• Allison Fahrenbach

Common Gut-Related Skin Conditions

As your body’s largest organ, the health of your skin is vital to your overall well- being.


When you think about how your skin looks and feels, your first reaction is probably to consider your skin-care routine, such as the use of face washes, lotions, and sunblocks. What you put on your skin does affect its health, but skin health is based on a number of internal factors – more specifically, what’s happening in the gut.


In fact, your outsides can be a great reflection of what’s happening inside.




The health of your microbiome is displayed through your skin.


Acne, eczema, rosacea, dry or sensitive skin, and rashes are some common skin conditions that can be traced back to gut issues.


So while your skin-care routine matters, if you’re dealing with a negative skin condition, in many cases, you may be treating the symptom, not the underlying cause.


Go to the gut. Good gut health is just as important for keeping the skin healthy and vibrant.


THE GUT-SKIN AXIS

It may not seem obvious, but your skin and gut have a lot in common.

They’re each neuroendocrine and immune organs that host a diverse community of microbes and work to protect the body from external pathogens. The gut and skin interact with each other, creating a biodirectional communcation link known as the gut-skin axis.


One of the main regulators in the skin-gut axis is how the gut microbiota communicates with the skin and it does this mostly via intricate interactions with the immune system to regulate systemic and local inflammation.

In addition to this mode of communication, research suggests that the gut microbiota can affect the skin more directly. In the case of an impaired intestinal barrier, intestinal bacteria as well as their metabolites can enter the bloodstream, accumulate in the skin and disrupt the skin microbiome.


The gut processes nutrients and houses most of the bacteria in your body. It provides a semipermeable barrier to prevent potentially harmful antigens or pathogens from entering the body, while allowing for absorption of nutrients.

If something irritates the gut lining, it can cause inflammation, and a stress response is triggered to fight the irritation, which can cause a leaky gut, where the usually tight barrier of the gut loosens, allowing unwanted bacteria to escape. This can create even more inflammation in the body.


This inflammation, however, is not necessarily confined to the gut. Although gut originated, it can become more widespread, affecting not only the gut but also your immune and nervous systems, hormones, skin, etc.


The gut communicates with the skin in a variety of ways, and gut-related skin issues can occur through multiple pathways, including diet, neurotransmitter production, hormones, and short-chain fatty acid (SCFA) production.

IN THE GUT, ON THE SKIN

No matter the exact method of communication, gut and skin health are closely related, and the gut microbiome can affect the skin’s appearance. There are a number of skin issues connected with gut issues:


Acne

Acne is a common skin condition that affects about 85% of young adults and adolescents. It’s the eighth most common medical disorder around the world.


Acne has been associated with an overgrowth of Propionibacterium acnes6 as well as hypochlorhydria (stomach acid), which can cause small intestinal bacterial overgrowth (SIBO) and intestinal dysbiosis.


Acne has also been connected to diets with a higher glycemic load that contain more refined foods, especially refined sugars.


Acne treatments come in many forms and depend on the type of acne and age

of the individual. Treatments can be topical or oral and are available in over-the- counter and prescription-strength options. These medications work by treating bacterial infections or reducing oil production and typically take several weeks to see results. Retinoids, antibiotics, salicylic acid, and oral contraceptives, as well as steroid injections, drainage, or chemical peels, are additional therapies available for acne treatment.

Antibiotics in general can result in microbial dysbiosis, but other side effects that can develop include sun sensitivity (retinoids and antibiotics), dry or irritated skin (retinoids and salicylic acid), redness (retinoids and salicylic acid), skin thinning (steroid), and scarring (drainage).


Some treatments can even increase the risk for breast or cervical cancer (oral contraceptives).

If you’re looking for a more gut-friendly method of treating acne, probiotics can be beneficial. Try foods and drinks that are naturally rich in probiotics, like kombucha, raw sauerkraut, kefir, and yogurt with no added sugars or flavors. Probiotic supplements, especially Lactobacillus, one of the most common for balancing out the gut microbiota, can also help. Foods with high glycemic loads can affect the skin, so a diet low in processed foods and added sugars can help to decrease the occurrence of acne.

Eczema

Eczema, or atopic dermatitis (AD), is a chronic inflammatory skin condition that affects 2%–10% of adults and 15%–30% of children.

Gut microbiota development and changes are linked to the development of AD and altered immune responses.Studies have also shown that AD sufferers have leaky gut, or increased intestinal permeability.


Treatments for AD include moisturizers, or emollients, which help dry skin; steroids or corticosteroids, which are used to reduce redness or swelling; and antihistamines, which can help control itching. Side effects connected to all of these treatments include nausea, weight gain, high blood pressure, and kidney or liver damage.


Relief from the red, itchy skin that AD causes can also come from changes to the diet.


Probiotics and prebiotics (fiber-rich foods that feed gut bacteria) have proven to be helpful. Foods high in omega-3 fatty acids, such as fish, olive oil, nuts, and seeds, are anti-inflammatory and can reduce inflammation on the skin. Additionally, foods containing quercetin, such as apples, spinach, and cherries, can reduce histamine levels and in severe cases a low histamine diet can be helpful.


Since intestinal permeability is a contributing cause to AD, addressing the health of the intestinal lining can also help. Intestinal permeability, or “leaky gut” is a condition that results when the cell wall of the small intestine gets so inflamed that it becomes more permeable then it should be, allowing bacteria and toxins to “permeate” or “leak” through into your bloodstream. High doses of therapeutic grade L Glutamine, Zinc L Carnosine, digestive bitters, HCL and HCL can help. So can consuming 1-3 cups of bone broth each day. Bone broth is a rich source of collagen, which has been shown to strengthen the lining of the gastrointestinal tract to protect against digestive issues like leaky gut.

Dry Skin, Sensitive Skin, and Rashes

Gut imbalances can also cause dry skin, rashes, and sensitivity. Some studies have shown that people who eat a diet low in certain fatty acids can suffer from inflammatory skin issues.


Typical treatments for dry skin can include moisturizers or creams with lactic acid and/or urea.


However, just as with other skin conditions, dietary changes can relieve dry or sensitive skin and rashes.


Whether obtained through foods or high-quality supplements, omega-3 fatty acids (salmon, walnuts, flaxseed, mackerel, and chia seeds) and vitamin E (sunflower seeds, almonds, avocado, mango, cod, and Atlantic salmon) help keep skin healthy, and zinc (oysters, lentils, crab, pumpkin seeds, and cashews) regulates inflammation and general skin health.


Rosacea

Rosacea is a condition that causes redness or

flushing in the face. There are three subtypes, one causes small, red, pus-filled bumps on the face in addition to redness; another causes broken blood vessels referred to as “telangiectasias” and the third causes thickening of the skin on the face.


While rosacea has many triggers (sunlight, heat, stress, alcohol, and spicy foods) one of the causes of rosacea itself is an unhealthy gut micro biome. In particular, the science has shown a higher prevalence of rosacea in those with small intestinal bacterial overgrowth (SIBO), and that treatment of SIBO could possibly result in an improvement in rosacea. This further supports that optimizing gut health (and microbiome health) can contribute to a reduction in rosacea symptoms.


To reduce rosacea symptoms, focus on fiber-rich prebiotic foods and probiotic foods, and crowd out consumption of sugars, refined flours, sodas, vegetable oils, packaged and processed foods and meats, hydrogenated fats, and other pro-inflammatory foods. Just as important is avoiding toxins, such as alcohol, tobacco, heavy metals, and pesticides because these factors can negatively impact the balance of the microbiome.


Suffering from any skin condition can be frustrating, and the experience can strongly influence one’s overall health, emotional well-being, and self-image. Achieving optimal skin health requires a holistic approach, recognizing that the skin and gut are intimately connected.


While there’s no surefire way to solve gut-related skin issues, understanding how the pieces work together is an important first step in the healing process.


There are a number of ways to balance gut bacteria to improve gut health and, therefore, the health of your skin! A high fiber diet, tolerance permitting, can improve microbiome quality and limit the growth of harmful microbes. Probiotics, whether from foods or supplements, can also calm inflammation and improve the function of the gut and skin.


It can be eye-opening to realize the direct impact lifestyle and eating habits have on the rest of your body and how simply prioritizing the health of your gut can provide natural and effective ways to heal.

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