Dermatology Milestone: 30 years old


Congratulations, you've made it to 30 years old.   You might be thinking about getting married and having kids, or maybe you are already there.  With children comes new responsibilities.  Not only as a parent are you responsible for the health and well-being of your mini-me, but you also need to take a step back and reflect on your own health and other matters pertinent to the welfare of your child.  This is the time to have health insurance, a life insurance policy, make decisions about who should be the caretakers of your child if something were to happen to you and your spouse and have a will drawn up.  This is the time to start saving for retirement and setting aside money for your kid's college AND mortgage payments.

At about 30 most folks start to comprehend that they aren't 20 anymore, and they really need to start taking better care of themselves.  After all, you want to set a good example for your children too, right? Make a list of the doctors you should be seeing for health maintenance.   You need a primary care doctor, a dentist, and a dermatologist, for starters.  Annual dermatology visits are a must.  Did you know that once you have been diagnosed with melanoma you won't be able to get life insurance or give blood anymore?  Statistically 1 out of 40 USA citizens will get a melanoma at sometime in their life.  That's 1:40 !

As far as your skin goes, you aren't too old for acne, you aren't too young for skin cancer, and you aren't too young for wrinkles.  You will likely see visible changes in your body's metabolism, and your skin will be a little drier than it once was, and it will be harder to lose weight.  Your face is still probably making some oil, so you need light weight products for moisturization like hyaluronic acid serums (that do not contain dimethicone). You probably aren't getting enough exercise or drinking enough water.   New growths are going to start showing up on your skin that weren't there before.  You will start learning to identify what a angioma, a seborrheic keratosis, and skin tag look like.  Angiomas aka hemangiomas are the little red moles that start to pop out everywhere.  Seborrheic keratosis are the rough raised tan or brown bumps that look like dead skin, and often referred to as barnacles; they're ugly, but at least they are harmless.  Skin tags develop where skin gets rubbed, and could be one more reason to try to keep that weight down.  Your brown flat moles called nevi are still at risk for melanoma, but now you are into the prime age group to develop a melanoma.

Overall though, you look great.  You are at your peak.  The age of 30 is considered to be the ideal for facial shape in our culture.  Young women apply blush under their cheekbones to look older.   Eighteen year old's hate how big their cheeks are.  Truly, at about 30, your face should look pretty good, and its just downhill from here.  So now it becomes about preservation and prevention.  I hope you are using your sunscreen, and have developed the common sense by now to not use tanning beds, ever.  Trying to get a base tan before trips is not wise.  Smoking is terrible, not only because it causes lung cancer, but it makes your skin age rapidly too.

For men, if baldness runs in your family, and you don't want to be bald, you should start talking to your dermatologist now (while your hair is still there!) about whether or not you want Propecia. For women, your hair is starting to thinning too.  You can take biotin, but Propecia won't help you, you'll just have to accept it, and find a great hair stylist.

For men and women, skin care needs to evolve to a new stage.  Your hands and legs are going to need more moisturizing CREAM (not lotion), and it might be time to say goodbye to Dial soap or any other soap that dries out the skin too much.  Just cleansing your face twice a day and slapping a little sunscreen on isn't quite enough anymore.  Now you should be considering regular exfoliation, and if you are constantly frowning or squinting you should consider the preventive benefits of Botox.   Looking angry all the time isn't good.  Waiting until 40 when the lines which some people call the "11's" between the eyebrows are very deep is on the late side for best results.

If there is something in particular you'd like to change about yourself, feel free to ask your dermatologist.  There are new options all the time.  The latest thing to come out is Kybella to remove fat under the chin, a purely genetic thing, and it's permanent.  So, happy birthday 30 year old, life feels great!    :D



First Botox Bonanza Day at Klein Dermatology May 20, 2016


Klein Dermatology & Associates will be hosting a BOTOX BONANZA DAY on MAY 20, 2016.  

Botox will be $10/unit for ONE DAY ONLY.   Xeomin will also be available at $10/unit.  In addition, to offering big savings on the botox treatments, information will be available about Kybella (treats the double-chin), Voluma (lifts the face), Juvederm, and other treatments we offer.  

Injectors for this special day will be Dr. Marla Klein, Alicia Wayland RN, Jamie Kersenbrock FNP, and Tasha Gouin FNP.   Schedule early, call now 503-445-2200, these appointments will fill up fast.  This is an excellent opportunity for first timers: for either relaxing and smoothing lines on the face and for people who suffer from migraines to try Botox with an expert at a low price.


Dermatology Milestones


What are dermatology milestones?  This refers to the way our skin changes as we age and that there are certain things a person might want to know about ahead of time, especially if there is a solution.

I've decided to start with the age of 18, but I'll cover all the "biggies" in the near future, so be sure to check back.

My view of youth today tells me that things don't really change that much with the generations, just the technology does.  I would expect that the average 18 year old thinks mostly about their sports, music, activities, friends and dating.  If their parents are lucky, they are thinking about either going to college or getting a full-time job.

They don't tend to spend too much time thinking about how they will age or how long they will live.  Seeing a dermatologist isn't too high up on their priority list and, "who cares about sunscreen, I think I look better tan."  Acne and warts are going to be the top reasons for an 18 year old to see a dermatologist.

Did you know that in the USA, the current life expectancy is 79 years old?  I checked on the statistics and I was surprised to learn that the USA ranks only #37 in the world for longevity.  Japan ranks #1 with a life expectancy on average of 83 years old.  Switzerland is #2, and Italy is #4.  I frequently see patients in their 80's, 90's and a couple over 100, so I think it is fair to say I know a lot about what the skin is going to do with time.

I don't think most 18 year old's think about how long their lives will be.  They are invincible right?  However, now they are officially adults, and certain things are expected of adults, so this milestone represents a big game-changer for our youth.

Here is my advice: hygiene matters.  Wash your face twice a day, brush your teeth twice a day, shower daily, use soap and shampoo, use deodorant and probably anti-perspirant. Dry completely off, especially between the toes.  Wear flip flops in public showers.  If you get athlete's foot then treat it to try to avoid ending up with nail fungus in your toenails.  If you have acne, treat it, don't let yourself get acne scars since they are so expensive to try to treat later.  Even excessive armpit sweating is a treatable condition.  See a dermatologist if you need help.

You might think you won't care what you look like at 60 years old, but you actually will.  Use sunscreen.  Never go in a tanning bed, and remember that a tan isn't beautiful, tan skin = damaged skin and faster appearance of aging.  Think about your habits, if you enjoy outdoor activities, protect your skin from the radiation of the sun by wearing SPF clothing, a hat and sunscreen. Getting a sunburn is painful and has long term consequences, avoid getting burned! EltaMD is an excellent zinc sunscreen that comes in clear, tinted, spray and even a sport version that doesn't sting the eyes.  You are never too young to protect your skin from the sun.

If you have a family history of melanoma, it is time for annual full skin monitoring to be done by your dermatologist. OK, yeah, its a little embarrassing, but you better get used to it, because you will have a lot of doctors in your future.  Suck it up, you're an adult now.

Melanoma is a skin cancer that can kill you if it isn't found early.  At 18 years old, it is possible that you could already have a melanoma somewhere on your body.  You are 10 times more likely to get a melanoma if a first-degree family member has had one.

The American Cancer Society predicts that in 2016 there will be 76,380 new melanomas diagnosed in the USA, and there will be 10,130 deaths from melanoma.  Your lifetime risk is 1:40 now for ending up with a melanoma.  How big was your graduating high school class?   My son's class was about 300 people, which means 8 of those teens will be diagnosed with a melanoma at some point in their lifetime.  Hopefully they won't die because of melanoma.  Statistically, women get checked younger than men do and women's melanomas are detected sooner than men's, which leads to the statistics that men are more likely to die of a melanoma than women are.

I'll save sexually transmitted diseases for another blog.  Happy birthday 18 year old!     :)

Klein Dermatology: Texting Appointment Reminders to Patients soon

textreminderWe are in the process of setting up appointment reminders by text for our patients who want this service.  In the past, we have called on the telephone to confirm an upcoming appointment 2 days prior to the appointment.

Soon we will be able to give our patients the opportunity to choose their preferred reminder method: phone call or text?   As the modern world changes, fewer people answer their phones or listen to their voice-mails.  We are a medical office that is interested in giving the best customer service possible, and we want to have the best communication possible with our patients.   Once the system is set up, when you call to make your next appointment, the receptionist will be asking how you would like to be reminded and confirmed for the appointment.  If you choose text,  a text reminder will go out instead of a call 2 days before hand.  If you still prefer the telephone, you can have that service too.

For text reminders, the patient should respond "CONFIRMED" to let us know that they received the message and will be there.  If the patient doesn't text reply to the confirming message, then the office will need to call you the following day to make sure you know about the appointment and that you will be coming.

We will also have the ability to set up reminders for procedures, such as your surgery or Voluma appointment is one week away, please remember to stop taking any blood thinners that you currently take.

At Klein Dermatology & Associates we truly hope that doing text appointment reminders will make your life a little bit easier.

Online Appointment Scheduling

Klein Dermatology & Associates has online appointment scheduling underway, and we hope to have it "live" by next week.   To make our practice more "patient-friendly" in this tech culture of ours, patients will be able to go online and see what appointment slots are available with Dr. Klein, Jamie Kersenbrock FNP or Tasha Gouin FNP, and schedule themselves in.  There will be a way to access it through our own KDA website and also through the zocdoc website who hosts it.  We are assured that all patient information is completely secure in the process.

makeapptAdded features that one gets through online appointment scheduling with Klein Dermatology, is a reminder text (yay, a text!)  one hour before the appointment that includes a google map giving directions.  (Remember our address is 5200 Meadows Rd. Ste 250, Lake Oswego OR 97035 now.)  It also does a follow-up later in the day asking for a review of how the appointment went.

We will accept old and new patients into our office via this route, in addition to the old way of calling us at 503-445-2200 to make an appointment.  With online scheduling, if the patient were to decide they needed a dermatology appointment as soon as possible, and it was say 10 pm when the office is closed, the patient will have a way to set up their own appointment right there and then.  The patient can also enter their own insurance information, which should expedite the check-in process at the scheduled appointment.  Patients will need to set up a account in order to use this service.

Only routine appointments will be scheduled this way.  Appointments such as surgeries and procedures which require more customized times will still need to be scheduled through the phone number.  Jamie has early morning appointments, and Tasha has late afternoon appointments available to better accommodate our busy patients with acne, eczema, skin checks and warts.  Accutane patients should still set up their appointments on the phone to be sure to have two back to back appointments scheduled, one for the labs and the other for the provider.

Scheduling appointments online for those who want it that way should be a great service, and we hope you like it too.

Marla Klein MDreal-self-top-doctor

Diving into Social Media

Recently, I went to a Dermatology conference in Maui, where I sat and listened to a 3 hour series of talks about, "How to Market Your Dermatology Practice".   It all boiled down to two words: SOCIAL MEDIA.  Admittedly, I have been resistant to this for a very long time.  My website designer has dutifully told me for several years, "Hey, you gotta blog, you gotta have a Facebook page, you gotta have videos,..." and so on.  After the meeting I came home and looked myself up on the Internet.  It had been a long time since I had done this so I was a bit astonished at how far behind my peers I was.

As a dutiful dermatologist (M.D.) I've spent my time being up-to-date and state-of-the-art in my field, which is dermatology; but I had somehow fallen off the turnip truck (my mom used to say that) in the world of marketing.   After 20 years of relying on word-of-mouth, the word no longer seems to be the spoken word but the social media word.

This past year in January 2015 I moved my practice and I chose a lovely easy to get to location in Lake Oswego near the 5 freeway, on the edge of Tigard.  Simultaneously, I had to study to take my Boards exam... because my generation of doctors is supposed to prove our competence by taking a Board exam in our specialty every 10 years.  I am happy to report that I passed my Board of Dermatology exam again for the third time, because I've been practicing in the Portland Metro area now for about 20 years.   I wish I could say that I'm now "triple Boarded" but I can't.  It doesn't work that way.  However, I am a medical doctor with 12 years of study prior to 20 years of experience in dermatology.   After reviewing what is being offered out there and by their level of training, it makes me think one thing:  please be careful out there.


I am jumping into Social Media with both feet, and headfirst, simultaneously:

1 We have a new facebook page facebookf  and we have to say things like "please like us"...  KDA facebook page

2.  We have a new fresh website, which you must have found if you are reading this.  It is full of new content including special offers for free stuff and coupons off expensive stuff, so be sure to check back frequently and look around.  It also shows the faces and bios of our friendly new employees.

3.  Blogs - like this one, I plan to talk about something once a week.  Stay tuned.  I might post skin stuff and ask you if you know what it is, or how we treat it.  I might give you suggestions on how you can treat stuff without a $$$ Rx and using something natural instead or over the counter.  Next week I think I will tell you what makes Klein Dermatology & Associates different from other dermatology practices.

4. New listings also with coupons for free stuff:  check out if you have an interest in cosmetic procedures, check out  if you have a kid with acne.  I plan to keep things interesting.

5.  Videos - we are starting to make videos of the random stuff we do, because some people like to watch this stuff I'm told.   So far we have made a video of "dermal piercing removal" and "large lipoma removal surgery".  Once I figure out how to edit them, I will post them on my new YouTube page, which will have to be linked to my website.

Twittering and instagram are in the works.

Lastly, now we have to ask people to remember to write a review if they are happy with our services.  (Why does this feel so degrading?)  The options for this are mind-blowing:  Google, Yelp,, bing, facebook, yahoo, CitySearch, HealthGrades, RealSelf, and so on for about 40 different sites, review do matter.

I hope you have a great day, and if it's a sunny one, remember to wear a hat and sunscreen,

Marla Klein MD now on  facebookf Read more

We've Moved

Klein Dermatology & Associates moved last year (January 2015) and we are all settled in.  Our new location is only about 2 miles away from the old building in Tigard.  We are located at 5200 Meadows Rd. Ste 250, Lake Oswego OR 97035.  Our phone number is the same: (503) 445-2200 and so is the email for contacting us:

Please come visit us!  The building is better and easy to find close to the 5 and 217 intersection.  From the freeway go to Kruse Way, turn rt in three lights onto Kruse Woods, a quick left onto Meadows Rd, and turn right right into the parking lot.  There are a lot of large buildings on Meadows, but we are the only 2-story little one, and there is a giant sign on the front of the building that says, “Klein Dermatology & Associates”.  From there you just need to go upstairs by elevator or stairway.

The parking lot is better, it is easy to park.  The office space is a little smaller, but much more modern.  Don’t worry, prices aren’t going up just because of a new Lake Oswego address, the rent is actually lower than it was over in that old building in Tigard.

We have some new faces, Marcia retired this past year to spend more time with her grandchildren.  Leslee and Erin are Dr.Klein’s assistants.  Alicia is still with us and the aesthetic nurse extraordinaire for Botox and Voluma.  I have two new nurse practitioners who are an absolute joy to work with: Jamie Kersenbrock, FNP and Tasha Gouin, FNP.  We have same day appointments available and we are lengthening our hours to make appointments later for our patients’ convenience.  I hope you come in to see one of us soon.

Free KDA LIP Balm!


Everyone loves our balm because it feels good, smells good and has SPF protection!

Print this page out and bring in on your next appointment or show us our KDA website on your smartphone screen on your way out.

Limit one per person while supplies last.