By far the most frequently made comment from someone who is about to be injected with fillers or Botox is “I don’t want to look done”. Everyone wants to look natural. No one wants to be that person that everyone whispers about as they walk by “psst, look at Elsa, now that’s Frozen”. I agree! I certainly do not want any of my sweet, beautiful patients to look like they have been treated. But there is a lot more to the “natural look” than just botox and filler injections. The other things you do to beautify affect your entire look. So, this week I want to encourage you to embrace your natural beauty. Here are some tips to enhance you and not change you, keep you just like you are!

1. Pick an above average injector-Who you choose to inject your botox and fillers should not be whoever is having a sale. Your injector matters. Pick one who has a natural looking staff because likely she/he has injected them. If the person coming at you with a needle has lips that look unnatural and ducky then you can bet that’s what she is going for on you too, so take note.

2. Keep your eyebrows natural- If you were born with thick dark eyebrows don’t go to thin lines. If you were born with thin, hardly there eyebrows don’t go to thick tattooed permanent eyebrows. Tattooed eyebrows may be a look you are going for and if so rock it girl, I know some people that look great with permanent make-up! But sometimes I look at tattoed eyebrows and think “she has tattooed eyebrows”, it’s not a “not done” look, it is something people are likely going to be able to tell you have had done. Be careful how much you pluck and shape, try to enhance your natural shape not change the shape of your brows.

3. Careful with fake eyelashes- Now these have become ever so popular over the past few years and sometimes they look full and beautiful but I must say sometimes they will make you get the “done” look. If they are peeling away from where they were stuck, you’re “done”. If they are freakishly long, you’re “done”. If your eyelashes are so long that you can give butterfly kisses with a 2 foot standing distance from the other person, it’s unnatural. An alternative is Latisse. Latisse is a topical prescription that will give you those longer, fuller lashes you’re looking for in a natural occuring type of way.

4.Hair style affects the overall look- What is Dolly Parton known for? Her music sure, and maybe a couple other things, BUT that hair! I don’t know what the saying is about teasing it closer to heaven but bleached blonde hair that is that tall is not natural. It may be considered beautiful, but not natural.

5. Make-up matters- Do you guys remember Mimi off of the Drew Carey show? She had electric green and blue eyeshadows and hot pink lipstick. She was not going for the natural look. Now she wore it well but I am going to go ahead and say I feel comfortable recommending against that look if you want to become a more naturally beautiful you. Don’t cake on make-up. Get a skincare regimen that works so that you don’t need it. You CAN get there. You could be using a make-up that is actually irritating your skin and making your skin problem worse. I use Colorescience powder and also recommend Jane Iredale.

6. Be secure- This is key to keeping the natural you beautiful. Insecurities can lead us to change what is already beautiful. Sure, we can get botox injections, filler, color our hair, get a nose job, get fake lashes, tattoo on the brows we want, wear make-up so thick we are unrecognizable after a shower but all that together, it’s just not us anymore. We should enhance what we have to feel good without changing what we look like. That takes embracing our imperfections sometimes. The perfect example is filler and botox goals. Your goal should be ten years younger, not thirty. A 60-year old with skin that is as tight and wrinkle free as a 20 year old is unnatural. You don’t want to rid every single line because at 60 a few lines show maturity. Look natural, you’ve earned those lines and you’re still beautiful. If a 60 year old wants enough filler and botox to rid every line and get the tightness of a 20 year old, it can be done but it’s not natural, it’s just done. But a 60 year old that looks like a 50 year old naturally occurs all the time so we can do that and look very natural.

I hope you all feel beautiful when you come to see me and even more beautiful when you leave me! There are a lot of opinions in this world and these are just mine so I really appreciate all of you that follow, trust and listen to my blog. Above all else, beauty is in the eye of the beholder so when you look in the mirror remember that, be nice to yourself. Hope you have a great week!

Stay totally skintastic, Nina

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So I obviously had a great holiday weekend as I am just realizing this is Monday and I didn’t post Sunday, time flies when you’re having fun. Happy Memorial Day. Thank you to all the service men and women. Freedom isn’t free. So very thankful for our troops; past, present and future. I am sure some, if not all of you enjoyed the holiday with some sun, whether it was like me at a waterpark and zoo or at the lake or just outside grillin, it is the unofficial start of Summer. As I scroll through my social media newfeeds they are overloaded with sunburn pictures. I mean I expect to see tanners out in public. I almost walked up to a lady at the waterpark to tell her she looked like she rolled in doritos and that is a bad example to her children but my husband wouldn’t let me. I figure premature aging is enough punishment for her anyways, those leathery wrinkles, bless her heart. But MY friends, on MY socialmedia feeds, SUNBURNED!!! Oh I just can’t have it, just won’t allow it! The thing is most of you tried. Most of the pictures were failed sun protection attempts. It’s amusing that it is so hard to use sunscreen which is why most of the pictures made it to social media anyways. I like the tips the American Academy of Dermatology gives on sunscreen (www.aad.org) and I will include some of that info in this post.

Drumroll please………Here are the top five sunscreen mistakes of Memorial Day 2014.

1. Thinking sunscreen is enough-MISTAKE! One made by the best of ‘em too. I saw one of my most favorite people posting a pic of her using her sunscreen, in a bikini, not under any shade, c’mon! You gotta seek shade, avoid the hottest hours of the day and wear sun protective clothing, sunglasses and hats. There is a reason the FDA made them quit putting the word sunblock on the bottle-its more like a screen door then a metal door-some stuff still gets through.

2. The mistake of thinking it is waterPROOF sunscreen when it is acutally waterRESISTANT. There is no such thing as waterproof sunscreen so you have to be extra careful when in the pool, lake, etc. The bottle should say 40 or 80 minute after the word waterresistant and that is how often you should be re-applying if in water. BUT you need to at least reapply everytime you get out of the water or after a good sweat. Just to be safe I advise a swim shirt, especially on your littles who have more sensitive skin. Use water resistant all the time.

3.Mistakenly not using broadspectrum sunscreen-Always use broadspectrum sunscreen. This means it gets the UVA and UVB types of harmful UV rays. UVA and UVB are basically just different wavelengths but they can both cause skin cancer so you want a broadspectrum to protect you. If you really want to get fancy use physical blockers like the ingredient zinc oxide-you can still see it after application but for kids you can do fun colors they like anyways.

4.The ever popular mistake of not using enough sunscreen-Apply liberally. This is one of those “the more the better” kinda gigs. AAD recommends a 30 SPF or higher and to use at least 1 ounce. One ounce is two tablespoons or a full shot glass. So don’t be stingy, lather up!

5. And my least favorite is the mistake of not applying frequently enough- If you put your sunscreen on at 7AM and then never reapplied, that’s a problem. You should reapply every two hours. If in water then everytime you get out of the water and every 40-80 minutes (check the bottle). If you get super sweaty then you should reapply like you’re in a pool. The more (often) the merrier but make sure you didn’t get a sunscreen/insect repellant combo because insect repellent should be put on less often and in a lesser amount.

Hope you all enjoyed the holiday weekend! If your sunburn made facebook then I expect to see you this week at the clinic to help you with that. I won’t even scold you, it’s hard to be sunsmart. That’s partly why 1 in 5 Americans will have skin cancer in their lifetime. Hope you all have an amazing week, stay skintastic.

Sending skin love your way, Nina

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I had the honor of spending the weekend in California at the Skinmedica Physicians Summit. As most of you know Skinmedica is my favorite skin care line. It is one of the only nonprescription skin care lines that has real science to back it up, I mean research and all people. It was so much fun connecting with dermatologists, plastic surgeons and other healthcare providers from around the US and Canada. It was even more fun learning more about all the Skinmedica products and how other experts are incorporating them into their patients’ skin health care plan. I could write this post about the stability of growth factors or melanin transfer to keratinocytes or even keratinocyte migration to stratum corneum but you will just have to make an appointment for that. This blog is way too fun for that chat. So here are the fun “take homes” I brought back from the Skinmedica Summit in California to Arkansas.

1.“Tugly”- This is a combination of tight and ugly. This happens when someone comes and gets their Botox and Voluma but then they don’t take care of their skin. Although they may be tight, ridding lines and sagging with neurotoxin and filler due to neglect of skincare, they still have dark spots or dilated pores or acne. The “take home” message is skin care is important too people. FYI: none of my patients are tugly.

2. The average woman has 183 products in her bathroom. COME ON! For real? How? Apparently we have foot creams, elbow creams, neck creams, tanning lotions, wrinkle creams, soaks, masks, tightners, brighteners, etc, etc, etc…….. The message is cut back to stuff that actually works and rid the junk.

3. “80% of skin care clients who leave a facility without buying a product for home use will purchase at least 1 skin care product in a drug store or department store within 24 hours” (MedEsthetics, October 2012) So basically, after you come see me and I tell you what will work for your skin you go buy a piece of junk instead(yes, “slap in yo face” is what I felt upon hearing this). Why? Probably because I’m not a good saleswoman, I’m a nurse practitioner. On the other hand, the girl behind the make-up counter is a great saleswoman. She draws you in and convinces you to buy her non-research, no scientifically proved benefit, smell good, feel good potion because she works off commission and she needs the money to buy her dress for junior prom this May.

4.  I’ve been given a gift, the eyes for cosmetic procedures- sounds weird that I learned that at a skinmedica conference, huh? When I arrived they gave us a book with pictures and bio’s of all the physicians. I obviously flipped through pics first, judging them all, seeing who had bad filler jobs, whose Botox was looking a little Spock like, who just needed to stop, who looked amazing, who I would let inject me, who had beautiful skin and so on and so on. Terrible, I know.  Well by the time I got to the back of the book I realized Dr. Sandy’s picture was on my top five list. She looks great and it is by no means because of me. She takes awesome care of her skin, she works out, eats rights, stays spiritually healthy and so on. But no one would look at her and say she looks done. She looks natural and that makes me proud because I’m the one who injects her.

5. You need more than a personal trainer. Say you go see a personal trainer 3 times a week. You aren’t going to get in shape with just that, you have to go home, eat right and exercise on your own other days of the week to stay in shape. Your personal trainer is for that extra boost. It’s the same concept with skin care. I am your skin care trainer. You come in and I give you a Vitalize peel, Botox, Voluma, whatever you choose but then you have to go home and use your retinol and sunscreen everyday, maybe even your TNS essential serum or Lytera to keep your skin in shape. It’s good, better or best. Don’t you want to be the best? I want you to be the best!

6. You spend lots of money on skin care products that don’t work. The Skinmedica Retinol 0.5 that I use every night is $82.31 with tax and last me 3-4 months. They showed us a product called la prairie platinum rare cellular cream that cost $1080.00 before tax!!!!!!!!!!! I choked on my ice and had to spit up some water. Skinmedica skin care products are cost effective!

Okay I will stop at 6 because that was a long post and because I am jet lagged and need to go to bed. Dr. Sandy and I went all the way to California to make sure we are bringing the best to the South, to Fort Smith. We care about this community and its skin! Come see us this week and let us share some SkinMedica secrets with you! Until then, please stay skintastic!

Love yourself, you’re awesome, Nina

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Mothers are all we really have when we are born. We rely on them for all our basic needs; food, shelter, bathing and protection. As newborns we can’t even go to sleep without them, scratch that, as newborns we can’t hardly sleep period. As we grow up we rely on them for much more complicated needs. In elementary school they help teach us how to read, in junior high they teach us how to get a date to our first school dance, in high school they are a shoulder to lean on during our first break up and our personal assistant to get into colleges and apply for scholarships. When we get married our Mothers are wedding planners and then we have children and they are our babysitters and life coaches. The job just gets more and more difficult for Moms but they just seem to get better and better at it. Then, at some point in our lives we look in the mirror and say “Wow, I’ve turned into my Mom”. It’s a proud moment and simultaneously a little gut wrenching. I mean we don’t usually decide to be just like our moms in our teenage years. Most of us aren’t really sure how it happened. Some people probably wish it hadn’t happened. However it comes to be, it most definetely happens. At some point in your life you will do something that is your Mom. So this post goes out to all the Moms out there. Make the realization that your kiddos are taking a piece of you with them forever. Let it be the good part, let it be something they are happy they got from you. Without further delay here are my Top 5 “Mom Skin Habits” you should pass on to the kiddos.

1. Don’t get in the tanning bed- Preach to them that the tanning bed increases their risk for melanoma and they may or may not listen but if you get in a tanning bed what’s the point. Don’t get in the tanning bed and use the excuse “because I’m the Mom”, lame! Teach them that not getting in that tanning bed is keeping the beautiful skin God gave them. Teach them to keep healthy skin habits through example!
2. Wash your face every night- Mom, I know you worked all day then chauffered to soccer and dance, then cooked dinner, then put the kids to sleep, then did laundry and now you are about to fall asleep on the couch and stumble into the bedroom but STOP and take the time to create a habit of skin care. If you wash your face before bed (and hopefully apply retinol) every night they will see that and it might just be a habit they can’t go without in adulthood. I see your daughter now telling her new husband “Oh I can’t go to bed without washing my face, it’s just not right”, she will tell him she doesn’t know why she can’t but we will all know its because she got it from her mama.
3. Wear sun protective clothing- If you only think you look good in an itsy bitsy teeny weeny yellow polka dot bikini that perception will be cast on your child. On the other hand if you can rock out a swim shirt and a big floppy hat and make it look good your daughter will probably think she can make it look even better. Won’t you be proud to see her strutting her stuff around the pool all covered up while all the other girls have to wear a bikini to feel like they look good. Different is so empowering!
4. Be proud of your cosmetic procedures- Why do Moms feel the need to hide the fact that we have Botox and fillers from our kids, like we are doing something wrong? We are taking care of ourselves, making ourselves feel good and beautiful. Don’t be ashamed of your actions. Rock out your Botox and teach your daughters that it is something women do to feel good and look good, just like we dye our hair and put on make-up. Change the negative connotations around it now so that our children’s generation doesn’t have to feel any embarrassment about their Botox injections.
5. Be comfortable in your own skin- Love yourself. Love your skin. Don’t be so hard on yourself. Don’t say you “hate” anything about your skin to your sweet kids. Teach them to be themselves and love living in the skin they were given. You are awesome! Own it and one day when you see that confidence in your child you will be proud you instilled it into their brains.

I have only been a Mom for 14 months so I don’t really know why I think I have earned the right to give out Mom advice. Although, I have spent 30 years on this planet under the guidance of one of the best Moms you could ask for. She did all five of the things that I recommend and even though there are days I really hate to admit it, I am her. We are kinda twinsies. Hope you all had a wonderful Mother’s Day. Would love to see you at the clinic this week. If you’re a Mom, I think it’s time you come give yourself a skin treat. Let me help you with that!

XOXO, Nina

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I spent this weekend celebrating a very special bachelorette’s last fling before the ring in Sin City. My Las Vegas weekend was filled with lots of laughs (7 BFF’s ), Brittany Spears, shopping, eating and poolside fun. Yes, you heard correctly, I spent a day at the pool, I may be afraid of the sun but I don’t let it keep me from a good time! We had reserved a cabana and I planned to stay in the shade all day reading a good book, laughing with friends and obviously, sipping a lemonade with an umbrella decor. As most plans go, we had a small detour. We got to the pool and the “Cabana concierge” informed us that there had been a mistake and he gave away our cabana. There were no cabanas available. He offered us a cabana at a different resort, which appalled most of my friends. He then offered us a day bed with a credit for food and drinks. I informed him that it is Melanoma awareness month and not having a shaded area was bad for my skin health, he looked at me like I just grew a third arm, in disbelief. I’m sure he is used to people who enjoy laying in the sun and getting a tan, I mean he lives in the middle of the desert right? Well I’m not that girl, I like my skin how God made it for me. After a few tears, seven disgruntled women agreed to the daybed. Poor guy must have wished he called in to work that day. So with 8 spray on sunscreens and two powdered sunscreens in tow I realized being sun safe just got a little bit harder for the day. I asked for an umbrella immediately but apparently it was too windy. I applied sunscreen every two hours on the dot to myself and my 6 girlfriends. I set a timer on my phone and when the alarm when off my girlfriends just stood up, closed their eyes, held their arms out and started doing a little turn (which soon turned into a turning shimmy and shake) so I could spray them down with sunscreen. Just letting me have my way was much easier than any debate they may try to have with me. Plus, they all trust me with their lives so why not trust me with their skin? It actually was really fun and other people at the pool started coming over for sunscreen from us. Dancing in a mist of sunscreen every two hours livened us up and was actually a blast. I sprayed down our waitress, who then asked to be covered in sunscreen during our two hour timer check which then turned in to all the waitresses in the pool area which then turned in to the dancers which then turned into basically anyone who wanted sunscreen coming to our day bed. While at the pool we went through 11 containers of sunscreen. Now I have to admit that 7 women spraying you down with sunscreen might be what attracted the males to get sun smart that day but who cares if we saved at least one sunburn, right? The lessen learned is that tanning is a culture. At the beginning of the day Henry, the cabana concierge, thought that I was very strange for demanding shade and sunscreen but by the end of the day the pool party was where the sunscreen was, our day bed. We made staying our natural colors and not getting tan fun and that was contagious. People saw us having fun, being silly with sunscreen and that feeling is something humans are drawn to. Sometimes I get discouraged listening to young women talk about loving tanning beds and saying that tanned skin looks good but this weekend rejuvenated my goals for sun smart behaviors. People were loving it. I can’t wait until that is the culture we live in, that tanning isn’t cool nor beautiful, that staying sun smart is what all the cool kids do.  So I hope this summer you can all find a fun way to wear sun protective clothing, apply sunscreen, seek shade and avoid the hottest parts of the day. I hope you are proud of the beautiful skin you’re living in and keep its natural beauty. Let me know any fun tricks for sun safety you use with friends and family. Remember to use at least one ounce (that’s a shot glass) of 30 SPF UVA/UVB on your uncovered skin every two hours please!

Are you doing any airline traveling this summer? You MUST get a BOB! The powder sunscreen is awesome for getting through TSA because there is no liquid. YAY, one less thing to go in that tiny quart ziploc bag you are supposed to fit all your liquids into. You have to carry on sunscreen in case you get a window seat! Perfect Mothers Day Gift so come to the clinic and get one stat!

Thank you for following the blog and helping me change the culture of our youth to a place where the only way to want a tan is if it comes in a bottle. Hope you all have a blessed week! If I don’t see you all at the clinic this week then just remember, stay skintastic and love yourself. You’re all awesome!

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This past week I turned thirty! It was a great week. To celebrate my aging, maturity and life I read a self help book on how to be awesome. If you want the deats on the book follow this link www.jensincero.com .One of my favorite ideas in the book was that as children we are not embarrassed, ashamed or nervous to learn new things. Somewhere along the way we learn behaviors of shame when we don’t know something. When you learn to ride a bike as a child it is so joyful and exciting but then as an adult some  people may be embarrassed that they don’t know how to ride a bike and that feeling keeps them from ever learning even if they really want to ride a bike. The idea was to never lose the joy of learning something new. Be an expert. Practice and practice your passion to be awesome but never stop having fun doing it. It made me start thinking about learning dermatology. I will never stop learning and I love that but my patients expect me to be the know all. I totally get it because that’s what I expect from my providers. When patients come to me, they expect me to have the answers from the skin gods and the magic wand to fix them. I want to have the answers so it stinks when you can’t give them to patients. I feel like Johnson Dermatology has the skin experts of the River Valley but we all just recently  learned about a new drug called Mirvaso. There are things experts don’t know until they learn those things. Medicine is a constantly growing realm of knowledge. So how then do you, the patient, pick which expert to trust with your skin? What if you pick an expert and they haven’t yet learned about something that would cure your ailment? What if you pick one that has lost their joy in learning? What tools do you use to pick the best? Because we all deserve the best healthcare, right? I have worked in a hospital or clinic in the healthcare field for 14 years and I feel like I have learned the difference between a good healthcare provider and the best healthcare provider. So here are my tips to assist you in deciding who takes care of you and your family.

1. Word of mouth-This is the top of my list. When you pick who is going to perform your knee surgery ask other people who have had knee surgery how theirs went and who performed it. When you pick who does your Juvederm or Radiesse injections, it is okay to ask for pictures or to see other people whom the provider has injected. Don’t just go by the picture on the products website. Always take recommendations with a grain of salt though, please.
2. Specialty Experts-See the right expert in a specific specialty. I learned how to manage cholesterol when I was in school and according to my degree, I could see a patient and tell him or her how to manage cholesterol but over the years, I have not used that knowledge and as you know, if you don’t use it, you lose it. Please don’t ask me to manage your cholesterol. Even though legally speaking I could do it, heck if it was a basic problem I might even be capable of doing it but it’s not my area of expertise.  It’s totally legit to ask your provider if the procedure they are doing is what they excel at doing. For example: In our office Dr. Brad is the surgery expert and Dr. Sandy is the laser expert. You won’t catch Dr. Brad with laser patients on his schedule and you won’t catch Dr. Sandy with surgeries on her schedule. Even though they are both capable, they have different areas of expertise in the specialty of dermatology. FYI-It doesn’t offend us when you ask. Just like we want to brag on what we are experts at, we also like to tell you when we don’t feel comfortable doing something you are asking us to do.
3. Education- Your healthcare provider should have some credentials. Choose board certified folks. That shows that they care about their credentials, education and professional development. Continuing education is important too. I go to dermatology conferences and extra training often and I even do a monthly book review club with my peers. If you call for an appointment with your health care provider but she is out of town for a conference and you can’t get in that week, it’s a good thing. Ask for an appointment the following week. Chances are you found a good one.
4. Happiness- Does your healthcare provider enjoy his/her job? When you go to the dentist, does he/she complain about what a day it’s been or get excited talking the whole visit about a new tooth implant that is awesome? If it’s the latter, that’s what you’re looking for. You may not really care about the latest and greatest in fake teeth but you should be glad that your dentist is excited about his/her profession. Sometimes I get giddy at work. I grin and giggle a little bit over getting to witness weird once in a life time rashes or surgical repairs that are complex or injecting a woman who cries because she is so happy with her results. I literally have to jump up and down sometimes at work. Find someone that loves to take care of you.
5. You need the “click”- You have your friends because you like them. You should like your healthcare provider as well. Pick someone whom you like to be around, whom you trust, whom you feel comfortable asking why your feet stink. Also make sure you “click” with the office staff. Often times your communication is through the nurse or the front office staff or the insurance gal. You will likely, at some point, have to deal with all different areas of the practice so pay attention to the vibe in the office. Pick a place that is on the same frequency as you. Be able to say “these are my kind of people”.
6. Pick the “can’t do it all” person- Sometimes you want your healthcare provider to say “I don’t know”. It shows that they know their limitations and won’t just “give it a whirl” on you. And if they are at the end of a rope and have already had you see multiple specialist, then maybe they will try something off the books and it will work but at least you will know they are exhausting all their resources just to help you.
7. Intuition-Don’t go by my rules. Don’t go with your rules. Just use your gut. I call it my spidey-sense. Your inner self knows who will take care of you and who won’t care one way or the other about you so follow your heart, as they say.

I hope these tips help you with your search for someone to care for your health. These tips are all just my opinion and I appreciate you all following my blog and listening to my opinions, it’s an honor. Stay skintastic! See you in cyber world next week. Until then, follow me on twitter @skinnyonskingal for quick, fun skin tweets.

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Happy Easter to all! Whether you celebrate the holiday or not you all know the age old tradition of the Easter Egg Hunt. How fun it is to watch all the children get excited about the Easter bunny coming and then finding all the hidden eggs. It’s quite the process; dying eggs, hiding eggs, preparing baskets, getting Easter dresses and teaching the reason for the season. Well, there is a hunt we do in dermatology that is actually a lot less exhausting. The hunt for skin cancers. The three skin cancers we mainly deal with are basal cell skin cancer, squamous cell skin cancer and melanoma. Melanoma is the bad guy that can move into your body and kill you. They are all bad guys but he is like the serial killer that needs to be locked up forever and the others are more like drunk drivers that deserve at least a night in the drunk tank maybe even an extended stay at the local jail. You should all come in and let a dermatologist hunt your skin for skin cancers at least once a year, maybe more often if you are high risk.  If it’s your birthday month then make that the month you always come for your skin cancer check, it’s easy to remember that way. I usually recommend taking pictures of your spots/lesions/moles and retaking the pictures in 3 months for comparison. Anything changing or growing needs a look sooner than later by a pro-fesh-on-al. Here are some red flags that should bring you to your derm sooner than later.

1. Spots that bleed and don’t seem to heal reasonably.

2. Asymmetry – That basically means a funky shape. If you draw a line through your mole and one side doesn’t match the other that needs further investigation.

3. Borders – Are the borders ill-defined or smudgy looking? Not good, please let me check that mole for you!

4. Color – In most instances of life variety is a good thing. Not when it comes to your moles. Different colors in one mole can be a characteristic of melanoma. Is a mole darker than the others and just really stands out? Go get that mole checked!

5. Diameter – Big moles need to be looked at by a dermatologist. Big is generally defined as bigger than a pencil eraser.

6. Evolving – We rely heavily on this. Anything that is new, changing or growing we want to see.

Are you worried about a spot and want it checked? It’s usually a pretty easy process so don’t fret! I had one removed a few weeks ago and then worked all day and forgot I even had it done(oh and I’m a baby that hates needles in me). In my opinion, you should make sure whoever removes your mole sends it to a dermatopathologist. That’s a pathologist that is expert at looking at diseases of the skin under the microscope. Did you know Johnson Dermatology has a lab with a dermatopathologist, Dr. Amy Hudson? We do and we are pretty proud of her! Yes that is my horn you hear-TOOT TOOT! Don’t just hunt eggs this Easter, get in on the skin hunt for cancers and come let us look you over at Johnson Dermatology. We promise to be gentle and take good care of you!

Stay happy, stay beautiful and as always stay skintastic! Thanks for following! Just opened a twitter account at the request of some very hip co-workers. You can get to know me better there as soon as I find the twitter manual on how to start tweeting. Yes, I am that old. Follow me there @skinnyonskingal

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Sorry but the only vampire I get excited about is Edward Cullen. The vampire facelift is all the buzz since Kim Kardashian had a vampire facial on national television. A dermaroller with microneedles made tiny little holes in her skin and then her own blood was placed in those holes. Her skin is beautiful but I’m not optimistic that’s solely because of her vampire facial. Who knows, maybe it is. The vampire facelift claims to be a combination of steps to make your skin rejuvenated. The first step is drawing your blood and putting it into a centrifuge to separate the parts of your blood. While that process plays out, you will be having hyaluronic acid injected into you-that’s juvederm or restylane. After your volume loss has been corrected with the filler of choice then they take the plasma part of your blood and inject it into your skin. On www.vampirefacelift.com they call this third step “injecting the magic into your face”. That just sounds awesome. No seriously, I would expect to have Harry Potter powers after that. I believe in magic. It’s called platelet-rich plasma rejuvenation. Theoretically this part of your blood is high in growth factor which then produces collagen resulting in a more youthful appearance. So what’s wrong with that, right? According to an article in medscape http://www.medscape.com/viewarticle/759592 “the efficacy and safety of PRP for cosmetic treatment have not been studied in controlled clinical trials.” Well all the FDA approved fillers that I inject have been studied in controlled clinical trials and are proven to show effects. Since they use one of these fillers in the vampire facelift, I’m sure people see some results in volume loss. What I don’t know with complete certainty is whether or not having the PRP part of the procedure is making any difference? So why go through the process and pay for that extra procedure called PRP on top of filler? In hopes that it works I guess. In hopes that it’s a procedure that will turn out to be awesome and it’s not just a gimick. In hopes that the results are worth the money. I rely on science, research and evidence and I can’t spend my tax return nor my savings on a hope. If I rolled like Kim K and Kanye then I might be able to give it a try. Maybe one day with more research and experience I will be using the vampire facelift on patients. Until that time comes, if you’re like me, you’re wondering “what is the newest advance in technology that’s cutting edge AND evidence based?” In my opinion it’s Voluma. Voluma is the most recent FDA approved hyalurinic acid filler. I’ve been injecting it since it hit the US in November and the results are pretty ahhhmazing! What’s the best part about Voluma? I can’t decide.Maybe that it’s so smooth or that it’s easy to inject. Oh, and did I mention it lasts up to two years?!?!?! I don’t know where this quote is from but I love it and it sums up how I feel about the vampire facelift.

“I’m not interested in competing with anyone… I hope we all make it”.

I don’t think the vampire facelift can compete with the fillers because part of the vampire facelift is filler. I don’t know if the PRP part makes your results better. In fact, I don’t think anyone knows on a level with which I’m satisfied. But, for the sake of all our youthfulness, I hope it does turn out to make the cosmetic world a better place! Until then, I’m gonna stay on the brink of research and on the look out for products proven to keep all our skin young and beautiful! Here are some before and after pics of a lady I injected with Voluma whose inner beauty is just as rad as her outer beauty.

Voluma may or may not be the choice for you. Come in for a cosmetic consult and let’s chat about it! I hope you have all noticed the follow button I added and put it to use. Thanks for following my blog! xoxo

Hope to see you all at the clinic this week. Remember you’re gorgeous so let it shine out through your skin this week!

Joy to all, Nina

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I hear it almost everyday, “I don’t want my face to be frozen” or “I don’t want to do anything that drastic”. I’m not sure where all these negative connotations against Botox started. I don’t think Botox is for everyone but I am here to tell you there is no moisturizer or prescription cream you can put on that does what Botox does for lines or wrinkles you don’t like. Although there is a topical botulinum toxin type A in the works who knows when or if it will ever hit the market. So this week I hope to bust the myths of Botox, Xeomin and Dysport. Plus, to prove it looks natural I have some before and after pics, yay!

1. MYTH-You will lose expression in your face. The botulinum toxins will relax the muscle. We inject it into the muscle and it blocks the nerves from sending messages to the muscle to move. I can still squint in bright lights, raise my eyebrows, smile, laugh and scold my daughter after injections.
2. MYTH-Your injecting a toxic chemical into your body. Botulinum toxin is a natural occurring protein. I guess this myth depends on your definition of toxic. Tylenol works by blocking an enzyme called cyclooxygenase. Botox works by blocking release of a neurotransmitter called acetylcholine. They both cause “harm” to a process in your body which then results in a desired effect.
3. MYTH-Xeomin and Dysport are “offbrands”. There are three FDA approved botulinum toxin type A which are offered in the US. None of them are considered “generic”. I describe them as Coke is to Pepsi. Some people like coke, some people like pepsi. Botox has been around the longest and is the most predictable because of that fact. Xeomin has less inactive proteins then Botox making it a purer product, which is theoretically a good thing. Research shows they are generally equal BUT do you consider coke and pepsi equal? No you probably like one better than the other. In my experience Dysport spreads a little more which can be good or bad depending on what your goals are. I offer all three products and I’m available anytime you want to chat more about their differences.
4. MYTH-Botox will make my lips bigger. There is a very big difference in botox and fillers. Botox relaxes the muscle so you can’t make lines in motion on your skin. Fillers replace volume loss and fill in lines at rest in your skin. Often time both of them together can be the best result!
5. MYTH-I only need Botox again when its completely worn off. Botox lasts up to 4 months. Some women tell me it lasted 3 months and some say 6 months, there is some variation person to person. You should make your appointments every three months just like you schedule hair appointments. You don’t let the color on your hair grow completely out, you color when you start seeing roots. Be diligent with your Botox don’t let the muscle get completely back to motion so you aren’t starting from square one. Over time that muscle will atrophy (become weaker) and you get even better, longer lasting results.

Next weekend is the big cosmetic event at Johnson Dermatology. April 12th from 10AM-noon. We will have special prices on all injections! Botox, Dysport, Xeomin, Voluma, Juvederm Ultra Plus, Radiesse, Belotero and Sculptra all discounted, can’t beat that! We will also be revealing a new service at Johnson Dermatology that I am giddy about, so be the first to know! You need an appointment so hurry and make one, it’s gonna be too good to miss. GIVEAWAY: If you share this blog post and comment shared below you will be entered to win an ELTA MD gift package. Elta MD carries my favorite moisturizer and spray sunscreen, this is an awesome prize. We will announce the winner on Saturday so get to sharing!

Here are some before and after pics for your enjoyment!

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tri·fect·a

trīˈfektə/

noun

noun: trifecta; plural noun: trifectas

• a run of three wins or grand events

This weekend my husband and I loaded up our 13 month old and headed to the horse races in Hot Springs. I’m not much of a bettin girl but I do enjoy the atmosphere at Oaklawn. My little girl loves the people watching and excitement. While my husband studied the horses and made bets we enjoyed the lawn and pretty weather. I diligently reapplied our sunscreen and we spent most of our time in the shade. I couldn’t get her to keep a hat on. She even wiggled herself out of the ones that tie around the neck. We are going to have to work on that problem. I’m so cautious about us getting sun damage for multiple reasons but one is how hard I see women working to get rid of those discolored brown spots. So in the spirit of horse racing, here is my trifecta for sun damage.

1. Sunscreen-every day you should apply sunscreen. Think of this as the preventative step. Even if you plan to be inside most of the day, protect yourself from rays in the car and walking to and from buildings or just unexpected sun exposure. I use the BOB – brush on block. It’s literally a mineral based powder that comes out of the brush and you simply brush it on, convenient and comfy.
2. Retinol- Are you getting sick of hearing me tell you that you need to be using a retinol yet? Use a retinol at night (not for the pregnant women) to get rid of what damage you got during the day. Retinol passively exfoliates off damaged skin letting new skin, with a more even tone, shine bright like a diamond! I use SkinMedica Retinol 0.5%.
3. Lytera Skin Brightening Complex- Some people with brown spots have used hydroquinone before and know it as a “bleaching cream”. It’s a prescription that you can’t use for an extended period of time nor during the summer months. Hydroquinone works on only one chemical pathway of the four that play a part in sun damaged skin. Lytera works on all four of those chemical pathways. The science behind it makes sense. It does have some retinol in it so be careful of the box instructions that say to use it in AM and PM. Although you may be able to tolerate that at some point it might be less irritating to your skin to start it once daily.

This is the skin care product trifecta but if you want to go for the superfecta then come in and let us discuss chemical peels or other options for you! Hope to see all of your beautiful faces at the clinic this week but if not please, please stay skintastic!

xoxo, Nina

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