Monthly Archives: July 2017

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!

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Stat Skintastic

xoxo, Nina