The Gut-Skin Axis
The gut-brain axis is a crucial connection to learn about for enhancing skin health and overall well-being. Our gut integrity, physiology and microbiome significantly impact our dermal health in a myriad of ways. Our gut not only influences aging processes but also regulates skin immunity, adaptability and barrier functionality.
Are you currently struggling with skin conditions such as acne, dermatitis, perioral dermatitis, psoriasis, rosacea, eczema, hives, urticaria or even melasma? Learning about the gut-skin axis is an integral part of your healing journey.
If you’re at the point where you’ve tried everything to resolve your skin condition but are not yielding adequate results, focus on your gut health. As someone who has a history of acne, eczema, PCOS and perioral dermatitis, I get it — it sucks! Don’t give up hope though; the gut can be nourished and supported with the right interventions.
Your skin and gut are colonised with diverse bacteria, all playing a role in skin anatomical and physiological processes.
What can cause stress on your gut?
Gastrointestinal stressors are everywhere and come in the form of:
- Toxins and chemicals
- Chronic stress, anxiety or depression
- Hormonal imbalances
- Imbalanced diet for your individual needs
- Nutritional deficiencies
- Medications (particularly antibiotics )
- Underlying health conditions (particularly those that influence immunity)
- Candida overgrowth
- Depleted digestive organs (e.g. stomach, intestinal integrity, insulin resistance, insufficient digestive enzyme synthesis or utilisation)
- Food intolerances
- Increased intake of alcohol, recreational drugs and smoking
- Genetic predispositions
Signs and symptoms of imbalanced digestion
- Daily gas and bloating
- Pungent smelling flatulence
- Loose bowels or constipation
- Feelings of inadequate evacuation
- Undigested food in your stools
- Oily films on top of your stool
- Mucus or blood when you wipe
- Regular abdominal cramping and pain
- Frequent nausea, especially in the morning (even if you’re not pregnant)
- Food intolerances
- Uncontrollable sugar and carb cravings
- Loss of appetite
- Slow-feeling metabolism
- Inability to digest proteins (like meats)
- Frequent burping, heartburn or reflux
- Nutrient deficiencies
- Chronic fatigue and low moods
- Brain fog
How many of these signs and symptoms do you have?
You’re at a higher predisposition to skin imbalances with gut imbalances. Here are a few links in which the gut-skin axis relates to chronic skin conditions:
- Skin ulcers, hirsutism, psoriasis: Inflammatory bowels and dysbiosis (imbalanced bacteria)
- Rosacea: Intestinal dysplasia, H. pylori infection, and intestinal bacterial overgrowth
- Dermatitis and psoriasis: Coeliac disease, malabsorption, chronic inflammation, gut permeability, and dysbiosis
- Atopic dermatitis: gut dysbiosis and small intestinal bacterial overgrowth (SIBO)
- Gastrointestinal polyps: perioral dermatitis or hyperpigmentation
- Acne: bacterial/fungal overgrowth, intestinal permeability and lowered levels of lactobacillus strains
In reality, it may be termed the gut-skin axis but this connection predominantly relies on the gut’s key role in immune and inflammation regulation.
Ways in which some probiotic strains influence skin health
- Lactobacillus reuteri can increase dermal thickness, folliculogenesis, pH regulation, sebum modulation and enhanced dermal immune defence.
- Lactobacillus paracasei is shown to improve skin sensitivity and barrier function. It also helps reduce inflammation.
- It has also been reported that Bifidobacterium longum strains exert pro‐differentiating and pro‐regenerating effects on epidermal keratinocytes (skin cells).
- The bacterial probiotics Bifidobacterium and Lactobacillus have been shown to exert beneficial effects on overall skin health and glow, particularly via immune modulation and promoting anti-inflammatory pathways.
Gut permeability AKA leaky gut and inflammation
There’s no doubt that a permeable gut can influence overall health and well-being, but let’s focus on the skin. Think of permeable intestines as a fly screen with holes. This intestinal wall is your defence against pretty much everything.
If you have a gaping hole in this defence system, you’re vulnerable to pathogens, food particles and toxins directly entering your bloodstream. Guess what happens next? Your little ol’ immune system comes to the rescue, inducing an immunological cascade against the ‘foreign invader’ causing a ruckus of inflammation.
If this permeability lasts long enough, that’s the beginning of a range of conditions including:
- food intolerances
- inability to detoxify efficiently
- chronic inflammation
- immune dysregulation
The adaptive immune system will make antibodies as a defence mechanism against these foreign blood invaders (even if it’s as healthy as celery). They want none of that in the blood. Sooner or later, the blood is overrun with a congested cytokine storm and there’s nowhere else to go but yelp – your skin – triggering autoimmune conditions like psoriasis or acne.
The degree of damage to the intestinal wall, microbiome and digestive organ functionality will determine the severity of your signs and symptoms. The intestinal wall barrier breach puts pressure on the liver to detoxify the blood and regulate the immune system, often leading to poor skin quality and integrity. In the body's hierarchy system, the skin is inferior to the digestive system and will become subordinate in healing priority.
The gut is considered a major immune system via the gut‐associated lymphoid tissue (GALT) being the most complex immune compartment. The GALT system is known to have significant communication with the skin. Our gut contains trillions of microorganisms, influencing every aspect of our digestive health.
The microbiome interacts with dietary compounds and metabolises them into bioactive nutrients for healthy bodily functions. Did you know that bacteria produce GABA, serotonin and dopamine? The microbiome has a major impact on how your immune, nervous and integumentary systems function.
It’s vital to remember that these microbial communities work in synergy; your vaginal, oral, skin, and gut systems are constantly communicating with each other. If one is out of balance, it can influence the other interactive ecosystems.
Functions of the Digestive Organs: A Brief Breakdown
- must provide sufficient HCl and gastric acids to digest proteins
- induces the digestive enzyme cascade to break down nutrients (particularly proteins)
- a major defence mechanism to pathogens
- secretes bile for gallbladder storage
- essential for detoxification
- stores essential nutrients
- creates antimicrobial peptides
- regulates blood sugars via insulin secretion
- essential for carbohydrate metabolism
- stores and concentrates bile
- secretes digestive enzymes to breakdown fats
- where enzymatic digestion mostly takes place
- essential for nutrient absorption and immunity
- major bacterial colonisation
- reabsorption of water
- key detoxification area of indigestible materials vital to a healthy immune system
All of the digestive organs must work efficiently to support the intricate gut-skin axis. To some degree, their functionality all rely on healthy ratios of bacteria.
An example is when your body is not metabolising carbohydrates or you have an excess of glucose in your diet. This can further dysregulate the microbiome and increase acne inducing Propionibacterium acnes colonies. P. acnes growth in skin cells stimulate comedones and congested skin. Yet, your carbohydrate utilisation and breakdown relies heavily on healthy bacteria and pancreatic efficiency.
Human studies have shown increased dietary probiotic intakes can result in reduced skin hydration and reduced size of corneocytes (found within the outermost part of the epidermis).
Questions to ask yourself:
- How often have I had antibiotics?
- When did my gut issues begin?
- When did my skin issues begin?
- Am I battling recurring infections? Particularly, thrush or UTIs?
- How many of the above signs and symptoms relate to me?
- What is my timeline of skin issues?
- What relating factors could have contributed?
- How is my current diet?
- How is my mental health?
Gut-Skin Axis Healing Considerations
- Support your intestinal lining with healing foods and nutrients such as L-glutamine, zinc, collagen, organic bone broth, and green vegetable juices. Get inspired with our Optimal Skin Guide.
- Eliminate inflammatory foods, particularly wheat, gluten, dairy, processed and high-sugar foods
- Enhance gut microbiome colonisation with fermented foods (e.g. coconut kefir, kimchi, sauerkraut, and miso. We also recommend Happy Turmeric and Happy Greens.
- Implement gut and skin detoxification lifestyle practices as advised in our Optimal Skin Guide.
- Support digestive enzyme secretion and antioxidant profile with Happy Liver.
It’s vital to investigate where the skin or digestive issues are occurring and find their root cause. If you’re not sure where to start, book in a HHY Holistic Health Consultation for a comprehensive health evaluation and skin healing protocol specific to your needs.
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Szántó et al. (2019). Targeting the gut‐skin axis – probiotics as new tools for skin disorder management? Experimental Dermatology, Nov;28(11):1210-1218.