Skin Conditions and Their Relation to Autoimmune Disease with Dr. Trevor Cates

Welcome back to the Healing Pain Podcast with Dr. Trevor Cates: Skin Conditions and Their Relation to Autoimmune Disease.

Thank you for joining us for another week on the podcast where we talk about all sorts of integrated strategies toward healing pain naturally and different pathways where you can look at your overall health and figure out how that relates your chronic pain or your chronic pain experience. Whether you are someone who’s struggling with chronic pain or whether you’re a practitioner who works with someone who has chronic pain.

This week on the podcast, I am excited to talk to Dr. Trevor Cates, who is a nationally recognized naturopathic doctor and also known as The Spa Doctor. She was the first woman licensed as a naturopathic doctor in the state of California. She has worked with world renowned spas and sees patients in her private practice in Park City, Utah, with a focus on graceful aging. She’s been featured on The Doctors, Extra, First for Women, Mind Body Green, and is the host of The Spa Doctor podcast which is a wonderful podcast I was on a couple of weeks ago. Her new book which comes out in March 2017 is called Clean Skin From Within. You can also find out more information about her at

About Dr. Trevor Cates

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Dr. Trevor Cates is a nationally recognized naturopathic doctor.  She is also known, as “The Spa Dr.,” and was the first woman licensed as a naturopathic doctor in the state of California, appointed by former Governor Arnold Schwarzenegger to California’s Bureau of Naturopathic Medicine Advisory Council. She has worked with world-renown spas and sees patients in her private practice in Park City, Utah with a focus on graceful aging and glowing skin. She has been featured on The Doctors, Extra, First for Women, Mind Body Green and is host of THE SPA DR. Podcast. Dr. Cates believes the key to healthy skin is inner and outer nourishment with non-toxic ingredients. Her new book Clean Skin from Within will be released in March 2017. Dr. Cates’ The Spa Dr. skin care and supplement lines are formulated with natural and organic ingredients designed to help you achieve the clean and natural path to confidence and beautiful skin.


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Skin Conditions and Their Relation to Autoimmune Disease with Dr. Trevor Cates

Dr. Cates, welcome to The Healing Pain podcast. It’s great to have you here.

Thank you. It’s great to be here.

I think it’s awesome that you were the first naturopathic doctor in the state of California. The state where I actually work and practice in New York state, naturopaths are not licensed yet. I think it’s exciting you’re the first woman to be licensed there. Tell me how you got involved and got the wonderful title of being The Spa Doctor.

Actually, it was pretty simple. I have been practicing naturopathic medicine for seventeen years. About five years ago, I started working in certain world-renowned spas as the doctor there. People have started calling me The Spa Doctor. I never thought I would focus a lot on skin issues and skin health. One of the things that was happening in the spas is I was running a two-week program for helping people with weight loss and pain and hormone imbalance, various things. One of the things that people kept mentioning is that their skin would clear up. To me, that made sense. Having clear skin, more youthful looking skin, glowing skin, all of it is a good sign of good health and that you’re doing the right things with your lifestyle.

For a lot of people, that surprised them. I thought I really need to get this message out to people that skin is our magic mirror. It gives us great clues about our overall health. When our skin is healthy, that’s a great sign that things are going well. A lot of times what happens is that people will notice multiple things with their health. They’ll have chronic pain. A lot of people listening to your podcast are interested in pain management. They might have pain and also have skin issues. That gives you a lot of great information when you have multiple symptoms like that to help figure out what’s the root cause.

I want people to look at skin differently and rather than something that needs to just be covered up with, for women it’s makeup or if you have a skin problem like acne or eczemas, instead of using a topical steroid treatment or something along those lines, to try ferret why is this happening with your skin and try and find out the root cause of the issue and address that. When you do that, you can help the body in a lot of different ways. You clear up your skin, the pain will start to diminish too.

It’s a great place to start because I think a lot of people take their skin for granted. It’s just something that’s there. Those of us who are in healthcare, we know this skin is actually an organ, correct?

Yes, it is. It’s our largest organ. You don’t need special imaging equipment to see it. You don’t need an x-ray or a CT scan. All you need to do is look on the mirror and you got your largest skin and what’s it telling you. I think that so often people are quick to cover up instead of looking at skin as a tool that we can use, whether someone’s a practitioner or a patient, somebody that looking for help. You can look at your own skin, just by looking in the mirror. As a practitioner, I know that it’s one of the first things that we see when we see our patients. We look at their skin. We see them. I think it’s important to not overlook that and to take a moment to check out our patient’s skin and see what kind of information it can be providing.

Sometimes the simplest things are those things that are right in front of us. It’s wonderful that you said you don’t need a special test or a scan or an MRI or an x-ray because we’re finding all those things really don’t tell us too much when it comes to chronic pain, but someone’s skin may give us actually a better picture. What are some of the signs, whether you’re a patient or a practitioner, that someone may look for that are signs of unhealthy skin or an underlying problem that could be showing up in your skin first?

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People can develop issues like eczema, psoriasis, uneven skin tone, hyper pigmentation, acne breakouts. All of these are signs that there is some imbalance.

I think that a lot of times, we forget what our skin can look like. You look at a healthy young baby and got this healthy glow and shiny glow. We forget that our skin can look like that too. Oftentimes skin can become dull looking or dry. People can develop issues like eczema, psoriasis, uneven skin tone, hyper pigmentation, acne breakouts. All of these are signs that there is some imbalance. They can mean different things and different root causes. I’d like to delve into and help people on how to figure out what this could possibly mean with your health, especially if you have pain and you have these other symptoms. What is that pointing to, what you might need to be addressing more closely?

I know in your book and a lot of your work, you talked about different skin types and what that may mean or what it means to you as a practitioner. Can you talk about them briefly?

I decided to redefine skin types because I was tired of the typical dry, oily, mature skin. That might help like an aesthetician with a facial or something like that. But it’s not going to really help us figure out the root cause. What I did is I renamed the skin types. I gave them all human names because I see my patients as people, not a disease or a skin condition. I gave them all human names.

It makes us look at it more holistically because each of these, I define them based upon the underlying causes, the root causes. I find that there are six root causes that trigger skin problems. Each of these skin types is the culmination of those root causes. They’re Amber, Olivia, Sage, Emit and Heath. They have human names. I talk about it all in my book. I also have a skin quiz that helps people identify their skin type. It’s really fun because people will start saying, “What skin type are you? Are you Olivia? Are you Sage?” It’s fun.

What’s the most common skin type you might see in practice?

It really varies. I think that a lot of times people suffering with chronic pain, I would say that I see a lot of the Emit types with people with pain. That’s because there is an immune component, an underlying immune imbalance with a lot of the Emit types. Emit types tend to get more of the eczema, psoriasis, the chronic skin issues that are inflammatory. Those patients oftentimes also have chronic joint pain or they have an injury and they just can’t recover from it and the pain tends to linger because of the underlying inflammation that is there. That’s really one of their big root causes.

When we address the internal inflammation and reduce that, then we start to see an improvement in their skin. Somebody that may have had a lifelong history of having a tendency to eczema or psoriasis, they don’t have that anymore. Then, also we see the pain go away. That’s one of the most common ones I see for chronic pain patients.

Oftentimes, patients that have an autoimmune condition, such as rheumatoid arthritis or lupus, I don’t have an exact number, but many of in my clinical practice oftentimes have some type of skin condition as well. They’re not quite making the link between the two. It’s almost like they’re separate. “I have eczema plus I have rheumatoid arthritis.” The truth is they’re really one and the same. Is that correct?

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People might not have thought that their skin condition is anything having to do with their immune system.

Yes. Psoriasis is a very common autoimmune skin condition. A lot of people don’t think of psoriasis as an autoimmune condition. They might know that they have other autoimmune conditions but they may not have thought that their skin condition is anything having to do with their immune system because of the way that skin problems are traditionally treated. Conventional dermatologists, generally the approach is, “How can we cover it? How can we suppress it? What kind of topical treatment can we do to just suppress the symptoms?” They’re not really explaining to patients how their immune system might be involved in that. If they do things to balance the immune system then that can actually help with their skin.

It’s a great point. I’ve talked about this on the podcast before, that I have a very rare skin condition called polymorphic light eruption, which not that many physicians have actually heard of. It’s autoimmune base. When I developed it in my 20’s, every time it would flare when I would go in the sun, I would develop back pain from it. Once I made some lifestyle changes and cleared it up, not only did my skin get better but my pain went away as well.

If you’re interested in learning about your different skin types, please make sure you go to You can take that great quiz. It’s wonderful. Dr. Cates created it. It’s really simple and easy and you can figure out which type of skin condition you are.

Thank you for sharing your example because that’s a perfect example. A lot of people reach out to me and they have this rare skin condition that a lot of people maybe don’t see commonly. There are a lot of autoimmune skin conditions out there. Even if they are not necessarily labeled as autoimmune, a lot of them there is an immune system issue going on with that skin problem. Because it’s not normal for our skin to break out and have bumpy itchy skin and redness and all these different kinds of things. Even with eczema, there’s usually an imbalance with the immune system. There are a lot of different skin conditions that are related to the immune system that people aren’t aware of.

It’s true. After about my fifth ‎Methylprednisolone pack I said, “Okay, enough is enough. Let’s figure out the real cause of this,” because I don’t like being on cortisone every two to three months. It’s not good for your joints. It’s not good for your brain. It’s really not good for your adrenals. It’s not really good for anything. Talk to me about products. When I think of the people in my life, most of them women, I open up their medicine cabinets and they’re full of all sorts of different products. Talk to us about some of the hazards or dangers that are in the more common products that we might find in our household, or ones that we can buy in a CVS or a Duane Reade that people commonly purchase. 

I think that we oftentimes forget how many products we actually use. The Environmental Working Group did a study of looking at how many products people use. On average, men and women across the board use nine personal care products a day, which exposes us to 126 unique ingredients. By the way, if there are any women listening to this who maybe thinking, “Actually, I might use more than nine products.” That’s exposure to more than 126 unique ingredients.

The problem with that is that the product industry is not well-regulated in the United States. In other countries, like in Europe, there have been over a thousand ingredients banned in personal care products. In the United States, they’ve only banned eleven ingredients. That’s it. It’s really up to us to do a little looking at our products because our products don’t just sit on our skin, or things that we spray in the air, they don’t just go in the air. We breathe them in. They land on our skin. Our skin is permeable. It can absorb things. People know, we use hormone patches, nicotine patches and creams and things like that, that we want to get absorbed. We know that’s a one way that we can apply medications.

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There’s a ton of research out there now showing that we are absorbing a lot of the ingredients in personal care products.

The same thing with personal care products, you’re going to be absorbing some of those ingredients. There’s a ton of research out there now showing that we are absorbing a lot of the ingredients in personal care products, such as parabens, for example. Parabens are used in a lot of personal care products. They are even in some so-called natural products. What you’ll see is paraben at the end of the word, so Methylparaben, Butylparaben, Propylparaben, there are a number of different ones. They’re used in products to help preserve them. The problem is that they have estrogen mimicking effects. They have hormone mimicking effects in the body. There have been several studies that have actually detected parabens in breast tumor tissue. They do get taken up into the body. They do get taken up into the tissues of the body, including breast tumors. That’s not a good sign.

We are exposed to them so much. If you start looking at personal care products, you’ll see them in a lot of the products. I’ve even done my own, I don’t want to call it a study, an internal look at with some of my patients. I did a group of just ten of my patients and having them, whatever products they were already using, do some urine sample testing on parabens. 100% came back with parabens being present in their urine. When they switched to my skincare line that doesn’t have parabens, then there was a big difference in that exposure. What was interesting is I thought, “That’s weird that it didn’t completely go away in some of the people.” Then when I started asking them they said, “I didn’t know you wanted me to stop using my body lotion too.” As soon as they pulled out the label and started reading off to me what was in their body lotion, sure enough there was the Methylparaben that had showed up in their urine sample.

We can definitely make a connection between what people are using on their skin and what shows up in their body. Parabens are one example. We want to be careful with those. When it comes to pain management, one of the reasons why it’s important for people with pain to think about these personal care products is that anything that your body sees is foreign or your body doesn’t recognize, it can impact your immune system. It can impact your hormones. Many of the conventional products, popular with skincare products out there contain endocrine disrupting chemicals. People talk about hormone disregulation. They think, “That’s going to affect women more than men. It’s going to only affect sex organs.” No, it is going to affect your neurochemistry. It’s going to impact the way you experience pain. It can impact your immune system. There are a lot of different ways that it can impact the body.

As a naturopathic physician, I’ve been practicing for seventeen years and I feel like I spend so much time talking to my patients about how to reduce their toxin exposure overall, because it is a bigger problem now than it’s ever been. It’s not going to go away. This is a big problem on people. I can’t even begin to tell you. Toxins in our air, water, food, and personal care products, we are now exposed to things that are being manufactured now but also things that are continuing to exist in the environment because a lot of these toxins don’t go away. Just because they were banned, doesn’t mean they go away from the environment. They’re still on our soil. They’re still in the air. Even if they’re in another country, they can travel over in clouds and when it rains down, we get exposed to what other people have in other countries.

Unfortunately, it is all around us. Anything that we can do to reduce our overall exposure to chemicals and toxins is important. Some things we don’t have control over. But we do have control over the personal care products that we use. What we put on our bodies every day, those nine products or however many products you use, you do have control over this. This a the way to reduce your exposure.

It’s a great point. In my book, Heal Your Pain Now, there’s a pretty big section on weight loss. Many people have said to me, “I get weight loss. Obviously, when you lose weight there’s less pressure on your joints and you have less pain.” I’m like, “That’s good. That’s important. That’s pretty simple.” What people don’t realize is that stored in your fat tissue are these chemicals that you’re talking about. Once they’re stored there, they can stay there for a very, very long time. Weight loss could be a way to reduce that toxic load. I think the more important thing that you’re talking, which is absolutely important, is not letting the toxin in your body in the first place.

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Clean Skin from Within: I talk about how to have a clean body, so how to reduce exposure in your water, in your food and things like that.

Yes, that’s really what it is about. It’s reducing our overall exposure. Personal care products, the food that you eat, the water that you drink, the air in your home. Those are the places you have control. That’s what I talked about in my book. In my book, Clean Skin from Within, I talk about how to have a clean body, so how to reduce exposure in your water, in your food and things like that. How to have a clean plate, so the foods that you’re eating, making sure that they’re clean. Having a clean slate, which is the products you put on your body, and a clean mind because our mental capacity, our emotions really impact. There can be a toxin that adds to and triggers a lot of the problems that we can have with pain and skin and autoimmune issues.

I do cover that because it is so important to look at all the different ways that you have control over your own environment. Unfortunately, you get active and be an environmentalist and do all of that, that’s great, but until things get banned and things get better in producing our exposures, we have to be proactive.

I know in your book, you talked about nutrition as well as supplementation, how it’s important for overall health and especially skin health. What are the top three supplements that you might recommend that would address someone’s skin health as well as potentially their chronic pain?

One of the big root causes of skin issues, which also relates to pain, and this goes to the gut-skin-brain access. That has to do with your gut health. Anything that you can do to support your gut health, a lot of times it’s going to help people, especially the Emit skin types that have those chronic, itchy or eczemas, psoriasis kinds of skin issues, and also pain is addressing what’s going on with the gut.

Things like probiotics or L-Glutamine, those are going to help heal the gut lining, help address any gut dysbiosis issues. Here’s the thing, we have a gut microbiome, and I’m sure you talk a lot about that. The balance of micro-organisms that are in our digestive tract that impact our health and certainly pain. We also have a skin microbiome. We also have a delicate balance of micro-organisms that are on our skin and they’re different and different areas of our skin.

Our gut microbiome directly impacts our skin microbiome. When we do things that help support our gut health, it’s definitely going to help our skin and it’s going to help our skin microbiome. When we talk about supplements, some of the tops ones would be addressing gut permeability or gut dysbiosis issues. Then, another thing that’s really important is addressing any kind of oxidative damage, because we certainly know that can lead to more pain, more inflammation, speed up the aging process or speed up our biological age and impact that which shows up on our skin. Taking an antioxidant supplement for skin, one of my favorite ones is Astaxanthin. I have an Astaxanthin Omega Krill Oil that my patients love. That’s quite a common one.

Excellent. I want to thank Dr. Trevor Cates for being on The Healing Pain podcast this week. I’d like for everyone to check out her new book called Clean Skin from Within available on her website as well as all retailers near you. You can find more information about her at As well as please make sure to go check out The Skin Quiz, that’s

We’ll see you next week. Please stay tuned each week for The Healing Pain podcast where we talk about integrated strategies to heal chronic pain naturally without drugs, surgery or injections.

Want to learn natural strategies for resolving pain for you or your patients? Purchase my brand new book!

Heal Your Pain Now; The Revolutionary Program to Reset Your Brain and Body for a Pain-Free Life.


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