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Hey guys, welcome back to the Treatment Room Podcast with your host Tessa Zolli, licensed esthetician, acne specialist and fellow skincare lover. So today's episode is very important to me to share because I think this is one of the biggest links that I see in my practice, and I think it's starting to be touched on a little bit more in the mainstream social media space. But because I notice it is such a factor for nearly all of my clients, to some extent, I don't think it's talked about enough. So we're gonna change that today and talk more about insulin resistance and the acne connection. So have you ever noticed or wondered why your acne seems to flare after you eat more sugar? You're constantly snacking. Maybe you're going through a really stressful season in life, or not getting enough sleep, or not getting any movement, whether it's walks outside or getting into the gym for strength training, it turns out that there may be a much bigger reason than just a poor diet eating a lot of fast food. It is a lot more nuanced than that. Research has consistently shown that people with moderate to severe acne tend to have higher insulin levels, greater insulin resistance, and higher levels of a hormone called IGF1 compared to those who don't struggle with their skin at all. Maybe your friend who eats whatever she wants, barely uses skin care and still has clear skin. Studies have even found that improving blood sugar balance through Nutrition can lower IGF1 levels in as little as two weeks. And I have seen this in my practice. It is also one of the reasons that inspired my acne focused nutritional therapy ebook, which is called Eat to Clear. And I'll just briefly say that a big part of the recipes is considering how I can create delicious, yummy recipes that still have a lower glycemic load and just help people find everyday meals that will not exacerbate your acne. So I think nutrition is so important, and we've barely scratched the surface with it even in the medical world today. Despite the new and emerging research, I think there are doctors that still believe that acne has no relationship with nutrition. And I just couldn't disagree more. So let's talk more about insulin resistance. We know that up to 50% to 70% of women with PCOS, which, by the way, the name has officially changed, this was big news in the medical world. PCOS has been renamed to Polyendocrine Metabolic Ovarian Syndrome, or PM Ovaries OS. So we know 50 to 70% of women with this condition do have insulin resistance. And acne is actually one of the most common symptoms of insulin resistance, which is why I see it so much in my practice, and I really make it a consideration for those who are in my program. But here's what's important. You don't have to have this condition or diabetes to be insulin resistant. In fact, insulin resistance can develop years before your blood sugar is ever considered abnormal or routine in lab work. And this actually used to really confuse me because I would have clients that showed such obvious signs of insulin resistance, whether it's really bothersome, facial hair, difficulty losing weight, irregular periods, jawline acne. And they would do their due diligence and go get the hormone test or do a fasting glucose test and just constantly be told, everything looks normal. And I think one of the issues with that is that we are looking at such a broad spectrum of people that a majority of them may have some level of insulin resistance. And so you might fall in the normal range. And the other component is that you may start to show the symptoms of insulin resistance, especially acne, years before it shows up in blood work. One of the most fascinating studies looked at people who were born with an extremely rare condition where they naturally produce almost no IGF one. And researchers found that these individuals almost never developed acne. But once they were treated with IGF1, acne began to appear. So this really highlights how powerful this hormone is in the acne process. So let's break down why this happens. Insulin is a hormone that helps move sugar from your bloodstream into your cells so that your body can use it for energy. But when your cells stop responding well to insulin, a condition that's called insulin resistance, your body has to produce more and more insulin to keep your blood sugar stable. So what does all that have to do with your skin? High insulin levels stimulate your ovaries and adrenal glands to produce more androgens, which we know are a powerful hormone behind acne pathogenesis, or they're also known as the male hormones. These hormones increase oil production in your skin, and it is just a crazy cascading effect of how one one marker can really create this domino effect with hormones, oil production, and eventually inflammation and clogged pores. And so at the same time, insulin increases IGF1, which speeds up skin cell turnover and tells your oil glands to produce even more oil. So now that you have excess oil, sticky, dead skin cells, AKA retention, hyperkeratosis on steroids, basically inflammation and clogged pores. This is the perfect environment for acne. And the frustrating part is that you can have insulin resistance long before anyone tells you that your blood sugar is problematic. So how can you know if you are having blood sugar issues that could be correlated to your acne? If you are experiencing acne, and you're also experiencing some common signs, such as intense sugar cravings, feeling really tired after meals, energy crashes, having a really difficult time losing weight, especially if you are tracking what you're eating and you're exercising. You're also noticing you are carrying more weight, specifically around your midsection, as well as skin tags, dark patches of skin around the neck or underarms. You're having irregular menstrual cycles, and of course, stubborn acne, which can often present in the jawline area and neck. Now, these symptoms don't automatically mean you have insulin resistance, and they're certainly not a diagnosis. But they are definitely clues that are worth exploring and possibly discussing with your healthcare provider. The really great news is that there are some super simple lifestyle habits that can dramatically improve insulin sensitivity. And I see this every single day in my practice. So let's talk about some of the things that I work on with clients to improve their insulin sensitivity. First is prioritizing protein. We want to aim for about 20 to 35 grams of protein at each meal. I'd say generally aiming for your body weight in grams of protein is a good goal to aim for. That said, I think tracking your protein can be a really vital first step, because I notice, especially with a lot of women, they are under eating Protein so significantly and they don't realize it. I've had a lot of clients that when we start doing this, we realize they're really only getting 40 to 60 grams of protein in a day. And so if that's you, it's best to slowly increase your protein. Make sure you're pairing it with fiber, because just jumping from 60 to, say, 125 grams of protein daily, it can slow digestion. So I think just slowly adding in more protein is also a great way to avoid feeling so overwhelmed. And you could literally start with adding a protein shake, ideally a pea protein or beef bone broth protein. I love equip code test 15. Save a little money on my favorite protein powder that tastes like whey. So delicious and creamy, but is dairy free and whey free. So adding in a protein shake as your snack, in addition to three meals that have protein, is a great little hack. A lot of my clients also love chomp sticks. Or you could simply look at how much protein you would generally have at your meals and weigh that out. You might realize, oh, I'm only putting 2 ounces of chicken on my salad. I could add 4 to 5 ounces of chicken. And if you're not used to eating, you know that amount. It can take a little bit of time, but generally the body does adapt. So even if you're starting to feel like, ugh, I'm so full, especially because protein is very satiating, just giving your body permission to adapt to the increase in food and knowing that it's okay to be a little uncomfortable at first, I think is a huge step in increasing your protein and focus on proteins that you like. If you really only like, let's see, ground beef or salmon or a couple of proteins, focus on those. Don't feel like you have to choke down protein that you don't like, because that's just gonna make it even harder mentally. Make a list of the proteins that you do like. And I actually do this in my consultations to help my clients increase their protein. And then I will create them meal plans, and I will create meals that I know they already are going to like. I know a lot of my CL really like any kind of bowl, a burrito bowl with some ground beef or chicken. You could do a poke bowl with some brown rice and cucumber. You could do chickpea pasta with an animal protein of choice, like chicken or beef or ground turkey. There are lots of ways to make sure you enjoy your meals, and I think that is the secret to success of healthy people. They aren't suffering through every meal and just eating it because it's healthy. They find ways to make their favorite meals a little bit healthier. And I think you can pretty much always do that. And you've probably heard so much about protein, but why is it so vital? Protein helps slow the rise in blood sugar. It supports muscle growth, which is very, very important in improving insulin sensitivity. Protein keeps you full longer. So if you're used to eating just a little bit of chicken, maybe 2 ounces, and you find in an hour or so, you're feeling super snacky. You want the simple carbs, you want the sweet treats. Try increasing the protein and you might find that it holds you over to the next meal just fine. And you can add in a snack or two as needed throughout the day. But one thing we don't want to be doing is just constantly snacking or eating late at night. Protein also stabilizes your energy throughout the day. So a lot of clients have told me, you know, I just feel so much better. I'm not crashing in the middle of the day. And, and so not only will it help your skin, but I think there are so many benefits for your energy, for your recovery from workouts, your cognition, your mood, your sleep. So all good things. Next, I want to focus a little bit on blood sugar balanced meals. And so this is where I want to talk about carbohydrates specifically. I think carbs have been, you know, demonized over the years. There's so many trends that come into the nutrition space. When keto was super popular, carbs were the enemy. I think now we're understanding they can have a very important role in the diet when you are acne prone and there is potential insulin resistance at play. I just think you need to be more strategic with your carbohydrates. You, you want to pair them with protein, healthy fats and fiber. So for example, instead of eating fruit by itself, pair it with some almond butter. If you're reaching for a snack, choose things like hummus with carrots and cucumber. Or you can even do a dill based coconut protein yogurt as kind of a ranch dupe. You could do turkey slices with apple. That's one of my personal go tos. You could do a meat stick that's super easy to take on the go. You could make a smoothie with some frozen berries that are very low in sugar, such as strawberries, raspberries, blueberries, blackberries. We love berries. Adding a little cashew butter or almond butter or coconut milk as A healthy fat source. Chia seeds are great as well for fat and a little protein, and then a protein powder of choice or a protein coconut yogurt in the smoothie. These options will help prevent the blood sugar spikes that can happen when we are eating what we call naked carbs. Just eating carbs alone is one of the most important things I can stress to you. And it sounds so simple, but it is surprising how many clients come to me and most of their meals are just a plate of carbohydrates, like having just a plate of pasta without much protein or healthy fats. So I think when you're choosing carbohydrates, we want to talk about what you're pairing them with, and then we also want to talk about quality. So instead of relying on refined grains or large portions of simple carbohydrates, which is also something to consider and simple, refined carbohydrates could be white rice, which is stripped of the fiber and swapping it for brown rice or black rice. I also love chickpea pasta. That is a great way to enjoy some pasta, but make sure it's more blood sugar balanced. I also love beans, black beans, pinto beans, navy beans, squash, zucchini, I think are a little bit slept on. And they can be so delicious as a form of pasta or just as your carb source. And I don't think you need to do a lot to them. Just roasting it with maybe some garlic powder, some olive oil, some sea salt comes out super delicious. And of course, non starchy vegetables. And I'd say most fruits can be included in the diet. That said, I'd say I'd put less of an emphasis on the really tropical fruits like mango, pineapple, dates, those super, super sweet fruits that they do taste so good because they are higher in sugar. And so I'd say those should be consumed, you know, in moderation, maybe not as your daily fruit source and maybe not in the first meal of the day when you have been fasted overnight. So these foods provide nutrients and fiber while supporting steadier blood sugar levels. Now, the next thing I really try to recommend to my clients, and surprisingly, everyone's been really, really open to it, which is really cool and exciting. And that is strength training. This is a game changer. This is one of the biggest things that changed my chronic comedonal acne is focusing on strength training. Whereas before I was doing a lot of cardio, a lot of running, a lot of different hit classes, and I basically just thought the point of a workout was to Move around and sweat as much as possible and constantly keep my heart rate up and literally just like kill myself in every workout. And that is actually not the best way to grow muscle. And muscle is important because it acts like a sponge for glucose. The more muscle you build, the more efficiently your body can use blood sugar instead of letting it circulate in your bloodstream. Even two to four strength training sessions per week can significantly improve insulin sensitivity over time. So if you're not doing any strength training, start with two times a week. The last thing you need to do is start going to the gym seven days a week and burn out because you're exhausted, your muscles can't recover and you just get fatigued of it. So start slow. And I think building, you know, as you go is a really great way to build your confidence and make sure you're still craving those workouts. Also, giving your body rest days is when that muscle is going to be built. Your muscle is going to be built in the rest periods, not in the actual workout, which is when you are actually breaking muscle down. So rest days are important too. And the message here is not to fry yourself in the gym. Also, if you were doing proper strength training sessions, I'd say, yeah, two to four or five times a week max, you will be feeling it. You, if you feel like you could literally go to the gym seven days a week, you might not be lifting heavy enough, you might not be doing enough reps or sets to really stimulate that muscle growth over time. So I was talking with some of my girlfriends at a coffee shop the other weekend. They also happen to be estheticians and business owners. And one thing that nobody told us when we started a business is that the better your business does, the more time it takes to run it. More appointments and more staff end up, meaning more hours spent on scheduling follow ups and marketing instead of time with your clients and staff, let alone your friends and family. But there's a better way. One where you can keep growing and get more of your valuable time back. Gloss Genius is the intelligent system that handles more of the busy work for you. Scheduling, payments, staff management, marketing and client follow up, all automatically working in the background to fill your calendar, grow your revenue and keep clients coming back. You can use code treatment at the link in my show notes to learn more and get 50% off your first two months of their premium plans. Now let's get back to the show. And I'd say, you know, workout classes, Pilates, they can have their place in a workout regimen, but I Would recommend really prioritizing strength training with lifting weights and just having sets. So doing a exercise for anywhere from 3 to 12 reps is kind of a good range to focus on. But if you feel like you could do 20, 50 or more reps with your weights, they might be too light. And again, the goal is really to lift the weights and then take at least a one minute break to allow your body to recover, allow your heart rate to come down, and then you're gonna repeat the exact same thing. This was difficult for me to get into because I came from such a background of going to a lot of classes and using class pass and I really just thought more was more and I had to be constantly moving. If you are constantly moving through a workout while holding rates, while holding weights, it's still more of a cardio workout. And we want to focus on the strength training so that you can push yourself to failure and you will need rest in order to do that. So in addition to strength training, daily movement really matters too. Even a simple 10 to 15 minute walk after meals can help your muscles absorb glucose more efficiently and reduce blood sugar spikes. It doesn't have to be super intense, but again, getting up for a short walk around the block after meals I think is great for mental health. It's great for your body to not be sitting in one place for too long. It's good to get up and move around. It's good to have your eyes see some sunlight for a circadian rhythm. And again, it really helps your muscles absorb that glucose more efficiently, which is what we want. And I think a lot of people are unaware of how sedentary they really are. A good exercise would be to look at your if you have an iPhone, if you look at your health stats, usually attracts steps pretty decently. Unless you're doing a lot of walking without your phone, then it won't. I personally do use an Oura ring and my iPhone and I find as long as I'm wearing the Oura ring, it's really accurate. And so I would look at your steps and I think this can be really shocking that a lot of people are way more sedentary than they realize. Especially if you are somebody who, you know, maybe you work from home, maybe you live somewhere where the weather isn't ideal a lot of the year and you don't have a walking pad. So you kind of just work from home. You will go to workout classes and because you're going to the workout classes, you feel like you're a really active person. But Your daily movement actually matters almost more than the workout itself. If, if you look at your steps and they are under 5000, this is universally classified as a sedentary lifestyle, which is crazy. So take a look at your steps and see where they are following. Make sure you're not spending six plus hours or more sitting. This also qualifies as sedentary. Even if you are working, sitting at your desk, commuting, reading, it's not like you're, you know, doing nothing or sitting idle on the couch. But your body doesn't know that. So we want to get up and just be moving throughout the day. And again, I think starting small here, if you look at your stats and you're at 2,000 or 4,000 steps, try to add a thousand steps every single one to two weeks and see if you can get near kind of a next level. Maybe you go from 5,000 to 7 to 8,000. See how that feels for your body. You know, I think easing into things is great to give your joints and your body just a chance to adapt without getting over fatigued. But walking does tend to be pretty reparative and low impact on the body as long as you have the right shoes. And you can probably slowly start increasing your steps and then see if you can aim to get near, near 10,000 steps. I know it's kind of the magic number and I don't think for everyone it has to be exactly that. But I think that can put you in a really sweet spot where you are making the most of how your body uses that glucose. Sleep is another huge piece of the puzzle. Even one night of poor sleep can temporarily reduce insulin sensitivity, making your body work harder to regulate blood sugar. This is my biggest challenge and I want to be, you know, transparent that it's not that I am perfect at all. I am informed about a lot of these things and I think even seeing how it impacts my clients is motivating for me to try to lead by example. But sleep is something I have to work hard on. I'm so envious of people that, you know, just sleep so easily, could fall asleep anywhere. I always say if I could have any superpower, that's what mine would be because I would put myself to bed at 9pm and be the most productive person ever when I woke up. But that's not always my reality. But I am really learning that poor sleep has one of the biggest impacts on my quality of life. It spills over to my communication, my relationships, my patience, my mood, my productivity, my performance in the gym, my Autoimmune condition and inflammation. So it's just really something I know is important. And I have to have boundaries and a regimental around my sleep. And we don't want to make our body work harder than it has to to regulate blood sugar. So aim for seven to nine hours whenever possible. And you might notice seven hours feels great for you. If you get more than that, you're more exhausted. So just finding what works for you and then trying to put a schedule together where you can be as consistent as possible. Ideally, your sleep shouldn't change too much from the weekdays to the weekend. That can be something that really throws people off. So just trying to keep things consistent. And I think also for me, I know it takes me sometimes 20 to 30 minutes actually fall asleep. So what I have to do is really disconnect from electronics from my phone. I try to get off social media a couple hours before bed, ideally after dinner, maybe a quick little tick tock scroll and then no more. I have to be careful not to have, you know, stressful conversations before bed and just really signal to my body that it's time to wind down from all the responsibilities of the day and put myself to bed. And so that means I know I need to get in bed by 9:45ish, so I can be asleep by 10:30 ideally. And so you could do the same thing with your schedule. Figure out how much sleep do I need to feel really, really good? I know I feel my best with eight hours. I feel on top of the world with eight. If I were to get nine, that would be amazing. But just knowing that and doing a little math, figure out when you can put yourself to bed. And yeah, just try to keep that schedule as consistent as possible. Stress management is the next piece. It's equally important. Chronic stress increases cortisol, which can raise blood sugar and worsen insulin resistance over time. This doesn't mean you're never going to have stress. It doesn't mean you need a perfect meditation routine every single time you get stressed out. But I think being self aware to know what helps you regulate, I need to be stringent on these things. I can let them go and focus on other responsibilities. And then I get to a point where I'm so depleted I'm broken down, I have no energy to pour out to anyone else. So it's crucial for me to really incorporate a lot of self care, you could say, and just activities that help me to manage my stress. So things like walking, especially walking outside, but walking on a pad or walking on a Treadmill at the gym, if that's your only option. Breath work. Sometimes I find when I'm having trouble falling asleep, focusing on five slow breaths in and out is just what I need to fall asleep. I think prayer and spirituality is major. I think in the past couple of years I have been on such a spiritual journey and realizing I can't do everything I need to by my own strength. So for me, having a relationship with God and not only praying in my own time, but making an effort to go to church, to have community at church, have friends who share spirituality, that has taken the pressure off of myself that I know I don't have to fix everything. I know there's a greater power and it's in his hands. So that alone has been life changing. If I even think back to a time where I was, you know, without that spiritual aspect in my life, I felt so chaotic. Everything felt impossible, and I would constantly be having breakdowns. And so, yeah, just really like releasing that to a higher power has been instrumental for me. It may not be everyone's journey, but if it's something you're curious about exploring, it's the most pivotal piece of my stress management puzzle. But you also might like journaling. I think releasing those thoughts on paper is so healing and powerful. And I think especially if you have a gift of writing, if you, you know, enjoy pouring out in a diary, I think that's something you should absolutely utilize. My sister is that way, and that is such a healing tool for her. So I think finding, you know, what works for you and then I'd say trying to slow down. This is so major. I think we can have to do lists that are way too long. And this is something I do. I can feel like if I don't get every single task done on my list, and maybe there's 10 tasks I have filled for that day. And so I've learn to have a lot more grace for myself and really kind of lower the bar, honestly, with productivity. I think realizing my productivity does not define my value. Getting things done doesn't define my value. My career successes are great and amazing, but they really don't define my character or who I am as a person. So honestly, having a shorter to do list, I've realized is just what I need to do. I think everyone can be different. I really value quality of life. I like to have flexibility. You know, in my days, if I need to go to the store or go to a doctor's appointment or take a walk outside, outside in the middle of the day, or end my day early to go to a workout. I'm okay with not maxing out my career success if it means I'm taking better care of myself on a day to day. And this is like an internal battle that I'm always fighting with because there's a voice that keeps telling me, do more. You have to do more to be successful and therefore to be valued. And I've realized that has just created, you know, a really chaotic energy for myself where I am constantly rushing from task to task and it's still never enough. So I'm trying to just chill out and slow down throughout my day, give myself more space and time than I think I need in between appointments or different things like that. Because there's nothing worse than feeling like you are constantly in a rush. I really don't like that feeling. I hate the feeling of being late. So even if it means waking up 10 minutes early or you know, taking out one task from the day so I don't have to be in that fight or flight mode, that is one of the biggest things I do to help reduce my stress. And lastly, trying to avoid snacking all day long. I think this is one that we might not suspect. But I've definitely noticed, especially with a lot of my female clients, they don't love the idea of three meals a day. So they tend to prefer snacks and that can lead to more processed foods and just constantly eating all day long. Not only does this not give your digestive system a break, it keeps insulin elevated. So instead focus on balanced meals, even if it's not what you're used to and you think your preference is a snack. Just challenge yourself to make a balanced meal, even if the portion is a little smaller to start out with. Or you could make a snack plate, but just make sure you are eating enough protein, healthy fats and fiber, and using carbs as more of a side dish than the main dish and choosing lower glycemic carbs wherever possible. I personally love some brown rice crackers. Those are great as a pre workout snack or with the snack plate. You can get a lot of different types of those. And if you are focusing on more balanced macros and meals, you probably won't find feel the need to snack every hour or two. You'll be more satiated. It's also important to remember that insulin resistance isn't the only cause of acne. Genetics, hormones, gut health, medication, skincare, cosmetics, bacteria and other medical conditions of course can contribute to acne. It is a complex condition because there's so many factors to consider. Which is why I think working with a professional such as myself is life changing, because you might feel like you've exhausted everything. But from a professional's perspective, a great acne specialist can really find those blind spots and help you identify more triggers to keep things more consistent. But one cool thing about acne is that it is often giving you clues about what's happening inside your body. So instead of focusing only on topical treatments, we want to support your metabolism through balanced nutrition, strength training, quality sleep, stress management and daily movement. These things can all not only help improve your skin, but your overall health and reduce chances for disease later in life. And if all those things together sound overwhelming, it's so okay to focus on one at a time. Maybe pick one to start with. Start with strength training twice a week. If you're not doing that, build your confidence and then when you feel ready, try to tackle the next thing. Maybe your nutrition or your sleep or your stress management or getting out for short little walks. Clear skin isn't just what you put on your face. It's also about your lifestyle and what you are doing for your body every single day. I hope you guys enjoyed this episode and found it educational. It would mean so much to me if you shared the podcast, shared an episode, or just give me a little five star review so that we can support the show and get more skin and acne related information out to the public. Especially information that I don't think is talked about enough. That is really my goal. I love you guys so much. Thank you so much for tuning in and spending your time with me. I love you and I will be back for another episode in two weeks. Remember, episodes drop every other Friday at 6:00am Pacific Standard Time. Don't forget to follow along on Instagram, my sdtessa and @free Skin by Tessa, my skincare brand. And I will talk to you guys next time.