Dear Melanoma Patient (past, present and future),

I would like to start this letter by saying I’m sorry. I’m sorry this letter is to you. I’m sorry that even though you wore your sun protective clothes, avoided the hottest parts of day, sought shade and wore sunscreen, you still got Melanoma. I’m sorry nobody told you to get your skin checked at least once a year. I’m sorry you didn’t know UV damage puts you at risk for Melanoma. No matter what the circumstances, I’m sorry Melanoma picked you. I’m sorry this letter is to you.

As the skin expert you trust to take care of your skin, I want you to know a few things.

Your opinion matters. Sure I went to school for over half my life time and I know the science behind your Melanoma. I know what the governing bodies say about treating your Melanoma. I know the statistics on Melanoma. But I also know you are a person, a unique person. What treatments your body undergoes I want us to choose together. I value your opinion because, above all else, you know what your preferred options are. I will give you those options and my opinion but lets make your treatment plan together.

You are at risk. Once you’ve had a Melanoma you’re at risk for another Melanoma. You can’t change your skin type. You can’t change your genetics. You can’t change your past habits. You CAN change your future habits. Be sun smart. Seek shade. Wear your sun protective clothing. Wear your sunscreen liberally and reapply often. UV damage is the only risk factor for skin cancer that you have control over. Take control of caring for your skin. Get your skin checked. Be friends with a dermatologist and visit them as often as they ask and whenever you have new or changing moles in between visits. Rely on your dermatologist.

Your testimony is important. I have spent a lot of time studying skin and feel that I am an expert in caring for skin. The problem is that sometimes I get as little as 15 minutes of a year with my patients. I try to educate them on the importance of taking care of the largest organ in their body (skin) but you have an incredible power. You have a testimony to which people can relate. People believe you. People will learn from you. People will change because of you. Please help me save skin. Use your testimony to change people’s lives, to save their skin. What you have learned from your Melanoma, how you feel, what it’s like, how you’re scared, how you fight, what scars you have endured. Share them with the world so everyone can know the truth about Melanoma.

I am here for you. I’m proud of you for being a survivor. Let me help you anyway I can. I know you are scared, nervous, confused and that I can’t understand how you feel but please let me know what I can do for you. Let me check your skin all over. Come see me when I ask you to get your skin checks and anytime that you need me in between checks. I have dedicated my career to caring for skin so please don’t stay away too long. I am honored to continue to care for your skin and I vow to always do my best to keep you and your skin healthy. Take care, you are beautiful!

With encouraging words,

Your Dermatologist, Nurse Practitioner and/or Physicians Assistant

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Fall is just around the corner and with all this beautiful cool weather we are having I am even more eager for fall to arrive. We are about to be sending the children back to school. Fall and school bring lots of fun things including sports. Athletics are such a big part of my family and so many others. I mean we do live in the South where most small towns close everything on Friday nights to head to the local football stadium. EEEEKKKK it’s exciting just thinking about the fun that’s about to be had by all! Along with sports comes celebratory slapping of booties, wrestling with heads in armpits, showering with feet sharing space, contact with each other, sweat, dirt and the dreaded injuries. The point is there’s a lot of potential when participating in sports to cause harm to your skin. So if you participate in sports, or have a loved one participating in sports this post is for you. Here are tips for an athlete’s skin.

1. After you exercise wash with benzoyl peroxide soap or antidandruff shampoo to kill that funky stuff living on your sweaty body. An occasional dilute bleach bath can be helpful too. Simply put 1/4 cup of bleach in a full bath tub and soak for 20 minutes.

2. Wash your hands and clean under your nails as soon as you are finished exercising. Don’t share personal equipment such as towels and washcloths.

3. Clean your equipment. Do you know how much funk accumulates in that chin strap. I don’t, I don’t want to know either, clean that puppy.

4. Limit antibiotics. If you have ever turned on the tv then you have heard of antibiotic resistance. Superbugs. If you need acne treatment feel free to ask your dermatologist about alternatives (we are full of them).

5. Stay moisturized. If you have dry, cracked skin its like little reservoirs for bacteria and infection to start. Your skin is a protective organ, give it the tools it needs to do its job. I recommend plain, thick cream that comes in a jar applied at least when fresh out of the shower.

6. If you get an injury to the skin, cut, scrape, etc. then keep it covered with a layer of vaseline. Vaseline provides a barrier from infectious agents. It also helps with the healing process resulting in lessening of discoloration and scarring.

7. Be Sun Smart- Shade, sun protective clothes, sunglasses and sunscreen when applicable can protect you from harmful UV rays you will be exposed to during outdoor activities.

Have fun out there all you athletes. I am starting my running game back in hopes of participating in the Fort Smith Marathon. Have you heard? It’s going to be February 2015 and a total blast. Athletics don’t stop after school. It may be time for you to find your inner athlete again. Whether you have always been an athlete, love an athlete or are going to become an athlete I hope these tips help keep your skin healthy!

Remember, everyday is a second chance, hope to see you in clinic, Nina

P.S. Shout out to Dr. Sandy who inspired and practically wrote this list. She is an amazing female athlete!

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Often times when I’m discussing Botox and Fillers I hear people say I don’t want my husband to know or my daughter or my best friend, which is fine. I want you to leave looking natural and refreshed, like you. My goal is that no one will be able to put their finger on exactly what you’ve done but they will notice something has given you a fresher look. But a little part of me also wishes that your loved ones would have no negative thoughts about cosmetic procedures.

Recently, while attending a conference, I heard a dermatologist tell a story about his young daughter. They were out to dinner when she told the waitress that her Dad needed to do Botox on her wrinkles. I laughed really hard. Kids have no filter. You can only assume that he has taught his daughter about Botox or she learned it from conversation. So that made me think about my daughter and I thought to myself “What will I tell her?”. Will I tell her what cosmetic procedures I have had done? What will my reasoning be as to why I had them done? Will I encourage her to get Botox one day, many, many years down the road? There are lots of things in our culture that change with time so who knows what the cultural norm will be in twenty years. But for right now these are the reasons I think we do cosmetic procedures. So this list is for all the nay sayers, all the loved ones of someone who feels like they can’t tell you about their cosmetic procedures and for my daughter who I want to be proud that her Momma feels beautiful. These are the REAL reasons why we have Botox and Fillers done on a regular basis.

1. Because we are confident- Contrary to people who think we do it because we are insecure. I consider myself to be humble but also confident. I almost stopped running during my run yesterday because I was so tired. I needed an energy boost so I had to turn my music up and dance/run down the street to my house to be able to keep going. Sure I’m confident enough to dance in the street. I like the natural beauty God gave me and I want to keep it that way, keep my confidence so I can continue to dance down the street.  So, I have Voluma and Botox.

2. Because we are powerful professionals- It’s a dog eat dog world out there. We all know professionals are competing in lots of ways. I am a professional and I want you to pick me as your professional skin expert. Your first impression of me is how I look and that may be how you pick me to be your skin expert whether you realize it or not. So I like to look professional, dress nice, wear make-up, fix my hair every morning and use skin care products. I want to keep that “well kept” appearance so I color my hair, brush my teeth, shop for clothes, get mani’s and pedi’s occasionally and of course, get Botox!

3. Because we want to prolong our natural beauty, NOT because we want to change how we look- We don’t want to look like someone else. We don’t hate our lips or hate our crows feet or hate anything about ourselves. We just want to enhance our natural beauty, prolong the things we do like about ourselves. You like your brown hair so you color it when it starts to turn white? Well same idea with Botox and fillers.

4. Because we deserve to put ourselves first for once- We work, we are moms, chefs, house cleaners, chauffeurs, nurses, book-readers, snugglers, wives, friends, daughters…… you get the point. We wear a lot of hats and usually we put everyone before ourselves. So this is one thing we can do for ourselves. One time we put ourselves first and give ourselves a treat. We earned it! And, especially for my daughter, please learn from me it’s okay to put yourself first sometimes.

5.  Because we are happy- We don’t get cosmetic procedures done because we are sad, depressed people. We are happy! We are blessed to be fortunate enough to consider cosmetic procedures. We wake up in the morning, look in the mirror, smile and get ready to conquer the world. I like to smile and not make crow’s feet, not have to notice something negative out of such an important part of my day. So yes, I have Botox.

6. Because we are hip- Yeah, we may be out of our twenties but we still got some cool! Botox and Fillers include some of the newest, greatest advances in cosmetic healthcare. We are ahead of our time!

Do you want to keep your cosmetic procedures a secret? Then do that. That’s perfectly reasonable. Do I hope that one day everyone looks at Botox the same as a manicure or hair color? Sure I do. I want my daughter to know that it’s a good thing to want to feel beautiful. Maybe this post hits home, maybe it doesn’t but I think the world should know the real reasons we real women have cosmetic procedures done!

I hope to see you all at the clinic this week! If not, please be dancing while you put on your sunscreen every morning! Cheers, Nina

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I live on Rye Hill in Fort Smith and ever since they put in the Dollar General I feel like I am going to another country if I have to leave the hill. I mean I have work, daycare and home in a five mile radius. I never have been a dollar store shopper but due to convenience of location I’ve become a “frequent flyer” Dollar General customer. My husband laughed at me the first time I came home from the new Dollar General because I couldn’t believe how “nice it was” and how “nice the stuff is” more than just “dollar pieces”. For some reason I thought every thing in a dollar store cost one dollar. Well that isn’t the case, not at the Dollar General on my hill (Rye Hill) anyways. So this blog is dedicated to dollar saving skin finds. There is a list of things that I think are worth spending money on and shouldn’t be replaced by a cheaper option such as Retinol, Growth Factor and Botox. But there is a completely different list of products that I think can be replaced by a cheaper, better option and this is that list……..

1. Face Soap- Ditch your fancy beaded, fragranced, colored face wash and keep it simple. Face wash is not the most important thing you can do for your skin as commonly misconceived BUT, you can irritate your skin with scrubs and fragranced residue causing breakouts and just angry skin. Money saved: $4. Skin saved : priceless

2.Antidandruff shampoo- Do you get heat rash or yeast acne over the summer? 86 your high fragranced Axe and Bath and Body works that could be leaving an irritating residue on your skin for some good ‘ol fashioned anti-dandruff shampoo. Money Saved: $2-$12. Heat rash and yeast acne gone: Priceless

3. Hydrocortisone and Clotrimazole- Got an itch? Please don’t get all those expensive Calamine lotions and anti-itch gels that really don’t help. Bug bites? Try some hydrocortisone. Heat rash or fungal stuff? Try some clotrimazole. Money saved:$2-$10. Not itching:Priceless

4. Diapers- Have you guys seen the warning on facebook of diapers “burning” kids? Well it’s contact dermatitis to the blue dye in some diapers. In simple terms they are allergic or irritated by color dye. Is your baby irritated by fancy diapers? Go get the plainest, simplest and quite frankly, cheapest diapers at Dollar General. Money Saving potential: About 4 bucks. A happy baby: Priceless (seriously priceless!)

5. Petroleum Jelly: You guys know its what I lather up in straight out of the shower. Such a great moisturizer. Need another reason to switch to vaseline? Trade neosporin for vaseline. Studies have shown that it prevents infection at the same rate and some people develop an allergy to neosporin which then causes a new problem on a booboo. This summer try putting vaseline on your cuts and scrapes to prevent infection. If you can keep it greasy enough to prevent a scab, you will minimize scarring.  Money Saved: $3. Skin saved:Priceless!!!!

I hope I helped your skin and your pocket books with this blog post. If you have more questions about skin care products come see me this Thursday afternoon at the clinic. I am doing free skin care consults by appoinment only. Would love to spend time with you chit chatting about skincare!

Until next time, dance like no one is watching, Nina

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Go to Google and search “botox testimonials” but make sure you’re sitting down because the results are scary. One girl had only half her lips injected because her injector said “there are no lines on the other side” which resulted in a crooked smile. And it just went down hill from there. So this week I have a guest blog writer, one of my patients. She came in this week for her first ever Botox injection and this was her experience. So here it is, a real Johnson Dermatology patient’s testimonial…….

When I first got back to the room the nurse took some pictures of me and I sat down and started signing a consent form. Thank God I’m a nurse and consent forms don’t scare me because everything that is on that consent will make you want to turn around and walk out of there. I was not too concerned about side effects, but that is just the type of person I am… worry about how to fix it later, because what will be will be! Plus, I had already decided I was going to do it and no consent form was going to scare me out of pressing forward.

Next, Nina came in and went over a bunch of information that I really didn’t care too much about. I was just thinking to myself “whatever, just make my wrinkles go away”. Then she asked if I had any questions. I really didn’t know what to ask so I just said no. If you have questions you might want to write them down because at this point you are a little overwhelmed and it’s easy to forget what you were planning on asking. I did however, ask if it was going to hurt. The thought of needles being stuck in your face should be somewehat scary, right?? Nina responded with “oh you will be fine, you’re tough”. I should have known that was a Nina style of “yes it’s a needle, it hurts”. Well, even though I am terrified of needles, it really didn’t bother me. Maybe it had something to do with the ice or the girl tapping my forehead or nerves but whatever it was that part wasn’t so bad. The actual botox medicine being injected hurt more that I expected. It was more like a burning sensation with each stick. The best way I can think to describe it would be to compare it to a TB skin test. The procedure itself is quick, like seriously 1 minute. Overall, the pain would not sway me from doing it again!

Next,they offered to touch up my make-up but I didn’t need it. I walked out of there with some bumps where my injections were but they were gone by the time I got to my car. They told me to make my “thinker expression” for an hour and not to touch or rub or do anything strenuous. I forgot to make the faces for an hour. I have a 2 year old so I still chased after her all day and lugged her around on my hip and I consider that pretty strenuous. I’m not a good patient, but it all worked out fine.

It will be a week tomorrow since I was injected and I could tell a difference within the first couple of days. If you can take before shots, do because you will be so surprised! They took pictures of me at the clinic but I don’t want to go back for a check-up just to see pictures. My iphone pics let me track it day-to-day. It seemed to take effect quicker in my forehead than around my eyes. My forehead is SO smooth! I never realized how many wrinkes I had there; I guess it is because I am such a thinker! My crows feet took a little longer to show results, but last night I looked at a before picture and was thrilled at the difference! This was the area that had bothered me the most, so I feel like the few minutes of pain was worth it for sure! Something else that I noticed was my eyebrows seemed lifted?? Not sure if they really are… We will have to let Nina answer that one.

The only issue that I had was a small amount of bruising. Just one bruise on my forehead. It was easily covered with concealer and has almost all disappeared. Nina said it might have to do with all the aleve I take, so beware if you’re a habitual NSAID user like I am! Overall, I LOVE IT and will definitely do it again!! Thanks Nina for being one amazing Dermatology Nurse Practioner!! Mwah!

Just quickly to answer her question, yes Botox can lift the brow’s slightly and give you more of an arch. I enjoyed reading her experience and I hope you did too. Are you considering Botox for the first time? This is a great time to take the plunge. Right now you can get double brilliant distinction points and we are donating part of the profit from cosmetic procedures and products to the fourth annual Back to School Shoe Giveaway. Thursday afternoon July 24th I am going to be giving FREE skincare consults with our expert skin care product specialist so call for an appointment now because space is limited. Hope we can talk skin soon!

Smiling, laughing and looking natural with my Botox, Nina

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This weekend my bestest girlfriend and her daughter came to visit. Although they only live a few hours away life always gets in the way and we don’t get to see each other as often as we’d like. Our daughters are nine months apart so it’s full on girl time when we are together. You might be imagining painting nails, movies, eating, drinking, laughing and pillow fights. The truth isn’t far from that except when you’re my best friend you get conned into being her next skin experiment. So this weekend my bestie helped me perfect the self tanner technique. It’s summer time and although I think you are all beautiful wearing the color of skin that God made you, I do recognize that some of you want that bronze look. So here is my self tanner experience. Step by Step.

Step 1: Pick a tanner. So I ask people all the time which sunless tanner they are using, either because I think it looks fake and want to advise against it or because I think it looks natural and I want to recommend it. My favorites are the Jergens, Jane Iredale and Tanwise. I picked the Tanwise for this weekends festivities because it doesn’t stink. You can get it at Sally’s from $6.99-$12.99. I tried the dark bronzing sunless mousse, wash-off bronzing mousse in light and the shimmer perfection cream.

Step 2: Wash your body, exfoliate your body, dry your body…… I skipped all of this. I hate exfoliating your skin with scrubs/beads/washcloths etc. Plus I had already showered that day and who wants two showers in one day? I went against the directions is what I’m saying.

Step 3: Apply self tanner. Okay so this is the scary step right? What if I get too much, not enough and oh lordy please not the dreaded streaky, concentrated around the joints look. You want what looks natural, not an “I just fell in my mop bucket of orange glo” look. So apply in small circles. Small circles continuously until even prevents streaks. I like the mouse because the consistency is easier to spread on your skin. Apply to calves and thighs then spread that onto the ankles and knees for a faded look. So don’t put any directly onto your knees and elbows. I diluted around my knees and elbows with a little plain moisturizer to avoid concentrating it at the elbows and knees. This is a good trick.

Step 4: Allow to dry. This is where you should have something to do planned that doesn’t involve sitting on anything or getting dressed. My BFF and I just stood there talking and laughing. Just know that until that stuff is dry, dry, dry you can spread the bronze look. I wiped hair out of my little girls eyes and put a brown streak across her forehead. This resulted in me frantically washing her face and it turned out fine but that could of been bad.

Step 5: Enjoy your bronze look. On a regular basis I skip all other steps and enjoy my natural color of skin. Don’t forget you always have that option available and it’s free.

Step 6: Optional-Wash it off. I used the dark bronzing and the wash-off. The wash off washed right off and the dark bronzing washed off some too because I didn’t let it set on me for the required 4-6 hours. Even going against directions I still have somewhat of a darker look though. I also tried the Tanwise tan remover but it has a bunch of beads in it and I don’t see that it worked any better than regular dove soap so I would pass next time and keep my $6.99.

Step 7: Use sun precautions. Don’t be fooled by myths lurking in our communities. You still need to seek shade, avoid the sunniest parts of the day, wear sunprotective clothing and wear your sunscreen. You aren’t safe from the harm UV rays can cause your skin.

Overall the experience wasn’t as complicated and scary as I anticipated. I was pleasantly surprised. I still won’t make it a routine. My BFF and I are pretty olive toned to begin with so I am sure you could get varied results with varied skin tones. That’s a good reason to start with the wash off. Hope this post motivates some of you to take the leap to stop sun bathing and getting in tanning beds and trade it for a sunless tanner or your natural color. Good Luck!

If the music is good then dance, Nina

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For those of you that know me at all you know I can get pretty excited about some things. I’m a high energy person and that energy explodes before vacations, when my family is having fun and with anything dermatology. The past 5 days I have been at my favorite educational conference of all time, Maui-Derm. It is a conference for NP’s and PA’s in dermatology. A LOT of the big names in dermatology are there to speak and it is so much fun learning about new advances in dermatology and networking with peers. I was honored to listen to Dr. Zirwas, the world’s leading expert on hot tub allergy, Dr. Zone who has published over 100 original articles and over 40 book chapters related to immune disorders in the skin, Dr. Rosen who has a resume I can’t even fit in this blog post, Dr. Rich who is a founding member of the Council of Nail Disorders, Dr. Marghoob, the world’s leading authority on dermoscopy, and so on and so on and so on. Who I came in contact with this past week made me feel what I would imagine is the equivelent feeling a 13 year old girl feels when she meets Justin Beiber. So this week I would like to share with you some of the exciting news in dermatology and “pearls” that I heard about this past week.

1. New Drugs- You have all seen the commercials for Enbrel and the other injectable medications we use for psoriasis. Well there are a lot more in the pipeline. Medications for people with chronic urticaria (hives that won’t go away), topical prescription products for brittle nails, Dalvance, an antibiotic like Vancomycin but less toxic. I mean we are really getting some cool drugs in the derm world which is exciting for people that haven’t had any luck with what has been available.

2. Arkansas made a top 10 list- Okay so during the venereal disease talk they put up a list of the top 10 states with the most syphillis and Arkansas was on that list. Sigh

3. Coconut Oil- With the world becoming a greener place people often ask me about natural products. We reviewed a research article that tested coconut oil against mineral oil for dry skin relief. It found that coconut oil showed 68% improvement versus Mineral oil’s 38% improvement. I wish they would have tested it against my favorite, petroleum jelly, but they didn’t so moral of the story is, go ahead, use coconut oil for a moisturizer. Seems to work well.

4. Hidradenitis advances- Hidranenitis simplified is a chronic problem where you get “boils” commonly in the groin and armpits. It can be scarring, painful and REALLY difficult  to treat. Some people have surgery to get rid of a large portion of skin and it still comes back. We reviewed studies about new treatments including new antibiotic combinations, metformin, (a medication for diabetes) and biologics (medications for psoriasis, bowel diseases and bone diseases). Hopefully we are getting better answers for people that suffer from this horrible disease.

5. Women use 12 skin products with 168 ingredients per day. Enough said. Please let Johnson Dermatology trim down your products. Help us help you save your skin and pocket book.

6. Gonorrhea- There is a new gonorrhea that recently made it to America that is drug resistant. That means we don’t have a good treatment to rid it like we do with the traditional Gonorrhea. Oh, and it is believed to be passed by oral sex. Not cool.

7. Nail Melanoma fact- 25% of nail melanomas are amelonotic. That means they don’t have that black, brown color in them. Frightening! Please keep your skin cancer checks at least yearly so a dermatologist (the skin experts) can help catch skin cancers early.

8. Scary Treatments- The main cause of death from the autoimmune blistering disorders is side effects of oral steroids. One in 300 people who have a sentinel lymph node biopsy will have a stroke related to the procedure. Although oral steroids (example-prednisone) and procedures can be very helpful in mutliple diseases these things have side effects and all clinicians should be reminded of that often, to do no harm.

9. Patients don’t fill prescriptions- Historically speaking people have said studies show that 50% of people fill the prescrition they were given from their doctor. Hmmmm, I know ALL my lovely patients fill their prescriptions. My patient’s are perfect!

10. Melanomas are changing- Most people know the ABCDE of melanoma and how it helps to spot melanomas. But now, some of the top expert dermatologist are using a different acronym called “looking for the ugly DUC”. The D stands for different then all the other moles, U is for uneven. Uneven in any of the Asymmetry, Border or Color of the traditional ABCDE. Lastly the C stands for Change. Any mole that is changing warrants a biopsy. Just another reason you need a skin expert in your life.

That wasn’t even 1% of the exciting things I did this past week. So come see me at Johnson Dermatology and I can give you an ear full of the other 99%! You will see me get excited if nothing else!

Hey, did you know Johnson Dermatology is having a hashtag contest this summer? Use #Johnsondermatology this summer in any skin related post and you could win a prize. I’ll be watching on social media so be sure to follow us on facebook or my personal twitter @skinnyonskingal

Dance the week away (in sunprotective clothes),

Nina

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This week Honey (the best Physician’s Assistant ever) became my neighbor. For those of you that haven’t met Honey, she has been a PA at Johnson Dermatology for about 3 years and truely is a gem! She is my work sister. For most of her time at the clinic she has commuted from Tulsa, OK. I’m not sure if she moved here because she was tired of the drive, loves the Fort Smith community, got sick of people asking why she commuted or just really wanted to be my neighbor. I am sure of one thing though and that is that Honey and I would both move mountains to be able to work at Johnson Dermatology forever. Some people never find a job they are happy going to every day. Your work life really does affect your overall happiness. When I sit back and reflect about why I love my job so much the obvious things come to mind first. I love my patients, I love what I do, I love my coworkers, I love my hours, I love the location and I have great bosses. There are some things about being happy at work that are just up to the person though and so this week you may not learn a skin trick but you will learn something about Johnson Dermatology and why we love our jobs. Here are some of the Johnson Dermatology Midlevel tricks to a happy job inspired by my new neighbor Honey Hill.

1. We try to be healthy– Don’t get me wrong, we currently have a large bag of chocolate in our office. But generally speaking we both stay on each other about sticking to healthy food. We recently did a juice cleanse together. We ban ourselves from Starbucks sometimes when it gets to be too frequent a habit. I go to barre regularly and Honey runs with her fiance. The point is, our bodies feel good and are feuled to feel good at work. If you feel good and look good, you’re setting yourself up for a better work jive.

2. We find a reason to dance, every morning– Have you ever seen kid president? If not, go to you tube and watch all his videos. In every single one he dances at some point or recommends it in making the world a better place. Every morning Honey and I play music to dance to while we get ready for our first patient. We may only get 20 seconds of a song, we may get 2-3 songs in, but we don’t skip dance party time. If my baby woke up 50 times last night or Honey is sick of driving (not anymore) it clears that bad mambajamba and brings happiness and joy to start the day with a good attitude. I am usually the only one dancing in my chair and I nominated myself DJ but Honey does a lot of the lip syncing. Most of the time we don’t need a reason to dance but some days we choose something great about work and dedicate our dance party to that. So instead of thinking about how tired we are, we think about the patient we saved from Melanoma. Try it! I don’t have the science behind it but it works everytime, I mean 100% of the time… Dance people!

3. We don’t make excuses– Excuses are great, aren’t they? I mean they totally take a little of the blame off of you. Whether you’re placing the blame on circumstances or someone else, with an excuse problems are less your fault. Get rid of excuses. Honey and I were covering a duty while one of our co-workers was out. Honey had Wednesday and Friday to finish this task and I had Monday, Tuesday and Thursday. Well, when we got to work Wednesday morning we realized that the person who sets everything up for Honey to do this task wasn’t told about the change of plans, so it wasn’t ready to go. The easy thing to do would be to say that because it wasn’t set up and ready to go, Honey could just do the task later. But being that it was not set up and ready to go would just be an excuse, because really, that would just be a bump in the road that slows you down but you can still get it done. So Honey and I set it up together, helped each other finish the task, got it done twice as efficiently and boom, it was done. When someone asks you to do something at work, do you say “I won’t have time” or “I don’t know how”? Those are excuses. Make time and learn how. I think you will be proud of yourself, feel like a harder worker and therefore be happier in your job.

4. We admit we have weaknesses and make mistakes– Honey told me last week that she was sorry for biting my head off. I apologize daily for being inpatient. My blunt, straight forward attitude is my best friend and worst enemy. I apologize for it often. We know we aren’t the best to share an office with or to work for. We aren’t perfect employees. But we want to be the best we can be. We try to recognize our faults and improve on them. It’s like a step program. The first step is always admitting you have a problem. I got 99 problems but finding ‘em ain’t one.

5. We put others before ourselves– All day, every day. We try to never tell our bosses no, as a general rule. We try to keep our nurses happy. We try to do things the way the lab staff asks us to do them. Above all else we put our patients first. They are always right, their needs come first. If a patient is waiting to be seen and I need to potty, patient first, everytime. If I’m hungry but my first patient after lunch got here 30 minutes early, patient first, then lunch. Kid president says you should treat everyone like it’s their birthday. That is especially true with your co-workers and in our case our patients. If everyone around you is happy that vibe surrounds you and you’re happier by association.

I know you all join me in welcoming Honey to the River Valley as her new home. I am originally from Fayetteville but Fort Smith has been my home since 2007 and I wouldn’t leave it for the world. I have lived in San Francisco, CA, Orlando, FL and many places in between but this little community is special and one that Johnson Dermatology is honored to serve.

Hope to see you all at the clinic this week with any skin needs you may have!

Peace, Love and Skin care, Nina

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Happy Father’s Day to all you Dads out there. Fathers are so hard to buy gifts for, men in general really. After the basic cologne, polo shirt and sports equipment you start to run out of ideas. Lets face it, those basics only get you through Valentines Day and an Anniversary then you still have to figure something out for Birthday, Fathers Day and Christmas. Men, as the saying goes, can’t live with ’em, can’t live without ’em. So in honor of Fathers Day here are some men skin gift ideas.

1. Laser hair removal- Does your man have weird hair patches on his back? Or just hate shaving? Buy him a laser hair removal package. Price is dependent on the size of the area being done and he will likely need 3-5 monthly treatments. Now this is a little painful and we all know God didn’t make man able to carry a child for a reason but our laser technician Tasha is an expert and she gets most men through it without a problem.

2. Laser tattoo removal- Did your Dad get a naked lady tattooed on his arm years ago? Does your husband have an ex’s name inked permanently onto his skin? This is the gift that keeps on giving…… to everyone! Get him an ATV laser package to have a tat removed. The ATV laser we use at Johnson Dermatology is new to our laser family and we are seeing amazing results.

3. Bro-tox- Think your man is too manly for Botox? Consider this. We women started the tight jean look and now men are wearing the straight-leg tighter fit. Pink is a stereo-typically girl color, we have worn it since the day we were born. Now it is totally in style, men rock pink all over the runway. It’s just a matter of time before it is socially accepted for men to use Botox too. Tell him he isn’t necessarily metrosexual. Tell him it’s to help him stay competitive in the workplace with all those young new college grads. Tell him he has to keep up with you. Tell him whatever you want, after his first injection he will be hooked.

4. Aftershave balm- Not that fru-fru smells like you just walked in Abercrombie and Fitch stuff. The kind that is good for your skin. I like the Avene After-shave balm because it has purifying ingredients made to prevent bacterial infections, is alcohol free and a rich moisturizer. It will calm razorburn and is good for sensitive skin.

5. A Buff- Okay, seriously I am officially not as cool as I once was, or just don’t watch enough Survivor. A buff is a seamless tube of fabric that you can wear a million ways. It comes in all kinds of decorated fabrics. This weekend alone I have worn mine as a headband, neck gaitor and face mask to protect me from the sun. A wide brim hat can sometimes be difficult for a man to wear, especially during sports events. Your Father can use a buff as a hat liner to protect his ears from the sun and still be stylish in his ball cap. I’m pretty much in love with it and mad that no one told me about it sooner. Go to www.buffusa.com and get one, you’re welcome.

Hope all the Dads out there had an awesome Fathers Day. Next time you have to buy a dude a gift consider a treat for his skin. It is the largest organ in his body, it’s worth taking care of!

Stay skintastic this week and always!

Hope to see you all at the clinic, Nina

P.S. Check out my Buff as a facemask!

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So incase you haven’t heard there is a new organic juice place in Fort Smith called Carrot Dirt. I love juicing but it can be a lot of work and since I have had my child my juicer has been collecting dust. The convenience of being able to buy a bottle of juice that is as good as the juice I made in my own kitchen is ahhhhhmazing. So one might say I’ve been a little obsessed. This week I did a 3 day cleanse and had nothing but juice. I talked it up enough that I was able to get Dr. Sandy and Honey to join in on the cleanse with me and it was actually really fun! We weren’t hungry, tired, cranky or anything really unpleasant. Actually, we felt great! We didn’t even drink all the juices we were allowed in one day because we were so full. Don’t ask me how much weight I lost because that wasn’t my goal. As a matter of fact I didn’t even weigh myself before or after. When I don’t have a lot of sugar and carbs and all the evils of food I just feel better. I can’t put my finger on what it is exactly but I think what it boils down to is food is simply fuel for the body. Just like your luxury Lexus, you can put premium gas in your car and run smoothly or you can use regular unleaded. The car still goes but your Lexus engine probably skips a few beats without the good stuff. There are lots of reasons to eat healthy but is good skin one of them? I get this question a lot. The simple answer is yes, there are conditions of the skin associated with food but if you are just looking for overall skin health there are other things I think you should put at the top of your “steps to healthy skin” list. For example, in my opinion sun smart behaviors are more important for your skin health than eating blueberries everyday (these berries make magaizine “good food for the skin” lists all the time). Here are a few food tips I do recommend for the skin.

Vinegar- This is one we use in dermatology for a variety of things. One of the most common is mixed toe webb infection. It’s that athlete’s foot like rash between your toes. I usually recommend a 1:4 vinegar to water ratio to soak your feet in.

Red Dyes- These are a no-no for people with perioral dermatitis (an acne-like rash around the mouth and chin). Try to avoid things like cinammon gum, fruit punch and diet Dr. Pepper these red dye enriched foods have been known to trigger perioral dermatitis.

Yogurt- Ladies you know when your doc puts you on antibiotics and tells you to eat yogurt to ward off yeast infection? Well yeast can cause problems on the skin like the infamous “heat rash”. Get the good yogurt with cultures for the most benefit.

Potato Chips, Pizza and Ice Cream- Somehow these foods got a bad rep for causing acne. Although I think these foods should be limited in your diet for overall health the research hasn’t found them to have an effect on your acne. So while they increase your dress size they will not be increasing your pimple size.

Colloidal Silver- People have claimed silver supplements can help rosacea, psoriasis, viruses (warts, fever blisters) and bacterial infections. I don’t recommend this. As a matter of fact, if you aren’t careful you can actually turn your skin a blue hue with too much silver, a condition called Argyria. I’m sure there are easier ways to become part of the blue man group.

Caffeine and Alcohol- These are known triggers of flushing. Those of you prone to redness and flushing, you should avoid these as part of your treatment plan. An ounce of prevention is worth a pound of cure.

I wish the best of health to all of my followers. Check out Carrot Dirt if you are in the Fort Smith area, you won’t be dissapointed!

Hope to see you at the clinic this week and maybe we can chat about this ever so popular topic more.

Until next time, stay healthy, stay happy and ALWAYS stay skintastic, Nina

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