Healthy Skin Comes from the Gut

A healthy microbiome benefits everything from your immune system to your skin
Smiling woman with healthy skin
Photo by Lesly Juarez on Unsplash

In a recent podcast, Deepak Chopra discussed the importance of the gut microbiome—the community of healthy bacteria residing in our intestines—in genetic health, explaining that even if we receive “crappy” genes from our parents, our digestive health can influence their expression. Apart from genetics, many research studies show that the condition of the gut microbiome also heavily influences the health of other seemingly distant organs, including the vital role it plays in the healthy functioning of the skin. In fact, the skin hosts its own community of microbiota which communicates with the intestinal flora, forming the gut-skin axis.


Tiny organisms in the microbiome help to stimulate the immune system and reduce inflammation in the body, which is often at the root of skin issues. They also act as soldiers, guarding the barrier of both the skin and the gut lining. The communities of gut and skin bacteria support each other by preventing growth of disease-causing bacteria, many of which are big contributors to skin conditions. But when these tiny soldiers are disturbed or are outnumbered by bad bacteria, creating a disrupted state called dysbiosis, toxins can leak through the gut and be deposited on the skin. Since the digestive system and skin are constantly engaged with factors that can disrupt the microbiome, such as food and the environment, protecting them from harmful bacteria is imperative.

Gut Health and Eczema

Atopic dermatitis, or eczema, is a common pediatric condition characterized by dry skin, an itchy red rash, and a weakened immune system. Although some may outgrow it, eczema often ends up being a lifelong affliction. Because it’s directly related to inflammation, a disrupted microbiome is often to blame and, not surprisingly, those who suffer from eczema often have several digestive issues, making a robust digestive system and microbiome a priority. Dysbiosis not only weakens the body’s immune response, making those suffering from eczema more susceptible to infections, it also weakens the skin barrier causing an increase in transepidermal water loss (TEWL), ultimately leading to the dry skin that permits the onset of eczema flare-ups. Luckily, making changes to your diet can help manage eczema.

Gut Health and Acne

Acne is another skin condition that relies heavily on the health of the gut microbiome. Acne is caused through three mechanisms: overgrowth of the bacteria P. acnes, excess secretion of oils in skin cells, and duct blockage by skin cells. Having a strong gut and skin microbiome prevents overgrowth of the acne-causing bacteria. Moreover, it reduces inflammation by protecting the gut lining and maintaining its integrity. When the gut bacteria are unable to digest and absorb food appropriately it can even lead to a deficiency in vital acne-preventing nutrients, including folic acid, zinc, chromium, selenium, and omega-3 fatty acids. (Here's more on how to manage your acne naturally.)

Dysbiosis Diagnosis

Some other skin conditions linked to gut imbalance include:
•    Psoriasis
•    Vitiligo
•    Rosacea
•    Tinea versicolor
•    Pityriasis rosea


Diet can play a major role in a disrupted microbiome. While many of us already know that processed white sugars and other sweeteners aren’t great for our general health, there is now more evidence of their negative impact on the microbiome in particular. According to research, too much sugar has been directly linked to the creation of a gut environment favourable for the growth of bad bacteria. Conversely, natural sugars found in fruits and vegetables have been shown to have the opposite effect, helping to benefit the microbiome.

The typical Western diet, high in inflammation-causing saturated fats and animal proteins and low in fibre, can also be to blame for a decrease in beneficial bacteria such as Lactobacillus and Bifidobacterium species. Sources of saturated fats include high-fat dairy foods, red meat, and poultry with skin. Conversely, polyunsaturated and monounsaturated fats have been linked to supporting the growth of good bacteria and inflammation reduction.

Antibiotics are extremely effective in killing off infection-causing bacteria. However, broad-spectrum antibiotics are unable to discriminate between good and bad bacteria, and eradicate all bacteria instead, creates an environment where an overgrowth of bad bacteria is possible. Antibiotics are commonly prescribed as a treatment for acne and while most people see initial improvement, many patients report a recurrence upon cessation which could be linked to a dysbiosis in their microbiome. This, of course, doesn’t mean we should avoid antibiotics when they’re required as they are essential for treating many infections that can have serious complications. Some bacterial infections, such as ear and sinus infections, might not need antibiotic prescription, and understanding how antibiotics are impacting your microbiome and when they should be used will allow you to better prepare for post-treatment recovery.  

The Centers for Disease Control and Prevention (CDC) is a great resource for when and how to take antibiotics. Note that antibiotics do not help treat viral infections (like colds and flus) and even some bacterial ones, like an ear or sinus infection, may not require an antibiotic prescription. If an antibiotic is necessary, talk to your healthcare provider about supplementing with probiotics to rebuild your gut and prevent some of antibiotics’ not-so-nice side effects, including rash, nausea, diarrhea, and yeast infections.

Birthing method may in fact play a significant role in the health of our microbiome. For newborns, the strength and composition of their gut bacteria is dependent on the health of the mom’s microbiome. During vaginal birth, the bacteria from the mother takes host in the baby’s gut and skin, forming the foundations of baby’s permanent microbiome. If the mother’s microbiome is disrupted or if the baby is delivered via c-section, the infant’s microbiome may be compromised, making them more susceptible to conditions such as eczema.

If a c-section is in your future, talk to your healthcare provider about vaginal seeding, a process that involves swabbing a newborn with their mother’s vaginal secretions to mimic the vaginal birth environment.

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When the body’s microbiome is happy, the skin is happy; but when it’s imbalanced, skin conditions can arise, or existing ones can become aggravated. While we may not be able to avoid that round of antibiotics or always eat a healthful diet, and since the body does not produce its own bacteria, probiotic-rich food and supplementation are key to restoring a healthy functioning gut-skin relationship.

Recently, there has been a keen interest in probiotic supplementation for the treatment and prevention of skin conditions and several studies support their use for this purpose, with different strains serving different functions and in specific situations. For example, in a study of infants with eczema, supplementation with Lactobacillus rhamnosus and Bifidobacterium animalis in late infancy resulted in lower incidents of eczema compared to those who did not take probiotics. And in a study of supplementation of Lactobacillus acidophilus and Bifidobacterium bifidum in patients with acne, the result was an improvement in acne lesions compared to those who did not take any probiotics. Since probiotic treatment for skin concerns is strain-specific, it is always best to consult your healthcare provider before starting supplementation to ensure you are getting the correct strain for your condition.

Good bacteria can also be found in a variety of foods. Although the concentration of probiotics found in supplements is much higher, adding probiotic-rich foods to your diet can also help support and maintain the gut and skin microbiome. Fermented foods such as Greek yogurt, kefir, sauerkraut, kombucha, tempeh, and miso are tasty ways to take full advantage of their probiotic goodness. You can even make your own fermented foods!

The importance of a healthy gut microbiome is essential in the prevention and treatment of acne, eczema, and possibly other skin issues. A strong gut bacterial community ensures that the skin stays healthy, and adding in probiotic-rich foods along with supplement strains specific to your skin’s needs can help support the growth of good bacteria to preserve the gut-skin relationship and keep you feeling and looking your best!