177: Liver Detox - Skin Rash Connection, Part 1

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I’m often asked so many questions about liver detoxification.

You can find so many different people promoting liver detoxes as “the way” to help rashes.

My approach (as you probably know) differs greatly. Partly due to my own personal experience living with hand eczema and also from working directly with clients.

I generally do not ever recommend liver detoxes or cleanses.

And for some who have a histamine problem or have allergies to pollen — I recommend you steer clear!

In this episode, I’m going to break down the different phases of liver detoxification so that you can understand my perspective.

Yes, it’s complicated and I have tried not to get too nerdy on this (because biochemistry can be confusing).

Join me as we dive headfirst into the liver detox-skin rash connection!

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In this episode:

  • 3 phases of liver detoxification
  • Distinct role of each phase of liver detox
  • How nutrients play a role in liver detoxification
  • Problem with using herbs to “detox your liver”
  • Ways that your liver detox system can become overwhelmed


Phase 2 detox handles the burden from Phase 1 AND everything that doesn’t need to go through Phase 1.

Liver detoxes that include herbs generally speed up Phase 1 detox resulting in a lot of more toxic byproducts.

Silymarin and other herbs

Liver Detox – Skin Rash Connection PT1 (FULL TRANSCRIPT)

Welcome back to episode #177 of the Healthy Skin Show!

In today’s episode, we’re going to take a deeper dive into one of the most requested topics — the liver detox – skin rash connection.

I initially talked about this back in episode #47, but I get sooo many questions about that episode which prompted me to put this together for you.

This episode will be the first of a 2-part series about liver detoxification. (Stay tuned for part 2!)

And I get it — liver detox is complicated for two reasons

First — you’ve been heavily marketed to + repeatedly told online that you need to “detox your liver” or to “do a detox” to fix your skin.

Literally, nothing could be further from the truth, in my opinion (and I’ll talk about why that is in a moment).

And it only feeds into the confusion about what your liver really needs.

Second — most people have either entirely forgotten high school biochemistry OR they never learned about it. Biochemistry can feel really overwhelming, and frankly, I wouldn’t be surprised if your mind just totally wonders as soon as someone like myself starts talking about it.

I had to take biochemistry for 6 or 7 semesters during grad school… so it’s not like I picked it up in a day or just from listening to a podcast.

It’s been a big deal to me to simplify complicated topics like this so that you can follow along picking up nuggets here and there to understand the larger concept.

By no means is this podcast a crash course in Nutritional Biochemistry. I teach about these concepts deeper in my group program and in my 2 ½ hour-long Eczema masterclass.

So if you’re inspired to get a little nerdy with me, those are great next steps!

For now, let’s dive into the Liver Detox-Skin Rash Connection.

Aquarium with fish

Basics of Liver Detoxification

First and foremost — your liver is not a fish filter (a valid point shared with me by a previous guest of the show — Chris Masterjohn).

If you’ve heard that analogy and believe that’s how your liver works, please throw that idea in the trash.

The process of detoxification is really more one of transformation rather than a fixation solely on toxins + waste.

I seriously doubt that you would consider sex hormone conversations that your liver is responsible for via its liver detox pathways as toxic!

We need it to turn progesterone into testosterone and estrogen, right?

Yes, some of what your liver deals with is handling waste and toxic substances, but it’s not like they just get lodged in your liver.

Toxins + toxic substances are converted via the detox process to ultimately become water soluble so you can urinate them out.

Some of these detox pathways need support because without it (and the nutrients they depend upon), toxins WILL back up.

Backed up toxins can end up getting pushed out other routes… like your skin.

That’s why you’ll hear me again and again and again say that your liver requires support much more than it needs another “detox”.

And this process happens in three phases of liver detoxification. Some people say there are four phases, but for simplicity's sake, let’s just focus on three distinct phases.

So let’s start off taking about liver detoxification and exactly what it looks like!

Foot on gas pedal

Phase One Liver Detoxification

Phase 1 is based on your genes and is actually called the Cytochrome P450 system.

Genes that are apart of the P450 system start with the letters CYP. These genes code for enzymes that ultimately do the work of Phase 1.

Genetic SNPs in those genes can alter how the enzymes function — meaning how fast or slow they process things.

Additionally, certain substances can up-regulate or down-regulate these genes.

Up-regulation is like hitting the gas pedal on your car. So basically upregulation speeds up how fast they process things (and this point is very important… more on it in a moment).

Whereas down-regulation is like pumping the brakes such that the enzymes will process things more slowly.

Substances that can up- or down-regulate your Phase 1 liver detox enzymes include things like cruciferous vegetables, CBD oil, liver detox herbs like milk thistle (which are problematic for someone with a ragweed allergy), caffeine, alcohol, high protein diets, steroid hormones, certain vitamins and certain chemical exposures.(1,2,3)

Once a substance goes through Phase 1 liver detoxification, it’s generally made MORE toxic.

Yes, you read that correctly.

That byproduct must now go through Phase 2 liver detoxification to be made water-soluble so that you can urinate it out of your system.

And this is a significant point because if Phase 1 is up-regulated (or sped up), Phase 2 has to be prepared to do its job and that’s where problems can really end up going sideways.

But let’s talk about Phase 2 liver detoxification first!

Vitamin b6 sources

Phase Two Liver Detoxification

In my previous podcast on why I don’t believe you should detox your liver, I used the analogy of Lucy + Ethel (from I Love Lucy) working at the chocolate factory to explain my position.

If you haven’t checked out that episode, you should because I’ve shared the chocolate factory clip to help you really SEE what’s going on in Phase 2.

Phase 2 liver detoxification is interesting in that:

  • There are multiple pathways that handle different toxins + substances.
  • Everything that typically is processed by Phase 1 then goes through Phase 2.
  • But some substances can skip Phase 1 entirely and just head directly through Phase 2.

That’s significant because Phase 2 has to handle the burden from Phase 1 AND everything that doesn’t need to go through Phase 1.

So its load is even greater!

The pathways in Phase 2 include the Glycine pathway, Glutathione conjugation, Sulfation and Glucuronidation.

And what’s more, the pathways from Phase 2 all require certain nutrients to work.

The glycine pathway, for example, requires the amino acid Glycine and Vitamin B6.

I talk a lot about the glycine pathway because it handles things like salicylates, solvents, pesticides, AND waste products naturally produced in your gut microbiome. The greater the level of dysbiosis in your gut, the greater the burden is for this pathway.

Hold that those for a moment and let’s talk about Phase 3 of liver detoxification!

Water for detox

Phase Three Liver Detoxification

Phase three of liver detox is really focused on how you get these substances out of your body!

Most commonly that’s by peeing them out now that they are water-soluble. This underscores the need for appropriate water intake.

In some instances, these substances can also be pooped out (which is why constipation is something that you MUST address).

Bowel movement is an elimination pathway and that’s why I constantly stress that a healthy pattern is 1-3 formed stools per day! Magnesium citrate can be a helpful tool as can aloe juice in optimizing stool frequency.

Without proper urination and pooping, waste products from liver detox continue to sit in your body longer than they should.

AND if they can’t even make it through Phase 2, you’re likely going to experience problems.

So the point to all of this is that you want a balance between Phase 1 detox all the way through to Phase 3.

Perhaps you’re starting to see where hiccups can arise. Now that we’ve talked through the three phases, let’s about the problems.

Woman thinking

Problems With Liver Detoxification

The problems with liver detox are rooted in my position that doing liver detoxes or cleanses often exacerbate liver detox pathway imbalances.

Because these products typically rely on herbs that generally speed up Phase 1 detox resulting in a lot of more toxic byproducts.

Knowing that Phase 2 requires nutrients to process these toxins from Phase 1 in addition to other toxins (like from an imbalance gut microbiome), this is where things can go really sideways.

As a reminder here, your body generally doesn’t make all the nutrients it needs to thrive. In cases where it does make a needed nutrient like Glutathione, your body still requires the raw ingredients to produce it.

Think of your body as a nutrient-consumption factory rather than something that can make what it needs to operate at 100%. This emphasizes why you have to eat AND absorb nutrients.

So, if Phase 2 pathways require nutrients that your body generally doesn’t make …

What do you think happens if the amount of toxins waiting for processing increases?

What could happen if your nutrient stores needed for these pathways runs low?

AND what about if these two problems happen at the same time?

Phase 2 detox pathways SLOW DOWN.

That can create a back up of toxins waiting to get pushed down their respective Phase 2 pathways.

The load of toxins continues to increase as Phase 1 runs.

AND then with additional environmental exposures along with gut bug waste products… you’re just swimming in waste.

You might start to see your liver enzymes (typically tested on a Comprehensive Metabolic Panel become elevated).

And you could notice that your flares and skin seem a lot worse because your natural detoxification system is overwhelmed.

This is why I do not recommend herbs for liver detox, liver cleanses or liver detox programs for those with chronic skin rashes.

Instead I focus SUPPORT around Phase 2 and Phase 3 first.

And it’s why I use P2 Detox in my practice (from Quell — use coupon code QUELL10 to get 10% off your first purchase) with clients because it does not speed up Phase 1, but instead hands your liver what it needs for Phase 2. Especially to help clear out the back up hanging out between Phase 1 and Phase 2 while you’re on your journey.

There are also fewer “flare ups” or reactions as well from those who have a lot of pollen allergies since it doesn’t contain any herbs.

Now I do want to say one thing here about liver detoxes…

There may be a time and place for them in those with psoriasis due to its connection to non-alcoholic fatty liver disease. But that’s only after your liver detox system as a whole is better supported and excess burdens are minimized.

I’m going to talk more in Part 2 about this because as I said in the beginning, this topic is complicated.

I’ve heard from too many people that they had horrible reactions after doing liver detoxes which is what initially peaked my interest in this area.

And it’s helped me understand why supporting your liver is a crucial first step to solving chronic skin rash issues before and during your journey.

If you’ve got any questions or thoughts to share about this, leave the comments below. I dive deeper into this in Part 2 and Part 3 of this series.

I encourage you to share this episode with people who are thinking that doing a liver detox will fix their skin. It’s my hope that this will save them a lot of time and from potentially unnecessary flare ups!

Thank you so much for turning in and I look forward to seeing you in the next episode!

Woman with reference books


  1. Bralley JA, Lord RS. Laboratory Evaluations for Integrative and Functional Medicine. 2nd ed. Duluth, GA: Metametrix Institute; 2012; pg 494-7.
  2. https://www.projectcbd.org/medicine/cbd-drug-interactions/p450
  3. https://www.sciencedirect.com/science/article/abs/pii/S0024320511002645?via%3Dihub

Phase 2 detox handles the burden from Phase 1 AND everything that doesn’t need to go through Phase 1.

Jennifer Fugo, MS, CNS

Jennifer Fugo, MS, CNS is an integrative Clinical Nutritionist and the founder of Skinterrupt. She works with women who are fed up with chronic gut and skin rash issues discover the root causes and create a plan to get them back to a fuller, richer life.

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