Monthly Archives: March 2014

Trifecta for “sun spots”




noun: trifecta; plural noun: trifectas

    • a run of three wins or grand events

This weekend my husband and I loaded up our 13 month old and headed to the horse races in Hot Springs. I’m not much of a bettin girl but I do enjoy the atmosphere at Oaklawn. My little girl loves the people watching and excitement. While my husband studied the horses and made bets we enjoyed the lawn and pretty weather. I diligently reapplied our sunscreen and we spent most of our time in the shade. I couldn’t get her to keep a hat on. She even wiggled herself out of the ones that tie around the neck. We are going to have to work on that problem. I’m so cautious about us getting sun damage for multiple reasons but one is how hard I see women working to get rid of those discolored brown spots. So in the spirit of horse racing, here is my trifecta for sun damage.

  1. Sunscreen-every day you should apply sunscreen. Think of this as the preventative step. Even if you plan to be inside most of the day, protect yourself from rays in the car and walking to and from buildings or just unexpected sun exposure. I use the BOB – brush on block. It’s literally a mineral based powder that comes out of the brush and you simply brush it on, convenient and comfy.
  2. Retinol- Are you getting sick of hearing me tell you that you need to be using a retinol yet? Use a retinol at night (not for the pregnant women) to get rid of what damage you got during the day. Retinol passively exfoliates off damaged skin letting new skin, with a more even tone, shine bright like a diamond! I use SkinMedica Retinol 0.5%.
  3. Lytera Skin Brightening Complex- Some people with brown spots have used hydroquinone before and know it as a “bleaching cream”. It’s a prescription that you can’t use for an extended period of time nor during the summer months. Hydroquinone works on only one chemical pathway of the four that play a part in sun damaged skin. Lytera works on all four of those chemical pathways. The science behind it makes sense. It does have some retinol in it so be careful of the box instructions that say to use it in AM and PM. Although you may be able to tolerate that at some point it might be less irritating to your skin to start it once daily.

This is the skin care product trifecta but if you want to go for the superfecta then come in and let us discuss chemical peels or other options for you! Hope to see all of your beautiful faces at the clinic this week but if not please, please stay skintastic!

xoxo, Nina


Sun Smart Spring Break

Tomorrow starts Spring Break around these parts. Lots of people use this as an excuse to hit the beach. Oh how I love the beach. I must admit when I was in college my Mom always told me to wear my sunscreen but I thought I was invincible and I would always go for a good tan. I’m paying for it now with sun damaged skin that is difficult to fix. I can’t tell you how many times a day I hear “no one told me not to tan” or “we used to use foil and betadine to get a tan, we didn’t know any better”. Well, here I am hoping to change this for our generation so that we do “know better” telling you to take care of your skin this spring break. Here are some spring break sun smart tips.


  1. Avoid the hottest part of the day. The Skin Cancer Foundation recommends staying out of the sun from 10AM-4PM when sun rays are most damaging. We went to the zoo yesterday and planned our indoor shopping and eating around lunch time. Zoo time was 2-5pm so although we were outside part of this time window we spent some of it inside as well. This is easy to do for the planner. Plan your vaca in a sun smart way this year.
  2. Seek shade. Bring your big umbrella. No I’m not talking about the umbrella in your drink. A big umbrella or sun protective tent can allow you to enjoy the sand and waves with less sun exposure.
  3. Wear your sun protective clothing. has some cute options for the fashion forward. What’s more timeless and chic than a big floppy hat on the beach? If I had it my way you would wear long sleeves, long pants, big floppy hat, neck drape and sunglasses.
  4. Obviously wear your sunscreen. Unfortunately its not enough to apply sunblock in the AM and be done. You should apply at least 30 SPF broad spectrum every two hours. For sun exposed skin you should use at least 1 ounce total, thats a full shot glass. We used BOB at the zoo. Its brush on block, sunscreen in powder form on a brush. It’s the bomb! My baby giggles every time I apply it to her little sweet cheeks.
  5. Don’t tan as beach preparation to avoid a burn. Seriously, why?!?!?! I constantly hear people say they are only tanning to get ready for the beach so they can avoid sun burn or so they can blend in the dark spots they already have. I don’t care how tan you get, if you aren’t sun smart you will still burn at the beach. Oh, and guess what? As you darken your skin you are also darkening those dark spots so they aren’t going to blend in any better.
  6. Spray tan or use self tanner. If you just want to look tan do it in a safer way please. I don’t want you to have thickened, thinned, wrinkly, leathery, scaly, spotty skin one day (were any of those real words?). My favorite self tanner is either Jane Iredale or Jergens. I have been fooled by them before thinking they were real tans. If you want my personal opinion, pale is the new style. Tan cellulite does not look better than white cellulite, I promise. It’s like saying hail damage looks better on a black car then a white car, nope it’s still hail damage. *Now stepping off of soap box*


If your all grown up and don’t get spring breaks any more then maybe I will see you at the clinic this week! If you didn’t listen to any of my tips and get home with a sun burn, stop in and let me help you.  I will only scold you a little! If you have been considering any cosmetic treatments we are offering some major SPRING BREAK SPECIALS on Botox and fillers this week. Hope you all relax and re-energize this week in a sun smart skintastic way! Toodles, Nina

I nailed it!

When I was pregnant I would get a pedicure once a week. It just felt so good to have my feet and calves soaked and rubbed after carrying all that extra weight around all day. Well, I recently watched a 2020 on ABC news ( about the healthcare risks of nail salons. This intrigued me so I took my Mom for a pedicure today to see if my salon did any of the “no-no’s” ABC had reported. Well, most of them happened. They used a tool that is supposedly only for podiatrist. They filed my Mom’s nails with the same file they used on my nails without cleaning in between and so on and so on. I still love my nail salon and plan to go back, I think they are just as good as any nail salon. One of my mentors explains risks by the discussion of wearing your seat belt. Nine times out of ten you wear your seat belt and don’t need it, you would have been just as safe driving without your seat belt as you would with it as long as you don’t get in a wreck. But we all (most of us) wear our seat belts every time we get in the car because we don’t want to take the risk that this drive is going to be the time we get in a wreck. Most of us go to the salon because, much like not wearing our seat belt, we are taking the risk of nail trauma, damage and infections over the benefit of a good looking pedicure. Just like you usually don’t get in a wreck you usually don’t have problems with your nails after a manicure. Before you take these risks you should know exactly what they are. So in hopes to not scare you away from a good pedicure but educate you on what risks your taking, here are the things that you could get after a pedi and mani.

1. Beau lines- This is a transverse depression in the nail plate. Basically a line going across your nail. This can be caused by the trauma of a manicure, usually in one nail. If seen in all your nails you should see your dermatologist to check for underlying diseases that cause beau lines.


2. Acute Paronychia-This is an infection of the folds of tissue surrounding the nail of the finger that lasts less than 6 weeks. It usually starts as a red, swollen, tender area after trauma to the cuticle. Trauma to the cuticle during a manicure can introduce bacteria and fungus. In the acute phase you may need drainage of pus or antibiotics from your dermatologist.


3. Chronic Paronychia- This infection lasts longer than 6 weeks and in chronic paronychia the nail plate separates from the cuticle leaving an area vulnerable to infection. In chronic paronychia the cuticle is gone. Among other causes this can be caused by aggressive trimming of the cuticles (like your nail lady may be doing). I never let them cut at my cuticles. Today the lady even said “but you have an ingrown toe nail that needs trimmed”.  I just kept insisting she leave my cuticles alone (as if I couldn’t diagnose my self with an ingrown toe nail??). Diaper cream is a good over the counter treatment for this problem.


4. Leukonychia and onychoschizia- big fancy medical words used to describe what a chemically damaged nail looks like. As you can probably guess, when we glue nails to ourselves those chemicals can damage and change the nail plate. Leukonychia is that white opaque discoloration and onychoschizia is splitting of the nail plate, basically your nail just looks jacked up.

The arrow is pointing to where the damaged nail starts, you can see where healthy nail is starting to grow.
The arrow is pointing to where the damaged nail starts, you can see where healthy nail is starting to grow.

5. Athlete’s foot, MRSA and warts- While most of us probably come in contact with staph, fungus and hpv on a regular basis we are probably more likely to encounter these at the nail salon. Person to person spread is a no brainer but think about your own skin too. For instance, if you have a wart on your foot, that pumice stone rubbing all over the wart then causing tiny little cuts in your skin on the back of your foot, yes that could spread the wart virus and spread your warts, not cool.

Cheers to good manicures and pedicures! I usually recommend keeping your nails trimmed to lessen the chance of injury. Keep them moisturized just like your skin and try to avoid harsh chemicals that can dry the nails. Hope to see all your nail probs this week at the clinic. Otherwise, stay nailtastic!

My Spring pedicure
My Spring pedicure

Wake up your eyes with me

I woke up Saturday morning, looked in the mirror and thought to myself “wow I look tired”. My thoughts were accompanied with the realization that I am turning 30 in less than a month and my body can no longer bounce back from a Friday night out with the girls like it used to. As we mature the eyelid skin thins and we suffer from loss of fat and collagen. All these things can cause bags, puffiness, and dark circles under the eyes that most of us don’t like waking up to on a Saturday morning as I did this weekend. So here are my tips for waking up those eyes and saying good bye to dark circles, puffiness, and lines!

  1. Cold compresses and elevation. I put a cool rag over my eyes while sitting upright for a few minutes. Gravity helped the puffiness. Just like swelling and edema you get anywhere else in the body cold compresses and elevation will help under your eyes too, for the short term. Consider sleeping elevated.
  2. TNS eye repair. This is my “go to” for people wanting a cream to help with the fine lines around the eyes. This is a Skinmedica eye cream that has growth factor and antioxidants that will help the appearance of fine lines around the eyes. I also recommend this cream for my patients who get Botox for crow’s feet. It helps overall results for the eyelid skin.
  3. Botox- You should always be careful when choosing your injector but when injecting around the eyes, its extra important. I don’t mind when my patients ask me “have you done this before?” or “how were you trained?”.  The injector you choose shouldn’t mind either if they are confident in their skills, be picky. Botox can get a slight lift of the brows and help you appear more awake, less tired.
  4. Filler- Belotero is a filler that is made to be put very superficial in the skin and unlike most of the other fillers, it isn’t seen when placed superficial. We can place Belotero under your eyes to help that dark hollow look. Sometimes using filler in the cheeks to replace volume there shortens the length of your under eye circles. During your cosmetic consultation ask which option would give you the biggest bang for your buck.
    Left is before picture and right is after one syringe of Belotero under the eyes. Notice the appearance of less "puffiness" when the Belotero fills the hollow space. Also take note of the length of the "dark circle", it shortens after Belotero.
    Left is before picture and right is after one syringe of Belotero under the eyes. Notice the appearance of less “puffiness” when the Belotero fills the hollow space. Also take note of the length of the “dark circle”, it shortens after Belotero.

    Left is before picture, the arrow points to where I injected her. Right is after one syringe of Belotero.
    Left is before picture, the arrow points to where I injected her. Right is after one syringe of Belotero.
  5. Blepharoplasty- This is a surgical option that removes excess fat or sagging skin. We don’t offer this at JD but we have been known to recommend this for you during a cosmetic consultation and can point you in the right direction.

I hope with daylight savings springing us forward this weekend you all adjust easily and get plenty of rest tonight and wake up alert and ready for the upcoming week. Have  the best week you’ve ever had! Hope to see you all at the clinic this week but if I miss you, stay skintastic!!!

Skin “Quick Fix”

Due to an ice storm and a sick baby its been a lazy Sunday of eating leftover birthday party food and watching the pre shows for the Oscars. Is it just me or does every single person at the Oscars have flawless skin? I mean flawless! And it didn’t become that way over night. I mean, I don’t think they had horrible rashes and acne yesterday. Obviously, they invest in their skin to keep it looking good. But realistically, one or two of them surely ran into some poison ivy while roaming the beaches of Belize last weekend, right? And pimples always find me the day before a big event, that happens to famous people too, right? So in honor of the famous and flawless, here are some tricks I think some of them have probably used this week for a “quick fix”.


  1. Acne- I tell my patients to allow 2 months of acne treatments before they see 50% improvement. You have to stick with a regimen to get results. BUT, if they had the Oscars this weekend I might offer to laser them with our pulsed dye laser. It would help calm that acne down before the big event. Bonus-we use it for redness too, killing two birds with one stone.
  2. Steroid injections-If Bradley Cooper came and saw me last week with a large, painful cyst on his neck, which was draining stinky pus and making it difficult for him to tie a bow tie around his neck without irritating it……. well he would still be the best looking guy at the Oscars! Seriously, I would inject it with a tiny bit of steroid to help resolve it faster and let him be partay ready! Steroid injections do come with risks however, so you should discuss and consider these with your dermatologist before you are injected.
  3. Make-up- Even the men are wearing make-up at the Oscars, for real. People forget how helpful make-up can be at covering up. Make sure you’re using it correctly and making things better instead of worse. Our cosmetic concierges at JD have lots of tricks. Did you know that if you have rosacea, using green tones will help cover your redness better? Shelly often picks out my make-up colors for me, Autumn is a brainiac with our products and Sharon is so easy to talk to. If you haven’t met one of them yet be sure to find them at your next visit to JD. They have a wealth of knowledge in skincare products to share with you!
  4. Rashes- Actors/actresses are rich and famous, not invincible. They get poison ivy, bug bites and psoriasis too. While I find it interesting that Kim Kardashian put her sisters breast milk on her psoriasis and found it to be helpful, most of us likely need an alternative. Make an appointment with your dermatologist. Don’t waste your time on trying five different over the counter remedies that may just complicate things and make the rash worse(like pink lotions). If you have a hot date, like the Oscars, in the upcoming days then even a small bug bite is not too small of a problem for me to spend time on with you, promise!
  5. Bruises- I bet at least one person has bumped into something this week and sustained a bruise right before the Oscars. Once again we can use the pulsed dye laser to help bruises go away faster. Another option is Arnicare, a homeopathic gel which helps reduce pain, swelling and the color of bruises. Give it a whirl.

Keep in mind no quick fix is as good as a regular routine skin care regimen. I hope you all enjoy this extra time stuck indoors with your families. Drink cocoa, stay warm and as always be skintastic!