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Welcome to Polite as Fudge!  

You know that thing you were nervous to ask your dermatologist about?  I asked her for you.

You know that thing you were nervous to ask your dermatologist about? I asked her for you.

Sunblock? Check. Hat? Check check. Reapply that sunblock every two hours? Whoops!

I forgot that part while chasing the kids around the lake on vacation and I sheepishly showed up the next day for my annual skin check with sunburned, um, bits. I confided in my new dermatologist, Dr. Laura Buford of Westlake Dermatology, and honestly, she related in more ways than one both during my visit and in the Q + A below.

Sometimes its hard to get real real with your doctor in person, and I wanted to know/didn’t want to know what the changing “mole-thing” was on my forearm. Can you relate to that? Dr. Buford totally could, and we talked about everything from spray tans to that old thing we used to do with baby oil and a beach day, eek!


Laura Buford, MD attended medical school at the University of Oklahoma College of Medicine, where she earned a Doctor of Medicine with Special Distinction. She graduated in the top 5% of her graduating class, and she completed her dermatology specialty training at the University of Chicago Medicine in Chicago, Illinois. Her other professional interests include adult and pediatric medical dermatology, skin cancer prevention and treatment, and cosmetic dermatology.

Laura Buford, MD attended medical school at the University of Oklahoma College of Medicine, where she earned a Doctor of Medicine with Special Distinction. She graduated in the top 5% of her graduating class, and she completed her dermatology specialty training at the University of Chicago Medicine in Chicago, Illinois. Her other professional interests include adult and pediatric medical dermatology, skin cancer prevention and treatment, and cosmetic dermatology.

Polite As Fudge:  How important are annual skin checks?

Dr. Laura Buford: The American Academy of Dermatology recommends an annual skin screening starting at age 18, unless you have a family history of melanoma or atypical moles.  Your doctor may make recommendations to follow up with yearly skin examinations or may increase the frequency to every three months depending on the clinical findings at the baseline full body skin exam or your family history of skin cancer. 

Polite As Fudge:  What’s something you wish your patients and our readers knew about their skin? 

Dr. Laura Buford: Skin is an organ that is constantly shedding dead cells and self-regenerating, but skin damage has a cumulative effect. So I wish people knew to start taking care of their children’s skin and their own skin on Day 1. It is never too late to start, but having a head start makes a huge difference in the long-term condition of one’s skin over a lifetime. 

Polite As FudgeWhat’s something you learned in medical school that surprised you?

Dr. Laura Buford: Dermatology itself surprised me! There are a lot of misconceptions about dermatology - even amongst other healthcare providers. I was surprised how much of a difference a dermatologist can make in their patients’ lives. Dermatologists care for the body’s largest organ, which can include anything from removing skin cancers or treating life-threatening drug reactions, to slowing the effects of gravity and time on our bodies. 

Polite As Fudge:  Did you take good care of your skin as a kid?  I’m someone who never wore sunblock as a kid (or young adult), hit the tanning beds and though I slather it on my kids and myself now, I do worry what damage I’ve done.  What’s your advice for someone like me?

Dr. Laura Buford: I grew up in Texas. I slathered baby oil on my skin and cooked myself under the Texas sun. I even made the mistake of crawling into one of those skin cancer machines (aka tanning beds) while I was in college. At the time, tanning beds were marketed as being “safer” than the sun. Ugh. Now I cringe anytime I think of this self-inflicted assault on my skin. The best thing to do now is to prevent further sun damage - be vigilant with sun protection (wear protective clothing, reapply sunscreen every two hours, seek shade, avoid peak UV hours) and to have a heightened surveillance for skin cancers by having at least a yearly full body skin exam by a dermatologist. 

Polite As Fudge:  How do you feel about spray tanning?

Spray tanning eliminates the risk of ultraviolet rays, but it involves chemicals being sprayed onto the skin. The long-term effects of these chemicals has yet to be fully elucidated. So I would not recommend spray tanning at this time. Just remember - pale is the new tan!!!

 Polite As Fudge:  What are patients nervous to ask about?  

Dr. Laura Buford: Patients are often nervous to ask about skin conditions involving private areas of skin. It is all skin to me, so I want patients to feel comfortable asking about all of their concerns – no matter what part of the body they are on. 

Polite As Fudge:  What are the best ways to prevent and minimize fine lines and wrinkles?

Dr. Laura Buford: The best way to prevent lines and wrinkles is to be vigilant with sun protection as described above.  Vitamin A derivative (retinoid) medications are great for minimizing fine lines and wrinkles.  Of course, the most popular treatment to minimize existent lines and wrinkles is Botox injections. 

Polite As Fudge:  I’ve noticed sun spots or age spots appearing on my skin.  What causes this and what can I do about it?

Dr. Laura Buford: The medical term for sun spots are solar lentigines (singular: solar lentigo). They are caused when UV light causes melanocytes (pigment producing skin cells) to become more numerous and subsequently leads to the accumulation of melanin (black pigment) in surrounding skin cells. Prevention is very important, so remember to wear sunscreen every day! Once solar lentigines appear, there are bleaching creams and certain lasers that can target the dark pigment in the skin and can lessen the appearance. 

Polite As Fudge:   I’m embarrassed to tell you I thought fillers literally “filled up” wrinkles and indents.  Really, they weaken the muscle that is causing it, right?  It’s such a personal choice, but what’s your take on if and when to go the filler route?

Dr. Laura Buford: I like to think of neurotoxins (such as Botox) and fillers as a way to restore youth and add to one’s existing beauty. Neurotoxins temporarily weaken the muscles that cause wrinkles, and fillers add volume. I like to use them in combination with each other. The decision of “if and when” is very individualized.

Polite As Fudge:  What is your daily skin care routine like and what is your favorite product? 

Dr. Laura Buford: I use Elta MD Foaming Facial Wash followed by Skinceuticals Discoloration Defense serum in the morning and evening. In the morning, I also apply Elta MD Barrier Repair cream followed by Even Up sunscreen by Colorscience. At night, I apply a prescription strength retinoid. I really like Colorscience sunscreen and Elta MD products. 

 Polite As Fudge:  If you had to pick between a grilled cheese and mozzarella sticks, what would you pick? 

Dr. Laura Buford: I would probably go for the grilled cheese if it’s on a great piece of bread.  However, I am not a picky eater, and I have yet to find something I don’t like! 

 Polite As Fudge:  What’s a life lesson that comes to mind that you hold dear?

Dr. Laura Buford: Don’t take your health or the health of your loved ones for granted. I lost my dad and one of my best friends over the past year. They were both perfectly healthy until they weren’t. Live life to the fullest and say “I love you” often. 


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