Inside job |
Aesthetic Medicine
Aesthetic Medicine


Inside job

Recent scientific findings about the gut-brain relationship and the many implications that gut health has on overall health and wellbeing have initiated a shift to a more holistic and integrated approach when examining the different biological systems of the human body. The communication between the gut and the skin microbiota has been widely discussed, looking at different ways of how the improper functioning of the gut and its inflammation trigger skin conditions such as cystic acne and dermatitis. Many studies now support the bidirectional and intimate connection between gastrointestinal health and skin homeostasis and allostasis, focused on examining a gut-skin axis. These findings were the basis for this case study, whereby a patient who had recently developed severe cystic acne agreed to take part in a three-month clinical study ingesting nutraceutical drink Totally Derma.

Left: before, Right: at the end of the 12-week trial
Week 2
Week 4
Week 6
Week 8
Week 10
Week 12


This female patient first presented to Dr Bev Darwin of Beau Medix Clinic in West Lancashire with acute and severe cystic facial acne, which began to develop in the summer of 2020. “Her appearance was making her depressed and anxious as antibiotics prescribed by her GP had not been successful,” says Dr Darwin. “Due to covid-19 I conducted her consultation via FaceTime. A full medical history was taken and questions regarding her skincare regime, diet and lifestyle and water intake were recorded. Photos were sent to me via WhatsApp. She was working long hours with a poor diet but drinking sufficient water daily.

“I had not seen anything so severe before so contacted other aesthetic practitioners and skin specialists via a Facebook forum to seek their opinions on the patient’s condition. This was when Anita Eyles [director of Boley Nutraceuticals, which manufacturers nutraceutical skin drink Totally Derma] contacted me directly saying she was certain her product would help my patient, as she believed the cause of the acne to be linked to leaky gut syndrome.”

While Dr Darwin had not witnessed Totally Derma treat such a case before, she says she had herself used the product to reduce arthritic pain, for which she believed it had been successful.

Due to the severity of her skin condition, the patient was unable to undergo any clinical treatments such as microneedling, microdermabrasion or laser, etc.

“The patient had tried a variety of over-the-counter skincare products, none of which had made any difference to her skin,” says Dr Darwin. “I advised her that we should commence treatment with Totally Derma to attempt to eliminate the cause of her cystic acne and then follow this up with clinical skincare products. I also advised her to reduce sugar and dairy products in her diet and increase her daily water intake. Post-treatment, there would be inevitable resultant scarring, and I advised that within the patient’s budget, this would be best treated with combined microneedling and clinical-grade skin peels.”


A 90-day supply of Totally Derma was provided to the patient. The formulation of Totally Derma Nutraceutical Drink Supplement contains high amounts of bovine-derived collagen amino acid peptides (namely patented Arthred, sourced via collagen-peptide supplier Gelita), hyaluronic acid and other synergistic cofactors which are distributed via the blood vessels into the dermis, where they stimulate fibroblast cells to produce more collagen and hyaluronic acid.

The patient understood the importance of compliance in drinking Totally Derma daily. Consistent topical skin protocols were maintained throughout the three-month trial; she was also following a skincare regime consisting of three prescription topical products: Dermol 500 lotion, erythromycin lotion (brand name Zineryt), and benzoyl peroxide 5%. The patient was not taking any oral medication throughout the trial.

As the patient agreed to feature in a clinical trial while undergoing treatment, for clinical research and data purposes she kept a weekly journal and submitted two “before” photos of the left and right sides of the face, followed by subsequent weekly photos over the 12 weeks.

At week two, the patient recorded “a huge improvement in the rest of my face”, despite “the odd whitehead here and there”. In her journal she said: “My skin felt hydrated and the stubborn dry patches are starting to clear up. I can see the colour back in my cheeks and feel that my skin looks healthier and plumper.” At week six, she said, “The largest and more problematic cyst on my lower right cheek is starting to shrink down drastically. I am noticing that I am getting far fewer new spots.” At week eight, she reported “no drastic breakouts in weeks”, and at week 10 she said she had begun to notice that her scars appeared a lot flatter, although she did experience “a few spots around my chin area due to finishing my period”, which she said is “completely normal for me”.


At the end of the 12-week course, the patient had observed a vast improvement in the condition of her skin, starting within the first week of taking the supplement. By the midpoint of the trial, a major difference can be seen between the baseline photos and photos taken during week six of ingesting Totally Derma. The patient also reported, “It is the best my skin has looked in a very long time”. In weeks seven and eight she reported further clearing of the skin, followed by minor breakouts in weeks nine and ten, which coincided with the luteal phase of her menstrual cycle, which is often associated with increased sebum production. By the end of the three months, it can be seen from the pictures that the skin of the patient has improved significantly – no active breakouts or cysts were reported.

The patient was very satisfied with her skin condition and her only concern was the postacne scarring. She has reported that her skin remained clear for two months following the trial but since not consuming Totally Derma for three months, acne has returned, however not nearly as aggressive as before the trial.

Cystic acne skin trial: 3-month clinical study ingesting nutraceutical collagen supplement Totally Derma was authored by Kunsulu Nurekeyeva.


1. Arck, P., Handjiski, B., Hagen, E., Pincus, M., Bruenahl, C., Bienenstock, J., & Paus, R. (2010). Is there a ‘gut–brain–skin axis’?. Experimental dermatology, 19(5), 401-405. Lee, Y. B., Byun, E. J., & Kim, H. S. (2019). Potential role of the microbiome in acne: a comprehensive review.

2. Journal of clinical medicine, 8(7), 987. Salem, I., Ramser, A., Isham, N., & Ghannoum, M. A. (2018). The gut microbiome as a major regulator of the gut-skin axis. Frontiers in microbiology, 9, 1459.


This article appears in the October 2021 Issue of Aesthetic Medicine

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This article appears in the October 2021 Issue of Aesthetic Medicine