There is a common phrase in the functional health community that “all disease begins in the gut.” The gut microbiome and intestine play a critical role in our overall health! In fact, healthy gut function is required for proper nutrient absorption, immune function, hormonal balance, and detoxification, among countless other processes.

Unfortunately, many gut-related conditions are on the rise from hormonal imbalances to autoimmune disorders. In my practice, I see this day in a day out! Many clients come to me with seemingly unrelated symptoms–especially skin-related symptoms–that all can be traced back to underlying gut dysfunction and hormonal dysfunction and nutritional deficiencies. Remember hormone problems and nutritional deficiencies are often gut problems! This can include poor nutrient absorption, bacterial overgrowth or imbalances, nutritional deficiencies, inflammation of the intestine, food sensitivities, and leaky gut. Oftentimes an unhealthy gut can manifest itself through skin symptoms.

The gut-skin axis refers to the intimate relationship between the gut microbiome and skin. The skin and the intestines function almost identically, keeping pathogens from entering the bloodstream and absorbing beneficial nutrients. Further, the gut-skin axis is regulated by the immune system (70% of the immune system resides in the gut!). Skin conditions such as chronic rashes, eczema, psoriasis, acne, keratosis pilaris, melasma, and rapid skin aging are increasingly common and can be a byproduct of inflammatory processes in the intestine which alter the body’s immune response. When the gut is chronically inflamed, imbalanced with bacteria and other pathogens, and burdened by toxins or maldigestion, partially digested food proteins can leak through the mucosal membranes, resulting in systemic inflammation. This too can alter the skin’s production of antimicrobial peptides, 100 of which are produced in the skin, leaving the skin susceptible to infections.

Your gut health and your skin health are NOT separate and when clients come to me with chronic skin related concerns, the gut is one of the first steps that we explore!

Here are a few underlying causes of skin conditions…

Rashes and eczema:

These skin concerns are commonly linked to bacterial of fungal GI imbalances, unaddressed food allergies, or food sensitivities on a burdened gut (commonly offenders are gluten, dairy, corn, soy, peanuts/tree nuts, types of fish/shellfish). An inflamed intestinal tract can be part of the picture of triggering this response.

Psoriasis:

This condition is characterized by dry, itchy patches of skin and has been linked to leaky gut and increased circulating endotoxin (byproducts of pathogens) often a byproudct of bacterial, fungal, or parasitic imbalances in the gut.

Acne:

Imbalanced bacteria, GI infection, inflammation, maldigestion,  and gut hyperpermeability leave the body/ susceptible to infections and bacterial imbalances on the skin often resulting in acne.

Keratosis pilaris:

These red bumps are commonly associated with poor nutrient absorption, especially vitamin A and fatty acids. We also see an association with GI inflammation, malabsorption, and environmental exposures driving up stress (like mold!).

Melasma:

Imbalanced bacteria can also disrupt proper estrogen metabolism which is eliminated via the intestinal tract. Elevated levels of estrogen are linked to melasma, skin discoloration, and hyperpigmentation.

Rapid skin aging:

Beneficial bacteria in the gut play an important role in producing anti-inflammatory compounds, especially short-chain fatty acids. Without these compounds, chronic inflammation can damage cells and increase aging.

Conventional vs. functional approaches:

Gut imbalances or dysbiosis:

Dysbiosis refers to an imbalance of beneficial bacteria to harmful bacteria in the gut. When there are more negative bacteria present, the body cannot absorb nutrients properly and eliminate waste. Many women today also have unwanted bacterial overgrowth in their small intestine (this is sometimes diagnosed as small intestinal bacterial overgrowth (SIBO)). Both imbalances can drive up inflammation, alter digestion, and drive up an immune response, resulting in skin dysfunction. Gut imbalances can be evaluated through advanced functional lab testing, you can learn more here. 

Hormonal imbalances:

There is an intricate relationship between the gut and hormonal imbalances. It often is the question of what comes first, the chicken or the egg. Regardless, addressing hormonal imbalances can in turn alleviate gut imbalances and vice versa. Part of this picture is that under chronic stress, the body increases the production of cortisol, a stress hormone, that directly suppresses digestion and secretory IgA, an immunoglobulin that is the body’s first line of defense in protecting the intestine from pathogens. Similarly, increased estrogen levels can increase susceptibility to pathogens. Addressing cortisol levels and encouraging a proper balance of sex hormones can prevent this suppression and improve intestinal health.

Nutritional deficiencies:

Bacteria in the gut play a critical role in the absorption of nutrients. Some bacteria even produce essential nutrients including vitamins B12 and K. When bacteria is imbalanced or you are not eating an adequate amount of nutrients, skin symptoms can appear. For example, vitamin A influences the barrier function of the intestines, and incidentally, vitamin A deficiency is implicated in skin conditions such as keratosis pilaris. Using functional lab testing can provide insights into any deficiencies or low mineral stores. Targeted supplementation and nutrient repletion can help restore intestinal function as well.

Inflammation:

Chronic inflammation, or oxidative stress, plays a significant role in the development of gut hyperpermeability (aka leaky gut) and other intestinal issues which can cause an immune reaction, influencing skin health. Inflammation may be a result of food sensitivities, diets high in processed foods, an imbalance of stress hormones, alcohol, medications, exposure to toxins, infection, dysbiosis etc. Finding ways to decrease inflammation through nutrient repletion, die choices, grounding, and adequate sleep, among other foundational tools is an important component of improving intestinal health and skin!

Stress:

As previously mentioned, stress profoundly impacts the digestive system. You can read more about the stress-digestion connection here. We prioritize mitigating physical stress by prioritizing blood sugar balance, adequate sleep, adequate nutrient intake, and mitigating toxin exposure as well as practicing mindfulness to reduce emotional stress. This allows the body to “rest and digest,” keeping the gut relaxed and functioning!

A note on gluten-free or dairy-free diets for skin health:

This is NOT a catch all. Food sensitivities can be commonly linked to chronic skin concerns like acne, eczema, and rashes, but there is a bigger picture here.  Many functional health providers suggest adopting a gluten-free or dairy-free diet in the face of skin symptoms. I have personally found that this can be supportive to some individuals in relieving symptoms although often this is only a short-term solution and symptoms usually return after a period. This is because a restricted diet does not fully address WHY the body cannot process the proteins in gluten or dairy. In our practice we use diet elimination as a tool – typically, it is not the food’s fault, but rather an imbalance in our own system and a message that the body needs support!  I believe that addressing the above is more effective in relieving inflammation and does not force clients to adopt a long term restrictive diet!

6 tips to start supporting your skin health today:

Connect with an esthetician and review your skincare routine:

Each individual’s skin barrier is different! Consulting with an esthetician can help you to determine which products are best to support your skin and address individual needs such as fine lines, melasma, etc.

Eat for blood sugar balance:

Balancing blood sugar is foundational for hormonal balance and keeping both inflammation and stress down. Hyperpigmentation is commonly a sign of insulin resistance and chronic blood sugar dysregulation. Keeping blood sugar stable can support immune function and alleviate/prevent discoloration! Learn more about blood sugar balance at this post here!

Increase food sources of minerals:

Minerals are essential for proper cellular function and digestion. For example, adequate sodium chloride (think high quality sea salt, like Redmonds) is necessary for the production of hydrochloric acid in the stomach, which helps to break down food so the intestine can absorb nutrients. Adequate mineral intake is essential for cells to properly run digestion. More on mineral intake can be found here!

Prioritize sleep:

Research indicates that sleep deprivation can lead to alterations in the gut microbiome. A disrupted circadian rhythm can prevent the intestinal lining from repairing itself and increase systemic inflammation. Prioritizing 7-9 hours of sleep a night ensures that the body has proper recovery time to heal tissues!

Increase plant-based foods specifically:

• • Gut-supportive foods including:
    • Aloe
    • Bone broth
    • Seeds fibers (flax and chia)
  • Detox-supportive foods include:
    • Crucifers
    • Raw carrots (carrot salad)
    • Cooked mushrooms
  • High Antioxidants foods including:
    • Berries
    • Beets
    • High polyphenol foods

Are you struggling with skin symptoms?