Monthly Archives: October 2017

Are you ready for Botox?

When should you start considering Botox? When are you too young? When are you too old? Can you be too old or too young? These are good questions I am frequently asked. Today I’m going to try to answer them.

To know when it’s time for you to skinvest in Botox you first need to understand how it works and what it achieves. To understand how Botox works you need to understand what makes wrinkles. The wrinkles that we soften with Botox are lines in motion. That means when you squint repeatedly over the years crows feet develop around your eyes. When you scowl and pull your eyebrows closer together and down, over the years “11’s” develop. Years of muscles repeating the same motions basically etch those lines into the skin. In other words, lines in motion become lines at rest. Botox is a medication we inject into the muscle, not the skin. The Botox relaxes the muscle enough that it can’t etch those lines into your skin. When done by an expert injector, the muscle is not frozen but relaxed naturally resulting in softer lines at rest. Back to the original question, when should you start injections? In my opinion, this age varies from person to person. I believe you should get your Botox at the first sign of a line in motion becoming a line at rest. Don’t wait until you have a deep line at rest. The first sign, make a consult with an expert injector. Although the theory of prevention of lines with Botox is out there I feel it may not be necessary. Why relax muscles that haven’t even started to etch a line in when you can wait until the very first sign of an etched in line and get Botox resulting in no line? Yes, of course if you start now you will never get that line but save your money and start a good medical grade skincare line until you’re ready for Botox.
The difficulty lies in knowing what the first sign of a line a rest developing looks like. I assess skin everyday. I could tell every single person I see everyday if, in my opinion, they would benefit from Botox. Unfortunately most people don’t have that assessment skill. And why should you? That’s not your topic of expertise. That’s why it’s important to have a dermatologist. The only medical specialty that is specially trained in skin. No offense to the pyramid scheme skin care line you are using but Dermatology is where the experts in skin reside. Remember that and make an appointment. Let someone you trust with your skin assess you and let you know where you should be putting your skinvestment money. I have 20 year olds with deeper lines than some of my 30 year olds. I don’t have a particular age number for you as the answer to when to start Botox, but I do have the assessment skills and the knowledge to tell you when you’re ready. So be proactive. Go get a consult. Take control of your skin. The answer isn’t on the Internet. It’s at a dermatology office near you(insert wink emoji here).

Can’t wait to see you at the clinic this week. Gearing up for our Gratitude celebration in November and it’s going to be great!
Stay Skintastic, Nina


Drug Store Picks

I am often recommending to you medical grade skincare. Injectables, lasers and topical anti-aging products are all skinvestments that I feel are game changers in taking care of your skin over the years. However, there are also drug store skin care items that I use regularly and save a buck or two. Here are my money saving skin care finds.

  1. Vaseline. If you’ve followed me for any length of time you know I use this as my body emollient straight out of the shower. Game changer. Winter is approaching, get you a jar.
  2. benzoyl peroxide. This is an acne medication found over the counter. I saw a gel at Target this weekend for $3.49. If you have acne prone skin this is a great starting point for you. I pair it with my retinol at night since I’m a dewy acne prone kinda gal.
  3. Albolene moisturizing cleanser. $5.56 at wal-mart. People ask me how I remove my make-up. This is it. It’s only 5 ingredients: mineral oil, petroleum, paraffin, ceresin and beta-carotene. Put some in your hand or on a cotton swab and it will melt your eye-make-up off for 1/4 of the price of those expensive make-up melters. I then use a cleansing cloth to wipe it all away.
  4. Cetaphil cleansing cloths. I use them to wipe away make-up(see #3) at night or when I need a quick cleanse. Not like a bird bath cleanse or anything. But after a work-out before running to the grocery store. Or washing my face after falling asleep on the couch while walking to my bed. They are gentle and non-irritating. Must haves for the working Mom or teenagers on the go.
  5. Maybelline super stay matte ink. This lipstick is not for the faint of heart. I swear I apply this stuff at 6am before work and it’s still perfect at 4:30pm with no re-application and more eating than any lips should have to endure(#whatsadiet). It’s not terribly drying although I do a dose of HA5 to my lips in the am before application to boost my moisture level. I recommend color heroin for a popping red that is great for Summer and can take you into the holidays. This isn’t a must-have unless your name is Nina Copeland and you can’t go without a lip color at all times. All times.

Go hit the drug store and try out some of my money saving faves. Let me know what you think. Leave a comment, tell me on our Facebook page or our Instagram. Or you could send me a snap!

Love to hear from y’all! Keep it Skintastic, Nina

Dermatology Saves Lives

For those of you that don’t know my background, I started as a nurse aide on OB/GYN unit at Washington Regional Medical Center In 2000. As a very young child I always wanted to be a plastic surgeon. I joined the healthcare academy in high school and that’s how I got involved in nursing. One of my very first mentors professionally was a nurse who taught at my high school. She helped me get my CNA license. I then worked through college at an outpatient surgery center and immediately after graduating became an ICU nurse. I worked as an ICU nurse from California to Florida. I only cared for people who did not know if they would live or die that day. I recovered open heart surgery patients and neurology patients. I took care of people on life support after traumatic injuries. Some of the medications I gave people would be keeping them alive. If I made a mistake it could literally kill someone. I loved that work and I was successful in that field. When I graduated with my Nurse Practitioner license I was offered jobs by neurosurgeons, cardiologist, cardiovascular surgeons, emergency rooms and hospitalists. All doctors who had learned to trust me and had seen my skill set over the years. So when I took a job in Dermatology you can imagine what some of my colleagues said. “Why are you going to waste all your knowledge in Dermatology?” Or “Have fun popping zits all day” and maybe the most annoying “You will be so bored there”. But I knew in my heart the reasons I wanted to be in Dermatology with Dr. Brad and Dr. Sandy as my mentors (I had only met Honey  briefly at that time but she has become one of my biggest supporters and mentors me still daily). I knew that I wouldn’t have to wonder if those people who moved out of ICU ever lived a fulfilled life. I knew that I wouldn’t be shocking hearts into normal rythym but that I would be changing lives. I knew that I would be working for a company that cared about their patients more than their numbers. I knew that I would be valued as a provider. I knew that I would get to know my patients and learn what was important to them and be able to help them reach their skin health goals. I made the right decision. I have never looked back. I am blessed. One of my beautiful patients wrote something to talk about how Johnson Dermatology and the medication dupilimab for atopic dermatitis has changed her life. Here is her story. I hope you read it and all understand how Dermatology saves lives.

By the time I was 2 weeks old my parents started to notice my skin was a little different. They never imagined this would be the beginning of a very long road.
It started with patches and cracks , from there it began to get infected. After months of trying to find therapies that healed my skin I was officially diagnosed with Atopic Dermatitis ( Eczema). Mine was considered severe, so I was started on steroids very young. At that time that really was the only treatment they could offer. Due to my severe case I was on a strong steroid called prednisone 2 to 3 times a month after I was a year old. This therapy was after trying betamethosone and topical steroids. I was also kept on antibiotics to help keep the infection down. I had a very strict regimen of 20 minute baths to soak my skin . I would then have to be covered from head to toe in steroid ointments and creams. By morning my skin would be dry so we would have to repeat this. This has been my life since I was born. Not only was this emotional for me but for my parents, sister, and family. These treatments were so painful because my skin was open. My parents told me as I got older I used to scream everytime we had to apply medicine. I remember it felt like my body was being lit on fire. I was prescriped atarax and benadryl to help me sleep and comfort the pain . This treatment did end up being unsuccessful because it caused night tears. I continue to use benadryl as a treatment when needed for itching .
As I got older I started to really realize how different I was . No one else had to pay attention to their skin like I did. No one my age felt pain like I did or had to have help from my parents in the morning opening their arms or legs. This was due to pus from my skin being cracked open and scabbing over. The creases in my arms and legs behind my knees would stick together. These were daily struggles for me that no one could sympathize with . There were times I felt very isolated and had to hide my skin from embarrassment. Due to my eczema being so severe I also developed severe Asthma. This led to more medication and years of trying to find inhalers that controlled it. I honestly felt like I was always sick and missed out on so much as a kid .
After years of being made fun of and constantly being asked “ what’s wrong with your skin?” I started to accept myself and realized this is a strength , not a weakness. I started to take real interest in my disease instead of despising it. I quit wearing hoodies to hide it and started being okay with explaining what I have. I started to explain to people that my disease does not make me ugly and that yes it hurts but I will not let it get the best of me .
Eczema not only affects your skin and body physically it is an emotional disease. It has caused me alot of anxiety especially with bad flare ups. It has made me feel alone. It made me worry no one would ever want to hold my hand or accept that my body was covered in this rash. There has been alot more to my eczema than I ever thought imagineable .
I was diagnosed with an allergy to the cold weather. I have grown up with severe allergies specifically pollens and grasses, dust and animals. I also had food allergies to eggs and peanuts. I was prescriped an Epi-Pen for my peanut allergy because of anaphylaxis . needless to say I was no stranger to allergies. But…. this was definitely new to me. How could you be allergic to the weather? Well I am . The cold really started to affect me. My legs were covered in so many hives you could see them through my clothing . My hands swelled so bad I could not make a fist. My joints started to be affected as well . These were new symptoms to my eczema I had never experienced. After moving to New York with my husband I started to experience severe joint pain . My hands started to curl up to the point I could not use them . This was the most difficult experience I ever had with my eczema. I never had to deal with this much pain.I went through multiple tests from rheumatology and dermatology I kept getting the same answer, “we have never seen this with eczema”. It was really discouraging and exhausting. I’m a very athletic person. I am optimistic. I was in school to become a nurse and help others. This was very discouraging . It was hindering my career, my life . For once my skin was stopping me. I continued to be told that it was environmentally induced. This gave me hope that when we moved back to Arkansas my skin would get better. I would stop having the severe joint pain . We did eventually move home and my skin did not get better. This was probably the lowest point for me. I didnt know how I was going to continue my life like this . I was in so much pain. I am a nurse so it was affecting me at work as well not being able to use my hands. I could barely walk due to my severe bone pain in my feet and ankles. I finally decided to start a medication called cyclosporine in hopes this would help. This and prednisone did help for about a month . After that month I started to get severe infections. It was one after another for about the next 6 months . I finally decided I could not take the cyclosporine . I was told there were no other treatments for me at that point. I was truly so sad. My skin was at its worst and there was no hope. I had so many cracks in each knuckle my gloves at work were inbedded every time I tried to take them off. My back was so raw my scrubs stuck to it every time I got up. I had a severe staff infection on my scalp . I never could have imagined I would be this bad.
I finally got a glimpse of hope soon after all of this . I was told there was a new drug being approved called Dupilumab . It was an injection for people suffering from eczema and asthma. In trials people had experienced great success. I was so happy and could not wait to try this medication. I ended up being apart of a clinical trial for this through Johnson Dermatology . I have always wanted to use my Eczema to help others with research and I was finally getting a chance to do that. After just a month my skin started to improve with Dupilumab. This meant so much more to me than just my skin looking better. This treatment and the support I received from Johnson Dermatology gave me quality of life back I had been hoping for. This injection gave me the hopes that I could have a successful pregnancy in the future. This treatment was and is a true blessing .
If I can say one thing about my eczema its that it is a gift. It has taught me so much and continues to teach me about my self and others. It has given me the strength I need to be a compassionate daughter, sister, wife, and nurse . When people ask me now “ what’s wrong with your skin?” I proudly say I have eczema. I am not ashamed. Its something I have to live with every second of every day. I still have a strict regimen every night and every morning. Our skin is our largest organ. Most people do not even think about it daily. My skin is different, it is dry, scaly and cracked . I have to really take care of it but it makes me who I am . I have learned I am not alone, I am not isolated, I am not ugly . I am strong. I am a person, beautiful inside and out.

Thank you so much for this inspirational story from our JD patient. I thank God that I was a patient in that clinic that day and she was my nurse. As soon as we met, I knew she was a perfect candidate for the clinical trial. This is how Dermatology saves lives. If you or someone you know is interested in participating in a clinical trial then e-mail

Stay Skintastic and don’t let anyone talk you out of your dreams or tell you that what your choices and missions are in life are less than theirs. Always go change lives the way you know you should. Nina

Specializing in Skin Cancer while Providing Comprehensive Skin Care

Dr. Sandy has done it again. I absolutely love when she guest posts on the skinny on skin. This blog makes you go hmmmmm. Then makes you want a skin cancer full body exam. Go ahead, you’re intrigued, read on……
October is Breast Cancer Awareness Month. This is important since breast cancer affects 1 in 8 women.
Did you know however that skin cancer affects 1 in 5 people (men and women)?
Did you also know that melanoma is the most common form of cancer in women ages 15-29 years?
Did you know that one American dies approximately every hour from melanoma?

Whether or not you already knew all of this, you may find more about skin cancer and other skin cancer statistics on our website as well as the American Academy of Dermatology’s website You will also find other helpful information about prevention and treatment of skin cancer. We take skin cancer prevention and treatment seriously at Johnson Dermatology. We still hold true to the vision that Dr Brad and I created when we opened the clinic in 2006 “Specializing in Skin Cancer while providing comprehensive skin care”.

Time for more questions—
Did you know that Dr Brad was the first fellowship trained skin cancer dermatologic surgeon in the region—including Ft Smith and NWA?
Did you know that every year since we opened in 2006, we have offered and will continue to offer free skin cancer screenings?
Did you know that Dr Nelson joined the JD team in 2016 because he also believes in our mission and vision and wants to offer the highest quality care to patients, especially patients with skin cancer?
Did you know that the number of patients with skin cancers and melanomas seen at our clinic have steadily increased in the past few years?

Here are some more sobering statistics about skin cancer at Johnson Dermatology.

The following are how many patients at our clinic were diagnosed with melanoma
In 2014, 35 patients were diagnosed with melanoma.
In 2015, 48 patients were diagnosed with melanoma.
In 2016, 48 patients were diagnosed with melanoma.
In 2017 (January through September), 47 patients were diagnosed with melanoma.

The following are how many specialized skin cancer surgeries with frozen sections were performed at our clinic for the same time periods.
In 2014, 1220 surgeries were performed at JD.
In 2015, 1339 surgeries were performed at JD.
In 2016, 1612 surgeries were performed at JD.
In 2017 (January through September) 1364 surgeries were performed at JD.

These specialized skin cancer surgeries are performed under local anesthesia at our clinic by Drs Brad and Nelson. They cut out the skin cancer with the smallest amount of normal skin around and under the tumor then gives that tissue to our amazing in clinic lab team who processes the tissue into frozen sections that Drs Nelson or Brad look at with the microscope. If they got all of the cancer cells then they close up the surgical wound as skintastically as possible. If there is a small piece of cancer left anywhere, they go back and remove some more tissue from that area and repeat the process until there are no more visible cancer cells. It is because of this tenacity that Mohs surgery has cure rates of 95-99% as compared with 90% with excision. Because we specialize in skin cancer, we offer not only Mohs surgery but we also offer excision, electrodessication and curettage (ED&C), creams, photodynamic therapy, chemical peels, laser, etc for skin cancers and actinic keratosis (pre cancers). When looking for a skin cancer surgeon, training and experience of the surgeon as well as of the lab team is important. Lisa, who now manages our lab team of 6 full time people and some helpers, has been working in the lab for more than 10 years. She and the team are skintastic and work extremely closely with Drs Brad and Nelson as well as with Dr Amy. Dr Amy is a board certified dermatopathologist extraordinaire on the JD team with more than 20 years of experience.

I know if you are reading this, then I am probably preaching to the choir. However, an ounce of prevention is worth a pound of cure. Get your birthday suit checked by your dermatologist at least yearly. Do self skin exams monthly. There is research that shows that having a significant other who helps do your skin exams also helps to catch skin cancers early. Also please try to prevent skin cancers and premature aging by using a sun block with antioxidants that is also broad spectrum against UVA/UVB/IR daily; using retinol nightly to reverse the damage caused during the day; wearing your sun hat, sun glasses and sun protective clothing; seeking shade; avoiding the peak sun hours of 10 AM to 4 PM; and if want to take it a step further consider taking Heliocare or Niacin. Email Samira will help you schedule you an appointment to have your spot(S) checked and/or to have your entire skin checked.

In summary, the skin is the largest organ of the body and your window to the world. Protect your tatas but also protect your skin.

Stay skintastic, Dr.Sandy.