928: The Root Causes of Acne and How to Address Them With Robyn Spangler

Child: Welcome to my mommy’s podcast!

Katie: This podcast is brought to you by Hiya for children and especially I love to talk about their new greens line for children. Now, I have tasted these vitamins and they’re delicious, and my kids are the ones who really love them though. And I love that they’re getting the nutrients they need without the sugar because most children’s vitamins are basically candy in disguise with up to two teaspoons of sugar and dyes and unhealthy chemicals or gummy additives that we don’t want our kids to have.

So Hiya created a superpowered children’s vitamin that’s chewable, without the sugar or the nasty additives and it tastes great. My little ones love it. They especially are designed to fill the most common gaps in modern children’s diets to provide full body nourishment with a taste kids love. And it was formulated with the help of pediatricians and nutritional experts and pressed with a blend of 12 organic fruits and vegetables, then supercharged with 15 essential vitamins and minerals, including vitamin D, B12, C, zinc and folate among others.

It’s also non-GMO, vegan, dairy free, allergy free, gelatin free, nut free, and everything else you can imagine. I love that they test every single batch with third party testing for heavy heavy metals and microbials in a qualified GMP compliant lab using scientifically validated testing methods so you can be completely at ease knowing it’s safe and nutritious and it’s designed for kids and sent straight to your door so you don’t have to worry about ordering.

My kids really like these and I love that refills show up on schedule with no stress. Also, again, honorable mention to their new greens because if you are tired of battling your kids to eat more greens, their Daily Greens Plus Superfoods is a chocolate flavored greens powder designed specifically for kids and packed with 55+ whole food ingredients to support kids’ brains, their development, their digestion, and kids actually like it. We’ve worked out a special deal with Hiya for the bestselling children’s vitamin. Receive 50% off your first order. To claim this deal you must go here. This deal is not available on their regular website. To get your kids the full body nourishment they need.

This podcast is brought to you by LMNT, and this is a company you might’ve heard me talk about before, and I really love their products because proper hydration leads to better sleep. It sharpens focus, it improves energy, and so much more. But hydration is not about just drinking water because being optimally hydrated, a state called euhydration is about optimizing your body’s fluid ratios. And this fluid balance depends on many factors, including the intake and excretion of electrolytes, which many people don’t get the right amounts of. Electrolytes are charged minerals that conduct electricity to power your nervous system. I talk a lot about nervous system on this podcast.

They also regulate hydration status by balancing fluids inside and outside of our cells. LMNT was created with a science-backed electrolyte ratio of 100 milligrams of sodium, 200 milligrams of potassium, and 60 milligrams of magnesium with no sugar. Since electrolytes are a key component of hydration, here’s what happens when we get our electrolytes dialed in.

We have more steady energy, improved cognitive function, suffer fewer headaches and muscle cramps, we can perform better for longer, and especially the support fasting or low carb diet because when we stop eating carbs like during a fast, the absence of insulin allows the kidneys to release sodium.

So replacing that lost sodium with electrolytes can help you feel good on a fast. Since LMNT is zero sugar, it also doesn’t break up fast. Electrolytes are also important for maintaining blood pressure, regulating digestion and proper fluid balance. Keeping skin hydrated, which is a big one that I feel like often gets missed and so much more.

I feel like proper electrolytes is a missing piece for a lot of people and I love LMNTs new canned drinks, which are sparkling water with all the same ratios and minerals I just talked about, and they are delicious. You can check it out and learn more here. And at that link you will receive a free sample pack with any order.

Katie: Hello, and welcome to the Wellness Mama podcast. I’m Katie from wellnessmama.com, and this episode is a deep dive on the topic of acne and taking a root cause approach to fixing it. It’s maybe a little bit more nuanced and also perhaps a little bit more straightforward than you might think. I actually learned a ton in this episode.

And I’m here with Robyn Spangler, who’s a functional dietitian, nutritionist with a passion for using food and lifestyle as medicine. This started for her with a personal battle with psoriasis, and she now specializes in helping women address the root cause of skin struggles and believes that your skin should be your favorite outfit.

We really dive deep on the topic of acne specifically in this one. I learned a ton, and stay tuned. We’re going to do another episode that dives deep on other skin conditions as well.

Robyn, welcome. Thank you so much for being here.

Robyn: Thanks for having me.

Katie: I feel like this episode is going to be really helpful for a lot of the women listening and probably also for moms to be able to help some of our kids who are going through this. And the topic we’re going to get to deep dive on today is acne and in particular the root cause of acne, because it seems like the conventional approach is very much kind of like a topical approach for the most part of trying to just deal with the skin itself.

And it sounds like with your expertise, there’s a whole lot more to understand on this. And I’m really excited to dive into this. To start, it sounds like you had a personal journey that actually led to the work that you do now. So can you take us on the journey that led you here?

Robyn: Yeah, absolutely. My skin started communicating with me back when I was 20. So in the middle of college, I got full body psoriasis. So covered in spots smack dab in the middle of college. And I would… at the time I was actually studying to be a dietician. And so I thought I was wating well and doing everything perfectly. Yet my body was not showing that it was the healthiest visibly with my skin. And I went through the traditional route. I saw a dermatologist. I got put on lots of prednisone. I did anything and everything that I was told and I was just stuck in a cycle of flares for about two years. And at that point I was in grad school and decided to take a completely different look at healing. And I was introduced to functional medicine and went down that rabbit hole and essentially I started studying what I could do internally to help my skin.

And in three months, I had no more psoriasis. And that is what really drove my mission to do what we do now with our clients is help clients address the deeper root causes so that you’re not stuck in the cycle of battling skin issues. Whether that’s psoriasis, acne, eczema, rosacea, hives, it appears differently for so many people of course.

Katie: That makes sense. And I would guess there’s a lot that could be going on with root causes and maybe it could be like multifactorial at times. And it sounds like for each person, it’s almost a learning of what your own kind of individual factors are. But I love that from what it sounds like you’re talking about, this is a kind of whole body approach or whole person approach versus just kind of trying to spot treat the skin.

For me, it wasn’t skin specific, but I encountered that with my thyroid, for instance, even just trying to symptom target and spot correct a thyroid doesn’t work either because the whole body is in harmony. So I’d love to get to understand the skin and connection to the body on a deeper level. And maybe you could walk us through things people might not fully understand about how the skin is maybe reflective or connected to other things that are going on inside the body.

Cause I feel like that’ll be a great springboard into approaching the inner versus just trying to deal with whatever’s showing up externally on our skin.

Robyn: It’s so connected in so many different ways. And I think you’re right that the traditional approach is just to spot tree or target one area. And even if we look at conventional medicine and acne with medications, they’ll often do birth control for hormonal acne, spironolactone for androgen acne, antibiotics for infections, Accutane for inflammation, and it’s still targeting one mechanism.

But the challenge is you may have multiple and also what’s actually causing inflammation, what’s causing the hormonal issues. And that’s what we do is we’re looking, like you said, at the whole person. And when we get into how is the body connected: inner body connected to the skin. This is where we go down lots of rabbit holes and I’ll try to be concise, but it really does. It starts with foundations. And I always talk about this in a way of fixing your cells. We are made up of trillions of cells. And I use the analogy of, imagine your body has trillions of little grapes inside that are telling your body what to do. Those cells tell your gut how to work. They tell your hormones how to signal. They tell your immune system what to react to. So we’ve got to start with the foundations and most people with skin issues are walking around with cells that are shriveled up little raisins and we’ve got problems there and we need to fix the cellular issue. And then we can maybe move on to targeting gut health, targeting detox systems, targeting hormones, targeting inflammation. Because to be honest, we have evidence of how all of those systems are connected to acne. And it’s just a matter of figuring out for that individual, what systems are not working and then we can repair properly for that person.

Katie: Got it. That makes sense. I would love to hear more about what are these kind of foundational approaches because I talk about something similar in relation to maybe like hormone health or circadian health of like we always want to hone in on the fancy supplement or the biohack or the whatever it may be.

But really it’s the getting our light dialed in and getting enough outdoor exposure and getting our basic nutrition and hydration dialed in that really make a huge difference. And then when you add those other more specific things on they work better. And it sounds like you’re saying there’s kind of a similar concept here with the skin. So what are some of those foundational things that we can all learn that are kind of like the basic building blocks of understanding our skin and how to support it?

Robyn: You nailed it with the foundation of real food nutrition, not saying diet has to be perfect by any means, but really focusing on real food as the primary source of fuel. I am really big on minerals, making sure that you’re eating a variety of minerals in your food. And this is probably a whole separate topic we could talk about.

But when it comes to repairing those raisins, we need minerals. And so I like the phrase roots and fruits. If you focus on your plate, are you getting root veggies and fruits? Those are really good sources of minerals. And then as is animal protein, which is very good for a bioavailable source of nutrients, meaning we absorb that well. So real food foundation. Protein rich foods, ensuring that we’re getting adequate protein throughout your day and at your meals to help balance blood sugar. Obviously we’ve got movement, we’ve got sweating, we’ve got good sleep habits, as you mentioned, light exposure for cortisol and stress. Those are foundations.

What we tend to see, at least with our clientele, most of our clients are doing all of those things and they’re still stuck. And so they’re frustrated for good reason of, Hey, I’m eating healthy. I’m living a healthy lifestyle. Why isn’t it working for my skin? And that’s where we go into the nitty gritty of, especially with the proper lab testing, being able to figure out. That’s amazing that the foundation is in place because then we don’t have to spend months doing that, but for a lot of people, they’re doing the foundations and the system’s still broken. And that’s where those fine tuning pieces is a big one is for acne, especially in eczema and psoriasis, is too much iron in the body.

And so that’s something we run into a lot with clients of getting their iron, what we call the iron recycling system working and sometimes doing blood donations to get rid of this toxic metal so that there’s getting rid of some of the cause of inflammation. That’s just one example of something that might need fine tuning.

Katie: I love that. Cause I don’t feel like I’ve ever heard that talked about in relation to the skin. I’ve had people on like Morley Robbins to talk about it in relation to other parts of the body or like cellularly with copper and how there’s a much more kind of like fine tuned equation than we often understand when we’re just told, like we’re anemic or we’re not.

So I love that you’re even getting that nuanced. And I would also love to touch a little bit more on minerals and protein. I love that you call it like the cells kind of being like raisins. And I have for years been ahuge proponent of minerals. And I wish we lived in a time where we never had to supplement anything.

But even Chris Kressor, when I had him on this podcast has said, unfortunately, with our food supply, you literally would have to eat an unreasonable amount of food to get the basic nutrients you need, especially when it comes to minerals. So I would love for you to just walk us through, are there any basic guidelines for women, especially about protein or maybe what minerals to at least be aware of and to kind of try to make sure we’re getting enough?

Robyn: Yeah, absolutely. When it comes to protein, I’ll touch on that one first. For most women, of course, this varies with weight and muscle mass. For most women, I would recommend getting over a hundred grams of protein a day. So that’s kind of a generalized statement, but aiming for 30 grams of protein per meal is a generalized recommendation. Now when we move into the mineral side, there are four minerals that we call macro minerals, meaning we have the most of them in our body.

And those would be potassium, sodium, magnesium, and calcium. One habit that we work with all of our clients on, and I talk about this all the time on my social media, is incorporating mineral mocktails. It’s something that I have sitting on my desk right now. It’s an easy habit to, it takes five minutes a day, if that, and it’s adding certain mineral rich products or foods to your water to enhance the sodium, potassium and magnesium specifically. I mean, Chris Kresser was right. It’s very difficult to keep up with our mineral needs and with a combination of stress load that everyone is inevitably under to some extent and our food not being rich, most humans are not getting enough of these minerals day to day. I think the estimate is 2 percent of the population gets enough potassium, and that is actually very tied to acne. If anyone’s been on spironolactone for acne, one of the mechanisms that helps it work for acne is because it’s a potassium sparing medication. So getting adequate potassium in your diet via food is extremely important and it is hard to do if you’re not giving it any attention. This is why roots and fruits is so important because we get potassium in potatoes and root veggies and in a lot of fruit, especially things like bananas and citrus fruits. So those would be the ones that I would be the most picky about with giving attention to because we just have the most of that in our body and we need so much of it.

Katie: That’s so interesting. I came across that not in relation to the skin, but in relation to when a family member had a mini stroke and going deep on the hydration equation and how these minerals actually seem like drastic needle movers and whole body health. But I didn’t know that in relation to the skin.

So that’s really fascinating to know, especially because it seems like we’re talking about minerals that are easy to find like easy to source. A lot of places carry them. They’re not super expensive and it makes sense. They’re kind of the basic building blocks for life, especially when we think of the electrical potential of the body and how those electrolytes support that electrical communication.

So this is so fascinating to me. And I’m also curious if there are truly actually different types of acne? Like we hear that classification kind of in the skincare world. And if it is actually different in cause and sort of what will help when we’re talking about teenage acne versus adult hormonal acne versus like cystic acne or are there truly different types and are they approached differently?

Robyn: Great question. There are different types. With maybe what this, how the skin would present it. You know, you’ve got cystics, you’ve got cystic acne, you’ve got comodomes. That from a root cause perspective is not as important to us as what’s causing it. So we look at different root cause types. So we look at five and they would be hormonal, inflammation, infection, irritation, and stress. Now the challenge is most people have more than one. There’s absolutely overlap. In fact, for our clients with more severe acne, the combination that we typically see is hormonal acne, infection, acne, and inflammation, having all of them. And so for those individuals, if you go down a… if you’re trying to address your root cause and you are working on gut health and you’re doing for gut health, you might only be targeting infection acne, but that’s not doing anything for the hormone piece.

So this is where having answers on what’s actually going on with your biology helps you create an effective plan. But we definitely need data to be able to save someone time, energy, and money. To be honest, I mean, no one wants to stay on the cycle of trying things and it coming back and losing hope. And so it’s just faster to get the right data so that you know what pathway you’re going down.

Katie: I definitely want to go deeper on dialing in on the root cause. And before we get to that, I’m also curious for any of the moms with teenagers listening, cause I’m in that boat as well. When we’re dealing with teenagers who maybe are not even going to be super receptive to our suggestions to begin with, and maybe don’t want to do a dozen different things, but do want to get rid of their acne.

Are there a couple of strategies that are kind of generally beneficial to them in general that we could suggest and implement? I’m thinking like, for instance, you mentioned gut health. Maybe if there’s a couple of things we can help them with their gut health and or like if they need to get more of these minerals in their diet and that can be an easy thing.

So when we’re talking about like teenage hormonal acne and maybe not the most agreeable, compliant people to help.

Robyn: Yeah, I know. Teens can be challenging, but also, they’re also motivated because they most of the time don’t want to deal with that either. One of the things that we’ve recommended for teens is to do mineral mocktails. It’s easy. And if you can get a blend or a recipe that they like, that they genuinely enjoy, it becomes the easiest habit for them to incorporate. And especially when you are working with hormonal acne, which for most teens, that is a factor, may or may not be the full story, but the minerals are important for the body’s ability to make and signal hormones. A lot of teens, especially teen boys, are dealing with androgen acne. Again, the reason spironolactone works is because it targets androgens, but also because the potassium reduces the androgens, the potassium sparing medication.

So if you can get teens just getting potassium through their food, you can also have a positive impact on slowing down that androgen mechanism causing acne. So that would probably be the easiest thing to introduce. Of course, there may be some basic probiotic support and obviously eating healthy and real food is a plus too, but this is where you get into the teens and what they want to do, what they’re willing to do. But I would say minerals is probably the easiest thing for them to introduce.

Katie: I love that. And I will say, as much as teenagers can sometimes resist, I also am highly encouraged by that age group a lot of the time because I volunteer coach track for high schoolers and I’ve overheard them talking about stuff like, Oh, my acne is bad. So I’m going to go off sugar for a while cause that usually seems to help, or I’m going to make sure I hydrate more. I’m like, wow, they’re paying a lot more attention than I did at 16 to those kinds of factors. So I actually am really encouraged for that population.

Robyn: Yeah, they definitely… I mean skin is emotional, it’s mental. I mean, I’ve been there and it’s not just a physical thing. So sometimes that motivation is coming from a deeper place and they’re willing to make some changes because it it affects them.

Katie: Okay, so let’s circle back to the root cause. I know the answer here, of course, is going to be that every person is different, so this is an individualized equation, but can you walk us through the process of how someone, whether they work with you or in general, can figure out their root cause or causes? Like, what does that process look like?

Robyn: Absolutely for us lab data is important. There are absolutely ways that you could maybe get a direction based on how your skin presents. For example, when we see body acne, back, butt, shoulders, chest, most of the time there’s a gut connection. So that may indicate giving attention to gut. So we’ll assess the individual and how their acne or their skin is presenting. And then we order labs on every client. So we’re looking at comprehensive blood tests. We’re looking at a stool test. We’re looking at iodine in a loaded urine test and we’re looking at minerals via a hair test. We take all of that information plus their story and maybe other symptoms they have as well, and we’re putting together a comprehensive plan specific to that individual based on how their skin presented.

And then we’re working with them for months on implementing, monitoring things, adjusting things and watching skin progress.

Katie: And I’m also curious how stress comes into play here. I mean, I know that like stress gets talked about almost anytime we’re talking about any kind of chronic condition. So I’m guessing there is a role where it comes into play. Bbut how does that come to play? And I guess the million dollar question is truly like, how do we begin to address that I guess? If we can solve that, we can solve a lot of things.

Robyn: Yeah, we can. And this is where I like to shift the language a little bit because we’re all going to have stress of some sort that’s just living in today’s world. And so it’s not about not having stress or just always managing your stress because we’ve all been told that, we know that. All that’s just a story we all know we could probably improve stress management. What we like to do with clients is talk about building stress resiliency cellularly so it’s not just about the actions you take, but it’s again, this grape versus raisin situation. The mineral status that you have, the nutrients in your system, those help build resiliency so that you are turning your little raisins into grapes.

That makes you more resistant to stress from a chemical cellular perspective. So that if you run into a real life situation, that I don’t know, work, work stress is rough for three months, that your body physically is able to combat that more and you’re not just taken down by symptoms. We want to strengthen the ability to combat stress versus every little thing causing some sort of new symptom that is a recipe of just survival mode and being in a chronic cycle. But this is where there’s so much power in how you nourish yourself because you can, be able to go through a stressful season and your body isn’t broken because of it.

Katie: I love that. That seems like, yeah, very important perspective. And I’d also love to just delve a little deeper on things like accutane or birth control, which I know those are commonly given for acne. It doesn’t sound like based on what you’ve been explaining they are solving the root cause of whatever’s going on.

So I’m curious if you think there’s like, is there a time and a place for those, or do they have downsides that people need to be aware of? And, or if someone’s going to try those options, can it go hand in hand with these more root cause things so that over time they become not necessary? Or how do you navigate if someone’s been trying one of those options to try to deal with acne?

Robyn: Great question. There can definitely be overlap with using medications and still addressing the root cause. When you say is there a time and a place. Yes, I think that mostly comes down to mental health because acne or other skin issues, they’re just tough on emotions and mental health. And there are times where we just need to get it calmed down so that someone can feel confident about moving forward. So those are the times where I would say consider bringing in a medication temporarily. Because also we’ve got to consider scarring and that is a big factor. And sometimes we just need to calm something down so that we can then move forward with the root cause approach. That would be the main time where I would say there’s a time and a place for it. But I also would want the individual to know that it isn’t addressing root causes. And when it comes to…there’s really four primary medication categories for acne, there’s birth control, spironolactone, antibiotics, and accutane or anti inflammatories. And so actually knowing, did one of those medications work effectively for you, can actually tell you more about what direction to target for a root cause. If you’ve got, if birth control worked, you’re probably looking at estrogen, androgen, or progesterone related acne. If Accutane worked, you’re probably looking at either inflammation or infection.

If antibiotic works, you’ve got infections. And if spironolactone worked, you’ve got androgen driven acne. So that information can be helpful and you can work on root causes to target those same pathways while being on medications and then it’s an easier transition when you work with your doctor to come off of those because now you’ve been supporting the body in a deeper way at the same time.

Katie: That’s so fascinating, but really helpful to know, like, that’s good data if it helps you kind of clarify what’s going on. So then you can, if you want to choose to take that more root cause approach, which I would guess since like we started, when we began this episode, everything’s so connected, that’s going to have also positive ripples other places as well, when you address the root cause. It’s going to support your body in other ways. And like I mentioned in the beginning, I know often skin problems are thought of as an external topical problem and you did so well explaining that it really does come from the inside, but it seems like there might also be kind of a both and situation of knowing the skin’s our biggest organ, we can, of course, also support it externally. We can support it from the outside in and the inside out, but what percentage is internal versus external and any guidelines on how to sort of best care for our skin as this massive organ that’s so important to health?

Robyn: Absolutely. It is two pronged approach. We talk about that with our clients all the time. It’s two pronged and inside out and outside in both matter. We actually have an esthetician on our team for this reason because taking care of the topicals is important. I think people just jump to that as the only option.

And so that part typically gets more attention. To be honest, most of our clients come to us already having a good topical routine because they’ve explored that so much. And so when it comes to topicals, I would say the biggest things are making sure that you’re nourishing your skin barrier. So that the skin is hydrated, that there’s no inflammation or infections. And sometimes that can be fungus, bacteria, mites. There’s lots of different critters that can be on the skin that are causing problems. And if there is an infection, it, it does need addressed. And that can be done with topicals. And then making sure that the skin barrier in general is taken care of. So if you’re dealing with very dry, dehydrated, damaged skin that in and of itself can create a kind of constant inflammatory state and make you vulnerable to infections all of that can be supported with the right topical care.

So that plus the inside out is really the whole person, big picture, long term solution to clear skin.

Katie: That makes sense and that’s really helpful and I know you have a lot of resources that go deeper on finding a root cause approach and on what to do for all of these specific things that we have gotten to touch on. And I know we’re also going to get to do a follow up episode that goes deeper on some other skin conditions like eczema and psoriasis, but also just like dry skin and how to to best nourish our skin.

But before we wrap up today, where can people find those resources and keep learning from you if they’re realizing like maybe something in what you said is going to be their missing piece?

Robyn: Yeah, we have a ton of free resources on the clearskinlab. com, and we have a whole free training that goes deep into this type of thinking for clearing skin. I also share a lot of information on my Instagram, that’s nutritionbyrobin, it’s Robin with a Y. So try to give a ton of free info. We have a free mineral guide, so if anyone wants to get started, that’s the clearskinlab.com/minerals. We have like 18 recipes in there. That’s an easy place to get started on helping those little raisins become grapes.

Katie: I love that. It’s such a good visual to think of and like what the difference in health of what that would look like. And I’ll make sure all those are linked in the show notes at wellnessmama.com for any of you guys listening on the go. And like I said, stay tuned because Robyn will be back with another episode that goes deeper on other skin conditions, but Robyn, thank you so much for the time today and for all that you’ve shared.

Robyn: Thanks so much.

Katie: And thank you for listening. And I hope you will join me again on the next episode of the wellness mama podcast.