The health of your gut microbiome may be an important determinant in the health of your skin. The role of the gut microbiome in skin disease is an exciting niche of research in the field of dermatology. Alterations in the gut microbiome have already been linked with type 2 diabetes, obesity, and inflammatory bowel disease (IBD).[1] We are only just beginning to discover and understand the relationship between the normal microbial residents in our gut (the gut microbiota) and their role in the pathogenesis of common skin conditions, such as acne.

A Brief Description of the Gut Microbiome

The gut microbiome consists of over 100 trillion bacteria (along with chemicals and molecules they produce) that ideally live in harmony within the small and large intestines. In addition to the gut microbiome, there also exists a skin microbiome made up of a similarly diverse community of microbial organisms. In order to have homeostasis, or healthy balance, the organisms living in our gut must thrive in harmony with one another. Any disruptions or perturbations in our microbiome, such as antibiotic use, illness, or worldwide travel, can potentially result in gastrointestinal (GI) distress, inflammation, disease, and possibly even skin effects. From person to person, the gut microbiome varies widely and one of the factors that may cause this variation is the diet that we eat. Research is being done to uncover how long-term dietary habits and patterns can significantly change the bacteria that make up our gut microbiota.[2]

Can Changes in My Gut Microbiome Be Causing Breakouts?

Figuring out how the gut microbiome and the skin microbiome communicate (recently termed the “skin-gut axis”) has become a hot topic of conversation. The gut microbiome and skin microbiome both act as a first line of defense between the outside world and internal human body. Additionally, they both communicate with the nervous system, immune system, and even hormones in the body. There are well-known associations between gut diseases and skin manifestations. For example, irritable bowel disease can introduce characteristic rashes and patients with celiac disease can develop a rash called dermatitis herpetiformis.[3]

Over 100 years ago in 1911, a gastrointestinal physician named Dr. Milton Mack wrote about the importance of the intestinal tract in acne and eczema.[4] Since then, there have been frequent cases of gut microbiome disruption (dysbioses) in association with skin diseases such as acne, rosacea, psoriasis, and eczema.[5]

It is believed that a more diverse microbiome (meaning a wider variety of different species of organisms) is associated with a healthier gut. For example, in a recent study of people with psoriasis, the gut microbiome was much less diverse in people with psoriasis than those without psoriasis.[6] In addition, psoriasis patients in a separate study who were treated with a probiotic containing Bifidobacterium infantis had decreased levels of inflammatory markers in their blood.[7]

The significance of the gut-skin connection is further exemplified by the importance of dietary patterns in some people with acne. There is significant evidence showing how the Western diet (high saturated fats and high glycemic load) can worsen acne.[8,9] Dietary patterns can alter the various species and diversity of the gut microbiome, which may theoretically influence how gut health impacts skin health, leading to various rashes and blemishes. One study found that over 54% of acne sufferers had alterations in their gut microbiome compared to people without acne.[10]

The skin-gut axis is a newly emerging avenue of research, and scientists are just beginning to understand the essential role of gut health in maintaining healthy skin.

A Healthy Gut Microbiome for Clear Skin

Many skin conditions are a sign or representation of something deeper going on internally. The same can be true for acne, which can be caused by a complex array of different factors. For many who have suffered from acne, it is easy to feel hopeless and frustrated after trying many different washes, creams, gels, and medications. It may be important to also consider your gut health and improving the diversity of your gut microbiome to optimize skin health.

Probiotics consisting of one or more different microbial strains can be consumed to improve the diversity of the gut microbiome. Capsules, yogurts, beverages, kefir, sauerkraut and many other commonly eaten fermented foods contain varying doses of probiotics. One study found that people with acne who consumed a Lactobacillus fermented dairy beverage enriched with lactoferrin for 12 weeks had significant improvement in their acne.[11] The researchers did not directly look at the gut microbiome, but the notion that fermented foods may be beneficial raises questions about the importance of gut microbiome health. As research continues to grow, we will better understand the role of the gut microbiome in skin health and how we can promote homeostasis of the gut microbiome.

 

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