Entries Tagged as 'Dermatology'

How to Pass the PANRE Exam

posted on: June 19, 2015

How to Pass the PANRE Exam Physician Assistant

If you’re not a Physician Assistant you probably want to tune out right now.

If you are, these 5 dreaded letters tend to haunt your existence around the 5 or 6 year mark after graduation (or 9/10 years if you’re on the new recertification cycle) . The Physician Assistant Recertification Exam (PANRE) is a recertification exam that all PA must take in order to maintain their certified status. No matter how you slice it-taking a large standardized test sucks. I find it especially daunting if you work in a speciality. The PANRE covers all aspects of medicine, not just the one you work in. For me, a whopping 5% of the exam was in Dermatology (woo hoo!) Even if you work in Family Medicine, there is going to be a significant amount of studying involved.

During PA School, your only job was to study. Once your career kicks off,  you must find some significant time to study while working a full time job, adult responsibilities, having a family, etc… It’s not impossible, but in my experience I realized I had to shift some things around to devote time to my studies. I started studying 3 months prior to my exam date and studying about 1 hour a day for the first 2 months. Then, I increased the time spent daily as the exam drew closer. Two weeks prior to the exam I studied 2-3 hours a day with a few 5 hour stretches on the weekends.

Here are a few tips may help you pass:

1. Study when you can-  For me, long gone are the 8 hour marathon study sessions in Starbucks. I found studying in 10-15 minute increments can be very effective too. Down time between patients? Do a few practice questions. Kids playing bath? Park it on the floor and watch an 10 minute review video on your iPad. Don’t make lack of time an excuse to study. Everyone has a limited amount of time, it is a matter of how you prioritize it (Instagram can wait)

2. Pick a date and pay for your exam- Having the pressure of an exam date will light a fire under you to get you motivated. It’s easy to keep putting things off when there is a 2 year window to take the test. Just get it over with, you will be glad you did.

3. Focus on the “big sections”- The PANRE is weighted by organ system just like the PANCE. Spend more time studying the organ systems that will be more represented on the exam like Cardio, GI, Pulmonary and Ortho. I honestly spend zero time on Dermatology and still got 100% on my Derm questions so I’ll take my 5% Derm of the exam as a gift.

4. Make sure you study all topics from the NCCPA Blueprint. They really will pull from all of these topics. There are A LOT of topics too .

5. Purchase a study guide. This pays for itself 10fold. I don’t know about you, but my notes from school are long gone. I needed something that was easy and convenient. A study guide allowed me to watch review videos on my lunch break and practice questions between patients. There are many programs/services that lay out all of the information you need according to the NCCPA blue print. A few of them I’ve personally heard good things about:

HIPPO Education PANCE/PANRE Review– This is the one I used. The videos are entertaining, concise and to the point. Lots of great practice questions and 50 Category 1 CME credits. $495

PA Board Review with Joe Gilboy– I had several friends attend this in-person 3-day course in Irvine, CA and really enjoyed it. $295

Med-Challenger PANCE/PANRE Board Review: $325

Please feel free to share in the comment section any tips you may have as well…good news is I passed my re-certification a few weeks ago! It can be done even with a full-time career, husband, kids, and while enduring 1st trimester morning sickness!

Cute Cover-Ups

posted on: June 2, 2015

I can’t believe it is already June! Whether it’s a trip to the beach or hanging around the backyard a cute cover-up is a must. Even if you re-apply sunscreens frequently they only provide so much protection. Throwing on a cute cover up is an easy way to get that extra sun protection your skin needs.

Here are my picks for cover-ups that in addition to Sunscreen, can help block UV rays.

Cute Sun Safe Cover-ups

1. California Dreamin’ Poncho by SPF Addict

I love the versatility of this poncho-it can be worn over your swimsuit, but I would also throw it on after yoga/barre class. Looks soft! has UPF 50+

2. Sungoddess Long Sleeve Rashguard by Swim Zip

My daughter has an adorable swim zip suit already, so it’s time I get one! I like the sporty look to this rash guard, and it has thumb holes which will ensure that the top on my hands and wrists are protected with the 50+ UPF fabric.

3. Tie Die Sleeveless Rash Guard by J.Crew

Beyond the awesome tie-dye print, I chose this as one of my picks because the cut of this top is great for women who want extra coverage for the décolletage (or help keeping your chi-chi’s strapped in) I would wear this on my morning walk too! Recommended by the Skin Cancer Foundation as an effective UV protectant.

4. ZnO Poolside Cover-Up Hoodie by Coolibar

This cover-up comes in 7 colors! The pockets could easily fit my cell phone and the hood is cute. This cover-up also has 50+ UPF in the bamboo/spandex blend

5. Bella Top by Sundriven

What caught my eye about this top is the surprise twist on the back! The right amount of flirt. Then I read that Sundriven is a brand endorsed by The Skin Cancer Foundation, and is handmade with UV protection fabric in Los Angeles! Local!

6. Gold Rio Flowing Cover Top  by Cabana Life

Loose and breezy, embellished with gold trim, I love this tunic. I would even throw some wedges on with this for dinner al fresco

7. NYC Bond Girl by Glamourpuss

Another sporty choice in Lycra, the colors are so bright, why holdback the boldness-it is summertime! I like how you can cinch the length-wearing it as a top, or loosening the strings as a dress. Versatile!

8. Razorback long dress by Cover

Crew neck cut and razorback showcases the shoulders and also covers the décolletage. Love the wavy print and length. Certified UPF 50+

9. Hooded Cover-Up by MOTT

Super cute striped cover up that you can transition to dinner or drinks. Or throw over jeans, leggings too…

10. Joan Ribbed Cardigan by MOTT

This can be worn multiple ways-the length of the cardigan allows it to be tied in front, or wrapped and tied behind you, or left open…what makes this different than any other cardigan is the UPF 50+ protection AND the thumb holes, so the tops of your hands are covered (where most people forget to realize can get wrinkled/sunspotty)

6 Ways To Prevent Eye Wrinkles

posted on: June 1, 2015

Have you ever had someone say to you, “are you tired? You look tired” As you’re thinking… “I feel great, I actually got 8 hours of sleep, I’m running on a grande latte and I have my good mascara on! how rude.” Well one thing that can make you look more tired than you actually are is excess eye wrinkles. These few tips will help prevent eye wrinkles and make you look as refreshed as you’re feeling.

1. Wear Sunglasses- Squinting from the glare of the sun can not only cause crows feet it can also make frown lines and forehead lines worse too. Invest in a few pairs of sunglasses. Keep a pair in your purse, home, car, etc… so you always have one handy when needed.

 

Not my usual pair-but perfect for a Bachelorette party!

2. Sunscreen- If I haven’t been clear in my previous posts, applying sunscreen is a MUST. It is inexcusable to not apply moisturizer with SPF every morning. Travel size bottles of sunscreen or powdered sunscreens make it easy to keep at your desk, in your purse, the the glove box, etc…

3. Rubbing Your Eyes- it may be a hard habit to break because most of the time we don’t realize we are doing it! The skin around our eyes is particularly delicate, so rubbing causes that thin skin to fold .

4. Sleeping on your side/stomach- when your face is scrunched in a pillow, the skin stays folded in that position for possibly hours. Try sleeping on your back.

5. Retin-A– aka Tretinoin is a prescription vitamin A derivative that speeds up cell turnover rates, rapidly exfoliating the skin. This exfoliation can soften the appearance of fine lines and wrinkles. The skin around the eye is very sensitive. I recommend starting with a low strength of Retin-A and only using it 2x/week. If your skin can tolerate it you can increase how often you are using it. Talk to your Derm to see if this prescription medication is right for you.

6. Botox- This is not only a treatment for crows feet but can also be preventive. If you temporarily paralyze the muscle around the eye you are unable to make the squinting expression that causes crows feet. Botox typically lasts 3-4 months.

Combining good habits and a regimen from your Dermatologist/Derm PA, can help decrease the look of wrinkles around the eyes…start now if you haven’t already!

The Best Summer Hats: PA picks

posted on: May 27, 2015

Sunhats

 

Yes I love jewelry…purses are nice too…but my favorite accessory is a lovely, wide-brimmed hat! It can make me feel a little like Carmen San Diego, but what makes me love wearing hats the most is the added sun protection for my face, scalp and décolletage.

Below are a few of my favorite styles. Of course a baseball cap is better than nothing, but the bigger the brim, the better the skin!

 

#1 ASOS COLLECTION

Oversized Straw Hat in Color Block

Neutral colors that can go with anything…and straw you can wipe clean? Perfect around my kiddos

#2 CHRISTY’S

Florence Wide Brim Straw Hat

This London company has been making hats since 1773, so they must be doing something right! I love the texture of the straw, looks sturdy.

#3 JANESSA LEONE

Gloria Hat

Ever since Jessica Alba was caught wearing this hat, it has been hard to track down. You can find other Janessa Leone hats on Nordstroms.com, I particularly like this style because it has a nice feminine touch to a usually masculine Panama style

#4 SEAFOLLY

Summertime Hat

Top off your outfit with a punch of Indigo-this hat is made in Australia by Seafolly, a company which has made summer the epicenter of their image since 1975.

#5 RIVER ISLAND

Black Straw Oversized Hat

Detail. DETAIL! I love the chain tassel and the pattern on the brim.

#6 BRIXTON

Shooter Hat

For those who like a more structured brim, this hat by Brixton is a cool choice. Comes in different sizes, unisex.

#7 ASOS COLLECTION

Straw Floppy Hat in Color Block

Another hat by ASOS, this one is particularly fabulous because the colors would be great to wear during my family 4th of July celebration in Newport. Enough red white and blue to feel patriotic, but  the colors are subtle enough that the hat can be worn year round. The brim size is dreamy!

#8 CATARZI

Wide Brim Fedora

Absolute classic. Catarzi is an Italian-Based hat company that has ben a family run operation since 1910. I am a big fan of established companies that are known for their craftsmanship

 

Best Summer Hats Anthropologie IMG_8586 IMG_8587 IMG_8588

My Hat: Anthropologie. Found HERE

Dr. Pimple Popper: Your Guilty Pleasure

posted on: May 21, 2015

Untitled design (1)A few weeks ago, Dr. Lee and I were discussing one of the segments she had taped on The Doctors Show. Her most popular clips seemed to be the ones in which she was removing cysts or blackheads.

“Why don’t we create an Instagram account that only shows us removing things that pop? Blackheads, etc..?!” I asked her.

Thats when @drpimplepopper was born.

There is something deeply satisfying about watching the removal of these skin imperfections. What I didn’t realize was how many other people felt the same way! Almost overnight, @drpimplepopper gained thousands of followers (at time of publishing 154,000 are following these 15 sec. videos of guilty pleasure)

Our Instagram has touched all corners of the world thanks to coverage by Buzzfeed USA, The Guardian, Allure Magazine Blog, Cosmopolitan.com, Daily Mail UK, Irish Mirror, Huffington Post UK, Terra Brasil. Thanks to such exposure, we have been able to give back to one of Dr. Lee’s special patients, Mr. Wilson.

Mr. Wilson lost his wife recently, and for each visit while Dr. Lee squeezed him, he would share more of his story, which touched many viewers. Thanks to a Gofundme.com collection started by Dr. Lee, Mr. Wilson was gifted $6,800 to help his current financial situation, and brighten his day since his wife passed away.

 

If you haven’t already, make sure to follow @drpimplepopper, my personal account @whitecoattreatment as well as @drsandralee

 

White Coat Wednesday: What I am Wearing

posted on: May 20, 2015

Medelita White Lab Coat Physician Assistant

The medical white coat has a lot of history behind it. Physicians adopted the white coat from scientists to emphasize the transition to the more scientific, modern medicine approach from the quackery of 19th century medicine. The modern white coat was also introduced as a symbol of cleanliness. Depending on the facility/speciality you encounter you may find your provider wearing scrubs, a white coat, business attire or flip-flops and shorts like one OB/GYN I rotated with (delivering babies=messy. so… no thanks). I choose to wear business attire and my white coat about 80% of the time. The other 20% you’ll find me in scrubs depending on what procedures I’m preforming that day.

This is the latest M3 Etsie lab coat from Medelita. I seriously cannot get enough of their lab coats, I have more than I can count. And the material is so soft and the fit is impeccable. As a medical professionally you work YEARS/DECADES to get to the point of privileged of wearing a white coat so why not splurge and get a nice one?

Dress: Maggy London (0ld) Similar: HERE

I was interviewed by Stena Chang from Medelita, learn more about me by clicking here!

 

Why Powdered Sunscreen is the Shiznet

posted on: May 19, 2015

Approx 5,328 times a day I educate patients on sun protection. This includes everyone from patients on sun sensitive acne medications to those concerned with brown spots and wrinkles. When I tell my patients that the most important aspects on using sunscreen is reapplication every few hours I commonly get the side-eye mixed with “haha you’re crazy if you think I’m reapplying this thick white crap over my make-up” look.

That is when I pull out my semi-secret weapon. Powdered Sunscreen. Now this is not a new technology, but I find most people are not aware it exists. I am not talking about powdered foundation make-up with and SPF in it. I am talking about straight up (typically zinc based) sunscreen powder. Simply tap, brush on and reapply. I still recommend a base of liquid sunscreen (I like ones with Zinc Oxide and Titanium Dioxide) in the morning before putting on all of your moisturizers and make-up but, reapplying with sunscreen powder doesn’t get much easier. It’s seriously the best for fussy kids (and husbands) on their faces too.

This is not just for your face, I wear this on my hands as well, especially when driving. There is only so much a Dermatology PA can do once skin has been damaged by the sun. Establish your regimen now!  Hands show the tell-tale signs of aging and most people are more concerned with the wrinkles and brown spots on their face and chest, neglecting their hands.

I am not sponsored by any of these products, I just feel a personal responsibility to spread the word about them!

Colorscience Sunforgettable– this is the one I use.

Screen Shot 2015-05-13 at 10.21.05 AM

Check out this other brand too:

Peter Thomas Roth Anti-Aging Instant Mineral SPF 45

Not a whitehead, but rather a Milia

posted on: May 15, 2015

Milia are small, pearly-white or yellowish bumps right under the skin which is actually a tiny cyst filled with a protein called Keratin. They are most commonly seen on the skin around the cheeks, nose, eyelids, forehead and chest but they can occur anywhere on the body.

Although harmless, they can be so annoying and darn near impossible for you to remove yourself. Often they will disappear on their own but that may take weeks or months to occur, and most people prefer not to walk around with this white bump on their face. While thick creams and ointments applied to the skin may cause milia, often we do not fully understand what causes them.

Screen Shot 2015-05-13 at 2.28.58 PM

How do we treat milia?

There are a few ways you can treat milia. What is not recommended is that you treat them yourself at home. If you try to squeeze or pick your milia this can lead to skin damage, scarring or infection. I will not even treat my own milia, as I find it difficult to do on myself. The problem with milia is there is no opening, like an easily extracted blackhead, so you have to create an opening to get it out. My go-to way to treat milia is by using a fine needle or light cautery to create an opening in the milia and then expressing the milia out with a comedone extractor. If milia become very widespread and persistent you can consider these options:

Chemical Peels: A light acid peel is applied to the skin for a few minutes and washed off. Over the next few days this will peel off the top layer of the skin and peel some of the milia off as well.

Microdermabrasion: This procedure utilizes the application of tiny rough grains to buff away the surface layer of skin where the milia are held.

How To Prevent Milia

If you are prone to getting milia follow these steps to prevent new ones from forming:

  • Avoid heavy cosmetics and creams- These products can block your pores causing more milia to form.
  • Apply a retinol/retinoid (rx) daily- They have exfoliating properties that turn over dead skin cells and keep your skin soft and clear.
  • Gently exfoliate your skin- My preferred method for gentle exfoliation is a Clarisonic brush. This product gently exfoliates your skin without causing further irritation.

Do you follow DrPimplePopper on instagram? You can see myself and Dr. Sandra Lee extract lots and lots of milia there!

Why you should be thinking about bikini season now: Laser Hair Removal

posted on: February 12, 2015

LASER HAIR REMOVAL

Is anyone else ready for summer time? I sure am. When we start thinking about summer time and hair removal it’s often too late to start treatments. Most laser treatments require you to avoid the sun or be very careful about avoiding the sun after the treatment. Patients must also wait until their tan has faded from the previous summer before receiving most laser treatments. Now is a great time to get started. Another advantage of undergoing laser treatments during this time of year is that most lasers require a series of applications to yield optimal results. For example, laser hair removal typically requires 5-7 treatments, while vein reduction with sclerotherapy usually requires 2-3 treatments, etc. Therefore, it’s wise to give yourself a little extra lead time if you want to be able to show off your results on that beach vacation you’re planning this summer.

Laser hair removal is the best way to permanently reduce unwanted hair. Laser Hair Removal will not remove 100% of your hair. Typically it removes 70-85% of the hair, but the hair that is left is thinner, finer and grows in slower. Laser hair removal involves a beam of highly concentrated pulses of light penetrating through the skin being absorbed by hair follicles. The heat that is generated will ultimately destroy the hair and it’s potential for regrowth.  Learn more about laser hair removal in the above video.

Moley, Moley, Moley: What to consider when evaluating your moles

posted on: January 29, 2015

Moles can appear anywhere on our bodies from the bottom our feet to the top of our head and everywhere in-between. While most of them are harmless, some may be cancerous and cause harm if not treated in a timely manner.  To decide if you should seek evaluation about a particular mole that may be dangerous, follow the ABCDE rules for potential skin cancer at home.

  • A is to see if your mole has asymmetry, meaning one half is larger than the other.
  • B is to look at border irregularity. Borders with jagged edges that are uneven can be some of the first warning signs.
  • C is to look at the color, if the color changes or is a shade of black or bluish-grey you can be at risk.
  • D is to look at the diameter of the mole, if it is greater than six millimeters, about the size of an average pencil eraser then you may want to have it evaluated.
  • E is evolution. This is probably the most important factor. If your mole is evolving (aka: growing and changing) it is very important to have it examined.

Although skin cancer seems scary, most moles are benign and we are able to test it in a timely manner. Having a cancerous mole is not the only reason to have a mole removed. Many people choose to have multiple moles removed for their own convenience due to factors such as; they simply do not like it, to it being in a highly seen place such as the face. The mole removal process is quick, safe, easy, and low on the pain scale. If you are questioning a mole, or feel at all uncomfortable about one, make an appointment to see what your treatment options are.