Hello skintastic blog readers of Nina.  Yesterday, I was asked to give my opinion for a segment on KFSM Channel 5 news.  A woman had a pedicure and got an infection.  She wanted to warn others so she posted it on Facebook.  There were so many comments and shares.  It was also sent to KFSM and they were encouraged to investigate it.  That is why they contacted us at Johnson Dermatology.  As dermatologists, we are the medical and cosmetic experts of the skin, hair and nails.  If you have any issues with your skin, hair or nails then we would love to see you and try to help you become and stay skintastic.

The link to the segment is http://5newsonline.com/2018/03/26/woman-claims-she-got-infection-from-nail-salon-in-fort-smith/   Unfortunately you cannot hear my commentary on the segment so I thought I would write about it instead for all of you.  I would like if you would please let us know who your favorite person or place is to have your mani-pedis.  We are also interested in your other comments.  Please share this blog as well as your comments and tag us on Instagram or Facebook #johnsondermatology.  We will give one person on Instagram and one person on Facebook a free sunblock.  After all, while everyone may not want a mani-pedi, everyone needs to use sun protection every day.

Here are my comments.  I would like to say that I follow all of these rules when I get a mani-pedi but in this case, please do what I say and not as I do.  I do not always follow all of this advice.  #trueconfession

1. Do not shave for 24 hours before your mani-pedi.  Shaving will cause small nicks in your skin that can be a portal for infection.  Also, do not get a mani-pedi if you have any cuts or breaks in your skin.  Again, infection can enter through these nicks, cuts.
2. Choose a person or place where you can easily see their business license AND their certificate from the Arkansas State Department of Health (or your respective state).  If you really want to be thorough, research them to see if they have any prior citations or violations.
3. Make sure their facilities are clean.  I usually like to check out the bathroom, the ceiling tiles and their sink areas.  I like to see their autoclave and sterilization equipment.
4. Make sure they clean the sinks and all tools used. I like to see them open the sterilized bag of tools in front of me.
5. This one may bother a lot of you AND it always upsets the person taking care of me, but…. DO NOT let them trim, push back or manipulate your cuticles in any way.  Your cuticles are there to protect your empty space between your nail plate and your skin. It also protects your nail matrix which is where your nail grows.  If you look at the picture of the nail of the woman in the story, she has lots of white lines on her nail.  This is from repeatedly damaging her nail matrix by manipulation of her cuticles.  The pus on the side of her nail is also from manipulating the lateral nail fold and allowed infection to enter.
6. Whenever possible, bring your own tools, instruments, supplies, polish, etc.  That way you know they are clean and only used on you.
7. If you like the care they give you, then please tip well and tell your friends.  Most of us are quick to complain or give a bad review.  Do you know that it takes on average 7-8 good comments to overcome every negative comment?  I think we can all make the world a better place by trying to use more positive language and compliment others.  My mom always told me to compliment loudly and in public; criticize or constructively comment quietly and in private.
8. In order to have 7 positive comments to my first negative or “do not” comment, I will give some advice to keep your hands and feet skintastic.
9. Keep a jar of Vicks/mentholatum by your sock drawer.  Apply the vicks to your feet and nails regularly before applying your socks.
10. Keep some hand cream in your purse/murse.  Apply it after you wash your hands. Apply it before you drive.  Moisturize it into your skin around your nails to keep them well hydrated.  I try to apply a sunblock to my hands and face before driving anywhere more than 30 minutes

Hope this helps to keep you skintastic.  Remember to share the blog and your comments for a chance to win sunblock.

Stay Skintastic, Dr. Sandy!

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One of my favorite perfumes is Replica which I have to order from Nordstrom online. It always arrives with a TON of samples. Some of them are fragrances or make-up but a lot of them are skincare products. Even though I know I won’t start using them on a regular basis due to the ingredient list I usually try them to see what all the hype is about. Sometimes they tingle, sometimes they burn, sometimes they make my skin feel tight, sometimes I like the feelings, sometimes I don’t. None of these feelings have any bearing as to whether or not the product is “working” or delivering its promises on the package. These feelings however were placed for a reason. To make the consumer believe the product was “working” to make you “feel” something. This is a common marketing ploy to entice you to buy the product. Don’t get me wrong, I like the feeling of a luxury product. But if I have to choose between how a product feels and how it changes my skin I will chose the product that changes my skin every time. My husband will frequently say to me “well then why did they put that on the package?”. Simple, to sell it. To make you think you need it. So how do you know what to use? How do you pick what skincare is best for you? Here are my tips:

1. Products Backed up by real science. Real evidence based research. One time a member of a pyramid scheme was hassling me on Facebook messenger so I asked her to send me the “research” she talked about. She sent me one article that wasn’t double blinded and had 26 subjects. It wasn’t what I would call good scientific research to make me believe in the product. Be careful.
2. Trust an expert. The problem is knowing what defines expert in skincare. Is it the beauty counter, an aestitician, your primary care doctor, your dermatologist? Who do you turn to for skincare advice? I’m biased, I vote dermatologist. Derms definitely have the authority as far as specific education in skin goes.
3. Expensive isn’t always better. Petroleum jelly is an excellent body moisturizer and it’s dirt cheap. La Mer has a moisturizer that is no better than Vaseline in my opinion and it’s over $2000 a jar!!!!!
4. Organic isn’t always risk free. Although there are great organic products they too can irritate the skin. Poison Ivy is organic but if you rub it on your skin you get a rash. People often develop rashes after coconut oil or other natural skincare products.
5. Keep it simple. Skincare products that have fewer ingredients tend to be more gentle on the skin. Less fragrance, less grit and less color are always more. Think plain.

Good Luck! And if you need help finding a good skincare regimen I highly recommend an appointment with Dani or Margaret for a free consult! Hope you all have a great week!

Sray Skintastic, Nina

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It’s so hard to know what you need to achieve the results you desire for your skin. There are literally millions of options and opinions. If you are on our clinic e-mail list you might already be receiving our “how to know” series that we have started in 2018! I think it is important for you to know that our opinions of what products and procedures you use are based off of science(evidence based) and years of experience in cosmetic Dermatology. This week my right hand lady to all things cosmetic, Margaret is sharing about chemical peels. Margaret is an aesthetician and the sweetest, calmest, most soft spoken angel. She makes my life better and makes your cosmetic experience at JD better. If you haven’t met her yet e-mail her (margaret@johnsondermatology.com) for a free consult. You will love getting to know her and she can make a plan customized for you with make-up, skincare, devices, lasers, peels and all injectables. Let me introduce you to her today by what she has to say about chemical peels!

How to know if a chemical peel is right for you

A chemical peel is a great way to refresh your skin and can treat several different signs of aging. But how do you know if a peel is right for you?  I am an esthetician by trade and have used several different kinds of peels, but it wasn’t until I started working for a Dermatologist that I really understood how peels work and why it is very important to trust who is helping  you with your skin. The main reasons you may want a peel are to treat acne, photodamage, melasma, or fine lines. Even if you just have one of these problems a peel could be an easy way to improve your skin’s overall texture and health.

Melasma,or pregnancy mask, is a brown patchy hyperpigmentation problem that most people get on their cheeks, chin, forehead, nasal bride and upper lip. It can be worsened by hormones, sun exposure and heat. Melasma is a chronic condition so once you have it you need to control it. It will never be cured. We use  a TCA (trichoracetic acid) peel and recommend using a good sunscreen with an spf of at least 30 or above. My favorite is Total Defense and Repair because it protects against heat, infrared rays, UVA and UVB, and also repairs your damage. It is very important that you have a sunscreen that is protecting your skin from heat when dealing with melasma because heat, light, and hormones can cause melasma to darken. The tinted one is nice for the week after your peel so that you can go without makeup and keep your face moisturized.

TCA is also good for other skin pigmentation issues and texture. It not only serves cosmetic purposes but our providers can treat actinic keratosis or precancers with TCA mostly for people who have had a lot of sun damage over the years and are fitzpatrick skin type 1, 2, and 3. The fitzpatrick skin type scale helps determine what type of skin you have based on hair and eye color and how much melanin production you have and if you burn easily in the sun. Melanin is  a pigment that determines the color of your skin and is your skins defense against the suns UVA and UVB rays.

Acne is another struggle all on it’s own. Salicylic acid peels are really good to help control acne and dissolve blackheads. As with any peel, you will see great results with the first one but may want a peel 4 to 6 weeks apart for continuing  improvement.

As we want everyone on a retinol every night to help speed up your skin cell cycle keeping your skin young and beautiful.Using retinol is like giving your skin a mini peel every day. It is always wise to stop your retinol a couple of days before your peel and wait to start back when you are not feeling dry and flaky. Even if you don’t experience flaky skin you will still have great results. You will need to use a good sunscreen and moisturizer for about a week after your peel and will want to schedule when you don’t have a big social event coming up for a few days.  If you have cold sores then you can take a prescription to help suppress them so that the peel doesn’t help bring any cold sores along. Most people prefer to get chemical peels in the fall or winter because you can not have any sun exposure for two weeks before or after your peel.

 Thank you for taking the time to read this and I hope it helped you decide if a chemical peel is right for you.

Thanks,    Margaret Patton – cosmetic coordinator

Isn’t she just the sweetest? It’s hard to believe she deals with me all day huh? We are yin-yang which makes the best team! Hopefully you can see us in action at the clinic soon. Like March 14th our cosmetic day when everyone injected that day gets a free collagen stimulation facial with our  yag laser($150 value)!

Have a great Sunday, stay Skintastic, Nina

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Who has met Dani? She is one of our AMAZING cosmetic coordinators! She has been personally trained by Dr.Sandy, myself, Shelly and multiple cosmetic world influencers from outside of the clinic. Her passion is cosmetic Dermatology. She has a degree in biology from UAFS so she really understands the science behind the products we use to enhance your skin.  We are so lucky to have her at JD on the cosmetic team! You lucky readers get to hear from her today as she gives you the low down on how to know what filler you need(need not want, NEED). From Dani:

When it comes to cosmetic injectables, how do you know what you need? Often times we will see patients who think Botox will make their lips bigger or that filler will make their face look frozen. These are both common misconceptions.

So…how do you know when to use what product and where?

Let’s talk Fillers
Think of fillers as a temporary implant. They are used in areas that suffer from volume/fat loss to rebuild the structure that is no longer there. As we age, our bone density and fat distribution in our face changes and with that change there is no support under our skin to hold our skin where we want it to be. Therefore, over the years as we age, our skin begins to sag and become heavy because the support we once had is no longer there. (see below)

Once you have determined that filler is in fact the injectable you need, then the question becomes:

Which filler should I use?

At Johnson Dermatology, we love the Allergan brand of the Juvederm family of fillers. Allergan strives to provide the most durable fillers with a high lifting capacity to deliver results. Their fillers consist of Vycross and Hylacross technology. Vycross technology is tightly crossed-linked fillers that take a longer time for our bodies to break down versus the Hylacross technology which is not as tightly bound but is more moldable.
Juvederm Voluma is the thickest of these fillers which uses Vycross technology. We prefer to use this filler deep and against the bone to help rebuild that structure that has been lost. The results of Voluma typically last for 2 years! Dr. Sandy loves this in her cheeks and asks Nina to inject one syringe every year to keep her looking skintastic and to help her continue to build collagen.
Juvederm Vollure is kind of like Voluma but is cut up into thinner pieces and also uses Vycross technology. Since this filler is a bit thinner than Voluma we don’t have to go as deep with this filler, so we often use this filler around the mouth to turn the corners of your mouth back to a smile. Dr Sandy has this in her lips and lip corners to prevent her lipstick from bleeding.
Then there is Juvederm Volbella which is another Vycross filler. This filler is the thinnest filler we use. It is perfect to fill in lines around the mouth and since this filler is so thin it is perfect for those patients who do not want their lips bigger but want the lines to be gone. I, have this filler in my lips to give me more definition and lift the corners of my mouth. There is a video on our Facebook page of me getting volbella to lift my lip corners.
Lastly, we have Juvederm Ultra plus which is our favorite filler we offer that uses Hylacross technology. We love this Hylacross filler simply because it last longer and is smoother than other hylacross fillers. We use this filler to make your lips “kiss ready”. This is our go-to filler to make your lips fuller or to help give you back the lips you once had. Many of our JD team members have this product in their lips(go check ‘em out on our Instagram:johnsondermatology). We also use HA lip plump by SkinMedica to keep our lips looking juicy and hydrated.
If you still are not sure which filler is right for you then come see the experts at Johnson Dermatology. I would love to meet with you and give you a free skincare consult! Email me at dani@johnsondermatology.com.

Thanks for reading, Dani

What a great read! And what a great family I have at JD that is stepping up to the plate and helping me write blogs while I am so busy on the campaign trail! If you want to have your skin taken care of by some of the most beautiful, kind, talented, loving staff in the River Valley then you better come see us at JD! Dani is just an e-mail away, your skin will thank you.

Enjoy your Sunday afternoon, enjoy your family and friends, enjoy your blessings and don’t forget to stay Skintastic! Nina

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