Monthly Archives: March 2016

Simple but Significant Skincare

I ended this past week with a girls night sleep over. I’m from Fayetteville and I have a group of girls with whom I have been friends since before I knew my ABC’s. They are my people, my low maintenance friends. You know someone is a best friend when they become low maintenance status. I mean I have other friends that obviously are special to me but they require some work. Like new friends who you aren’t sure if you can feed your kids marshmallows for dinner and not be judged by them. Or your classy friends whom you can’t have more than one glass of wine around. Or your sensitive friends whom you can’t accidently tell the hard core truth to or they will be mad at you for a week. What about the picky friend who you have to always eat where they want to eat or do the activities they are comfortable doing or they get cranky. I really LOVE all my friends low maintenance or not. I’m just saying, some friends take work and that’s okay. I’m most relaxed when it’s just easy. I never have to worry about what I say or if my actions will be judged, if something will make them mad or if they like me-everything is set because we have been friends for so long we understand each other and it’s just easy. That’s how I like my skin care too. The other day I looked over at my counter top and realized I had more skin care products than necessity products (toothpaste, deodorant, etc.) and it dawned on me that I was no longer a low maintenance skin care regimen. I have made lots of new friends (added skin care products). Partly because I’m getting older, partly because I test products and partly because I’m struggling with hormonal acne as we speak. So for those of you who like the low maintenance skin care regimen that will take you day to day with healthy skin, here it is-bonus:only two products involved.

Morning regimen for the low maintenance girl boss:

  1. Gently cleanse-with just water, with plain white soap whatever you choose just don’t irritate. No scrubs, beads, exfoliators, toners and loofas.
  2. Sunscreen- The best for the low maintenance gal is  tinted Total Defense and Repair by SkinMedica because it really is 3 products in one. You get sunscreen, repairing antioxidants and the best color matching tint with which you won’t even need powder make-up. It dries like a powder and doesn’t leave that greasy film you sometimes feel with sunscreen.

While doing your thing all day remember to protect your skin from the harmful UV rays with sun protective clothing and reapplying your sunscreen.

Night time regimen for the low maintenance boss babe:

  1. Gentle cleanse again. Pretend you have the most sensitive skin.
  2. Retinol-I use the SkinMedica Retinol (do you ask your dermatologist what they use? you should). It’s plain and doesn’t irritate your skin as bad as other retinols that have irritating additives, fragrances and colors. Plus, it’s scientifically proven to be as effective as prescription tretinoin. Retinol is a perfect product for the low maintenance regimen because it helps with so many skin problems including brown spots, acne, uneven skin texture and tone, blackheads, fine lines, wrinkles, melasma and dull skin. It’s the most tried and true anti-aging product.

There is something refreshing and invigorating knowing that you can take care of the largest organ in your body so easily. I definitely have increased my skincare regimen and the time it takes me to care for my skin but on those nights when I fall asleep on the couch or I am just not in the mood, I go back to this regimen. This is my low maintenance go-to and it works! There is so much trickery in skin care product marketing so whether you’re the low maintenance kind of girl or you like to up your game and have the best of the best, we have a regimen for you at Johnson Dermatology. Let one of our skin care experts tailor a regimen that fits your skin needs and your budget perfectly. Just call and schedule a free consult at your convenience we would love to help you become skintastic.

Happy Easter everyone! Hope to see you at the clinic this week!

“Make it simple, but significant” -Don Draper

XXOO, Nina

P.S. To all my friends reading this, it’s not about you! Promise, nothing but love to all.


How to Sunscreen

Every single day someone tells me “back then we didn’t know the sun was bad for you, we wanted tans” or something of this nature. How they used baby oil, iodine and aluminum foil. In my head, I sometimes think to myself “you wouldn’t have done anything different if you did know”. That sounds awful doesn’t it; that I think like that? But currently we all know tanning beds and sunburns increase our risk for skin cancer, specifically melanoma, the one that can kill you. Still, I see teen girls getting in tanning beds before prom, women tanning before their wedding or my favorite excuse, tanning to get ready for vacation so they don’t burn (insert eye roll emoji here). But I do realize that some of those people who say they wish they had known really would have changed their habits. Some people out there really are applying sunscreen, seeking shade, wearing sun protective clothing and keeping their skin healthy. For those people, here are my sunscreen tips.

  1. Choose appropriate sunscreen for the event. If you are sunscreening a bunch of kids on a field trip pick a cheaper physical sunscreen like barerepublic at Target. If you are acne prone pick a light sunscreen such as a mineral powder like the BOB. If your skin is dry and it’s winter pick a creamy, non-greasy sunscreen like Elta MD sport. My point is, I use different sunscreens everyday. You have a go-to daily lipstick but you change it up for a special night out or family photos. Have that same arsenal of sunscreens.
  2. Apply everyday. Often times when I give this advice people say “oh but I don’t go outside”. If you see light of day then the UV rays see your skin. Do you walk from your car into work and then from your car into the grocery store, then back to your car, then into your home? That alone is a good 30 minutes outside. Every. Single. Day.
  3. Reapply, reapply, reapply. Every 2 hours while outdoors. More often if participating in water sports. Usually people say “I burned even though I used sunscreen” and then I say “did you reapply?” and then they give me a deer in headlights look.
  4. Use enough, which seems like a lot. Most adults need one ounce to cover all exposed areas of skin. That’s about a palm full. Or for all you spring breakers it’s a shot glass full. So fill your palm with sunscreen and then rub that all over. Don’t try to spread a pea size drop of sunscreen on your hands, feet and face-it’s just not enough! If you’re burning while using sunscreen then most likely you’re not using enough or not reapplying enough or it’s just expired sunscreen.
  5. Only use GREAT sunscreen. Here are my rules: #1 at least 30 SPF #2 UVA/UVB #3 water resistant #4 a physical sunscreen (like zinc oxide). That’s just 4 rules so don’t break them-your skin deserves the best, right?
  6. Apply BEFORE you go outside. Cloudy, sunny, hot or cold you have to apply every day  so just get in the habit of applying before walking out the door.  People on spring break who walk out to the beach, set up the umbrella, lay out the towels, order a drink, grab a magazine and then pull the sunscreen out have already had harmful sun exposure for a good 20 minutes before they even start applying sunscreen then another 15 minutes for the sunscreen to absorb. You don’t grab a hot baking dish out of the oven without your oven mit, get a slight burn on your hand, then decide to put on an oven mit to finish getting your casserole out of the oven. You put the oven mit on first so that you don’t burn yourself at all. Sunscreen first, that’s how protection and prevention work.

Sunscreen is one anti aging product every single person should be using. It’s not easy to use sunscreen in our busy lives but you will be happy you did. I’ve never met a patient who said “I wish I wouldn’t have used sunscreen”, not one. But I meet a lot who say they wish they would have been more sun protective. Hind sight is 20/20, have 20/20 vision now for you skin, protect it.

Happy Spring Break to everyone this week! I will be at the clinic for all your spring break skin needs, hope to see you there.

Sun smart and proud, Nina

What’s the difference?

People come to me for advice on their skin care. That’s what I do all day, give skin advice. When it comes to the products that I recommend people don’t just ask me what products to use, they want to know why as well. After I suggest products, I can almost gaurentee that half those people are going to say “well what’s the difference in what you want me to use and what I already use?” in some form or fashion. So here are my most common “what’s the difference?” questions and answers. Hope this helps explain why I give good skin advice, muah!

  1. What’s the difference in SPF # of sunscreen mean? SPF stands for sunburn protection factor. The number after SPF represents how much UVB (the burning rays, not UVA) the sunscreen can filter out. SPF of 15 filter 93% of UVB and SPF of 30 filter out 97% which is why I recommend an SPF of 30 or higher and sun protective clothing too because neither are 100%!
  2. What’s the difference in chemical sunscreen and physical sunscreen? Chemical sunscreen (ingredients like oxybenzone or avobenzene) protects you by absorbing the suns’s rays while physical sunscreen (ingredients like titanium dioxide or zinc oxide) protects by deflecting the sun’s rays. Chemical sunscreen is like a sponge on your skin if you drip water on the dry sponge it will protect you from getting wet  but you may still feel some moisture. Physical sunscreen is like putting aluminum foil on your skin. When you pour the water on you, the aluminum deflects it from hitting your skin. That’s why I recommend physical sunscreens.
  3. What’s the difference in the SkinMedica Retinol you use and local drug store retinols? The SkinMedica retinol has anti-inflammatory properties instead of pro-inflammatory properties so it’s less irritating. It’s also very plain. Some of the drug store retinols have added fragrances or 30 other ingredients that actually cause irritation. The SkinMedica Retinol I use has been tested against prescription retinoid tretinoin and proven to be just as effective. The difference is the tolerability, the effectiveness and the science to back it up!
  4. What’s the difference in the Jane Iredale makeup you use and other makeups? The Jane Iredale powders use pure mineral pigment with no fillers such as talc that can irritate the skin. They have been tested and proven to be non-comedogenic (they don’t clog pores and cause acne). They have received the Skin Cancer Foundation Seal of Recommendation. To achieve this, they had to provide scientific data showing the products aid in the prevention of sun-induced damage to the skin. They have good adherence (don’t streak in creases),  minimum allergy risk and have anti-irritant, natural ingredients-paraben free. My drawer at home is full of Jane Iredale.
  5. What’s the difference in Botox, Dysport and Xeomin? They are all neuromodulators meant to do the same thing-relax the muscles that cause lines in motion. I usually explain to people they are like drinking coke and pepsi, although both are colas some people prefer coke and some people prefer pepsi. Some say that Dysport spreads more which can be a good or bad thing. Xeomin claims that it doesn’t have the proteins that Botox has so it is a “more pure” product. Botox is the tried and true, it’s been around the longest in the USA and it’s what I personally prefer.
  6. What’s the difference in neuromodulaters and fillers? Neuromodulators, like Botox, are placed in muscles that make lines in motion so that you don’t have lines in motion develop into lines at rest (unwanted wrinkles). Think of fillers (Juvederm) as temporary implants. We use them to stretch the skin or lift what has fallen. When there is volume loss, we can replace that loss in the face with fillers. For a natural appearance, most people will use both neuromodulators and fillers together.
  7. What’s the difference in SkinMedica AHA/BHA exfoliating cleanser and the exfoliating at home you’re telling me not to do? The roughness that you feel in the AHA/BHA cleanser is jojoba which is a natural ingredient that dissolves as you are cleansing your skin so that it is very gently exfoliating. The scrubs and beads (that have been outlawed by the way due to their harm to our environement) don’t dissolve, they just harshly scrub your skin causing inflammation and irritation that leads to dullness, acne and redness.
  8. What’s the difference in the lasers and the sublative treatments? We have an ATV, PDL and YAG laser. These all use light to treat different conditions like tattoo removal, brown spots, redness, red lesions, hair reduction and skin tightening respectively. The sublative device doesn’t use light; instead it uses microneedling and radiofrequency to treat scars, fine lines and wrinkles. I recommend a consult with Dani, our cosmetic coordinator, for a consult to determine  your best option.
  9. What’s the difference in prescription retinoids and the retinol you use? The retinoids are pro-inflammatory and the SkinMedica retinol is anti-inflammatory so you will be able to tolerate it better without as much initial redness, peeling and irritation.
  10. What’s the difference in the millions of moisturizers and washes? Usually what irritants are in them. Remember, moisturizer is important but it is just water and/or oil so although it keeps your skin hydrated improving overall skin health and appearance it doesn’t actually induce change in your skin. So either use products that change your skin AND moisturize like the HA5, which has hyaluronic acid, to intensely moisturize but also has vitis flower stem cells that tell your skin to make more hyaluronic acid or just pick a cheap, plain white moisturizer at the drug store to use everyday. I like cetaphil dermacontrol for the acne prone.

I know this was a long post but I promise I could’ve easily gone to 50! I hope this answered some of your questions and gave you a peek into my evidence-based practice. What I use on my skin and recommend to you guys has been researched and proven to work. I want you to see results and reach all your skin goals!

Hope you all had a great weekend, stay skintastic!

xxoo, Nina


International Women’s Day is this Tuesday, March 8th, 2016. According to Tuesday is “a global day celebrating the social, economic, cultural and political achievements of women”. I’de never heard of the day until one of my favorite bloggers ( go follow, you will love her energy) was posting about the party she is throwing to celebrate. I work with over 40 women every day and life is good so it’s hard for me to wrap my head around the struggle in other workplaces, countries and continents where women are constantly fighting to be equals. I hope my daughters grow up in a world where they feel like boss babes, like they can do anything anyone else can do when they put forth all their effort. In honor of International Women’s Day, this week I wanted to share the things that I do to try to lead by example to my friends and especially my daughters how women really can rule the world.

  1. Befriend other women who achieve. My boss and mentor is a woman. There are tons of small businesses in Fort Smith owned by women, support them. Show them you support them. Collaborate with other powerful women. Together we can lift each other and achieve even more greatness.
  2. Don’t be mean jealous. Do you know how jealous I am of the Moms at daycare who send Valentines that look exactly like a DIY off pinterest that took at least 10 hours to make when all I threw in the bag was a tootsie roll with a dollar store Elsa card? But I love those moms for it. I’m thankful that my kid gets those awesome treats (especially since she will never get them from me). I let them know I think it’s awesome. If you are feeling jealous of another woman’s degree, mom skills, wife skills, home or clothes that is a feeling that you are getting because another woman is doing something right and maybe even better than you do it. But that’s okay, someone is jealous of you too. So when I feel that jealousy, I give a shout out. Props to the Moms with the creative craft skills.
  3. Competitors are a good thing. I know I’m not the only nurse practitioner in Fort Smith. I know you could chose to trust me with your skin or someone else. I don’t speak negatively of other nurse practitioners in the community. Do your thing girl, I’m gonna be doing mine. There is enough room in this world for all us ladies to be successful and rise up!
  4. Offer your help. Is there a student you could mentor? Are there other women you could collaborate with? Is there a class you could teach? Do you write a blog to help share your knowledge (toot-tooting my horn)? Help other women achieve with you! You don’t want to be sitting on top of the world by yourself do you? Women should help each other just like men help each other and men help women and women help men. Help a sister out!
  5. Be kind and have courage. So Cinderella said. If you haven’t seen the new Cinderella you may not know this line but I love this advice Cinderella was given. If you are kind to people and you have courage often that is all you need to be a successful woman.

On a side note, most of my cosmetic dermatology practice consists of women and I want to take a minute to thank them for trusting me with their skin. They are all hard working women who invest in the care of their skin and I have a little place in my heart for all of them. Taking care of our skin, oddly enough, is something women already excel in, usually (not always) better than men so shout out to all my women out there who take such good care of the largest organ in their body, the skin!

Hoe to see you this week, Happy International Women’s Day to all!

xoxo, Nina