Whether you have a skin interest asked in query as Skin trauma or skin disease I warmly welcome you to heal. Thy skin a podcast brought to you by term Costco. I'm Marni Derma clinician to mosque first annual podcast host skin is deeper than Beauty and our mission is to build the largest platform of specialized practitioners focused on skin health and skin empowerment. Join me each week where we go.Under the Skin and Beyond to hear stories and education from leading practitioners on a journey of skin health Almost everyone at some point in their life will experience acne from the Teenage break out to persistent inflamed cystic acne and adulthood. I'm sure you've had at least one experience of trying to conceal dry out or reduce a dreaded break out in your skin and it's usually seems to occur right before an event or something important. I'm no stranger to acting myself and I had the usual hormonal breakouts as a teen, but they were persistent. They were saw they were It I was so self-conscious and I even recall not going to school some days because I was just you know afraid what people would think of my spotty skin. It did come down in my later teens, but it reappeared with a Vengeance in my early 20s. And ironically this was actually when I was studying at Uni and I was working in a Skin Clinic where I had access to every topical skincare cream serum treatment and peel that was possible, but it continued to get worse it didn't get better. Better and it was only when I took a hard look at my lifestyle and I stopped over doing it that my skin improved and now I've just turned 30 and I don't recall the last time I felt worried about leaving the house because of a breakout but it certainly has been a journey. Welcome to episode number 9 of the hill I skin podcast. I'm mining your host. And today I'm speaking with Carly with Crossfit is a demo clinician at caps Plastic Surgery Clinic in Canberra Carly graduated from Bachelor of Health Science specializing in dermal therapies degree that finish or she finished in 2010 and for the last, you know many years since then she's worked in Canberra is leading aesthetic Plastic Surgery Clinic caps Clinic with a renowned plastic and reconstructive surgeon. Dr. Alastair Taylor Carly is one of the senior dermal clinicians and she's also the unit manager within the practice and her experience and dedication. Education has led her towards mentoring training and educating new staff within the practice as well as being a past Clinic supervisor at Victoria University. She's really passionate about all facets of the dermal sector, but when it comes to actually treating her clients, she specializes in photo aging and treating acne. So today Carly is going to share with us how viewing more holistically Or viewing acne more holistically will lead to better outcomes. But she's also going to give us some practical tips on how you can treat or seek out treatment for your own acne or acne scarring and I started by asking Carly what she thought the biggest misconception about acne was. I think that there really is a big misconception around the fact that there is a quick fix or a magic pill or magic solution for for acne. Unfortunately, it's multifactorial meaning that there are many contributing factors that need to be addressed or investigated in order to manage the condition. And I think that's so true, especially with you know, the Instagram world and everyone's wanting a quick fix an overnight fix and we want things done now and unfortunately, we just don't have control over our skin to that point or to that extent as much as we would all love that. I know I wish and tell us about your background just over this is to have a bit of a perspective of your background what you do what you practice in sure. Sure, so I completed the Bachelor of Health Science Gemma therapies 10 years ago actually, so in 2009 and for the past 12 years, I've worked for the Caps Clinic which is in Canberra for a plastic and reconstructive surgeon named. Dr. Alastair Taylor, and I've also done a little bit of clinical supervision with Victoria University. So working in their teaching clinic and I've been on the committee for the Australian Society of dermal clinicians. It's 2013. So as Vice chair chair and now in the marketing and media portfolio, which I'm really enjoying so it's safe to say you've seen a lot of skin and probably a lot of acne in your time as well. Yes. Yeah, so we know acne is a concern for many Australians young and you know going into their 30s and 40s. Are you able to provide a bit of an idea of the actual impact? Yes, certainly. So look acne affects so many Australians. I think probably majority of people would suffer from acne at some point in their life where they're going through adolescence or even later in life. I'm seeing it a lot a lot of adults adult acne and it not only affects people physically, but Also psychologically or mentally as well, which is huge in which is why I guess I do my job or why I love my job is helping people to gain that confidence. Mmm. Yeah absolutely. So is acne is acne is acne. Like other different types is one is kind of teenage acne the same as adult acne. Is there a classification? There is so the way I look at it is teenage acne and adult acne is technically all the same in terms of how it is comes about but the causes are often and the presentations are often different. So we have non-inflammatory inflammatory acne or lesions. So you're not inflammatory is you things like your blackheads and whiteheads? And your inflammatories more papules pustules and nodules so in non-technical technical terms your papules are your like you're blind pimples your pastures are more the little Posse ones and the nodules of the little lumps that you get deep under the skin. You can have a one or or all of them and mixture of both and it will commonly affect, you know, the face neck chest and back but there are different as you think different. Classification so as to how they come about so acne cosmetic are is caused by what you apply or use on the skin. So a lot of that I personally find is makeup. We will talk to a client about how to make changes with their regime and a lot of it comes down to just making changes to The makeup that they're that they're wearing and there are some main culprits that I have personally found it generally comes down to the ingredients but there's also things like acne mechanica, so it's from friction and heat so we look at during a consultation we look at what people are doing. Not only what they're applying. But what are they? What are they doing? And what are those factors and I mentioned briefly also just about where things will Went as well so that often will give you a bit of indication as to what might be what might be causing the acne as well. Hmm. Okay, so it's more than just hormones could be caused by things. We're doing in Addy day-to-day life. And even when you're talking about makeup considering things like sunscreen, you have an impact or you know wearing your yoga pants or I got top around all day. For example, yes. Yes. Yeah, I often find kids that wear helmets or headbands caps and they're not sort of that again that friction and the sweat and also blow dryers and things like that as well. Just that that heat from constantly blow-drying the hair is quite interesting as well MMP. I wouldn't consider that you know blow drying their hair every morning. They wouldn't consider that that would somehow contribute to acne. Mm9 not necessarily. And tell us a little bit more about I guess the the actual mechanism of acne. So you've kind of talked about some of the causes but what's happening within the skin? Yes certainly. So it is multifactorial as I talked about before and there are sort of four main factors that people talk about or know about into that can be impacting or causing in terms of the mechanism. So excess oil production. So most people will notice that there are a little bit more oily. There's inflammation within the the skin as well. There's often overproduction of cells, which will actually cause a blockage of the follicle. So you little plugs or again back but kids like people Presence of bacteria. She's a cutie bacterium Hackney's. Mmm. Okay, so it can be not just one thing but perhaps all these four things working together. Yeah will produce different types of acne whether it be all the different presentations whether it be blackheads or actual pustules and more inflammatory type acne. Yes. Yeah. So what are some of the common treatments for these? Types of presentations for acne so in my experience it's the exfoliation type treatments. So things like microdermabrasion and peeling procedures but led is quite popular and effective as well. So that's sort of I guess the the most common treatments that I find for treating acne, but then there's also the scarring side of things. So we hope that we don't get to that point but a lot of patience May not have intervened early enough. So there is some scarring. So that's where the lasers and other light modalities come into play needling is quite popular and effective as well particularly for superficial scarring helps with the overall appearance of the texture of the skin. They can also be treatments from cosmetic injectors. So the use of fillers to Improve the appearance of pitting but also plastic surgeon. So I would get dr. Taylor in some cases to exercise some deep scarring efforts appropriate. So sometimes no matter what we do from a skin level and treatment and Skin Care perspective the deeper the scar the harder it is to treat so accession can work quite well in some cases and you mentioned about scarring And you said if we have an intervened early enough then scarring can become an issue. So what would be intervening and why I would ask our occur. Mmm. I find that the more severe the acne is so the more inflammation that there is the more severe it's going to be so some people have as I mentioned before acting not only on their face but on their chest and back. And their bodies is so working so hard and so overloaded that yes scarring will will occur. So Journey think a chewable early enough when it is generally some of your non inflammatory type type lesions, then you can manage it really quite well often people will sort of think I'll just let it go and and see what happens. Can you never know I guess which way it's going to going to go that it can go downhill very quickly and scarring as I said psychologic people are left with those scars for unfortunately the rest of their their life. So we want to try and calm the inflammation and repair the barrier function as as quickly as possible and try and investigate what the client is currently doing or not doing or using and make suggestions for changes. So what would the ideal kind of acne treatment plan look like or at least in your practice? In our practice look it really is one. That is that takes a holistic approach. So that's looking at skin care what's used or not used diet lifestyle whether hormones may play A Part genetics often do and often to be able to take a holistic approach. It generally means working collaboratively with a team of So there might be endocrinologist new nutritionists dermatologists. It's even Beauty therapists. We can we can call on them to help out as well. So that's how we get. The best best results is doing the groundwork first and investigating and looking into all of the causes and contributing factors and then working out a plan that not only involves. Elves me or us but also looking outside of my scope and seeing who else can can help in that situation. Hmm and I can imagine especially if you know you mentioned before about acne having a psychosocial effect on people some people might feel anxious or depressed or or even not wanting to leave the house if they're having acne breakouts. So even not just from a physical standpoint it's also To have a look and see if it's necessary to refer them to someone to assist with their psychological. I guess Health as well. Definitely. That's that's really important. Mmm. And you mentioned within that about you look at lifestyle in the consultation process. So do you think lifestyle plays a role in the development of acne or even in the treatment of acne? Yes. I truly believe that. That it plays a massive massive part. So I know that when we're stressed we get breakouts, but I also know that the food and or medications that we put into our body will affect our skin and actually is some evidence that are started to come out to support this which is great. So what kinds of foods and things would you say may have an impact or even Of stress. How did what does that look like? Hmm. So things like there's been a correlation between milk and for some people it's end dairy in general that has an effect on causing breakouts and also high glycemic foods has also been been shown to have an impact. So if people have low glycemic diets and Some people don't need to cut out or significantly cut down on Dairy and or milk as well. So I find it's easier to talk to patients about what to eat and drink rather than what not to so obviously plenty of water eating more fresh vegetables and you need a bit of protein and good fats in there as well by doing that you're crowding out the things like sugary drinks and foods. start your high high carbohydrate type foods as well that which will convert to to Sugar within the body which then spikes your insulin insulin is a hormone which then obviously goes on to effect and cause acne as well really interesting how you know things like stress will spike is, you know cortisol levels which then in turn affects hormones and even with food, you know, we don't often think about how these Things like a low-grade stress which all of us have because we all live busy lives and we might not think we're stress, but we can have this hello gray cut type of chronic stress that we might feel okay about it, but our body is producing these hormones as as a result of that and clients or patients might not even realize that this and alone could be enough to perhaps cause acne or some other condition in the skin. Definitely a pleasure really big partner should say people just don't realize so if someone was actually having treatments and say that it was a holistic approach in those and dermal condition or dermatologist or dental therapist. How long would they kind of expect to see results when treating acne man's look I'd love to say that I could just click my fingers and their skin would be that it would be gone and their skin would be amazing, but unfortunately, The results aren't immediate. I think that the more people do. In terms of looking at that holistic approach the faster it will happen but the success definitely comes with time commitment and definitely compliance often. You can start to see some kind of results as early as sort of two weeks. And that's a lot of that comes from just, you know, taking out certain ingredients or products from from the regime trying to really calm At inflammation, but in my experience it can take anywhere from three months and even for some people even up to two years, but as I sort of mentioned before that early diagnosis and treatment is really important to try and seize that that progression of the disease as well. So it really is a journey mmm. We do regular check-ins and education with the patient we find.That really helps with with managing it so so that the client doesn't feel like they're alone that you're sort of constantly holding their hand through the process and reassuring them that it is going to get better. Yeah, and I think when you having treatment for whatever we kind of view the results by what we can actually physically see with our eyes and I can imagine with acne sometimes Yes, it may be improving maybe yes, there's less inflammation. But unless you're looking at the skin with a trained eye you might not necessarily see those changes that may seem subtle but actually signifying that there have been improvements in the skin and I can imagine that it would be quite disheartening for some people live there spent time and money on these treatments and seen professionals and doing these investigation and you know, it takes two to three. Two months to even two years to see real results to clearer skin. Mmm. Yeah definitely it is it is tough and it is heartbreaking. Sometimes I think that photos in this particular situation. I really important I think photos in general are important but I think in this particular scenario just to be able to refer back because people do forget what they look like or what they started with so that's a really good. Good tool but also asking them other questions, I tend to find that they'll mention things like they're either ask do I wearing less makeup or something as simple as as that or how long it might take them to put their makeup on in the morning or little things like that might give them a different perspective on how how much it has actually improved because most people will find that they're wearing less less makeup or it's quicker to apply or which generally means that it's improving. Yeah, that's really that's a really good point. So in regards to the different types of not different types of acne, but I guess they could different grades or severity of acne. When would it be appropriate to actually have further investigations when I'm doing a consultation and there appears to be other involvement. I would generally refer so what I mean by that. That is if I felt that there was some kind of hormonal involvement that I might refer to an endocrinologist. So if I feel that yet, so the hormones are potentially causing it or have quite a big impact. So we often see clients with polycystic ovarian syndrome. They can often have excessive hair growth as well as acne, but they're generally Looked after by an endocrinologist as well. I would refer their clients to say a dermatologist. If as I mentioned before the acne is really severe with large painful nodules and the presence or high likelihood of developing scarring. I think it's important to to refer and I may refer to a nutritionist as well. If the client seems to have things like allergies or food intolerances. Tummy tummy troubles and your mention you also I guess about out stress and things like that that there is sort of this link with the gut. So I think that I do have some knowledge and some interest in nutrition but it is good to refer out as well. Mmm. Yeah, absolutely. And obviously if someone is just experiencing some some congestion or some blackheads, it might not be appropriate or necessarily to actually have further investigations. I guess we talk more talking when it's really impacting that His life or it is quite severe or if it's become chronic and it's not actually resolving after treatments, right? Yes. Yes. Definitely. You can based on those you can sort of ya know who needs referring and who doesn't. Yeah, and so what are the common things that you tend to see that may that people do that may be aggravating they condition whether they've been trying lots of treatments before they came to Or whether they've just started, you know started to develop acne What are the main types of things that people think they're doing the right thing and it's simply not helping them at all. Hmm. Probably then the number one thing is over cleaning the skin and that goes onto then dry the skin which then goes on to produce more oil is sort of this vicious cycle. I think that they think that they can scrub away. Oil or that somehow their skin is dirty, which just unfortunately, it's not the case. Yeah, so I'd have to say that that's probably the main. Mmm, and I can imagine that happening and I remember even having acne as a teenager. I would wash frequently and not with gentle cleansers that might come inflammation. These would be like things that would be deep cleansing type things and maybe even have granules in them and I do it multiple times a day thinking if my skin was just cleaner than maybe it would be able to really try this break it out and heal it more quickly. Yes. Yes you and everybody else thinks like that. And I think a lot of it comes from the a lot of the product companies, I guess sort of, you know on TV or that type of thing that are sending that message message out. So I think it's really important to see someone who can give you the right information and assess you as an individual rather than just asking you you know, what's your skin? Like I have oily skin. Skin will here's and you know and in all your free cleanser and moisturizer or something like that. It's really important to get get the right advice. Mmm. So if someone was experiencing acne, and maybe they weren't under the care of someone. Where would they go? How would they know who would be the best person to treat them? How would they know what treatments were actually going to work? I mean, it's all good. Well to say go to your local clinic or go to your local pharmacy or go, you know by this thing that you saw on TV, but that's not necessarily the best advice because there's so much information out there. So what can someone do yeah, look it's really confusing to be honest. I'm probably a little bit biased and I would say go and see a dermal. clinician, I you know, that's what I know because that's what I've studied where skin experts and we have the time and the interest to spend investigating into all things relating to the skin and why something may be presenting or occurring where like detectives I think looking for links between systems within the body or outside factors that may be contributing to why something is a occurring budding having said that look the same as I said, there's so much information out there. I think just trying to find someone that you that you trust a lot of democratization and even skin specialist will have relationships with their General Practitioners as well. So if you were to go to your general practitioner, they may refer you to a dermal clinician or a skin. Specialist at yeah that it is a bit of a tricky one. I must say. Hmm. So well, I'm sure we can we can provide some more information in the show notes of some some resources. For example, some links to perhaps find someone in your local area, but you were talking about or you My previous question was about what people do to aggravate the condition and we don't want to be dr. Google here and be telling people, you know giving advice without seeing their skin, but what would perhaps one or two things be that someone could do if they're experiencing acne that may see an improvement in their skin or or just help with their conditional I start patients off at looking at what's actually doing an It of what's in their current skin care because it's not all about saying or you have to use what what we use in the clinic often. When you go to a clinic they will have products there, which is great because we know what's in them and back to front and inside out we know what's in them and what works and what doesn't work got endless, you know experience with them. But the main thing I start with clients is to give them information that that even if they don't choose to come on board with us as a client or a patient that giving them some information to take home. So things like avoiding sulfates. That's probably a really a really big one sulfates will act bit like detergent on the skin and strip and dry there's things like or so properly and glycol. Yep. Petroleum type based ingredients as well. So I find it just comes back to the ingredients and auditing what's actually in them. And for those that that don't know is consumers then generally your general clinician or your skin specialist will be able to give you a list. But also just if you're interested typing into into Google each ingredient and trying to figure out what is the actual purpose of that. Ingredient is it an emollient a humectant? Is it a surfactant? What it what is the purpose of it in that product? Because a lot of them that you're fine, especially over counter products what they put on the label is not always doesn't always match up to what's in the ingredients so that can be again a little bit confusing for for the average person. So just becoming a bit of a self. give and and not self-diagnosing necessarily but becoming a bit more of an informed consumer and I think there's lots of information online about that and and people really are being climbing up a bit about what is actually in their products and what the ingredients do and I think that's a really good movement that is occurring but also really good advice that yes, it's important that you go see someone that is specialized and that they know what they're doing and their experience and their qualified but it's also really important that you do your due diligence yourself. Mmm. And you know you perhaps you have a look at your own lifestyle and even keeping a diary of when you might have flare-ups in your acne and you can link that may be back to certain foods or certain situations and I think that's a really great way of Trading holistically, but also when you do go see a specialist you have a bit of an idea about what you're dealing with is well, yes, because the more information that you can give then the easier it is and the more information you're giving them. They can construct put more pieces of the puzzle together, I guess to actually know where you've come from. What's working. What's not what potentially is? Yeah causing it so they can put all the pieces of the puzzle together to sort of go. Okay. Well, this is what we need to concentrate on. And this is how we're going to move forward. So Carly York caps clinic in Canberra. Yes. So for anyone in local to Canberra passing through that may have acne then how would they find out a little bit more about caps? So we do have Instagram and Facebook. So if you just type in caps Clinic, we also do have a website as well as www.captionlink.com dot are you and I'll be there and do you have any ending words or parting words with our listeners? That's a good question stick with it. I guess it may seem like a really long journey journey, but if you put all the pieces of the puzzle together and not do anything in in unison think of it as a whole lifestyle type modification or change then Yeah, this game will improve in Leaps and Bounds for yeah. Yeah great advice. Well, thank you so much for being a guest on today's show Carly. It was wonderful to have you. Thank you for having me. Alright. Bye for now. Bye. What a great interview curly shared with us their different types and causes of acne and gave some really practical advice on how to manage and treat acne. But the three deeper than skin insights that really stood out to me were number one stress can actually lead to acne breakouts. I don't know about you. But any excuse for some relaxation and a bath or yoga class is good enough for me. So start running that tub number two, the treatment of acne should take on a holistic approach. So if your acne is Progressive or it's affecting your self-confidence, or there may be some underlying conditions it may it will it is really important that you seek the experience of other Specialties and you may even need further investigation as well. To make sure that there's not some underlying conditions that is causing or affecting your breakouts such as thyroid or hormone issues. Number three over cleansing your skin is not the solution to treating your acne. In fact over cleansing can lead to what we call an impaired barrier. So the Skins vital oils are removed stripped and as a result excess oil is produced and inflammation is also increased and it's this vicious vicious cycle. So thank you so much for joining Carly and I on the hill by skin podcast today if you found it interesting or useful. I'd love for you to subscribe. So you get notified on future episodes until next time. Are you feeling disempowered or confused about your skin? You can now join the Derm House Co Insider Community to learn about your skin connect with others in the community and find Practitioners to feel empowered on your skin Health Journey so you can face the world faster whether you are experiencing a long-standing skin condition recent disease injury trauma or niggling skin question. There is a place for you at Durham House Co and there's best part is that as a dome house coincide are your membership is absolutely free. So jump online at Derm Health dot cocoa and join today. I look forward to seeing you on the inside.
 Almost everyone at some point in their life will experience acne. From the teenage breakouts, to persistent inflamed cystic acne in adulthood. I’m sure you’ve had at least one experience of trying to conceal, dry out or reduce a dreaded breakout on your skin….. And usually it seems to occur right before an event. I am no stranger to acne myself. I had the usual hormonal breakouts as a teen, but they were persistent, sore and red… I even recall not going to school some days because I was so self conscious of my skin… then it calmed down in my later teens and reappeared with a vengeance in my early 20’s. Ironically this was when I was studying at uni and working in a skin clinic where I had access to every topical skin care cream, serum, treatment and peel possible… but it got worse, it was only when I took a hard look at my lifestyle and stopped over doing it that my skin improved… and now I’ve just turned 30 and I don’t recall the last time I felt worried about leaving the house because of my breakouts…. But it’s been a journey. Welcome to episode number 9 of the Heal Thy Skin Podcast, I’m Marni, your host and today I am speaking with Carly Whytcross, Dermal Clinicianat CAPS plastic surgery clinic in Canberra. Carly graduated from the Bachelor of Health Science Dermal Therapies degree in 2010. For the past 12 years she has worked in Canberra’s leading Aesthetic Plastic Surgery Clinic (CAPS Clinic) for renowned Plastic and Reconstructive Surgeon, Dr Alastair Taylor. Carly is the Dermal Clinician and unit manager within the practice and her experience and dedication has lead her towards mentoring, training and educating new staff within the practice as well as a past clinic supervisor at Victoria University. She is passionate about all facets of the dermal sector including advocating on behalf of and creating awareness of the special skill set of Dermal Clinician`s. Clinically, her eye for detail has created a special interest in treating acne and photodamage. Carly shares how viewing acne more holistically leads to better outcomes and some practical tips on how you can treat or seek out treatment for your own acne or acne scarring. Learn more about acne: http://www.capsclinic.com.au/acne-lifestyle-factors/ http://www.capsclinic.com.au/acne-what-is-it-and-how-do-we-treat-it/ Learn more about CAP's Clinic: http://www.capsclinic.com.au/   Be sure to subscribe to the podcast! 