Is the secret to glowing skin in your gut?
One of the most intriguing developments in modern dermatology is the emerging evidence of a bidirectional link between gut and skin health (sometimes called the gut-skin axis). If you have noticed breakouts or redness the day after a heavy meal or when you have had a bit too much sugar, you might be seeing the gut-skin connection in action. The skin is our largest organ, and can be a strong reflection of what is happening inside our body, especially in the gut. When the gut is out of balance we often see increased inflammation, rashes and acne in the skin. When these symptoms are being driven by something happening on the inside no amount of serums, lotions or potions can fix the problem - we need to look within.
Understanding the Gut-Skin Axis
The gut-skin axis refers to the complex communication between the gastrointestinal tract and the skin. The health and function of the gut has a profound influence on everything from nutrient absorption, detoxification, metabolism and immune function. The impact of gut health on immune function is not surprising; it is estimated that over 70% of our immune cells are located inside the single cell wall that lines the gut. Any damage or inflammation in the gut can therefore have a direct effect on the immune system, and can influence whether the body is in a state of immune tolerance or inflammation (1). Many of the most common skin conditions, including acne, eczema, psoriasis and rosacea are characterised as inflammatory skin conditions, and there is increasing research showing that imbalances in gut health can contribute to the development and severity of these skin complaints (1).
The skin and the gut are both home to a large community of bacteria and other microorganisms (the skin and gut microbiomes) that have been shown to have a significant impact on our overall and skin health. The gut microbiome seems to influence skin health through various mechanisms, including:
The immune system: some beneficial bacteria produce metabolites like short-chain fatty acids (SCFAs) that have been shown to support the integrity of our gut lining and support anti-inflammatory responses. Imbalances in the levels of these beneficial bacteria have been linked to damage to the gut lining, inflammatory immune responses and the development of inflammatory skin disorders including acne, eczema and psoriasis (1).
Direct effects: the gut microbiome can also directly protect against pathogens that could trigger skin symptoms by binding to the epithelial cells that make up our gut lining, preventing pathogenic bacterial invasion (2).
The skin microbiome: the gut microbiome appears to influence the skin microbiome, as SCFAs produced in the gut seem to determine the levels of certain bacteria in the skin microbiome, which has a direct influence on the skin’s local immune defence mechanisms, and therefore its vulnerability to irritation, infection and inflammation (2).
The nervous system: bacteria in the gut also contribute to the production of neurotransmitters like dopamine, serotonin and GABA, which can influence skin health through the nervous system (1). While more research is needed, there is some evidence that modulating the gut microbiome can influence not only the development of skin rashes but the production of skin collagen via its effect on neurotransmitter production (1).
Maintaining a healthy balance in our gut microbiome is therefore important not just for skin health, but every aspect of human health.
How Gut Health Affects Skin Conditions
There is increasing research showing the link between the gut microbiome and specific skin conditions, including:
Acne: an inflammatory skin condition that occurs when dead cells and sebum from the skin clog hair follicles, leading to blackheads, whiteheads and pimples. Increasing research shows that the development of acne is linked to changes in the gut microbiome, and increased levels of bacteria such as C. acnes are often seen in individuals with acne (2).
Eczema: a chronic inflammatory skin condition that is often accompanied by dry, itchy skin and red patches. Studies suggest that individuals with eczema often have an imbalance in their gut microbiome (3), with lower levels of beneficial bacteria such as Lactobacillus and Bifidobacterium. This imbalance may contribute to increased gut permeability ("leaky gut"), allowing inflammatory molecules to enter the bloodstream and provoke immune responses that can lead to skin flare-ups.
Psoriasis: an autoimmune skin condition characterised by rapid skin cell turnover, leading to scaly, red or silver plaques. While more research is needed, emerging evidence indicates that gut dysbiosis is common in individuals with psoriasis, often accompanied by increased levels of pro-inflammatory immune signalling molecules (2, 4). An unhealthy gut can fuel systemic inflammation, which could worsen psoriasis symptoms and reduce the effectiveness of treatments.
Rosacea: a chronic skin condition that results in persistent redness, visible blood vessels, and, in some cases, acne-like breakouts. Research suggests that individuals with rosacea frequently have small intestinal bacterial overgrowth (SIBO), a condition where excessive bacteria in the small intestine cause inflammation and immune system dysregulation (5). Treating SIBO has been shown to improve rosacea symptoms significantly, indicating the importance of the gut microbiome in rosacea.
Ways to Support Gut and Skin Health
Given the impact of the gut on skin health, some of the best ways we can support our skin is through nurturing the health and diversity of our gut microbiome. Follow these five steps to support your gut and skin health:
Step One: incorporate probiotic-rich foods like whole-fat yoghurt, kefir, kimchi and miso, and prebiotic-rich foods including all high-fibre foods like garlic, onions, broccoli, beans and legumes to nurture the community of beneficial bacteria in the gut.
Step Two: focus on including antioxidant and polyphenol rich foods found in brightly coloured foods (like dark leafy greens, blueberries, beetroot and green tea), as well as sources of omega-3 fatty acids (like salmon, nuts and seeds) in your diet, which have been shown to support the integrity of the gut lining, reduce inflammation and improve symptoms in acne, eczema, psoriasis and rosacea.
Step Three: reduce intake of highly processed foods and sugar, which have both been shown to promote inflammation and negatively affect the gut microbiome and skin health. Reducing sugar intake might be particularly useful for individuals with an inflammatory skin condition, as there is evidence of a link between sugar intake and psoriasis (7), acne (8), and rosacea (9).
Step Four: chronic stress can negatively impact gut bacteria and trigger inflammatory skin conditions. Taking steps to manage stress, through mindfulness, meditation and maintaining good sleep hygiene, can therefore help to support the gut microbiome and may help to improve skin quality.
For some people, it may also be necessary to consider food intolerances based on their individual symptoms.
Conclusion
Achieving healthy skin isn’t just about topical treatments; it requires a holistic approach that prioritises internal health. The gut-skin axis highlights the profound impact our digestive system has on skin conditions like acne, eczema, psoriasis, and rosacea. By nourishing our gut with a balanced diet, reducing inflammation, and managing stress, we can support a healthier microbiome and, in turn, promote clearer, more resilient skin.
If you want to find out more about how to support your gut and skin health, book a free 20-minute call with me to receive a personalised gut assessment and to find out how I can support you to achieve your health goals.
References:
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(2) Salem I, Ramser A, Isham N, Ghannoum MA. The Gut Microbiome as a Major Regulator of the Gut-Skin Axis. Front Microbiol. 2018 Jul 10;9:1459. doi: 10.3389/fmicb.2018.01459.
(3) Díez-Madueño K, de la Cueva Dobao P, Torres-Rojas I, Fernández-Gosende M, Hidalgo-Cantabrana C, Coto-Segura P. Gut Dysbiosis and Adult Atopic Dermatitis: A Systematic Review. J Clin Med. 2024 Dec 24;14(1):19. doi: 10.3390/jcm14010019.
(4) Yunusbayev B, Bogdanova A, Nadyrchenko N, Danilov L, Bogdanov V, Sergeev G, Altinbaev R, Bilalov F, Yunusbaeva M. 2025. Gut dysbiosis narrative in psoriasis: matched-pair approach identifies only subtle shifts correlated with elevated fecal calprotectin. Microbiol Spectr 13:e01382-24. https://doi.org/10.1128/spectrum.01382-24.
(5) Parodi A, Paolino S, Greco A, Drago F, Mansi C, Rebora A, Parodi A, Savarino V. Small intestinal bacterial overgrowth in rosacea: clinical effectiveness of its eradication. Clin Gastroenterol Hepatol. 2008 Jul;6(7):759-64. doi: 10.1016/j.cgh.2008.02.054.
(6) Zujko-Kowalska K, Jankowska B, Zujko ME. The Antioxidant Power of a Diet May Improve the Quality of Life of Young Women with Acne Vulgaris. Nutrients. 2024; 16(9):1270. https://doi.org/10.3390/nu16091270.
(7) Kanda N, Hoashi T, Saeki H. Nutrition and Psoriasis. Int J Mol Sci. 2020 Jul 29;21(15):5405. doi: 10.3390/ijms21155405.
(8) Penso L, Touvier M, Deschasaux M, Szabo de Edelenyi F, Hercberg S, Ezzedine K, Sbidian E. Association Between Adult Acne and Dietary Behaviors: Findings From the NutriNet-Santé Prospective Cohort Study. JAMA Dermatol. 2020 Aug 1;156(8):854-862. doi: 10.1001/jamadermatol.2020.1602.
(9) Akin Belli A, Ozbas Gok S, Akbaba G, Etgu F, Dogan G. The relationship between rosacea and insulin resistance and metabolic syndrome. Eur J Dermatol. 2016 Jun 1;26(3):260-4. doi: 10.1684/ejd.2016.2748.
