Discussing Your Acne Scar Removal Options With Your Dermatologist

Signs You Should Dump Your Dermatologist

She’s Bossy!

Dinosaur doctors are not extinct. Once in a while you may run into a physician who is practicing medical paternalism, which means what she says is what goes, and your wishes and priorities are left in the dust. But today’s standards are different. As a patient, you’re the expert on your body, and decisions about how to treat it are made together; you and your doctor are a team. If you feel your dermatologist is giving you advice without taking what you want into account, it’s probably time to move on.

You Don’t Trust Him

It can be hard to get a good handle on your dermatologist’s level of knowledge. But there are ways to figure this out. One of the easiest is to confirm that your derm is board-certified. Log on to the American Academy of Dermatology Association and look your doc up using the Find a Dermatologist tool. Trusting the care you are receiving from your physician is crucial. If that trust has been broken by a lack of responsiveness to issues of concern, or lack of positive results, then, at the very least, a second opinion is warranted. Remember, the medical provider works for the patient!

You Feel Frustrated and Down After Appointments

There’s a mental as well as a physical component to psoriasis; when we don’t look good, we don’t feel good. And vice versa. Ideally, the dermatologist is part doctor and part cheerleader. When you leave your appointments, you want to feel encouraged and hopeful about marching out into the world again. If instead you dread the visits, or have to pick yourself up emotionally after walking out the door, it might be time for a switch. As with any relationship, you can also just try telling them you need more encouragement–and that your psoriasis will improve. This may work!

The waiting room is a circus.

While there are many factors (such as emergencies) that can derail a doctor’s schedule, some healthcare practices purposely overbook due to the high probability of no-shows; others are just plain lax. Whatever the reason, having to cool your heels in the waiting room for 20 minutes or more devalues your time and gets everyone off on the wrong foot. If the staff seems disorganized or unprofessional, it may be a sign that the practice is overloaded with patients or that there are internal management issues. See how the reception desk handles the chaos during your visit: Frequent updates and apologies for the delay might signal that it’s worth giving them a second chance.

The doc doesn’t delve into your past.

The purpose of your visit may be purely cosmetic, but if there’s not even a brief discussion of your personal and family history of disease—especially regarding skin cancer—this derm may not be for you. Dermatologists are physicians, whether they practice cosmetic procedures or not. Whether they’re doing Botox or discussing a changing lesion, they need to keep the patient’s overall health in mind. Before any treatments are performed, the doctor should have you come clean about allergies, surgeries, and whether you’re getting regular skin checks elsewhere.

When Do I Need to See My Dermatologist During the COVID-19 Pandemic?

Is this skin growth dangerous?  How can I get refills of my medications?  Is this rash a sign of something more serious?  What should I do about my recently diagnosed skin cancer?

As the SARS-CoV-2 virus continues its march across the globe, and the number of COVID-19 cases surges throughout the United States, healthcare workers and patients alike are making daily judgements of what constitutes “essential” medical care.  It has many of us asking “Should I keep my doctor’s appointment?” Because the pandemic status is changing on a daily basis this is a question with which we will grapple for many weeks and months to come.  Dermatology is no exception.

When to See a Dermatologist

There are still many reasons to see a dermatologist during the COVID-19 pandemic, and for this reason most Dermatology offices are remaining open on a limited basis. Some conditions will require an office visit while others can be handled via teledermatology (see below). Dermatology is a visual specialty that is perfect for telemedicine consultation and dermatologists have been performing this type of care for decades. By visiting your dermatologist via teledermatology we can help divert care away from overburdened urgent and emergency care facilities.

Conditions Needing Immediate Care

As a general rule, if a lesion is growing rapidly (i.e., significant change over a 1-3 month period), bleeding spontaneously, or painful, it is worth further evaluation.  During this time, your dermatologist may advise a preliminary telemedicine visit as an initial evaluation, and may either provide reassurance or recommend a clinic appointment for a possible biopsy.  Similarly, if you notice a mole that is changing in size, shape, color, or symptoms, or is showing features of the ABCDEs of melanoma, it should be evaluated by a dermatologist, especially if you have a personal history or strong family history of melanoma.  While many rashes can be managed very well via a tele-dermatology visit, a rapidly expanding rash or a rash with other symptoms (such as fever or abdominal pain) will likely warrant an in-person visit.  Additionally, any concern for an active infection that would require intervention – such as an infected cyst that needs drainage – may necessitate a clinic visit.

What Can Wait

The American Academy of Dermatology (AAD) has communicated continuously with its members over the past several weeks.  They have provided practical guidance on topics encountered daily by dermatologists.  Among these guidelines is a recognition that each clinic will have to address their particular situation differently, based on patient population, acuity of disease, and prevalence of COVID-19 in their area.  However, certain restrictions are widely advised during the pandemic.  For instance, if not already mandated by local government authorities, all elective procedures should be deferred.  Examples of elective procedures include neuromodulator injections (e.g., Botox), filler injections, laser treatments, non-invasive fat removal (e.g., CoolSculpting), elective/cosmetic mole removals, and others.  Non-urgent medical conditions such as precancers (actinic keratoses), cysts, acne, rosacea, and hair loss are also being routinely deferred, as are chronic skin conditions, such as psoriasis and eczema.  Furthermore, in-person evaluation of limited rashes and stable skin lesions should be delayed.  Regular skin checks for patients without a history of melanoma or aggressive skin cancers are also being pushed back by most practices.

We understand that the issues above, while not life threatening, are very concerning for many of our patients. To that end, like many other practices, we are scheduling everyone who has any concern involving their skin, hair, or nails for a teledermatology visit. Over 90% of the time this type of visit will address the problem; for the rest, we will get them in to our clinic to see one of our dermatologists in person. This allows us to safely address all of our patients’ needs during this time of social distancing.

Would You Trust Your Dermatologist If He/She Had Extremely Poor Skin?


Some of the best gymnastics coaches I know never did gymnastics. One was a kick boxer! They are still incredibly knowledgeable and very good at their job.

In fact, one could think you are getting the best dermatologist. They aren’t treating themselves, so maybe they are helping all the other physicians with beautiful skin.

Some of the richest men and women in the world trust their money to financial advisors who could never dream of owning a fraction of the things those men and women have. They are the best at what they do.

Trust them until given a reason (based on your health) not to trust them. A physician can only help you as much as you are willing to be helped.

Four questions to ask yourself before buying skincare products from an independent consultant

When an independent consultant approaches you, be sure to ask yourself these four questions before putting your skincare needs in their hands.

Does my consultant really want to help me reach my skincare goals?

Many independent consultants work to recruit people to their team: people that don’t have any expertise. You want to make sure they’re not just trying to sell you a product, but truly motivated to help you figure out what’s best for your skin.

These products are developed by doctors, but are they really as good as those dispensed at a physician’s office?

Yes, many of their products are “developed by doctors,” but that doesn’t exactly mean they’re as good as those that you have to see a doctor to access. These products are still sold by non-professionals, so they don’t always have the knowledge base to comment on ingredients. They also don’t have access to the ingredients that are as effective and proven by science.

Are these before and after photos realistic?

When deciding on which products to purchase from an independent consultant, you might come across some before and after photos. But any trained eye can look at some of these pictures and tell that they’re just not accurate. They may be using the skincare line they’re promoting, but don’t ignore any laser, Botox, or filler that may be present in those “after” pictures.

Is this the most cost-effective way to reach my skincare goals?

The truth is, a lot of times, these products are more expensive than those dispensed by a physician. In countless instances, I’ve helped patients access more effective products for even half the price. Whether we decide to go with over-the-counter products or look at more generic-type brands, it’s my job to give you options and help you find the right products that fit within your price point.

Reasons Why Your Vehicle Needs To See An Auto Repair

How do I start a small auto repair shop?

Define the Scope of Your Operation

Determine how many customers you plan to help per day and to what extent you will help them.

  • Types of services. You can either provide basic services such as oil and tire changes or comprehensive services such as collision repair, engine maintenance and electrical services.
  • New or current shop. Determine if you will start from scratch or buy a current shop. Buying new means you have to buy everything including tools and equipment, whereas buying a current shop might mean that you already have everything you need to run your business.
  • Franchise or independent. Starting as a franchise such as Jiffy Lube or Midas requires franchising fees of about $200,000 to $400,000 and an ongoing royalty fee of three percent. Therefore, the financial barrier to entry is high. However, if you can afford it, you get the advantages of marketing and the recognition of a national brand name.

Find a Strategic Location

Situate your auto repair business close to main roads and highways. It needs to be in a centralized location to your customer base. Towing services are normally charged by the mile, and if you are not near your customers, they may go somewhere closer. The garage needs a wide access to allow customers to drive their cars in, a high ceiling of at least 15 feet to accommodate car lifts and a minimum of a 6-inch thick floor to mount your equipment to.

Look for a location with good natural lighting, as it helps the mechanics when checking the cars. The space should have an office area for your administrative needs and a waiting area for customers who plan on waiting for their cars to be repaired.

Get Certified

You’re not required to have ASE certification to work on cars, but without it, you might find it substantially more difficult or expensive to obtain liability insurance and find financing for your new business. ASE certification tells potential customers that you know what you’re doing. It gives car owners confidence, and can be a very important marketing tool. Before you qualify to take the certification test, you’ll need a minimum of two years of work and educational experience combined, with at least one year obtained on the job.

Know the Startup Costs

Before you spend a dime opening your shop, you need to know the total projected cost to get up and running. If you don’t, you might run out of funds before gaining your first customer. While it is impossible to project certain costs ahead of time, the most common and expensive line items are easily predicted. The total cost is right around $47,000, in equipment, insurance, and rent. Buying a building and making alterations can significantly change that number, depending on construction costs. Choosing to buy an existing auto shop can also affect the bottom line.

Get Legal Advice

A lot more goes into opening a business than just finding a location and serving customers. You’ll need to obtain a business license, look into the regulations surrounding liability insurance requirements, open accounts to handle payroll and tax reporting, file your articles of incorporation, and other pre-sale steps. A lawyer is invaluable during this process, helping you ensure every “i” is dotted and “t” crossed. You don’t have to retain a lawyer, but it can save you from a lot of mistakes along the way.

Set up Interviews

If you have a very small shop, you might do all of the work yourself, but you will probably still need at least one employee to handle telephone calls and customers. If you have a couple of lifts and want to maximize your capacity, you’ll need additional mechanics to help service vehicles. The hiring process should start at least a month before your grand opening. You’ll want enough time to check references, find the best candidates, and negotiate compensation packages.

Get the Word Out

Marketing is another big part of opening the doors. Be sure to schedule a Grand Opening, so locals can stop in and see the shop. You might want to advertise special discount pricing for that first day or week, just to bring customers through the doors. You’ll also want to have a standard service list of pricing and a shop rate finalized, so you can estimate your revenue potential.

Advertising Your Auto Shop

  • Hang up fliers around town.
  • Advertise on your local television station.
  • Offer discounts on common repairs and oil changes
  • Use social media sites

Hire the Right Employees

Finding exceptional employees can be a difficult and time-consuming task. However, it’s important to remember that there are auto mechanic colleges across the country ready to provide garages with newly trained employees. You’ll want to strike a good balance between experienced employees and recent grads, so your garage has an effective ratio of experts and novices. Most garages engage in the apprentice system. An auto mechanic apprenticeship is a paid position, which can last from one to four years. It is assumed that after the apprentice period, the employee will continue to work for the repair garage. By hiring apprentices, a new auto body shop can establish a long-term, fruitful working relationship with a skilled mechanic – carefully trained by its own experts.

Market Your Business

Good advertising will get customers to your shop, but fulfillment of promises made in your ads will keep those same customers coming back, year after year. Online advertisements can go a long way, especially if you have your own website on which to showcase promotions. As for your advertising content, a popular route is to offer customers guarantees, such as a guaranteed free repair if your brakes wear out within a certain time limit. Guaranteeing your work gives customers a reason to trust that you will do a good job. You may also choose to create an ethics statement which can be featured prominently in your workplace, or online. This may outline your duty to satisfy customers, conform to established laws, and to keep customers fully informed of costs throughout the repair process.

A Local State Mosquitoes Control Mist System

A Natural Remedy for Mosquitoes

Mosquitoes are eating us alive every time we go outside on our deck. What can I spray to get rid of them that won‘t poison our cats

Forget the sprays! There is a much simpler solution that harkens back to grandmother’s day, even before window screens. First off, sprays are temporary at best – if they work at all. And plants that supposedly run off insects are very impractical (forget anything sold as an “amazing mosquito repellent” – they simply don’t work).  Even the misters that spray a fog of insecticide won’t work for long, and are expensive and smelly to boot. Plus who knows what all else they may kill

The simplest solution, other than applying bug repellent creams, the simplest solution, which I employ all the time in my hot, humid, ‘skeeter-ridden garden, is a fan.

I set out a cheap box fan, like the ones we used to put in windows, on one corner of my patio, which makes a slow breeze. Then I put a small oscillating fan nearby where its regular back-and-forth movement breaks up the steady stream of air from the box fan. The combination is guaranteed to thwart the most persistent biters, as well as provide a nice cool breeze.

Mosquito Control Tips Every Homeowner Should Know

Both annoying and potentially dangerous due to the number of serious diseases they carry, mosquitoes are an insect that no one wants to encounter. Unfortunately, they are almost impossible to escape, especially during the upcoming wet, humid summer months. If you are tired of constantly swatting away mosquitoes but refuse to resign yourself to living with them, the following five mosquito control tips are meant for you.

Watch Out For Water

Mosquitoes can’t resist standing water, so if there is water pooling up around the yard you can expect plenty of mosquitoes as well. Here’s how to keep standing water at a minimum: Make sure your outdoor faucets aren’t dripping or leaking – leaky faucets can quickly create puddles near your foundation that are inviting to mosquitoes looking to lay eggs. Also remove any items in your yard that serve no real purpose except to collect water, such as buckets or overturned trash can lids

Use Natural Repellents

One of the best ways to control mosquitoes around your home is to use natural repellents. This can include lighting citronella candles or torches in the parts of your yard where you’ll be hanging out. Also, although not a true repellent – yellow outdoor lighting can help keep mosquitoes at bay since they are not attracted to yellow light the way they are to traditional incandescent lighting.

Invest in a Mosquito Magnet or Mosquito Trap

These machines are capable of controlling the population of mosquitoes across an entire acre of property. The machine burns propane and sends out a steady stream of carbon dioxide – something that mosquitoes are incredibly attracted to. When the mosquitoes come close to the machine, they are sucked into a net and killed.

Some of these beneficial plants are:

Horsemint: a fast-growing, drought-resistant plant that reaches a height and width of two to three feet. Horsemint is well-suited to dry, sandy soil and tolerates salty conditions – which is why it’s ideal for coastal and beach areas like North Florida.

Ageratum: also known as Flossflowers, ageratum gives off an aroma which mosquitos find very offensive. Ageratum plants secrete coumarin, a widely used component in commercial mosquito repellents.

Marigolds: normally used as an ornamental border plant, marigolds also give off a distinctive smell which mosquitoes (and even some gardeners) find particularly offensive. Marigolds contain pyrethrum, a compound used in insect repellents.

Catnip: the plant that makes cats go crazy is an effective mosquito repellent as well. This plant is particularly effective at controlling mosquitoes and has been shown to be possibly more effective than DEET in small areas. If you are a cat owner beware, however: catnip plants will cause your cat to respond to it the way they do to dried catnip – you may want to choose another plant if you have cats.

Surprising Secrets to Mosquito-Proof Your Home

Mosquitoes raiding your space? From practical tips to prep your yard to bug sprays and plants that repel mosquitoes to citronella accessories and more alternative options for bug bite protection, we’ve got you covered.

Know Your Enemy

Bust those mosquito myths by learning what really attracts mosquitoes

If you’ve ever wondered what makes you a tastier meal for mosquitoes compared to others, it’s not because of your blood, or what you eat. Any advice you may have heard to load up on garlic, bananas, and vitamin B12 does not have any effect on reducing mosquito bites.

Protect Your Skin

How to choose the best bug spray for your family

For active adults and children, knowing how to find the right mosquito repellent is just as important as the freedom it provides outdoors.

Turn Your Garden into a Mosquito-Free Zone

Add mosquito-repellent plants to your perimeter


Lemon grass




Lemon balm


Using special plants as secret weapons against pests like mosquitoes is not just for experienced gardeners anymore.

Find the Hidden Hot Spots

Squash mosquito breeding in your yard before it starts

Mosquitoes are known for laying eggs in stagnant water, which can be found in more places around your home than you think. Check all potential areas that can hold standing water for more than a few days at a time. Fountains, ponds, and swimming pools may be the most obvious, but also try to consider any other unconventional sources such as, clogged gutters, birdbaths, pet dishes, and more. Replace tire swings and drill holes to the bottom of any containers that may need to be outdoors. Turn over any empty flower pots, wheelbarrows, watering cans, and other garden accessories to avoid collecting water.


If you have a mosquito problem, it’s time to do something about it. Here are three reasons why you need to remove these pests from your backyard.

Mosquitos Carry Disease

Mosquitos carry a wide range of different diseases, including the Zika virus and malaria. Although mosquito-borne diseases are a bigger problem in other countries, getting rid of these pests from your yard will keep you and your family safe.

Mosquitos Bite

Mosquitos bite millions of humans every year. Sometimes, mosquito bites cause swollen, sore, and irritated skin. What’s the solution? Mosquito misting systems protect you from mosquito bites by creating an invisible barrier between you and these pests. These products kill mosquitoes by spraying safe, natural pesticides in a fine mist. Use a misting system to target mosquitoes in your backyard.

Mosquitos are a Nuisance

Like all pests, mosquitoes are seriously annoying. They can lay eggs around your backyard and even enter your property.

How to get rid of mosquito bites fast, and prevent them in the first place

Ever notice that when you scratch a mosquito bite it just makes it itchier? There’s a reason for that — and a way to treat that itch so it’s not so annoying. But scratching is not the way. When a mosquito bites you, it triggers your immune system, which releases histamine to attack the foreign invasion.

However, if you’re patient, don’t scratch, and try some of the following treatment options, you can find relief as well as get rid of that mosquito bite faster.

Apply calamine lotion or anti-itch cream

Calamine lotion is made up of the medication calamine and zinc oxide, which are used to treat skin irritations like mosquito bites. “Most lotions and creams create a cooling sensation that temporarily relieves itching and discomfort,” says

In addition to calamine lotion, you can soothe a mosquito bite with:

Hydrocortisone cream. This over-the-counter steroid cream relieves swelling and itching, but should not be used on broken skin, Mentel says. If you’ve been scratching, skip this, as these steroids are meant to be used only on top of your skin and should not enter your body.

Antihistamine cream. These creams, which are available over-the-counter or as a prescription, counteract your body’s release of histamines to reduce itch. You should talk with your doctor before using an antihistamine cream, as in some cases, it may have adverse side effects.

Take antihistamines

Antihistamines can be applied topically with a cream (as mentioned above), or taken as an oral tablet. If you have an itchy bug bite, topical cream might work better to alleviate itch and it will help you avoid side effects like drowsiness, which are common with oral antihistamines. However, oral antihistamines can still help.