They say that the eyes are the windows to the soul. If you believe this, then you agree that the eyelids are the window treatments that you see the soul through. Many people don’t come to me seeking treatment for around the eyes but after they are treated there, they absolutely love how refreshed, awake and youthful small tweaks to the eyelids have made them feel. There are lots of safe, effective treatments for the eyelids but beware this is a high risk area to treat and you should seek an expert healthcare provider when treating this area. I can’t tell you how many “botched” eyelids I’ve fixed (#humbrag). Here are my favorite options for treating lines, wrinkles, crepe paper like eyelid skin, dark circles and the dreaded “bags”.

1. Blepharoplasty- This is a surgery where they repair or reconstruct the eyelid. We don’t perform this at JD but it is a good option for some people.
2. Filler- I personally think this is the easiest way to “botch” the eyelids. It’s a high risk area to inject and can even cause blindness. I often times inject the midface to pull the skin under the eyes which looks natural and works wonders. warning: seek an expert, please!
3. Botox- FDA has approved 24 units for “crows feet”. If your main focus is to enhance your smile with softening your “crows feet” then Botox is the way to go. Warning: Seek an expert. When injected incorrectly this could cause a “shelf” look to the cheek when smiling. FYI: This is my personal favorite location to have Botox injected. It opens my eyes and helps me look so refreshed compared to how tired I am with two kids under 3.
4. Growth Factor- This is the precursor to collagen. It’s a hot ingredient right now and guess what?  You don’t have to pay all that money for a poorly studied procedure (cough, vampire facial, cough) to get the benefits of growth factor. It is an unstable molecule so you need a good researched skin care product to reap the benefits. My favorite is TNS recovery or TNS essential serum from SkinMedica. It works, it’s magic like breastmilk and it can’t be reproduced. It tells your collagen factory, which  starts slacking as you age, to make more collagen. The recovery I recommend for acne prone skin and the essential serum is good for everyone else, especially if you tend to be dry skinned because it has vitamin C which is excellent for moisturizing. Warning: You must get through two bottles before you decide if it works-it’s like losing weight, real results that last take time to achieve.
5. HA5-The newest product to the SkinMedica family and most patients’ current fav addition. Imagine a cream that fairies make with the water from the fountain of youth on the beaches of Bali and then travel via Unicorn to have it packaged in a magical factory made of spring flowers where the employees let little newborn babies give each bottle a little giggle and snuggle. That’s the feeling I get and what I dream of as I apply HA5 to my face. It’s that good. It contains 5 hyaluronic acids that get you an immediate plumping but as you use it over time the vitis flower extract in it tells your skin to make more collagen resulting in reduction in fine lines, wrinkles, redness and irritation. Come get some, you can thank me later. Your eyelids will go from scratchy potato sack to silk curtains before you know it.
6. Sunscreen- To prevent premature photoaging around the eyes you should apply at least a 30 SPF broad spectrum, waterproof sunscreen daily and reapply every 2 hours while outdoors. My favorite for antiaging is the Total Defense and Repair by SkinMedica because it repairs but it also has a tinted version that covers and protects against infrared rays too!
7. Latisse-This is a prescription FDA approved and effective treatment for lengthening, darkening and thickening the lashes. If I use mine every night I can’t wear my glasses without my super lashes pushing them down my nose-yes I’m serious. There is no generic or alternative with the same ingredients. It’s very cost effective compared to eyelash extensions but it is also great to use with eyelash extensions. After I have injected and lasered my mom, she feels like Latisse is what really made her look/feel younger. You don’t realize how much losing your thick, dark, long lashes matures you.
8. Sublative- This is thought of like some people may think of laser but it is not a true laser because it isn’t light. It is microneedling and radiofrequency. It breaks up the top layer of skin and makes you rebuild collagen. It tightens the skin helping fine lines, wrinkles, crepe paper like skin and sagging around the eyes. There is some downtime with this procedure but when you see the before and after pictures of some of our patients you won’t care what kind of labor you have to go through to have those babies!

I would encourage you all to come see us at Johnson Dermatology and let us consult what the best option for you is to beautify and enhance the window treatments for the windows to the soul. Dani is our cosmetic coordinator who loves talking procedures with you and we also have a great skin care product team to discuss products with you anytime.

“Seek the wisdom of the ages, but look at the world through the eyes of a child” -Ron Wild

Hope your weekend was perfect, xoxo, Nina

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Someone once said that you can’t give advanced knowledge to someone who is basic, even if the knowledge is basic to you. It makes sense. We all have different expertise, knowledge on different topics. If I try to talk to my husband about healthcare he often gets irritated with my medical terminology skills. 10-4 is my most advanced radio lingo but he can have a full conversation with his cop friends in nothing but numbers. One question that I get asked a lot about products is “how do I use it?” which seems self explanatory to me. But something so basic can actually be very complicated. How much do you use? In what order do you use it? Wash first or after? Leave it on indefinetely or wash it off? Where can I put it? Where shouldn’t I put it? Skincare product application can actually be trickier than I give credit. So here are my tips for skin care product application.

1. Always apply sunscreen as your LAST product in the mornings. Otherwise the order is usually flexible. At Johnson Dermatology we try to write down what order to use products if it makes a difference.
2. Put product on the back of your hand before applying it to your face. This allows control of consistency of the product before going to your face and it keeps your hands’ skin taken care of too. If you pump the product into the palm of your hand then some of the product is wasted on the tough, thick palm skin. The back of the hand can really age a person. You want your hands protected with sunscreen and reversing the damage with retinol or other specialty products. Some products separate in the packaging. Squirting onto the back of your hand and then mixing with one finger there allows you to get rid of any dry clumps and mixing any separation that may have occured in the bottle.
3. One pump is enough. If you are using a product that comes in a pump (retinol, TNS, lytera or HA5 for example) then one pump is a sufficient quantity. If you are using a product that comes in a jar (like redness relief calmplex) then use one pea size drop amount for entire face. This is a general rule, sometimes there are variations but this is a good starting point at least.
4. Apply evenly to face. My favorite technique is to get the initial pea size drop of the product on the back of the hand and make sure it is mixed evenly and remove any clumps from drying. Next, take one finger from the opposite hand and put an even amount on each cheek, forehead, chin and nose. Then you can rub it all over your face for an even distribution. If you have some product left on your hands rub down the neck and decollete. Lastly, rub the back of your hands together so no product is wasted.
5. Wash your face prior to applying product. This simply gets off any dirt or product that could block your skincare products from penetrating the skin like you want. I don’t recommend cleansing more than twice a day.

What tips do you have for applying skin care products? Would you like to see a video on our youtube page of me applying my regimen? Do you have any questions? I love hearing from you guys! I always take your suggestions to heart. Hope your weekend was magical!

“It’s still magic even if you know how it’s done.” -Terry Pratchett

XOXO, Nina

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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.

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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

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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

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International Women’s Day is this Tuesday, March 8th, 2016. According to www.internationalwomensday.com 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 (www.thealisonshow.com 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

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When life throws you curve balls it’s easy to get down. To feel sad and grumpy. I know that all too well as of late. My husband has had the usual police officer stressors and then some, we lost my Father-In-Law, I have two kids under 3 years of age, just a full plate in a busy life that doesn’t seem to have time to slow down. We all have our own coping mechanisms. I personally use simplicity. I slow down and take time to really enjoy the small simple things that make each day great. By changing my focus to the little happy things, it leaves little room for sadness and anger. It may be something as simple as a warm, quiet shower, a soft snuggle from my baby, a poached egg that’s cooked perfectly or just a breeze in the air that feels amazing. You know the little things that make you smile. Making things simple just brings life into focus for me. This weekend I’ve been really working on simply enjoying every second. What do they say? “the days are long but the years are short”.  Making life simple makes the time that passes easier and happier. As that time passes, so do most of the curve balls and life circumstances that have been trying to get you down. So I started thinking about how to simply care for your skin. Skin is the largest organ in your body so you need to take care of it. Some people probably don’t want to go to the extent that I do daily so here is how to very simply care for your skin (no injections, no regimens,no lasers, nothing complicated).

1. Moisturize- Dry skin can crack and be prone to infection, itching and flaking. At least slap on some moisturizer right after the shower once a day.
2. Avoid irritants- Avoid colors, fragrances, additives and chemicals. This is easy if you follow a simple rule while picking out products: avoid products that have more than 10 ingredients.
3. Use a good sunscreen- I recommend UVA/UVB, at least 30 SPF, water resistant and preferably a physical blocker such as zinc oxide. (I like BOB, Elta MD, SkinMedica and Bare Republic brands).
4. Be gentle- Don’t scrub, pick, scratch nor pop your skin. Simply avoid loofas and scrubs.
5. SUN PROTECT-Sunscreen is just a small slice of the pie! Seek shade (cheap and easy), avoid the hottest parts of the day and wear sun protective clothing! Wide brim hats are so in style right now this should be a simple outdoors outfit staple!

Follow these tips and your skin will simply thank you…..

I hope you simply enjoyed your weekend, I know I did!

XOXO, Nina

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Valentines Day is all about love. Kisses, hugs, snuggles, roses, chocolate and all the good feels. That’s what makes a great Valentines Day, right? I’ve spent the day hugging my girls a little tighter and giving out extra kisses to my hubby. I hope you all have had as much love in your day as I have enjoyed today. If you are lucky enough to have some smooches today, I hope your lips were smooch ready. Here are my tips for getting those lips ready for the big kiss!

1. Be bold- No one looks bad in red lipstick. If you think you can’t pull it off you’re wrong. If you need a day to try it, Valentines is THE day! My favorite right now is Jane Iredale lip crayon in hot.
2. Don’t be afraid of filler- Do you want fuller lips? Want more of a cupids bow? Want a sexy pout? Don’t be ashamed of filler, it’s in style and can be done to look very natural. Do you follow us on snapchat(@jdermatology) and instagram(@johnsondermatology)? That’s where we have video and before and after of injections for you to check out.
3. Avoid irritating lip colors and products- Some “chapsticks” tingle or burn when you put them on-don’t use these they can irritate and dry out the lips.
4. Apply sunscreen daily-Pick a lip balm that has broad spectrum SPF 30 (at least). You can get skin cancer on your lips and it can be aggresive so sunscreen is a daily must. Plus sunscreen can prevent brown spots on your lips and premature aging.
5. Stay hydrated- Drink plenty of water. And keep the air hydrated during these dry winter months. Consider a humidifier.

Hope you felt the love today. For the rest of this month you get a free Jane Iredale lip color of your choice with the purchase of just one syringe of Juvederm for your lip injections. Now that’s a Valentines present you deserve! Hope I get to see you at the clinic this month where love is in the air.

Happy Valentines, x’s & o’s, Nina

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It always surprises me what people like and don’t like aesthetically speaking. Some people like a hairy armpit and some can’t stand the thought. Almost everyone I know has removed hair from one unwanted area on the body or another. There are lots of hair reduction and hair removal techniques including creams, waxing, laser reduction, shaving, blading, sugaring and threading (just to name a few). Some of these techniques can result in rashes, burns, infections and even scarring. Here are my do’s and don’t of hair care to avoid these complications.

1. Shaving- Make sure you change your blade frequently to avoid infections. You also want to have a sharp blade. If your blade dulls you will be more prone to folliculitis or razor burn.
2. Waxing- I usually don’t recommend waxing because I want all my patients on a retinol and you can’t wax on a retinol. Waxing can cause hyperpigmentation which is a dark discoloration left behind. You’re especially prone to this when you are tan.
3. Creams- There are both over the counter and prescription creams. Be cautious with these because some of them can irritate the skin. I would advise doing a small “test area” first and follow directions exactly. These can cause chemical burns when not used with care.
4. Laser reduction- When done by a trained medical professional laser is an excellent option for dark hair. Blonde or white hair doesn’t respond well to the laser. We have both the YAG and the elos lasers for hair reduction at Johnson Dermatology. We usually recommend monthly treatments for 3-5 sessions until desired results are achieved.
5. Blading- This is a really good option for blonde, gray or white hair. I usually recommend this for people that want to get rid of their facial “peach fuzz”. It’s a tool that gently removes the unwanted hair at home. Most people do it every 2-4 weeks. You can schedule a cosmetic consult for more information at Johnson Dermatology.

Thank you to Honey who helped me form this blog as we enjoy the super bowl. Our half-time was spent talking about hair reduction and dancing to Beyonce. Hope your team takes home the trophy! Hope to see you this week at the clinic!

XOXO, Nina

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It’s hard to introduce one of your favorite role models in the world. Words don’t do her justice. Without delay, here is Dr. Sandy’s blog post “Choices, Skin Care Edition”.

As you know, I am a big fan of Nina and Jarrard Copeland. They are amazing human beings who make our world a better place to live. Instead of singing their praises for the rest of Nina’s blog, I will state that I wanted to write another blog post for Nina to free up some of her time to deal with some of the challenges life has dealt them currently. They have a lot of inner strength and as usual, choose to take the high road. I am still reflecting on life and life choices. Sometimes we get to choose in life and sometimes life chooses for us. How we choose to deal with life determines our character. Nina and Jarrard have impressive character.
Since childhood, I have been self-conscious about my crooked teeth. Our dentist told my parents that braces were not needed…..and they believed him. Not so pretty dentition greatly impacted my life. As I age, I think my teeth have become more crowded. So….I chose to get braces at the same time our children have braces. This means that I am choosing to have braces for 3 years during my mid-40s. I know that my teeth are already moving and I will be happy when the braces are removed. I know that I chose this. The awkwardness and other consequences however of wearing braces is more than I anticipated. Reflecting on this choice, I realized that I am a patient and consumer of health care instead of my usual role of being the health care provider. This process has made me even more sympathetic towards my patients. Health care choices can be overwhelming. “Cosmetic” choices can carry even more emotional ramifications. I however look at things differently than most people. I believe that our life is God’s gift to us and what we do with it is our gift to God. We must always give and do our best with everything. When it comes to our bodies, we are taught that we are temples of the Holy Spirit. I want to keep my temple looking good until God calls me home. This is why I try to eat well, exercise, get enough sleep, drink water, use sun protection, minimize stress, etc. This is also why I color my hair and use good skin care. This is also why I got braces. This is also why I go to experts for my care. This is why Nina injects 50 units of Botox into my upper face every 3 months and she injects 1 syringe of Voluma every 6 months into my cheekbone area. This is also why one of our laser techs treats me “as needed”. This is also why I continue to study skin care. God made the skin the largest organ of the body. And since I think one of the gifts God gave me is a passion and love for skin, I want to share with you some of my thoughts about skin care. I hope you love the skin you are in. I don’t want you to feel uncomfortable about your skin because I know how uncomfortable I felt/feel about my teeth. So to start, be nice to your skin. We take an oath in medicine to first do no harm. Treat your skin with love and respect. Why would you want to scrub, pick, dig, your skin? Why would you want to change the color of skin that God gave you by tanning and therefore cooking your skin? Why would you trust your treatments to someone less educated and passionate about skin?

Last blog, I shared with you that I was honored to spend the weekend with international skin care experts and researchers on the Allergan campus. Until this weekend, I have believed at a minimum one needed sun protection during the day to prevent damage and retinol at night to repair damage. Other specialty products are added as the need arises. Such as TNS/growth factors to build up your dermis or lytera to diminish discoloration. I now also believe hyaluranic acid is needed to restore the epidermal barrier.

Many years ago, I switched to retinol made by SM because Dr. Vega, one of the SM researchers, developed the first retinol that also had anti-inflammatory properties. This is important because it allowed the retinol to be less irritating as well as more effective at repairing damage and preventing skin cancers. I could tell a huge difference in my skin within 2 skin cycles. (A skin cycle is about 28 days. To see any real change in your skin it takes at least 2 skin cycles.)

Dr. Vega and her team are superstars. They did not quit after developing the best retinol ever. Last year, they developed a Superscreen called TD&R for total defense and recovery. This product not only protects against UV damage but also protects against IR radiation AND has antioxidants. It prevents new damage and reverses existing damage at the same time. I no longer have to preach wear your sunscreen—people want to use this product! For what you get, it is an amazing buy. I am such the bargain shopper. The price is high if you consider it a sunscreen. But when you take into account that it blocks UVR, IR and reverses damage—it is a steal.

So now about hyaluronic acid (HA). We all know that hyaluranic acid is the current fad when it comes to skin care. We know that our body makes less of it as we age. We know that it is important for our epidermal barrier. We know it makes our skin look radiant and less wrinkled. We know that it is too large to penetrate into the skin. We know that most available products only last on the skin for 1-2 hours. What we didn’t know until these scientists did their homework is that an extract from the Vitis flower can penetrate the skin for the skin to produce its own HA. Amazing! So they developed a product that overtime (at least 2 skin cycles) will stimulate your body to make hyaluronic acid. Since they know that some people want to look “instantly ageless” (even though those claims make me cringe), they mixed this Vitis flower with other antioxidants and 5 types of hyaluronic acid. This allows my skin (and yours) to feel amazing not for 1-2 hours but for 8-12 hours. Also, with continued use, our skin will feel “forever young” by training the skin to make more HA.

If you are interested in learning how to better take care of your skin AKA your window to your soul AKA the biggest part of your temple, then I encourage you to come visit one of our excellent JD team members. One of JD’s finest would love to prescribe a personalized plan just for you. Use our education and passion for your personal benefit. Thank you Nina for allowing me to share my thoughts for the past 2 weeks. I doubt you will choose to go another week without sharing with your followers your own thoughts and choices. Thank you who have read my posts the last 2 weeks. One of the last things I say to my kids before we part is “I love you and make good choices”. So until next time, make good choices, take care of your temples and Stay skintastic!

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