The Gut-Skin Connection

Did you know ….

  • Acne affects more than 80% of people at some point in their life
  • About 3.5 million GP consultations for acne occur in the UK per year
  • 1 in 5 children and 1 in 10 adults in the UK are affected by atopic eczema (atopic dermatitis)

Although generally not considered as serious, skin conditions like acne, eczema, psoriasis, rosacea and atopic dermatitis can majorly affect an individuals confidence, mental health and quality of life because the skin is the first thing we see when we look at someone. 

Hence it’s super important to identify and address potential underlying causes. 

How does the gut influence the skin? 

There is a significant association between an imbalanced gut microbial composition and skin conditions like acne, eczema, psoriasis, rosacea and atopic dermatitis.

There are several ways in which the gut can influence skin health (listed below) but many are yet to be fully understood:  

  • Food sensitivities or intolerances 
  • Imbalanced gut microbiome (dysbiosis) 
  • SIBO 
  • Intestinal permeability 
  • Nutrient malabsorption 
  • Gut modulated immune responses
  • Inflammation 

In this blog, we will be focusing on intestinal permeability, a.k.a leaky gut. 

What is intestinal permeability?

Your intestinal lining serves as a barrier between the intestines and bloodstream – I like to imagine the intestinal lining like a fishing net with tiny holes in it!

In a healthy gut, the tiny holes allow the passage of smaller molecules like vitamins and minerals from the intestines into the bloodstream whilst preventing the passage of larger molecules.

If the fishing net gets damaged, the holes become bigger and allow larger things to pass through. When we relate this to a damaged intestinal lining, it means that larger molecules like toxins, undigested food particles, fungi, parasites, bacteria and bacterial metabolites can now pass through and enter into the bloodstream. 

Once in the bloodstream, these large molecules can travel (via circulation) to the skin, where they accumulate and disrupt skin homeostasis. Because these molecules are not supposed to be in the bloodstream, our immune system launches an attack against them. Research suggests that over time, this inflammatory immune response triggers a wide range of symptoms and likely contributes to the development of skin conditions like atopic dermatitis, acne and eczema as well as the development of chronic disease states.

Interestingly, gut bacterial DNA has been isolated from the blood plasma of individuals with psoriasis, further strengthening the gut-skin connection.

The role of our gut microbiota 

Our gut microbiota, which refers to the trillions of microorganisms (like bacteria) that live in our gut, feed on and ferment the fiber we consume through diet. During this process they produce bacterial metabolites like short chain fatty acids (SCFAs). SCFAs have anti-inflammatory and immuno-modulatory effects and serve as the main source of fuel for our intestinal cells. As such, SCFA are important for regulating gut inflammation and maintaining intestinal integrity.

Therefore, it may come as no surprise that there is a significant association between an imbalanced gut microbiome and intestinal permeability. Hence looking after your gut microbiome is a crucial consideration when dealing with skin conditions! 

Nutrition and Lifestyle interventions for healthy skin 

Nutrition plays a huge role in optimizing gut health, and therefore skin health. Generally speaking, we want to ensure our diet is diverse, colorful and nutritious. Simply put, eat real food:  

  • Anti-inflammatory fats e.g. wild caught oily fish, nuts & seeds, avocados, good quality oils like olive oil, organic pasture raised eggs
  • Fiber and antioxidants from a variety of different plant foods e.g. different coloured fruits and vegetables, whole grains, pulses, herbs and spices
  • In certain individuals, an elimination diet may be required (where trigger foods are removed for a period of time before being reintroduced to identify tolerance levels)

Research tells us that diets high in artificial sweeteners, processed foods, refined carbohydrates and industrial fats are one of the main causes of imbalanced gut microbiota, leaky gut and inflammation – so it makes sense that we would want to reduce or remove those!

Equally as important is lifestyle interventions: 

  • Stress management – stress plays a huge role in not just gut health but also our overall health – including our skin! 
  • Exercise to support a healthy gut microbiome, overall digestion and clearance of toxins 
  • Mindful eating (e.g. chewing properly, eating in a relaxed environment) to optimize the microbiome, overall digestion and skin health 
  • Optimizing sleep – a foundation to optimal health (including skin health)! 
Supplements: 

Specific supplements such as omega 3’s, zinc and pre/probiotics can be really helpful in addressing skin conditions. As always, please speak with your GP before using supplements if you have an existing health condition or are currently taking medications.

If you’re fed up of suffering from a skin condition and would like some help, do contact me so we can chat about your health concerns and explore the options of getting you the support you deserve.

For all you sciency people whom want to delve into the nitty-gritty of the gut-skin axis then check out the list of references below. 

References:  

Deng (2018)  Patients with Acne Vulgaris Have a Distinct Gut Microbiota in Comparison with Healthy Controls, ActaDV, 2018 Aug 29;98(8):783-790. doi: 10.2340/00015555-2968.

Fasano (2020) All disease begins in the (leaky) gut: role of zonulin-mediated gut permeability in the pathogenesis of some chronic inflammatory diseases, F1000Res. 2020 Jan 31; doi: 10.12688/f1000research.20510.1

Kanda (2020) Nutrition and Psoriasis, Int J Mol Sci. 29;21(15):5405

Lee (2019) Potential Role of the Microbiome in Acne: A Comprehensive Review, J Clin Med, 7;8(7):987

Losurdo et al., (2020) The Influence of Small Intestinal Bacterial Overgrowth in Digestive and Extra-Intestinal Disorders, Int J Mol Sci, 16;21(10):3531

Mu (2017) Leaky Gut As a Danger Signal for Autoimmune Diseases, Front Immunology. 2017 May 23; 8: 598.

Pereira (2018), Effect of dietary additives on intestinal permeability in both Drosophila and a human cell co-culture, Dis Model Mech, 2018 Dec 1; 11(12): dmm034520.

Polkowska-Pruszyńska (2020) The gut microbiome alterations in allergic and inflammatory skin diseases – an update., J Eur Acad Dermatol Venereol; 34(3):455-464

Salem (2018) The Gut Microbiome as a Major Regulator of the Gut-Skin Axis, Front Microbiol. 2018 Jul 10;9:1459

Sikora (2020) Gut Microbiome in Psoriasis: An Updated Review, Pathogens. 2020 Jun 12;9(6):463

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