I had an awesome client experience recently that solidified the connection of my nutritional therapy training to my skin therapy training.
I think I blew my client’s mind! I know I was super excited about what we discovered.
So you are probably wondering, “what does this even mean?”, “nutrition-based aesthetics”? What it means is, seeing the skin conditions present on the skin, and being able to connect them to the internal issues that your client tells you about, or connect them to the nutritional deficiencies that you see from their intake form and client consultation. When you have studied a science-based nutritional therapy course, you will be able to link the skin conditions you see, to the internal ailments the client describes. And if, in the state you live in, you are able to offer some basic nutritional adjustments, you will be able to make an even bigger impact in your client’s skin health, and maybe even see a faster result from your treatments.
Let me tell you about my client and our interaction.
CLIENT: Female, 48 years old.
- Spent her first 25 years on the East Coast, and in Kansas and Louisiana, at a time when people didn’t wear sunscreen. - Family background is Polish and UK, but no redheads in the family. She is able to tan and has burned before, but has never used a tanning bed.
- She works at a fairly stressful job and is taking meds for high blood pressure.
- She does not eat a low fat/no fat diet, but has had her gall bladder removed.
- Takes a high dose Omega 3 as recommended by her eye doctor.
- Has been taking Prilosec for reflux for 10 years.
- On birth control pills.
- Dermatologist told her she may have rosacea on face and melasma on forearms. (I saw neither).
- She uses Cerave cleanser, moisturizer, sunscreen, and eye cream, and Mad Hippie Vit. C/HA serum. - She drinks a lot of water, but has (according to her) “puffy eyes, uneven skin tone, and large pores.”
Everything she was saying about her skin was beginning to make sense when I heard about her ailments and medication usage.
1. Because she has had her gall bladder removed, this immediately puts her at risk for having Essential Fatty Acid Deficiency (EFAD). Lacking fatty acids makes dendritic cells, such as the melanocytes, unable to stretch. And in the case of melanocytes, that means they will not be able to evenly distribute melanin. Remember her complaint? “Uneven skin tone”.
The other thing about gall bladder removal is that doctors will not tell clients that they need to replace their lack of bile contribution at the appropriate mealtime with a bile salt supplement, so they will never be able to adequately emulsify the fats they may eat, resulting in EFAD, and other gut problems. Or the doctor may tell the client to just eat a low fat diet from then on, which, again, results in EFAD. (And likely may have been the cause of them needing the gall bladder removal in the first place. The gall bladder is a “use it or lose it” organ” which helps to emulsify the fats eaten).
Now add in that she is taking a high dose Omega 3 prescribed by her eye doc (presumably for dry eyes). If she is not able to emulsify fats, it would make sense that she would have to take a “high dose” Omega 3, in order to even “try” to get ANYTHING from consuming it. If you can’t emulsify fats, how can you absorb Omega 3 fatty acids?
*Recommendation: Even without a gall bladder we still need essential fatty acids, but we need something that can be emulsified in our lessened-bile state. I learned from a very sick client, who not only had her gall bladder removed, but also had her stomach partially removed, that there is an emulsified form of Omega 3 called Coromega (brand) that they all take because it is an easily digestible form that doesn’t cause distress on their compromised system.
Anyone without a gall bladder should also be taking a Bile Salt supplement at every meal, particularly a meal that contains fat, and all meals SHOULD contain fat.
A very simple, easy, and natural recommendation for someone without a gall bladder is to recommend coconut oil or palm oil to be eaten daily, whether by the spoonful, in foods, or used as a cooking oil for foods. Coconut oil and palm oil do not require bile to be emulsified and digested by the body, but they will provide the necessary essential fatty acids, that are lacking.
All of these recommendations should help to even out skin tone, as well as strengthen skin cells, and improve barrier function.
2. Her “potential rosacea,” was just a comment in passing from the doc, not an actual diagnosis, but looking at her, I was saying “no” to active rosacea, and started thinking about how I was going to help her avoid even getting rosacea. As I looked at her chart and saw the Prilosec, I knew it was going to be an interesting conversation, especially since she has been on it for 10 years.
Prilosec is a Proton-Pump Inhibitor, one of the most potent types of acid blocker. Taking acid blockers for reflux is the wrong answer, because reflux is usually caused by TOO LITTLE stomach acid which reduces the stomach’s ability to break down food in a timely manner. This inhibited breakdown leads to proteins putrefying, fats randicifying, and carbs fermenting, while still in the stomach. The resulting gasses can cause food particles and what little stomach acid may be in the stomach to reflux into the esophagus (the original problem). This should be addressed early on by adding HCl to the diet, NOT by adding acid blockers which compound the original problem, which is too little stomach acid. It has been known by the medical community since, as far back as, 1925 that rosacea is a result of low stomach acid.
So my client, though not presenting with full blown rosacea, is definitely on her way to it if she doesn’t do something about her digestion. But since she has been on acid blockers long term, the best I could do for her was to recommend a consultation with reknown stomach acid doctor Jonathan Wright, MD of the Tahoma Clinic in Kent, WA. Because the likelihood of her own doc, who prescribed the acid-blockers in the first place, knowing anything about low stomach acid or how to get her off the meds is slim to none.
Another aspect of low stomach acid is the vitamin and mineral deficiencies associated with not breaking down macronutrients. Vitamin A, Vitamin B12, Zinc, Iron, Calcium, are all deficient when there is a lack of stomach acid. And interestingly, zinc is required to make stomach acid, but you have to have stomach acid to absorb zinc.
In addition to Prilosec which causes protein deficiency, and Vitamin B12 deficiency, she takes high blood pressure (HBP) meds (for stressful job?) and BCPs (birth control pills). - Lisinopril, the HBP med, causes deficiencies of Calcium, Magnesium, Potassium, Zinc, CoQ10, and sodium. - BCP causes deficiencies of B Complex, Vitamin C, Magnesium, Zinc, and selenium.
Notice the vitamins and minerals in bold that are especially deficient from multiple inhibiting sources?
*Recommendation: Consult with a doc who is a specialist in low stomach acid and getting off acid blocker meds. Work on healing the stomach with cabbage/cabbage juice/cabbage supplement (vitamin U/ methylmethionine), squash and yams, cooked greens, fermented foods and bone stock/broth. Gently assist the stomach to create its own stomach acid by eating more bitter greens, or taking digestive bitters available in a tincture, and/or drinking a digestive tonic made from apple cider vinegar, lemon juice, and honey. (See pic below).
Additionally, the emulsified Coromega omega 3s will be anti-inflammatory to help reduce the inflammation that underlies rosacea. For a client who still has their gall bladder, regular liquid cod liver oil is recommended.
And lastly, recommend that the client eat their food in a relaxed state with no stresses surrounding the time of food intake. It is critical to be in a parasympathetic state during meals, or the process of digestion will not be initiated. Digestion does not take place in a sympathetic (fight or flight) state. Sitting down, deep breathing, and calming aromatherapy can induce the parasympathetic state.
All of these recommendations should help to reduce the inflammation that caused this particular client to present in rosacea, or beginning rosacea symptoms.
3. Client rates her job as a logistics planner for an international tech company as relatively high stress which puts her into a chronic sympathetic state. And how does that affect her digestive state? Which leads to… potential for rosacea. Isn’t it amazing how it all starts to come together?
So let’s summarize by skin condition reported: Rosacea - Client has a high stress job that may contribute to a chronic sympathetic state (fight or flight) which will inhibit her digestion and ability to produce stomach acid. Low stomach acid results in foods rotting in her stomach and the offgassing causes reflux, for which her doctor prescribed acid blockers which just compounded the problem. Inhibited digestion and low stomach acid are known to trigger rosacea in those predisposed to this presentation. She may or may not develop full blown rosacea, but she definitely has internal inflammation going on, from stress, which starts a domino effect of other issues, which would also include her complaint of puffy eyes. Uneven skin tone/(EFAD)/melasma - She also has no gall bladder and is not taking any bile salts to help with emulsifying any fats in her diet and this causes Essential Fatty Acid Deficiency, which can be seen in the shortening of dendrites in her melanocytes, limiting their ability to create an even pigmentation of skin. EFAD also presents in a compromised barrier and keratinocytes which will contribute to the previously mentioned rosacea. She takes high dose non-emulsified Omega 3 which may or may not be getting absorbed, but based on pigmentation issues, not likely. Additionally, she has pigmentation sustained as a youth in a southern state with no sunscreen protection, and at 48 years old, has had many years of environmental exposure plus the inevitable intrinsic dermal aging, oxidizing cells, and large pores.
Finally, she is using Cerave Skincare. At this point I am just thrilled she has a full skincare regimen that includes eye cream, and it isn’t Cetaphil. At least Cerave has the barrier repairing ceramides in it, and I let her know that for a drugstore choice, she did well.
For her treatment I chose to do a nutrient infusion for sensitive skin. We used an Omega-3-rich oil cleanser; a gentle papaya gel enzyme; a gentle ultrasonic nutrient infusion that contained ceramides, zinc, and cholesterol; a flower blossom mask of arnica and calendula blossoms and azulene; a hydrating treatment toner; boswelia and linseed nanoparticles; and a magical moisturizer containing peptides, stem cells, ceramides, cholesterol, Omega 3s, GAGs, rose oil, and vitamin C.
I sent her home with a sample of the Omega-3-rich oil cleanser, and a whole page of notes she took during our consultation. She placed an order for bile salts and booked another clinical nutrient infusion with a red LED treatment for 3 weeks out, and told me she was going to call Dr. Wright.
"The Renegade Esthetician" Cassandra Lanning, LME, NTP, CPE, CLT
Cassandra is a Master Esthetician and Nutritional Therapy Practitioner in the state of Washington. She has 20 years of experience in the beauty industry including electrolysis, laser hair removal, skincare, nutrition, and teaching. She is a member of the International Association for Applied Corneotherapy, the Association for Holistic Skin Care Practitioners, and the National Aesthetic Spa Network. WWW.THERENEGADEESTHETICIAN.COM