266: Decoding Skin Health, Eczema, Acne, and More With Jennifer Fugo

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Katie: Hello and welcome to “The Wellness Mama Podcast.” I’m Katie from wellnessmama.com, and I’m here today with Jennifer Fugo who is a clinical nutritionist empowering women who have been failed by conventional medicine and who are trying to beat chronic skin and unending gut challenges. And we’ll talk about her story today, but she’s overcome a long history of gut issues and eczema, so she has empathy and insight to really help dig in and create integrative plans for healing. She founded skinterrupt.com to interrupt the failed conversation about chronic skin problems with helpful alternatives that you aren’t being told by many doctors and practitioners. And she has a master’s degree in human nutrition from the University of Bridgeport and is a certified nutrition specialist. Her work has been featured on “Dr. Oz,” Reuters, Yahoo, CNN and all over the Internet. And she’s also an Amazon best-selling author and the host of her own podcast “The Healthy Skin Show.” So, Jennifer, welcome and thanks for being here.

Jennifer: Well, thank you so much for having me, I’m very excited to be here.

Katie: I touched on it a little bit in the intro but I would love to start with your story because I know, for me, the reason that I am here doing this today is because I had my own health journey. And it sounds like it’s the same for you, so tell us your story.

Jennifer: Basically, I came to this whole world as a little bit of a fan, about 10 years ago. And I’d had a lot of gut challenges then, didn’t realize the connection between the gut and everything else. And I addressed that and I thought, “All right. I’m gluten-free, I’m dairy-free, egg-free. I’m good. I’m set for life, I just gotta stay on track and nothing could go wrong.” Except, when I was going through my grad school program, which is highly stressful, for anybody who’s going to school and working during the day, you know how much stress that can put on you, in 2016, I developed eczema. And I was shocked because it doesn’t run in my family, I don’t have allergies, there was no rhyme or reason to why that could’ve possibly happened. And what happened was it started on my hands and I got these little…I don’t even know what to describe them as other than these little clear balls underneath the skin. And I thought it was so strange, and they would get kind of itchy, but then, it would stop and I wouldn’t think anything about it. And then, as we moved into the summer, because I live on the East Coast and we got very humid hot summers, the areas of the skin where those little crystal-clear balls were began to become incredibly red and itchy. Insanely itchy to the point where I could not stop itching my skin, and that’s really when the rash started. And I began to get this oozing and the rash began to spread up the sides. Like basically the webbing of my fingers, all the way up onto the palms of my hands.

And that’s a really interesting point for people who have eczema in different parts of their skin. If you have it on the palms of your hand or the bottoms of your feet, it becomes a real challenge to be able to function like a normal person because we take for granted how often we utilize those surfaces. It’s just a routine thing. Well, when you can’t touch things anymore, when you can’t open a doorknob, when you can’t wash your hands because even water burns horrifically, it really changes your perspective of what it means to feel well, to be able to function like a normal person. Because I had to question whether it was worth it to touch anything, whether it be like my cats, papers, anything in the house. I couldn’t go to the gym anymore and I had to end up wearing blue gloves all the time, that I would get at Home Depot, to try to prevent my hands from getting wet or dirty because I couldn’t wash them, I couldn’t clean anything. I had a hard time showering, I couldn’t wash my hair. It was so frustrating. No matter what I did, nothing would make it stop.

And I was lucky in that my dad’s a doctor and he said, “Hey, you know, here’s a steroid cream. Use it sparingly and see if that helps.” And it did but it would come back after a few days. And so, I went to the dermatologist and the dermatologist told me, “Well, keep doing the steroid cream but you could try putting like some of this fanny cream. And you know what? To keep it from drying out, put some vaseline.” Now, I don’t know about you but I don’t feel comfortable putting a petroleum-based chemical on my hands. I realized that they use that in hospitals and things but I just was not comfortable with that. I had open wounds and such. It was just very sad that this was the state of the best that I could get from a doctor.

And so, you know, I repeatedly tried different things that I read online and nothing would really help. I tried salves that I bought at Whole Foods. I had my sister, who’s an herbalist, to make me up tinctures to try that. I was just desperate because I had found myself waking up in the middle of the night scratching. I had gashes sometimes on my hands because I gotten so itchy. And, in the wintertime, I had the further unpleasant experience that it went from being incredibly red, inflamed, burning, oozing, itchy to this incredible dried-out scenario where my skin would break every time I would bend my fingers. And it was just so ungodly painful.

And so, I got to the point where people didn’t want to touch my hands, people didn’t want to eat the food that I was making. Obviously, my immediate family understood what was going on but strangers were uncomfortable, which I understood, I would wear gloves when I would cook, but still. And I started to think like, “I’m going to grad school to help people and here I am completely helpless. I don’t know what to do and I can’t get answers anywhere.” And probably one of my darkest moments was when my husband stepped in and he’s like…you know, husbands are there to support you, and he says, “You know, honey, like, have you looked at this from the perspective of, if you were your own client walking in your door, what would you do to help you?” I don’t know why I never thought of that. I think that’s sometimes why I always think like us, as health practitioners and such, we should always reach out for help because sometimes you’re too in it to really see all the options.

And that was the moment that really changed everything because I began looking at my skin problems through a much different lens and realizing that the skin problems and the skin symptoms were just that. It wasn’t that I had eczema. I mean I did have eczema, I actually had dyshidrotic eczema is the form that I had. But what if that was the body’s way of saying, “Hey, there’s something underneath that is manifesting in the skin.” And while you’re only paying attention to your skin, other things underneath the surface need to be looked at. You need to put a microscope in your body and say, “Okay, let’s look. Let’s look and see what exactly is going on.” And that’s where everything really changed and I began tinkering with a bunch of different things and created a protocol for myself. And it took about six months before my flares stopped, finally. And then, around the, like, eight to nine month mark, I started to see some really significant improvement. Around the year mark is where my skin was completely…I would say mostly normal, I still had some dry patches, but it was no longer itchy and flared. And then, it took another about six months for…three to six months for the nails to finally grow out. Because they had become quite wrecked from the eczema, it’s really interesting the damage that’s done to your nails.

So that was my journey and I realized, in that moment when I thought, “All right, I’m done,” I kept seeing images of people online who share in these Facebook groups about skin rash conditions, just the suffering and the pictures of babies who are crying, and I’m like “I’m not done. This was just the beginning, I thought that I was at the end but I’m not.” And that’s where the rest of my journey has since begun is realizing that mine was just introduction, and now, it’s this piece where I really wanna help people get connected with alternative options that their doctors aren’t telling them about.

Katie: I love that. And I think that’s the reason I always, you know, resonated with midwives sometimes more than doctors because they had had babies themselves and they could come for a place of understanding and empathy. And I love that you have turned what was very much a trial for you into a way to help other people. I think that that’s when we are our most powerful is when we can turn a really tough situation into a way to springboard and to create good in the world. And I know that there’s obviously a ton of factors that go into skin health, but I’m curious, from all the work that you’ve done and your own experience, what are some of the common hidden root causes that you find when it comes to skin issues?

Jennifer: Well, what’s interesting is that, again, the skin is not the main thing. There are some some factors to it that are important, genes for example. We can have some genetic snips that can cause issues in how a very specific protein, called filaggrin, is produced and that actually helps us maintain a healthy barrier. We could have drug reactions to different substances that can also trigger skin issues. You can actually have a trauma or become injured in a certain area and that can actually be a precursor to developing a skin rash in that particular area. So those are like some very obvious issues as well as just maybe having an exposure to Staph aureus, which is one of the types of microbes that can live on the skin. It shouldn’t really be there, if at all, however, in eczema or atopic dermatitis, it tends to overgrow. But dysbiosis of that microbiome… And for those listening, they’re like, “Wait, there’s a skin microbiome?” I mean obviously, if you follow the work from Dr. Maya Shetreat and some of the others who’ve really encouraged people to get back out into the dirt, we know that we have microbes living on us and in us. Which is amazing, there’s microbiomes all over the place and we’re learning more and more about them. But the microbiome dysbiosis is a major problem for skin issues. However, if we pull back the layers, we’re looking at a bunch of other issues that include diet and food reactions, gut microbiome dysbiosis, environmental allergies, nutritional deficiencies, autoimmunity. Gut dysfunction, and I separated out gut for a very specific reason because a lot of people with skin issues actually have some level of gut dysfunction, even if they’re not aware of it. Liver detoxification challenges.

And I wanna go back to the trauma piece, I know I said like, “Maybe you had an accident, you bumped yourself or you, you know, became injured in a certain area of the skin and it can make it more prone for that particular area to end up prone to having a rash or a rash condition down the road. However, trauma, in general, looking at like, “I lived in New York City during 9/11. That was a major trauma in my life,” and so looking back into the past and saying, “hey, am I carrying forth any of these traumatic burdens, whether they’re small or large,” that can certainly be a piece. Thyroid dysfunction, mitochondrial dysfunction, hormone imbalances, especially sex hormone imbalances, unmanaged stress, and then, heavy metal exposures as well. And I’m sure we’ll probably find others as I continue to delve into the research, but that’s how I’ve sort of created a little chart for people who are wondering what are some root causes to look for.

Katie: Yeah. I think that’s such a good overview. And you mentioned the skin microbiome and you also have used a couple connections that, like, I feel like tie into the gut microbiome as well. And I know, in your writing, you’ve talked about leaky skin, so walk us through some of the things we know about the connection between the gut and skin. And also, what does that mean “leaky skin”?

Jennifer: Everyone’s like, “Leaky skin. That sounds so awful.” It kind of does but it’s not a term that I coined. I initially read about it many years ago on Dr. Sarah Valentine’s website. And, you know, it hasn’t been written about enough, there’s been more articles that have come out about it but, essentially, what leaky skin is, and we’ll start there, and then, talk about the connection between it and leaky gut, is that your skin, when you think about what it is, it’s a barrier. Right? It helps protect us from the outside world. And so, we’re looking at a state of barrier dysfunction where, number one, we have moisture loss so we see that incredible drying, but you also have incredible irritation, inflammation, itching. Sometimes people end up with very awful wounds that can hurt and be quite painful. And typically, we’ll see this in combination with some sort of microbiome dysbiosis on the skin itself because the bacterial community is part of what keeps that tissue layer happy. And so, as I was saying, like with atopic dermatitis, for example, we’ll see an increase in Staph aureus, and that is not something that you wanna see. In other instances in a person who has, say, dandruff or seborrheic dermatitis, they’ll have this…well, we know it as an overgrowth of malassezia, which is a type of fungal or yeast infection, but, in fact, malassezia, it’s actually a really great commensal bacteria for the skin microbiome. And that’s a whole other discussion about that. And it should be there but there’s other factors that go on for it to end up being involved in this whole process of causing dandruff.

But we see this increase in internal inflammation, we see elevations sometimes in some people with histamine, whether they’re exposed to histamines in food or their body is, for whatever…causing a lot of histamines to be released. There’s also the exterior sort of more mechanical factors at play, so scratching or rubbing the area can also increase the state of leaky skin, poor thyroid function as well, because you see this reduced blood flow that ends up out the skin, and that reduces nutrients that end up heading out there to help us build our skin, because we build it from the inside out. It also reduces the waste products from those cells that are then removed. And, of course, we can’t forget that genetic component that I mentioned with filaggrin, filaggrin’s very very important and we can…I think some of the research, at this point, is indicating that about 30% of people who have some sort of eczema may also have this snip in filaggrin. However, that said, all of my research, and from talking to different dermatologists, is that if you itch, for example, which is really hard not to do when you have skin-rash conditions that are highly itchy, that in and of itself, combined with the internal inflammatory processes going on, actually cause an issue in how filaggrin is produced.

And so, that right there is an unfortunately perfect storm for people to end up with the state of leaky skin. And so, I mentioned, a moment ago, about the connection between the gut, so leaky gut and leaky skin. And obviously, one of the big pieces that is oftentimes overlooked in the skin, because we’re like, “Skin’s on the outside, gut’s on the inside. How are they connected? It doesn’t make sense,” for those of us who are a bit more in the know we know that the gut…it tends to be a huge root cause for many different conditions. And what is so cool is that, when we see a healthy gut, a gut that is producing a lot of short-chain fatty acids, so those are substances that your gut microbiome, its bugs, the healthy bugs, are producing as a result of fermenting fibers and such. We’re specifically looking at butyrate, though the other two short-chain fatty acids are important as well. But those short-chain fatty acids act as almost a communication-signal system that helps anchor basically how healthy and vibrant the skin microbiome is. So when we see this dysbiotic state where we have maybe too much e. coli, or we have outright infections, or parasites, or whatever is going on that is not in alignment with optimal health in the gut, we then see, a lot of times, this disruption between that connection. Because, if you don’t have enough butyrate being produced, you are going to have a problem anchoring the healthiness of that skin microbiome.

So that’s just one important way. Because I know a lot of times people focus on the food component, like, “What foods can I take out?” But they miss the fact that there are underlying issues that could drive the skin to react or appear the way that it does, forgetting that it’s not always just about the food. If you’re feeding, for example, your gut-bugs proteins, which should have been digested and absorbed further up in the GI tract, like in the small intestine, and they’re making their way down into the colon, you have a process that happens called putrefaction. Which is not good, it doesn’t sound good. And that in and of itself can be a prime example of how the microbiome internally can be thrown off. And that’s just one of the factors that plays a role.

Katie: For sure. And I think that’s a common thought, now especially with eczema community, of that there could be a food-sensitivity connection at least being talked about. So let’s go deeper on that. Do you think it is sometimes tied to a food sensitivity or do you think like we need to look at a much bigger picture when it comes to this?

Jennifer: I think looking at a much bigger picture is critical because what I tend to see in my community are people who have tried many different diets. They’ve tried the eczema diet, they’ve tried the psoriasis diet, they’ve tried AIP, they’ve tried low-salicylate, they’ve tried low-fodmap, low-histamine. I mean we could go on and on and on with all the different foods they’ve taken out of their diet and seen oftentimes some or minimal or no improvement. Some people, a small percentage, actually might hit the jackpot early and they just happen to stumble across something that will make a difference. Eggs, for example, chicken eggs specifically tend to be something that we see a higher reactivity rate to in those who have eczema. Whereas, there’s some interesting data now about the potential of taking out like night shades and those who have psoriasis. So it just really depends.

My big piece to this, and this is where I get nervous, is, when people start only focusing on food, they’re taking out more and more, they’re losing critical nutrition that can come from other foods and they’re trying to address a problem that’s complex. So I gave you, and I shared with everyone listening, a lot of different root causes. And while I would love for food to be able to address all of those, it isn’t always possible. And so, just focusing on the food piece means that you’re missing out on a constellation, a very unique constellation, in your particular case that could be at the root of your skin issues. And so, if you just say, “Okay, I’m just gonna worry about food,” what happens if any food that you eat is not being properly digested because you don’t have enough stomach acid and you’re inhaling your food because you’re really crazy busy at work and with the kids and everything, and then, it’s throwing the microbiome off. And, as a result, you’re not absorbing your food. So now, you have nutritional deficiencies as well, and then, that can then cause an issue with your mitochondria because maybe the mitochondria, your little power plants in every cell, don’t have the proper nutrients, or cofactors, in order to produce energy that’s required for so many different biochemical pathways in your body to allow for your body to function. And then, maybe that too then plays a role in your hormone conversions or thyroid function, any number of things.

So what I would say is consider food sensitivities a symptom, a symptom that says, “Okay, I’ve got something going on in my gut. There’s a state of leakiness there that’s allowed the food to become a familiar face inside of my body where it really shouldn’t be known in that regard.” We should not have partially-undigested food proteins inside of the body, they should be digested and absorbed in a very different manner than they are. And so, in and of itself, take a look at it from that perspective, and then, say, “Okay. So I know I’ve got gut issues, but what else could be possibly going on underneath the surface?” And don’t just get stuck there because, otherwise, you can get stuck on a really limited diet that is not providing your body enough food, you can become incredibly frustrated, and just wanna throw in the towel. So that’s my two cents on that.

Katie: Yeah. So that’s a good perspective because I think certainly nothing is to be gained from acting out of fear anyway when you’re in a health crisis like that. Like, for me, with Hashimoto’s, there was a time when I had to avoid certain foods. But you wanna focus on the positive and the healing and, hopefully, getting back to that. So, with the positive in mind, are there any like favorite foods or things that are very nourishing that you think are great for people, in general, with skin problems?

Jennifer: Yes. I have to say that one of the big things is there’s always that caveat because somebody could be sensitive or allergic to them or they could have a situation like with…I love ground flaxseed, for example. And I don’t even know how I exactly stumbled across it but I found it to be really helpful with people who have, like, eczema, for example. However, if you’ve got diarrhea, it’s not a good fiber to add into your diet because it’ll probably exacerbate things. I love beets, for example, and for some people beets are wonderful, whereas there are a handful of people who have salicylate issues. And if you’re struggling to process salicylates appropriately, beets are not going to be your friend. And I think too…like I love salmon, wild-caught salmon is another great option, like a lot of omega-3s, the cold-water fishes if possible assuming you don’t have a fish allergy. This is the danger that happens when you’re a nutritionist, you can like get into the weeds with all the different foods. Oats can be really helpful at times. I just always recommend everyone get gluten-free oats especially because there can be… I always like my clients to go gluten free simply because I don’t…we already know that there is a leaky gut…if you’ve got skin issues, you’ve probably got gut issues, it’s pretty highly likely. And I don’t want your gut to become more leaky because gluten is being added into the mix of things because it is the one food protein that we do have plenty of research to indicate that it can increase gut permeability in all individuals. And if you are struggling to address something, my feeling is like, “Hey, you know, I’m probably better just to take that out for right now,” rather than saying like, “gluten is the devil,” and focusing on it from a fear perspective. I just wanna do whatever I can to help manage this state of the gut and whatnot. Those would be like my top…I would say those are probably my top foods.

I also love ghee as well. And I know some people get freaked out because it’s dairy but ghee is actually a really good source of butyrate, which I mentioned earlier. And you can also, if you don’t want to do cow’s milk ghee, I recently found goat’s milk and yak milk ghee as well, so you can order them online, they are available. I don’t remember the company’s name but I’m sure, if you search them, they’ll probably come up. But those are great options as well, you know, and I used to throw it right into a protein shake, and it actually tastes really good. So it’s a great way to kind of sneak in that healthy dose of butyrate and something that I was really enjoying.

Katie: So you’ve mentioned salicylates a couple of times, and I feel like this is an area that not as well known, in general, when it comes to health. And so, a lot of people may not be totally familiar with that term. So explain to us what are salicylates, what are they found in, and how might they cause problems for some people?

Jennifer: Salicylates are a phytochemical that is naturally produced in certain really really healthy foods. So I don’t want you to think that salicylates are bad for you, they’re not, it’s the plant’s…it’s a mechanism, so to speak, for it to protect itself. It just so happens that some people, for varying reasons, have a difficult…have difficulty processing them. And so, if you go online, you’ll see like the the salicylate diet… Different diets, a lot of actually skin diets are based off of this concept of reducing the salicylate load. But what they advise you, and this was kind of confusing to me the more and more I thought about it, is salicylates, it’s not that you have a sensitivity to them in the sense that one might have a sensitivity to eggs, or dairy, or soy or some other food sensitivity, instead this is actually an issue in your liver. And that was one of the biggest eye-openers for me that we weren’t really looking at this from a root-cause perspective, we’ve been kind of trying to use food as like the second line of defense after you get out of the dermatologist’s office, not realizing that food is a piece but it’s not the whole and that different phytochemicals can have responses in the body but maybe not necessarily in the gut, like we would assume.

The most common salicylate that I would bet everybody here is familiar with is aspirin. That is based off of an herb, or a botanical, called willow’s bark. And so, it contains salicin, which then is converted to salicylic acid, and it is processed through your liver. Now, I just wanna be very clear when we talk about liver detoxification. A lot of people commonly confuse the liver with a sponge or a filter, like on a fish tank, and that is not how the liver operates. It has a lot of important roles, like managing your blood sugar, but one of the most common misconceptions has to do with detoxification. There are two separate phases of detoxification. So we’ll see phase one, which is also for the more sciency people listening, this the P450 cytochrome system. And then, we’ve got phase two detoxification where we’re looking at different pathways. There’s a glycine pathway, glutathione, glucuronidation, and sulfation. And so, salicylates are processed specifically through the glycine pathway. And so, if you have this phytochemical that you’re exposed to in very healthy foods…like I mentioned beets, like beets are really great for you, they’ve great supportive ingredients for liver detoxification, and for supporting the liver, and a great amount of vitamin C, which is important for collagen as well which I also love for skin. But if you can’t handle the salicylate load, you’re gonna end up not feeling well, as a result of eating these foods.

And so, the best way is to say, “Okay. Instead of going, I’m just gonna take out all the salicylate foods.” I mean you certainly could maybe reduce out the high salicylate foods but think about what you could do to support your liver because, to me, it’s a sign of saying, “The liver actually needs more support. And that particular pathway, glycine is really important, B6 is also gonna be helpful, as is magnesium. And just as a note, if anybody’s listening to this, if you are…and I always have to specify because like I also work with a lot of gut clients, if you’ve got more constipation, magnesium citrate might be a great option, but if you’ve got diarrhea, you don’t want to just throw any type of magnesium into the system, magnesium glycinate tends to be the more absorbable form, and that can be really helpful for your body to have enough magnesium for that pathway, aside from all the many other things that it uses magnesium for. And for those of you who’ve maybe done like a urine test where we were starting to look for organic acids in the urine…you know, when I look at those tests, like I love to do the one from Genoa, what I’m looking at to say like, “Hey, what’s going on with this glycine pathway?” I’m looking at elevations of hippurate, benzoate, these are produced in the liver. Though sometimes benzoate you always have to question, “Are you consuming a lot of processed goods that have like benzoate potassium, benzoate etc. in them?” And then, 2-methylhippurate. And those all have to do with the consumption of glycine in the system. And glycine is an amino acid by the way, it’s important to note that because we do need some protein into our system, they do different things, the different amino acids. And so, that’s one of the biggest things is, like, salicylate foods, if you’re sensitive to them, you need to look at your liver. You shouldn’t just be afraid of the foods and taking them all out because they’re really healthy foods. But if you don’t ever support your liver, you’re never gonna get to a point where you’re really gonna be able to consume them. Otherwise, every time you try and add them back in, you’re gonna have the same problem all over again.

Katie: That makes sense. And I’ve heard that said too that, like, sometimes skin issues can be a sign that something’s going on with the liver and you need to support the liver. And you gave some great suggestions already but are there other ways, in general, we can all learn to support our livers, even if we don’t have a specific skin problem, just to make sure we’re taking care of our liver well?

Jennifer: I would say the one big piece, and this has been a big eye-opener for me, it was not something that I learned in grad school, it was just through clinical experience, is that, when people think of supporting their liver, they think of doing a liver detox. And that, I think for most people who are sick or have some sort of health issue in general, it would probably be more beneficial to support your liver, to say, “What nutrients does my liver need?” as opposed to constantly detoxing your liver and doing liver detoxes. I found a lot of people with skin issues, some will notice some slight improvement if they do a liver detox, a lot of people will actually notice a worsening because their liver’s already stressed out. So I love glycine, I know I mentioned that already, that’s really helpful. I mean dandelion root tea can also be very helpful, that’s one of my favorites. And, you know, I don’t know when this is going to be released but you can buy…if you don’t have dandelions in your yard, which the dandelion greens are also really, really helpful and nutritious and nourishing, the dandelion root tea can be purchased in bag form and you can make teas out of it, especially if you’re transitioning away from coffee but you need something that you feel, like, has this like really great grounding effect in the morning, I love roasted dandelion root tea. So that’s one of my favorite things to do.

I’d also say too is to think about all the different exposures that you have throughout your day. I’ve had clients who didn’t realize, they didn’t have, like, a radon sensor in their home, like make sure that you check for radon, make sure you’re thinking about all the fumes that are in your home. Like do you store paints and solvents in your basement? Is it possible that some of the cans have opened and those fumes are rising up through your house? Think about all of the filters that you use throughout your home. You know, we take for granted because we don’t see things that our body isn’t being exposed to things because they’re plastic. So even the dry cleaning, you know, you have to be really careful in bringing dry cleaning into your home. I recognize some of our clothes require dry cleaning, you have to really try not to buy any clothing with dry cleaning. But that, too, that is very hard on your liver. Buying organic or, when you can, grow your own. Strawberries are really easy to grow, they’re one of my favorite foods but tend to be very high in pesticides. So pesticides can be another way to stress your liver. And obviously medications as well, but you really wanna do your homework on what your medications…how they’re processed because a lot of medications are processed through the liver, and so, that may also determine how much work your liver has to do during the course of any given day.

Katie: That makes sense.

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Katie: And to circle back a little bit to the beginning and to your story, I have a feeling there are people listening who have, either they have eczema or they have a child with eczema, and I mean you explained just how frustrating and helpless that can feel and how you even had tried all the diets and all the different things before finding the answers. So, if there’s someone listening who’s still in that and it feels like they’ve tried everything, where would you have them start to, hopefully, try to find their own answers and to work through that?

Jennifer: What I would say is to sit down with a pad of paper and list out all of your symptoms. Not just the skin symptoms, get really clear on what symptoms are, like redness, itching. I know it sounds silly because sometimes people go, “Well, I have eczema, of course, you know what my symptoms are.” Well, everybody’s skin rashes actually show up differently. And so, you wanna list that out. Then, start going through and taking an inventory of the rest of your body. What’s going on? And don’t self-edit, as we oftentimes are encouraged to do in the doctor’s office, because those are clues they’re, your body’s way of saying, “Hey, I need some help. This is how I’m trying to communicate with you. I recognize it’s not convenient, it’s not comfortable, it might not be pretty, but I’m trying to tell you something. I’m trying to direct you where to look.” And the more we ignore that, the more we’re deprioritizing our health and our body.

I’d also say that, in the process of doing this, it isn’t about the blame game, so avoid thinking like, you know, “I did this to myself. I let this go,” just let that piece of it go. This isn’t about the blame game, we’re all starting someplace and wherever you’re starting is okay. But, by creating that list of symptoms, that can really help you, or whomever you work with, begin to clearly figure out, “Are there nutrient insufficiencies? Are there specific bu…” I like to call them buckets, but like is there a gut bucket, a liver bucket, what have you. You know, “What buckets are there? Where are the areas we really need to look and to pay attention to here?”

Also, just start paying attention to patterns. Do you notice if there’s a cycle? Maybe start charting out your flares. Some people will notice that there is a connection between their cycle, their menstrual cycles, in women, the menstrual cycle and the skin-rash flares or with acne, the flares with acne. And then, where are things located? There are different microbiomes on the skin, so we have a whole microbiome but there’s a community, there’s like little different townships, so to speak, or little different towns of bugs that live on our skin. So what lives in our arm pit is gonna be much different that’s gonna live on the back of your elbow or the back of your forearm where it’s a lot drier. And so, starting to categorize all of that, like as if you were an investigator, can be incredibly helpful so that that way you can get a sense of what and where and when things are happening.

And then, I would also say, too, if you are having skin-rash issues, please stop using coconut oil. I know that we read a lot, all over the place, that it’s really good for the skin. And maybe for some people it is, but coconut oil is very very antimicrobial, too much so, and there’s a number of other reasons for it that I’ve written about extensively. And unfortunately, that can be another thing that will drive dysbiosis even further in a direction you don’t want to go. And so, there’s certainly other oils. Jojoba oil is a really great option because it’s closest to skin sebum. Olive oil. I know that they’re omega-6 oils but safflower oil and sunflower oil are actually pretty good for the skin and there’s some great research to back that up. So you might not want to ingest them but, used on the skin, might actually be helpful. So those would be probably the main things of where to start.

Katie: And what’s your take on supplements? Because I know, in general, in the health world, they can be a little bit controversial. Some people say, “We should get everything from food,” and others say, “no, we actually need supplements sometimes because of our modern food supply.” So, strictly from a skin perspective and the work you do, do you think there is a time and a place for supplements? And if so, what are some of the common ones that might benefit the skin?

Jennifer: There is absolutely a need for supplementation. I wish there wasn’t, I wish that we could just get it all by food. But if your body is not well, even if it’s just a skin rash, there’s something going on underneath. And you know what? Look, if you wanna change your diet and you wanna make sure that what you’re eating is being appropriately absorbed, you can get that into your system, that’s awesome. But for most people, by the time we actually get to a point where we’re willing to look deeper and to say, “Okay. You know what? This topical stuff’s not working. Now I wanna look at root causes.” At that point, the wells tend to be so dry that it’s very difficult to get to a point where you’re just gonna get it all from food. So I do use some supplements with my clients. I try to be very sparing and conscientious of what we’re using and to make sure that it’s in alignment with that person’s health values.

I would say one of the number one things to look at is…so the different formulations that you use, if you’ve got skin issues, especially because there’s such a high rate of sensitivity and allergy associated with it, I would be very cautious of supplements that have a laundry list of ingredients. And I understand, like, with greens products, they have all these different greens, or you have some protein powders that have, like, all these different superfoods thrown in. But it could be any number of items in that laundry list that are causing a problem. So simplification, at that point, is actually more helpful. This isn’t forever. This is not a forever state, you don’t stay on protocols typically forever. It’s just to get you from point A to point B, we don’t quite know how big that distance is but supplements can dramatically reduce that journey. And so, you know, protein powders, I’d say, to find the simplest ones possible, if it’s one ingredient, or two ingredients, or if it’s just one form, or two forms of protein. So pea, or I love the hydrolyzed beef proteins because they are hydrolyzed and it doesn’t require any activity or really any work on your guts’ behalf. I really love, as I said, glycine…so glycine powder can be added to a shake, or smoothie, or any type of cold products, and that’s really easy and inexpensive and I tend to use that with clients. As well as collagen powders, as long as you’re comfortable using them. I just wanna just point out, there are no vegan collagen powders out there, that’s not a thing. The collagen comes from animals or beef predominantly, chicken, as well as fish. And so, those can be really great things to add in.

I’m trying to think what else. Sometimes I’ll do a liver support but it just depends on what exactly I think is going wrong and what specific areas of the liver need to be supported. If someone has more hormonal issues, like with estrogen and whatnot, I really love things that have sulforaphanes in them because that helps support that pathway. So there’s one, I think it’s Nrf-d2, I think is the name. I could be slightly off on that but it’s from Pure Encapsulations. But there’s others that provide the liver the cofactors or the ingredients that it needs for those pathways to operate appropriately. Those I think would be like my main go-tos, and then, everything else is sort of refined.

I love probiotics. I use MegaSpore a lot of times. However, they’re not always appropriate for everyone and it can make things worse. And you can also sometimes just apply them to the skin and see if that will also help stabilize the microbiome on the skin by, at first, applying some of, like, a healthy oil, and then, sprinkling the probiotic on and allowing that to sit for a period of time. Do it in the evening when you’re done with your day, not out at work. But that can also be really helpful as well.

Katie: That’s a great list. What about labs? Do you start with any particular labs if someone comes in with skin issues? Is there like a common one or is that really person-dependent as well?

Jennifer: It’s person dependent. However, I will say that most people don’t have good labs. It’s really surprising. Because doctors don’t run labs, dermatologists are very funny about running labs, they always tell you to go back to your primary care doctor most of the time. And a lot of times, unless you push them, they won’t even do a skin biopsy, they’ll just eyeball it. And there have been times, by the way, for everybody listening, there have been a shocking number of times, in my practice, where someone came in and said, “Oh, I was diagnosed with psoriasis,” and they’re describing to me their symptoms and I’m like, “I think you need to go back and get a biopsy.” Turns out they don’t have psoriasis and they don’t have whatever the condition was that they were told when the biopsy comes back. So it’s not always a bad thing to ask for that. And if your dermatologist won’t do it, find somebody else who will just to get a confirmation of what exactly it is that you have.

Because, if we’re talking about an autoimmune disease, we’re looking at this, we’re saying, “Okay, your body’s in a state of autoimmunity,” but that might not be the case if you have, like, seborrheic dermatitis, or rosacea, or eczema. It’s just a different piece to things. And so, what I like to do is, like, just get an overview. First of all, CBC panel, fasted CMP, or comprehensive metabolic panel. I always like to look at ferritin to see what’s going on with your iron. I like to look at vitamin A and vitamin D, honestly, those tend to be low. Usually vitamin A is low in people with skin issues. But if both are low, that makes me wonder if you are having difficulty absorbing fats. So that can be really helpful when you look at it from that perspective. And then, from there, I’m looking at like the C-reactive protein, the sed rate, those are two different ways we look at inflammation, as well as some other potential nutrients, depending on what’s going on with the person. You know, maybe it’s appropriate to look for B12 and folate. And maybe in others, it’s not, it depends on how recent you’ve had labs run. But there’s also functional labs that could be incredibly helpful. Typically, in my practice, we’ll usually start with something like the organics comprehensive panel or the GI effects. So either looking at the stool and the microbiome in the gut or taking a more comprehensive approach and saying, “Okay. How are a bunch of different systems running? Let’s look at the liver, let’s look at the mitochondria, let’s look at some gut markers,” and see are we really struggling overall and what we can get out of that. But I think there’s a lot of great places to begin, those tend to be the best. At least what I’ve found in working with clients.

Katie: Got it. And I’ll make sure all those notes are in the show notes as well, for you guys listening, I know we’ve listed a lot of very specific resources so you can find those at wellnessmama.fm so you don’t have to try to write them down, especially if you’re driving or exercising or whatever you’re doing while you listen. To switch gears a little bit as we near the end of our time, I’m always curious if there is a book or a number of books that have really dramatically impacted your life, and if so, what they are.

Jennifer: Well, the one that I can think of that was given to me a long time ago, and I think a lot of people have read this, is the “Alchemist,” by Paulo Coelho. That book helped me realize that what I felt inside in helping people was something that I should chase after. Because I was very much stuck in this notion that somebody else had to give me a job and provide for me, you know, my ability to make a living, as I became an adult after college. And that book was really pivotal in helping me see that it worth it for me to follow my dream, it was worth it for me to believe in this inner calling that people needed more help than what they were getting at the doctor’s office. And I’m not putting down doctors by any stretch of imagination, my dad’s a doctor and a surgeon. So I worked for him for a long time and it helped me realize that there was a better or different way possible. And while it didn’t necessarily exist where I lived, I was able to help be a part of that movement and support people. So I would say that was one of the the biggest books that really changed the course of my life.

Katie: I love that. And lastly, do you have any parting advice for our listeners today?

Jennifer: Yes. And actually I’m gonna frame this from a different perspective. With skin issues, the one piece is that people tend to feel very alone, it can be a very, very lonely journey. You can feel like nobody understands you. And so, I want you to realize that, a lot of times, people don’t know how to support you. They try by making suggestions that oftentimes are not actually very helpful at all, but they’re trying. And so, what I would say is be clear with people about how they can help and support you, when they show that impetus to try and do something. Get really clear on what it would be, what would be most beneficial for you. And for anybody listening who you know somebody that has skin issues, I’m gonna be very honest and frank with you, don’t try and give them advice or try and fix their problems. And this kind of goes along with, I think, almost any health issue. It’s better for you to be present for them, to listen and learn how to support them and ask them how you can support them rather than trying to fix them. Because the worst thing was when people would try and tell me, “You just don’t know how to wash your hands.” “Oh, you’re just using the wrong moisturizer.” It was always about what I was doing wrong. And I already felt bad enough, I just wanted somebody to feel for me, to have empathy for me. Not to feel bad but to be there with me in that moment, even if I just wanted to complain, or grumble, or whatever, or just to sit there and watch TV and not pay attention to how itchy my hands were, I just wanted some connection.

And I think that’s oftentimes what gets missed in this whole conversation. We focus so much on all of this stuff, the skin, the food, the root causes and everything but we forget that emotional connection and the trauma that can come along with it, with every day. And I just wanna remind people that there are people out there that totally and completely understand what you’re going through and, you know, and you should find a support system. But try to have empathy for those that are struggling with these conditions. They will love you through and through.

Katie: That’s so beautiful, it’s true, and such a good reminder of the power of just loving someone where they are and saying like, “I’m here for you, I’m in your corner.” Not trying to fix it but just being there I think that’s one of the most powerful things we can do for each other. And something that maybe gets missed a lot, in our modern world, where everything is social media and technology. So I think that’s a perfect reminder and a perfect place to end. But thank you so much for your time and for sharing all of your knowledge and resources today. I know that skin issues are a big problem for a lot of people and I hope that your wisdom today has given people hope and direction. And of course there’ll be links in the show notes so that they can find you and your website and keep learning, especially if they are in that place of struggling with a very specific problem. So thank you for your time.

Jennifer: Thank you for having me.

Katie: And thanks, as always, to all of you for listening, for sharing your most valuable asset of your time with us today. We don’t take that lightly, we’re so glad you’re here. And I hope that you will join me again on the next episode of “The Wellness Mama Podcast.”

If you’re enjoying these interviews, would you please take two minutes to leave a rating or review on iTunes for me? Doing this helps more people to find the podcast, which means even more moms and families could benefit from the information. I really appreciate your time, and thanks as always for listening.

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