Andrew: That’s good. Now, I think first we need to sort of get a handle on both of you. You’re not sisters. You’re praccies.

Andrew: Tell us a little bit about how you met and how you started practising together.

Pip: Well, we were introduced as friends. And as we started to talk about what we do, and what we treat, and how we treat, we realized that we had a huge crossover, and that not only did we have a crossover, but we were trying to treat the same things and give advice that we realized that the other one could give.

Isabella: Yeah, good support. I think, yeah, we sort of started off more in a social environment, but then Pip had been suffering with rosacea, and I was talking a bit about some of the skin conditions that I treat, and she was like, “Wow, okay. I’ve been suffering from a few of those. I’d better come and see you.” So, she did, and then kind of went from there, didn’t it?.

Pip: Yeah. Yeah. So, Isabella opened my eyes, I guess, a lot to the topical treatment, and her approach to skin, as opposed to just going to a beautician. And in reverse, when we started talking, Isabella actually thought she was symptom-free when talking about nutrition. And as I dove a bit deeper into her health, she realized that she actually had a lot of things going on as well that needed my treatment. So…

Isabella: Yeah. So, I think we, like, it was a really interesting mutual respect for things that we hadn’t put a lot of weight on in our life, or had sort of brushed it off as something that we were to live with. And then when we started to explore each other’s modalities, we realized how powerful they were for us as individuals. And then we realized, “Oh, my gosh. If we’re seeing this for ourselves using each other’s modalities, imagine the power we’ve got for our clients. So, then we started to heavily cross-refer. And we’ve seen an incredible relationship develop through using both of our skills for the common good, effectively.

Andrew: A mutually serendipitous professional relationship.

Isabella: Exactly.

Pip: Very much. We’re very symbiotic.

Isabella: Symbiotics, all of that.

Pip: We’ve created, you know…

Andrew: And we’ll be talking about that a little bit later, symbiotics.

Pip: Yes, we will be. But it has. It’s been a great journey.

Andrew: Yeah. So, we’re talking about skin disorders, not just beauty and things like that. So, let’s delve into this. I think we’ve gotta start right back at the beginning. Let’s start back at anatomy. You know, skin, how many layers, different aspects of skin, if we could go through that. Isabella, can I ask you first?

Isabella: Yeah, sure. So, the skin’s made up of six layers of epidermis, which is a majority of the work and the time that I spend with the skin, it’s in those six layers. And each layer works synergistically with the next layer. And I kind of look at skin the way I look at the customs department at the airport. The customs department works in the same way that skin does. It controls what comes in and out. And it protects us as a whole entity. So, when it comes to the layers, they have to all be protected, but then again, all work synergistically, again, together. So, as well as the anatomy and the names of the layers are important if you really wanna delve into that, the way the skin actually works is it’s not only a physical barrier to our organs, but it’s also works as a chemical barrier, which is where our acid mantle and our barrier repair really plays a huge role. And acid mantle and barrier repair is where I do a lot of my work, and do a lot of my recommendations and fixing in my career.

Andrew: Can I have some clarity for myself on that? The acid mantle. So, we’re not talking about something that sits on the skin. We’re talking about in the skin. Is that correct?

Isabella: Yeah. Look, it actually is both. So, the acid mantle is a material that is made in our sebaceous glands, our sebum, our oil production glands. And when we produce sebum out of our gland, it actually mixes with sweat, and it travels up the hair follicle, and it smooths out onto the skin, giving us nutrition, hydration, bacterial protection, all of the above, to make… It’s like an oily substance, which is why our skin is waterproof, which means bacteria that is not designed to enter the body and challenge the immune system will be trapped on the outside. So, the acid mantle is a very important factor of the epidermis. And we kind of need our acid mantle to stay on an acidic level and not an alkaline level. So, like, a 4.5 to 5 would be somewhere we would aim to sit. Because, again, it keeps that ecosystem really safe.

Andrew: Okay. So, Pip, just, if I can get you to take over here, we talk about, you know, our bacterial milieu. And of course, we’re not just talking about what resides inside our gut, but we’ve got a normal microbiome, a microbiota, that inhabits all of our skin as well. So, it’s not just antibacterial per se, but we’ve gotta think about what is, we said the word previously, symbiotic to us, on the outside. So, what governs that? Are we talking about just the pH, or are we talking about, you know, antimicrobial parts of the immune system that might be active and actively secreted?

Pip: So, we’re looking at it from a holistic point of view. With our skin health, you know, once you’ve compromised that barrier, so, say you’ve got bacteria overgrowth, or particles coming through the skin, or leaky skin, which is another term for it, which is more the inside coming out, or displaying symptoms on the outside. So, with the symbiotic, what we’re talking about is we’re looking at the whole system, and what’s going on, that may have caused any of these issues. So, yes, of course, the gut, and we have our own microbiome in the gut. And if that becomes disrupted, that can, you know, display on the skin in a really… You know, it’s not like…a roundabout way. It’s a symptom of, say, a leaky gut, or small intestinal bacterial overgrowth, or H. pylori, or bacterial infections, can display or present in a compromised skin barrier. And that might be acne, dermatitis… Sorry, was gonna say, even accelerated aging.

Andrew: Right. No, I think I’m just waking up to something. So, you know, my previous thoughts were things like, if you get, you know, what’s it, Corynebacterium acnes, and that’s on the skin, causing the problem. An overgrowth causing the problem because it gets into a follicle and causes a problem by attacking from the outside. What you guys do is you treat in a holistic manner, to say, “Okay, we’ve got inflammatory mediators coming from the inside out, which might compromise that integrity, thereby allowing that thing to invade from the outside.” Is that right?

Isabella: Yeah, exactly. I mean, that’s where we’re… Yeah, that’s where we’ve made huge movement and ground in working together. And I’ll use my husband as an example. My husband has quite bad acne rosacea. He has had for the entire time we’ve been in a relationship, so seven years. And I’ve treated it those whole seven years. Now, you can’t cure rosacea. You can reduce the symptoms, but I could only reduce them so much as a skin therapist, and I kept saying to him, “You need to get your gut health sorted out.” And he wouldn’t listen to me. And then when I introduced him to Pip and she spent five minutes with him, he was like, “Oh, maybe I should have my gut health looked out.” And of course, his rosacea is now under control. So, it was a perfect example for us to realize, “Wow, we could be offering our clients so much more support if we just teach our clients that they…” It’s not a silver bullet just to go to one practitioner. We have to work synergistically together. So, your point about working internally and with the P. acnes external is perfect. We absolutely work together from internal and external avenues.

Andrew: Propionibacterium acnes. Forgive me, you’re right. The correct genus, Andrew.

Isabella: That’s okay.

Andrew: I had Corynebacterium.

Isabella: That’s the old term.

Andrew: And, Isabella, it wouldn’t be the first time in history, by the way, that a spouse wouldn’t believe the other, even though they’re professionally trained.

Isabella: Yes, yes.

Andrew: Yeah, happens all the time. Happens to even famous cardiologists like Dr. Ross Walker, just so that you know.

Isabella: Interesting.

Andrew: Yeah, yeah, yeah. So, can we just go through, do you tend to see more of the, oh, acne-related…

Isabella: What come first, the chicken or the egg?

Andrew: …skin conditions in practice, or do you see the whole gamut? You know, psoriasis, eczema…

Isabella: I see a whole gamut. Yeah, and I used to work in dermatology for four years. So, I saw everything in dermatology and, like, shocking, shocking stuff, whereas now, in private practice, it’s a bit different. I do see across-the-board symptoms, but I don’t see everything all the time, obviously. And I find it goes in peaks and troughs, like, I might see a rosacea patient, and then that rosacea patient talks to their friends, and the next minute I have 20 rosacea patients booked in, then it’s an acne patient, and then the same again. So, I see a lot of everything. It just depends on kind of the cycle and what’s happening.

Andrew: Okay. So, Pip, can we start, let’s just delve into treatment. Forgive me. Reword that. Let’s delve into conditions. So, you mentioned it just before, Isabella, and that’s acne. So, acne and scarring, something that still, you know, causes tragedy with people’s self-esteem. It’s not just a physical thing, but it affects people mentally throughout their teenage years and even onwards. So, let’s talk about acne, and how bad it is, what causes it, and the sequelae that happens with the scarring, things like that. Pip, can I get you to start off, and we’ll transfer over to Isabella?

Pip: Of course. So, with acne and we do know there are a lot of types, I always want to know, and this goes across the board, but what’s the driving cause, and that’s the main part for, you know, the main, I guess, strategy behind being a holistic practitioner. We don’t just go and treat it acutely. I wanna know what’s going on. So, for a lot of my acne clients, you know, they’ll come and they’ll present a myriad symptoms that range from stress, poor sleep. Some of them might be hormonal. So, we might be looking at cyclical acne that’s coming out at different times of the month, whether they’re ovulating or going through menstruation. Where the acne’s actually presenting. Are we looking at it on the chin? Are we looking at on the jaw, the chest, the back? Is it there all the time? So, we’re going to do a deep dive into where the acne is, and when it’s presenting, as well as their gut health, their hormone health, as I said, their sleep, their stress, their detoxification, their liver function.

And it sounds like, I think, to the external person, like, that’s a lot of work. But realistically, you know, we have a process and we have a plan. And we have a lot of testing these days, some fabulous functional testing that I use a lot of, the gastrointestinal mapping test I use, and which gives us a full picture on our gut health, you know, if we’ve got a compromised gut lining, if we’re looking at bacterial overgrowth. So, we start there, and, you know, making sure that all our nutrients are in order you’re getting your vitamin D, you’re getting a lot of antioxidants support. But really, a lot of it comes down to healing and sealing that gut lining. Glutathione, glutamine, zinc, vitamin C, and then rebuilding that collagen for wound healing, to reduce that scarring as well. So, you want both of these things to be happening. We’ve gotta repair, we’ve gotta regenerate. So, we’re often doing the healing and sealing of the lining at the same time as regenerating this collagen, so that they can get the best results, and that’s just internally. So, then we go, you know… Yeah.

Andrew: Excellent. Your turn, Isabella.

Isabella: It’s so interesting, because Pip and I talk about this, obviously, all the time, and we’re constantly talking about our work. But, yeah. So, a lot of it is internal. And then, the external work that I do is literally we’re looking at the layers of the skin, and where that pilosebaceous unit is, and the pilosebaceous unit is the hair follicle, with the sebaceous gland attached to it, and the health of that, the health of the oil that’s being produced, which then relates back to me asking what their omega-6 and 3 ingestible levels are. I look at how much dead skin buildup is on the face, because if there’s a lot of dead skin buildup, and their skin is super dry, we’re gonna be working to reduce that, so there is an even, non-blocked access or exit for the oil to come out. We’re gonna look at if they’ve been on the pill, I’m gonna ask them about their cycle, their genetics, where their parents and their grandparents were born to, you know, work out what type of skin they have.

What products they’re using, that’s one of the biggest things. I mean, obviously, I’m a skin therapist, so I use lots of products to treat skin. So, a lot of people turn up to me and they’re using products that are actually exacerbating their acne symptoms, which is half the problem. So, the list is absolutely endless about what we ask. And both Pip and I, we have a heavy focus on a strong consultation, because without a consultation and gaining all of that information, we can’t really do our jobs properly. So, Pip works a lot of… She works through her consultation in depth. I work through my consultation in depth. She works the internals, I work the externals. But the entire time, we’re kind of thinking, “Oh, that’ll be something that Pip can fix.” And Pip will be saying, “Oh, Isabella’s gonna be able to talk to you about this.” So, we’ve kind of worked into our consulting style that we are already going to send our client to come and see each other.

Andrew: Yeah. So, have you systematized this? So, for instance, you know, going through, say, various organs, various body systems, you know, alimentary tract or digestion, and then hormonal system and things like that. Do you systematize that?

Pip: I do, yes. Yeah, absolutely.

Isabella: Yeah, Pip does heavily. I do it in a way that isn’t heavily based on organs, but all of mine is a whole other layer of things. So, your systems is going through all of your…

Pip: Absolutely. And look, a lot of it is symptomatic, what they’re presenting with as well, but I want to make sure that everything is covered.

Isabella: Covered. Is covered.

Pip: Yeah. That we’re not missing anything. You know, the skin being the biggest organ, it’s also the last organ to receive all nutrients.

Isabella: But the first one that everyone sees.

Pip: The first one that everyone sees and criticizes. Yeah. So

Andrew: And very often, the people come to you and they say, “I’ve got a wedding on Saturday.”

Isabella: Yeah. We get that a lot.

Andrew: Yeah, I’ll bet. Okay. I mean, that must be, seriously, your nemesis that question. It’s just, “I need it in three days, by the way,” that sort of thing. But I just wanna ask about things like hormones, and acne, and for instance, diet. And I still remember, this was a few years, 10, 12 years ago now, this argument, this debate that went on with acne, and a paper came out that says, “Diet has nothing to do with acne.” Not a month later… Yeah, I know.

Isabella: We don’t agree with that.

Andrew: And not a month later, a paper came out and said, “Acne is definitely driven by diet.” And then this paper almost responded to them, saying, “No, it doesn’t.” And then it was, “Yes, it does.” So, it was just this jockey. So, it really astounds me. It absolutely astounds me how you can get such quick effects from diet. Like, for instance, I mean, let’s talk about babies with strawberries, adults with sugar. You can get breakouts of pimples like that. And yet they deny that diet influences acne. Where are we at with the evidence to say, “No, no, we told you so.”

Pip: Okay.

Isabella: It depends on who you ask.

Pip: Well, yeah, it depends on who you ask. My opinion that I’ve developed through for 10-plus years of treating clients, both with hormonal disorders as well as skin disorders, they often go hand in hand, skin is very symptomatic of a hormonal disorder, as well as a lot of other things that come up. But I see my, for example, polycystic ovarian syndrome girls. So, girls that tend to have excess testosterone, and sometimes with excess estrogen as well. But what we’re looking at is a hormonal imbalance. And one of the symptoms of that is acne breakouts that are, we call them the more masculine. We’re looking at excess testosterone, it’s more masculine breakouts. So, your jawline, your neck, your chin, your back. And often, it’s cyclical. Some girls have it all the time. Now, with diet, a big hand-in-hand symptom of polycystic ovaries or excess testosterone is insulin resistance. And with insulin resistance, your body is not able to metabolize your glucose and your carbohydrates properly. So, we’re looking at blood sugar spikes. And I have literally seen, you know, a client eat chocolate, that has polycystic ovarian syndrome, and will develop a pimple within…

Isabella: Straight away.

Pip: Straight away. Straight away. Yes. And I’ve dealt with clients that are going through this. And to me, it’s good, because I can go, “Right. We clearly haven’t nailed this insulin sensitivity. We do need to change your diet until your body can actually deal with this.” And we might be adding in berberine, chromium. You know, there are obviously medications that the doctor will prescribe for insulin resistance, but they’re not necessarily fixing a problem. It might be more of a band-aid. So, we’re getting your body to metabolize these glucose and sugars. Also, look at the stress response as well, because if your body isn’t able to metabolize glucose and sugars, it could be a cortisol response. So, diet, absolutely. If you’re eating foods that are high-sugar, high refined carbohydrates, your breads, your pastas, your cakes, sugars…

Isabella: All the good stuff.

Pip: All the good stuff. A lot of packaged foods. A lot of foods high in omega-6s, which is vegetable oils, very inflammatory, they are absolutely related to how your skin is gonna react.

Andrew: Gotcha. So, my next question, just, I have to get this answered now. And that is evening primrose oil. You know, we had black currant seed oil. So, we talk about seed oils being bad, mainly. And yet, we use black currant seed oil as an omega-6.

Pip: So, omega-6s aren’t bad. I need to say omega-6s, topically, are good, especially if you’re acne-prone. And correct me if I’m wrong, because it’s not as viscous. It’s not as thick.

Isabella: So, you can ingest it, but you have to be the right type to be able to ingest it, because if you are acne-prone, I think it’s the omega-6 that’s not going to give you that outcome in the oil gland. Because it’s gonna make your oil more slippery and more thin, so it can get out. And that’s one of the big… That’s why I always ask about what my clients are taking on an omega level, and if they are or they’re not. Because I know that if they’re not, it’s one thing we’re gonna have to explore getting them onto, because we want that sebaceous gland and the oil gland to be better, and then not get trapped in the skin and cause a pimple.

Pip: And can I just say, the problem with Western diets especially is that we are heavily loaded in omega-6, and not enough omega-3. So, we need to get that ratio of 1 to 1. At the moment, I think it’s 6 to 1, and that’s omega-6 to 3. It’s probably even more some Westerners… I was gonna say, some Westerners might be like 50 to 1. And that’s when we start to see the big inflammation issues. And I do love to use an omega test, omega ratio test, even just to show the client how far off they are. But if you’re eating a lot of processed foods… I mean, yes, your natural nuts and seeds, almonds are high in omega-6. But very different to added vegetable oils, which are very inflammatory, very…you know, throws your hormone balance out, and therefore can cause skin conditions. Topically, we use a lot of seed oils for the skin, to protect that lipid barrier, which we do see better results, then, internally.

Andrew: Isn’t it interesting that we call them vegetable oils?

Pip: What vegetable has an oil?

Isabella: favourite quote.

Pip: Such oily vegetable.

Andrew: But we do. But it’s like saying the word “cholesterol” when we mean lipoproteins. It’s a vernacular thing. But anyway. There’s so much I could ask you. Oh, gosh, we could do 10 podcasts and not get through all of it. So, with regards to acne, you know, traditional things that we’d use is things like zinc. And I’m mindful of this in arachidonic acid cascade. Talking about the omega-6s, or the omega-3s, or omega-7s, or whatever you’ve got, the, what is it, delta-6, delta-5, and then whatever textbook you use, delta-4, or 5, or 6 desaturated. Zinc, B6, magnesium help to transfer those. So, do you employ these really simple nutrients? People think, “Oh, but zinc’s for healing.” But then you’re thinking in a different way. You’re thinking, “Ah, now I’m helping the enzymes.” Is that the way your minds work?

Pip: Oh, yes, it does. Are you talking topically or ingesting?

Isabella: Or ingestible?

Andrew: Ingesting. So, it’ll be you, Pip.

Pip: Yes. Okay. So, my mind goes, yes, okay, zinc, collagen, vitamin C, all your antioxidants, all work synergistically to create beautiful skin. If your body is not absorbing, or activating, or your other organs are needing these, we don’t know what’s going on, and if they’re needing these nutrients…

Andrew: That’s a good one.

Pip: …then your skin will be the last place it goes. It’s that age-old, like, everyone taking collagen for their skin and expecting to see that they’re all plump and all the anti-aging signs. But I’m sorry, if your body is using it for all the other organs, then it’s the last place it’s going to go, so it’s the last place you’re gonna see the effect. So, I think that, like, you know, you can always have a baseline products to take for skin maintenance, but not necessarily… You know, there’s no one-size-fits-all. And I prefer to know the full picture before going, you know, “Just go and take some zinc,” or, “Just go and take some digestive enzymes,” which I think we should all be on anyway. You know, the lipase, amylase, protease, fabulous. Let’s get those nutrients absorbed. But let’s have a plan in place first before we just go and spend all this money and take everything as well.

Andrew: Got it. You’ve actually, you’ve changed the way I practice, because there’s something that I thought I knew, but I’m not cognizant of doing this. And now I’m gonna be cognizant of doing this. I’ve known, for years, about, you know, glucosamine, for instance, is first utilized by the gut before it’s gonna get anywhere near the joint. So, if your gut is crappy, there’s no, don’t ask it to help heal your joints, and likewise with collagen for the skin. And yet I have never asked somebody what their gut function is like when I’m prescribing collagen for joints or skin, or whatever. Practice-changer. Thank you.

Pip: Yeah, no problem.

Andrew: So, look, again, each of these topics that I’ve got written here are a seminar in themselves. So, I’m so sorry we’re gonna have to rattle through them. But you mentioned before, acne rosacea. Now, this is something that, again, like, people struggle with. How do you help treat that inflammatory process?

Pip: Who?

Isabella: Me, or…?

Andrew: Isabella, your turn.

Isabella: So, acne rosacea. So, one thing that I’ve learned in 15 years of looking at skin is that a lot of skin conditions that I see are really inflamed barriers or impaired barriers. So, call it what you will, acne rosacea, psoriasis, eczema, whatever it is, generally it’s an inflammatory disorder, and it’s mostly caused by, on an external level, mostly caused by an impaired barrier system. And an impaired barrier is when that acid mantle is compromised for some reason. It’s usually that the sebaceous gland isn’t producing the right mix or concoction of sebum to come out and evenly cover the skin and protect it properly. So, it’s a mixture of wax esters and all sorts of amazing lipids. And if the recipe is off, the quality isn’t great, which means that protective layer isn’t functioning as well as it could be. So, I find that most skin conditions are… I always start my consults talking about inflammation and redness, because I find that if we can treat any type of resounding redness and bring that inflammation down, the skin calms itself, because we’ve fixed the barrier. And once the barrier is fixed, everything underneath settles right down.

So, acne rosacea, I would actually start completely, and Pip referred to this before, a gut heal and seal. I actually have the same thing. It’s a barrier function heal and seal. So, I start the client on, say, a month of just barrier function repair, which is super boring for a client. They wanna get right into all the exciting products and amazing stuff. And I’m like, “Well, you’re just gonna pour your money down the toilet. You’re actually gonna make your skin condition worse, so let’s just heal and protect that barrier function, get that fixed first.” Then by the time they come back, they’re like, “Oh, my gosh. My skin looks so different,” because actually, it’s been given a chance to function normally, instead of constantly under attack from all the bacteria and the external extrinsic assaults from bacteria, and pollen, and pollution, and whatever it is that’s irritating and making their skin more red. So, I always start with a barrier repair plan, which is treating, the first step to treating the symptoms of acne rosacea. And once it’s calmed down a bit, normally I can then go, “Okay, now what are we actually looking at?” And remember that rosacea isn’t curable. We’re just effectively managing the inflammation of bringing it down a bit. But if that leaves room to start controlling some of the papules or pustules that they’re getting, then we can start treating that.

Andrew: Right. Okay. So, I mean, the first thing that we think about with topical use would be the soap that we clean our skins with daily because we’re Westerners. So, you know, do you change the type of soap? Do you look at goat soap or oat soap, or any sort of different types of cleansing agents?

Isabella: Yeah. So, I have a special cleanser that I recommend, that is an aloe-based cleanser, actually, like, the base of it is an aloe hydrator. And it’s actually got a tiny bit of very stabilized AHA, so, alpha-hydroxy acid. And funnily enough, all my rosacea clients and severe rosacea acne clients can use this, including Pip. It’s been a really great product because I’ve formulated it in a way that can treat everyone properly, but very carefully. Soap-free, sodium lauryl sulfate-free, doesn’t foam. It’s not a soap. It’s a cleansing agent. And then I would recommend that they don’t cleanse their body, they only cleanse the important parts. They don’t scrub away their arms and their legs with soap. So, my main area of treatment is the face, but then I go down according to what their symptoms are. But, yeah. So, for acne rosacea, I definitely recommend they cleanse their face. But I would never say, you know, cleanse with a BHA, a beta-hydroxy acid cleanser, or cleanse with a scrub. Like, that’s off the cards. It’s always gonna be super gentle, with no foaming ingredients. The problem that we’ve got in our Western world is that everything we clean with has sodium lauryl sulfate, which is that foaming. So, Palmolive, toothpaste, whatever you put in, hair. Shampoo is crazy. So, it foams away, and obviously strips the acid mantle, and then we get more problems.

Pip: But we think that we need the foaming.

Isabella: We do. We’ve been trained.

Andrew: Yeah, we’re trained. Oh, we’re trained, all right.

Isabella: Yeah, especially by our parents.

Andrew: Yeah, yeah. Well, this is a marketing thing.

Isabella: Yes.

Pip: Exactly. But as a client of Isabella’s who really suffered from angry, sensitive skin, and to be honest, I was so hesitant to try anything because I was in pain as well. Like, everything’s stung.

Isabella: And you’re scared.

Pip: I was scared. I used a bad product. It’s essentially how my rosacea came out. I’m also the perfect demographic. I’m pale-skinned, middle-aged…

Isabella: Likes to buy products

Pip: …female, and likes to experiment with products. So I was, like, the perfect candidate to get rosacea, unfortunately. And I had a baby, so my hormone changes really escalated that. We were in lockdown. I used a lot of products on my skin and, like, came out so, you know, sensitive. Completely ruined my barrier. So, when I saw Isabella…

Isabella: You were very hesitant.

Pip: …I was really hesitant to try anything. So, it was her approach that was super gentle. And also realizing that, like, not, this vitamin C that you buy off the shelf over here is not the same as this vitamin C that we recommend for skin like yours. And I think that’s a problem we have as consumers is we’re so overwhelmed…

Isabella: With choice.

Pip: …with choice, and marketing, and, you know, like, the latest fads and social media and everything, that we’re, like, we just go and grab what we think…

Isabella: Will do.

Pip: …will do. And unfortunately, I suffered from that, and I will suffer from this forever, because, as you know, we can’t cure it, or yet. We’ll try and work that out. But it was so interesting to speak to an expert who could actually help my skin problems. And I’ve seen a significant change just because we did the proper consult. We actually went, got to the root of my problems, and we worked out a treatment plan that was right for me.

Isabella: And just to add to that. That’s one thing that I see a lot of. I see clients or patients at the end of their road. They are frustrated. They’ve been to a dermatologist. They’ve been to 50 different skin therapists and beauticians. And then by the time they get to me, they’re so angry and skeptical. So, it’s actually quite a big job for me to be able to coach them, you know, and nurture them and explain to them that the reason that their skin is like that is because they’ve been misdiagnosed and mis-prescribed over and over and over, and they’ve effectively caused the problem themselves, but they didn’t know. They were being told by all sorts of different practitioners. So, it is something that I’m very aware of, and I have to be mindful when I see my clients in that, you know, there’s a level of frustration and burnout in our world of heavy marketing, and heavy practitioners, and heavy prescriptions from doctors. So, it’s a bit treacherous. That’s for sure.

Andrew: What about the topical use of B vitamins, like for instance, vitamin B3, B5? Useful? Useful in certain situations?

Isabella: Yeah, niacinamide. Yeah, niacinamide is a big one. It’s one of the only topical ingredients that’s clinically proven to remove and reduce pigment. And I see almost every single client of mine that arrives to see me has some form of pigment. Scandinavian women, not so much, interestingly, but every Australian woman comes to see me with pigmentation. So, niacinamide, I recommend constantly. Fabulous. And it also is a barrier repair healer. And you can take it, the right client can take it as well, ingest it. So, yeah, it’s a hugely popular and hugely results-driven ingredient for both skin and health.

Andrew: I think it’s very interesting that the research is now coming out. It needs to be furthered. But there’s decent research on the use of niacinamide with prevention of non-melanoma skin cancers. So, it’s definitely having an effect orally as well. Isn’t that interesting?

Isabella: Yeah. It’s amazing. I’ve been doing a lot of research on that myself. It’s huge.

Andrew: So, Pip, do you employ these B vitamins? Do you tend to give a B complex? Do you tend to use certain ones in singular? How to use them and what for? Forgive me, it’s a broad-brush question Sorry.

Pip: So, again, going back to making sure you’re methylating, you’re absorbing, that your gut’s in good health. And we’re not just, as you know, putting money down the toilet, or vitamins down the toilet. Everyone sees their urine turn yellow and thinks that’s the B vitamins that aren’t being used, you know, that your body’s flushing through them. Not quite accurate. It’s actually riboflavin that dyes your urine. Anyway. Yes, I do. I always recommend B vitamins. So, we wanna get it from the diet. Always diet first and foremost. So, your whole grains, your leafy greens, your veggies in abundance. I’m a big… I’m not plant-based, but I do want you to eat plants with every meal, vegetables, fruits. Get your fibre up, get these B vitamins into you. And with B vitamins as well, they’re anti-stress, you know, nutrients that we need. But obviously, we need different ones that do different things, and it does come down to a case-by-case analysis. For example, a girl who might be presenting with excess estrogen, whether that’s breaking out on the skin, chin, usually, at time of menstruation, we might be looking at B6.

So, you know, it is case-by-case. B12 is a big one for energy, and we get that, and a lot of people can be deficient at that, and we’re actually re-looking at the range for that. They’re now saying that we should actually be a lot higher. And seeing things like a lack of B12 can be resulting in things like depression and symptomatic, and things like that. So, I guess every client’s different. And I absolutely would recommend B vitamins. A complex one, I do have a few favorites that I would recommend that are, you know, either slow-release ones that I can recommend twice a day, depending on your symptoms. They’re an energy vitamin. So, you probably wanna have that in the morning if you’re gonna do the complex, so you’re gonna have the energy throughout the day. Yeah. It’s one of those, as I said, case-by-case. I’d say if you can get it from the diet, first and foremost. But let’s check the whole body holistically and see what was missing as well.

Andrew: We’ve only scratched the tip of the iceberg here. There’s so many other questions I need to ask you. Can I just preempt this right now? Would you be amenable to come back on the show, and we’ll discuss other skin conditions in this sort of way? Because this is too important. Well, it’s too important not to cover. And there’s no way that we’re gonna give this the proper respect it needs if we just, you know, give it a little piecemeal answer.

Pip: No, we’d love to do that.

Andrew: So, how about we get you back on the show, yeah? All right. So, I’m gonna leave a few questions there for a few skin conditions. We’ll cover those sort of allergy, atopy, and inflammatory skin conditions at another time. Let’s continue on with acne, acne vulgaris, and acne rosacea. So, inflammatory-based. Genetic? What’s the etiology?

Pip: Well, yeah, there’s always gonna be a level of genetics that come into play with any disease or disorder. And it doesn’t necessarily dictate.

Isabella: No, it doesn’t happen every time. But, yes, genetics play a role.

Pip: We have to consider it. Genetics play a role. Genetics play a role in our hormones, our hormone balance. You know, not always our gut disorders, but if there is a compromised immune system, we’re going to see, you know, a potential for offspring to have the same genetic disorders.

Andrew: Got it. And what about triggers? Like you mentioned, you had a baby, and da, da, da, so there was a hormonal trigger. What about stress triggers and these other sort of antecedents? Do you find that there’s something when you look back in patients history and you go, “Hang on.” You know, “that’s when it happened?” Is that the big aha moment for them?

Pip: Yeah, absolutely. And we do. We deep dive with every client. Like, I want to know the history, the health history, your sleep history, your stress history, and there’s such a correlation with something that’s gone on. I mean, once we get to age 35, especially for females, a lot changes for us. We start to decline in our hormones, our microbiome changes, our skin microbiome changes. Throw a baby or two into the mix, and we’ve got this cool, you know, up-and-down hormones, plus perimenopause. So, there’s so much going on that can escalate our stress levels, and also in reverse, our stress levels can escalate anything there related as well. So, stress is such a big, you know, cortisol, adrenal fatigue, anything like that, is such a big driver for a lot of conditions. And the difference we see, and we do talk about this a lot, the difference you see in someone’s skin from when they’re going through something traumatic or have been through something traumatic, and come out the other side and change their lifestyle and for the better, is unbelievable. They may not have changed anything else…

Isabella: Yeah. And I think we’ve been talking about this a bit, like, the silent symptoms of what we do, which relates to not only acne, because acne is not a silent symptom. Like, it’s pretty obvious, but the silent symptoms of what we do are, I was a perfect example of that, in that I was kind of like, “Oh, I’m pretty good. I’m healthy.” But, you know, why don’t you do a consult on me and let’s see. And then we did this consult and did all my hormone tests, and Pip rang me and was like, “You probably need to get onto some supplements. Your hormones are out of whack.” And I didn’t know because I’d been existing with all these silent symptoms that I wasn’t aware of. So, I think we need to pay attention to triggers like that. And I think that plays a large role in, these silent symptoms play a large role in both women and men’s lives. Because once you get on top of that and start to right your hormones, and start to right your gut health and everything intrinsically, suddenly your skin looks better, you feel better, you are alluding a lot more confidence, you’re happier. So, it’s a really holistic way to look at everything. So, when you say triggers, yes, we absolutely agree that there are many triggers, but there are also many silent triggers that we ignore, and we just live with because we think that’s just how we are.

Andrew: I’m really annoyed that we’re running out of time because there’s so many questions I wanna ask you. But just as a sort of a couple of wrap-up questions. So, firstly, Isabella, it would be plainly obvious to you that you are dealing with, you know, genetic influences. Like, for instance, you know, many Asian people suffer from really bad acne because of their hormones, I’m imagining. Certainly not because of their diet. I shouldn’t say that. Sorry. I’m just gonna stop there. Marcus, sorry. This is gonna edit point. Sorry, mate. Isabella, it’s pretty obvious that you’re going to be dealing with sort of a major genetic… Again, start again. Sorry, Marcus. Yeah. Obviously, Isabella, you’ll be well aware of the genetic influences on acne, acne vulgaris and acne rosacea. But let’s say acne vulgaris, for instance, various cultures, for instance, they tend to have a better or worse predisposition for acne. Do you find that, or is it only diet, or Western diet?

Isabella: It’s a really tough one. Yes, genetics play a role. But the problem is, because Australia is such a melting pot of so many cultures, to be brutally honest, genetics are really, really diluted now. We can’t really find that vein back to, “Oh, you’re a straight Asian person, so you’re gonna have a genetic predisposition to acne,” because most of the clients I see aren’t. We’re all crossbreeds now. There’s a lot of mixing in our genes. So, yes, that would have existed probably more, maybe 50 to 80 years ago, we were seeing a lot more strong genetics when it came to skin diseases. But I wouldn’t put as much weight on that now in my practice anymore, because of the melting pot that has become our country.

Pip: I’ll put my hand up and say it probably plays a bit more of a role in what I do, especially along the hormones.

Isabella: Definitely.

Pip: I see a lot of more indigenous background and genetics…

Andrew: Oh, that’s interesting.

Pip: Yeah. They tend to be more prone to, say, like, the estrogen excess-related disorders, like endometriosis.

Isabella: Yes, definitely.

Pip: Yeah. So, yes, I would definitely say it can be, and I would put that down as not a cause, but a link.

Isabella: A player.

Pip: Definitely, a player. Yeah.

Andrew: Well, that’s really interesting you say that because I remember a pharmaceutical company, the maker of a contraceptive pill, decades ago now. They actually got in trouble from the TGA or the FDA, and it was because of the way that they skewed their results of the efficacy of their contraceptive pill by utilizing a cultural population of women within a certain country. It was India. And they metabolize estrogen differently, on the whole. So, that’s really interesting.

Pip: Yeah. It is interesting, and it’s something we have to keep in, whether it’s implementing our Western diet, that’s just infiltrated everyone’s kitchens, and how that’s affecting us and other people. There’s so many causes behind a hormonal imbalance that we’re all surrounded by on a daily basis, endocrine disruptors, alcohol, even what we, fire retardant we spray on our couches before sale. These are all endocrine disruptors. The mattresses we sleep on. So, it’s much more prolific these days, but there’s going to be definitely different people that are more sensitive.

Andrew: Gotcha. A last wrap-up sort of question. This is for both of you. There’s the obvious things, hydration and things like that. But with regards to things like detox, it’s a concept that we throw around a lot, whether we do it correctly or whether we go to heroic, sometimes. Like, do you tend to err on the side of beauty, do I say, by going gently? Do you tend to heal the gut first? Pip, can I ask you first and then ask Isabella to finish off, with regards to detoxing, that concept?

Pip: With detoxing, I think everyone’s gotta remember that we are designed to detox. We are efficient machines designed to detox. Lymphatic drainage, our kidneys, liver, gut function, all of it is designed to work synergistically and to allow us to detox. Now, if there’s any stage of that process that is, let’s say, a little bit sluggish or compromised, and that’s why we start with the gut, to make sure that that gut lining is effectively doing its job, absorbing nutrients, not attacking

nutrients and causing autoimmune response, and then making sure our liver function’s working properly, our kidneys are doing their job, that our, essentially all the way through to our skin and what it should be doing as well. I will always take a case-by-case, client-by-client, based on their symptoms. I don’t think there’s any one-size-fits-all detox, “You all do this and this is all going to get these results,” for any type of practice that you have. So, yes, I think detox is a broad word. I think you can hone in on it for different people. I like to use the heal and seal, probably more than detox, because exactly that’s what we’re doing. We’re replenishing, we’re regenerating, we’re repairing, and that way, we can assess results as we go, but we’re not taxing the system, we’re not overloading the system. We’re letting the system do its job. We just might be giving it a little bit of assistance.

Andrew: That’s actually really responsibly put. Thank you. Isabella, can I ask you, just to finish off really quickly. With things like dry brushing, far-infrared saunas, things like that. Are these things that you employ?

Isabella: I don’t employ dry brushing, not because I don’t think it’s effective, but… Interestingly, I actually come from a psychology background from a long, long time ago, where I treated autistic and Asperger kids. And so, we did a lot of dry brushing to get them used to or desensitize them to touch they didn’t like. So, I have a slight mental block against using, body brushing and skin brushing.

Andrew: I could imagine. It’s like aversion therapy.

Isabella: Yes. I don’t really use that, purely because it belongs in a different place in my brain. But your infrared saunas are fantastic. You know, very similar to LED. Absolutely. I have a Healite LED in my business. I’m a huge fan of infrared, of LED, of that kind of modality in my business. So, yeah, definitely.

Pip: Can I just say, Andrew, we were talking about this before, and not necessarily along the lines of detox, but a lot of people do see an issue that they wanna fix immediately, and might go and have laser, or something that they think, a chemical pill, something that they think is what they need to make them better.

Isabella: Silver bullet.

Pip: Yeah, silver bullet. And that can be a real problem. And that can cause a lot of more issues in the future if you’re not in excellent health. So, if your immune system’s run down, if your gut’s not functioning properly, anything like that, and you go and just effectively destroy the layer of your skin with a laser or something, then you’re probably going to cause yourself more issues, long-term.

Isabella: Yeah. I think Pip makes a great point in that we’re living in a world where instant gratification is king. And there’s a lot of people out there that buy very expensive laser machines and cosmetic machines to tighten and brighten, and do all these things. And Pip and I come from a slow-and-steady-wins-the-race frame of mind. So, I don’t offer laser, I don’t offer skin tightening, I don’t offer any of those things because, I guess because I’ve been working in the industry for so long to see that slow and steady, actually, for me, provides a lot stronger results for long-term gain. So, yeah, there are heaps of modalities that you’ve mentioned, and especially with the LED, which is a rejuvenator. But even that’s a stimulating treatment, and I don’t recommend it constantly and I don’t recommend it to everyone. So, Pip and I are real, like, I’m a hands-on therapist. Pip uses her brain to analyze. I use my brain to analyze, and we use our mouths to educate. So, we’re very hands-on, and therapists that focus on slow and steady wins the race. And the focus being on slow. You know, making sure that we’re getting the right results at the right step-by-step fashion.

Andrew: Well, people listening to this podcast won’t obviously know this, but you’re obviously walking your talk. You’re absolutely glowing. So, it’s obviously that you’re in excellent health.

Isabella: Thank you.

Andrew: So, I can’t thank you enough for taking us through this today. I mean, these are conditions which, they might seem to be remedial, but they affect people’s mental health and their development, their social, sociability so much. And people pour millions and millions of dollars into these frustrating conditions, not largely, but commonly without satisfactory effect. So, I’m just so glad that you could take us through a truly holistic way of treating these patients so that they actually get the benefit from the inside out. Thank you so much, so much, for joining us today on “Wellness by Designs.”

Isabella: Thank you for having us.

Pip: Thank you for having us. We could talk for days.

Andrew: Absolute delight, and I look forward to welcoming you back.

Andrew: Yes. So, thank you, everyone, for joining us today. I’m so sorry, this is just so much of an iceberg, and there’s so much to cover, so we will welcome both Pip and Isabella back at another stage. And of course, you can catch up on the show notes to this podcast. We will put as much information as we can as possible in there. And you can catch up on the other podcasts on the “Designs for Health” website. I’m Andrew Whitfield-Cook, and this is “Wellness by Designs.”