Skin problems? Focus on your gut

Acne, eczema, psoriasis, itchy scalp… Is your gut trying to tell you something?

Is that problem skin you see in the mirror, or the reflection of a problem gut? If you have tried pills, potions, and lotions, all to no effect, perhaps you’re looking at the problem from the wrong end.

You may not always love the skin you’re in, but there are countless microorganisms that do, and are happy to make it their home. Just as the gut houses its own microbiome — colonies of bacteria, fungi, protozoa, and others — the skin has its own living microbiome.

“Cumulative evidence” shows that there is bidirectional communication between gut and skin and that what happens in the gut often shows up on the skin.

Skin conditions are highly complex with many different causes. We are all unique: each case requires a comprehensive evaluation and individualized care. Here I discuss one factor - the role of the gut microbiome in skin disorders. It may apply to you.

How trouble begins

So many health problems can be traced to changes in gut microbiome activity. The ‘friendly’ bacteria are overrun by the bad, creating a state of dysbiosis — disharmony in the gut environment.

When dysbiosis commences, so too does battle. Gut bacteria compete for food and shelter, and when dysbiosis arises the pathogenic microorganisms flourish and go on the rampage through their dark kingdom. They make their presence felt through pain, gas, bloating, and constipation that sometimes alternates with bouts of diarrhea.

Under normal circumstances, any troublemakers are given short shrift and expelled from the gut in the usual manner. But when an overgrowth of pathogenic bacteria creates dysbiosis, the next step on this downward spiral is intestinal permeability, or leaky gut.

Dysbiosis can damage the gut lining, or epithelium. The epithelium, composed of just a single layer of cells, forms a barrier between the body and the outside world, and friendly bacteria play a critical role in maintaining barrier function and keeping out undesirables and their toxic by-products.

Once the barrier is breached, toxic metabolites from bacteria gain access to blood, accumulate in the skin, and disturb healthy skin homeostasis.

All this activity triggers an immune response. The gut is a major component of the body’s immune system and as part of this response, it releases inflammatory agents, including substances called cytokines, that travel via the blood to the skin.

The consequence of this response is inflammatory skin disease. This may take the form of eczema (aka atopic dermatitis), psoriasis, acne vulgaris, and seborrheic dermatitis, a dandruff-like condition of the scalp.

“Indeed, a growing body of evidence supports that intestinal dysbiosis, a state of microbial imbalance, can almost invariably be observed in common inflammatory skin pathologies, such as atopic dermatitis (AD), psoriasis, rosacea, and acne vulgaris.”