The health of the skin at any given time is the result of any number of things. From genetics and hormones to diet and nutrition, the skin is often a reflection of what is happening internally within the body. So, it should come as no surprise that an unhealthy gut can reveal itself through various skin conditions. On the flip side, a well-balanced gut can help ward off potential complexion concerns. Here is a guide to everything you need to know about the relationship between the gut and the skin.
What Is a ‘Healthy’ Gut?
If you associate the word ‘gut’ with a big ol’ beer belly, you’ll be pleased to know the term actually refers to a person’s gastrointestinal tract. This includes the entire digestive tract from the mouth, passing through the digestive organs (like the esophagus, stomach, and intestines), and ending with the rectum and anus. The gut is responsible for processing all nutrients that are consumed, and it uses peristalsis (a.k.a. muscular contractions) to move the food through the digestive system.
Your gut also houses the majority of the bacteria in the body. The National Institutes of Health (NIH) Human Microbiome Project found that the body contains trillions of microorganisms that outnumber human cells by a 10 to one margin, and the largest number of microbes can be found in the large and small intestine.
While the word ‘bacteria’ tends to have a negative connotation, it is important to remember that there are good bacteria, too. As the Harvard School of Public Health reports, microorganisms in the microbiome exist to aid digestion, stimulate the immune system, break down potentially toxic food compounds, and synthesize certain vitamins and amino acids critical to human living. Maintaining optimal health means having enough good bacteria to counteract the bad bacteria. While each person has a unique microbiome that is initially determined by genetics, it can ultimately be impacted by environmental factors like diet, medical history, and more.
In the gut, bacterial imbalances are linked to inflammatory conditions like irritable bowel syndrome (IBS), diarrhea, and constipation. And gut issues can also manifest in other parts of the body. “Overgrowth of bacteria in the gut, also known as small intestinal bacterial overgrowth (SIBO), has been linked to both acne and rosacea in several research studies,” says board certified dermatologist Adriana Lombardi, MD, of Skin Cancer and Cosmetic Surgery Center of New Jersey. “A genetic predisposition will make a person more likely to get a specific condition, but sometimes balancing the gut microbiome will help these patients even with genetic predispositions.”
The Relationship Between the Gut and the Skin
The Gut-Skin Axis (or the Skin-Gut Axis, depending on who you ask) is a widely researched concept — though not yet fully understood. Regardless, researchers are confident that there is a relationship between gut health and skin health.
“It has been clinically proven that when digestive balance is off — whether the cause is stress, poor diet, or lack of sleep — the gut becomes overrun with bad bacteria, which can lead to skin-aggravating inflammation,” says Roshini Rajapaksa, MD, a board certified gastroenterologist and co-founder of TULA Skincare. “This inflammation can cause acne, redness, sensitivity, and even the breakdown of collagen, which can cause wrinkles.”
A recent study from Frontiers in Microbiology concluded that — through complex immune mechanisms — the gut microbiome influences distant organ systems, including the skin. Through modulations of ‘good’ bacteria (think: probiotics, prebiotics, and synbiotics), they have found proven benefits in the prevention and/or treatment of inflammatory skin disorders, like acne vulgaris, atopic eczema, and rosacea.
“The gut holds a highly immunoregulatory role. Various foods that we eat or bacteria that colonize the gut can potentially cause inflammation in the gut. Inflammation in the gut releases pro-inflammatory cytokines throughout the body,” Dr. Lombardi explains. “The skin is the largest organ in the body and does react to these inflammatory cytokines in various ways resulting in different forms of skin disease.”
Naturopathic doctor Nigma Talib, ND, agrees, adding that eczema, acne, rosacea, dry skin, collagen breakdown, and sagging skin are just a few of the common skin concerns linked to the gut microbiome. “You have trillions of bacteria in your gut and they control the condition of your skin,” she says. “Bad bacteria can cause your skin to break out, while, from my clinical experience, the good bacteria can help prevent and treat acne, rosacea, and eczema.”
How to Improve Gut Health
At birth, your microbiome is the result of genetics, but external factors come into play as soon a person begins interacting with the outside world. As such, environmental changes can have both positive and negative effects on the gut. Here are three ways to improve gut health.
1. A High-Fiber Diet
While you can’t change your genes, you can change your diet. On one hand, sugars like glucose and lactose are quickly absorbed in the upper part of the small intestine and do little to improve gut health (in fact, they do more harm than good). On the other hand, high-fiber foods can be beneficial to the quality of bacteria in the microbiome. According to Harvard’s School of Public Health, the way the body digests dietary fiber in the large intestine can lower the pH of the colon and limit the growth of harmful microbes.
High-fiber, prebiotic-rich foods can be found in the raw form of the allium family (i.e. garlic, onions, and leeks), in addition to bananas, nuts, whole grains, and legumes to name a few. While these foods provide several gut benefits, moderation is key. Because they are so fibrous, they can cause bloating, gas production, and other digestive issues.
As she outlines in her book, Younger Skin Starts in the Gut, Dr. Talib recommends a diet that avoids dairy, sugar, gluten, and alcohol (specifically, wine) 80 percent of the time, while increasing the intake of healthy proteins, leafy greens, and cruciferous vegetables. Once on the eating plan, her clients typically start seeing gut and skin improvements in about four weeks.
2. Ingestible and Topical Probiotics
Consuming and applying probiotics is another avenue to take to improve both gut and skin health. While there are countless probiotic supplements on the market, there is no shortage of foods with naturally occuring probiotic properties. Fermented foods and drinks like kefir, kimchi, kombucha, sauerkraut, tempeh, and miso are just a few of nature’s probiotic sources.
“Probiotics are natural, good-for-you bacteria that work to improve your health, both inside and out,” Dr. Raj says, adding that the use of topical probiotics, as found in TULA Skincare, is a “true breakthrough” for the complexion. While ingestible probiotics balance the microbiome, probiotics in skincare have been shown to soothe and calm skin inflammation for virtually every skin type (i.e. sensitive, dry, oily, acne prone).
“Probiotics are clinically proven to reduce the appearance of inflammation and can also help to reduce the appearance of redness and irritation, which helps improve the skin’s clarity and tone,” Dr. Raj explains. “Probiotics help defend the skin against age-accelerating environmental stressors and free radicals, which can help the appearance of fine lines and wrinkles.”
Additionally, research shows certain skin conditions can be effectively treated with good bacteria. “It has been found that using oral and topical probiotics to restore the normal gut and skin flora is helpful in treating acne and rosacea,” Dr. Lombardi says. When looking for anti-inflammatory skincare, Dr. Raj recommends prioritizing clean and efficacious ingredients, like probiotics, turmeric, blueberry, rice nutripeptides, and watermelon fruit extract, for best results.
3. Lifestyle Changes
By now you can probably tell that the health of both the gut and the skin requires an internal and external approach. “What you do on the inside will show on the outside,” Dr. Talib says. “There is no getting around this. Inner health and wellness gives you glowing skin.”
In addition to a well-balanced diet, a regular fitness routine and good sleep schedule will help keep the entire body (including the gut) operating optimally. “The results of resetting the gut microbiome take a month or two and require a good diet and supplementation — in addition to hardwork and dedication,” Dr. Lombardi says. “Monitoring inflammatory markers is an option in gauging how inflammation in the body may be decreasing as a result of changes to the gut.”
Another thing to consider? Your antibiotic intake. According to the Centers for Disease Control (CDC), about 30 percent of antibiotics are prescribed unnecessarily in the United States. Antibiotics are designed to kill bad bacteria, and they can effectively treat certain bacterial infections. But they also damage the microbiome by wiping out a significant number of ‘good’ bacteria. After a course of antibiotics, it can take months and even years to restore the beneficial gut bacteria that is lost. Consulting with a board certified provider will ensure you receive the best course of treatment.
Your skincare routine is an important part of your skin health, but so is your gut. While researchers are still learning to understand the full scope of the gut-skin axis, there is no doubt that the health of the microbiome can impact the appearance of the skin. Fortunately, there are several ways to improve gut health and restore ‘good’ bacteria, including adopting a high-fiber diet, incorporating topical and oral probiotics into your wellness routine, and limiting your sugar intake.
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