Real Beauty is More Than Skin Deep: Addressing Skin Problems Internally


Over the years, I have told countless skin practitioners that as they grow in skill and bedside manner, they become psychiatrist, confidant and, in some cases, even religious counsel to their clients. When this occurs, they are privy to secrets that even the client’s spouse or best friend does not know.

At this point, total trust is established, and it becomes the ideal time to get below the surface where diet, supplementation and other wellness advice may influence what is going on in the epidermis. Although many skin care practitioners may not be qualified nutritionists or doctors, you can still advise and refer to qualified practitioners.

The more you advise, the more you know and the more confidence your clients will have in you. Of course, your topical treatments will show accelerated results. Beautiful complexions really are more than skin deep.

Consultation and Intake

Have the client list all their supplements and prescription drugs on your initial consultation chart, enabling you to research everything later to assess any benefit or contraindications to the skin.

Some of our teams in other countries are heavily into wellness and have a connection to local labs that will assess saliva, fecal and urine tests to be used by the skin therapists. In the United States, this is sometimes difficult to do, although not impossible.

Keep in mind that even if you can order these tests, you cannot diagnose or prescribe supplements from them. It can give you an overview of the client’s health, which allows you to better plan their topical treatments and home-use prescriptive.


Make sure you do your research and do not depend on internet searches. Take a few courses and read textbooks on nutrition and supplementation. You will clearly see that the knee bone really is connected to the thigh bone and every organ of the body, including the skin.

Concepts of therapy are more important than trending products. Internal observation is a large part of faster successful results, and products are just tools with which to implement the concept.

Making the Connection

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If a deficiency is shown on the test, you can recommend co-enzymes, herbal supplements or dietary foods to the client. Without the tests, you can rely on questions and answers while using your eyes to make observations. Go beyond just listening to the client tell you what they need; instead, look at the entire body, not just the face.

Make sure whatever you recommend is approved by the U.S. Food and Drug Administration (FDA) and it comes from a pure and reliable source.

Many therapists stock their own range of co-enzymes and supplements, but knowledge is power here. Unless you have researched how these, including botanical supplements, work with the body, I would simply refer the products to be purchased by the client at their risk. After all, many herbs can be contradictive and some even dangerous in certain circumstances. Almost all drugs started out with a plant at some level.

The Aging Client

In the aging client, the matrix gets thinner and thinner each year. This matrix keeps skin turgid and bouncy when young, while a thinner matrix leads to crepey skin in mature clients. Skin is easily injured and bruised in addition to irregular melanosome activity such as age spots on the backs of hands and elsewhere.

Outside of relieving the hyperpigmentation and melasmas, the matrix cannot be restored topically and has little to do with transepidermal water loss (TEWL).

EFAs. The client must increase their ingestion of essential fatty acids (EFAs) in supplement form. Part of this can be done by increasing EFA foods in their diets, such as green leafy vegetables, nuts, eggs, fish and olive oil. To really boost and thicken the matrix, evening primrose and sea buckthorn oil must be taken orally. Gel capsules can be found with a blend of those two oils for the client to take twice daily, focusing on EFAs that directly promote skin, nail and hair health. Evening primrose oil is also loaded with prostaglandins, which help with menopause irregularity. The body does need other EFAs such as omega-3, but that can be taken in diet form.

Vitamins. Tocopherols (vitamin E) will aid in destroying free radicals that can attack skin cells. Vitamin A can increase fibroblast activity and lead to new collagen factories in the skin. At least 1,000 international units (IU) of vitamin C, both topically and internally used, will kick-start these little factories into producing new collagen one and three, which can result in firmer skin.

Stress and Acne

Off-the-chart cortisol flux can influence an acne situation, along with hormonal cascades that are put off balance by stress via the hypothalamus gland. Assisting the client in regaining their self-worth and confidence from the outside in goes a long way with reducing the second main enemy of skin–stress.

Think of the hypothalamus gland as a radio antenna on top of the head, capturing all signals of stress. It can be teenage to adult stress (acne), middle-aged stress (menopause), spousal stress, work-related stress or, the worst type, subliminal stress. This type is source unknown and can signify deeper psychological trauma as opposed to pathological. After receiving the signal, the hypothalamus relays the message to the pituitary gland that then picks up the phone and tells the adrenal glands that stress is on its way. The adrenals get all excited and immediately ring up the testosterone with the message, which then shoots the message up to the sebaceous gland in the skin yelling “we need more oil.”

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At this point, the acne client would only have a little excessive oil on the skin, but unfortunately, they are suffering from cuticle build up, which becomes a barrier to the rushing oil. Unable to ascend to the epidermis and become part of the acid mantle, the trapped oil begins to reservoir under the epidermis. In defense of this onslaught, baby skin cells surround the reservoir, trying to encapsulate it. This odd granuloma appears on the surface as a pustule and sometimes as a hard cyst. The client observes these and squeezes it.

At that point P. acnes bacteria decides to march in, and the client is on their way to full blown acne vulgaris. Of course, there are various stages of acne and many other contributing factors, but it all starts with stress. If you relieve the burden of cuticle build up and start regulating homeostasis in the skin, the client views these fundamental changes in their skin, and the stress signals can subside.

You have just given them healing components from the inside out. Add to that proper dietary practices that do not stress the insulin in their bodies. Also recommend vitamins E, C and A as well as the mineral zinc and beta carotene, and you are on your way to a controlled remission.

Recommend less than 25,000 IU a day on vitamin A. Beta-carotene is from vegetable sources and is therefore less toxic than vitamin A from fish liver. Digestive enzymes along with good probiotics will aid in dermatitis, rosacea and acne.


You will have the clients who claim that they cannot afford to purchase supplements, see a professional skin therapist and buy skin care products. It is important to tell them that the body works both internally and externally in tandem to heal the skin.

Start by addressing their diet, since everyone must eat. Recommend low carbohydrates and clean foods.

For those looking for affordability, have only a few of the more important supplements at a basic level for them to take. Anyone can afford these if they can afford to come to an advanced esthetician.

Look Inside

I know most readers have had client that they worked with for weeks and received minimal results that were successful on other similar clients in a short time span. Did you ever have that nagging feeling that the client’s skin anomaly was connected to something else going on inside? You were totally right. To find out what that something may be, you must first gain the trust and confidence of your client. Eventually trust will prevail, she or he will “spill the beans,” and now, you can create a real plan of action. Real beauty is more than skin deep.

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Danné Montague-King is the founder of DMK Skin Care, which is based on his “remove, rebuild, protect, maintain” concept. He is a known educator, author and presenter.

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