them, even if you don’t listen to me.


9. Don’t pick, pop or squeeze a single pimple this year. If you do, it will stay around much longer and scar your pretty skin. Resist temptation this year, you can do it!  And, if you have a hot date, then go see your dermatologist and they will try to help you out in a less destructive way.


10. Listen to your dermatologist before deciding on which products to spend your money. Sorry to say, the high school girl working the make-up counter this summer may not be advising you on what we call evidence-based practice. Evidence-based practice means we advise you on what the research shows works.  We aren’t simply trying to sell you something.


11. Love your skin this year. Look at yourself in the mirror and say “My skin is beautiful” and believe those words. Don’t be so hard on yourself.  This year, don’t judge yourself, especially not your skin.


12. Watch your moles closer this year. Take a picture of your moles every three months. Compare the pictures to each other and see if you have any moles that are changing in size, shape or color. If you have a changing mole in 2014 it needs to be evaluated by a dermatologist.


Hope everyone has a skintastic next 12 months! Happy New Year!