Our “gut health” continues to be one of the hottest topics under the broad umbrella that is all things wellness, and for good reason: the makeup of your gut microbiome and all the “good” and “bad” bacteria it contains. thrive on it, they have been linked to almost every other health factor, including immunity, mental health, our environment, medication history, and more.
One relationship between gut health and intestinal health that researchers have been looking at is the gut-skin axis. The reasons why skin problems often go hand in hand with intestinal problems are not fully understood.
“There are a lot of overlapping diseases between the gut and the skin,” said Dr. Hadar Avihai Lev-Tov, a board-certified dermatologist and associate professor of dermatology at the Dr. Phillip Frost Department of Health at the University of Miami Health System. . Dermatology and Skin Surgery. “The question is always: What is the root of this connection?”
Some of those roots grow from the depths of our gut microbiome and, more importantly, the imbalance or lack of diversity in it is called “dysbiosis,” according to Dr. Niket Sonpal, gastroenterologist and clinical assistant professor. at Touro College of Osteopathic Medicine. . And as with many aspects of health, the impacts are not limited to a single organ or system: the intestine, in this case.
“There are some studies that show that the gut microbiome of patients who have acne is actually less distinct and less diverse than those who don’t have acne, so we know that plays a role,” Sonpal noted, adding that there is also a relationship between how the microbiome can affect the immune system and its responses in people with other conditions such as eczema.
However, he said the “exact mechanism” of how skin health may be related to gut health is still unclear.
“It’s very diverse and the microbiome is as unique as each person,” Sonpal said.
This is what we know today.
Acne, gut health and the limited number of acne treatments
Common acne is a common skin condition that occurs when hair follicles become clogged; It occurs in about 85% of adolescents, according to the American Academy of Dermatology, and continues into adulthood for many people.
Although acne has different causes and varies in severity (some people’s acne may be primarily due to hormonal responses, for example, while other cases may be more limited or made worse by skin care products or sweat), People with acne may be more likely to experience intestinal problems such as irritable bowel syndrome, according to one. Turkey preliminary study 2020. The researchers found that IBS was “significantly” more common in patients with acne than in those without.
Sonpal says the “vast majority” of his visits are for irritable bowel symptoms, and he notes an overlap between them, the presence of acne, and other potentially gut-related symptoms, including fatigue. When asked why IBS is so common (between 10% and 23% of adults worldwide have IBS, according to an estimate for 2022), Sonpal pointed to a Western diet that relies heavily on processed foods. , lack of fiber and too many antibiotic prescriptions as some of the potential factors.
However, the relationship between gut health and skin doesn’t go in one direction, and antibiotic use is another point where skin health and gut health can merge. Antibiotics are commonly prescribed as a treatment for some cases of acne. and endorsed by the AAD for short-term use. But because there is a well-known relationship between taking antibiotics and altering the gut microbiome. (antibiotics kill bacteria, including the “good” ones in the gut), this means that people with acne can end up with effects on their gut health if they are prescribed antibiotics as a treatment.
Lev-Tov recognizes the intestinal disruption that comes with taking antibiotics, as well as the public health problem of antibiotic resistance that is due to too many people being prescribed too many antibiotics. But he says that for some acne patients, antibiotic treatment is the best course of action, as many cases can cause pain, skin tears, and generally disrupt a person’s quality of life. Antibiotics, for all their gut-destructive properties, can help significantly.
“They need treatment and they deserve it,” says Lev-Tov, adding that dermatologists have limited treatment options for acne patients. For people with acne who benefit from treatment, routes are primarily limited to medications that control androgen hormones such as testosterone (birth control pills and spironolactone); isotretinoin or Accutane (which Lev-Tov says is heavily regulated due to the risk of birth defects if taken during pregnancy); and certain antibiotics.
“I would like the lesson to be: we need more innovation,” says Lev-Tov.
Read more: Who should take probiotics for gut health?
Sourdough is one of many foods that are good for the gut. (And potentially, your skin.) Check out a list of 12 foods to get you started here.
Photograph by Ian Laker/Momento/Getty Images
Eczema, gut health and the role of the immune system
Some people with eczema can potentially reduce their symptoms or attacks by making changes to their diet, one of which includes adding probiotics or gut-friendly foods. According to Zoe, a health sciences company that studies gut health, the most common type of eczema (atopic dermatitis) may be linked to gut health because of the way the gut microbiome influences the immune system, which then It influences breakouts and skin sensitivities such as eczema.
Some research has found that people with atopic dermatitis have more or less of certain types of gut bacteria, according to Zoe.
The idea behind this is that microorganisms in the intestine “cause an excessive amount of certain types of white blood cell reactions,” Sonpal explained. “And those white blood cells react to a chemical found in the intestine, and that chemical causes them to fight against the barrier,” which in some cases causes skin reactions.
A stronger implication that the gut microbiome causes skin problems is in the case of patients with hidradenitis suppurativa (HS), a non-contagious skin and immune condition that causes often painful blemishes in places where skin rubs against skin, such as the armpits or groin. Lev-Tov, who is the president of the HS Foundation, says that experts know that HS is associated with irritable bowel disease and that “improving the gut microbiome can actually help prevent disease.”
‘You feel like you’re at Hogwarts at Whole Foods’: What to eat for happy skin and a healthy gut
As experts continue to work on solutions for the gut-skin axis, the simplest tool we have at our disposal to improve gut health may be to add the right foods to our diet. According to Sonpal, the first thing you should do if you suspect your gut health is responsible for the state of your skin is to take inventory of your diet: Is it diverse enough? Are you eating enough fruits, vegetables, and plant-based foods compared to processed foods?
Natural prebiotics and probiotics are abundant in delicious natural foods like yogurt, sauerkraut, and more, and simply adding these foods to your diet can improve your health, especially if your diet doesn’t include a broad enough picture of all the “good stuff.” bacteria that your gut craves to maintain your microbiome. This means there is no need to purchase an expensive bottle of prebiotics or probiotics. Comparing supplements and foods marketed as healthy to “potions” and “magic elixirs,” Sonpal says it’s easy to feel discouraged when walking down the grocery aisle.
“You feel like you’re at Hogwarts at Whole Foods,” Sonpal said. “It is extremely overwhelming.”
“A very simple sauerkraut, which is extremely inexpensive, is just as good as that ‘billion dollar pill’ in the freezer aisle that costs a co-pay,” Sonpal said.
