Filler Crash Course

I’m giving you the break down. This is a basic, beginners crash course on different “filler” options.

1. Sculptra-not immediate, needs to be drawn up prior to day of injection. Needs to be massaged by patient to prevent nodules. Not immediate results. Best results 2 months after injection day. Lasts about 2 years but can’t win the fight against voluma so we don’t use much (if any) in our clinic anymore.
2. Restylane family-tends to be lumpy and have more swelling and bruising IMO (and SJ) plus only lasts 6-9 months so we don’t use this a lot in our practice.
3. Radiesse-Not a hyaluronic acid so it can’t be dissolved. It’s calcium hydroxyapatite. It is what we use in the hands-one syringe per hand lasts about a year.

Now let’s get to the good stuff……. The Juvederm Family

1. We love that the Juvederm fillers are by Allergan so people can use Brilliant Distinction points to get discounts with SkinMedica products, Botox and Kybella.
2. The vycross technology means lasts longer, less swelling initially. These are Voluma, Vollure, Volbella (that’s thickest to thinnest).
3. Not in a vycross technology are Juvederm Ultra Plus and Juvederm Ultra. We almost always use the first(Ultra Plus) because it is a little thicker and gives us more robust results.
4. The thickest of the family is Voluma-it lifts. If you have someone that complains of “sagging” or volume loss/ “hollows” then Voluma is your #1 lift power filler. It is immediate and lasts 2 years! However, we will not be 29 those entire two years as we continue to age we will continue to drop and be 31 in two years so patient needs to be seen every 6 months to assess for need of touch-up.
5. Vollure-thinner than Voluma, thicker than Volbella. It’s right in the middle of Voluma and Volbella and that’s how we use it. Someone with deep etched in lines around the mouth that are too deep for volbella but too shallow for Voluma will get Vollure. This lasts 18 months! That’s longer than any other FDA approved filler for nasolabial folds. It’s target is 20-30 year olds that don’t have the “sagging” but starting to get the nasolabial fold. Results we give them with Vollure are treating deep etched in lines, nasolabial folds and for some candidates even lips. Not to put her on the spot but check out what we did for Honey with Vollure next time you see her in clinic!

6. Volbella-The thinnest vycross technology filler. It is FDA approved for lip lines. Great for people that want lines treated but no plumping of the lips. Great for small etched in smile lines. This product doesn’t tyndall (look blue when put very superficial) so we use it in the tear troughs and fine superficial lines. Great for someone who wants very subtle lip definition. Lasts about a year. Call and make an appointment for a cosmetic consult with Dani and check out her volbella enhanced lips!
7. Juvederm Ultra Plus-Our go-to product for lips. It’s great for plumping the lips, treating deep lip lines and redefining the lip border, cupids bow and philtrum. Lasts about a year.

To simplify: voluma is like silly putty, Vollure is like pudding and volbella is like icing. Juvederm Ultra plus is different because it isn’t a vycross technology so it’s like jello. It plumps stronger than pudding does but it’s just a completely different substance.

Any questions please feel free to ask me…..
At the clinic! Immediately because I love talking beauty, refreshing and injecting!

We have a few Vollure coupons left so call today to snag your appointment before they are gone!

Do you watch our videos on Facebook? Follow us on snapchat? Let me know what you want to see in the comments!

Stat Skintastic

xoxo, Nina


Sunscreen for Kids

What sunscreen should I use for my kids? This has to be the number question I get as of late. What better time to answer it than right here, right now? First of all I must say it’s great to be a parent. Happy Fathers Day to all the great Dads out there! One of the magical things about parenting is we are the dictators. Although there may be a place for democracy in the family setting, as a Mother I get to say “because I said so” and “do it or go to time out”. I get to essentially force my children into doing things. Why? Because they can’t survive on Oreo cookies and cherry slurpies and someone has to keep them alive. After survival, I would also like to raise productive, good citizens into our world. So when my kids say they don’t want to wear their swim shirt or sunscreen I pull the Mom card, trump them, and they do it anyway. Since UV damage to the skin is a carcinogen much like cigarettes I encourage all you parents out there to do the same for your children. Teach them how to be healthy.

But, before sunscreen give them sunprotective clothing. Make sure they wear a wide brim hat, sunglasses, swim shirts and pants (yes pants). If you take this simple step, sunscreen for your kids will be so much easier!

Then pick a sunscreen:

Just like for adults you want broad spectrum, at least 30 SPF, water resistant and a physical blocker. To find a physical blocker look for one of these two ingredients: zinc oxide or titanium dioxide. If your child’s sunscreen hits all 4 of these requirements and doesn’t irritate their skin you’re golden. Here are a few other tips:

For sensitive skin children, find a fragrance free physical blocker.

Look for less than 10 ingredients.

Some good brands are Bare Republic, Kiss My Face, Elta MD and the BOB.

Grab a stick sunscreen for around the eyes to avoid sunscreen in the eye.

If using a spray make sure to rub it all over with your hands for good coverage. A “spray and go” technique will leave areas of skin without protection.

If it leaves a white residue that’s a good thing. It allows you to see where you have good coverage. It’s hard enough to lather a two year old in sunscreen so I’m all about what makes it easier on me.

I’m glad to hear you’re all lathering your kids up this Summer. Now if we can all just work on taking care of ourselves as good as we take care of our children. That’s the real struggle.

Hope this helps you protect those little angels. Just think about how many brown spots, wrinkles and possibly even skin cancers you are saving them in the future! I guarantee you when they are young adults, they will be forever grateful to you for it!

Happy Fathers Day to all the Dad’s out there!


JD Laser Toolbox

Sometimes people ask me how I got to JD. I had always worked in Intensive Care Units and Emergency Rooms. I traveled in this setting from California to Florida and I loved my job. So after 7 years of that how the heck did I land in derm? The PDL laser, that’s how.

Dr. Sandy and Dr. Brad had just opened their practice in Fort Smith and Dr. Sandy had a booth at the FSPD health fair to spread the word. Jarrard(my cop husband) stopped by her booth and informed her he was always red but knew she couldn’t help him with that problem. Never tell Dr. Sandy she can’t do something. She very quickly informed him he had Rosacea and she had a laser that would semi-permanently solve his problem. This was life changing. My husband was on the news regularly as the public information officer and people commonly asked him why he was so red. Was he mad, nervous or anxious? He wondered why as well and always felt frustrated to not have answers. It was a nuisance on top of an embarrassment. That’s the thing about the skin, it’s very difficult to hide your condition. He could very easily keep his high blood pressure, high cholesterol and heart stents a secret (if it wasn’t for me being his wife). He could never hide his rosacea. So monthly he went and saw Dr. Sandy for her to personally laser him. She changed his life and attitude with that laser. So much so that he made me go with him to his future treatments so I could see how amazing Dr. Sandy and her laser were in person. I saw what results she achieved and it was much more than the redness on his skin. That’s where my love for Dermatology began. Fast forward 10 years and here we are at JD with 4 laser rooms and 10 devices with a variety of results we can achieve. We have the largest laser center in the River Valley so I asked Dr. Sandy to write a blog about our lasers and here it is…….


As the granddaughter of a carpenter and a concrete man, I was taught the importance of having the right tools for the job. They taught that just because you have a hammer, not everything is a nail. As a child, I wanted to enter the family concrete business….I was denied and was told I needed an education. Reflecting on this, I am grateful because I love treating skin so much. Also, it may be that because they let me play with their tools as a child I now like to have so many tools in our armamentarium in our family business of Dermatology. My favorite tools in the clinic are the toys/tools that I and our well trained and physician supervised laser techs get to play with daily.
I love lasers and was fortunate to be trained by experts at UAMS and Harvard. I was honored to use some of the latest technology when I was on faculty at UAMS. I learned to respect lasers and what they can do when I served on the Laser Committee for the Arkansas State Medical Board. These experiences early in my career further enhanced my desires to have a lot of laser tools as well as my desires to provide the highest level of patient outcomes and experiences.

So now at Johnson Dermatology, if you tell us what you would like to enhance, we can tell you if we have a tool or tools for that. As Alice, one of our lasers techs, likes to say…”we have the most comprehensive laser center and the best trained team to use those lasers”.

Acne…we can treat with the Blu light, PDL or sublative

Acne scars…we can treat with PDL, sublative, YAG, IPL or subcision

Red marks, spots, birth marks, facial redness, or broken blood vessels…we can treat with PDL, KTP, IPL

Psoriasis…we can treat with PDL

Excess hair…we can treat with YAG for patients who have very light colored skin to very darkly colored skin. We can also treat with the motif for a more comfortable treatment experience

Loose skin…we can treat with YAG, sublative, PDL or velashape

Stretch marks…we can treat with PDL, YAG, sublative, velashape

Want 32% fat reduction that is permanent and painless…we can do that with velashape and ultrashape power

Unwanted tattoos…we can rid those with PicoSure or ATV

Brown spots…we can treat those with creams, peels, ATV, PicoSure, PDL, IPL
Yes, we have a lot of toys and we have fun playing with them for the benefit of our patients. The PDL and YAG were the first lasers we purchased for Johnson Dermatology in 2006. The V-beam perfecta we use now is the third version of the PDL I have used; and is still my favorite laser of all time. One of my favorite patients of all time was a sweet guy with a tattoo on his arm that he wanted gone before his baby was born. He challenged me and we accomplished his goal with the laser. Together our laser team has more than 40 years of experience and countless stories of these success stories. We are so thankful to every patient who has trusted us for that past 11 years and for every patient who will trust us in the future.

I would like to take this opportunity to offer Congrats to Dr. Bise on his retirement after a very successful plastic surgery career. I also want to thank him for trusting us with his PicoSure and KTP lasers…the latest tools we have added to our laser toolbox. We will do our best to make him and his patients satisfied.
Stay skintastic!

Skin Tips for Mom

Happy Mothers Day. I dread the day that I don’t have two little girls running around (mine are 2 and 4). Whoever said “the days are long but the years are short” was exactly right. There are some  skin tricks every Mom should know in my opinion. Let me share them with you.

  1. Laser hair reduction. I’m a pretty hairy chick. By the time I got done shaving my bikini line, legs, abdomen, underarms and feet(yes, I might be from the shire) in the shower my kids had enough time to destroy at least two rooms, maybe three. Laser hair reduction is once monthly for 3-5 months and boom daily time saved approximately 20 minutes.
  2. Sleep deprivation. It’s part of motherhood. First they don’t sleep through the night, then they are scared of the dark, then they just don’t want to be alone, then they have first love problems, it just goes on and on and you never sleep again. Keep those eyes looking fresh with Botox cosmetic for crows feet and to lift the brows and upper lids. I also love sublative for around the eyes. It’s radiofrequency that tightens the skin. Try keeping your under eye cream in the fridge. The cold will decrease swelling that accumulated while you slept and the moisture will create a smoothing effect.
  3. For the kiddos. Keep over the counter hydrocortisone handy. Use it on bug bites, sunburns(no judgement, just job security) and “poison ivy”. Keep Vaseline for cuts and scrapes to prevent infection.
  4. Use sun protective clothing on you and the kiddos. Who has time to grease down an entire wiggly 2 year old with sunscreen every two hours while outdoors? Long sleeve swim shirts, pants and wide brim hats. Cut the sunscreen to only areas of the body that can’t be covered with clothes and you’ll get better sun protection and save those precious minutes moms live for, you know when you get to pee alone.
  5. Basic skincare. All you really need is a sunscreen every morning and a retinol every night. The other stuff is extra. Use sunscreen to prevent damage to your skin and retinol to reverse any damage your skin might receive. Keep it simple for you because keeping up with your kids’ schedules is complicated enough.

May is skin cancer awareness month and we are celebrating with a sunscreen special. In the month of May, if you buy a brush on block you get a free refill. That’s a $17 value. The BOB is everyone’s favorite sunscreen for reapplication because it’s a clear powder that goes on invisible and dry. If you haven’t tried it, now is the time.


See you at the clinic this week, stay Skintastic Moms!

Xoxo, Nina

Fort Smith

Doesn’t it feel good to get home after a vacation? There is something about sleeping in your own bed that can’t be explained. Or your own shower. You sure do get used to your own shower head, don’t you? If you follow us on snapchat (jdermatology) then you saw some of my beach vacation. I am relaxed, recharged and ready to make my mark on Fort Smith. I personally chose Fort Smith as my home. After being born, raised and educated in Fayetteville it wasn’t a far leap from home but sure felt like a different planet when I moved here in 2006. I absolutely love my life here. Good food, great boutiques, booming downtown and the best people around. Dr.Sandy has chosen Fort Smith as her hometown too. We both were encouraged by our husbands to chose Fort Smith but I admire how she has made her own mark on The River Valley. We enjoy being a part of Fort Smith and serving all your skin needs. Listen to what Dr. Sandy had to say in a recent journal article she wrote about Fort Smith.

Life is worth living in Fort Smith.  This was the motto of our former mayor Ray Baker.  I believe it.   I also believes what goes around comes around.  After all, 1980’s hair and clothing are hip again.  Anyway, in the very distant past, Fort Smith was the mecca for health care. But then, corporate America took hold of health care and that changed….for the worse.  Doctors left Fort Smith in record numbers. We don’t need to harp on that era.  It was during this dreary period however that my husband wanted to move back home and open a Dermatology practice together.  My husband loves his hometown and he was unaware of the downturn in the medical community when he insisted we move to Fort Smith (Greenwood actually) to open our Dermatology practice after his derm surgery fellowship in 2006.  After all, he insisted, if there are not many doctors we should be busy.  (I love him and how he always look at the bright side.) He was right.  Even though Fort Smith was not my hometown, it is now.  I love it here.  I love the community.  I love that it is family oriented and is a great place to raise our children.  I love it so much that I love to give back to our community.  I love being a part of Leadership Fort Smith, the local Chambers of Commerce and various committees.  Life is worth living in Fort Smith (and Greenwood).


Fast forward to present day and Fort Smith is thriving again.  Many physicians are moving here and enjoying it.  Our Chamber of Commerce even started a New Physician reception a few years ago.  In fact, even we were able to recruit a wonderful Dermatologist who joined us last year.  For those of you interested, we (Johnson Dermatology) are still recruiting as are the hospitals and other groups in town…for all specialties.  There seems to be a new Mercy clinic with new primary care physicians opening every month.   There is actually a lot of collaboration occurring between the local hospitals…at least in my opinion.   We have an impressive Good Samaritan Clinic.  The UAMS West AHEC wins many awards.  The residents who rotate at our clinic from UAMS West are the best and brightest.  IM Well clinics started in Fort Smith about 10 years ago with forward thinking physicians and has grown tremendously with far reaching benefits for employers, employees and communities.  Health and Wellness programs are thriving.  We are fighting the good fight and we are winning.


The first class of medical students will start in a few months at our new medical school.  I was overwhelmed by the facility, technology, faculty and campus of the Arkansas College of Osteopathic Medicine.  I was told there were thousands of applications for the about 100 positions and the average MCAT score was 3 points higher than the national average.  The people behind the medical school are working with other community leaders and have big plans to help our health care system and health care education in many ways to help our community for years to come.  I think this collaboration is an important part to the improved health and health care situation of our community.  Don’t get me wrong, there are still naysayers and people who belittle and don’t play well in the sandbox.  But in general, the situation continues to improve.  Our trails continue to lengthen.  We have had a marathon for 3 years.  We have impressive bike races.  Our economy is steadily growing.  Physicians are serving on multiple organizations.  Our university, UAFS, is thriving in athletics and acadmeics. Health care, education, family values, quality of life—what else does one want or need?


In summary, life is worth living in Fort Smith.  If you don’t believe me or would like me to show you, let me know.  You can reach me by phone, email, website, Facebook, Instagram, twitter, Snapchat, or even snail mail….we have all of those in Fort Smith.  Even if you do not make it to Fort Smith, I hope your life is worth living wherever you are.

Stay Skintastic.  Dr. Sandy

We have so many exciting things coming to Johnson Dermatology. Hope you guys make it out to see us soon! Have a great rest of your week! Nina



Skin Cancer Awareness Month

Did you guys miss me this weekend? I missed you too. I totally forgot to post because I was busy celebrating. My youngest turned 2 and I turned 29 again. I have lots of blog posts stocked up from Dr. Sandy and myself so get excited for the future of “the skinny on skin”. This week our newest Dermatologist at JD, Dr. Nelson is guest posting. He specializes in skin cancer surgery and is the perfect addition to the JD team. He has a beautiful wife, Ashley and two little, little ones. Did you see the newborn picture of his son Grant on our facebook? Want to meet him in person? Now is the time to call the clinic and let Dr. Nelson do your skin cancer check. It’s a great way to get to know him and welcome him and his family to Fort Smith. Plus, what better way to celebrate Melanoma Awareness Month than with a full body skin exam? While you’re here ask him what skin care products he uses, his skin is JD flawless. (#Brotox) Here is what Dr. Nelson has to tell us all about skin cancer…..

May is Skin Cancer Awareness Month. This month is dedicated to educating the public about the importance of skin cancer prevention, diagnosis, and treatment.


Skin cancer is the most common form of cancer in the United States, with 3.5 million new cases diagnosed yearly. Approximately 1 in 5 people will develop skin cancer during their lifetimes.  There are three major types of skin cancer:  Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC), and Melanoma.


BCC and SCC are the two most common types, and have a very good prognosis if detected early. Left untreated, they will continue to grow and possibly spread.  Our clinic diagnoses and treats over 2,500 of these skin cancers in our community per year.


Melanoma is the 3rd most common type of skin cancer, with about 140,000 newly diagnosed melanomas per year.  Melanoma is the type of skin cancer that can spread and cause death.  We diagnose approximately one new patient with melanoma per week.


Some of the most common risk factors for skin cancer include exposure to ultraviolet radiation from the sun or tanning beds, a history of sunburns, and having light-colored skin. Thankfully skin cancer can be prevented in many cases by protecting their skin; this includes avoiding tanning beds, avoiding the mid-day sun, wearing wide brimmed hats, broad-spectrum sunscreens, sunglasses, and sun-protective clothing.


Dermatologists are the experts in skin cancer detection, diagnosis, and treatment. Every patient is unique, and treating their skin cancer treatment must be individualized.  Our team is highly trained in all aspects of skin cancer management and offer a full range of treatment options.


In May, dermatologists across the country will be offering free skin cancer screenings in their community. In the River Valley, Dr. Sandy Johnson and I will be offering free skin cancer screenings on May 1st and May 4th in conjunction with the Reynolds Cancer Support House.  You can contact the Reynolds Cancer Support House at 479-782-6302 for more information.


If you are unable to come to one of the free screenings, we would still encourage you to contact our office at 479-649-3376 to schedule your yearly skin cancer screening.


Garrett Nelson, MD

Board Certified Dermatologist

Fellow of the American Academy of Dermatology


Like This?

Haven’t we all wondered why there is no “dislike button” on Facebook? I can only assume it’s because disliking something feels mean and gives negative connotation. I guess that’s a vibe Facebook doesn’t want. They want a place of happiness, positivity and (most importantly) all are welcome here.

Even if we don’t want to admit it we all feel the need to be liked. Last night at 8:30 PM as I was checking out at the grocery store my 2 and 4 year old daughters were climbing all over the carts and pulling at me and being toddlers. The woman behind me said “oh they are so sleepy, huh?”. If I responded truthfully I would have told her how they never go to bed before 9 on weekdays and 10 on weekends. How they climb all over the place and act more like apes than humans most public places. Explain that they only mind other people and my voice goes directly in one ear and out the other. But that’s not what I said. I wanted her to like me and think I was a great Mom not a terrible Mom that had her hooligan toddlers out past bed time. So, I just laughed and explained how they took their time at the restaurant for dinner so we were out later than expected and my sweet innocent kid’s were just worn out and ready for bed. Not a lie, but the truth twisted into a way this random stranger would still like me.

This need to feel liked drives us to act a certain way. It’s why I sometimes avoid product reviews on my blog. I don’t want the people that sell the product or make the product or use the product to not like me. I have realized this is a disservice to my readers. I don’t recommend things based on feelings, money or friendships. I recommend products and procedures based on science. I have a masters degree in the science of nursing. I am literally specifically trained to practice evidence based (scienctifically founded) nursing. So since Bridgett and I have been reviewing products on snapchat we have had multiple requests for the Rodan and Fields review. I thought it was more fitting to put it in a blog but if you want a quick review on any product whatsoever, just snap us (@jdermatology) and we will shout it out.

The unblemish regimen was most requested so that’s what I’m going to address today. If you like this review and want to learn about another regimen they offer just ask me in the comments.

According to the Rodan and Fields website the Unblemish regimen is $120 before shipping. Here are the products/steps with my review.

  1. Sulfur wash. I think sulfur wash is a fine wash for acne treatment. This one however has 40 ingredients (I counted) and one of them is alcohol which is drying. Another is red dye which can trigger perioral dermatitis. And then there is fragrance (yuk) which can irritate and inflame the skin. I would pass.
  2. Second step is a toner. I generally do not recommend toners. No offense to this specific toner I just find them to be more drying and irritating than helpful. I pass on all toners without prejudice to any specific toner.
  3. The third step of the regimen is the “dual intensive acne treatment”. Its active ingredient is benzoyl peroxide 5%. Benzoyl Peroxide is an ingredient that I recommend all my acne patients use if they have never had an intolerance before. Here’s the thing about this specific one- it’s got over 40 inactive ingredients that are unnecessary in my opinion. Number one inactive ingredient is water, number three is benzyl alcohol. This is 2 chambers of 0.76 ounces. Now here is my real problem. Go to Wal-Mart and get equate brand benzoyl peroxide gel 10% and it only has 6 ingredients! Simple basic- gets the job done for $3.13 in a 1 ounce package. I mean….. you pick.
  4. The final step in the regimen is an oil control lotion broad spectrum SPF 20. Now that just annoys me. If this is a truely dermatologist made brand then why only SPF 20? The American Academy of Dermatology recommends an SPF of at least 30 and most derms agree. I’m thinking in my head “girl if derms really put their minds into this, they at least would have gotren the sunscreen right!”….. c’mon sunscreen is like the peanut butter to our jelly, the fries to our cheeseburger, get it together!

Overall I do like that this regimen has a benzoyl peroxide and that it is only 4 steps. I don’t like that there is no retinol. Any derm expert will tell you that after benzoyl peroxide you should be on a retinol or prescribe you a retinoid if you have acne and aren’t pregnant or breastfeeding. I also don’t like the price point. In my opinion you can get the same active ingredients MUCH cheaper. I don’t enjoy talking about products I don’t recommend. It makes me feel like I am gossiping behind people’s back. But I consider all my readers my friends and I am just giving you my opinion. I follow the American Academy of Dermatology guidelines for treating acne which is evidence based. There are lots of opinions out there and I hope mine doesn’t hurt anyone’s feelings. I must say that particular sunscreen hurt my feelings though. I do hope that my opinions help someone’s skin. Someone who might read my blog and go to wal-Mart and get some equate BPO and have less acne for $3.13. If I help just one person, then it’s worth the few that may not like me. We do everything with a purpose, right? Sometimes it can’t just be so that you like me.

Happy Easter, hope you’re hoppy with this blog, Nina


Team JD Behind the Scenes

Who wants to hear some of the behind the scenes JD work that was done this weekend? Dr. Sandy guest post is another amazing one. Be sure you follow us on snapchat (jdermatology) to follow along with her there too!
Ellie Goulding sings “I do what I love and I love what I do”. Well, Ellie and I have this in common. Fortunately, I work with a team of people who feel the same. At Johnson Dermatology, we strive to give every patient the very best experience and outcome when they contact and interact with our clinic. From the time you choose to contact us via phone, email, social media, etc to when you come to the clinic to when you are at home following your skin care program and every step in between, we want you to feel skintastic.
In order to create this experience, we work a lot behind the scenes outside of regular patient care hours. These include team meetings, team trainings and team parties. We apply extra effort as a team and as individuals. For example, Dr Nelson just attended the national American Academy of Dermatology meeting. Lisa, our lab manager, visited 2 other labs in the state to ensure that our patients get the best pathology experience and results.
I am not sure what you did this weekend but Crystal and Christa, two of our clinical trials coordinators, attended an investigator meeting in Chicago so that we can offer another great clinical trial to our patients suffering with eczema. I spent the weekend at a skin care educational event where I was honored to present some of our research and experience at Johnson Dermatology. It was fantastic. I got to share the stage with amazing people and scientists. We chatted about a new product from Skin Medica called the HA5 lip plump system. The basic science rocks. The results from our patients and other patients from around the country however exceeded results. The JD team is excited to share this product with you. Just wait until you personally get to experience the enhanced results when you combine our lip injections in the office with your at home applications of HA5!!!

It was also rewarding to share my personal story how HA5 has improved my rosacea so much that I no longer use prescription products and “need” lasered less often.

One of the best parts was being able to #brag about our awesome team. It may take a village to raise a child but it takes a team to provide the highest level of effective, efficient, empathic and empowering care (our motto). So thank you to the JD team for all that you do and thank you to every person who trusts us with the care of their skin—whether in clinic or online. Without you, we would not be able to do what we love and love what we do.

Stay Skintastic, Dr. Sandy


Rosacea Awareness Month

An estimated 16 million Americans are effected by rosacea according to the National Rosacea Society. They have great resources at for people who want to learn more about rosacea. Rosacea has four subtypes including redness, papules and pustules (pimples), skin thickening and ocular (in the eyes). Even though we can not cure rosacea we can control its symptoms. Similar to the nature of high blood pressure you can take a pill to make your blood pressure normal but it isn’t cured because if you stop your medicine the symptoms return. There are lots of options and I recommend you make an appointment with your dermatologist to hear what would suit you best. Here are some of the exciting options we have at JD changing the game in Rosacea.

  1. Pulsed dye laser- works well for redness, broken blood vessels and “pimples”. We recommend 3-5 monthly treatments for semi-permanent results. You will likely need a “touch-up” treatment about once/year. Feels like a rubber band popping you. Not painless but not a big deal. In my opinion it’s one of the least painful lasers with powerful results.
  2. SkinMedica HA5: This isn’t an FDA approved treatment for rosacea or anything but it’s the cream of choice for Dr.Sandy on her own Rosacea. It’s ability to pull water into the top layer of your skin(epidermis) helps rebuild the irritated, red skin of rosacea. Bonus is that it treats fine lines and wrinkles making it a no brainer for women who are more commonly affected by Rosacea.
  3. Clinical trials: We have another Rosacea study starting up in April so if you are interested e-mail I don’t know the details of this particular study for Rosacea patients yet but hopefully I will very soon. Clinical trials are a great way to make the world a better place in science. Getc one of the newest treatments out there and get healthcare for free. That’s a win-win-win!
  4. On the horizon is the newest FDA approved topical for rosacea called Rhofade. It’s a competitor to Mirvaso that claims to be better about rebound redness. These are both prescription creams you put on in the morning that treat redness. For those of you that could not tolerate Mirvaso then Rhofade should be available to prescribe very soon. If you haven’t tried Mirvaso or didn’t know there was a cream for redness come see one of us at JD or ask your derm. This is one of my husbands life changing creams that he uses for his redness.

These are some new and innovative ways we treat rosacea. Although the tried and trues are still available and I use them in our practice daily the new stuff is just exciting. That’s the great thing about science in medicine, we keep learning new ways to improve our patients outcomes. If you or someone you know suffers with symptoms that might be Rosacea then April is a great month to recognize that and seek advice for your skin health. Your skin is your largest organ, it deserves health maintenance too.

Make sure you follow Johnson Dermatology on Facebook, twitter, Instagram and snapchat as we celebrate Rosacea awareness month with education and specials!

Roses are red, Violets are blue, if you have Rosacea we want to help you!

See you this exciting month at the clinic, Nina

Why worry?

I’ve never been appreciative of how precious time is in our short lives. How blessed we are to have each day. Recently, with my husband working a shift that keeps him from me and our children four days a week I’ve found greater value in time. I’ve been putting a lot of thought into exactly how I spend my time. What activities I want to do, what goals to spend time on and with whom I want my time spent. Ofcourse, my family is number one. However, I spend a large amount of my time working. A great deal of my life is spent with the people I work with and my patients. I love my patients. However, what originally drew me to Dermatology is the team at Johnson Dermatology. The teamwork practiced at JD is unheard of in the medical field and the caring hearts found in that clinic are unfortunately a dying bread in hospitals I’ve worked before. But what the true rarity is at that clinic is the leadership. Dr. Sandy makes me believe in the good in this world and in healthcare generally. She gives me an environment where caring for patients comes before meeting quotas, where taking care of employees comes before taking care of herself and where everyone feels motivated to be better. She worries from a sincere heart. When she sees me under stress, she helps without asking. Which is why she wrote a blog post for me (Thank You SJ). She reminds me why I want to spend a great deal of my precious time investing in and working at Johnson Dermatology. I know you all will enjoy her post as much as I did. Cheers.

From Dr. Sandy:


I know better than to worry. I know to let go and let God. However, I do worry. I worry about a lot of things. As a mom, wife, daughter, sister, friend, doctor, business owner, etc…I worry a lot. I have a lot to worry about in life (or so I think). Funny thing is that there are things I don’t worry about in life. Those are the things that end up getting the best of me and about which I should have worried.

Take this spring break for example. My family and I left the clinic to go skiing. I was worried about the logistics of travel. I was worried about us getting hurt skiing. I was worried about leaving the clinic….although I know the clinic is in good hands. I was worried about Honey’s maternity leave and new baby. I was worried about Dr Nelson and his wife having their baby. I was worried about Nina being the only provider in the clinic…although I know she could handle it. I worried about a lot of things. However I did not worry about our leisure bike ride at our destination before our ski trip. Well BAM! … just imagine…perfect day…family happy and sun protected…enjoying our ride…BAM! A woman stops her bike right in front of (Dr.) Brad. He flies over the handlebars and lands very awkwardly. BAM! He looks nauseated but shakes it off and walks his bike back to the store. He drives us to our destination then tells me he thinks he may want to go to see if he broke his arm. WHAT? BAM!!! We leave the kids at the hotel (not worrying or thinking about them eating dinner) and he and I head to the Emergency Department. Of course if you know me you know I don’t like waiting (which is why we try to see patients within 20 minutes of their appointment at our clinic). Well this ER had 3 (yes 3) “waiting rooms”. It was like a Disney ride. Just when you think you are at the front of the line… move to a different line to wait longer and worry more. Turns out he did break some bones. He did get to ski some and our family is having a great time. We have 3 more days left of our vacation so I am still worried about our safety and getting home.

While we are away, some unusual activities occurred at the clinic; but our team is handling them well (big thank you to our clinic manager Shelly). Dr Nelson and his wife Ashley had a beautiful healthy baby boy (check out the pictures on our social media). Honey and her family are doing great and she has started seeing patients. Nina did have to handle some extra work but she worked diligently and survived. Nina’s work in the ICU and ER and inner cities has paid dividends.

What will happen next? I don’t know. I will try to worry less and enjoy more. After all, like the old English proverb states… “worrying is like sitting in a rocking chair….it gives you something to do but it doesn’t get you anywhere”. Since we already mentioned Disney, I should also try to follow the advice of Walt…”Why worry? If you have done the very best you can then worrying won’t make it any better”.

So my spring time resolution is to get out of the rocking chair, use sun protection and start moving. I hope you will join me but I will try not to worry about you. Stay skintastic.