Gut-Skin Axis

Gut Health and Eczema: Can a healthy gut help manage eczema symptoms?

Hussain Abdeh Pharmacist

Written by Hussain Abdeh Mpharm

Sarah Morton Dietitian

Reviewed by Sarah Morton RD
on 23 Sep 2025

Key Takeaways

  • People with eczema often have different gut bacteria patterns, with fewer helpful species like Bifidobacterium and Lactobacillus.
  • The gut–skin axis connects digestion, immunity, and inflammation, meaning gut imbalance can show up on your skin.
  • Supporting gut health may help calm inflammation and strengthen the skin's protective barrier.
  • Diet, probiotics, and stress management can all play a role in supporting eczema care, but they are most effective when used alongside traditional eczema treatments.

Sarah's Summary

"The connection between gut health and eczema shows how linked our body systems really are. People with eczema often have different gut bacteria and immune responses, which may make the skin more reactive. Improving gut health won't cure eczema, but it may help support your skin and reduce inflammation as part of a complete care plan."

— Sarah Morton RD

What is eczema and why does it happen?

Eczema, also known as atopic dermatitis, is a long-term skin condition that causes dry, itchy, inflamed patches. It affects around 10-20% of children and 3% of adults worldwide (1).

When eczema flares, the skin's natural "shield" called the skin barrier doesn't work as well as it should. The barrier is the outermost layer of your skin that helps keep moisture in and irritants out. When it's weakened, the skin loses hydration more easily and becomes more open to allergens, bacteria, and inflammation.

Because much of your immune system lives in your gut, researchers have begun to explore how gut health might influence the skin barrier and inflammation seen in eczema.

The gut-skin axis

Your gut and skin constantly communicate through what's known as the gut–skin axis (4), a network that links digestion, immunity, and inflammation.

A substantial proportion of immune cells reside in the gut, often estimated around 70% (2). When gut bacteria are well balanced, they help regulate the immune system and produce beneficial compounds called short-chain fatty acids (SCFAs) (3). These are tiny molecules made when gut bacteria digest fibre, and they help:

  • Keep inflammation under control.
  • Support a healthy immune balance.
  • Strengthen the skin barrier by encouraging the production of protective lipids and proteins.

When gut bacteria fall out of balance (a state called dysbiosis), fewer SCFAs are produced. This can make it harder for your body to control inflammation, which in turn may contribute to eczema flare-ups or make existing symptoms worse.

In summary, when your gut is unhappy, it can send "inflammatory messages" that your skin ends up showing.

Did you know the gut–skin axis is linked to other skin conditions, including acne, psoriasis, and rosacea?

Do people with Eczema have different gut bacteria?

Scientific studies have found clear differences in gut bacteria between people with eczema and those without.

Fewer helpful gut bacteria

Several studies have found that individuals, especially children with eczema/atopic dermatitis often show lower abundances of beneficial gut bacteria such as Bifidobacterium and Lactobacillus compared with people without eczema

Gut microbiome in children

The gut microbiome starts forming at birth and continues developing in early childhood. Babies who later develop eczema often have fewer helpful bacteria like Bifidobacterium in their first months of life when compared to healthy individuals.(5,6)

In infants, 60-70% of their gut microbiome consists of Bifidobacterium, particularly Bifidobacterium breve, Bifidobacterium infantis, and Bifidobacterium longum. With age, those levels decline and stabilise to around 10% in adults.

This early imbalance can affect how the immune system learns to distinguish between harmless and harmful substances, increasing the risk of allergic conditions like eczema.

How do the gut and skin interact?

The gut and skin have their own microbiomes, but they influence each other via what is known as the gut-skin axis. Substances made by gut bacteria can circulate in the bloodstream and affect the skin's surface bacteria and moisture balance, potentially influencing irritation and healing (8).

Is leaky gut linked to eczema?

Your gut lining acts like a selective barrier, allowing nutrients through while keeping out larger food particles and bacteria. Sometimes this barrier can become more permeable, a condition scientists call increased intestinal permeability or leaky gut as it's more commonly known. When this happens, small fragments that would normally stay in the gut can pass into the bloodstream, triggering an immune response and inflammation (9,10).

Some research suggests people with eczema may be more likely to have this increased permeability, though scientists are still working to understand whether gut barrier issues contribute to eczema or if eczema-related inflammation affects the gut.

Not everyone with eczema has gut barrier issues but supporting your gut lining through a fibre-rich diet, omega-3 foods, stress management, and good sleep can help reduce overall inflammation, which may support your skin health as part of a complete care approach.

Can diet and food influence eczema?

What you eat is one of the most direct ways to influence your gut, and that, in turn, may influence your skin.

Foods that support gut and skin health

  • Fibre-rich foods like fruit, vegetables, beans, and whole grains feed your beneficial gut bacteria.
  • Omega-3 fats from oily fish (salmon, mackerel, sardines) have anti-inflammatory properties (12).
  • Fermented foods such as yoghurt with live cultures, kefir, sauerkraut, and kimchi naturally contain good bacteria.

Read our comprehensive list of foods for a healthy gut.

Can foods trigger Eczema?

Some people find that dairy, eggs, nuts, or wheat can trigger flare-ups, particularly in children. These foods don't affect everyone, and removing them unnecessarily can make your diet less balanced. (11)

Do probiotics and prebiotics help eczema?

While some studies show promise, systematic reviews reveal mixed results. Probiotics work differently for different people, and we still don't fully understand why some people respond better than others. They're worth considering as part of a broader approach, but expectations should be realistic.

Researchers have explored whether probiotics (live "good" bacteria that live in the gut) and prebiotics (the fibres that feed them) can support eczema management.

  • The strain Lactobacillus rhamnosus GG is the most studied and has shown potential to reduce eczema severity, mainly in children (14).
  • Other Bifidobacterium strains, including B. lactis and B. longum, have also shown benefits in some studies (13).
  • Prebiotic fibres in foods like garlic, onions, leeks, and oats help your gut bacteria produce anti-inflammatory compounds (15).

Can stress cause Eczema flare ups?

Stress can make eczema worse, and your gut plays a big part in that link.

When you're stressed, your body releases a hormone called cortisol that can disrupt gut bacteria and weaken the gut barrier (16). This can create a cycle as stress worsens gut balance, gut imbalance increases inflammation, and inflammation makes eczema flare-ups more likely.

Simple, consistent habits such as good sleep, gentle movement, mindfulness, or breathing exercises can reduce stress hormones and help restore balance in both your gut and skin.

Stress in every day life is inevitable, whether that is in your working life or personal life, but learning how to deal with it can significantly improve the health of your gut and overall wellness.

Can gut microbiome testing help?

Gut microbiome tests measure which gut bacteria are present in your digestive system and how diverse your microbiome is using our Shannon diversity index.

For people with eczema, results may reveal patterns similar to those seen in research, for example, reduced bacterial diversity or low levels of beneficial gut bacteria.

However, these gut health tests that measure eczema markers are not able to diagnose or predict exactly which treatment will work. They're best used as an educational tool, alongside advice from a healthcare professional. The insights you gain from a gut microbiome test are not designed or intended to replace traditional eczema treatments, as many studies reveal that alternative therapies are most effective when used in conjunction with normal treatments.

At Feel Gut, we measure the gut–skin axis by comparing your gut microbiome results to a large database of public research studies that include people with and without skin conditions. This allows us to identify microbial patterns that are commonly seen in individuals with issues such as eczema, acne or psoriasis.

Can improving gut health cure eczema?

No, eczema can't be cured by diet or supplements or medical treatments alone. But supporting gut health can help calm inflammation and make symptoms easier to manage.

Which probiotics are best for eczema?

Lactobacillus rhamnosus GG and some Bifidobacterium strains have shown potential, particularly for children. Always choose clinically studied products and check with your healthcare provider.

Does diet make eczema worse?

It can for some people. Common triggers include dairy, eggs, nuts, and wheat, but these vary widely. Keep a food and symptom diary and discuss changes with a dietitian.

Is "leaky gut" real and linked to eczema?

Increased gut permeability is real. Some studies show it may contribute to inflammation seen in eczema, though it's usually one part of a bigger picture.

References

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  2. Vighi G et al. Clin Exp Immunol. 2008;153(Suppl 1):3–6. - https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2249.2008.03713.x
  3. Koh A et al. Cell. 2016;165(6):1332–1345. - https://www.sciencedirect.com/science/article/pii/S009286741630592X
  4. Salem I et al. Front Microbiol. 2018;9:1459. - https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2018.01459/full

  5. Lee SY, Lee E, Park YM, Hong SJ. Microbiome in the Gut-Skin Axis in Atopic Dermatitis. Allergy Asthma Immunol Res. 2018 Jul;10(4):354-362. doi: 10.4168/aair.2018.10.4.354. PMID: 29949831; PMCID: PMC6021588. - https://pmc.ncbi.nlm.nih.gov/articles/PMC6021588/

  6. Kalliomäki M, Kirjavainen P, Eerola E, Kero P, Salminen S, Isolauri E. Distinct patterns of neonatal gut microflora in infants in whom atopy was and was not developing. J Allergy Clin Immunol. 2001 Jan;107(1):129-34. doi: 10.1067/mai.2001.111237. PMID: 11150002. - https://pubmed.ncbi.nlm.nih.gov/11150002/

  7. Björkstén B, Sepp E, Julge K, Voor T, Mikelsaar M. Allergy development and the intestinal microflora during the first year of life. J Allergy Clin Immunol. 2001 Oct;108(4):516-20. doi: 10.1067/mai.2001.118130. PMID: 11590374.
  8. Byrd AL et al. Nat Rev Microbiol. 2018;16(3):143–155. - https://www.nature.com/articles/nrmicro.2017.157
  9. Arrieta MC et al. Gut. 2006;55(10):1512–1520. - https://pmc.ncbi.nlm.nih.gov/articles/PMC1856434/
  10. Mu Q et al. Front Immunol. 2017;8:598. - https://pmc.ncbi.nlm.nih.gov/articles/PMC5440529/
  11. Chang A, Robison R, Cai M, Singh AM. Natural History of Food-Triggered Atopic Dermatitis and Development of Immediate Reactions in Children. J Allergy Clin Immunol Pract. 2016 Mar-Apr;4(2):229-36.e1. doi: 10.1016/j.jaip.2015.08.006. Epub 2015 Nov 17. PMID: 26597013; PMCID: PMC4789144. https://pmc.ncbi.nlm.nih.gov/articles/PMC4789144/
  12. Foolad N, Brezinski EA, Chase EP, Armstrong AW. Effect of nutrient supplementation on atopic dermatitis in children: a systematic review of probiotics, prebiotics, formula, and fatty acids. JAMA Dermatol. 2013 Mar;149(3):350-5. doi: 10.1001/jamadermatol.2013.1495. PMID: 23682371.
  13. Panduru M et al. J Eur Acad Dermatol Venereol. 2015;29(2):232–242. - https://pubmed.ncbi.nlm.nih.gov/24698503/
  14. Kalliomäki M et al. Lancet. 2001;357(9262):1076–1079. - https://pubmed.ncbi.nlm.nih.gov/11297958/
  15. Bindels LB, Delzenne NM, Cani PD, Walter J. Towards a more comprehensive concept for prebiotics. Nat Rev Gastroenterol Hepatol. 2015 May;12(5):303-10. doi: 10.1038/nrgastro.2015.47. Epub 2015 Mar 31. PMID: 25824997.
  16. Chen Y, Lyga J. Inflamm Allergy Drug Targets. 2014;13(3):177–190. - https://www.researchgate.net/publication/263287535_Brain-Skin_Connection_Stress_Inflammation_and_Skin_Aging

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