Entries Tagged as 'Dermatology'

Perfect Pout: What type of filler is best for you lips

posted on: February 4, 2017

Minor cosmetic procedures like botox and filler have skyrocketed in the past few year. With Kylie Jenner putting lip enhancement on everyone’s radar, filling those lips has never been more popular. What you need to understand is there is no one size fits all when it comes to lip fillers. There are about 10 different fillers on the market you can use in the lips. All of the products are different. In this post we are going to break down the different types of filler so you can educate yourself and discuss with your injector which filler would be the best for you.

While there are many different fillers that can be placed in the lips, for simplicity sake let’s discuss the Juvederm family of products made by Allergan. They have a broad range of fillers we can compare. When it comes to Filler and Botox in general there can be this stigma that if you have these treatments you will look frozen, fake or over done. That may have been the case with the first generation of fillers but that is not the case these days. If you go to the right injector, fillers and botox have the ability to make you look rested and refreshed while not changing your look. The most reassuring thing about most fillers is they can be dissolved if you don’t like the results.

Lips are one area in particular where people have a fear of looking over done. Not everyone wants lips as big as Kylie, and the great thing is you don’t have to. There is a filler type out there for everyone’s needs and desires. Let’s break them down so you can figure out what filler is best for you.

Volbella XC- This is the newest filler in Allergan’s arsenal. This filler is intended for subtle results. This filler works best if:

  • You are a first time lip filler with thin lips
  • You suffer from “smokers lines”, the little fine lines that makes your lipstick bleed that you want improved but don’t necessarily want your lips bigger.
  • You are nervous about having your looks look too big
  • You simply want your lips to look hydrated vs much larger.

Volbella currently comes in a 0.55cc syringe which is smaller compared to other fillers. Keep this in mind when making your decision.

Juvederm Ultra XC- A great in-between filler. Juvederm Ultra comes in a 1.0cc syringe giving us more filler to work with. This filler would be great for you if:

  • It is your first time getting lip filler, but fear looking too big.
  • You have thin/medium lips.
  • You want your lips to look enhanced, but want a very soft feeling lip.
  • You have “smokers lines” plus you want to enhance your lips too.

Juvederm Ultra Plus XC– A more robust filler in the Juvederm family. This filler also comes in a 1.0cc syringe. This filler would be great for you if:

  • Your end lip goals are a very full look. (this may require more than one syringe)
  • You’ve had filler done before and liked the results, but wouldn’t mind more fullness.
  • You desire to spread the filler around and use in multiple areas (i.e. nasolabila folds or marionette lines).
  • You have fuller lips to start with.
  • You have deeper “smokers lines” and have lost a lot of volume in the lips.

The thickest filler in the Juvederm family is Voluma, while injectors will put Voluma in the lips, I do not recommend this as the results risk the area becoming hard and bumpy. There are other great Juverderm products available for lips and as Voluma is more expensive and more risky, I do not recommend it.

Fillers in the lips can last anywhere from 3-12 months. After your treatments wears off you can discuss with your injector your experience and determine if another type of filler would be better for your next treatment. This is intended to be educational, however you should take the time to discuss your enhancement goals with your provider and together determine which type of filler is best for you.

Chronically Chapped Lips: Is there really a solution?

posted on: February 2, 2017

Chapped lips are an issue I see very often in my practice. For many people, liberal use of a lubricant will help ease the discomfort. But there are people who have tried every chapstick and lip scrub out there with no relief. Some people are prone to just having dry lips, but there is another condition you should consider.

Allergic Contact Dermatitis

This condition occurs when an allergen causes a reaction and irritation to the skin. The lips are a very common area to see this type of reaction as the skin on the lip is thin and it reacts easily to allergens. Scaly skin or itchiness can occur directly on the lips or around the lip area. Figuring out what is causing this reaction is easier said than done. This rash could be caused by an allergy to one of the countless products, ingredients and chemicals we are exposed to every day. From shampoos, make-up and perfumes to metals such as nickel, gold and cobalt, allergic contact dermatitis will continue until the allergen is no longer coming in contact with the skin. Fortunately, there are things you can do to get to the bottom of this annoying condition.

Be You Own Detective

Your lips come in contact with hundreds of ingredients per day. Take the time to be aware of what you are using directly on your lips and what is in your environment. Make a journal of things you came in contact with on the days your lips are worse. Think beyond what you are putting directly on your lips. Remember that indirect application can occur from an allergen transmitted via the hands.

Avoid certain products

Stop wearing jewelry that contains nickel as this is a common allergen. Remove your nail polish/gel polish. Even if you’ve been doing your nails for years, nail polish is a very common allergen. Stop all lipsticks, lip gloss, sunscreen or metal-containing products, such as a dental tools that have direct contact to the lips. Indirect application can occur from an allergen transmitted via the hands

Beef up your treatment

At this point chapstick or vaseline may not be cutting it. Pick up some 1% hydrocortisone ointment at the drug store and apply 2-3 times a day for more relief. Feel free to use vaseline or aquaphor in-between the application of hydrocortisone as needed.

If all else fails, see a Dermatologist. We have the ability to preform an examination of your lips, prescribe prescription medications or preform allergy tests to try to determine the cause of your chapped lips.

Lash Battle: Latisse vs Extensions

posted on: January 8, 2017

latisse vs eyelash extensionslatisse vs eyelash extensions latisse vs eyelash extensions

 My lashes by Amazing Lash Studio in Eastvale (I ask for natural)

Eyelashes make such a difference to a women’s appearance, more than you even realize. Overall they feminize the face and compliment anyone’s complexion. Most women already incorporate mascara into their beauty regiment , but in recent years women have really stepped up their lash game. While there are tons of lash boosters and serums that claim to make your lashes grow, in my opinion there are 2 options that really get the job done: Latisse and Eyelash Extensions. They are both great options, but two very different options and everyone has a personal preference. Let’s break down the each one so you can see which one is best for you.

Lash Basics

The upper eyelid has approximately 90-150 eyelashes on it, while the bottom has between 70-80 eyelashes. Most eyelashes grow to be about 10mm long. Lashes are like other hairs found on the body. Every hair on your body has a growth cycle. It will grow to a specific length and eventually reach its full cycle, and then fall out. There are three phases to all hair growth cycles.

Anagen (Active Growth Phase)– This is when the hair is growing. About 40% of the upper eyelashes are actively growing at any given time. This phase lasts for about 4-6 weeks.

Catalan (Transitional Phase) During this phase the eyelash stops growing and prepares to fall out.

Telogen (Resting Phase)- During this period the eyelash falls out.

This information applies to how Latisse and eyelash extensions work. Let’s compare the two.


My personal results with Latisse:

matisse after 12 weeks

How does it work?: Latisse is a medication that is applied directly to the lash line. Latisse works by lengthening the anagen phase. While the normal phase is 4-6 weeks on Latisse it lengthens to 8-12 weeks. This means your lashes are growing for for a longer period of time which enables them to grow longer than normal. Latisse was originally designed as a glaucoma medication. Doctors observed that patients using the medication in one eye had really long lashes on that side, and that is how latisse was born.

Time Commitment: Latisse does not work overnight. It takes approximately 4 months to see the full results of thicker, longer and darker lashes. You apply Latisse to your upper lash line before you go to sleep. The medication from the upper lash line will spread to your bottom lash line so you don’t have to apply it there.

Side Effects: There is a lot of talk about Latisse’s side effects, so let me set the story straight. The most common side effect seen with latisse is eyelid irritation. Most of the time it goes away after using the product for a few weeks. If someone is really irritated I recommend backing off to using just 1/2 drop per eye every 2-3 days then building up to every day. Latisse also has the potential to darken your iris, the colored part of your eye. Now while this sounds scary, it’s not what it seems. When people were putting the drops directly into their eyes for glaucoma they only saw this side effect 0.1% of the time. It has never been reported when using Latisse as directed for eyelash growth.

Can you use while pregnant?: No, it is not recommended to use while pregnant.

Mascara?: Most people who use Latisse will still use an eyelash curler and mascara for a more dramatic effect.

Customizable?: Latisse will affect everyone differently. You cannot choose how long or thick Latisse will make your lashes.

Cost- Latisse runs about $120 for a small bottle. The average person will use 4-5 bottles per year.

Maintenance: Lashes enhanced by latisse are your own lashes. No special treatment is necessary.

Lash Extensions:

How does it work?: Lash Extensions have become extremely popular the past few years. Lash extensions are synthetic strands that are made to replicate a natural lash. When applied, eyelash extensions lengthen and thicken your own natural lashes. Single strands are applied to each individual eyelash, one by one. With proper application, lash extensions look and feel completely natural. When applied by a professional, lash extension will last as long as your hair’s growth cycle. Everyone’s body is different and depending on your daily activity you may need a refill every 2-4 weeks.

Time Commitment: The initial application of lash extensions take 1-2 hours. During the process they make everything as comfortable as possible. Don’t be afraid to ask for an extra pillow or a bathroom break if necessary. Refills of lashes are typically 30 min-1 hour every 2-4 weeks depending on the amount of lashes needed.  

Side Effects: Rarely people can be allergic to the adhesive used to bond the extensions to your natural lashes. If you have a history of allergies to adhesives you should let your lash expert know before application.

Can you use while pregnant?: Yes, you can get lash extensions while pregnant.

Mascara?: Most people do not need mascara as the extensions give the illusion of mascara, but if you do make sure that you only use water-based mascara.

Customizable?: Yes! You can choose if you want a very natural look or something more dramatic and glamorous.

Cost: Depending on your area an initial set of lashes can run $100-$200 with refills running $30-$100.

Maintenance: You should take special care of your lashes for best results. You should not rub your eyes excessively, avoid steam or saunas, don’t use an eyelash curler and don’t pull on your lashes.

The Ultimate Question: Latisse or Lash Extensions

The question I get all the time is: Which one is better? Latisse or Lash Extensions? I really don’t have an answer to that question. They are both very different and what is good for one person may not be good for the next. I personally do a “double dip”, I have lash extensions and use Latisse simultaneously. The Latisse keeps my lashes thick and strong and extensions give me the dramatic look I desire. I used Latisse for years, but stopped using when I was pregnant. I wanted to give lash extensions a try and was so lucky to find Amazing Lash Studio in Eastvale. If you’re looking for a place, I highly recommend them. In summary, good lashes are universal to beauty. You just have to decide which option is best for you.

Boo Boo Basics (plus giveaway!)

posted on: October 27, 2016


We’ve all been there- you trip on a crack in the sidewalk or over a toy, or maybe you’re simply clumsy then BAM! Next thing you know you’re on your hands and knees fully loaded with new scrapes, bumps and bruises. What’s your next plan of attack? Hydrogen peroxide, antibiotic ointment or water? Do you cover the scrape or let it dry out? Will you need stitches? In this post I’m going to give you the boo-boo basics and have you fixed up in no time.

Wounds generally fall into two basic categories:

  1. Seek medical attention
  2. Take care of it yourself at home

When to head to the ER

Yikes, You’ve got a cut and it looks pretty nasty. How do you know if you can just put a bandaid on it or if you need to head to the ER for stitches? Here are some basics to follow:

Might be time for a trip to the ER:

  • If you have anything stuck in the wound you can’t remove
  • If you can’t stop the bleeding
  • If you have a puncture wound- i.e. stepped on a nail
  • If you were bit by an animal or a human
  • if the cut is greater than 1/4″. If  you can see fatty tissue or bone you definitely need to go to the ER.
  • If the wound is wide enough for you to push together to close to cover underlying tissue.

At home boo-boo basics

So your wound doesn’t meet any of the criteria above? Good! A simple scrape or minor cut (like a paper cut) are wounds that only affect the 2 most superficial layers of skin- the epidermis and the dermis. While these have a very low risk of becoming infected, it is still important that you practice proper wound care to ensure things heal properly. Typically simple antibacterial soap and water is sufficient to clean the area. After you have cleaned the area, apply a thin layer of  anti-bacterial ointment, like vaseline or Aquaphor to the area. The skin will heal better if you keep the area lubricated and covered. It may seem like it takes longer for the scrape or cut to heal, but the ultimate scar will look better if you don’t allow a thick scab to form. On the flip side don’t keep the area too gooey. Make sure you are changing any bandages that have become wet and you only need a very thin layer of the ointment. Most basic wounds heal within 1-2 weeks. If your wound is taking longer to heal or becomes more painful you should seek medical attention for an evaluation.

If you’re treating a kiddo, you know how scary getting a boo-boo can be for them. Having 3 kids of my own and seeing pediatric patients who require painful procedures I am not above a little bribery to make them feel better during their time of discomfort. Stickers and ice packs go a long way. I love these kits from Me4kidz. My mother-in-law picked up the big doctor Medibag  for my kids last year. While my kids love playing doctor with the bag it’s also a fully first aid kit with every boo-boo dressing you could need including the ever important stickers. In addition to the big kit Me4kidz makes these little medibuddies that are perfect to throw in your diaper bag or purse.

I’m hosting a giveaway for all the goodies seen in the picture below. You can enter the giveaway in one of two simple ways.

  1. Comment on this post saying what goodie you’d be most excited to receive
  2. Tag a friend on my instagram @thewhitecoattreatment who would love some me4kidz goodies too.

I’ll announce the winner on Oct 31st! Good luck!

unspecifiedGiveaway winner wins everything above. Medibag first aid kit, medipro first aid kit pod, medibuddy first aid kit and two cool it buddy ice packs.

Boo Boo Basics White CoatTravel kit perfect for your car, purse or diaper bag. 
unspecified-2Fun stickers for your brave little patient!

But I’m too old for zits! Adult Acne Solutions

posted on: June 6, 2016

Acne can be extremely frustrating, especially for adults. A few pimples when you’re a teenager, ok- most of us can accept that as normal. When you’re dealing with a Mt. Vesuvius-sized cystic pimple on your chin plus wrinkles, it just doesn’t seem fair.

Many adults who get acne never suffered with acne as a teenager. Some adults have been suffering with acne for decades. So why do adults get acne?

Reasons for adult acne

First off, women tend to get adult acne more often than men, so unfair. If you’re suffering from acne as an adult it is likely due to one of the following:

Crazy Hormones: Hormonal imbalance can lead to breakouts. Women tend to experience fluctuations around their period, during pregnancy, menopause or starting/stopping birth control pills.

Stress: When you’re stressed, your body produces more androgens (a type of hormone). These hormones stimulate more oil and hair follicles in the skin, which can lead to acne.

Family History: Yep, thank your mama for this one. Research suggests that some people have a genetic predisposition for acne.

Skin Care Products: Your thick anti-aging night cream could be making your acne worse. Make sure you are using moisturizers, cleansers and sunscreens that are “non-comedogenic”, aka won’t clog pores.

Medication Side Effect: Acne is a side effect of some medications. If you suspect that a medication is making your acne worse talk to the doctor who prescribed it for you. They may be able to change the medication you are on.

How to treat adult acne

Cleansers: Make sure you cleanse your skin every day. Don’t let dirt, grime, make-up and pollution build up and clog your pores.

Over the counter treatments: Using a face wash or applying an anti-acne gel can help kill bacteria and reduce oil, both of which are contributors to acne. Look for products at the drugstore with the following ingredients: Benzoyl Peroxide, Alpha Hydroxy Acids (AHAs), Salicylic Acid and Retinols. If you don’t see an improvement with your acne after 4-8 weeks, it is suggested to see a Dermatology professional to determine the most appropriate treatment.

Prescribed treatments:

Topical Treatments: There are probably 30+ different prescription topical treatments to choose from. We consider factors like your skin type, age and severity of acne when choosing the right cream for you.

Oral Medications: If you suffer from swollen, painful, cystic acne, a pill may be prescribed to help treat your acne from the inside out. Depending on my patients needs, I prescribe antibiotics, birth control (helpful for women with balancing hormones), or Isotretinoin (commonly known as Accutane).

Pre-Physician Assistant Internship Program

posted on: January 12, 2016

Pre-PA Internship Program Physician Assistant


I am so excited to share this with all of my Pre-PA folks. I have been working hard to develop a Pre-PA internship program for those who are on the path to become a Physician Assistant. As a PA I know one of the most difficult things to obtain while prepping for PA programs are shadow opportunities or hours working directly with a Physician Assistant. I receive many inquiries from pre-pa students looking to shadow me at my office. Unfortunately, I am not able to accommodate most of those requests due to my schedule and the nature of my job. While I was not able to provide sporadic shadowing opportunities for students I still longed to somehow help pre-pa students because I know how difficult the journey can be to become a PA. I began to think if there was some way I could share my knowledge and experiences with those seeking guidance. After much work this Pre-PA Internship Program was born. This internship program allows pre-pa students to work side-by-side with myself, other PAs and Physicians to experience health care and see what we do day to day. We are currently interviewing candidates for our inaugural class. Read more about this program below and if you would like more information about applying please contact erin@skinps.com for more information.

Pre-PA Internship Program

The Physician Assistant Internship Program is available for college students who demonstrate a strong and sincere interest in becoming physician assistants. This program provides volunteers the opportunity to experience health care from a clinical perspective through patient contact and volunteer experience. Volunteers are trained to assist physician assistants or physicians, who, in turn, are able to share their personal experiences with their volunteers.

What does a volunteer do?

Time spent in the program proves invaluable because it provides each volunteer with an “in-the trenches” experience in a real medical setting. Volunteers are respected as professional members of a patient care team. As a result, they gain an insiders’ understanding of the operations of a medical office- an experience which helps them determine their specific course for future studies. Students support physician assistants or physicians by performing such tasks as checking in patients, assisting in procedures, acting as scribe for PA and additional duties as requested.

What is the time commitment? 

To participate in the Physician Assistant Internship Program, students must have graduated high school. Volunteers must fill out application and proof of a permanent residence. A minimum of a 6 month commitment, volunteering four hours a week. Shifts are M-F  8am-12pm or 1pm-5pm depending on availability. You are required to work one shift per week and are welcome to work more. If you miss your assigned shift you must make it up. In order to complete the program in good standings you must complete 100 volunteer hours with in the 6 month program.

Who can volunteer?

Anyone age 18 and older, currently attending college or who already has a degree is eligible for the Pre-PA Internship program.

Where is this program located?

Skin Physicians and Surgeons. 859 East Foothill Blvd. Upland, CA 91786. (909) 981-8929


SPF in a pill?!

posted on: August 11, 2015

SPF in a Pill?! Best supplements for your skin: Heliocare. The White Coat Treatment

Earlier this month, I went to Las Vegas to attend the SDPA Annual Dermatology Conference. During one of the break-out sessions, I was introduced to HELIOCARE®’, a daily dietary supplement that contains extract from “Polypodium leucotomos (PLE), a fern native to Central and South America that has been used for centuries as a remedy for skin related conditions.” PLE is a plant filled with anti-oxidants that created its own form of sun protection, once it adapted from a water plant to a land plant.

“HELIOCARE®’s active extract contains antioxidants, which aid in eliminating free radicals produced by sun exposure.”

What does anti-oxidants have to do with Sun damage? Rays from the sun can cause the release of free radicals, and that PLE extract in the pill has anti-oxidants which combat those free radicals, halting any possibility of causing damage.

Note: this is not a sunscreen, but rather something that should be taken in addition to applying a daily sunscreen.  Why not throw another pill in your morning vitamin routine?

Screen Shot 2015-06-16 at 4.39.08 PM

Note: I have not personally tried this product yet as I am currently pregnant and this supplement has not been tested on pregnant women. I can tell you I brought a bottle to Cabo for a bachlorette party I attended and burning of the group was kept to a minimum!

Buff & Shine: A one-two punch!

posted on: July 22, 2015


The Buff and Shine Treatment, a term coined by us here at Skin Physicians and Surgeons, is ideal for the individual that struggles with acne scars, fine lines, wrinkles, uneven pigmentation, brown spots or skin laxity (saggy or loose skin). This procedure combines skin blading to remove unwanted peach fuzz on the face along with a fractionated mixto laser resurfacing treatment. Due to this new technology, in as little as one treatment, the Buff and Shine Treatment can give you healthy, younger, more vibrant looking skin.

First we “buff” the skin by preforming skin blading. This part of the procedure utilizes a sharp blade to shave off peach fuzz and dead skin cells covering the surface of the face. After that a numbing cream is applied to the face for about 20 minutes. After the face is numbed we preform a treatment with the a fractionated CO2 laser. This procedure is fractional meaning that it is only exposing a part of the skin at a time to the laser. This means less downtime and less risk of scaring. The procedure is very tolerable.

The Mixto laser works by using tiny beams of light penetrating into the top layers of the skin. When the procedure is finished you will see these tiny little dots on the skin. Those little dots will flake off and reveal rejuvenated skin. The flaking process takes about 3-5 days. During that time you can continue your normal skin care routine and wear make-up. There is essentially zero downtime to this procedure. To see the best results, a series of treatments are needed.

Buff and Shine is a suitable treatment for almost anyone: the combination of removing the dead skin layer then using a laser to rejuvenate can help achieve beautifully textured and evened-out skin! Add it to your skin care repetoire.


More Than Just a Zit! The Ultimate Guide to Dr. Pimple Popper

posted on: July 14, 2015

Thanks to the coverage of Dr. Pimple Popper by way of Buzzfeed, UK Mirror, and more, we have now reached 205k followers on Instagram! Who would’ve thought that there were so many popaholics in the world? The idea for the Dr. Pimple Popper instagram was brainstormed when Dr. Sandra Lee and I were talking about how her most popular posts were on cysts and extractions. An instagram fully dedicated to these procedures seemed like the most logical step, hence Dr. Pimple Popper was born. There is more to this instagram account then just “popping pimples”. I thought it was time for a comprehensive guide to everything we’re “popping”. After reading this article you can consider yourself an Dr. Pimple Popper expert!

Check out Dr. Lee’s full videos on YouTube.

The Dr. Pimple Popper Instagram shows many different types of extractions using different tools and an array of “pimples”-all of which have specific terms. Below are definitions of the different terms of what we remove or “pop”.


Comedone: Open Comedone are also known as “Blackheads” (comedo is singular). Comedones are formed when cells lining the sebaceous duct build up and there is increased sebum production. In simplest terms it is a plug in your pore; made up of dead skin cells, oil, and bacteria.

Blackhead/Comedone Extraction

Dilated Pore of Winer:  Named after the Doctor who first desribed it, a dilated pore of Winer is a hair structure anomaly that appears as an enlarged solitary comedo. In layman’s terms-a big and usually old blackhead that hardened, one that has been building for years! Sometimes a stitch or 2 is required because the gaping pore needs help closing.

Dilated Pore of Winer

Lipoma: Lipomas are the most common soft-tissue tumor. These slow-growing, benign (harmless) fatty tumors form soft, lobulated masses enclosed by a thin, fibrous capsule. In non-med terms, Lipomas are typically a soft and rubbery glob of fat that does not cause pain. They usually remain the same size over time.Surgically Extracting Bumps on the Arms, Called Multiple Lipomatosis

Epidermoid Cyst: Epidermoid cysts are the most commonly found cysts and they contain a soft “cheesy” material made of keratin, a protein component of skin, hair, and nails. The surface of your skin (epidermis) is made up of a thin, protective layer of cells that your body continuously sheds. Most epidermoid cysts form when these cells move deeper into your skin and multiply rather than slough off. Think of it like a “snowball effect” of collecting more and more dead skin along the way.  A cyst appears as a domed-shaped, skin-colored growth that usually moves when touched and pressed upon. It may have a small opening in the center called a punctate.

Removal of a large epidermoid cyst, upper back

Pilar Cyst (Cyst on Head): Pretty common fluid filled growth that forms in hair follicles, most often found on the scalp. They are smooth and filled with keratin (that soft “cheesy” material I referred to in the Epidermoid cyst). In the animation below, the cyst is removed while the keratin stays intact in the sac, popping out like a garbanzo bean. Excellent removal!

Pilar Cyst Removal

Milia: Milia are very common, benign, keratin-filled cysts. Milia occur when dead skin becomes trapped in small pockets at the surface of the skin, forming a tiny little cyst.  An individual milium (the singular of milia) is formed at the base of a hair follicle or sweat gland. Milia appear as 1–2 mm white-to-yellow, dome-shaped bumps that are not painful or itchy. Many patients try to remove these themselves, thinking they are whiteheads, but they are difficult to remove without the help of a trained professional.

Milia Removal


“Punch” aka Biopsy Punch: This disposable biopsy instrument handles like a pen, with a grip at the top that allows you to twist, apply pressure, and drive the stainless steel blade into the skin with ease. It creates a very clean, perfectly round incision which leaves minimal scaring. This is best practice when excising a small cyst.

Punch biopsy on neck cyst

Comedone Extractor: The wire loop of this tool when pressed on the skin, creates a pressure which forces the blackhead (trapped sebum) up to the surface which then can be easily removed. Official Dr. Pimple Popper comedone extractors are coming soon!

Solar Comedones Extracted, aka Favre Racouchot

Forceps: Small forceps, which look like tweezers, are used to grasp fine objects. In the animation below, forceps are used to pull out the growth.

A Dilated Pore of Winer. For medical education- NSFE.

Excision: Simply put, to remove completely.  In the animation below, a pilomatricoma (benign tumor) is removed from behind the knee with dissecting scissors and a tug!.

Excision of a pilomatricoma behind the knee

I&D (Incision & Drainage): Slice and squeeze! Below is an animation of a cyst I drained

Incision & Drainage of cyst

Thank you for following! If any of our posts help answer your questions or demystify dermatology, then I am a happy Physician Assistant.

The Ultimate Guide To Sunscreens: Physical vs Chemical

posted on: July 1, 2015




Sunscreen and Sunblock are descriptions used interchangeably but it is important to know that technically they are different products-it is a matter of chemical protection versus physical protection.

Here are some abbreviations you may not know the meaning of:

UV=Ultraviolet referring to radiation.

UVA Rays=Long wavelengths which penetrates skin deeper, the culprits in premature aging, wrinkles and sunspots. Present whether it is sunny or not. Weaker than UVB rays, they can still contribute to skin cancer.

UVB Rays=Slightly more energy than UVA rays, exposure can cause skin to burn and  lead to melanoma and other forms of skin cancer.

Here is a quick comparison of Chemical Sunscreens VS. Physical Sunscreens


-Noticeable on skin, most sunblock leaves a thin white-ish layer on skin

-Contains ingredients like Zinc Oxide and Titanium Dioxide which physically block the sun, reflects the rays off skin, almost like a mirror.

-Effective immediately after application because it remains on the skin surface-doesn’t need to be soaked into the skin

Deflects UVA and UVB rays, reduces the radiation that hits the skin

A few Physical Sunscreen I recommend:

1. Blue Lizard Sunscreen– This is the best sunblock that is difficult to find. It is an Australian based company and can be purchased online. You can even buy this stuff by the gallon! The bottle also turns blue when exposed to UV rays. No need to question if you’re getting  UV exposure on that cloudy day, just look to the bottle for the answer.

2. The Honest Company Sunblock Stick– Putting sun protection on your kids faces is the worst (even for this Derm momma). Most kids hate putting lotion on their face and with one quick move they always end up getting it in their eye. This stick makes physical application of the sunscreen a breeze with no mess.

3. Colorscience Sunblock Powder– I’ve talked about this product many times before. While it wouldn’t be my whole body go-to if at the beach it’s great to apply over make-up or even put on the part on your scalp, an area that is often overlooked when it comes to sunscreen application and easily burned.

This YouTube clip below shows with a UV camera how Sunblock acts as a physical barrier on the skin, you can see clearly once the subjects smear Sunblock on their face!


Chemical Sunscreens:

-Usually appears clear on skin

-Contains special ingredients that act as chemical filters and reduce ultraviolet radiation penetration to the skin

-Must be applied at least 30 min. before sun exposure to soak into skin

Absorbs UVB rays

-Any sunscreen with less than 15 SPF is a waste of time and money

1. Aveeno Protect and Hydrate Lotion Sunscreen– One of the biggest complaints I hear about physical sunblock is that “it’s too thick”. This product absorbs quickly and moisturizes the skin, plus it is recommended by the Skin Cancer Foundation

2. Sun Bum Original Sunscreen Lotion– This product also absorbs easily into the skin and has that classic beachy scent. Is it weird that I keep a bottle of this stashed in my desk, and take a whiff when I need a mental break? “Sun Bum, take me awayyyyyyyyy!”

3. Supergoop Everyday Sunscreen– Non-comedogenic formulation designed for everyday use over the whole body. This is a great choice is you are particularly sensitive to paraben, synthetic fragrance or oxybenzones.

Please note:

  • “Waterproof” is better than “water-resistant”, but it doesn’t mean that lotion can be applied once and you’re covered for the rest of the day. “Waterproof” can maintain an SPF level 80 min. after swimming or sweating, whereas “water-resistant” maintains SPF only 40 min. after being in water.
  • Oils, even if they have SPF, aren’t really a protective form of sun protection. The oil intensifies the rays, as if you are basting your body. Unless you want roasted turkey skin, don’t use tanning oils.
  • According to the Melanoma Foundation, Even on a cloudy day 80 percent of the sun’s ultraviolet rays pass through the clouds. Especially important to wear sunblock even on an overcast day.

I personally hate spray-on sunscreens. Yes, they are convenient as can be, but almost no one applies them correctly. To get the level of SPF protection suggested on the can you must apply the sunscreen to dry skin with no wind present and you must apply a LIBERAL amount of the spray to the skin (the skin should look wet) and then you need to rub in the spray into the skin. You then must wait for everything to dry and absorb into the skin before it starts working. Do you know anyone who does all of these steps? I have some patients refuse to wear anything but sprays (cough…cough…my husband) so I tell them it’s better than nothing, but in general I highly advise against them. Also, you want to avoid inhaling spray sunscreens as there is still investigation occurring on any potential risk in the lungs.

Bottom Line: These days, sunscreen and sunblock are so interchangeable, they are not scientific terms to describe sun protection. In my field we compare the two as “chemical vs. physical”. Many lotions are a combination of both so it is best to look at the labels; mineral ingredients like Titanium Dioxide or Zinc Oxide-those inorganic ingredients physically block the sun.

Regardless of whether you use sunblock or sunscreen, they both have the ability to protect you from damaging ultraviolet rays and should be a part of your daily routine.