How Gut Health Impacts Your Skin:

Ever wonder why you get a seemingly random breakout after a greasy, cheesy burger? The answer lies in your gut. Unbeknownst to many, there is a complex, yet intrinsic link between the health of your gut and your skin. Imbalances in the gut have been linked to common skin conditions like acne, inflammation, eczema, psoriasis, and rosacea.

In part 1 of our new series on gut health and your skin, we will explore the gut-skin axis and exactly how gut inflammation can impact your skin.

The gut-skin axis:

The connection between the gut and the skin is often referred to as the gut-skin axis. This term refers to the overlapping connection between the gut and skin conditions like acne. The gut-skin connection has been proven by several studies highlighting the unique link between the skin and gut imbalances:

• One study found that people with rosacea were 10 times more likely to have small bacterial overgrowth (SIBO).

• Another study found that 34% of people with irritable bowel syndrome (IBS) have skin manifestations.

• Similar studies demonstrated that 15-20% of those with ulcerative colitis, an inflammatory bowel disease, and 25-30% of those with Crohn's disease will also have a skin condition.

• One study found that people with psoriasis are more likely to have bacterial DNA in their bloodstream than those without psoriasis.

• A study by Frontiers in Microbiology concluded that modulations of good bacteria like probiotics and prebiotics resulted in the prevention and treatment of inflammatory skin disorders like acne, eczema, and rosacea.

These studies, and many more like them, suggest that inflammation and imbalances in the gut will lead to skin conditions and disorders. Many of these studies also demonstrate that healing gut conditions will also result in an improvement to skin conditions.

How does the gut affect the skin?

Unfortunately, researchers and doctors are not 100% sure how the gut and the skin are connected or why gut imbalances impact the skin. But there are several theories as to how this relationship functions.

The first gut-skin axis theory relates to what happens when your gut becomes irritated or inflamed. The gut acts as a barrier between the interior of the digestive tract and the rest of your body. The lining of the gut can become inflamed by irritants like food allergens, alcohol, medications, diets low in fiber and high in sugar, and food additives.

When the gut becomes inflamed and irritated, the normally foolproof barrier that blocks gut contents from the rest of your body becomes weakened. When this barrier is weakened, bacteria and other micro-organisms can enter areas it should not be able to. This will cause the immune system to go awry, resulting in systemic inflammation throughout the entire body.

Systemic inflammation impairs the integrity and protective role of the skin. When the skin is weakened, it will produce fewer antimicrobial peptides that normally act as a first-line defense. Without these peptides, skin infections can occur and weakened defenses will further aggravate skin inflammation.

Specific skin conditions:

As described above, imbalances in the gut can wreak havoc on your skin. An inflamed or irritated gut can lead to conditions like:

• Acne- The acne microbiome has been studied for decades, starting in the 1960s and continuing through today. Due to the numerous and complex causes of acne, scientists have struggled to identify the bacteria that cause acne. However, scientists have determined that acne is promoted by inter-microbial interaction rather than just the presence of one specific microbe. Bacteria such as S. epidermidis, Malassezia, and Candida have all been implicated as facilitators of acne on the skin.

• Atopic Dermatitis (Eczema)- Atopic Dermatitis, more commonly known as eczema, is a chronic skin disease associated with dry and intensely pruritic rash in a specific distribution. It is widely acknowledged that eczema is a multifactorial condition, with both genetic and epigenetic contributors. However, scientists have demonstrated that patients with eczema commonly suffer from a compromise of the intestinal permeability barrier- meaning bad bacteria is escaping from the gut. One study found a strong correlation between the gut bacteria Faecalibacterium prausnitzii and gut inflammation and eczema.

• Rosacea- Rosacea is a chronic inflammatory condition of the face identified by flushing or persistent facial erythema and inflammatory papules and pustules. Like eczema, rosacea is a multifactorial condition, with no one cause. However, researchers have identified alterations in the gut microbiome that can contribute to rosacea. One clinical trial found a certain type of “bad” bacteria more common and types of “good” bacteria less common in those with rosacea.

• Psoriasis- Psoriasis is characterized by scaly, raised, well-demarcated lesions on the skin. In some severe cases, ocular or joint involvement can be present. Growing evidence suggests an imbalance in the gut microbiome can lead to psoriasis. A 2015 study found that patients with psoriasis have less microbiome diversity than healthy individuals. A similar study from 2018 found reduced stability in the gut of those with psoriasis. Further animal studies have found that taking probiotics can reduce and even prevent psoriasis and other biomarkers of skin inflammation.

Solutions?

Solutions to your gut-induced skin conditions involve first healing the gut. The gut is a dynamic system influenced by genetics, diet, and other environmental factors. Nearly 10 million genes have been identified in the microbiome. These genes support the human genome in performing many important functions, from immune regulation to protection from pathogens to producing vitamins.

While you can’t fix your genes, you can make special considerations in your diet to promote gut health in correlation to your unique genetic variations. Such considerations are in an effort to support and balance the trillions of microbes that live in your microbiome.

Luckily, there are several universal steps everyone can take to promote good gut health. Such efforts include:

• Increase fiber in your diet- Fiber provides your colon cells with fuel to function optimally. The best way to get fiber is through leafy and cruciferous vegetables, berries, and raw nuts and seeds.

• Avoid inflammatory foods- Inflammation in the gut causes many gut diseases, including leaky gut, Crohn’s disease, and ulcerative colitis. Avoid vegetable oils and most processed foods, which are inflammatory. Instead, increase wild-caught fish and non-starchy vegetables like spinach and green beans, which normalize inflammation levels in your gut.

• Eat foods rich in antioxidants- Oxidative stress, when too many free radicals overwhelm your body’s defenses, can damage the gut. Antioxidant balance can be improved by eating colorful plant foods like berries.

• Consume spices that rid the gut of harmful bacteria like garlic, turmeric, and ginger- These spices are all bioactives- chemicals, chemical molecules, and microbes that create a biological effect on our body. Studies on the effects of bioactives have indicated that high consumption of bioactive-rich foods has a positive effect on human health and could diminish the risk of Alzheimer’s, cataracts, heart disease, stroke, cancer, and diabetes.

• Avoid eat non-nutritive sweeteners- Saccharin, sucralose, and aspartame have been shown to have long-term consequences for microbiome composure and glucose intolerance. While they may be lower in calories, non-nutritive sweeteners ultimately do more harm than good for your body.

• Consume more fermented foods like kefir, kimchi, and kombucha- These fermented foods are all probiotics. They aid digestion and have numerous positive effects on many biological systems including the immune system.

A great way to truly know if your gut is healthy is through microbiome testing. A healthy gut will have large biodiversity without an overgrowth of candida or other potentially pathogenetic bacteria that may lead to chronic health conditions. GI testing will also show inflammation, the ability to absorb fats, digestive enzymes, and immune response.

Specific therapeutic recommendations can then be recommended based on symptoms and testing. For further information about microbiome testing at the Johnson Center, click here to contact us!

The Johnson Center for Health services patients in-person in our Blacksburg and Virginia Beach / Norfolk locations. We also offer telemedicine for residents of Virginia and North Carolina!