The Gut-Skin Axis, does our gut really impact our skin?

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Key Takeaways

• The gut and skin are closely connected. Imbalances in gut bacteria and inflammation in the digestive system can influence common skin conditions such as acne, eczema, rosacea, and psoriasis.
• Supporting gut health may help reduce skin inflammation. A balanced, fibre-rich diet, adequate sleep, and stress management can benefit both gut and skin health.
• Probiotics and diet matter. Specific probiotic strains (Lactobacillus and Bifidobacterium) and anti-inflammatory dietary patterns like the Mediterranean diet show promise for supporting skin health.
• Skin improvements may take several weeks to months. Gut and skin improvements may typically take several weeks to months of sustained dietary and lifestyle changes.

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Sarah's Summary

"The link between gut and skin health is becoming increasingly clear in scientific research. Studies show that people with inflammatory skin conditions often have different gut bacteria compared to those with healthy skin. Since a large proportion of the body's immune activity is centred in the gut, it makes sense that inflammation in the digestive system can affect the skin too. While improving gut health isn't a cure for skin problems, evidence suggests it can play an important role in supporting skin health. The good news is that habits that nurture the gut, like eating a balanced, fibre-rich diet, managing stress, and getting enough sleep also benefit overall health."

Sarah Morton RD

What is the gut-skin axis?

If you've been struggling with persistent skin issues like eczema, acne, or rosacea, you may have wondered whether there's more to the story than what appears on the surface.

It may seem completely unlikely that your gut and your skin can communicate with each other. Increasingly, research is revealing that the health of your gut and the condition of your skin are more connected than previously understood and are in constant communication with each other via the gut-skin axis.

The gut skin axis is the complex relationship and communication network between your digestive system and your skin. This bidirectional relationship involves multiple pathways, including immune system signalling, inflammation processes, and the influence of gut bacteria on skin health. Understanding this connection opens new possibilities for supporting skin health from within, as opposed to just topical treatments.

The gut hosts a substantial portion of your body's immune tissue through gut-associated lymphoid tissue (GALT), making it a major regulator of inflammatory responses throughout your body. When the gut barrier becomes compromised or when harmful bacteria outnumber beneficial ones, inflammatory signals can be sent throughout the body, potentially affecting skin health. This process, known as systemic inflammation, may contribute to various skin conditions.

The gut microbiome plays a particularly important role in this axis. These trillions of microorganisms don't just help with digestion; they also produce metabolites that can influence immune function and inflammation levels. Short chain fatty acids (1), produced when beneficial bacteria ferment dietary fibre, have anti inflammatory properties that may help maintain healthy immune responses both in the gut and systemically.

Research has identified several specific pathways through which gut health may influence skin conditions (2). The production of inflammatory cytokines in the gut can affect skin barrier function, whilst imbalances in gut bacteria may influence the production of sebum and the skin's natural antimicrobial defences. Additionally, the gut's role in nutrient absorption means that digestive issues could potentially affect the absorption of nutrients crucial for skin health, such as zinc, omega 3 fatty acids, and vitamins A, C, and E.

The nervous system also contributes to this connection through what's called the gut brain skin axis. Stress can affect gut health (3), which in turn may influence skin conditions, creating a complex web of interactions that researchers are still working to fully understand.

Common skin conditions linked to gut health

Eczema

Studies consistently show that people with eczema often have different gut microbiome compositions compared to those without the condition (4). Research indicates that individuals with atopic dermatitis frequently have reduced bacterial diversity in their gut and different abundances of beneficial and potentially harmful bacteria.

A clinical trial found that certain probiotic strains, particularly Bifidobacterium and Lactobacillus, may help manage eczema symptoms in children and adolescents aged 6 months to 19 years when used for at least 6 months. The study noted that probiotics work best when used alongside traditional eczema treatments. (5)

Learn more about the connection between gut health and eczema and how the gut microbiome may influence eczema symptoms.

Acne

The relationship between diet, gut health, and acne (6) has been a subject of increasing research and interest. Studies suggest that certain dietary patterns may influence both gut bacteria and skin health, with high glycaemic index foods (foods known to rapidly increase blood sugar levels) and dairy products being particular areas of investigation. The gut microbiome's role in hormone metabolism may also be relevant to acne development, as gut bacteria can influence the metabolism of hormones that affect sebum production.

Rosacea

Research exploring connections between rosacea and gut health is still in early stages. Some small studies have observed associations between rosacea and digestive conditions like SIBO (small intestinal bacterial overgrowth), though results have been inconsistent and the clinical significance remains unclear. Scientists continue to investigate whether gut microbiome patterns might play a role.

Psoriasis

Research indicates that people with psoriasis often have altered gut microbiome compositions and are associated with increased intestinal permeability compared to healthy cohorts. The inflammatory nature of psoriasis appears to be connected to systemic inflammation that may originate in or be influenced by gut health.

Signs your gut may be impacting your skin

Understanding potential signs and symptoms of gut skin axis involvement can help you recognise when this connection might be relevant to your condition. However, it's important to note that these signs are not diagnostic and should always be part of a wider diagnostic process.

Digestive issues

Chronic bloating, irregular bowel movements, food intolerances, abdominal discomfort after eating, and frequent digestive upset. Some people notice that their skin conditions worsen during periods of digestive discomfort, though this connection isn't universal. It's worth noting that digestive discomfort such as bloating and flatulence can be completely normal after eating foods, particularly those that are considered to be healthy such as high-fibre foods and even leafy greens.

Skin symptoms

Inflammatory skin conditions that fluctuate without clear external triggers, skin issues that seem related to dietary changes, conditions that appear to worsen during times of stress or digestive upset, and skin problems that don't respond well to topical treatments alone.

It's worth remembering that digestive and skin symptoms can appear on their own or at the same time. This doesn't always point to a problem with the gut–skin axis, as these issues are quite common and usually not a cause for concern.

How to improve your skin through the gut

Current research suggests several approaches that may help support the gut skin axis, though it's important to understand that individual responses can vary significantly and these approaches are not intended to replace any medical treatments.

Dietary approaches

Studies indicate that certain foods may benefit both gut and skin health. The Mediterranean diet (7), rich in omega 3 fatty acids, antioxidants, and fibre, has shown promise in some research for supporting healthy inflammatory responses. 

Anti-inflammatory foods like fatty fish, leafy greens, berries, and nuts provide compounds that research suggests may benefit both gut and skin health.

Reducing highly processed foods, excessive sugar, and foods high on the glycaemic index may help some individuals.

A poor diet can significantly increase the risk of gut dysbiosis, which may contribute to increased intestinal permeability (leaky gut), unpleasant digestive symptoms, and potential disruptions to the gut–skin axis.

Probiotics for skin health

Several studies have investigated specific probiotic strains for skin conditions (8). Lactobacillus and Bifidobacterium are the two most well-known and studied types and have been used in trials related to eczema, with some research showing potential benefits. For acne, certain Lactobacillus strains have shown promise in small studies, though more research is needed to establish optimal strains and dosages as an effective treatment for acne.

Further reading: Probiotics and prebiotics, what is the difference and why do they work.

Lifestyle Factors

Stress management appears important for gut skin axis health, as chronic stress can negatively affect gut bacteria (9), even causing dysbiosis and may exacerbate skin conditions. Research supports stress reduction techniques like meditation, regular exercise, and adequate sleep for overall health, may indirectly benefit both gut and skin.

Regular physical activity has been shown to positively influence gut microbiome diversity (10) and may help with stress management, potentially benefiting the gut skin axis through multiple pathways.

What testing can reveal

Gut microbiome testing has emerged as a tool that may provide insights into the gut skin axis, though it's important to understand both the potential benefits and current limitations of this approach.

Comprehensive gut microbiome testing can identify the diversity and abundance of bacteria in your digestive system particularly the presence of any harmful or disruptive bacteria.

For skin health concerns, testing might reveal bacterial imbalances that research has linked to inflammatory skin conditions. Some studies have identified specific bacterial patterns in people with eczema, acne, or other skin conditions compared to those with healthy skin.

Testing can also assess markers of gut barrier function and inflammation levels, which may be relevant to the gut skin axis. Additionally, some tests can identify the presence of beneficial bacteria that produce compounds like short-chain fatty acids (SCFAs). Research suggests SCFAs may help maintain balanced inflammatory responses throughout the body, including the skin.

How do Feel Gut measure the Gut-Skin Axis?

Our microbiome test also tests for gut parasites. While parasitic infections are relatively uncommon in developed countries, certain parasites can occasionally contribute to digestive symptoms. However, it's important to note that parasites rarely cause common skin conditions like eczema, acne, and rosacea, which typically have other underlying causes. Combining parasite screening with a comprehensive microbiome analysis provides a complete picture of your gut health.

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 acne, eczema, or psoriasis.

By seeing how your gut bacteria compare to these reference profiles, we can highlight whether your microbiome shows similarities linked to skin imbalance. While this isn't a medical diagnosis, it provides useful insights into how your gut health may be connected to your skin and overall wellbeing.

At Feel Gut, our gut microbiome health test specifically measures biomarkers that are linked to the gut-skin axis that research suggests may impact skin health.

Limitations of testing

It's crucial to understand that gut microbiome testing cannot diagnose skin conditions or predict treatment outcomes with certainty. The field is rapidly evolving, and our understanding of optimal bacterial patterns is still developing. Test results provide a snapshot that can change over time based on diet, stress, medications, and other factors.

Can improving gut health clear my skin?

While gut health alone doesn't "cure" skin conditions, research suggests it may reduce inflammation and support overall skin wellness as part of a broader approach. Improving your gut health should not replace any treatments you are currently taking.

Which probiotics are best for skin?

Studies suggest strains like Lactobacillus and Bifidobacterium longum may benefit certain conditions such as eczema, but effects may vary individually.

How long does it take to see changes in skin after improving gut health?

It can take several weeks to months for the gut microbiome and skin to rebalance. Consistency with diet and lifestyle changes is key.