Women looking at skin in mirror

How Does Your Gut Health Affect Your Skin?

Doug Cook, RD

Written by: Doug Cook, RD

Updated: November 19th, 2022

One of the biggest motivations to ‘eat clean’ is the longing to have better-looking skin. I get asked all the time if diet and nutrition have any real impact on skin health and skin appearance.

In a word, YES!

Many people, of all ages, struggle with skin conditions such as acne, rosacea, dry skin, excess wrinkles, eczema, psoriasis and more. Let’s face it, we all want to look the best we can and feel good about ourselves and our appearance. There’s nothing wrong with that, and for those who struggle with skin health issues, it can be very upsetting when a solution to their problematic skin hasn’t been found.

Gut-brain and… skin axis?

The gut-brain connection has been known about for decades but only now is it getting the attention, and legitimacy, it deserves. The health of our gut influences the health of our brains and vice versa, so it really shouldn’t come as a surprise that gut health has an impact on other organs such as the skin.

In fact, over 70 years ago two dermatologists John H Stokes, and Donald M Pillsbury first suggested an overlapping connection between the gut, mood disorders such as anxiety & depression and skin conditions such as acne (1).

Ahead of their time, by light years, they proposed that emotional states (stress) might alter normal gut/intestinal gut microflora (microbiota), increase intestinal inflammation and intestinal permeability (a.k.a. leaky gut), and contribute to systemic (whole body) inflammation. One of the remedies proposed by them was to use the bacteria Lactobacillus acidophilus, a common bacteria in cultured/fermented dairy foods at the time, which they used with some success.

Gut disorders and skin conditions

Several lines of evidence have shown a connection between gut problems and skin disorders. A recent study found that those with rosacea were 10x more likely to have small intestinal bacterial overgrowth(SIBO) compared to those without rosacea and that eradication of the SIBO resulted in almost complete regression (elimination) of this common skin disorder/condition (2).

Similar findings have been found in those with inflammatory bowel disease (IBD); 15 to 20% of people with ulcerative colitis and up to 25 to 30% of those with Crohn’s will also have skin conditions. A 2012 study demonstrated this unique connection between the skin and gut when a drug used to treat the skin disease psoriasis resulted in less disease activity in Crohn’s patients, a.k.a. improved their Crohn’s disease (3).

The gut-skin connection doesn’t have to be explained to anyone with celiac disease; the skin condition dermatitis herpetiformis (DH) is very common and the better-controlled celiac disease is, the greater the improvement with DH.

How does altered gut health/function affect the skin?

The gut provides a barrier between the interior of the digestive tract and the general circulation; all that separates the contents of your intestinal tract from the rest of you. Anything that irritates the lining of your gut can cause it to become inflamed. This could be anything like food allergens, alcohol, medications, antibiotics, common food stuffs of the modern diet like food additives and artificial colouring, as well as, food borne illness (a.k.a. food poisoning), or diets low in fiber and high in sugar or the commonly overlooked culprit SIBO.

When the gut gets irritated and inflamed, several things happen.  The nerves that permeate the digestive tract are signaled to tell the body that war has been declared on the gut and it triggers the alarm bell; the body responds by ramping up the stress response to help ready the body to fight and no good fight can happen without a supercharged immune system.

Other consequence of gut irritation and inflammation is the loss of the tight barrier that normally keeps unwanted gut contents out of the circulation – as a result, bacteria and other micro-organism can enter along with food proteins and more, all of which sets the stage for the immune system to go awry leading to systemic, or whole body, inflammation. The innocent bystander in all of this?

Leaky skin? Now I’ve heard everything

As I mentioned above, leaky gut has been know about for a looooooooooong time but leaky skin? Turns out stress and systemic inflammation can impair the integrity and protective role of our skin. When this happens, the skin produces less of the naturally occurring antimicrobial peptides (think anti-bacterial proteins) it normally makes as a first-line defense; with weakening defenses, skin infections can occur and worsen and weaken defenses will aggravate skin inflammation further (4).

Improving your skin via your gut

Considering how intimately the gut-skin (and brain) are connected, good skin health and a great complexion can only be achieved when you take an integrative & functional approach; you need to consider all players and how they all work together. As your largest organ, your skin needs as much TLC as any other body part that you care for. Good skin health needs to include good skincare, there’s no denying that, but it also needs to consider what’s going on in the inside.

You need to minimize gut irritation and inflammation which requires looking at your food, beverage, supplement and medication use, assess your stress levels including sleep, consider any undiagnosed food allergies and do what you can to support a healthy gut microbiota/bacterial population.

While eating nutritious food is important, it’s not what you eat but rather what you absorb that’s important when it comes to both skin and overall health which is why getting your gut health in order is priority number one; only then can ensuring you’re getting enough of the skin-supporting nutrients vitamins A, C, E, K2, B3, B5 along with the minerals selenium, zinc, silica and sulfur and omega-3 fats make sense.

Doug Cook RDN is a Toronto based integrative and functional nutritionist and dietitian with a focus on digestive, gut, and mental health.  Follow him on FacebookInstagram and Twitter.

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