Transcend Acne: A Holistic Case Study

Acne case study ft. connective tissue massage, buccal massage, lymph drainage and more

Client:

Lindsay from Beauty by LC

Lindsay is an esthetician, badass brow artist + makeup artist (and a former student from my Avenue Five days)

Time Frame:

2 months total from start of new product to final photo

Sessions:

6 total

4 - 90-Min Spell + Ritual

2 - 120-Min Spell + Ritual

Total Estimated Investment:

$1400


Primary Client Concerns:

Persistent acne on the jawline and cheeks, which began somewhat randomly and progressed rapidly within the last 6-12 months. Her lesions were inflamed and not helped by using her regular skincare line (Skin Script). She also had a good amount of post-inflammatory hyperpigmentation left after lesions healed. Her goals were to clear the lesions and get rid of the pigmentation.

My Concerns:

I could tell Lindsay had a LOT of lymph stagnation in the jaw area because of how puffy it was. I also knew that she had a good amount of jaw tension and a little asymmetry because of there being more tension on one side, and it was interesting to see that her acne was presenting more persistently on that side. Reducing the tension in the jaw and neck would be important for removing the waste build up in the area she was experiencing breakouts. She needed regular lymphatic drainage to improve flow and stress relief to reduce cortisol, which massage is perfect for. I also noticed her skin was dehydrated, puffy and she had dark circles under her eyes - all signs that the lymph is not moving in the face. My last concern, which was of least importance but still fun to work on, were lines that were presenting on the chest, neck and forehead from repetitive motion + adhesions in the fascia.

Pictured: Before first session + photos of each primary concern during first few sessions.

Root Cause Investigation:

Before our first treatment, Lindsay and I had a few discussions about the possible root causes of her acne. The more “mainstream” approach to this is blaming diet and hormones, so it is no surprise that one of the first things that came up was dietary changes she had made in the timeframe that her acne flared up + possibly removing gluten and/or dairy. I knew there had to be gut issues, but I am not a fan of elimination diets because the food is often not the cause - it is the way the body responds to it. There is also a lot of evidence that hormonal changes are not a root cause in most cases either, but a symptom ALSO exacerbated by the gut. This gets wrapped up in food elimination diets (take dairy as an example) and all the sudden you can’t eat anything. I just don’t buy it... in fact I honestly believe restrictive diets for acne clients are a huge victim-blaming mind fuck that cause unnecessary guilt and shame. This is not the way to get results.

I had been researching the correlation between nutrition, skin and the gut for my holistic esthetics course and was racking my brain for all the things I had found. I had a few light bulb moments with this.

  • First, I remembered that Lindsay had taken antibiotics at some point and we were able to correlate the flare up of her acne to around the same time this happened. Antibiotics are notorious for wrecking your gut so this was an important part of the puzzle.

  • Then, I also remembered from my research that just doing a probiotic doesn’t fix the issue. You have to know exactly what you are dealing with so that you can effectively heal the gut, and for that you need a gut microbiome test. This is a test that does DNA sequencing on what is in your gut to determine what type of bacteria, yeast, etc. is growing there and whether it is supposed to be there or missing in some way.

Lindsay decided to invest in a recommended gut test to see what is going on there because regardless of the treatment outcome, acne will just come back without treating the root cause. More to come on this later!

Another factor I was interested in was her skincare regimen and treatment history. These aren’t root causes necessarily, but they are definitely triggers. I knew she had a history of dermaplaning, and from what I have seen on clients this correlates with 1) fungal acne infections and/or 2) extreme barrier disruption. Her acne did not appear fungal in nature, so that was crossed off my list. As far as barrier disruption goes I was extra concerned because she had also been using Skin Script for her regular skincare. I am pretty hesitant to believe that Skin Script is good for anyone other than an oily skin type... the products are full of drying alcohols and fragrance, which to me is an acne disaster and a huge NO for anyone prone to inflammation or barrier disruption. Lindsay also has a history of eczema flare ups which is a red flag for barrier disruptive products. I anticipated her barrier had been pretty destroyed over time, but it ended up not being AS bad as I thought. Her skin was definitely dehydrated and depleted but not so barrier impaired that we couldn’t work on it. My secondary skincare concern was that she was changing up her products right before we started to an acne-focused regimen, and I wasn’t sure what was going to happen or if that would dry out her skin more.


Treatment Approach:

  • Home care: Before beginning this series, Lindsay got certified in Face Reality. She began her regimen the week before her first treatment and changed up her products about halfway through as her skin progressed. She was fully responsible for this portion - I am not trained in Face Reality and know pretty little about it, outside of it having a great reputation as an acne line. I know her home regimen included benzoyl peroxide and mandelic acid.

  • Services: My ultimate fear was that doing treatments + a new skincare regimen would inflame her skin more, leading to more acne breakouts. I started as simple as possible with barrier repairing products and lots of hydration. My main lines are Color Up Therapeutics + Hale and Hush with a little bit of Laurel Skin, which are all fairly gentle and barrier friendly. I incorporated enzymes, exfoliating cleansers and retinol as needed.

  • I used fascia sculpting and intraoral massage in every treatment with manual lymphatic drainage. More drainage was included as needed.

  • Energy work and sound healing were used in every session to encourage relaxation + parasympathetic activation.

  • I don’t usually do extractions, but I did lance some very inflamed lesions and extract during her first session. No further extractions were done.

  • Microneedling was used twice at 0.5mm with large molecular weight HA and a brightening growth factor solution. I do this at the end of the facial after my massage and combine with LED to reduce inflammation.


Results:

Pictured: Before session 1 or 2 next to photos from before session 5.

As soon as we saw how well Face Reality was working for her skin in conjunction with hydration and lymph flow from treatments, we were able to progress into more aggressive treatments. I jumped on a chance when her skin was clear of active lesions (just 2 weeks after her first treatment and 3 weeks after starting her home regimen - I was honestly amazed) and did a microneedling session. It seemed like her Face Reality was keeping her lesions fairly clear, with random eruptions here and there, and within a few days after that session we saw a huge improvement in pigmentation. I began adding in retinol and more exfoliation in her weekly sessions. Her skin purged a bit during this time, but by her 5th session it was BEAUTIFUL. I died inside a little bit.

For her final session, I did a light peel in addition to microneedling. It looked a little rough immediately after and purged a little in the following week, but currently is still looking AMAZING.

Pictured: photos taken by Lindsay Oct 26 (immediately after session 1), Nov 11 (3 days after her first microneedling) and Dec 18 (10 days after her final microneedling).

You can see an obvious improvement in photos that speaks for itself, but I will add my 2 cents on the improvements:

  • Her skin is way more hydrated, leading to a healthier appearance and smoother texture (hydration also = less retention hyperkeratosis = fewer acne lesions)

  • Her skin tone looks healthier due to improved circulation

  • The change in stagnation is HUGE... I honestly questioned if she lost weight (and the answer is no)

  • Improvement in dark circles under the eyes

  • More symmetry in the lower half of the face

  • Her right side is still tighter in the neck and face, and that is the side that was more stubborn to clear

  • The lines on the chest and forehead are reduced, but they are also stubborn so this will be a long-term focus

Pictured: top view from before each session + photos of each primary concern during the first few treatments and after the last.


Follow Up + Long Term Plan:

  • Continue to adjust Face Reality regimen as needed.

  • Try to use Gua Sha to move lymph in the jaw and reduce adhesions.

  • Use Face Reality peels to work on remaining pigmentation.

I also think she should have regular body work (massage) to reduce tension in the neck, shoulders, back, etc. especially on the right side, as she will continue using that arm more dominantly in her career and that tension refers up into the face. She should stretch regularly and make sure to practice self-care for relaxation.

Reducing stress (and cortisol levels), improving hydration, keeping skin clear with product, doing peels, helping lymph flow, getting tension relief, etc. are all ways to manage acne triggers and control or reduce symptoms, but a long-term solution requires addressing the root case which I believe is gut-related. She won’t get her test back for a few more weeks, but I am so interested to see what shows up and if it is in line with current acne-gut research.


More Information:

Interested in working with us to clear your acne? Book a service with me!

Get certified in my Sculpting the Face and Intraoral Massage techniques online or in Austin, TX.

Learn more about the causes + holistic treatments for acne in my Transcend Acne course, included in both my Comprehensive Holistic Facial Certification and free Holistic Esthetics Library offerings.

Listen to this Podcast about the acne-gut connection.

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Transcend Aging: A Holistic Case Study