Dr. Puja KathrotiyaVitamins for Skincare

By Dr. Puja Kathrotiya




  1. Vitamin A derivatives

    Referred to as retinoids, or retinols

  • Can be found in over the counter skincare products as well as prescription creams


  • Increases skin cell turnover, leaving skin looking younger, smoother and brighter
  • Increases collagen production, reduces appearance of wrinkles, fine lines and prevents skin from getting thin
  • Decreases sebaceous gland activity,  helps prevent comedone (black-head, white head) formation and treats acne
  • Anti-inflammatory, treats acne and other inflammatory skin conditions

OTC recommendations:

  • RoC retinol correxion Deep Wrinkle Night Cream
  • Neutrogena Rapid Wrinkle Repair
  • La Roche Posay Pure Retinol Face Serum
  • Elizabeth Arden Retinol Ceramidses Capsules
  • Olay Regenerist Retinol 24
  1. Vitamin B3

    Referred to as Niacinamide, Nicotinamide


  • Helps reduce hyperpigmentation (helps treat melasma, or post-inflammatory hyperpigmentation from acne, ingrown hairs, etc)
  • Helps reduce sebum production (helps with excessively oily skin, and acne)
  • Helps decrease redness and inflammation (helps with inflammatory skin conditions such as acne, rosacea, perioral dermatitis)

OTC Recommendations:

  • CeraVe Skin Renewing Night cream
  • Paula’s Choice Niacinamide 20% Treatment
  • The Ordinary Niacinamide 10% + Zinc 1%
  • Olay Tone Perfection Serum B3 + Vitamin C
  1. Vitamin C

    Referred to as L-Ascorbic acid

  • Helps reduce hyperpigmentation (helps fade sunspots, post-inflammatory hyperpigmentation)
  • Boosts UV protection when used in conjunction with a sunscreen (keeps skin looking younger, and  thicker)
  • Helps increase collagen production (helps prevent fine lines, wrinkles and maintain skin thickness)

OTC Recommendations:

  • Neutrogena Rapid Tone Repair 20% Vitamin C serum
  • La Roche Posay Active C10 Dermatological Anti-Wrinkle Concentrate
  • CeraVe Skin Renewing Vitamin C Serum
  • RoC Multi Correxion Revive + Glow Daily Serum + Vitamin C
  1. Vitamin E

    Referred to as Tocopherol

  • A fat soluble anti-oxidant that has emollient like properties (keeps skin soft and hydrated)
  • Helps prevent against sun-damage (prevents sun-induced damage such as sunspots, freckles, and lines)

OTC Recommendations:

  • Olay Total Effects 7 in 1 Moisturizer
  • CeraVe Skin Renewing Night Cream
  • Cetaphil Deep Hydration 48 Hour Activation Serum

April Featured Products


An Ounce of Prevention is Worth a Pound of Cure

By Katie Keel- APRN-C & MidState Skin Institute

Now that January and February are behind us it’s time to ask – did you keep your New Year’s Resolutions? About 50% of adults in the US make New Year’s Resolutions but fewer than 10% actually keep them. If you were one of the 90% of those who don’t, it’s not too late to make a new one. One you can keep and reap the benefits for years to come. One you don’t have to wake up at 5am to get to the gym for or miss out on your favorite candy, chip, or baked good. Let’s pick one you can do in the comfort of your own bathroom and takes 2-3 minutes, the same amount of time you spend brushing your teeth. Let’s take care of our skin!

“You can’t help getting older, but you don’t have to get old.” – George Burns

At MidState Skin we like to change that quote a little bit – You can’t help getting older but you don’t have to LOOK old. This month we will discuss with you how to fight looking older, tooth and nail, but first we need a bit of background to discuss the pathology behind lines, wrinkles, skin discoloration and aging. Lines and wrinkles form from a combination of sun damage, gravity, smoking, genetics and muscle movement.

Although some of these things we don’t have control over, the good news is many of these factors we do have control over. First, sun damage – in case you haven’t heard, sunscreen is your friend. The key is finding one that is a physical or mineral sunscreen that contains active ingredients like zinc oxide and titanium dioxide. Apply it every morning even if it’s raining or you “aren’t going anywhere”. It is the little bit of sun exposure every day while driving in the car, walking to get the mail or into the store that accumulates and accelerates skin aging.

Gravity – darn you Sir Isaac Newton, can’t control this one, we will skip it.

Smoking – if you never have, never start, and if you currently smoke there are so many options to help quit. On average it takes seven times to successfully stop smoking. If you slip, get back up and try again. You are not alone.

Genetics – quite literally you can’t live without them. We all have that friend that uses only water to wash their face and Ponds Cold Cream to moisturize and doesn’t have a single spot, line, wrinkle, or acne bump. More likely than Ponds Cold Cream being a miracle product, your friend probably is just blessed with that skin genetically.

Notice we saved the best for last – muscle movement. Despite great advertising and famous paid spokespeople there is nothing topically that will decrease the muscle movement beneath the skin which is driving the collagen loss and furrows and lines. We call these dynamic wrinkles. Each muscle contraction and facial movement causes the skin to bunch together forming lines between the bulk of the muscle. Dynamic lines include the “frown” lines between your eyebrows, “crows feet” on either side of your eyes, and horizontal forehead lines. Once you see fine lines forming the damage is being done. It is time to seriously think about a sprinkle of Botox. The longer you wait because you “aren’t old enough for Botox”, the harder and more expensive it is going to be to improve those lines.

Contrary to popular belief, well placed Botox will not make you look fake or frozen. In fact, well placed Botox will result in barely perceptible decrease in expressions and amazing relaxation of the dynamic lines of your face. Your friends and family won’t be asking if you got Botox, they will be asking you if you got your hair done or what makeup or moisturizer you are using. There is a high likelihood your friend that “only washes her face with water and uses Ponds Cold Cream to moisturize” is sitting in our Botox cosmetic chair as we speak.

But – you may say – Botox is too expensive – WRONG. You can achieve a full face refreshed, natural result from Botox for about 35 – 40 units which will last 3-4 months. For $25 a week, you can have less lines on your face and look more refreshed and radiant. Remember, the deeper the line, the more Botox will be needed; therefore increased cost if you decide to wait until you are “old enough”.

There is no magic age to start but remember, “an ounce of prevention is worth a pound of cure”. Why is it no one bats an eye when you start eating healthier, exercising, reading more, drinking more water, highlighting your hair and getting a fun haircut, or getting a well-deserved pedicure but Botox and filler has to be such a taboo subject? Well it is 2021 and it doesn’t have to be taboo anymore if we don’t let it.

Like all great things in life, repetition, consistency and maintenance is key – whether it is exercising, relationships, eating right, parenting or keeping up with never ending laundry and housework.  Your mind and your body and your health are your greatest gift and it’s time you start investing in all three if you aren’t already. You can invest in your mind by reading, meditating, praying, learning a new language to name a few. You can invest in your body and your health by eating clean, moving your body, and stopping (or at least decreasing frequency of) habits like smoking or fast food.  Let’s take this a step further and discuss investing in your skin!

You owe it to yourself (and your skin) to set aside a couple minutes in the morning and before bed to cleanse, treat, and moisturize. However, walking the aisle in the personal care/beauty section of a store is overwhelming. There are so many options for cleansing, treating and moisturizing where do you start? Let’s start at the basics: cleanse, treat, moisturize and prevent.

This chart below can be printed, taken to the store as your shopping list and taped to your bathroom mirror until it becomes second nature. There are two columns – one for medical grade skincare and one for drugstore finds. Medical grade skincare is of higher potency and active ingredients and therefore is typically a bit more of an investment. If you have been trying drugstore products and not seeing results, it is probably time to run to your dermatologist’s office to pick up something a little more potent.

Good habits start young and in conclusion we will touch on adolescent issues or teenage skincare. Starting a good skincare routine early in life can make it a habit that lasts into adulthood. Good, consistent skin care can help prevent or control acne, prevent acne scarring and prevent sun damage and pigmentation.  Acne scars, sun damage and pigmentation can be forever or extremely expensive to improve (note: we did not use the word cure or fix). What doesn’t bother a teen now, might when they get a little older or in adulthood. A good teenage skincare regimen doesn’t have to be complex or expensive, but it does have to be consistent. Waking up 2 minutes early each day to ensure at least a 30 second cleanse and moisturizer with sunscreen is key to good habits and clearer skin. Trying to tell a teenager this is difficult but if you buy them, number them in order of use or tape instructions to their mirror, there is a good chance they will use them. You can lead a horse to water but you can’t make him drink is true, but if you make it easy and put it in clear line of sight, likelihood increases.

There is no more profitable investment than investing in yourself and an investment in yourself pays the highest dividends. If there is anything we at MidState can do to help your skin goals please give us a call!

Featured Products

Lipid Replacing Cleansing Gel

This revitalizing cleanser effectively removes dirt, makeup and excess lipids without damaging the skin barrier.


  • Non-irritating foaming gel cleanser
  • Slightly acidic pH
  • Excellent professional cleanser that works well prior to microdermabrasion, chemical peeling, enzyme or oxygen treatments



 Micro-Exfoliating Honey Cleanser

Micro-beads of natural beeswax gently cleanse and exfoliate, while absorbing excess oil. Leaves all skin types feeling fresh and revitalized.


  • Gently exfoliates, leaving the skin silky and smooth
  • Naturally oil absorbing and hydrating at the same time
  • Fragrance-free and sulfate-free
  • Gentle enough to be used twice daily

Allison Weber, APRN-CThe Cost of Keeping Up

By Allison Weber- APRN-C & MidState Skin Institute

The cost of treatment will always outweigh the cost of prevention. This holds especially true when it comes to your skin. Once a skin condition has set in, it’s exponentially harder to get rid of. Let’s take a look at some of the costs to prevent these skin issues vs. the cost of treatment.

Melasma and sun spots are common in our beautiful sunshine state. Typically found on the cheeks, nose, forehead and chin, melasma or sun spots are dark grey/brown patches. Prevention starts early, and it’s simple- sunscreen! Choosing a broadband, SPF 30 or higher product with zinc/titanium dioxide and applying it every 2 hours might be the easiest prevention tip we have. Allison Weber, APRN-C at MidState, says her favorite SPF is EltaMD. Treatment for melasma/sun spots can take months, and involve a plethora of options such as prescription topical hydroquinone ($10-100), topical retinoids ($50+), cosmetic peels ($90+), Vitamin C ($20+) and tranexamic acid ($20+). It’s important to note, some forms of melasma are hormonal and may not be preventable.

Wrinkles are a natural part of aging; we can’t change our DNA. However, there are many factors that can speed up aging skin such as excessive exposure to UV rays, smoking, dehydration and pollutants. Prevention of wrinkles should involve daily sunscreen ($10+), a consistent skincare routine ($20-100) and a healthy lifestyle. Additionally, starting preventative neurotoxins like Botox early on can lessen the amount of neurotoxin that’s needed ($100+), and also the number of areas to be treated. Late treatment of wrinkles can almost double the cost of your skin care regime. Not to mention, not keeping up with your health may result in more than just a trip to the dermatologist. Treatment of deep, set in lines could require more product resulting in higher costs ($300+) and additional treatments.

Dyshidrotic eczema is a form of eczema that shows up on the hands or feet, and causes tiny, intensely itchy blisters. For most people, having dyshidrotic eczema falls somewhere between having it once (3-4 weeks) and living with the chronic, debilitating condition. Moisturizer plays a key role in helping your skin heal, and stay healthy. Dermatologists recommend you use a fragrance-free ointment or cream (not lotion) to help prevent skin from reaching the point of severe irritation. A MidState favorite is CeraVe Moisturizing Cream that can be found at your local drug store for $10-15. Alternatively, treating dyshidrotic eczema can involve prescription topical treatments, multiple visits to the dermatologist and steroid injections. Depending on insurance and severity you could be looking at months of treatment and $100’s.
Consistency is key. Keeping up with your skin care is health care. Once a day care adds up to weekly, monthly and yearly benefits. Conversely, neglecting your skin can add up as well. Put the time into yourself, it’s a good return on investment.

Splurge Worthy-
1. Dr. Brandt- No More Baggage
2. Neocutis- Bio Cream
3. Neocutis- Lumiere
4. EltaMD- Barrier Renewal Complex
5. EltaMD- So Silky Hand Cream
6. EltaMD- UV Broadband SPF
Drug Store Finds
1. Yes to Tea Tree- Scalp Relief
2. CeraVe- Vitamin C Serum
3. Vichy- Mineral 89
4. Aveeno- Repairing Cica Hand Mask
5. Burts Bees- Lip Scrub
6. Neutrogena- Hydro Boost Water Gel
7. Neutrogena- Rapid Wrinkle Repair

2020 was definitely a memorable year. As a society, we navigated a crippling pandemic, social isolation, divisive politics, and riots for racial justice. Some of us lost love ones, some of us lost our livelihood, some of us lost our hope. We could dwell on all that negativity or, we could be thankful we are a strong, resilient, loving species and approach 2021 with a refreshed attitude and the confidence to face what tomorrow brings us without fear. That’s what I’m choosing.

Regarding skin, this is a great time of year to start undoing all the damage we did from the summer. Procedures like chemical peels and IPL that we use to treat sunspots require sun avoidance for a couple of weeks which makes these cold winter months ideal timing for scheduling that. Also, if you haven’t already lasered unwanted hair on your body, getting started now, will ensure soft smooth hairless skin in time for summer.

As we look to set resolutions, make goals, and dream big, I encourage you to focus on health, energy and happiness. Be well my friends!

Happy New Year!


Did you know there’s a season for certain aesthetics procedures?

Despite the fact we’re here in sunny Florida, sweater weather is upon us! The winter months are a great time for procedures that have a little longer downtime, and the perfect opportunity to hibernate and recover. Let’s look at a few.

IPL- Intense Pulse Light is used to treat a myriad of issues such as wrinkles, age and sun spots, birthmarks, varicose veins, rosacea and so much more! Since it’s recommended to avoid sunlight, these winter months are perfect to start your treatments.

Laser Hair Removal- Laser hair removal is best done when you will have no sun exposure, because it reduces the risk of pigmentation. Treatment can take multiple sessions, so doing it in the winter months when the beach is less tempting is the ideal time.

Sclerotherapy- Treating spider and varicose veins can be hot, not that way! Some patient require compression socks and hosiery, so it’s not always preferable to start these when the temperatures are hitting triple digits. “Pants” season is a convenient excuse, and can allow you plenty of time to heal without anyone ever knowing.

Chemical Peels- Limiting sun exposure after a chemical peel is a crucial part of healing. Peels can make your fresh, baby smooth skin more susceptible to burn and that’s why these chillier months are called peel season.

Ready to book? Call Anna now! 352-512-0092