A Deep Dive into Acne with Jacinta Barbagallo

Why isn’t your acne responding, no matter how “clean” your skincare routine is?

In this eye-opening episode, skin specialist nutritionist Jacinta Barbagallo shares why stubborn breakouts rarely start on the skin’s surface—and why real solutions lie far deeper. Together, we explore the three root causes of acne: retention keratosis, hypersebum secretion, and skin pH imbalance, and the surprising internal drivers behind them, from nutrient deficiencies and cortisol surges to gut dysfunction and metabolic imbalances.

Jacinta unpacks how to go beyond surface-level treatment with targeted clinical tools like strategic blood testing (e.g. SHBG, fasting glucose, insulin, hormone panels) and foundational nutritional strategies, including 30g of protein per meal, omega fatty acid balance, and key herbal medicines like burdock, Oregon grape, and peony licorice.

Most importantly, she reframes what progress really looks like. With hormones taking months to recalibrate and skin cells needing 6–8 weeks to renew, Jacinta shares what signs to look for along the way, like faster breakout recovery and reduced inflammation.

Whether you're navigating your own skin challenges or supporting clients through theirs, this episode offers a comprehensive and empowering roadmap to finally understanding what your skin is trying to tell you.

Connect with Jacinta

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DISCLAIMER: The Information provided in the Wellness by Designs podcast is for educational purposes only; the information presented is not intended to be used as medical advice; please seek the advice of a qualified healthcare professional if what you have heard here today raises questions or concerns relating to your health

Episode Transcript

Speaker 1 (00:12):
This is Wellness by Designs, and I'm your host, amy
Skilton, and joining us today isJacinta Barbagallo.
Jacinta is the founder and skinspecialist nutritionist of
Arenda Women's Health and,having worked with hundreds of
clients one-to-one, as well aseducating skin therapists across
the world, jacinta has workedextensively with some of the

(00:35):
most complex skin conditions,including acne, rosacea,
perioral dermatitis, melasma,psoriasis and eczema, staph
infections and so much more,previously working in the realm
of functional pathologyinterpretation.
The basis of Jacinta's clinicalpractice is helping her clients

(00:55):
find the answers to the causeof their skin condition and
provide realistic, long-termsolutions to achieve and manage
clear skin, and we're so honoredto be chatting with Jacinta
today about the naturopathicapproach to treating acne from
the inside out.
So, jacinta, welcome to thepodcast.

Speaker 2 (01:17):
Thank you so much, amy, for the introduction.
I'm very excited to get intoeverything today, and I know
that you love skin too.
It's been a great conversation.

Speaker 1 (01:25):
I'm so excited to be speaking with you because skin
is certainly a huge passion ofmine as well, and for me
personally, it was born out ofhaving chronic acne as a much
younger woman, which led me tostudying to be an aesthetician
as well.
But I'd love to hear your storylike how did you end up working

(01:47):
in this space yourself?

Speaker 2 (01:50):
So, as you mentioned in my little bio, so I used to
previously work for a companythat was a supplement company
and also functional testing.
So I was really working in thespace of education for quite a
period of time and with that,involved me training a lot of
different skin therapists aroundthe benefits of essential fatty
acids and how it can supporttheir clients to be able to meet

(02:13):
the topicals halfway and toreally work on the internal
drivers of a lot of most of thetime acne.
And it really helped me to findmy niche of an area that I
wanted to really delve into inclinic because I could just see
that they could really only getto this the skin so far with the
type of treatments that theydid and their clients really

(02:34):
required that internal supportand they just weren't feeling
supported by finding a long-termsolution with being given
prescriptions of the pill ordoxycycline or arachatine and
they really wanted to find along-term approach and
essentially from there it's awhole.

Speaker 1 (02:51):
The whole of arenda started because I was educating
so many skin therapists abouthow they can support their
clients but they did just needsomewhere to go to have someone
else to really delve into allthe internals with them and I
think that's one of thechallenging things, because one
of the blessings of a skin issue, if I can call it this, is it's

(03:11):
an organ that we can actuallytopically apply things to, which
means we can support our skinin additional ways that we
perhaps can't do topically, toour liver, for example.
But I do find, you know, in thegeneral public, most people end
up pursuing topical treatmentsover and over again, thinking

(03:34):
the holy grail lies in a certaincream or a certain serum or a
certain treatment, when you knowchronic skin conditions are a
sign of chronic dysfunctioninternally, and so the
naturopathic approach is alwaysto find those root causes and to
address them.
That being said, towards theend of our conversation today, I

(03:54):
do intend to talk to you abouttopical support, because it is
one of those unique aspects ofhealth where we can use a
combination approach and enhanceeach of those things as well.
But looking into the internalcauses, I know that taking a

(04:15):
long-term approach is certainlywhat you're very passionate
about, and when I say long-termapproach, I also don't want
people to hear it takes a longtime to fix.
Certainly, that can be true forcertain patients, but what I
mean by that is the approachthat Jacinta crafts is one that
sets people up for good skin forlife, meaning it's not like a

(04:40):
symptomatic fix or a quickcleanup with antibiotics or you
know something that temporarilyshifts the state of the skin,
only for it to return to itsdefault because the underlying
drivers weren't actuallyaddressed.
And I think you know again,allopathically speaking, for
convenience, you know things getpigeonholed and therefore, if

(05:02):
it looks like this, you givethis particular medication, but
when it comes to this, you givethis particular medication, but
when it comes to, you know,functional and root cause
medicine, you might have 10 acneclients and each one of them
has a different prescription,lifestyle nutrition and, you
know, supplement wise, and soI'd love to hear from you your
reflections on why there isn't ablanket treatment for acne and

(05:24):
why, you know, differentpatients can present so
differently.

Speaker 2 (05:30):
Absolutely well, I think with that, it's probably
good to delve into what wedefine as acne and the causes of
acne, because it's really thecauses of acne and once we truly
understand that, we then knowwhy there's no blanket treatment
and why it's so different forevery individual.
So the way that we essentiallydefine acne, it's an infection

(05:51):
of the palosibaceous unit andit's driven by an excess
proliferation of C acnesbacteria and essentially that's
because there's a blockage inoxygen into the hair follicle
which then creates theenvironment for the C acnes
bacteria to proliferate.
So essentially, when we'relooking at our individual acne

(06:11):
clients, we need to look at thethree main causes of what allows
the blockage of the oxygen flowinto the hair follicle, and
each individual can then bedifferent with the causes of
what could be driving thatpathophysiology to start off
with.
So one of the main causes.
So we'll break it down into thethree causes of what blocks the
oxygen flow into the hairfollicle.

(06:31):
One of them is retention,keratosis, and that's
essentially where we get thethickening of the shard and
corneum and that's that outerlayer of the skin and that
blocks the hair follicle, theoxygen into their oxygen flow
into the hair follicle and thatcan be driven by, from an
internal perspective,dehydration of the skin, which

(06:52):
includes things like lackingessential fatty acids.
So if the skin and the stratumcorneum doesn't have enough
essential fatty acids, thenit'll cause basically like a
buildup of these skin cells onthe top of the surface that
stops the oxygen flow to come into the hair follicle.
But then we also think of othernaturopathic reasons that would
cause retention, keratosis,like thyroid dysfunction,

(07:16):
because an underactive thyroidwould cause sluggish
desquamation of the skin.
So you get that dryness, thebuild-up of the stratum corneum,
and again we then get thisblockage of hair, of oxygen flow
into the hair follicle as well.
Um, for other people can alsobe a vitamin a deficiency as

(07:37):
well, and that's where, evenjust in that one cause, you can
see that it's so differentperson to person, because not
everyone has a thyroid issue,but there might be some that
have a thyroid issue and theirsymptom is they present with
acne.
And then we have another cause.
Our second cause is eitherhypersebum secretion, so excess
sebum production, or we have anincrease in the sebum viscosity.

(08:01):
Now, when we're thinking ofhypersebum secretion, this is
that classic kind of picturewhere everyone's like acne is
driven by excess androgens,because androgens are what cause
excess sebum production or theycontrol the sebum production in
the sebaceous gland.
But the sebaceous glands alsoreact to things like

(08:21):
testosterone, dhea, cortisol aswell and also histamine.
So when we're thinking aboutthe reason that our clients
might be presenting withhypersebum secretion, it may not
be testosterone and DHEA, itcould also be cortisol, because
they're stressed, and justbecause they're stressed doesn't
mean that they've got excesstestosterone and excess DHEA.

(08:45):
And then we think about thesebum viscosity, and this is one
that we do see in a lot of acneclients, which is where the
sebum viscosity it's quite thickand it's congested, and that's
because they're lacking theessential fatty acids.
And we can see that there'seither that excess omega-6 in
the diet or that lacking ofomega-3.

(09:06):
So even within that again, theroot cause of acne can be so
different person to person,because you can have clients
that have low androgens, theirtestosterone is bottoming out,
their DHEA is so low, but thenwe see them present with acne
and it doesn't necessarily meanthat they're getting this
hypersebum secretion becausetheir androgens are high.

(09:27):
They could be very stressed andit's the cortisol that's causing
their sebum to be excessivelyproduced.
And then our final cause wehave is the pH balance and
that's where the skin pH and theacid mantle, which is the outer
layer that protects theessentially the skin barrier
function.
That ph is so tightly regulatedin order to protect the skin

(09:52):
and it has certain antimicrobialpeptide properties that are
really important to try toprevent acne.
And, essentially, the phbalance that can be drastically
impacted by the type of topicalproducts the clients are using,
so everything from theircleanses, their moisturizers,
their serums, their, their spfas well.

(10:14):
But the ph balance of the skincan also be impacted by the gut
microbiome.
Just like we know that the gutmicrobiome ph can be impacted by
the types of short chain fattyacids that are produced within
the gut, it's very similar withthe skin that the skin ph can
then be influenced by both thegut microbiome and the skin

(10:35):
microbiome.
So that's essentially why, in anutshell, that when we're
looking at different causes ofacne, no two cases are ever the
same, because you can even seewith the definition of acne, the
complexity of all the potentialdrivers and how no two clients
have the same exact hormonehistory, the exact same blood
sugar issues, the exact samediet and you've got to treat

(10:58):
them based on the individualyou're seeing in front of you
and it just, you know, such adomino effect when we're looking
at the cause of the cause.

Speaker 1 (11:07):
Also, you know, just thinking about retention,
keratosis and vitamin Adeficiency, obviously we've got
to consider, you know, what'stheir retinol intake or vitamin
A intake, because beta caroteneconversion is pretty low.
I personally, in clinic, haveseen high amounts of SNPs for
BCM01, meaning the conversion ofbeta carotene to vitamin A is

(11:32):
even lower than 1.5%, which ison average what Gen Pop will
have.
But further to that, zincdeficiency is incredibly common
and you need zinc for retinolbinding protein to distribute
vitamin A around the body andtherefore, even if you're
consuming sufficient vitamin A,zinc deficiency will have your
skin remain vitamin A deficientand fail to desquamate properly.

(11:55):
And you know there's just sucha flow on effect, you know, with
pH balance and antimicrobialpeptides being produced at the
skin.
You know a vitamin d deficiencyalone will do that, and we know
that more than half australiansare vitamin d deficient at any
time of the year.
So that's exactly right yeah,and it's so important, you know.

(12:15):
And again, essential fattyacids.
If anyone's listening to thiswho is maybe struggling with
their skin and like, oh, but Itake essential fatty acids, you
know, are you digesting andabsorbing them properly?
Are they in the right ratio?
Are you taking omega-3 in plantform?
Because alpha-linolenic acid isnot the same as EPA and DHA
from fish oil, even though theyremain in the same family?

(12:39):
So, yeah, I certainly thinkthat's just even just scratching
the surface ultimately ofwhat's behind someone's skin
presentation, but I think reallyserves to explain why there's
not a cookie cutter approachthat practitioners can take, and
that's also why if someone isstruggling with acne and they
try something that worked forsomeone, it might not
necessarily work for thembecause it's not working on the

(13:02):
drivers that they actually have.
That's exactly right.

Speaker 2 (13:06):
I see that so often in clinic.
We see such an influx of youknow new clients that will say
well, you know, I've been tryingthis supplement that's been
advertised for acne and it's youknow, it's not working.
Or, like I've heard, vitex isreally great for acne and it's
flared my skin.
Or you know, you hear so manydifferent things.
But then you'll hear the nextperson say Vitex worked
incredibly well for my skin.

(13:28):
And that's where you can't saythis is the only herb you can
use for premenstrual breakoutsand this is the only thing you
could use for the lymphatics oranything like that, because
everyone is going to respond sodifferently based on their own
individual cause, and that'swhere I think it's so important
as a practitioner.
We really have to understandtheir timeline of the client's

(13:48):
skin, the things that they havedone, they haven't done, what it
responds best to what it youknow what it doesn't respond to
at all, and also couple thatwith things like you know you're
testing to see your hormones,so you're not guessing, because
I think that's a reallyimportant thing.
You can't guess a person'shormonal status unless you

(14:08):
actually see what's going onwith the bloods yes, yes, oh my
gosh.

Speaker 1 (14:14):
So this is such a good segue into my next question
for you because when we'relooking at those root causes
like so much of what we'vealready mentioned can be tested
either directly or indirectly.
Certainly there is a time and aplace for hormone testing,
assuming you're testing for theright thing at the right time of
the cycle to be able toactually interpret those levels

(14:36):
properly.
But I also know from my ownclinical experience and also our
chat is that there's a lot youcan also glean from basic
pathology blood testing as well.
So I'd love if you would takeme through some of the general
bloods you might run and whatyou're looking for when you do
that.

Speaker 2 (14:57):
Yeah, exactly.
So essentially, when it comes tolooking at the bloods, the main
thing that we want to try to dois rule in or out potential
pathology like PCOS, for example, because we know a lot of
individuals that have PCOS.
They also have acne and a lotof clients that will come to us
they're coming with a suspicionthat they think they have PCOS

(15:18):
because of how they'representing.
So when we're doing the bloods,we're really trying to find a
specific hormonal profile thateither rules in or rules out of
diagnosis for PCOS or we'retrying to find a particular
imbalance with the connectionbetween the brain and the
ovaries that can signal theareas that we need to optimize

(15:38):
with their diet and theirlifestyle and determine what
types of herbal interventionsthat you need to use as well,
what types of herbalinterventions that you need to
use as well.
But basically, we're alwaysrunning a hormonal profile
pretty much on every single oneof our clients that come with
acne, because we want to rule inor out.
That it's, you know, theirhormones that are impacting it.
We generally always do day twoor day three testing where we

(16:03):
would be doing things like FSH,lh, estrogen, your prolactin
testosterone, dhea, shbg, andthen we're also looking in some
cases that post ovulationestrogen and progesterone ratio,
and I generally do that in someof my clients that may also be
presenting with a little bitmore PMS or maybe they've got a

(16:24):
bit of an endo or adenomyosiskind of history as well as acne.
So you can see what's going onpost ovulation and the main
things that we're trying to lookout for in that day two or day
three testing is first the ratioof the FSH and the ALH, because
that can give us an indicationif there is some kind of other
blood sugar dysregulation that'sassociated with PCOS and if

(16:47):
there's that imbalance there, ifthere's something that's there
that's connected to the androgenprofile as well.
We then also like to take intoconsideration things like the
SHBG, because the SHBG is areally great indicator if there
is excess estrogen but isactually so important when we're
trying to potentially rule outcases or rule in where the

(17:10):
client actually may be undereating and maybe it's actually
insufficient nutrient intake ordietary intake in general that's
impacting their skin.
So even in the hormonalprofiles we can see if a client
isn't eating enough food and ifthat's impacting their skin,
because you can see a classiclow estrogen, low testosterone,

(17:32):
high SHBG kind of profile or lowLH, low FSH and that kind of
profile.
You know you're treating thatclient so differently to say a
classic PCOS kind of case, sodifferently to say a classic
PCOS kind of case and thatclient is so.
The treatment plan is reallysupposed to be focused on really
rebuilding their system andsupporting their adrenal,

(17:53):
supporting their reproductivesystem, giving them enough food
in their diet, making surethey're eating enough, they're
not skipping meals, they're notrunning off caffeine, and then
also making sure they'recoupling that with rest and
they're not running off caffeine, and then also making sure
they're coupling that with restand they're not over training.
And that's the.
That's the beauty of thehormone test, because it can be
so easy for clients to thinkokay, well, I've got breakouts

(18:14):
in my skin and my cycle isirregular, I must have pcos or I
need to train more and I needto eat um very low carbohydrate.
But if that's not the rightprofile for that type of client,
they're actually reallynegatively impacting their
hormones in that regard.
So we look for similar patterns, like basically trying to

(18:34):
create a story with yourhormones.
That's what we're trying to doso we can see how does this
match the type of diet orlifestyle you're currently
living and what do we need tothen change to support that
profile?
The other things that wegenerally look at as well is, of
course, beyond the hormones,we're always looking at
nutritional status, like youriron, your b12, your folate,

(18:55):
your vitamin d, because,especially when we're thinking
about iron, that's so importantfor building collagen, which we
need for skin repair.
So, for those clients that havesluggish skin cell turnover and
that's the same asinvestigating their zinc as well
and just like we all know asnaturopaths, when you find
specific things in the bloods,it can lead you down other areas
that you may not have thoughtof before, like if you can see

(19:18):
severe iron and B12 issues.
You're thinking is there maybesomething going on in terms of
absorption in the gut?
Is there a digestive pathologythat has been completely
overlooked, that maybe they haveundiagnosed celiac disease,
which I can tell you.
I've seen so many times inclients that they've got an
undiagnosed celiac disease andthat's the cause of their acne

(19:38):
and their hormones are actuallyfine.

Speaker 1 (19:40):
You can just see it in their nutritional profile and
their digestive symptoms aswell and if someone's looking at
their bloods, um, while they'relistening to this, what are
they looking for?
Like as far as like fsh lhratio, and like where do you
like to see shbg sitting to kindof say that's not an issue,

(20:01):
like, what is your frameworkthere?

Speaker 2 (20:04):
yeah, it's really dependent because I often like
to look at them all in relationto each other.
But essentially the thing is,with FSH and LH, I generally
rather than saying like Ispecifically want to see it in
this exact ratio, becausesometimes it's really difficult
to get it that exact I generallyjust don't like to see the lh

(20:24):
sit higher than the fsh.
So as long as it's sittingbelow the fsh, um, even if you
can see it's kind of sittingone-to-one with fsh, that's not
ideal um, and we generally liketo see the fsh sit below the 7
to 8 mark on that day 2 or day 3.

(20:46):
And with your estrogen it'sreally on day 2 or day 3,
ideally we like to see itbetween like 120 to 160.
But that can also really vary.
Like I've seen some clients thathave had an estrogen that sits
at 110 and it's not a massiveissue.
You've just got to take it intoconsideration with their

(21:08):
testosterone levels and theirSHBG as well.
But in saying that, withtestosterone that's a massive
one, because I can tell you nowthe amount of clients that I've
seen with testosterone that sitsabove the reference range.
It's probably like less thanfive clients in total that I've
seen that actually havetestosterone that sits above the
conventional reference range,and generally I see testosterone

(21:30):
that sits at 1.0 to beproblematic for clients that
have acne, and there can be sucha difference between, you know,
a 0.7 to a 1.0.
You can actually have clientsthat have testosterone at 0.7
this they're you know that it'snot androgen dominant, for
example but then it sits at 1.0and we can see that's a problem

(21:53):
for them.
And that's because we're takinginto consideration some of
those other markers like theDHEA and the estrogen levels as
well.

Speaker 1 (22:00):
Yes, of course, and SHBG in terms of when you would
think, oh, this person's undereating or overexercising or just
running themselves ragged.
Where do you start to getconcerned on what?

Speaker 2 (22:12):
you see, generally, if we see it above, like that 90
to 100 mark, we're seeing thatas a bit of a flag for our
clients.

Speaker 1 (22:19):
Okay, Red flag.
Yeah, so from what you'resaying there is so much that can
be gleaned from just standardblood tests.
I'm curious to know, like whenwe zoom out and think about all
of the ways in which we canassess someone's hormonal
balance.
I'm a big fan personally ofbasal temperature tracking.

(22:39):
I can see so much based on whenthe thermal shift happens, the
length of the cycle, all ofthose kinds of things.
In the past I've done a bit ofsalivary hormonal profile
testing.
I also have clients that come tome with urinary not necessarily
estrogen metabolites for likeelimination, but maybe a bit
more of a broader profile.

(23:00):
But all of these things add upeither in the time it takes to
track them, whether it's, youknow, basal temperature tracking
or ordering specializedfunctional pathology, and you
know just in our briefconversation about what you can
pick up from just a day three,hormonal panel progesterone
excluded.

(23:20):
You can tell an awful lot onbasic blood testing if you know
what you're looking for andyou're testing it at the right
time.
And how often would you then goon to you know functional,
fancy functional testing orsecondary testing?
Or maybe a better question isto ask how many clients can you

(23:40):
just simply proceed with, basedon just normal standard blood
pathology alone.
Yep.

Speaker 2 (23:47):
I could tell you now I haven't run any other form of
hormone testing for a very, verylong time when you really
understand bloods and you knowhow to interpret them, you
understand the role of FSH andLH and how that impacts the
reproductive system and theconnections between prolactin
and androgens and thyroidfunction and all that that comes

(24:08):
into it, you can get so muchfrom your bloods.
I've never done well, I haven'tdone for a very long time
actually like any form of urinehormone testing, and the reason
is is because I generally findlike one I can get enough
through bloods, um, but two Idon't particularly find that it

(24:29):
gives me any additionalinformation that I wouldn't be
able to be able to detect from ablood panel.
The.
If you're trying to look atthings like your estrogen
detoxification capacity, thatpost ovulation estrogen and
progesterone ratio via blood Itend to find can be enough.

(24:49):
And if you have an extremeestrogen dominant case, you see
it in the SHBG.
The SHBG is often well abovethe range in clients that you
can see that that's actually aproblem for them.
So I generally don't find itadds any extra value.
And I absolutely agree with whatyou were saying about the cost,

(25:11):
because, especially when you'vegot clients that are coming to
you.
They've had acne.
On average, I think most peoplespend about $6,000 a year on
acne treatments if they haveacne, and we've got to consider
that those same clients that areseeing us they're already
either seeing a dermatologist ora dermal clinician or a skin
therapist and they're spending$400 to $500 every five to six

(25:35):
weeks on a facial or a new rangeof like a change in their
skincare prescription.
So if we can also meet theclient halfway, especially with
economic crisis at the moment,with, you know, clients not
being able to maybe afford asmuch as they used to, we're
really going to be cautious withwhere we're thinking that we
need to prioritize the testing,and I'm I absolutely think that

(25:57):
we can.
You can just do it with bloods.
Even the whole, our whole teamat arenda, every single
practitioner that we have in theteam when we onboard them.

Speaker 1 (26:06):
We all go through hormone training together, like
I'll go through that hormoneassessment and how to do it with
them, and no one is doing urinetesting for hormones so,
jacinta, you mentioned PCOS acouple of times and we're going
to talk about diet in just aminute but In terms of people
assuming PCOS means that theyneed to go on a low-carb diet or

(26:29):
they necessarily have bloodsugar or insulin problems, I
think it's important to pointout there are different kinds of
PCOS.
Not all of them are related toinsulin and blood sugar
metabolism issues, but by thesame token, you could have
someone with acne who doesn'thave PCOS but who does also have
some sort of metabolicdysfunction there.

(26:50):
Where it comes to insulinsensitivity and blood sugar
balance, do you have any furtherinsights on what we're looking
for when looking at blood sugar,insulin and determining that,
if that's an issue, yeah,absolutely so.

Speaker 2 (27:05):
One standard test that I always do for every
client is a fasting glucose testand generally a fasting insulin
as well, the reason beingbecause we want to be able to
see if there is hyperinsulinsecretion and whether that might
be associated with the cause of, let's say, if there is an
androgen dominant acne.

(27:25):
We want to see is that stemmingfrom too much like excessive
insulin secretion?
And generally what we'relooking for.
Ideally, we want the insulin tobe less than nine if it's
fasted and if we're looking at afasting blood glucose, I find
it gives me so much information.
Ideally, we want a fastingblood glucose around 4.6 to 5.0.

(27:48):
Generally, anything from 5.0plus is a flag that there's
something going on in terms ofblood sugar regulation, and
anything less than 4.6, I'mquestioning if they're actually
eating enough food.
And that's where I'm alsomaking sure that when I'm
looking at a client's testresults, you've got to be so
specific Look at the time thatthey got the test, because they

(28:10):
could have got that test in theafternoon and they fasted all
the way until 2 o'clock and thenthat's an inaccurate result.
But also questioning well, whattime was the meal the night
before and what kind of meal didyou eat the night before?
Because if it was a night thatthey've had more sugar, then
that could be an inaccuratereading just based off the
consumption of what they'veeaten.

(28:30):
Or if they didn't eat enoughthe night before, is their
fasting glucose just low becauseof that?
But that's where I find theinsulin doesn't generally lie.
Oh, that much um, but thefasting glucose can give us
plenty of information and insome clients that have pcos or
that, I can see that they'vejust got metabolic dysfunction.

(28:51):
I generally get them to tracktheir blood sugar response and I
often get them to do, like theblood sugar, the finger prick
test, where they can, you know,do a fasting test in the morning
, eat their breakfast, tracktheir blood sugar two hours
later and continuously do thatthroughout the day, especially
with those clients that I cansee have a major blood sugar
dysregulation issue, because Iwant to actually see what is

(29:14):
their body doing when they eatoats, rather than just because
the internet says you can't eatoats if you've got blood sugar
issues.
I want to see how your bodyactually handles oats when it's
coupled with the protein and afat, or I want to see how your
body handles potatoes withdinner, but potatoes with dinner
, then you go for a walk andlet's see how your body handles
that, and I find that's such anincredible clinical tool because

(29:36):
I'm not just giving my clientsblanket treatments in terms of
diet and lifestyle advice.
You're actually being able totailor the advice according to
the way that they live theirlife already and then, and the
factors that we can see areimpacting their blood sugar,
based on actual data.

Speaker 1 (29:52):
Yes, I think that's so important because you know
bioindividuality.
We preach it, but sometimes Ithink clinically you can fall
back on protocols withoutthinking about how to apply that
.
I've got a couple of questionsfor you on that.
In terms of monitoring bloodsugar, you sort of mentioned the

(30:13):
finger prick.
Do you have a reason you preferthat over a CGM, or is it more
just price accessibility thing?

Speaker 2 (30:21):
Yeah, so I'm actually starting to move more over to
doing the CGMs.
I've personally actuallyrecently just did it over the
summer and I actually chose theChristmas period of time to do
it, which was kind of funbecause obviously lots of
different periods, and the onlyreason I hadn't up until that
point was because I just thoughtit would be a barrier for me to
confidently explain to myclients this is how we can use

(30:41):
it, this is how we can interpretthe data.
If I hadn't had the experiencemyself doing it.
So now that I have, then I caneasily guide my clients through
it, whereas I know with thething I know the ins and outs of
the finger prick test.
So it was more just being ableto know that if a client had a
question I wasn't stuck with howto respond to it.
I knew exactly how they couldyou know navigate?
But yeah, when I did the CGMrecently, I actually I have the

(31:06):
finger prick test at my parents'house and I did the finger
prick test at my parents houseand I did the finger prick test
at the exact same time thatobviously I had the CGM, so I
could see the accuracy and itwas probably a 0.1 or 0.2
difference.
So it's very close in terms oflike the accuracy of the CGM.
So I would absolutely still usethe CGM with clients.

Speaker 1 (31:28):
Yeah.

Speaker 2 (31:28):
It's just that I haven't done it just yet.

Speaker 1 (31:31):
Yeah, yeah, great.
I mean, that makes perfectsense.
You want to have that livedexperience.
So if you can troubleshoot withthem, you know, having actually
done it yourself, and I thinkit's nice to hear that, given
you've done it for so oftenalready, we're using another
method that they dovetail reallynicely in terms of data.
Um, one last question on on theblood sugar thing before we

(31:53):
move on to diet.
But you mentioned obviously lowblood sugar, potentially
indicating under eating.
What about low insulin?
What's your read on that?

Speaker 2 (32:04):
yeah, I don't really see it as the same as well.
I often see if clients have alow insulin reading, it's that
there's no demand to have toincrease insulin because there's
low intake of the carbohydratesas well.
So I kind of couple the boththe same, the same.
Yeah, and you can also see insome other markers as well, if

(32:25):
the clients are under eating aswell, like in some cases, if you
can, the clients are undereating as well, like in some
cases.
If you can see that there's lowblood sugar, low insulin, but a
high cholesterol profile,you're questioning, well, what's
going on here?
Because we know that we can seehigh cholesterol even in
individuals that have anorexia.
So we have, and if you havethat plus an elevated shbg,

(32:46):
you've got a whole story theretelling you that the client may
not be eating enough food yeah,yeah, brilliant.

Speaker 1 (32:53):
Well, speaking of food, I know um, again coming
back to bioindividuality thatthere might be some nuances for
people as far as macronutrient.
You know ratios, micronutrientprofiles, but can you walk us
through what you find to be timeand again applicable in acne

(33:14):
patients, maybe more across theboard than otherwise?

Speaker 2 (33:18):
Yeah, absolutely.
I generally try to educate myclients on diet in three kind of
categories.
So one is making sure thatwe're actually correcting, like
nutritional deficiencies in thediet, so making sure that
they're actually eating enoughantioxidants and such to be able
to support their skin, whilstalso correcting deficiencies we

(33:39):
can see in the bloods.
And the reason that I gothrough that is, of course,
because the skin is the lastplace to get our nutrients and
if we're nutrient deficient, ourskin cells every single day
they're developing new DNA andthey're growing and they're the
skin cells we're going to see onthe surface in six weeks time.
So if there's insufficienciesin things like your b vitamins,
vitamin a, your zinc, evencalcium, that's all going to

(34:02):
significantly impact the healthand the function of that skin.
So I'm often working withclients to try to increase
diversity in the diet and tomake sure that they've got
enough fuel nutritionally to beable to support the function of
the skin cell.
The second aspect is, of course, optimizing blood sugar
regulation and I find thatthat's just crucial, even if it

(34:22):
isn't an insulin resistance,pcos kind of case, because let's
say, for example, it's a clientthat's got a very stress driven
acne.
We all know naturopathicallythat a healthy, stable blood
sugar helps to support thenervous system, to feel calm and
feel safe, and you'resupporting your adrenals in that
way as well and, with that,optimizing the blood sugar.

(34:43):
That's where I have a very bigemphasis on clients making sure
they're having at least 30 gramsof protein with every meal,
particularly making surebreakfast is a priority as well.
I know that there's a lot ofindividuals that will educate on
making sure every meal andevery snack is protein rich,
which I understand because it'sso important because we need

(35:05):
protein to synthesize new skincells and so on.
But I think if we can reallyaim for getting three protein
rich meals in a day at least 30grams each then that's that's a
really great goal to aim towardsand, of course, try and
optimize, if it is a blood sugarissue, to focus on those low
glycemic carbohydrates as welland generally, with that I'm

(35:29):
often advising if they're goingto be eating sweets, have a
sweet after a meal to try tooptimize that blood sugar
response.
If you're going to be having alarger carbohydrate meal and
you've got blood sugar issues,to go for a stroll or something
afterwards to help with themetabolism of the glucose um
yeah from a blood sugarperspective.
That's generally the factors ofwhat we're looking at, and then,

(35:50):
finally, there's the wholeinflammatory aspect of it.
So trying to balance theomega-3 to the omega-6, which is
where, of course, we're lookingat increasing essential fatty
acids omega-3, so like yoursardines and mackerel, herring,
anchovies and so on and thenalso looking at reducing omega-6
, which is going to be fromcanola oil, sunflower oil.
I know a lot, of a lot ofindividuals then start to become

(36:13):
, have a have a fear around foodand they're like well, that
means I can't eat nuts and Ican't eat this, I can't eat that
.

Speaker 1 (36:19):
But it's all just about the balance and the
quality and the source thatyou're getting from as well yeah
, I think that's importantbecause it can feel a bit
overwhelming looking at it all,which is why you put together
the Clear Skin BlueprintMasterclass, which I just want
to quickly mention.
It's something that Jacindacreated for clients.

(36:40):
It's a 90-minute masterclass, Ithink it was, and really just
summarizes all of those keyprinciples and provides that
information to clients outsideof the one-to-one setting.
And you can actually accessthat straight off Jacinta's
website, which we have in theshow notes.
And although it is for clients,if you are a practitioner who

(37:01):
is looking to learn more in thespace, jacinta welcomes you
signing up for that too, tolearn a bit more.
But the other I guess importantthing to share here is there is
going to be practitionertraining later in the year from
Jacinta on acne specifically.
So if you do want to sign up tobe notified about that, the
link in our show notes to signup to her newsletter will give

(37:24):
you access to that.
And the only other thing I justwant to share from my own
clinical experience is circadianeating as well, which is like
just a whole other layer ofblood sugar balance.
But our insulin sensitivity isalso dictated to by light and
dark environments and eating oneparticular meal under blue

(37:48):
light and the same meal outsidein sunlight has quite different
and profound effects on bloodsugar as well, and that's
probably really like a phase twothing.
Like getting those coreelements right is always the
place to start.
But I think, because so many ofus work indoors and we spend we
spend 95 of our time indoors,you know, I'm noticing that some

(38:12):
of that uncoupling of bloodsugar and insulin sensitivity is
partly a result of non-nativeemf and and blue light exposure
too.
So if anyone's listening tothis and they're like tick, tick
, tick, tick, tick, I've doneeverything you've just mentioned
, then I would be starting to goa bit deeper and looking at
your circadian biology, timingof eating you know that kind of

(38:35):
thing as well.
But once you get those corebasics right, that's when we can
look at how do we support thosereally important like dietary
elements with you know this thejudicious use of supplements and
my gosh, we're so lucky to haveso much to choose from Um and I
know at Arenda health you'vegot your own compounding

(38:58):
dispensary, which means you'rein the you know, a wonderful
position to actually customizeformulas for clients um on site,
which I just think is sobrilliant, and I'd love it if
you would take me through maybesome of your favorite
ingredients and like where yousee those applied and a few that
I would love to hear you riffon.

(39:19):
Are you know, myo-inositol PHGG, where you might use broccoli
sprout, or glycine or calciumduclucarate?
What are?

Speaker 2 (39:28):
your.
What are your favorite?
favorite children, absolutelyyeah so we I guess a lot of the
clients of what we see ifthey're presenting with more of
like a hormone, a hormonal kindof acne.
A classic formula of what wewould put together would be kind
of similar ingredients, likeyou said and also told.
We would use broccoli sprouts,we'd use calcium to glucurate,

(39:51):
we'd also add in some zinc, we'dalso add in some dim, and
that's essentially because we'retrying to work on all those
specific areas of optimizinginsulin receptor sensitivity
with the insulin.
That was sorry, with theinositol.
That really helps to get thatglucose into the cell.
And then we're working on thingslike supporting those phase two
detoxification pathways andsulfation, specifically when

(40:13):
we're looking at things like thebroccoli sprout extract and
that is really helpful whenwe're looking at things like an
estrogen dominance or even atestosterone excess issue.
And plus the DIM that's in thereas well.
That DIM is extremelysupportive for supporting that
detoxification pathway's inthere as well and that DIM is
extremely supportive forsupporting that detoxification
pathway via the liver as well.

(40:34):
Then the PHGG is amazing as oneto add in, because we know PHGG
works incredibly well forsupporting blood sugar
regulation when you're having itwith a meal because of the
fibre and the slowing of thegastric emptying as well, whilst
also helping with supportingbowel motion regulation and gut
microbiome balance as well.

(40:54):
So it ticks quite a few boxeswhen you're thinking of a client
that might have constipationand detoxification elimination
issues whilst also having bloodsugar problems.
That, alongside of those othernutritionals that we just
mentioned, can work incrediblywell.
And then, of course, most ofour clients get a zinc in their
compound formula because we knowhow important it is for

(41:16):
supporting the aromatase enzymes, for supporting the
antimicrobial properties that ithas within the skin and the
skin repair, as well, beautiful,such a lovely place to start.

Speaker 1 (41:29):
And of course, nutrition always comes first,
over and above herbal medicine,because you can't.
Your enzymes literally needminerals to function.
But once you've covered thosebases, of course herbal
medicines can be incrediblypowerful to up regulate or down
regulate enzyme activity wherewe see it's required.

(41:50):
What are some of yourfavourites in your herbal
dispensary?

Speaker 2 (41:54):
Yeah.
So I'd say the most popularones that we have would be
burdock, peony licorice, oregongrape and gosicola.
They're probably the ones thatare used the most in our
clinical practice, reason being,I guess, that peony licorice is
that classic combo for whenwe're seeing like an
androgen-dominant type of acne,alongside salt palmetto that

(42:15):
will be added in there as well,of course.
But again, the herbs are reallyspecific based on what the
hormonal profile is actuallyshowing us as well.
And then the Oregon grape.
We love that because it helps toact as an anti-inflammatory for
the skin when we can see thereis more of those painful cystic
type of breakouts.

(42:36):
But because Oregon grape alsoworks as an antibacterial, it's
also working on the fact thatacne is an excess proliferation
of C acnes bacteria.
Although we don't love to treatacne as, oh, it's an infection,
just kill the bacteria and it'sgone, because that's very

(42:57):
reductionist in its approach, wedo recognize that the immune
system needs a bit of a helpinghand to try to support those
deeper cystic breakouts.
And that's where thecombination of something like
oregon grape and burdock workreally well together, because
you've got burdock in there tosupport the lymphatics and to
support the immune system whilstthe oregon grape works its

(43:18):
magic as the anti-inflammatoryas well, and then having the
rest of the herbal formula beingmade up by the specific
hormonal issue that's present.

Speaker 1 (43:28):
Well, yes, of course, as you mentioned earlier, like
sometimes, it's easy to assumeit's hormonal or, in particular,
it's androgen-driven, when inactual fact it's not.
It's just you can look that wayon the surface, but when you
actually look at what'sunderneath, you realise that's
not the case, in which case, ifit's not hormonally driven,

(43:48):
you're not going to be includingherbs herbs for hormones, I'm
sure, um, but I'd love to hear abit more about where you see
gotu kola playing into this yep.

Speaker 2 (44:01):
So we love gotu kola when we're thinking about
specifically tissue repair.
So when we can see clients aremaybe even going through that,
stepping into that route ofdoing more skin needling so
their skin they're actuallytrying to work on the scarring
aspect.
And for those that may not beaware, skin needling it's
essentially a process, a methodthat's used by dermal clinicians

(44:23):
and skin therapists to try toinduce inflammation in the skin,
to provoke an anti-inflammatoryand immune response, to get the
skin to heal and to supportrepair and helps with collagen
synthesis and so on.
And we find that gotu kola canreally help with supporting that
aspect of it.
So to support the rate of acnerepair.

Speaker 1 (44:44):
Yes, that makes perfect sense.
So from a prescription point ofview it sounds like I'm
generalizing greatly here, butclients will almost always get
zinc, maybe inositol, somethingfor liver detox, maybe PHGG for
elimination and microbiomesupport and then a custom herbal

(45:05):
blend which is going to addressthose drivers.
So if it's hormonal we'll seehormonal regulating herbs.
But we've got so many othertools in the toolkit and of
course I think probably everyclient will get essential fatty
acids to try and correct that.

Speaker 2 (45:20):
Without a doubt, yeah , yeah, yeah, absolutely,
because you know you could beworking on trying to reduce the
hypersebum secretion with, youknow, hormone regulation or
working on the stress responseor whatever that might be.
But if the sebum viscosityisn't addressed, then the oil
that's still going to beproduced.
It could be produced within anormal rate, but it's still

(45:42):
thick and it's still going tocause congestion in the skin.
And I think that's where it'seven important for us to
recognize that a blackhead isessentially a pimple in the skin
.
And I think that's where it'seven important for us to
recognize that a blackhead isessentially a pimple in the
making.
It just hasn't become severeenough to actually cause a
breakout.
And that's where, if we'restill seeing that clients are
saying there's a lot ofcongestion in my skin, then we
can see that that reallyrequires the essential fatty

(46:05):
acids to step in.

Speaker 1 (46:07):
Yes, yeah, I think a lot of people are shocked to
learn that oily skin is usuallydehydrated and the oil can
sometimes be a bit of acompensatory mechanism in some
ways to try and prevent thatwater loss.
But actually allowing the rightessential fatty acids to
provide a healthy hydro lipidfilm will then help regulate the

(46:28):
sebum and it's kind ofhilarious really that it's oils
that's regulating oil.
But yeah, that's right, yeah,it is what it is.
Um, I'm gonna ask you aboutlifestyle in a moment, because,
of course, taking a holisticapproach, that's always really
important.
But you did just mention thatgo to COLA as one of those ones

(46:49):
that you think, oh, let'ssupport tissue healing If
they're, say, doing skinneedling, or maybe they're
having sclerosing agentsutilized in, maybe deep
pockmarks or you know more heavysort of scarring situations.
And one of the things that Ireally love about your practice
and your approach is howintimately you work with dermal

(47:10):
therapists, and I wanted to justtouch on this for a moment
because there's a couple of keyelements that I want to just pop
in this conversation before weend it to.
You know, I guess bring thisinto an awareness for
practitioners who are working inthe skin space about just how
powerful it can be to workcollaboratively and what that

(47:30):
looks like and why you wouldwant to do that.
Because it is that, again, as Isaid at the start of our chat,
the blessing of the skindisorders is that you can apply
things topically and you can dothings topically that are really
powerful also.
So will you talk me through,like how you began collaborating

(47:52):
with skin therapists and dermalclinicians and, number one,
what you look for in terms ofthe way they approach skin,
because of course, there aredifferent avenues you can go
down and that break down theskin barrier versus preserve and
protect it.
And also, for a clinician who'sworking in this space, like how

(48:15):
they should expect that to lookand ways in which you'd
recommend they approach dermaltherapists.

Speaker 2 (48:20):
Yeah, absolutely so.
Essentially the way that itstarted was similar to like how
I mentioned before.
I was working in the educationspace with a lot of skin
therapists and then I started mypractice and essentially from
there they were like we need ourclients, someone to go to to do
all the internals, and that'swhere that kind of rapport
building really began, and a lotof my Instagram is actually

(48:43):
tailored around education, justin general on the skin.
But it also then sparked theinterest of a lot of dermal
clinicians and skin therapistsbecause they could see that
there was a gap, that there'slike right, we're doing
everything we can, there'ssomething going on, and I guess
it's because there are such a.
You know, there's a largedemographic of skin therapists
and dermal clinicians that thinkfrom a holistic perspective and

(49:06):
understand that the skin is aliving organ.
It doesn't need to be strippedand peeled and killed and so on,
and that treatment needs to befocused on identifying the
internal drivers.
So a lot of our practice wehave a really strong standpoint
and it's something that Icontinuously always speak about
with Arenda is that we do nottouch the topicals, and I think

(49:28):
that's really important whereyou're identifying your scope of
practice and understandingwhere you need to collaborate
with your client, with your um,with another skin therapist for
your client.
And I guess it's just like withanything.
If we thought, you know, ourclients needed to see a physio,
we weren't, we wouldn't all of asudden youtube how to, like you
, you know, relocate this in aperson's body.
Like you know, you wouldactually refer them to a physio,

(49:51):
and it's the exact same when itcomes to the skin.
The unfortunate thing is, ofcourse, with the nutrition and
the naturopathy degree.
We do cover skin, but we do notlearn it in the lengths of a
dermal clinician or a skintherapist.
That is their specific focusand I think we don't know enough
like we don't know near enoughto be able to understand how to

(50:14):
identify what type of cleanserthey might need, the type of
moisturizer they might need, theserum that they need.
And we know a lot aboutinternals, but we shouldn't have
to take on the responsibilityof the externals as well.
So this is where, with ourclients, I'm always having
honest conversations with myclients.
If they ever have any questionsto say, what do you think I

(50:35):
should do with my topicals, Ijust straight out say it's not
my area.
I know people that can help youand I know that they're going
to work incredibly well for you.
But I would be doing you adisservice if I tried to tell
you what type of skincare to do.
And I think that's reallyimportant because, from that
perspective, like there's somepeople that can think, oh, you
know, from a businessperspective you could be taking

(50:56):
them on and doing topicals.
But I don't care about thataspect because my care is making
sure that the client has theright practitioners on their
team and, especially whenthey've been suffering with the
skin condition for so long, theywant someone that they know can
get to the root cause from atopical perspective very quickly
.

(51:18):
So with that, the main thingsthat we're looking for are skin
therapists and dermal cliniciansthat focus on maintaining and
restoring the skin barrierfunction, and what I mean by
that is you'll see a lot ofclients that will be focusing on
doing, you know,microdermabrasion and peels and
dermaplaning and excessexfoliation.
I've had some clients thatexfoliate four times a week and
it's like their skin isconstantly trying to repair and

(51:41):
rebuild, but every two daysthey're going, they're stripping
and stripping and stripping.
I guess if we were to thinkabout it from a similarity of
the gut.
Our gut microbiome, you know,tries to maintain a healthy,
happy environment.
And then when we put alcohol oranything like that into the gut
, that impacts the gutmicrobiome, which we know is

(52:01):
counterintuitive to supporting agood, healthy gut microbiome.
And it's the same with the skin.
Skin conditions start becausethere's a skin microbiome
imbalance and that there'ssomething wrong with the skin
barrier function.
So anything topically that'stouching the skin can impact
that homeostasis of a good,healthy skin microbiota.

Speaker 1 (52:21):
So the treatments of what we try to focus are on skin
therapists that have a veryholistic approach in their way
that they're treating andpossibly also making sure that
the skin therapist is on boardof knowing that the internals
have a role, but it's also notan overnight thing as well yes,
I have a really importantquestion to ask you around

(52:43):
expectation management, whichI'm going to just save for just
a moment because I want to justlastly touch on lifestyle for a
moment, and that is, you know,obviously a holistic approach
does require us to assess wherepeople might be living in a way,
or have developed habits thatare counterproductive to, you

(53:05):
know, skin health, eitherdirectly or indirectly, and so
I'd love to hear about what yousee come up time and again for
acne patients as well, and whatkind of lifestyle
recommendations you often findyourself giving in that case.

Speaker 2 (53:21):
Yeah, I think we can see people that sit on
completely different ends of thescale.
Sometimes we can see theindividuals that they get up,
they go to work, they come home,they go to bed and there's
nothing in between in terms ofexercise or sunlight and the
sleep quality is not great andthey're not feeling happy with
their kind of environment inthat way and their schedule of

(53:42):
how they're running.
And then, on the opposite endof the scale, you see the people
that are waking up at 3 am tofit in the gym, their steps,
their breakfast, their morningroutine that's supposed to
counteract all their stress, andthen work and come home and
then just the excess.
You know the type of case thatyou can see of a client where

(54:03):
they're excessively running,that go, go, go type of energy.
Running that go, go, go type ofenergy.
And our ideal goal of ourlifestyle change is, you know,
for that individual that'spresenting with that go, go, go
is how can we change yourschedule to help you to actually
slow things down so your skinactually has time to repair, so
your hormones can balance alittle bit better and so we can

(54:25):
actually get the body to feel abit safe?
And then, in the other end ofthe scale, when we have a client
that might just get up, go towork no sunlight, no exercise,
maybe not eating home-cookedmeals how can we shift their
lifestyle to kind of be thatmidway in between?
and they can incorporate moreexercise to support their

(54:46):
lymphatics, because the poisonwith anything is in the dose
right Like exercise is great,but you do too much and it's a
problem.
You don't do enough and that'sa problem you know, there's.
It's the same with being able to, you know, be too social,
you're too social.
That's, you know, can be aproblem for some, and then not
having enough social life is aproblem as well.
So I think, when it comes to tolifestyle, it's about finding

(55:08):
out where your client sits onthat scale and then being able
to find a healthy dose of thelifestyle things that are really
important for them.
And, of course, sleep is anessential one, um, making sure
that they're getting really goodquality sleep.
So, whatever lifestyle that isthat they live, that they're
having enough time to wind down,get good quality sleep, wake up

(55:29):
not feeling excessivelystressed or that they're anxious
as soon as they wake up,because their sleep quality is
obviously so important forgetting their hormones balanced
and that's where a lot of repairhappens.
Like, melatonin is one of thebody's most natural antioxidants
.
It's so powerful and if you'renot sleeping enough, then that

(55:50):
can have such an impact on theskin as well.
So our lifestyle factors isdefinitely trying to find that
healthy balance with good, goodexercise routine, good sleep and
, of course, good, good methodsof stress reduction and
management as well.

Speaker 1 (56:08):
Yes, it's such a so lovely to capture all of those
different elements that comeinto a holistic strategy, and
you mentioned, you know, givingyourself enough time to allow
your hormones to rebalance, andI think this is probably a
lovely place to wrap up ourconversation, and that is we
live in a day and an age ofinstant gratification, and

(56:31):
sometimes, certainlypharmaceutically or
allopathically, we can produce aswift result, albeit, you know,
maybe temporary if theunderlying causes haven't been
addressed.
And so one of the challengeswith taking a root cause
approach is that it most oftendoesn't result in overnight
results, and it can be.

(56:53):
I think skin stuff, more thananything, is incredibly
distressing maybe nausea andpain as well but the degree of
suffering, because it's visibleto everybody else, can make
clients really anxious to seebig changes really quickly, and
I think it's important you knowwe don't conclude this
conversation without talkingabout what kind of timeline

(57:15):
should we expect, and alsounderstanding that it's not
binary that you're going to goto sleep with bad skin one day
and wake up with good skin thenext, there's a.
There's a spectrum of healingand perhaps other green flags or
signposts along the way thatindicate you are actually on the
right track and you just needto keep going and stay the

(57:35):
course.
So how do you couch that toclients, like, what do you say
to them?
Obviously, everyone'sindividual.
I'm sure you can see from howsevere something is.
You'll have a rough timeline inmind, but just generally
speaking, how do you manage that?
What do you say and what do youreally put on the table for
clients to consider as theystart their skin journey?

Speaker 2 (57:58):
yeah.
So first I love to take amatter of fact kind of approach
with my clients and I'm veryfactual with things and I'm very
factual with things and I thinkthat's important so they can
feel like they have a plan thatthey can follow and they know
exactly the timeline ofpotential things.
And first, it's important tolet our clients know the fact
that a normal skin cell turnoveris about four weeks in a

(58:18):
condition or as you get older,that can extend in its time,
which means our body right nowis making the skin cells that
are going to show on the surfacein possibly about six to eight
weeks time.
So if you're trying to work oncorrecting your skin, everything
we're doing right now is goingto be impacting the quality of

(58:39):
the skin barrier, the quality ofthe sebum production, your
hormonal status in the skin or,even longer actually, if you're,
hormones, in six to eightweeks' time.
So anything that you're doingright now you're not going to
see in seven days' time, you'regoing to see it in six to eight
weeks' time.
Even the pimple you see nowthat started its way six weeks
ago and that's where it'simportant.

(58:59):
Even when clients are goingthrough flares, it can be maybe
immediately.
They drank a lot of alcohollast night and their skin's
dehydrated and it's moreinflamed.
But those pimples would haveprobably started their way six
weeks ago anyway.
And first I lay that out to myclients.
I'm like right, these are thefacts of skin cell turnover.
So let's wait at least six toeight weeks' time.
That also means during thatperiod of time I don't want you

(59:23):
to change your skincare and gorogue and try different things.
Because how do we know ifyou've had a flare is because of
something internally or becauseyou've tried to change skincare
in between?
And again that brings me backdown to expectations of clients
knowing you need to see a skintherapist that's guiding you
through everything, because theyprobably won't change your
skincare all that drastically ina six week period of time as

(59:44):
well.
So, first I'm discussing withthem the skin cell turnover.
The next thing that I'm gettingthem to understand is that
hormones take a minimum of threemonths to see change, just like
with any of our clients.
When we're thinking aboutpainful periods or regular
periods or PMS or anything likethat, we're usually giving them
a timeline of about three months.

(01:00:04):
And that's the same as whenwe're working with our clients
with a hormonal skin conditionand with them it's important to
recognize.
I might see you for your firstappointment in Feb, but you
might not get your bloods doneuntil April and then we're
finding out your hormonal issuethen and then you can count
three months from thatparticular point of time to work
on your hormones.

(01:00:24):
but the thing, that I alsoreiterate to clients is when
you're seeing a before and afterphoto on TikTok or Instagram,
you're not seeing week onecompared to week four.
You're seeing week one comparedto like six months later, and
that's not an overnight thing.
So generally, when we'relooking at improvements in the
skin, we're seeing well is, thismonth maybe there's less

(01:00:47):
severity in terms of thebreakouts, maybe there was the
same amount of breakouts, butthis month they weren't cystic,
they weren't painful, they weremaybe a little bit more surface
and they were easier to control.
Maybe this month when thebreakouts came up, they came up
and they turned over veryquickly and they didn't linger
for weeks and weeks.
Maybe this time when thebreakouts came up, they were

(01:01:07):
still severe, but there was lessof them.
So we're kind of looking forchanges in the patterns of the
breakouts rather than saying isit completely clear, did you get
a breakout?
Or if you've got a breakout,that means it's not working.
No, it's still working it justmeans that we're looking for
slow, like the other, signs ofprogression as well and for some
clients.
It can also be that I'm gettingthem to take a photo one month

(01:01:30):
of their skin before theirperiod if that's their most
problematic period of time andthe next month or maybe the
following month, they'recomparing that photo to the same
period of time because ifyou're comparing your like
post-period ovulation skin toyour pre-period skin.

Speaker 1 (01:01:47):
It's going to be a very different type of pattern
if your breakouts arepremenstrual as well so I think
having a formal measurement foryour client is also really
important, whilst also settingthe expectation that we're
looking for signs the skin ishealing, rather than is there a
complete resolution overnightyes, I think that's a wonderful

(01:02:08):
way of actually monitoringthings and, in particular,
making sure before and aftersare consistent with the cycle
day that they were taken on too,and maybe that means two
bookmarks a month you know apre-ovulatory and a you know a
mid-luteal or whenever theirmost problematic time is and
counting the amount of you knowcomedones, pustules, and taking

(01:02:32):
those sort of before and afterpictures.
The same position, same time ofday, the same kind of lighting.

Speaker 2 (01:02:38):
Same lighting yeah.

Speaker 1 (01:02:39):
Yeah, so that they can be monitored.
And I think, yeah, I thinkthat's really lovely to be able
to say, you know, it's eitherless inflamed or there's less
breakouts or they're moving onquicker as green flags, um, that
you're heading in the rightdirection and understanding that
although skin, you know, sixweek every six weeks, is kind of
refreshing itself, the hormonaldrivers might be lagging behind

(01:03:02):
a few months too.
So it'll be, you know, it'll beincremental improvements, as
opposed to you wake up one daylooking, you know, with your
dream skin, although wouldn'tthat be nice yeah, I know it
would be a dream.

Speaker 2 (01:03:15):
Um, it would be, you know, I think that's where it is
important to have those photosand also, in saying that, making
sure you're then not becomingobsessive with that.
I know that I've had, you know,some clients where their skin,
it's their whole life, like it'swhat they think about all day,
every day, and what am I goingto do to fix this?
And I've had some clients that,on their own accord, will
decide to take a photo everysingle day, which I advise

(01:03:37):
against, because then you'reputting this energy every day
that it's like there's somethingwrong.
There's something wrong,there's something wrong or
you're picking apart your skin.
So, of course, take the photos,but don't take them every day
and, you know, maybe spacingthem out, like you said, in the
same conditions and certain daysof the month.

Speaker 1 (01:03:56):
Oh my gosh, jacinta, you're just such a wealth of
knowledge and really yourexpertise and experience in this
area just really shines through, and I just thank you so much
for your time today.

Speaker 2 (01:04:06):
It's been such a joy chatting with you.
Thank you.
Yeah, thank you.
I know we could talk for agesall about skin, but I appreciate
you having me on today yeah,thank you.

Speaker 1 (01:04:17):
Well, for those of you enjoyed um, jacinta's
naturopathic approach to acne,the links and resources we
mentioned are in the show notesof this episode.
And yeah, thanks again, jacinta, for your expertise and thank
you for joining us today.
Remember you can find all theshow notes and other podcasts on
the Australian Designs forHealth website.

(01:04:38):
I'm Amy Skilton and this isWellness by Designs.