Monthly Archives: September 2015

Double Chin Trouble?

There is a new injectable drug out that is designed to get rid of submental fullness (that’s a fancy nice medical term for double chin). It is so exciting and amazing because there is nothing out there like it.

Kybella (deoxycholic acid) is the first and only FDA approved injectable for contouring submental fullness. It is a series of 3-6 treatment sessions about a month apart. The medication is injected directly into your neck underneath your chin where the fat is located. After your initial injection there is an inflammatory response over the next month that takes the fat away and tightens the skin. The clinical trials of the drug that were done to get FDA approval had over 1600 patients in them and the drug has been found to be very safe.

Johnson Dermatology is one of only 10 offices in the state of Arkansas that was chosen to launch the medication. We are currently the only office offering Kybella in the River Valley and I would like to “toot toot” our horn on that fact!

As soon as we received the product Honey injected it into my double chin. The actual process of injections is actually pretty simple. We clean your neck off with surgical scrub and then mark out anatomical locations to see exactly where you will be injected. We numb your neck with lidocaine because the dissolving of fat can be painful. After you are numb the rest is a breeze. We inject the medication, which takes about 45 seconds and then you leave. For the next 24 hours you will have swelling, minor pain or tingling and paresthesias. You can take some ibuprofen and ice the area for up to 20 minutes of every hour to help. These symptoms are the worst the first 24 hours and then continue to get better over the next 4-6 weeks or so.  I’m almost 4 weeks out from my injections and my double chin is still slightly numb but literally it has been getting a little better everyday since I was injected. I can already see a significant difference in my double chin shrinking after just one treatment session. It’s like birthing a child. When I was in labor, I swore I would never have another baby but after that sweet little baby arrived I wanted another one. When I was all swollen I didn’t think I would do another treatment but now that I see my double chin shrinking I’d do it 20 more times! I should also point out that I saw patients all day the next day and no one noticed my swelling. People that knew me could tell I was swollen from injections but a stranger would probably just look at me and think I was 5 pounds heavier than I truly weigh.

This treatment is so exciting because it is the first time we have had something for double chin other than liposuction. It is a great adjunct treatment to your botox and fillers. Remember full facial rejuvenation always looks more natural while working on anti-aging.

For a consultation to see if you’re a candidate for this new and exciting treatment call Johnson Dermatology at 479-649-3376. Dani is our cosmetic concierge and she can get you scheduled and answer all your pre-visit questions. You can ask to speak with her and get to know her!

See you at the clinic!

Happy Fall Y’all!!



Friday Pearls

When I come to these dermatology conferences I listen to a TON of lectures. At each one I try to pick at least one point that I’m going to take home and apply to my practice.  I just got done with todays sessions and I’m about to head to a networking reception but thought I would share with you some of my “pearls” or “take-homes” of the day.

1. Derms disagree- Have you heard the saying “there is more than one way to skin a cat”? Even the best dermatologist have different opinions on how to approach a disease or wha drugs to use. Sometimes you just have to see what everyone else does and then pick what works best for you and your patients. There isn’t always a right or wrong answer, everything isn’t black and white.

2. The more you magnify skin the uglier it gets. This was a realization I made today thanks to the 5x magnifying mirror in my bathroom. I was thinking my skin looked pretty good until I looked at my self in that thing and saw every little bump and discoloration. Then during dermatopathology lectures I looked at skin as seen under a microscope, even crazier. The lesson learned here is, if you are going to judge your skin do it from the same distance as everyone else. Magnifying mirrors are unnatural and not nice, get rid of yours, no ones looks at your skin under a microscope and you shouldn’t either.

3. Dermatology is its own language. Some of the words we use sound like I just got cursed at in German or some other language I don’t understand. My point is that if I can get overwhelmed then I know you guys can get overwhelmed. Don’t feel bad to stop me and ask what something means. It’s normal to be overwhelmed by the language of dermatology, it’s foreign to most people.

4. Nail polish doesn’t necessarily cause brittle nails, nail polish remover is the problem. Brittle nails are a common problem and women constantly ask me what they can do to strengthen the nail. Dr. Pheobe Rich is a renowned nail expert who I love to hear speak. She gets so excited about nails so take her advice. She recommends good nutrition (plenty of protein since nails are protein) and good nail care practices (moisturize, don’t traumatize).

5. Women generally earn less than men. What?!? Why?!?! {insert sad face emoji here} It’s not because we are less than men but because we don’t negotiate. They did a study called the boggle game study where they told men and women they would pay them $20 to play a board game. After they were done playing the board game they payed them only $10. The study found that women were much more likely to take the $10 and go on whereas the men wanted to know where the other $10 were and spoke up about it. I’m now brainstorming ways to help women in the work force not be afraid to stand up for themselves and show support for each other. Let me know if you have any ideas.

I’ve learned so much more than what I even have time to put in my blog but I hope you guys are enjoying the little skin tidbits that I’m throwing at you throughout the week.

Enjoy your weekend!

Stay Skintastic, Nina

Derm Girl Moments

Can we please talk about how it’s not even lunch time yet and I already can’t wait to blog about what I’ve learned?!?!? I’m on my first pumping break (I’m a breastfeeding working Mom and I love it) and I just had to share some of the mind blowing moments I’ve already had today.

My “Light Bulb” moment- The iPad has nickel in it. Nickel is a common product that causes contact dermatitis of the skin. For example, people that get a rash from the metal button on their pants. Some kids still rash and can NOT figure out where they are coming in contact with nickel. Most kids have ipads or devices that I never thought to tell them get covered if nickel is your problem. DUH, lightbulb went off, don’t touch your ipad if nickel doesn’t like you.

My “Thank God” moment- Pimecrolimus is a non-steroidal medication that we use often in kids with eczema or facial rashes that we can’t use steroids on for an extended period of time. Unfortunately, it has a black box warning that it can cause lymphoma leukemia. Parents don’t like that. We derm people still believe it is safe and use it often. Today they reviewed a HUGE study that followed children for MANY years and found that there is no increased risk of cancer with the use of pimecrolimus. So now you don’t just have to believe me, there is good data that shows it is safe to use. (they are trying to get rid of the black box warning, will take an act of God)

My “Game Changer” moment-Early introduction of peanuts may decrease the likelihood of peanut allergy in high risk infants. We reviewed a study which results revealed in high risk kids(ones most likely to be allergic to peanuts) given peanuts at 4-6 months old had less allergies to peanuts then babies that didn’t have peanuts when they reached the age of five. Seems like we’ve always been told the opposite so this is good to know.

My “Natural Girl” moment- I always love learning about treatments that are for the organic, nature lovers that use alternative therapies. Probably because I am one of those people. Lindioil is an extract of the Indigo naturalis plant that was studied against olive oil and found to be a good treatment for nail psoriasis (something that can be difficult to treat). Plus, you can get it online for $11!

My “Why Not?” moment- They reviewed a study that showed patients on isotretinoin (Accutane: a medicine used for severe acne) had less initial flare and less side effects if they took Clarinex with their isotretinoin. It’s fairly inexpensive and low risk to take a couple claritins a day. Why not have my Accutane patients take it if it could make their experience on Accutane better?

This is just the tip of the iceberg of the info I have gotten today to bring back to the River Valley and save some Arkansas skin!

Love your skin today, you’re going to be in it for awhile, Nina

Disclaimer-this post has not been proofread, I’m on a schedule here people and I can’t miss a thing!

Adventures of a Derm Girl

I didn’t post this weekend because I have such an exciting week this week! Today I am traveling to Washington D.C. for my favortie dermatology conference(Maui Derm). While at the conference I will listen to speakers that have some of the biggest names in dermatology. I will also get to meet and mingle with some of my dermatology colleagues from all over the US. I plan to learn what’s new in dermatology and how other providers do things in their practices. It’s an exciting time for me to learn and make myself a better provider. I initially became a nurse because I wanted to help people. I kept going to school so that I could better serve my patients with more knowledge. These conferences are a way for me to serve my patients skin care needs at the highest level. I decided that I shouldn’t keep all the excitement to myself, so this week I am going to do a “mini series” of all the exciting things I’m learning. Every day I will post a summary of what I think is relevant and exciting for my readers and patients.

To start things off I just read an article on my first plane leg about cosmetic procedures for men. Here is what I learned.

1. Men want cosmetic procedures too. The amount of men getting Botox and fillers is growing exponentially.

2. It is most important to a man to look natural and untreated. Even more so than for a woman, the article proposed.

3. Men don’t want to say they are having a cosmetic procedure. Men won’t say they want to look younger or get rid of wrinkles. Men say they want to look refreshed and less tired.

4. Men want cosmetic procedures to be able to compete with other men. Just like everything else, right? The article I just read discussed how men are getting cosmetic procedures to be more competitive in the work place. It makes sense to me.

5. Men have feelings too. Okay that wasn’t in the article, but why don’t I as a provider discuss cosmetics with men as much as women? They care what they look like too. They want to feel good. I need to consider how a mans appearance makes him feel, tap into that part of their skincare better. I’m sorry to all my male patients that I haven’t offered cosmetic procedures to, you deserve to feel your best!

6. Men have different facial structures than women and should be treated accordingly. I already knew this. I actually love treating men with Botox and Fillers because it is a refreshing change. I often times have men come to me because an injector made them look too feminine, I can fix that. For example, women have an arch in their brow and men have horizontal brows. You must take this into consideration when injecting Botox. I’ve fixed a few dudes who were looking a little lady like after injections elsewhere.

Fall is here which means christmas is just around the corner! If you have a man in your life that you think would like to feel refreshed then send him our way. Gift certificates for procedures are the best gift! Johnson Dermatology injectors are the experts and we promise to make him feel comfortable and keep him looking the best version of himself.

Stay tuned for more derm info the rest of the week!

xoxo, Nina

The Nina Experience

At Johnson Dermatology we are always working to be better employees, better humans, better friends and a better place for our community to get skin care and health services. This past week we were discussing our “brand”, you know what you think of when you think of Johnson Dermatology, reviewing our mission statement and such. Well of course, as I lay there at night on my pillow it made me start thinking about the “brand” idea. I discussed with one of my friends who owns a clothing boutique that I like her business because of the experience she gives me more than the clothes I buy from her. So then I started wondering about my personal “brand”. What people think of when they think of seeing me as a licensed healthcare provider in Dermatology or what my blog says about me. I know that the way I make people feel and the experience I give you when you are my patient may be as important as the results you get. Just like how I feel when I try on that dress in my friends store is just as important as how much I love that dress. That’s why we all love shopping local, right? Getting to know our community and the people who run it, I would rather spend $100 on a dress from one of our local boutiques than order the same one online for $50 because of the fun it is to go try it on and spend time with my community! Getting back to my “brand” I want all my blog readers to know a little bit more about me, my outlook on healthcare, my style and what it’s like to be my patient. So without further delay here is what I like to think is “The Nina Experience”. (thank you to anyone that cares enough to read on, for real)

1. My team is a part of seeing me as a patient- My nurses are the best. My front office staff is on fleek. My lab techs are not forgotten. Your healthcare plan when you come to see me is not just in my hands. Sometimes I’m the coach of my team, sometimes I’m the MVP and sometimes I feel like I’m on the bench cheering on the other players. Expect to get to know us all.

2. I like to talk and laugh. Some people may consider this a good thing but some patients are all business. One of my nurses once said I can’t tell if you just met the patient or if the patient is one of your friends since kindergarten….. I took this as a compliment. I like getting to know my patients and I think it helps our provider-patient relationship. You feel more comfortable telling me about your health issues and I can understand what plan will work better in your life.

3. I care about your outcomes. My feelings get hurt if you aren’t happy with your results. I lose sleep over worrying about my patients. I don’t want you to be sick, have a rash, acne or even a wart! I take critcism to heart and if you tell me I’m doing something wrong I will internalize and try to change to become a better person and better healthcare provider. I know I’m not perfect but I will try to be for you.

4. I’m not perfect. I will strive for perfection but will never be perfect. Sometimes you will have to wait on me because I run behind at times. Sometimes I’m in a bad mood (very rarely). Sometimes my kids get sick and I have to cancel your appoinment and move it so I can stay home. My schedule sometimes doesn’t accomodate yours. I’m loud, sorry if it annoys you, I know you’re not hard of hearing. There are times when I ask my patients to be understanding too. There are things out of my scope of practice that I can’t do for you.

5. I love skin. I didn’t know it 5 years ago. I used to think that head traumas and open heart surgery patients were cool and then I met Dermatology and I never looked back. I dated the intensive care unit and emergency room but I married Dermatology. Your skin is so AMAZING! I love how skin forgives after surgery, how it “rashes”, how it ages and how we anti-age it and teaching you about how to take care of your skin. I hope you can see my passion for skin.

6. I want you to feel special. I want you to know I care. I want you to feel like you are the only person’s skin in the world that I care about. For that 15 minutes (or however long) you’re in my exam chair that’s exactly the case. If I don’t have the answers I will help you find them.

7. I love fashion. You aren’t going to catch me in the clinic in last years fashions (well you might but that would be considered vintage chic, not out of style). I like to look good, I like make-up and I actually enjoy spending 30 minutes every morning fixing my hair and make-up. I will look good, or at least think I look good when you come to see me at the clinic.

8.  I love social media. I like to facebook, tweet, instagram, blog, snapchat and am looking forward to venturing into the youtube world. AND I don’t think there is anything wrong with that. I like being an open book and sharing my kids with everyone more than the world cares to know or see.

9.I’m smart, confident and love positive vibes. I’m the person that always raised their hand in school and then if I got the answer wrong I turned around and announced to the class “I know y’all were thinking the same thing! I’m not the only one that didn’t know!”. I got a 4.0 in school and I am technically gifted. I’m humble when I need to be but heck why not flaunt what I’m good at too! When I do a procedure for you I do it because I think I can do a darn good job for you.

10. I don’t judge. You can tell me you use a tanning bed, I will scold you but I won’t judge you. I’m a hot mess sometimes, I make mistakes too. I don’t know what I would do if I was walking in your shoes. I won’t judge you if you can’t afford a medication, or let a skin cancer grow to an unsightly size, went to a kitchen table to get Botox and now you need it done right. I got your back whatever decisions you’ve made or circumstances you’re in currently.

I hope this gives you an idea about my “brand” who I am and what to expect when you’re my patient. Some people probably say this shouldn’t matter. That you’re either a good nurse practitioner or not. That you shouldn’t mix business and pleasure. To those people I say, I’m giving you an experience as my patient, not just a product. I’m not just going to treat your acne, we are going to travel a road together to get your acne where we want it and I hope that trip is enjoyable for you and me.

Here is to making Fall of 2015 the best Fall ever, Pumpkin Spice Lattes are here and just so you know, I love them no matter how cliche that is!

Happy Labor Day, Nina