Monthly Archives: March 2019

Dr. Sandy Patient Helping Patients

I really enjoy traveling. I also really enjoy using the toiletries at the various hotels. I asked Nina if I could write this blog while I am traveling and after sampling various lotions and responding to work emails. Unfortunately, not everyone can enjoy using the various toiletries and sampling various lotions and potions. I do however consider part of my job to test products.
One of my favorite patients is one of those unfortunate people who cannot try various toiletries or lotions. She suffered with various rashes and ailments for years before she presented to our clinic. She would often “break out in a rash” while traveling or visiting a friend. We decided she should be patch tested and learned that she was/is sensitive to some chemicals and ingredients. She learned how to avoid those ingredients and became loyal to “free and clear” products. She was doing fine for a few years but then returned to the clinic with a new rash around her eyes and neck. She was perplexed because she did not change anything. She has not tried anything new. She didn’t even travel somewhere and try their soaps and lotions. So we decided to patch test again. Lo and behold she now is allergic to Cocamidopropyl betaine. This is not something I could easily pronounce but do know that it was the allergen of the year in 2004. I also know that it is related to coconut oil. The surge in popularity of coconut oil may be related to the surge of people allergic to Cocamidopropyl betaine.

One of the reasons that she is one of my favorite people is that she is a great researcher and sleuth. She learned that there are many alternative names for this ingredient and that it also cross reacts with other ingredients. She also learned that it is in some products even if it is not listed on the label. For example, it is found in many mascaras…even the “organic” or “natural” ones.

According to (I like the way they worded this) “Cocamidopropyl betaine is a chemical found in many personal care products, including shampoo, toothpaste and body wash. The chemical is derived from coconuts and is used to make products produce more foam. Because cocamidopropyl betaine originates from coconut oil, even some personal care products labeled as natural still contain it. Although the government regards the ingredient as safe, some people do have negative reactions after exposure to it.” Many of us like Cocamidopropyl betaine because it is a “natural” surfactant that makes products sudsy. After all, we all like “natural” products, right? After all, coconut oil is natural. Poison ivy is natural. True mascara is made of bat guano which is also natural.

She was generous enough to share with all of us some ingredients that she can use even though she is allergic to Cocamidopropyl betaine. She shared this list with us.

1)Laundry detergent-the only SKU from 7th Generation

2) soap/shampoo bar from amazon-all 3 of us love this. It has no chemicals so after 3-4 washes, your hair is much softer. It takes a few times to detox the hair.

3)lotion-this is WalMart’s version of Aveeno. We use both.

4)I’m making my own makeup remover with equal parts Witch Hazel (Walmart) and Grapeseed oil (Old fashioned Foods) plus 4 drops lavender oil. You have to wipe it off with dry cloth but it works.

Like many people who suffer with contact dermatitis, she has learned to be creative. We would be honored if you suffer with contact dermatitis or other skin ailments and would like to share some of your creative solutions with us. Please do so by emailing our skin care product specialist Brooke at or posting on Instagram or Facebook and tagging us at location Johnson Dermatology or with #realJDpatient Until next time, stay skintastic and know that our team at Johnson Dermatology is here to serve you and your skin care needs and wants. S



Go Back!

I’ve been injecting for about 7 years. When I first started injecting I had very few side effects or undesirable outcomes. I’ve had more this past year than any year before. Sounds backwards, right? I should be a more experienced injector now. Well, I am. I also inject over 100% more patients than I did 7 years ago. The more patients you inject the more likely one of them will have a side effect. That’s because any injector that injects long enough will eventually have a complication. It’s not a matter of if an injector will have a patient with a complication, it’s a matter of when. Now don’t get me wrong, a good injector that knows the anatomy of the face and puts safety first is less likely to cause a complication. However, an injection is never 100% safe with zero possibility of undesirable outcomes. I’ve had patients who have had complications. I also have prepared for how to treat those complications. Through continuing education and consulting with colleagues and choosing to practice in a Dermatology clinic that values patient safety I feel prepared for complications. At JD we keep hyaluronidase on hand at all times to be able to immediately dissolve hyaluronic acid fillers. We take MANY precautions to prevent complications like infection and vascular occlusion and bruising and swelling and more. Some complications happen immediately but many develop over a period of time. This is why it is very important to have a good relationship with your injector. At JD we have an after hours phone number that I encourage my cosmetic patients to call if they are having any symptoms that were not expected with their treatment. It is always important to contact your injector and follow up with them if you have any undesirable outcomes or fear you are having a complication. Often times patients come to me from another injector after being “botched”. The very first question I ask them is “did you go back to discuss with your injector?”. If they have and still don’t have desired results then I proceed but often times they come to me immediately and I recommend they allow their injector to “fix” the problem first. Because that’s usually how the patient has the best results. Botox and fillers can be forgiving. I have all my first timer patients come back and see me in two weeks for this exact reason. We want to make sure it’s perfect and usually if there is any small tweaking we would like to do we can achieve it at that visit. It’s easier for me to tweak my own injections because I know exactly what I injected and where I injected it. When someone comes from somewhere else, especially if it wasn’t a medical facility, it can be difficult to track down what was injected and where. I’ve had times when I didn’t know if the patient had silicone or HA filler or something else. This makes it difficult to know the best way to fix the problem. It’s also important to keep the same injector because we get to know the little things you like and don’t like. No one has the exact same anatomy. Yes we all have a nose but none of our noses look EXACTLY the same. We all have the same muscles in the face but they don’t move and look EXACTLY the same. So there is a science to injecting and an art to injecting. The more times you are treated by the same injector the better the art of injecting becomes for you specifically and results tend to get better and better over the years. Which is how we age backwards naturally at JD. If you’re still hanging on at this point, thanks for reading. The moral of the story is there is value in trusting your injector and building a long lasting relationship with them through good communication. I hope all my patients know I sincerely care about their results and their safety. I hope they all trust me to do the right thing to enhance their beauty and know that my heart hurts with every complication but that I promise to do everything possible to make it right. I hope that everyone that is injected understands the risk of cosmetic injections and the importance of an expert injector. The core specialties are Plastic Surgery and Dermatology and I recommend starting there for your search for the right injector for you and not on social media. Photos can be a trap. Lighting and angles and more really affect before and after photos and they can be deceiving on social media. Interview your injector during a consultation before you pull the trigger. Make sure they (and their staff)look natural and in line with your goals. Make sure they know how to treat complications. Do your research and then feel the vibe. There are some patients who don’t vibe with me and we agree together to not form a long lasting relationship. There are other good injectors out there. More often than not, we do vibe and we stay together for a long, long time. And that my friends is my favorite part of being in aesthetic Dermatology. The relationships with all my clients that will last a lifetime, of 29. Vibing at 29 years old forever. That’s the goal.

Stay Skintastic, stay vibing and stay 29 with me forever, Nina

Almost Spring Break!

It’s almost spring break. Who is excited? I am! It’s my first time to celebrate spring break in 8 years. I was in that chapter of life between graduating from grad school and having children in school. My oldest daughter started kindergarten this year and that means spring break is back baby! We are heading to the beach so I immediately started my wardrobe search. I’m so excited about some of my finds I just knew I had to share them with you! I added in a few of my tried and true beach must haves to the list.

  1. Blue Stone Sun Shields. This is my favorite new find this year. These are basically a visor that has a shield that you can pull down to protect your entire face from the sun. They come in the best colors. I’m not going to lie, I also love that people can’t see my face. I feel so incognito like I’m someone important hiding from the paparazzi when I wear it out. Go check ‘em out!
  2. Beachriot. My new favorite swim pants. Rashguards and swim shirts are fairly easy to find. Swim leggings are harder. Finding anything but black is even harder. Then I found beachriot who has the cutest swim pants ever. They run small so I would size up when you order. I got the leopard but plan to get more because I love the waistline. It sits in the perfect spot for slimming and it’s wide so it doesn’t roll down with activity. Promise you will still be fashionable with these on poolside.
  3. My kids favorite sunscreen. Sea Star Sparkle Sunscreen. It is SPF 50, water resistant, physical blocker with zinc oxide and broad spectrum so it meets all my requirements. It smells like cake and is FULL of rainbow glitter so my kids love it! They have other fragrances/colors but I’ve stuck with the rainbow. Might not be best for sensitive skin children due to the fragrance and all the glitter however, my kids never complain about how it feels on the skin. Find it here
  4. My favorite rashguards. The Seea is by far my favorite swim top. They have the cutest designs and it’s fashion first when you are dressed like a ninja on the beach. It’s what I’m wearing almost anytime you have seen me out. They are on the luxury side price wise but they always have sales and that’s when I stock up. Here is the link to one of my favorite designs that is currently on sale!
  5. Tinted Lip balm with sunscreen by Coola. This is one I haven’t worn all day. Just got it though and love one application. It comes in multiple colors so everyone can find a tint they like. It’s one of the only lipbalms I have been able to find that has a physical blocker. It has zinc oxide and titanium dioxide. I plan to pat a little on my cheeks while I am at the beach for a little blush look too.
Leggings:beach riot. Rashguard: The Seea Visor: Blue Stone Sun Shields
Leggings:beach riot. Rashguard: The Seea
Visor: Blue Stone Sun Shields

I hope you all have a Skintastic spring break! Let me know if you enjoy any of my favorite Skintastic finds by tagging @johnsondermatology