Melanoma Survivor Story

I am a survivor of Melanoma…

melanoma survivor

I was diagnosed at the age of 6 with malignant melanoma. I was in and out of the hospital for over a year. My lymph nodes were removed from my left groin and I still suffer from swelling in my left leg.  The swelling I have is a reminder of how blessed I am to still be here.

Now I work for Sand Lake Dermatology Center, which is another blessing! What a full circle I have taken from being a patient at such a young age to now working with exceptional dermatologists and physician assistants that passionately work to prevent and treat skin cancers. Melanoma affects many! My story is not to be taken lightly.

Today is Melanoma Awareness Day! I encourage all those that have survived melanoma to share their stories in an effort to raise awareness. On this day and every day, make sure you are wearing sunscreen and putting sunscreen on your children. It is so important! And make sure to take time for annual skin check appointments with your dermatologist.

By: Judy Passmore, staff member at Sand Lake Dermatology Center

Correcting Crow’s Feet

Crow’s feet are the lines and wrinkles that develop around the eyes over time. These can develop as early as our thirties. They are due to excessive sun exposure, squinting, frowning and smiling. Many patients ask how they can prevent and treat these lines around the eyes.

How can I prevent Crows feet?

  • Wear SPF 30 or higher daily
  • Wear sunglasses daily to prevent squinting
  • Injection of neurotoxins such as Botox Cosmetic

How can I treat crow’s feet?

  • Under eye serums with hyaluronic acid and retinol
  • Chemical peels
  • Microneedling
  • Injection of neurotoxins such as Botox Cosmetic

The U.S. Food and Drug Administration (FDA) approved the use of Botox Cosmetic for temporary improvement of moderate to severe crow’s feet in 2013, making Botox the first and only product to receive FDA approval specifically for treatment of crow’s feet. Botox targets one of the underlying causes of crow’s feet—the repeated muscle contractions from squinting.  The procedure takes 10 minutes in the office and results are seen within 7-10 days, usually lasting 3-4 months.


It isn’t just women looking to soften crow’s feet and facial lines. According to the American Society for Aesthetic Plastic Surgery, there has been an 84% increase in men’s Botox procedures in the past 5 years. As of now, 1 in 10 Botox patients are men and most of them are interested in treating their crow’s feet. Treatment of crow’s feet with Botox requires minimal downtime and results are subtle so patients will still look like themselves.

botox man crow's feetCall our office to schedule a complimentary aesthetic consultation to learn more about preventing and/or correcting crow’s feet.

By: Gina Mangin, MPAS, PA-C

Clearing Up Acne Myths

Young woman inspecting her skin

I am not shy in admitting that I enjoy treating acne.  There is nothing more satisfying than feeling fresh faced and confident to start the day, and I believe anyone can accomplish clear skin with the appropriate regimen in place.  In treating my patients, I hear many myths that make understanding acne and how we can heal it difficult.  I’d love to clear up some of the most common acne myths.

Myth #1: Poor hygiene causes acne

Acne tops the list as the most common dermatological disease for which patients seek treatment.  Most of my patients come with carefully constructed regimens already in use.  Yes, washing twice daily is vital to maintaining clear skin, but the root of acne goes much deeper than cleaning off dirt, oil, and bacteria.  We find that most forms of acne have a genetic or hormonal influence that stirs up inflammation within the skin.

Myth #2: Avoid greasy foods

Fatty and greasy foods are actually not the reason we get new breakouts, contrary to old beliefs.  In fact, new studies suggest that skim milk, chocolate, and high glycemic foods (Think: white pasta, sodas, candy) can really be the foods to blame for flare ups!

Myth #3: Tanning will help acne

Now of course we need to debunk this myth!   Although certain wavelengths of light can be therapeutic for inflammatory acne, tanning beds or laying out are not.  The large majority of radiation our skin receives from the sun and tanning beds is UVA which does NOT help acne.  Rather, UVA is responsible for photoaging with brown spots and wrinkles and also can cause skin cancer.  Believe me, an attempt to settle that cystic pimple with a tan won’t be worth the trade off for a skin cancer scar 10 years from now!  Broad spectrum sunscreen is key to any acne regimen to protect the investment you are making now.  Check out my favorite for acne-prone skin – Elta MD UV Clear SPF 46.  We do also offer safe phototherapy treatments through our office that can calm acne.

Myth #4: It has worked in the past so it always will

As many of you can attest, acne can evolve and so must our treatment plans.  In addition, some medications are not safe or intended for long term use.  Others simply don’t work well if not balanced by other ingredients.  Successfully treating your acne can be an art.   Let us help you navigate!

Myth #5: It’s just a phase

Unfortunately, many times it is not.  Remember how I mentioned that many forms of acne are genetic or hormonal?  These cases can be the most stubborn, painful and threatening for scarring potential.  The best time to treat acne is when it starts, whether as a pre-teen or adult.  We realize that acne is not just an aesthetic issue.  It can be a deeply emotional condition as well, affecting your self confidence, behavior, daily habits, and pocketbook.  We take that very seriously.

Oh, and as a reminder… Don’t squeeze it!  Leave that for the professionals.

Warm regards,

Jessie Holland, PA-C, MPAS

Cooler weather = Dry Skin

woman winterThe recent “cold snap” here in Florida is welcomed but with the cooler weather many of my patients with skin conditions such as eczema, xerosis (dry skin), or psoriasis can flare. With less humidity in the air our skin can become dry more easily. Simple tips to do during the cooler months for skin health is listed below.


  1. Avoid “HOT” showers or baths, only use luke warm water when bathing
  2. Use gentle soaps and cleansers such as Dove Unscented, Vanicream, Cerave, or Cetaphil
  3. Moisturize daily with a gentle moisturizing CREAM, my favorites are Cerave or Vanicream

Not only do these tips help in our “winter” months but also throughout the year to help our skin remain hydrated.

A patient should always seek medical attention if a skin condition is chronic or not resolving.

By: Gina Mangin, MPAS, PA-C

Is sunscreen still important in the fall months?

The simple answer to this is, yes, but many people are under the assumption that even here in Florida sunscreen only needs to come out during the summer months when temperatures are above 90 degrees. When the lower temperatures and decrease in humidity comes around, the beach towels and swim suits are traded in for sweaters and scarves. Some of us even bring the boots out! Make sure that you still keep that bottle of sunscreen out and ready to be put on daily. We might not be applying to as large of a body area since a little more body surface area is covered up, but it is still important to keep exposed areas protected.

Happy parents having fun with their children in nature. They are looking at the camera. [url=][img][/img][/url]

Substituting beach days for picnics and book reading outside on a breezy day leaves our skin exposed to the elements. It is true that the UV index is lower in the fall months, but this does not mean that the UVA/UVB rays are non-existent and sun damage does not occur. UVA rays are still intense and can cause not only wrinkling but also irreversible damage and possibly skin cancer, such as melanoma. Broad spectrum sunscreen with SPF of at least 30 is recommended to apply to all exposed skin during outdoor activities. Wearing a zinc oxide or titanium dioxide based sunscreen would be best! Although daily application of sunscreen is preached, sunscreen alone won’t keep you fully protected. It is also important to wear wide brimmed hats, protective clothing, and sunglasses as well as seek shade as much as possible. Darker clothing is a better option than white or lighter colors. When deciding on outfits, keep in mind your activity, if it’s going to be an outdoor sporting event day, pick the navy blue top and save the white for an indoor lunch. A good general rule of thumb is it you can see through the fabric, the rays can penetrate it.

It is not only important to wear sunscreen year round in Florida. If people are traveling up north to the cooler climates for ski or holiday vacations, some might skip the sunscreen when packing up the winter clothes and snowboards. Just like the sun reflects off of the sand and water during beach activities, it also reflects off of snow. Some reports even state it reflects at a much greater intensity off of the snow. Since not much is left uncovered while gearing up for activity in the snow, it is very important to focus on the areas of skin left unprotected. Your face, lips and ears are vulnerable areas that should have sunscreen applied at the beginning of and every 2 hours during any outdoor activity. Make sure the lip balm you wear also has an SPF in it. Many have SPF 15, but if you look hard you can find the SPF 30 and even products with zinc oxide are available. There are newer products available that make reapplication easy. Ask us about the tinted zinc powder with application brush that goes over makeup very elegantly but can be used on men and children as well.

As previously stated, the simple answer to the question “is it still important to wear sunscreen in fall months?”, is yes; but I hope the explanation will leave people a little more inclined to keep out those bottles year round and not tuck them away after summer fun. If your post-summer sunscreen supply is low, stop by our office this month to pick up more– ALL of our sunscreens, UPF50+ sun hats and umbrellas are 20% OFF this month!

By: Lauren McConeghy, MPAS, PA-C

My Personal Experience With Precancers

Precancers or “actinic keratosis” is one of the most common diagnosis made in the field of dermatology. They are caused by chronic sun exposure, and typically appear as dry, flaky spots of skin. Because there is a risk that these findings can advance to certain skin cancers, it is important to have a conversation with your provider to properly address how to manage these changes in the skin once they are identified.  There are many treatment options for precancers, ranging from freezing individual spots to using photodynamic therapy, also known as “light treatment” by many of our patients.

This past May, I found a new red, scaly growth on my chest. I decided to use Picato, a 2 day treatment for actinic keratosis.  Similar to other topical precancer medications, Picato is proven to be highly effective in treating “fields” of skin such as the face, scalp, forearms, and in my case, the chest. I was curious to see what type of reaction I would have considering this was my first precancer. I was shocked with the results.

Here is a photo of my chest prior to using Picato. The pink spot on the left side of the photo is the area of concern.


I used the first tube on a Friday night. It is a gel, and I covered as much of my chest I could with the small tube. I was able to extend it from the outside corners of my clavicles, across the top of my chest, and down centrally to where a scoop neck shirt would lie.  That night, my chest became very itchy. In fact, I recall waking up in the early morning and noticing the itch. I found using a damp, cool washcloth helped soothe my skin.  The next morning I noticed redness starting to spread. See the photo 12 hours after my first application below:

The itchiness remained and grew on Saturday, especially with activity that raised my body temperature such as walking my dogs or working out at the gym. After showering on Saturday night, I applied my second dose.  By Sunday I noticed small blisters develop on my chest. My skin was still itchy, but I found it to be more tolerable at this point.  Day 2:


On Monday, the itch was completely gone and I noticed my skin healing. The blisters resolved and I was left with small, scabs.  Day 3:


The scabs healed relatively quickly and by Tuesday (or day 4), I noticed a considerable improvement.  Day 4:


The following Friday, my chest was completely cleared.

The following photo was taken 2 weeks after the first application. You can also appreciate how the red spot is much improved. Day 14:


Picato allowed me to see the extent of my sun damage while treating it at the same time. And I am happy knowing that it has peeled years of sun damage in the form of precancers off my chest. With continued sun protective habits, I am hopeful to prevent similar precancers and even more concerning skin cancers.

It is worth mentioning that Picato is not necessarily for everyone. It is also very important to note that each patient’s experience with Picato may be different. I have had patients experience much more exuberant reactions, and other than presence of more precancers on the skin, it can be hard to predict who will react more severely. Also, not every red, scaly spot is a precancer. Remember, if you find a new spot or have a spot that is changing, please make an appointment to see your dermatology provider. They will discuss a plan that makes sense for you.

By:  Jessie Holland, MPAS, PA-C

What are these bumps on my child?

Every few weeks I receive a text message from a friend concerned about little bumps that recently appeared on her child. The bumps are often round and flesh-colored and have an indentation in the center. Most of the time, the bumps seem to bother the parent more than the child but can occasionally become red and swollen or feel sore and itch. The diagnosis? Molluscum Contagiosum.

molluscumeditMolluscum, much like warts, are caused by a virus that spreads from person to person. It is a very common condition and children are more likely to get molluscum than adults (although, we do see adults with molluscum too). The virus can be transmitted by direct skin-to-skin contact or touching an object (like a towel, mat, toy or clothing) that previously touched a lesion on someone’s skin. There are also reports of people getting molluscum from a gym or swimming pool. Molluscum can spread to other parts of the body if a lesion is rubbed or scratched so it is important to avoid picking at the bumps.

Although molluscum is a virus, it dwells so superficially in the skin that the body’s immune system often doesn’t recognize it is there. Although it may clear on its own, it may take months to years. For this reason many dermatologists recommend treatment. In addition, molluscum can multiply quickly, spread to other areas of the body and to other people, and can be difficult to treat if it spreads. Treatments usually include some type of irritation to the skin in attempt to call the immune system to action in order to clear the virus. Treatment varies from patient to patient but may include liquid nitrogen (freezing the lesions), topical acids or blistering solutions (like Cantharadin, aka “Beetlejuice”), or electrocautery (burning the lesion). We often prescribe or recommend at-home treatments as well. Skin discoloration resulting from infection and treatment is generally temporary and will fade with time.

Besides children, other people at higher risk for molluscum include: those who participate in close contact sports or activities, those living in hot and humid areas, individuals having a disease that weakens the immune system (such as HIV), and those with eczema. Molluscum can spread quickly on eczematous skin and is generally more stubborn to treat due to barrier compromise.

A few caveats: Be really careful about purchasing at-home treatments online. Sometimes they can do more harm than good. Seeing a dermatologist will help you make an informed decision regarding treatment and like most medical conditions, it is always better to seek evaluation and treatment early. Finally, it is important to note that not all cases need treatment. Sometimes it just makes sense to allow the molluscum to resolve on their own. We can help you decide!

By: Theresa Helsel, MS, MPAS, PA-C

Reference: America Academy of Dermatology

How to keep your makeup from melting in the summer heat

Summer is here and it is HOT! Heat and oil can make your makeup melt away and we have the frustrating task of trying to keep our makeup in place and our skin clean and clear. The combination of heat, sweat and oils from our skin makes our pores clog easily and can also cause breakouts so it’s really important to keep your makeup natural in the summertime months.

I am using Colorescience, which is a sun-protective skin care line. Colorescience products are formulated for different skin types and concerns and all of the products contain zinc and titanium, which are great physical blockers from the sun. Colorescience products are also great because they don’t contain any talc, dyes or fillers so the products do not absorb into the skin and clog pores. Click here to learn more about Colorescience minerals.

Colorescience has fantastic makeup primers that are designed to help makeup stay on all day, offer great benefits based on skin concern, and also provide SPF 20-30 sun protection. The skin mattifying face primer has an oil-absorbing formula that controls shine and reduces the appearance of pores to create a matte finish with the added benefit of sun protection. Other Colorescience makeup primers target concerns such as redness and hyperpigmentation.

I also love the Sunforgettable SPF50 mineral brush which releases sunscreen powder as you sweep it over your skin. It contains 11.8% zinc oxide and 21% titanium dioxide, which are great physical-blocking sunscreens. The powder leaves a smooth, matte finish, and helps to control some of the shine that appears across the T-zone as the day progresses.  In addition to the face, I use it on my ears, neck, chest, and the backs of my hands. I throw the Sunforgettable brush in my bag and carry it with me throughout the day without running the risk of sunscreen leaking or being heat sensitive. I love this product because with the powder brush applicator it offers the perfect solution to re-applying sunscreen over my makeup.

If you have any questions about Colorescience products for flawless and protected skin, not just for summer months but all year round, join us for Coffee & Colorescience on Thursday, June 25th or Friday, June 26th as we welcome Christen Williams, professional Colorescience makeup artist. Christen will be providing personalized color matching and application instructions with your scheduled consultation.

By: Nancy Foster, certified and licensed esthetician

Having Fun in the Florida Sun Without a Sunburn!

I was so excited after I spent an entire day out in the Florida sunshine with my family and not one of us got a sunburn! My husband, two girls, and I recently spent 8 hours at Discovery Cove this past weekend. Our day consisted of snorkeling with the sting rays, swimming with the dolphins, and floating along the lazy river. All of these activities consisted of being exposed to the hot Florida rays. I can 100% say my sun safety techniques worked. Wearing our 30 SPF zinc/titanium water resistant sunscreen with regular reapplication and wearing our Coolibar rash guards kept our skin safe from sun damage. Not once did my husband or two girls complain they were hot in their Coolibar long sleeve UPF 50+ rash guards.

discovery coveIt proves that you can still enjoy all the Florida activities in the summer sun and escape without a sunburn as long as you practice sun safety measures!

By: Gina Mangin, MPAS, PA-C

Pale Skin is In: The Science Behind Sun Protection

In recent generations, popular American culture has portrayed tanned skin as an image of good health.  Yet in reality, suntans and sunburns are a sign of damaged skin.  With an overwhelming amount of studies accumulating from different countries over the years, the word is out about the dangers of UV radiation.  Unfortunately, Florida remains high on the list of tanning bed salons per square mile, new skin cancer diagnosis, and melanoma deaths.  So the question remains – what can we do better to protect our body’s largest organ from its most well known carcinogen?

Speaking from my own experience, the best way to change a habit is to understand why it must change.

First we must understand what UV radiation is and how it harms the skin.  When UV energy is absorbed by the skin, it has the opportunity to damage DNA in our skin cells.  DNA manages new cell division, and once injured, may allow cells to divide uncontrollably and eventually develop into cancer.  Depending on the type of skin cell affected, different skin cancers can form.
When your skin creates “color” in the form of burning or tanning after sun exposure, it is showing you the effort your body is exerting in order to repair injury and prevent further damage.  Sunburns are the surge of blood to the superficial skin delivering immune cells to heal injury after excess UV radiation.  Tans show pigment called melanin that is released in an attempt to shield future damage.  Having a “base tan” means the harm has already been done.  This is the main reason we vehemently discredit the misconception that base tans are good for you.  Furthermore, repetitive exposure to maintain a base tan does not give the body a fair chance to nurse the damage and restore its cells.

Peeling sunburned back

You may notice that burns and tans form several hours after exposures to the sun.  This is because it can take over 4 hours for your body to respond to the initial assault on the skin.

Beyond harming skin cells, more deeply penetrating UV-A rays break down skin fibers and elasticity that leads to deep wrinkles and sagging skin.  Sun spots and uneven skin tones are also a product of over-exposure.  By routinely protecting your skin, you are not only setting yourself up for a lower risk of skin cancer, but you are also “pre-juvenating” to keep your skin looking fresh and healthy.

iStock_000019535250_SmallSo what are the best ways to prevent sun damage?  Sunscreen is a must.  I highly recommend daily sunscreen use. Think of how much sun exposure your skin gets during a normal day.  Add up your trip to the grocery store, the ride to and from work, walking your dog, and so on.  We get much more cumulative sun than we realize!

My favorite type of sunscreen are physical blockers such as zinc oxide and titanium dioxide, which you can find in the Elta MD line we carry in the office.  Physical blockers work by reflecting and scattering UV energy compared to chemical sunscreens which absorb the radiation.  Look for SPF 30 through 50 and you will get over 96.7% protection.  But remember, no matter how high the SPF, it is important to reapply at least every two hours.  Ask about the Colorscience Sunforgettable brush as an easy way to reapply without having to use a lotion.

Sun protective clothing is becoming my favorite way to keep my skin covered.  I don’t have to worry about applying and reapplying sunscreen over the covered skin throughout the day.  Most sun protective clothing is SPF 50 too!  I am finding more of my favorite brands are offering UPF in everyday clothing, sportswear, and swimwear.  Hats and umbrellas can keep our scalp covered and our skin cool during the hot Florida summer.

I wish each of you a happy summer time!

Jessie Holland, MPAS, PA-C