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Alex Manos | 15 Jan 2025 | Gut Health

The Gut-Skin Connection

The Gut-Skin Connection

The relationship between gut health and skin conditions has garnered increasing attention over recent years. This connection, often referred to as the gut-skin axis, highlights how imbalances in the gut microbiome can manifest in skin issues such as acne, eczema, psoriasis, and rosacea (source). In this blog, we will explore the gut-skin axis, highlight key bacterial players, and offer practical tips to support both gut and skin health.

The Science Behind the Gut-Skin Axis

The gut and skin are both home to diverse communities of bacteria, and other microorganisms, that play vital roles in maintaining health.

The mechanisms by which the gut microbiome influences the skin appear to be related to:

  • The immune system – certain bacteria and bacterial metabolites, such as the short chain fatty acid butyrate, promote anti-inflammatory responses (source).
  • Bacteria and bacterial metabolites influencing the skin directly (source).
  • The gut microbiome appears to influence the skin microbiome as well (source).

It therefore comes as no surprise that when gut dysbiosis (an imbalance of gut bacteria) occurs, it can trigger a cascade of effects that negatively influence the skin. For example, increased intestinal permeability (“leaky gut”) allows toxins and inflammatory molecules to enter the bloodstream, which may exacerbate skin inflammation and disrupt the skin barrier (source).

It’s not just short chain fatty acids that the gut bacteria produce though. Neurotransmitters including GABA, acetylcholine, dopamine, and serotonin are produced by gut microbes and these neurotransmitters can modulate the function of the skin through the nervous system (source).

Evidence Linking the Gut and Skin

We know that certain skin conditions frequently co-occur with gut conditions. Arguably the two most evidenced examples are:

  • Psoriasis is associated with inflammatory bowel disease (source).
  • Celiac disease is associated with psoriasis, atopic dermatitis, and rosacea (source).

But let’s look at some other associations:

  1. Acne: Studies suggest that individuals with acne often exhibit an imbalance in the gut microbiome. One study found that 54% of acne patients had altered gut bacteria compared to healthy controls (source).
  2. Eczema: Research indicates that children with eczema often have reduced gut microbiome diversity and lower levels of beneficial bacteria like Bifidobacterium (source). Leaky gut has also been associated with eczema (source)
  3. Rosacea: Rosacea has been linked to small intestinal bacterial overgrowth (SIBO), and treating SIBO with antibiotics has been shown to improve skin symptoms (source). H. Pylori has also been associated with rosacea (source).
  4. Psoriasis: Gut dysbiosis, particularly a reduction in Akkermansia muciniphila and Faecalibacterium prausnitzii, has been observed in psoriasis patients (source). SIBO has also been associated with psoriasis, with improvement in the condition after treatment for SIBO (source). Finally DNA of intestinal bacteria has been successfully isolated from the plasma of psoriatic patients which provides evidence for leaky gut in psoriasis (source).

The fact that many of these skin conditions improve after gut specific interventions is compelling evidence that the may originate, or at least are significantly influenced, by imbalances in the gut.

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Tips to Support the Gut-Skin Axis

Maintaining a healthy gut-skin axis involves nurturing the gut microbiome while adopting skin-friendly dietary and lifestyle habits. Here are some practical tips:

1. Consume Probiotic-Rich Foods

Incorporate fermented foods like yogurt, kefir, sauerkraut, kimchi, and miso, which contain live beneficial bacteria to support gut diversity.

2. Focus on Prebiotics

Prebiotics are fibers that feed beneficial gut bacteria. Include foods like garlic, onions, leeks, asparagus, bananas, and whole grains to nourish your microbiome. Prebiotics support the production of bacterial metabolites such as butyrate, and butyrate has been shown to successfully treat psoriasis (source).

You can consider supplementing the prebiotic PHGG, which increases butyrate producing bacteria, or/and, supplementing butyrate itself. My favourite product for this is Tributyrin. I often recommend to clients to supplement both products simultaneously for a short period of time before simply focusing on diet and lifestyle (exercise increases butyrate producing bacteria too!).

3. Eat plenty of polyphenols

Polyphenols give plant foods their colour. So focus on eating a colourful diet.

Examples include olives and olive oil, tomatoes, peppers, coffee and tea, dark chocolate, grapes, beetroot, celery. You get the picture!

Polyphenols play a preventive role and possess the ability to delay the progression of several skin disorders, ranging from small and discomforting to severe and potentially life-threatening ones (source).

4. Reduce Sugar and Processed Foods

High sugar and processed food intake can promote inflammation and worsen both gut and skin health. Research has shown as association between sugar intake and psoriasis for example (source).

5. Take collagen

There is an abundance of research that provides evidence for collagen supplementation, which supports the enhancement and/or improvement of skin health (source). Regularly consuming bone broths is a way of getting colleagen, as is supplementing collagen. My personal favourite is this one which can be added to your morning coffee/tea.

6. Manage Stress

Chronic stress can contribute to imbalances in the gut microbiome and disrupt the gut lining leading to leaky gut. Chronic stress can also contribute to systemic inflammation (source). Practice stress management techniques like mindfulness, yoga, or meditation.

7. Consider Probiotic Supplements

If fermented foods are not a regular part of your diet, high-quality probiotic supplements containing strains like Lactobacillus and Bifidobacterium can support gut health. Here are just some examples of studies that have been conducted:

  • A probiotic containing 5 strains of bacteria has been found helpful in psoriasis (source). RestorFlora contains two of these strains.
  • A probiotic containing 3 strains of bacteria has been found helpful in eczema (source). Everyday Max contains two of these strains.
  • Probiotics have been studied extensively in acne with very promising results from a wide range of strains. One study using several strains found in Bio.Me Barrier found improvement in immune function in patients with acne and concluded that probiotics are an effective adjunct therapy to conventional treatment (source).
  • A study investigating the probiotic Bifidobacteria infantis  in people with several inflammatory conditions, including 26 people with psoriasis found that those taking the oral probiotic had reduced levels of inflammatory markers in their blood, compared with people taking a placebo.

8. Avoid Antibiotic Overuse

While antibiotics can be life-saving, their overuse can disrupt gut bacteria and contribute to dysbiosis. Use them judiciously and always under medical supervision.

Conclusion

The gut-skin axis underscores the profound impact of gut health on skin wellness. By fostering a balanced gut microbiome through diet, lifestyle, and targeted supplementation, it is possible to support both digestive and skin health. As research evolves, the potential for gut focussed therapies in treating skin conditions offers an exciting frontier in holistic medicine.

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