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- [00:05]
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Hello, you guys. Welcome back to the Treatment Room podcast.
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I am your host, licensed esthetician, Tessa Zali. I am also an acne specialist, certified.
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Through the Preston Method, as well as Face Reality, and I'm also a National Academy of Sports Medicine nutrition coach. So I have been treating acne for the past six or seven years, and I just wanted to share my insights. I feel really comfortable treating this condition, very confident in treating it. At the same time, I have been an acne sufferer. I know the weight of not feeling.
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Confident in your skin, feeling so frustrated.
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With it, feeling like it's ruling your.
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Life, controlling your emotions.
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I. I also know the other side of being the person that those people depend on for results, and it's a big job. So I also, I want to recognize.
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All the SDs, and I know we.
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Just care so, so much about our clients, and I know we all want them to get clear, to feel confident.
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And this is a tough process. And I was thinking about this the.
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Other day, just kind of the audacity.
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And bold confidence we estheticians have to say to our clients and to open.
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Up a business saying, you know, please.
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Trust me with your face, trust me.
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With one of your possible insecurities, invest.
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In me and trust that I can help improve this.
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Like, that's a big job.
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It's a lot of pressure.
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I also think with social media being what it is, and all of us SDS want to, you know, show our best results, there's a lot of pressure.
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For incredible before and afters.
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And I think this episode is just going to be helpful to anyone struggling with their skin and also hopefully to professionals who want some extra insights as to why people could be kind of hitting plateaus or struggling to get clear.
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So today we're going to talk about.
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Why your skin isn't clearing and what I have seen as some common themes.
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And threads and patterns with all of.
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The clients I have treated over the years. So let's get into this topic. Firstly, I really want to recognize acne for what it is because, again, we.
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Can put so much pressure on ourselves.
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To get clear, but we need to.
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Recognize this is a disease of the.
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Poor for which there is no known cure. It is a chronic, ongoing, cyclical condition. And that's one of the reasons there's no cure for it, because it's this process that happens internally, that happens in the follicle that is, you know, constantly going. We're constantly producing new skin cells, oil and bacteria, and those things combine and create an impaction that is the Start.
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Of the acne process.
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I think it's just important we recognize.
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That because I see a lot of misinformation online.
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I think a lot of people would probably assume acne is a hormone problem.
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It is a diet problem, or a hygiene problem.
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And although I'm going to touch on some of these factors because I do recognize they, they have a major influence in acne clearing.
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But at the end of the day, we need to recognize acne for what it is.
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Again, it's a disease of the pore.
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It involves a malfunctioning pore.
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And the main problem and main reason.
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We struggle with acne is that follicle is producing too many excess skin cells.
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Or ke, and that clogs the follicle. Again, that is the start of the acne process.
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There isn't necessarily something wrong with you.
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Medically if you have acne, it's usually not a hygiene problem, usually not a hormone or a diet problem. However, again, it can be so.
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I have worked on thousands of acne cases.
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I have seen so many people. Generally everyone I've worked on has gotten to clearing. As long as they follow my recommendations and my protocol and they stay consistent with it. That said, humans are not perfect and clearing can present a big challenge. So my program is incredibly successful, I believe, for a couple of reasons.
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One, it is a holistic approach covering many lifestyle factors, including nutrition, that are often ignored and not even addressed in western medicine.
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And then two, I know how to push the skin in a safe and gradually aggressive way. So my goal is to find out.
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What the individual's threshold is, how much, how many dead skin cells are they.
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Producing, and what is required to interrupt that acne process. I think we are kind of sold this myth of monotherapy that there is like one prescription, like tretinoin or one topical that is supposed to manage your acne. And I have actually found that typically successful acne clearing requires, unless it's extremely.
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Extremely mild, for a chronic, ongoing, more.
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Moderate to severe acne condition, it tends to require treating acne from a few.
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Different angles with a few different actives. So I generally have a layered approach with my acne treatments.
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And I feel this is kind of a missing secret key and very valuable to the acne sufferer because this is.
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Just something the average person is not doing and they, they generally can't do.
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This on their own.
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An acne expert that knows how to.
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Use active ingredients and knows how to do this with a layered approach is a gem, because the average person doesn't.
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Necessarily know how to do this, they don't have the knowledge of the skin or active ingredients.
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And they don't know how to implement this in a structured, safe way without damaging their barrier. Because what can often happen is somebody.
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Tries to treat their skin, they use the wrong products, they use them too.
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Much, they're too aggressive, and then they.
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End up damaging their barrier. They have stinging and burning, peeling, and they have to stop everything. And then they're losing days where they could be interrupting that acne process.
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So the process kind of gets ahead of itself again. And so the reason topicals are so.
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Helpful and the reason I view them.
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As targeting the root cause of acne is because at the end of the day, acne starts with a clogged pore. I think some people might think of.
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Skin care as kind of like, superficial.
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And, oh, it doesn't work.
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It can work if you're using the.
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Right products in the right way. Because when we interrupt that acne process.
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With resurfacing ingredients, we prevent that clog from ever forming.
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And a successful acne approach needs to.
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Be preventative versus reactive. Most of us also take a reactive approach to acne with spot treatments and such.
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And, you know, this is kind of what we saw on infomercials with product lines like Proactive or all these spot.
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Treatments we were sold. I don't know if anyone else grew up in the 90s, but I feel.
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Like that is what you thought was.
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The correct way to treat acne is.
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Like treating a breakout, you know, with.
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A little spot treatment.
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But since ACNE can take 90 days to form, the real work really starts when you are like three months into.
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An acne program, because that's how long.
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It kind of takes that old congestion.
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To generally surface and make its way out. So at that point, like, that's when.
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We have a cleaner canvas and we should kind of be like, starting the clock. And in this episode, I'm going to.
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Share a few of the common themes.
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That I see holding people back. But I did want to say if.
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You need help implementing a tailored approach to actives, if you want a professional who can help you and essentially hold.
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Your hand and guide you through this.
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Process, I highly recommend joining my virtual acne program.
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I will put the link in the show notes. You can also visit tessaskin.com and I just want to say actives are huge guys. We can't expect results using an acne product a couple times a week or.
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Just even relying on one acne product. It's not about blasting your face off, but you need to have a targeted.
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Approach and it, it needs to be as intensive as your skin requires. I think we're also sold this lie that you know, you should be using.
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An active maybe like three times a week. You should be taking rest days, skin.
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Cycling or just exfoliating, you know, two to three times a week. For a chronic acne sufferer, this is.
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Generally not enough to interrupt that acne.
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Process because there are literally thousands of tiny skin cells piling up and creating a blockage in that follicle every single day. So here's a hot take.
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I feel most people who continue to.
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Struggle with acne probably haven't found out.
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How many dead skin cells their skin is producing and the appropriate level for controlling it.
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Let's talk some more about some other reasons that you might be struggling to.
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Get clear aside from actives, which is something I can definitely help with.
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Okay, number two, oftentimes there are dietary triggers that we need to pay closer attention to.
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And remember acne is a skin cell problem. Doesn't necessarily mean there is something wrong with your diet. However, because I do have my nutrition.
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Certification and I am able to take a deeper dive into my clients diets, I will do 24 hour diet recalls. We might do this for a few.
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Days to a week. I do tend to find some sneaky.
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Little triggers and it's, it's nobody's fault.
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You're not supposed to know this stuff.
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It really does take an expert in, somebody who's seen, seen the role that food can play with skin health. So triggers could be something like peanuts, soy dairy, seaweed, sugar, or even just excess simple carbohydrates and a higher glycemic load than your body requires for balanced blood sugar. You actually could be avoiding a lot of these common triggers that you might.
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You know, hear about or see on.
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Instagram, but you might not be eating the correct macronutrient ratio that your body requires to counter a predisposition towards acne. I will say the standard American diet tends to be higher carb focused and it's, it's not easy to kind of change this standard. I will say since I am gluten free, I, my diet naturally kind of crowds out a lot of simple carbohydrates. So in eating this way I have come to realize like how difficult it is to eat a high protein, lower glycemic, low diet in today's modern age.
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Like even with all the healthy restaurants and, and things that there are available, even though there are healthy snacks out.
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There, it really requires Some education and.
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Effort that's not easy to implement.
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To eat in a way that supports acne. Which to eat in a way that supports acne. Typically it is a lower glycemic load, a higher intake of protein, plenty of fruits, veggies, and ensuring you're eating a diverse whole foods diet. Again, way easier said than done.
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Not necessarily the cheapest way to eat.
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Definitely not the easiest way to eat.
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Especially if you live a busy life.
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You don't have a lot of time to cook or meal prep. So I'm just putting it out there like the world is not designed to.
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Support this type of diet, but it.
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Can be really, really helpful.
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And again, this is something I can.
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Help coach you on if you are.
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Wanting to take a closer look at.
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Diet and start eating in a way that's a little bit more structured to support your skin.
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Number three.
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Okay. I want to be very careful in how I phrase this because I think a lot of people could assume if you have acne, that means you're not healthy, you're not taking care of your body. And I will say it's generally quite the opposite. Like, most of the clients I coach are aware of their diet and they're definitely making conscious efforts to eat in a health conscious way. And I think there's also this messaging that, you know, acne is this hormone problem. Like, I feel like especially a couple of years ago there was this almost paranoia that acne equaled a hormone problem.
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And I think we're kind of debunking that.
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And I do try to put out.
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A lot of information to help people understand.
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Just because you have acne doesn't necessarily.
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Mean you need to get your hormones tested. Doesn't necessarily mean there's anything wrong with your hormones. Again, it could literally be excess keratin.
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Excess skin cell production, which by the way, is not related to your health. It's an inherited disease of the poor.
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But I will say I have seen.
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Certain patterns and trends with acne and, and internal health. And I would actually say this is not the majority of clients. This tends to be kind of a unique group of people who I know they're extremely aware of diet.
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I know they're using the correct products, they're on a treatment plan. And sometimes there is that small group.
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Of clients that is just really struggling. And it's an unusual case where you, as a professional have to, you know, be honest with the client. And I will always do this. If this is something that comes up.
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And I notice somebody isn't getting clear.
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In a, you know, a generally acceptable time frame.
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Like sometimes there have been some really.
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Tricky, challenging cases where I have to take a pause and I need to talk to my client and say, hey, let's look at a couple of other things. And generally we've also had lots of in depth conversations and we both, both know at, at a certain point that there are also some, some issues, some internal factors, some inflammation, and some reasons that they're already aware of, like digestive issues or pcos, thyroid imbalance, celiac sibo H. Pylori. These are some of the common threads and more challenging cases where it really is beyond skin care and lifestyle habits. And that said, we, we obviously want to keep those things because with acne.
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There are going to be variables we.
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Can control and they're going to be variables that are outside of our control. So my approach is always to give my client the tools and the best possible plan for success. And you know, at a certain point we can say, okay, we know we're.
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Interrupting the acne process on an intensive level. I know generally what your nutrition is.
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Like, how you're eating, what you're buying at the grocery store. Not saying it has to be 100%.
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Perfect every day, but generally I know.
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You are eating in a way that supports your skin. But let's look at these other factors. Whether it's been blood work, a condition, you know of, something that could be.
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Creating some systemic inflammation or possibly affecting hormones. And if you do fall into this category, like maybe you do have pcos.
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You have thyroid issues, I want you to know there's still hope for you. I have still gotten clients with these conditions totally clear because again, we really maximize those factors that are within our control.
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But they can be conditions that just.
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Make it more challenging than the average person to get clear. So there's still hope, hope for anyone with those conditions, you still can get clear.
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Sometimes it takes longer and sometimes it.
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Does take a second look.
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Making sure you have a great specialist.
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On your healthcare team and, you know, just making sure we are paying attention to outside factors and when it comes to systemic health, like these are, these.
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Are areas that are outside of my scope. And I'll never pretend to be a.
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Hormone expert or an endocrinologist, but I may implore my client to, you know, seek a referral or to get a second opinion. I think there are ways we can stay within our scope, but use the power of suggestion to try to ensure.
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Our client gets the help that they need. Aside from internal health issues, another internal.
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Factor I think we need to recognize that can really be an obstacle for.
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Clearing is birth control complications.
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And again, I want to preface this.
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By saying I'm not an endocrinologist, I'm not a hormone expert. I have a baseline understanding of hormones.
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And birth control, so that's just what.
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I'm going to touch upon today.
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But this is really a subject you.
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Want to explore with an endocrinologist or.
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Somebody who has extensive hormone knowledge. So what I can tell you is that birth controls, IUDs, implants and shots.
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Are popular forms of birth control.
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Typically, birth control is either estrogen or.
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Progestin dominant and it may have a.
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Varying degree of androgenic or testosterone like.
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Effect, just depending on the birth control.
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And depending on the person. Birth controls with potential for higher androgenic effects can exacerbate acne. So we do know that birth control that is more progestin dominant is more commonly associated with breakouts. And again, although I'm not a hormone expert, I will say just from what I've seen in working with thousands of.
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Women and getting to know them pretty.
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Intimately, I feel we are only at the tip of the iceberg when it comes to understanding how birth control can.
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Affect women, affect our hormones, and affect our skin overall.
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And I will say, I think the.
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Full equation of our hormone health gets.
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More and more complicated the longer we stay on birth control and the more varieties we try. So I also want to recognize we need birth control.
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I'm not saying it's bad across the board.
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I just want to say, and I think it's fair to say I am noticing some patterns. Like I see the toll years of birth control can take. And I, as a skin professional, am.
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Seeing a lot of the complications that.
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I think we're not talking about super openly.
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And I think most women would agree that we rarely receive much information, if any, on these big decisions and very.
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Powerful hormones that may affect us for many years to come.
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And.
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I just know myself, like when I went in to get birth control in my 20s, I don't remember any conversation about how taking that hormone would affect me. And I know I dealt with a.
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Lot of mental health issues.
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I saw skin issues out of nowhere. And although this isn't always everyone's average.
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Experience, it definitely can be.
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And I just, I wish it was different. I wish there was just more awareness around birth control. So I'm not here to say again, it's bad. I personally use birth control and, you know, I think it has its place. But I do think we should Just be more careful and cautious when we.
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Are going into these appointments. I want you guys to feel empowered to ask questions. And I will say there's absolutely no.
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Shame in this, but I just want to, I want to bring it up when I'm talking to my clients about birth control. Most of them don't know the name.
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Of the birth control they're on, and.
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They certainly aren't aware whether it is progestin or estrogen dominant or combination.
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And that's not their fault.
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And that's again, why I'm bringing this up.
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I think we should know more about.
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What we are putting into our body.
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So we can make very educated decisions.
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And I think there's a lot of.
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Dismissal that can go on in these conversations. And you can feel very silly asking questions.
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You can feel pressured to keep your appointment short. But I just want to encourage you.
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Guys to try to find caring providers, providers that are willing to talk about.
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The possible effects of, of the birth control you take. And I think we should just feel.
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More educated and empowered with this topic and not so in the dark because again, acne can have such devastating mental health consequences.
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And birth control, although it is not the main, main cause of acne, it.
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Can be one of them.
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Hormones are truly an important factor when it comes to skin health. And this is a thread I've seen with clients who are, again, doing all.
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Of the right things, who are in my program.
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And the one common like thread that's.
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Still standing is the birth control.
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And I have had clients who I would never tell them to get off birth control, but it is something I think, you know, they should look at, they should consider, and if they're kind of doing all the right things. But there is this huge obstacle making it difficult to clear.
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I think it's so worth talking to.
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Your provider about, especially if it does.
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Have those higher androgenic effects.
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So, sorry, I get a little fired up about this conversation just because I see a lot of women kind of in the dark on this topic, but.
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They'Re the one feeling the consequences and.
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The effects of that decision every single day.
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And they may not have considered, you know, if birth control could even be a factor.
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And I will say there can even be like a degree of decision dismissal on the whole topic of if birth controls can even affect acne. I've had a lot of clients tell me, oh, but you know, my doctor told me it could not have that effect. And I just think that's silly when.
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We know hormones are an important factor in the acne equation.
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And we know we're taking something that alters our hormones. It may not be permanently, but it.
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Could have a significant impact.
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So I think that's something that can deserve a second.
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A second look.
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The next factor that can impede clearing is lifestyle habits. And I think this is an area I am a true expert on. I think I'm really good at finding.
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The sneaky triggers, asking the right questions.
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And I always continue to ask my clients questions and check in with them because I'm just aware these factors can be really important. So again, your lifestyle habits are not.
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The direct cause of acne.
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This is inherently a skin cell shedding problem.
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However, I do witness the power of positive lifestyle habits every single week with my clients.
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Everyday habits that could be as small.
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As changing your bed linens often.
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So it's not adding bacteria to the acne flame, waiting too long to wash.
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Your face after the gym, which creates.
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A breeding ground for heat, inflammation, bacteria and oil. The perfect environment for acne to thrive. Picking, squeezing, or constantly touching your skin. Even the supplements you consume daily can.
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Impact keratin production or even impact certain hormones.
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So that's also something I look at on your intake form when you go through my program.
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The makeup you use and how you're.
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Applying it, your hair care, of course, your skin care, your diet, whether you.
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Are managing stress or living in constant.
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Fight or flight, I think is definitely impactful. Oftentimes, a very stressful life event, such as a breakup or a move, can precede a big acne flare up. And these are just super common factors I see over and over again and again.
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If you need lifestyle guidance and you want a seasoned professional to literally comb through your life and support you to.
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Get on the right track to clearing, please book in a call with me. I would love to help you. And I just have to say this.
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You are not supposed to know all this stuff.
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Like, this stuff is so nuanced.
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Again, it can be very harmless.
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Everyday habits. And I did not come out of.
- [28:28]
B
The womb knowing this stuff. I didn't even come out of esthetician.
- [28:31]
A
School knowing this stuff. It really took me years to understand acne and years of seeing hundreds of clients to start to see patterns and, you know, common, common threads.
- [28:47]
B
And again, if you need lifestyle guidance.
- [28:49]
A
And you want a seasoned professional to.
- [28:52]
B
Literally comb through your life and support you on the right track to clearing.
- [28:56]
A
Please book in a call with me. I would love to help and I.
- [29:00]
B
Just want to say this, you are.
- [29:01]
A
Not supposed to know all of this stuff. I don't want anybody to feel ashamed or, you know, like they, they should.
- [29:11]
B
Know all of this stuff.
- [29:12]
A
I didn't come out of the womb knowing this.
- [29:14]
B
I definitely didn't come out of esthetician.
- [29:17]
A
Knowing all of this. It really took me years to understand acne and it took me years of.
- [29:25]
B
Real life practice and working on clients, talking to them, having lengthy, deep conversations about like literally every area of their.
- [29:35]
A
Life, to start to put pieces of.
- [29:37]
B
The puzzle together and then to align that with research to understand what the.
- [29:43]
A
Patterns are that can affect acne clearing. And also, also, I just want to.
- [29:51]
B
Say it's, it's not easy being acne prone.
- [29:54]
A
Let's acknowledge that the cards are stacked.
- [29:57]
B
Against you in a way.
- [29:58]
A
When you are acne prone. Because you have an incredibly sensitive follicle.
- [30:04]
B
Doesn'T mean you have sensitive skin, but.
- [30:06]
A
Your pore may be very sensitive to the internal materials that are contained within it.
- [30:16]
B
And again, you may have excess keratin production.
- [30:19]
A
So acne clearing, it is literally an art. And even when I was a newly.
- [30:25]
B
Licensed esthetician, I did not know how.
- [30:28]
A
To clear my own skin.
- [30:31]
B
It took me again years to really.
- [30:34]
A
Be immersed in this stuff and to start to understand what factors are significant and need adjusting and to create protocols.
- [30:47]
B
That really help people get to the other side. Okay, guys, so these are a few.
- [30:51]
A
Of the more common reasons I see people really struggling to get clear. But if you're listening, I just want you to know how beautiful you are.
- [31:02]
B
I want you to know there's nothing inherently wrong with you if you're struggling.
- [31:06]
A
With to get clear, aside from the fact that you may have a malfunctioning pore. However, we can organize it, we can.
- [31:15]
B
Treat it, we can make very important strides.
- [31:18]
A
But I know it's so tough and I just want to be here for you. I know it can be just so.
- [31:26]
B
Hard to live in your skin every.
- [31:28]
A
Single day when you're struggling. It can be hard to make eye contact.
- [31:33]
B
Sometimes even just having close interpersonal relationships.
- [31:37]
A
Like acne takes its toll on some of your closest personal relationships and friendships. You would maybe assume that if you are very close with people, it doesn't.
- [31:52]
B
Necessarily bother you to be around them.
- [31:54]
A
When you're having breakouts, but it absolutely can. You can be very self conscious even around people that you love and trust. And it can be so hard to see other people living normal lives. Maybe your friends don't have to worry about what they consume or put on their skin, whereas it requires constant effort for you. And it can be something that just Takes up a lot of mental space and it's not fair.
- [32:24]
B
I do think sometimes there can be a silver lining to having acne, which maybe sounds a little cheesy or trite.
- [32:32]
A
But I do think sometimes it can be a little bit of a check engine light that can encourage us to.
- [32:41]
B
Explore a lifestyle that would better support.
- [32:44]
A
Us or even enlisting a healthcare professional that could possibly change your life. And I, I wish we didn't have to deal with the beast that is acne. But sometimes I do think it can, it can be a bit of a blessing and it can also force us to find meaning outside of, you know, what we see on the surface.
- [33:10]
B
And I'm not negating that, that's important.
- [33:12]
A
Like, we all want to feel great in our skin. We all want to feel our best and feel confident.
- [33:17]
B
But I do think sometimes it can.
- [33:19]
A
Encourage us to dig deeper and find, you know, more purpose and other things.
- [33:27]
B
That we love about ourselves aside from.
- [33:29]
A
You know, what we see on our skin. And lastly, I just want to say.
- [33:35]
B
I firmly believe that there are great solutions out there. I have witnessed what seems like miracles. Like I lit, I literally witness it happen. Every single week.
- [33:45]
A
People come to me who say they.
- [33:47]
B
Have, they feel, they have tried everything.
- [33:50]
A
They feel hopeless. I have literally like cried with parents.
- [33:55]
B
Because I get emotional when I see.
- [33:57]
A
People hurting who are emotional.
- [34:00]
B
I have seen parents feel so defeated by this condition because it's, it's not their expertise. They don't get a manual when they.
- [34:08]
A
Become a parent on how to help a young kid struggling with their skin.
- [34:13]
B
And it can be debilitating not only for the person struggling with acne, but for the people, people around them and.
- [34:19]
A
For parents who just feel so helpless. And I've seen parents who want to do anything and everything for their kid. Like, I've seen parents bring a bowl of water in their, in their car.
- [34:33]
B
When they pick up their child because.
- [34:35]
A
They know their child is, is afraid.
- [34:39]
B
To go to the bathroom to wash their face after soccer practice because they feel embarrassed.
- [34:43]
A
They feel, feel it's going to draw.
- [34:45]
B
Attention to their skin condition.
- [34:47]
A
So I've literally seen parents like pack.
- [34:50]
B
A skin routine, pack a bowl of.
- [34:52]
A
Water to like help their kid wash their face in the car after practice.
- [34:57]
B
Which I will say my idea, not.
- [35:00]
A
A terrible idea if that is your.
- [35:02]
B
Scenario and you need to wash your.
- [35:04]
A
Face, like, whatever it takes, I will try to help you find ways to, to get clear. But I just want to say, like.
- [35:13]
B
I recognize the everyday struggle.
- [35:15]
A
I know how helpless you can feel.
- [35:18]
B
But there are solutions. I've seen very stubborn and very severe.
- [35:25]
A
Acne cases, and I've witnessed them get.
- [35:29]
B
To the other side. I've helped them get to the other side.
- [35:31]
A
So I know it's possible, and I just don't want you to feel like it's. It's hopeless because although there is no.
- [35:38]
B
Cure, the condition can be controlled.
- [35:42]
A
So I want you to stay hopeful, and I want you to know if.
- [35:47]
B
If you are, like, struggling year after year and you haven't seen improvement, there's probably something we can tweak. There is probably a different treatment plan.
- [35:57]
A
We can put you on. And I just. I do think there are always answers out there.
- [36:04]
B
I love you guys so much.
- [36:06]
A
My treatment roomies. I hope you have an amazing day.
- [36:10]
B
I hope you take care of yourself today.
- [36:12]
A
Think about what you need, and I hope you take care of your skin today and tonight.
- [36:19]
B
Say something that is kind to yourself when you look into the mirror. Take a moment and remember, life is about so much more than perfect skin.
- [36:28]
A
But if you do want to improve.
- [36:29]
B
Your skin, there's also nothing wrong with that. And we are so fortunate to have.
- [36:33]
A
Amazing technology and really smart acne experts out there. So stay hopeful. I love you so much, and I.
- [36:42]
B
Will talk to you in the next episode.