Is low stomach acid flaring your eczema? – The Eczema Podcast S3E1

Abby: Hi everyone. Welcome to The Eczema Podcast. Today I have a very special guest here with me and I’m really excited to have her on the show because she is a wealth of knowledge. She is an expert when it comes to skin issues and chronic skin conditions. Her name is Jennifer Fugo and she’s a clinical nutritionist. She started a really successful website called Gluten Free School and now she also started a new website called Skinterrupt and you can find it on skinterrupt.com. She has a great podcast out and it’s about everything to do with chronic skin conditions. The thing that I love about it is that she actually takes a really natural approach and she doesn’t just talk about conventional remedies but also natural remedies as well. In her practice, she works with people with chronic gut and skin conditions and she takes a root cause approach, which is great because we want to heal the skin from the inside out. In today’s podcast I’ll also be sending out a link in the description or in my blog where you can get her seven free eczema smoothie guide, so be sure to check that out in the description as well. Welcome, Jennifer.

Jennifer: Thanks for having me, Abby. It’s such an honor to be here.

Abby: It’s a pleasure to have you and I know we’ve spoken a few times and you had me on your podcast too. You’re just a great person to interview and you’re a wealth of knowledge, so thanks for being here.

Jennifer: I appreciate it. Honestly, this is really my tribe, right? We are basically like all one eczema community because a lot of people don’t fully realize that I actually had dyshidrotic eczema and so I get what it’s like to go through it. If I had found your podcast when I was in the midst of all of my stuff, I would’ve felt like, gosh, you would have saved me so much time.

Abby: Thank you so much for saying that. Yeah, I know that. When I was suffering from it, there was not a lot of information out there but now there’s a lot more information out there and people like yourself who are putting great information about skin conditions and eczema out there so it’s great to have you on the show. My viewers would love to know more about your history and your story about dealing with the eczema and how you overcame it. Tell us more about that.

Jennifer: My eczema started to flare up initially when I was in my grad school program for my master’s degree in clinical nutrition. Of course, it’s like a super stressful time so big shocker that’s when it showed up. I never really had skin issues as a kid. I did have rashes about 10 years before I knew that I was gluten sensitive and had a bunch of food sensitivity. I started out my teenage years into my 20s with a lot of gut issues but I had no idea that the skin was so interconnected. When I took gluten out, the rashes went away so I thought, oh great, that’s great. I don’t have rashes but lo and behold about 10 years later, my skin was just really unhappy because of a number of factors.

One, I was chronically stressed out. Two, I was not eating very well. I was having blood sugar issues pretty badly. My last year of grad school, probably due to stress and I wasn’t eating super great, I was eating gluten free but more processed stuff than I probably should have been eating. Ultimately, I just still had more gut work to do. I didn’t fully realize that there was more things going on in my gut than I had really paid attention to. The skin piece, the blessing of it was that I realized there’s a lot more, A, there’s a big connection between the gut and the skin and B, you really need to optimize what’s going on in the gut as well as the nutrition that your body has access to in order to build healthy quality skin.

Anyway, I ended up with this dyshidrotic eczema all over my hands. It wrecked my nails. I had no idea that a skin condition could do that. They were all pocked and just deformed almost which was really upsetting. I went to dermatologist. They just kept giving me steroid creams. They were like, “Oh, that’s great. You’re doing all this gluten, dairy and egg free stuff. I don’t know what else to tell you.” I got just so frustrated because I had to wear these blue gloves that I had bought at a hardware store, disposable gloves because I could no longer touch water so I can’t wash my hands. People think it’s just a soap. I couldn’t even put my hands under water, it burns so badly. I stopped working out. I had a hard time cooking.

I couldn’t shower because no matter how tight the gloves are, the water will go in and I just became incredibly withdrawn. People would recoil when I would go to shake their hand. It’s like they would give it a second thought and be like, wait. I could see the thought process going through their head about whether was I infected, was I dirty? Do I want to catch that? They’d be like, “Oh, ah, you know, it’s great to see you,” like almost try and play off that they didn’t try and shake my hand.

Abby: It’s not a good feeling.

Jennifer: No, it’s really not because it makes you feel so alone. My husband actually was the one who said to me, “You know, I know you’re still in school, but if somebody came to you with this issue, like it’s not you. Pretend it’s not you, but somebody comes to you and has this condition, what would you do? Where would you start?” Because obviously the dermatologists don’t have any idea and a lot of the information, while yes, there is better information on eczema and psoriasis and rosacea, et cetera out there, it’s not consolidated very well. Your website is a fantastic resource for people but you know, it’s not like gluten free. Everybody’s got gluten free everywhere. Whereas skin conditions, because they are harder to treat and resolve, I think it can feel like a very frustrating long process both for the patient as well as the clinicians and the practitioners at times.

Anyway, I decided to start my journey and looking at my gut and that’s what I did. I built a protocol using supplements and food to make sure that I was getting enough protein in every day, adding in collagen and other skin really rich building type things like magnesium and vitamin D and vitamin A and zinc, etc. Just really trying to bolster everything up. It took, I mean, I had it for almost three years. It took about six months for the flares to stop. In the meantime, yes, I was still using steroid cream. Then, it took about a year where it finally seem to fully stop. I still had dry patches and within a couple months that went away and then it took about another four to six months for the nails to finally grow out correctly. I do not have eczema anymore.

I don’t necessarily assume that I will never get it. I still have my steroid cream upstairs in the medicine cabinet, but I do every day things to make sure that I’m nourishing my skin and taking care of it from the inside out so that I don’t end up with a potential flare on my hands.

Abby:               I think that’s really important that you mentioned that it’s something that we have to continually manage and work on. It’s not just a thing where we just work on one day and then we stop. I had a lot of friends who actually, they went on a clean diet, but then once they heal, they went back to eating a not so clean diet anymore and their flare came back. It was a bad experience for some of them.

Jennifer:           It’s interesting, the more doctors that I’ve spoken to, especially doctors that are aware of some of the genetic implications for why people develop these issues. For example, people that end up with eczema on their hands. I had eczema on my hands. A lot of other people do as well. You are more prone to have a genetic SNPs in the filaggrin protein that no one seems to understand why. Filaggrin is really important for maintaining that skin barrier so that you don’t end up with what is known as leaky skin. The more you itch, the more inflammation degrades the process within the body to create this protein that’s really important for this filaggrin protein as well. It doesn’t matter whether you have a SNP or not, either way you want to maintain lower inflammatory rate.

Jennifer:           You want to do whatever you can to reduce any sort of histamine or itchy type response so you’re not irritating your skin further. I mean ultimately, this is a lifelong journey. If this is what I have to do in order to maintain hands that I don’t have to think about, I’m happy doing that. That is a small price to pay compared to the hell that I went through before. I would never wish it on anyone, but I would much rather stay here.

Abby:               Yeah, I definitely agree with you. It’s painful to go through it. It doesn’t just affect us physically but also a large part of it is emotionally as well. That’s the toughest part.

Jennifer:           That’s true. The other piece to this, and I know this was something that you definitely wanted to touch on is that … I shared a moment ago that I came into this whole world like with gut issues, right? I started off Gluten Free School as a fan. I was really interested in health and nutrition and I became a wellness coach. I have so much background in gut health and whatnot and I didn’t know until this really happened that there is a distinct overlap between the two. That’s why I love that you’re constantly encouraging people to look deeper at what’s going on. You have to look at root causes because I get it, you’re in the mindset of like, I just want it to stop. What cream can I put on? What can I do? You’re always in firefighter mode of trying different things but the thing is if you’re just trying to address symptoms, you’re never going to get to the end of the road.

You have to find what’s underlying and perpetuating that inflammatory process or the histamine generating process or whatever is part of your, you know, whatever is fueling this process. Interestingly, and I’m sure you could probably talk about this too, is that the clients that I get or who come to me and I love them all dearly and I really feel for them because I know what it’s like to be in their shoes.

Some of them don’t have any gut issues at all. They poop like normal. I don’t know if you guys talk about poop on your podcast. I can talk about poop all day and if anybody’s being like totally grossed out like wait, did she just mentioned poop. Let’s first reframe this conversation. Your poop is a barometer of health in your body and your gut is directly connected to not just your brain. Yes, we call it your second brain, but it also is connected to your skin.

There is a gut skin access in the body that we are learning more and more about. All of these clients that I have that come to me who have all these chronic skin issues, I’m like, all right, we got to look deeper. You’ve got some issues. They all, for the most part, I’m going to say about 85 to 90% of them have low stomach acid. They’re not properly digesting their food, which means that these enlarged and partially undigested food particles are moving further down stream in their GI track. They, A, can’t really be fully absorbed because they’re not broken down enough and B, the gut lining, which is only one cell layer thick. Unlike your skin, your gut, you’ve only got one cell layer. It’s like a hose, and that has become leaky so to speak. Those partially undigested proteins are able to sneak in triggering inflammatory issues.

Now that said, food sensitivities are not a root cause. It’s one reason why people who often times will take out foods, they’ll start to feel better, but they can’t add them ever back in. It’s because that process doesn’t reseal the gut. There’s something that caused the gut lining or those cellular junctions to open and become leaky.

That typically has to do with a state of dysbiosis where there’s too much yeast in the gut or there could be a gut infection or parasites that are inflaming and irritating the gut lining that is driving this process. Food sensitivities are a symptom of leaky gut. Yes, gluten does and is the only food protein that also has the capacity to increase leakiness in the gut but to be fair, I think we’ve given a lot of focus on gluten and food sensitivities and probably a bit too much emphasis. That’s why people will get somewhat better, but not fully better because they’re not looking for those underlying reasons of imbalances within the gut. It’s important to look.

Abby:               Yeah, definitely. I agree with you. I love where this conversation is going right now. Jen, when clients come to see you, number one, how did they know they have low stomach acid? Number two, how would they discover their root cause?

Jennifer:           Yeah, those are great questions. Low stomach acid test, this is super easy. It’s cheap. You can do it at home. I have a great handout and an article all about this so Abby and I can share the link with you if you want to share this with your community just so they can read more about it since we don’t have a ton of time. Basically, you’re going to take baking soda and mix it with water. You want to drink that mixture on an empty stomach and there is a specific proportion. Like I said, it’s better to read the article and understand the intervals in which you want to do this so that you follow the directions exactly. Whether you burp or not and how much you burp. If you have a little tiny burp, you don’t have enough stomach acid.

You want a big burp like you just had a big gulp of pop or soda and you’ve got a lot of air coming back up out of your system. If that’s not happening, then you don’t have enough stomach acid. For people listening to this saying, “Well, I don’t have GERD, I don’t have any heartburn or anything,” or, “I do have that. How would I have slow stomach acid?” High stomach acid and low stomach acid have the same symptoms and more people have low stomach acid than high stomach acid. The only reason that you’ve only heard of high stomach acid issues is because there’s so much medication for it. That’s all you hear about. A lot of times low stomach acid is a major problem and that’s the first step. Number one, actually, it’s the second step. The first step is chewing your food properly. If you eat fast, if you’re unable to chew your food slowly and calmly.

Something really tough, like if you’re eating steak or meat or really crunchy fibrous vegetables, you should chew 25 to 30 chews per bite. Whereas softer foods you could get away with like five maybe to 10, five to 10 chews. If you’re not chewing enough, you don’t have teeth anywhere else in your digestive system. Now your stomach is charged with trying to break down large chunks of food that it’s not really prepared to deal with. This is an added stress. If you don’t also have enough stomach acid, you’re now just putting a heck of a lot of a burden on your stomach. This can cause indigestion, it can cause upset, it can trigger rashes, all sorts of stuff. Believe it or not, it’s a really big deal. It also helps set the stage for SIBO, small intestine bacterial overgrowth. It’s a big deal, like making sure that gut function is working properly is important.

The last thing I’ll mention is this. If you do not have a gallbladder and it was removed, you really need to take bile supplementation every day because, and that’s before every single meal because you do actually need bile. It’s very important and that helps you absorb that soluble vitamins like vitamin D and vitamin A. Vitamin A especially is integral to your skin as well as your thyroid and your eyes actually. You can’t absorb fats if you don’t have bile present when you eat. Again, I know everybody’s like, I take digestive enzymes, I’m fine. Digestive enzymes are one small, tiny piece of this picture. Optimizing digestive health can be a major help in the right direction.

Abby:               I love that. I love that you talked about this because I don’t think we’ve actually talked about this part before, but I had about two seasons of this actually. You’re the first person I think to be covering this part and it’s very, very important. This is actually something I teach in my 8 week group coaching program as well. I think a lot of people are surprised because they’ve never heard about this before. I remember going to a dermatologist and I asked him, you know, I have some gut issues. Is this something that you deal with as well? He was like, “No, I don’t talk about this at all. You have to go to someone who specializes in gastrointestinal disorders.” I was just very, very surprised. I’m glad that you talked about this. It’s just super important and not a lot of people realize it.

Jennifer:           That’s so true, and it’s one of those things that we’re conditioned. Like my dad is an ophthalmologist, he stares at eyes all day and I worked for him for about 12 years in his office before starting my own business and whatnot. I had a lot of experience working in conventional medicine, and the truth is we’re used to cutting up the body into pieces. It’s like if you have an eye issue, we only look at the eyes. If you have a skin issue, you only look at the skin, or gut issue, you only look at the gut. That’s not true. Your gut can be completely messed up because you actually have underlying Hashimoto’s, which is a thyroid condition. Actually, your thyroid can also mess up your skin as well.

It’s important to take a whole body approach and say, all right, if the skin is, and it is, by the way, the lowest total on the totem pole of priorities as far as organs are concerned. You could walk around with open skin and wounds and you’re still walking around. Your heart stops, your brain stops, your lungs stop, you’re dead. We know that for sure, it is lowest on the totem pole, but it’s also a mirror just like your bowel movements are, your skin is another window to what’s going on in the body. When you start to look deeper and you start to say, okay, what else could be at play here that’s contributing to these issues? That’s when you can begin piecing it together. It takes time.

I don’t think anyone should think this is a fast process and I hope, I know sometimes that’s disappointing. My journey was long. You got to stick to it. You have to take, put one foot in front of the other every single day. It can feel like you’re moving a boulder up hill sometimes and we all know what that’s like. You take it one day at a time, but if you’re consistent and you have those root causes in front of you and you work at them, you will hopefully get to that end goal. Sometimes it’s a squiggly line. It’s not always straight. Use Abby’s podcast and her website to help you. You’re a great resource for them, Abby.

Abby:               Thank you so much. I would love to know more about how you treat your clients when it comes to figuring out the root cause. I’d love to dive a bit deeper into that and then maybe we can also end with just hearing about one of your client experiences that someone has worked with you and healed. I love that. I just love talking about that because I really want to end on a note where people leave with hope and I think those stories are always the most encouraging.

Jennifer:           Absolutely. One of the first things that I do when I work with clients and by the way, I should say this. I see all my clients virtually, so they’re all over the place. I’ve consulted on client cases as far as Hong Kong. That was a little tricky to schedule by the way, but we did make it work. The reason this is important is I think we’re so used to seeing a doctor one-on-one that it’s hard to imagine not sitting in the same room with somebody that you’re working with but I’m sure like you, Abby, you don’t necessarily need to be in the room with a person in order to help them find a root cause. For me, I have a really comprehensive intake form. It’s about 10 pages long. It asks questions that you probably never even thought of like, have you been exposed to any toxic chemicals, including by the way chlorine.

Chlorine does affect your thyroid and your thyroid can affect your skin. We look at labs, so I ask people for labs anywhere from the last two, three, four, five years. Sometimes they’ll give me even further back if they have them, even if it’s just regular blood panels. I’d love to take a look at the different values as far as kidney and liver function, the way that the red blood cells look, that can tell us a lot about nutrient values. Vitamin D, vitamin A, which they never run and I always have to ask for and we’ll look at a bunch of other inflammatory markers. I’m building this case file, this picture. Were you on a lot of antibiotics? Did you have a history of yeast infections? Do you have a lot of trauma in your life? Go ahead.

Abby:               This is so crazy because you mentioned that your intake form is like 10 pages and you go through so much detail and I was thinking about like a dermatologist. Their intake form is like-

Jennifer:           One page.

Abby:               Yeah, one or two pages, they can ask all these questions, but it’s not only treating the symptoms. I love that you actually go through lab results too.

Jennifer:           I’m not allowed to diagnose and that I do always want to be clear with that. I’m very clear with clients cause that’s beyond my scope of practice. I am allowed within my scope of practice to educate people on what their labs are reflecting. I’m allowed to build protocols off of that that includes woman’s lifestyle and food and dietary changes obviously. With that said, we’ll sit down then for an hour initially and go through that form and they’re like, what more do you want to know? I’m like, well let’s start here and I start asking questions. Believe it or not, I don’t even see somebody when we’re talking, I do everything just by listening. The reason is that by shutting off any visual, just like, “That’s a pretty blouse or oh, I saw your cat run behind you.” There’s no distractions.

Just listening to every word how they say it and if I hear something that I’m like, wait, can you describe that further for me? You know, I dig, that’s the whole point. I pull out, I use the form as the basis to drive the conversation to get even more detail pulled out. That helps me then figure out, okay, where do we need to look using other conventional labs? I think conventional labs and functional labs are both helpful tools. They look at different things as well. I don’t think you should discredit one or the other. We work within that person’s budget and you know, obviously if they have health insurance, I try and utilize that as well to figure out through testing what else is going on because I don’t like to guess.

I’ve had plenty of clients where they swore to me they had candida overgrowth and then all the testing came back and their values for the byproducts of what yeast produces. It’s an organic acid called arabinitol, it was like almost nonexistent. They didn’t have yeast as a problem. They actually had overgrowth of E. coli or something else. It’s not the bad E. Coli that’s going to make you sick. We have that in our gut, but it’s something else. I don’t like to guess. I always like to know what are we dealing with so we can figure out the most efficient way forward. Then we’ll sit down again and we’ll go through those labs together. I mean, I’ve reviewed them already. I spend a lot of time, not even on the calls with clients reviewing stuff and putting together protocols myself.

I don’t have custom cookie cutter protocols. They walk away going, “Wow, I had no idea that this is what was going on because no doctor has been able to tell me why the symptoms keep recurring, why I’m having these flares, why I’m waking up in the middle of the night super sweated and hot and not sleeping well or feeling so exhausted that I get home from work and I fall asleep on the couch.” Any type of thing, like all the symptoms. If I could implore your audience right now, one thing, consider every single symptom that you have important. Don’t blow it off. Don’t assume that because a doctor has told you that it’s, “Oh, don’t worry about that. You’re making a big deal out of nothing.”

Write everything down because those are clues and you can’t actually understand the full picture of what the body is trying to tell you when you blow things off. If you can’t stay awake past 7:00 PM at night, you can’t get up in the morning. You eat and you start to feel nauseous or any number of things. You have a weird metallic taste in your mouth, write it all down so you have a clear picture for someone that is looking at you from a holistic standpoint, from a full body perspective of what’s going on.

Abby:               That’s really important. It sounds like the labs that you do, which not a lot of practitioners or doctors even do really picture into the root cause of the issue.

Jennifer:           Exactly. It’s funny, I have only, I think out of all the clients I’ve worked with, only one dermatologist has ever been open to running the regular like conventional labs. They’ll be like, “Oh, you have to go back to see your primary care doctor. I don’t run the labs.” I’m like, you’re a doctor, what do you mean? Part of this, they’re afraid they don’t know how to read them. They don’t know how to translate them. They’re afraid that they’re then going to be on the hook for it. There’s a lot of fear of malpractice, at least in the United States. I just find that you’ve got to find a way. You should not for any reason ever throw in the towel. This is a journey. It is a process of stepping up to the plate and saying, “I’m going to be responsible for myself. I’m going to advocate for myself. I’m going to learn how to ask the right questions.”

Jennifer:           If you need help, you’re going to ask for help. Just like I don’t do my electrical problems. I don’t take care of my plumbing. I call a plumber, I call an electrician. You get somebody by your side that is a copilot that can help you understand how to navigate this and ask the right questions. You find a community that you feel comfortable in, that you can be yourself, that you can share your good days and your bad. Just know that you got to put one foot in front of the other. I don’t know how else to say it. Things do and can certainly get better, but you just have to never give up hope that it’s possible.

Abby:               That’s the most important part I think it is. You’re right. It’s like trying to get a boulder up a hill. It’s very tiring.

Jennifer:           It can be, but you know, again, when you have a community and you have people at your side, like I always tell my clients, I’m like, I’m your copilot on this journey. You’re coming to me because you don’t know all of this stuff. You don’t know how to understand these labs and translate into real life and to look for all this stuff and figure out what the right supplements are and whatnot but I’m relying on you to do the groundwork, to be in your body, to implement and to give me feedback. We’re a team. To me, that’s the most important part is to be on a team together. I think when you’re having bad days, it’s nice to be able to reach out to somebody and be like, “Help. What do I do?” You know? They’re there for you.

Abby:               That’s what a lot of people don’t have. I’m so glad that you’re offering that. I know we don’t have a lot of time left, but I would love if you could share maybe like story of how someone got better after seeing you and how their skin improved as well.

Jennifer:           Yeah, absolutely. I have one client, she had rashes everywhere and it had gotten so bad that she had them in her armpits, in her groin area. She also worked in like skincare and that was like, she just was like, “Oh my gosh, I can’t even tell you how embarrassed I am.” You know, really hurt her confidence because she work in an industry that’s so fixated on the beauty of your skin and here she was with these really awful rashes. The doctors just kept giving her creams and she just was not getting any better, super itchy. I looked at a bunch of her lab. She definitely had deficiencies and a bunch of things. She had a red flag. She had had like just unending yeast infections for 10, 15 years. She even at one point had been hospitalized because they’ve gotten so bad that she was sick. I mean, this was many years ago. I was like, “I think you have a yeast problem but let’s be sure.”

We did the task, came back saying she was super positive for yeast overgrowth in her gut in addition to some of the other issues that were going on. I built a protocol to help address that, to rebalance the gut, eliminate and knock the yeast down cause you’re never going to get rid of it 100%, but just to balance the gut so that the gut flora you should have, a healthy gut flora can help manage that population and get the nutrients back into her. She also wasn’t eating a lot of protein, which you really need if you’re going to rebuild healthy skin, you need to be eating a significant amount of protein because there’s no protein stores in your body. We don’t save protein. You have to be consuming it. Over the course of about three months, she was able to start seeing the rashes dissipate as we were able to knock down that yeast population and get her body replenished. I think we started working together in January and now she doesn’t have anything.

It was a few months ago. We sat down and she was like, “I don’t have anything, I have no itchiness, I have nothing. I’m feeling so much better.” Now, that’s an easy case. I don’t want to mislead people into thinking, three months, four months, I can get better. For me, it took six months before the flare stopped. Everybody’s different. The fact that she got her quality of life back, she has, and she even said the same thing, “This experience taught me that I have to make some significant lifestyle changes. I need to manage my stress better. I need to make sure that I’m bringing in the right nutrients. I can’t just have like a piece of toast with some almond butter on it and run out the door with a cup of coffee.” She actually had to really take care of herself and we meet periodically to do some check ins and make sure that everything is optimal. I’m really proud for her. I’m really happy for her that she’s been able to change that, but she was super committed to doing it.

Abby:               That’s amazing. You basically saved her life. It must be such a good feeling as well.

Jennifer:           It is. A lot of the women that I work with are professionals. Not all of them. Some of them just mom’s at home and they’re really busy with their kids and you know, but I also work with women that are professionals in the working world that are either representatives of companies or they’re in sales meetings and whatnot. This is a huge blow. I understand we all have this funny thing about, “I’m not vain.” The reality of it is people do judge us. I wish that they didn’t, but they do. I came to learn the hard way when my hands were all messed up. People thought I was infected and dirty. It’s a real blow to your confidence when you stand up there and all people are really able to see is your rashes and not the message or whatever it is you’re supposed to be sharing at that moment.

For anybody to be able to feel more confident, to feel more healthy, to not have to focus on that stuff because it’s just not an issue anymore. I feel like you’re giving the person a gift back of normal, the gift of normalcy in a sense. But again, you worked, she worked for that. She worked her butt off for it and I would feel very lucky that I got to be the copilot along the way.

Abby:               That’s amazing. Thank you so much, Jen, for sharing your story, giving us some education on root causes. Just also sharing things that have been lacking a lot in teaching people how to overcome the skin condition because I know it is, it is very, very tough. Now if people want to get in touch with you, book an appointment with you, or maybe even just learn more about you and your teachings, where can they find you?

Jennifer:           Absolutely. You can find more about me obviously at skinterrupt.com. You can also check out my website. You can look up Gluten Free School, but I also have a website, jenniferfugo.com. Then if you’re interested in tuning in, like Abby, I have a podcast called The Natural Skin Show. What’s really cool about it is that I have doctors, researchers, nutritionists. Abby is a guest on this. I’ve got so many interviews of people from all walks who are sharing research and information and inspiration even, some are patients and clients that isn’t in textbooks, that isn’t being taught to dermatologists, that’s on the cutting edge of what we all wish we knew and want to know but we’re just not really getting. If anybody wants to tune in to that and tap into that wealth of knowledge, I invite you to do so.

Abby:               Amazing. Thank you so much, Jen, for being on the show.

Jennifer:           Thanks for having me.