Warning: Your web browser is outdated, which may cause this website to display improperly. Click here to update.

Blog MD

Visit Drs. Timothy and Jennifer Janiga’s blog regularly for office and product updates and information about important topics in plastic surgery and dermatology. If you have a question that you would like addressed, please contact us.

Sunscreen Chemicals: The Verdict

sunscreen safety

There has been a lot of talk lately about sunscreens as they relate to chemicals, safety and SPF. Even “Good Morning America” had a recent expose on the topic. The hype in the media comes from the EWG’s (Environmental Working Group’s) 9th annual Guide to Sunscreens, the release of which has spurred a significant amount of talk.


The first controversy surrounds SPF values higher than 50. The EWG does not feel sunscreens higher than SPF 50 should be recommended. Additionally, the FDA reports that the benefits of SPF max out around 50 and notes that in Europe, Japan and Australia, any SPF claims above 50 have been banned. The American Academy of Dermatology recommends SPF greater than 35 as its threshold. The bottom line here is that, if you are applying sunscreen that is above an SPF 35, reapplying every two hours when outdoors and using a sufficient amount of the product to cover you, there is no need to choose a sunscreen with an SPF of 100. That being said, if the one you like happens to have an SPF of 100, there’s no harm in having a higher SPF rating. I tell my patients that if you wear it, it works. So, wear what you like, reapply – and apply liberally.


Other controversies center on two ingredients in sunscreens: oxybenzone and retinyl palmitate. Oxybenzone is a synthetic estrogen that has been present in sunscreens since 1980. The controversy here exists in the concept that, as a synthetic estrogen, if absorbed by the body, oxybenzone could affect hormone levels. The EWG recommends avoiding all sunscreens with oxybenzone while the Skin Cancer Foundation suggests there is no evidence that it is absorbed in appreciable amounts and, even if it was, that there would be no adverse health effects. The original research that is cited for the dangerous claims comes from a study in 2001 that fed young rats more than 1,500 mg per kilogram per day which was in a very high dose that is not achievable in humans without oral consumption. My bottom line to my patients is that if you are concerned about oxybenzone being a synthetic estrogen, even in small amounts, there are plenty of sunscreens to choose from that do not contain it.

Retinyl Palmitate

The second ingredient in question is retinyl palmitate. Retinyl palmitate is a form of vitamin A that some people suggest may increase the risk of skin cancer. In fact, the EWG website reports that this form of vitamin A can be linked to skin damage. However, the Skin Cancer Foundation reports just the opposite, stating that, when used in this formulation for sunscreen, this vitamin A derivative may actually be an antioxidant and protect the skin. My bottom line for my patients on this ingredient is similar to that of oxybenzone; if you are concerned, there are many sunscreens that are available without it to choose from. With both oxybenzone and retinyl palmitate, the two sides cannot seem to agree. Luckily, we have many choices in the United States and we can all wait for all sides to agree and avoid these products in the meantime if we want to.

Aerosolized Sunscreens

Another area that has been discussed recently is aerosolized sunscreens. The American Academy of Dermatology and other groups have long reported that cream-based sunscreens are better. We have known for a long time that application of aerosolized sunscreens can be irritating to the skin due to the propellants and alcohol base in these products. We have also known that people do not apply them in large enough quantities to make the SPF rating as it is stated on the bottles, and more recently people have been discussing the possibility of inhaling large quantities of the sunscreens as a dangerous delivery method. This is one area where the American Academy of Dermatology, the FDA, the EWG and the Skin Cancer Foundation can agree. Each group cautions against use of aerosolized sunscreens in favor of cream-based applications.


Nanoparticles, which exist in titanium and zinc oxide based sunscreens, are another controversial topic. Zinc oxide is EWG’s first choice for sun protection. This is the famous white paste that you remember from so many lifeguards’ noses in the ‘60s. These days, we micronize zinc oxide so the application looks less white. The micronizing is the nanoparticle. The nanoparticle is essentially necessary in order for it to be clear on the skin, otherwise it would look white. Current theory from EWG, the American Academy of Dermatology, the Skin Cancer Foundation and the FDA supports that these particles do not penetrate the skin in appreciable amounts to cause damage. These are the physical based sunscreens or non-chemical that are advertised.

From my perspective, the most difficult things about a titanium or zinc sunscreen are the availability and price. Honestly, these are a more expensive type of sunscreen, sometimes costing up to five times as much as a chemical sunscreen. Titanium and zinc sunscreens can be difficult for some people to afford and difficult for some people to find in their area, and you have to become a label reader to find them. Look for labels that read “chemical free” or “physical blockers only.”  Some examples are from the Honest Company, which makes an SPF 30 called Honest Sunscreen Lotion. This product is completely chemical free. Aveeno recently came out with one that is available at regular drugstores called Aveeno Baby Natural Protection (for adults it’s labeled Aveeno Natural Protection.) These are essentially the same product with mineral-based sunscreen titanium and zinc oxide. If you can find either, they will work the same. CeraVe also produces a great line of physical blockers.

Other products we recommend and carry at our office: TIZO, Elta MD, Skin Ceuticals and Replenix all offer sunscreens that are chemical free. TIZO’s Lip Fusion is one of the only sunscreen sticks for lips I have found that is physical blocking only.

A tip I give my younger patients is to use a titanium and zinc face stick. It does a great job covering the cheeks and nose without burning children’s eyes when they rub their faces. This product has been available over the counter for more than 15 years and I have used it on my own children since they were born. I used to only be able to find it at baby stores and online, but now major drug stores as well as Aveeno have created their own, more widely available formulations.

There is a lot of information to wade through when you are a consumer. When experts disagree, it further complicates things. Either talk to your dermatologist or avoid the controversial ingredients until all the experts can agree. Personally, I have been putting mostly titanium and zinc oxide based sunscreens on myself and my children for more than 10 years. There are times when chemical sunscreens are the only thing available or affordable, so I use some of those in a pinch. Today’s children will be the first generation to have sunscreen applied to the skin from six months old on to old age. If we make the best educated choices that we can at the time, then we’ve done what we can to protect ourselves from skin cancer and maintain as healthy as a lifestyle as possible.

Hopefully this information helps you sort through what is out there and to make your own, educated decisions.

Learn more about the difference between physical and chemical blockers.

Why Eating Dark Chocolate is Good for Your Skin


The answer begins with an understanding of free radicals, which are the biological “bad guys” that damage cell structure. In the skin, this damage leads to the breakdown of collagen and blood vessels, which then manifests as uneven skin tone as well as sagging and wrinkling. Free radicals are the result of the oxidation of atoms, or the exposure of atoms to oxygen, which causes them to break apart and become “unpaired electrons,” or what are otherwise known as free radicals. These free radicals then steal electrons from otherwise stabile atoms, thereby preventing these atoms from providing cell structure, thus impairing the cells’ ability to function in a healthy fashion.

Dark chocolate is loaded with nutrients that benefit the skin, such as soluble fiber and valuable minerals, but more importantly, it also contains antioxidants, which prevent or diminish the cell damage caused by free radicals. On a molecular level, any compound that can donate electrons to counteract these free radicals is said to have antioxidant properties. These “good guy” antioxidants either break down the structure of free radicals or they neutralize them by providing an extra electron to pair up with the loose free radical, thereby rendering it stable and no longer capable of damaging cells.

The importance of these antioxidant biological compounds such as polyphenols, flavanols and catechins cannot be overstated. In addition to skin cell damage, which leads to the signs of aging, oxidative stress free radicals have been linked to heart disease, diabetes, cancer, arthritis and eye conditions such as macular degeneration.

Unlike many of the things we love to eat which are not particularly healthy, the good news is that dark chocolate is both delicious and – more than most other foods – contains a wide variety of plant based antioxidants. To reap these benefits, be sure to eat only high quality dark chocolate with at least 70 percent cocoa content. There is not only less sugar in chocolate with a higher cocoa concentrate but, specifically from a dermatological standpoint, the flavanols in cocoa have been shown to increase the blood flow to the skin which helps to protect it from sun-damage.


How Young is Too Young for Cosmetic Surgery Procedures?

There’s been a lot of hype and interest in some of the young starlets having cosmetic procedures performed at very young ages; sometimes even younger than 18-years-old. While each situation is unique – and there are specific times where cosmetic surgery can be performed for patients younger than 18 – my general rule is usually 21 or older.

Let’s first discuss some of the special circumstances that might allow someone under 21 to have a cosmetic procedure. First and foremost, parental consent is required for patients younger than 18, except those who are emancipated adults. If that consent has been obtained, some special circumstances that might allow cosmetic procedures for people under 21-years-old would include genetic abnormalities of the chest wall, hypoplastic (underdeveloped) breasts, abnormalities of the jaw bones that would impede normal chewing and development, deviated septum in the nose preventing breathing, disfiguring scars after an accident, or other abnormalities that prevent normal growth and development or are psychologically damaging.


Interestingly, the FDA will not allow silicone breast implants to be placed in anyone younger than 22, even if they are born with genetic abnormalities or disfiguring medical conditions. Fillers such as Restylane and Juvéderm are not approved for anyone under 22. Botox and Dysport are approved for 18 and older. All of the above factors need to be considered in addition to a young person’s mental health, parental involvement and long-term safety.

For adults older than 21, some factors are less complicated. When you’re 18, you are considered a legal adult and can consent to surgery. The FDA will allow fillers and silicone implants for adults over 21, so those issues are removed from the equation. But, whenever I am considering an operation on a young person – whether it be for strictly cosmetic purposes or for developmental abnormalities – there are many factors to take into consideration.

Please make an appointment with me, Dr. Timothy Janiga, so we can discuss both your personal situation and what is most appropriate for you.

~ Dr. Timothy Janiga

Secret to a Picture Perfect Face

Summer means vacations, special events, weddings and photographs. How do you keep a picture perfect face?

face cream

First and foremost is keeping your face protected from the sun. Sunscreen with an SPF greater than 35 will keep your face clear of brown spots, freckles and peeling sunburns. This has long-term benefits by preventing sun damage and skin cancer, but also helps the appearance of the face immediately by decreasing the amount of brown spots that form. Additionally, the sun exposure will cause blood vessels to grow. By protecting your face from the sun, you’ll see a decrease in those red lines and blotches on the nose and cheeks.

The second best piece of advice is to wear a wide brim hat. Hats with a brim larger than four inches will protect the face and neck from unwanted sun exposure. Combined with sunglasses (the third best piece of advice), this will prevent squinting that causes lines around the eyes and forehead to etch. This has the short-term benefit of making you look better now and the long-term benefit of preventing those squinting lines later.

A makeup containing titanium and zinc oxide will keep the skin even. These are mostly water- and sweat-proof. My favorite is Shiseido’s Urban Environment UV Protection Cream – SPF 40. This is non-comedogenic (meaning it won’t cause acne), and gives the skin a nice, even tone and texture. It can also minimize the appearance of pores with its matte coverage.  As an added benefit, it doesn’t feel oily or greasy on the skin.

Lastly, there is still time to have laser for brown and red areas of the face before your first summer event. Call Janiga MDs and schedule a laser consultation with my mid-level, Melanie Buckley, or myself.

~ Dr. Jennifer Janiga

The Best Season for Your Skin

Although Reno is enjoyable year-round, spring is definitely my favorite season. The days are longer and warmer and, with the help of daylight savings, we have those extra couple of extra hours each day to hike or mountain bike or walk the dogs. While those of us who live in the Reno area are fortunate to have easy access to all of our favorite outdoor activities without having to bundle up, we must not forget to care for and protect our skin. Here are some tried and true skin care tips for you to follow.


Skin thrives in the higher humidity and warmer temperatures but after the cold, dry winter we must prepare for the warmer months. When the skin transitions from cold to warmer temperatures, the temperature increase can cause the sebum, or oil, in the pores to liquefy which gives the skin a shiny or greasy appearance.  So, as part of your spring cleaning, when you sort through your skin products and toss out those that have expired, consider switching from a heavier winter hydrating cream to a slightly lighter cream. For spring and summer, I like to use lotions containing a tint or self-tanner.  Using an oil-absorbing product such as oil-blotting papers can also help avoid this greasy look issue.  It is recommended that you exfoliate your skin regularly, but extra exfoliating is probably needed after the long winter. In the slightly higher springtime humidity, the drying or irritating effects of exfoliants are less of a concern. I personally use AmLactin, a daily-use body moisturizer with an alpha hydroxyl exfoliant additive. Also, several times each week, I apply Skin Medica Retinol Complex to my face at bedtime.

Keep in mind that the severity of many common chronic skin conditions can change with the seasons.  Thankfully, psoriasis and eczema flare ups, which are mostly associated with the dry cold months, tend to lessen in the spring. Rosacea and acne may also subside as spring arrives, though for some patients their disease actually worsens. It is good idea to take note of your skin’s particular trends and develop a plan with your dermatology provider to treat any worsening symptoms.

We recommend the use of sunscreen every day of the year, however, it is especially important to remember to re-apply sunscreen while outdoors during the warmer months. If you are not planning to spend time outdoors, the application of a SPF 15 once in the morning to the face, neck, ears, upper chest, forearms and hands should be sufficient. On the other hand, if you  plan to be outside hiking, running, biking, or simply walking then you should use at least a SPF 30 and carry enough of the product with you to reapply every two hours.  My favorite brand is Elta MD because all of their products contain zinc, a physical block, rather than a chemical block, and their application is aesthetically appealing with no white tinge left on the skin. Elta MD also makes a sport product which is water and sweat resistant and an aerosol product which I find more convenient when I am outside exercising.

Now that the snow and ice have melted, the numerous hiking trail networks in Reno and Tahoe are opening up and inviting you to visit.  I encourage everyone to take advantage of the outdoor activities this area has to offer, but please protect your skin while doing so.

How to Maximize Your Cosmetic Surgery Results

You’ve done the research, you’ve saved for the procedure and now you’ve finally pulled the trigger on the cosmetic surgery procedure you’ve wanted for a long time. Now what? I am often asked by my Reno plastic surgery patients, “What can I do to get the best results from my surgery?”

There are two ways to answer this question: the short answer and the long one. Today, we’re going to give you both.

Reno Cosmetic Surgery Results

The short answer:

The best thing you can do to maximize your outcome after surgery is to follow your pre- and post-operative instructions diligently. There are a lot of things that we are not able to control or predict when it comes to cosmetic surgery, but for everything that we can control and predict, we like to try to make sure those things happen.

The long answer:

When you book a surgery with Janiga MDs, you are provided written and verbal detailed pre- and post-operative instructions. It is very important to follow these instructions carefully to maximize your results.

The instructions before surgery include preoperative tests that vary by procedure, like a mammogram, bloodwork, abstaining from certain medications while making sure you take others. We ask you to get a good night’s sleep beforehand, as surgery is taxing on the body. It’s also important to have a good support system in place ahead of time so someone else can care for your basic needs while you recover.

Postoperatively, you will receive similar printed instructions, as well. These include details about when to restart your medications, as well as any food restrictions, how to take your medication for discomfort, phone numbers to call in case of emergency and approved activity level after surgery.

This last one is important. Often we hear from patients who feel good and would like to be more active than our instructions state, but it is crucial to your recovery that you refrain from too much activity too soon. Patience is key to achieving the best results from your cosmetic surgery procedure.

Many factors go in to a surgical procedure and maximizing outcomes. As a patient, your most significant contribution to this surgery is your full participation in the before and aftercare.

Call our Reno plastic surgery offices any time to discuss your cosmetic surgery needs. You can trust us to provide you with the best comprehensive care available.

~ Dr. Timothy Janiga

The Most Common Wrinkle Treatments

The Most Common Spots for Wrinkles and How to Treat Them

As we age, we begin to etch lines on the face from sun exposure, genetics and facial movement and also environmental factors.  Thankfully, there are many wrinkle treatments available. Let’s go through some of the common areas on the face we see wrinkles, and how best to treat each area.

How to Treat Wrinkles

Forehead Wrinkles

We will start from the top down with forehead wrinkles. Wrinkles on the forehead are mostly from elevating your eyebrows and etching those lines. Over time, the lines become permanent even when you’re not raising your eyebrows. The best way to treat these lines is with a neuromodulator such as Botox or Dysport. Botox and Dysport are chemicals that inhibit the muscles from contracting, and over time as you’re not able to raise the eyebrows as much, those wrinkles will soften.

Between the Eyebrows

Moving down the face, the next area is the two lines between the eyebrows called the glabella. Some people refer to these as the “11’s” as they can be the most deeply etched lines on the face. People will squint with sun exposure or frown, causing these lines to worsen as we age. The best treatment for this area also is a neuromodulator such as Botox or Dysport. Treatment is administered every three to four months and the inhibition in this area also gives you a nice lift for the eyebrows, which can open the eyes quite nicely.

Botox Injections

The Eyes

Around the eyes, we have a fine sunburst projection of lines on the sides of each of our eyes. This is from smiling, sun damage and squinting in the sunlight. My primary recommendation for this area of wrinkles is to wear sunglasses. After that, we can soften these lines with a neuromodulator such Botox or Dysport.  Once we have a good inhibition, we can also do laser resurfacing to soften these even more and stimulate collagen.

Under the Eyes

The line under the eyes – also known as the tear trough – is a very difficult area. Some people have this line and some do not. It is more prominent as we age due to volume loss in the central part of the face, as well as gravity. In this area, you have to have a very experienced injector. I treat this area with a small amount of filler such as Resylane or Juvéderm Ultra Plus.  Being conservative is the way to go here as overfilling the tear trough can make you look puffy and tired. If done correctly, this can completely change people’s perception of whether you look tired.

The Cheeks

Continuing to move down, there is a line on the cheek that is diagonally placed in the mid area called the malar crease.  This crease is due to volume loss and gravity over the years. Again, some people have this anatomy and some do not. There is a new product from the Juvéderm family of products called Voluma. Voluma became available in 2014 and is a thicker, more robust product that gives a lift to the cheek area. It masks that malar crease quite nicely. You can also use Radiesse in this area, which is a calcium hydroxyapatite based filler. Both work well to improve the malar crease.

Above The Mouth

Next is the nasolabial fold, or the line between the nose and the corner of your mouth. This line comes from gravity, natural aging and volume loss, as well as loss of some of the bony structure. When I treat the nasolabial fold, I try to first address the mid-face or cheek volume with Voluma or Radiesse, then go back and treat the nasolabial fold afterwards. This gives a nice lift to the cheek, decreasing the amount of filler that we need in the nasolabial fold. There are times where only the nasolabial fold needs to be treated and we commonly put Juvéderm Ultra Plus or Perlane in this area.

Upper Lip Lines

Next are the lines on the upper lip. These are some of the hardest wrinkles to treat. They are caused from the loss of volume in the upper lip, genetics and loss of bone volume underneath. Smoking can also worsen these lines. I usually use a combination approach with four units of Botox every three months, small amounts of filler to soften the lines and laser resurfacing.

Corner of the Mouth

Marionette lines are the lines from the corner of your mouth to your jaw line, and are called marionette lines because they look a lot like the lines on the face of a puppet. This line is due to the combination of volume loss, laxity and facial bone volume loss. They can be quite stubborn in a face with a lot of laxity or redundancy of skin. Sometimes I am not able to completely treat this area and the patient will need to first have the laxity removed by a facelift, but other times the lines are minor and we can do a nice job with Perlane or Juvéderm Ultra Plus in this area.

Lower Lip and Chin

The mental crease is the line between the lower lip and the chin bulb. This is prominent in some people, and is one of my favorite areas to treat. Most people do not notice how much this line ages the face until I correct it with filler. Sometimes, I add four to six units of a neuromodulator such as Botox or Dysport to decrease the amount of contraction in this area. It is surprising how much mobility the chin can have.


The last area on the face with wrinkles that I would like to talk about is the pre-jowl sulcus. The pre-jowl sulcus is on the jaw line behind the chin on both sides. This area becomes prominent as the cheek fat behind it falls down below the jaw line, leaving an indentation on each side. This is amenable to facelift of course, but if someone is not ready for a facelift, I can give him or her a significant improvement with Voluma, Juvederm ultra plus, Radiesse or Perlane. I place these products on the jaw line to rebuild that indentation. I have had many patients come to me, especially young people thinking they need a facelift, when one or two syringes of filler have completely reversed this pre-jowl sulcus and allowed them to hold off on a facelift for many years.

In general, we can improve lines on the face with all of these measures and sometimes we do all or some of these in combination with laser resurfacing. Laser resurfacing stimulates collagen and gives a nice smoother texture to the skin and can be used in conjunction with these treatments to improve your outcome.

If you are worried about your wrinkles, call our Reno dermatology and plastic surgery office any time to set up a consultation to get a customized treatment plan.

~ Dr. Jennifer Janiga

Best Skincare Products for Mother’s Day Gifts

Mother’s Day is coming up! We have many mothers in the Janiga MDs Reno office, including myself, so we thought it would be fun to do a post strictly for the mom in your life. Below is a list of products and treatments that the moms in our office picked out for great Mother’s Day gift ideas.

Mommy Skincare


Antioxidants reverse the damage and stress done to skin on a daily basis. Our moms are out and about all day running errands for us, going to and from sports activities, and being exposed to environmental damages. An antioxidant gift is the perfect way for mom to help combat these skin stressors.

Antioxidants include vitamin A, vitamin C, green tea, and many others. My favorite is Skin Medica’s A/C Antioxidant, as it has antioxidants and is a glycerin-based application. This glycerin-based product slides smoothly across the skin. I have had very few people have irritation from this product. It is good for even the most sensitive skin. This product costs about $100 for a three-month supply, and is available in our Reno dermatology offices.


Sunscreen is another great gift for mom. Sunscreen protects her from the daily exposure she gets at all those outdoor activities she takes the kids to, as well as the protection she needs just driving in the car. Some of our sunscreens have anti-inflammatory properties such as niacinamide, are moisturizing for dry skin, or are made specifically for oily skin. We can help you find the right sunscreen for your mom. The sunscreens available in our office range from $25-$40.

Anti Aging Serum

We all want to look our best, including mom. A great gift for mom is our combination product, TNS essential serum by Skin Medica. This essential serum includes peptides, antioxidants and growth factors. The growth factors help with cell turnover, collagen stimulation, reversal of environmental damage, and improvements in texture, tone and pigment irregularities. It is truly an all-encompassing anti aging product that is perfect for mom. This product is more expensive because it is three products in one bottle. The cost is $270 for a three month supply.

Botox or Dysport

If you’d like to get mom a treatment rather than a product, Botox or Dysport is another option. Botox and Dysport are neuromodulators that inhibit muscles from contracting, and are used in the frown lines around the eyes and forehead. If you think your mom scowls at you a lot, this will help! One area costs about $300.

If you can’t decide what you would like to get mom for Mother’s Day, and you’re not sure what products or treatments she would like, you can always buy a gift certificate in any denomination she can use however she sees fit, because as we all know, “mom know best!!!”

We want to with you a Happy Mother’s Day to all our readers.

~ Dr. Jennifer Janiga

How to Identify and Treat the Different Types of Dry Skin

Dry skin, or dermatitis, is a generic term used to encompass multiple conditions. Sometimes it’s difficult even for doctors to know exactly what is the cause of dry skin is as there are a variety of dry skin conditions. At Janiga MDs Dermatology in Reno, we are skilled at determining the cause of dry skin and treating it appropriately. Today were going to go through some of the common causes of dry skin that we often see with our Reno dermatology patients.

Dry Skin

Typical Dry Skin

Let’s start with the most common cause of dry skin, the weather. In climates with low humidity readings such as Reno, Nevada, it is common for people to have dry skin from lack of moisture. The dry air in Reno sucks the moisture from our skin to maintain equilibrium.

This will manifest usually as dry flaky skin on the entire body that may look like the bottom of a dried-out riverbed. The skin is driest usually on areas of friction and areas that are difficult to get lotion onto, such as the front of the legs and back. This form of dry skin is mostly environmental, and is treated with thick moisturizers to increase the moisture in the skin and create a barrier from evaporation. My favorite moisturizers are Cetaphil cream, Cereve cream, and Eucerin cream. Make sure you are applying these creams right when you get out of the shower when the skin is still moist. Apply a thick layer all over the body. Also make sure that you are using the cream and not the lotion, cream is thicker and comes in a tub not a pump.

Moisturizing Cream

Red, Itchy Patches

Another common form of dry skin is what I call “dry skin gone wild.” This condition is when dry skin goes untreated for long periods of time, and begins to change into itchy, red areas that resemble eczema. People with this condition usually have dry skin on the entire body, and then localized areas of red, itchy skin where small areas have become inflamed. At this point more aggressive treatment is needed. This form of dry skin will usually require a prescription to treat the inflammation from your primary care doctor or dermatologist. Once the inflammation has calmed down, the treatment is the same as regular dry skin- using heavy moisturizing creams.

Keratosis Pilaris

Keratosis Pilaris

Keratosis pilaris is a form of dry skin that manifests itself as small little bumps on the back of the arms, top of the thighs and sometimes the buttocks. This type of dry skin is typically genetic, and while it usually does not itch, the red bumps can look unsightly. In most cases we see, small bumps that are less than 1 mm in diameter stud the back of the arms where the skin cells are sticky around the individual hair follicles.

Keratosis pilaris can be treated with over-the-counter creams such as lactic acid 12%, AmLactin, Lac-Hydrin, glycolic acid creams, and even acne preparations that contain salicylic acid. The acid in these formulations is mostly a fruit-based, and helps exfoliate those sticky skin cells so the skin appears smoother. If you stop using the cream, the bumps will return to their normal state. This condition is not harmful overall, but can be a nuisance.


Atopic dermatitis, or true eczema, is a condition that most people are born with. Research has shown that these people have abnormalities in their skin that does not allow them to hold on to moisture as well. More research is being done in this area all the time.

Children as young as six months old can have atopic dermatitis, and while most people will outgrow it, there is a small percentage of people who will have this condition even into adulthood. Atopic dermatitis is treatable, but not as easily as dry skin, or “dry skin gone wild.” Eczema is related to seasonal allergies, other allergies, allergic sinusitis, keratosis pilaris and may run in families. Patients with atopic dermatitis are usually treated by a team of doctors including an allergist, dermatologist and pediatrician.

Allergic Reaction

Another form of dry skin can be a true allergy. If you have ever been exposed to poison ivy or poison oak, you know exactly what I’m talking about. Most people are allergic to poison ivy and poison oak, however there are some people that have contact allergies to regular environmental things as well. The allergen that most people are familiar with is nickel, this is a metal found in a lot of jewelry. Exposure to this metal gives some people a rash. If they have had a significant amount of exposure overlong periods of time, this itchy, red rash can disseminate to the entire body.

Irritant Dermatitis

The last type of dry skin that I’m going to talk about is what I call irritant dermatitis. The term “irritant dermatitis” is exactly what it sounds like; a rash from an irritation. Rather than being allergic to something specific, your skin can be irritated by chemicals, friction, solvents such as cleaning solutions, paint thinners and even some soaps, as they remove the fat and barrier protection of the skin.

Irritant dermatitis can cause fissures and cracks in the skin. This is the most common form of dermatitis that I see on the hands, and is very common in nurses, healthcare workers, painters, carpenters and any person with a job where they work with their hands a lot. Irritant dermatitis can also come in the form of a frictional variant. This is common on the thighs and armpit area of men and women from the clothing rubbing against the skin. Irritant dermatitis is treated by identifying the irritant, trying to avoid contact with it, rehydrating the skin barrier and protecting yourself from the irritant in the future. At times a prescription may be needed if it is very severe.

Less common forms of dry skin include conditions such as psoriasis, perioral dermatitis, lichen planus, granuloma annulare, and many others. Each one is a topic in and of itself and has specific treatment protocols.

As you can see, the evaluation of dry skin is sometimes difficult and varied. Visit our Reno dermatologist office for evaluation of your dry skin to see what category you fall into. But, before you make your appointment, make sure you’re putting on a nice thick moisturizer to the entire body from the neck down after each shower to give us a good baseline of hydrated skin to evaluate.

~ Dr. Jennifer Janiga

The Benefits of Having Dermatology and Plastic Surgery in the Same Office

The specialties of dermatology and plastic surgery complement each other exceptionally well. We like to say that where one begins, the other ends, but it is a continuum. At Janiga MDs in Reno, most of our patients take advantage of both the plastic surgery and the dermatology side of the practice.

janiga mds reno

One great example of how plastic surgery and dermatology work together is in how we treat patients who are looking for an anti aging affect for their face. From the plastic surgery side, we can treat those larger issues that require surgery like removing excess skin, tightening underlying structures, and removing fatty deposits. From the dermatology side, we can improve the texture and tone of the skin, improve volume with fillers and help with fine lines and wrinkles.

At Janiga MDs, our patients enjoy a well-rounded approach to treatment. For example, all of our surgery patients receive a gift certificate to have a complimentary consultation with my wife our dermatologist, Dr. Jennifer Janiga.

During this consultation, they can talk to Dr. Jennifer about how they can maintain their youthful appearance after surgery and into the future. When she meets with people after I have operated on them she will advise them about skin checks, brown spots, fine lines and wrinkles and what products would best work for them. Often times these surgery patients will opt to receive lasers, botox or filler to complete their anti aging goals.

The reverse is also true. A lot of our dermatology patients will see Dr. Jennifer Janiga for many years and then decide that they would like to have surgery. Lasers, filler, botox and product are great for maintenance of the skin, but sometimes the only thing that will fix laxity issues is removing and lifting the skin, and that’s where I come in.

By having both dermatology and plastic surgery in the same office, we can offer a well-rounded approach to procedures and skin care. Many times I will see a patient for surgery and let them know they are not ready for that extensive of a procedure and my wife will perform a less invasive treatment for them. This holds surgery off sometimes forever and other times for a few years.

This combined all-inclusive approach allows our patients to get the best long-term result as possible with the best approach for their individual needs.

Call our Reno plastic surgery and dermatology offices any time to set up your consultation. We can help you decide if you should see Dr. Jennifer Janiga in dermatology or myself, Dr. Timothy Janiga in plasic surgery (or both).

~ Dr. Timothy Janiga