The Gut-Skin Axis

The gut and the skin are organs with crucial immune and neuro-endocrine roles and are uniquely related in purpose and function. The intimate relationship between these organs is referred to as the “skin-gut axis” and numerous studies have linked gastrointestinal (GI) health to skin homeostasis.

The relationship between the gut microbiome and skin health

One of the main regulators in the skin-gut axis is how the gut microbiota communicates with the skin and it does this mostly via intricate interactions with the immune system to regulate systemic and local inflammation.

In addition to this mode of communication, research suggests that the gut microbiota can affect the skin more directly. In the case of an impaired intestinal barrier, intestinal bacteria as well as their metabolites can enter the bloodstream, accumulate in the skin and disrupt the skin microbiome [1].

GI disorders are often accompanied by skin manifestations and the gut microbiome appears to play a key role in the development of many inflammatory disorders of the skin.

Altered gut function and associated skin disorders

Intestinal dysbiosis, a state of microbial imbalance, has the potential to negatively impact the skin microbiome and its basic function. This can contribute to common skin disorders such as acne, psoriasis, atopic dermatitis (eczema) and rosacea.

Research suggests a potential relationship between rosacea and Helicobacter pylori, a pathogenic bacteria found in the stomach and small intestine. A recent study demonstrates a significantly higher prevalence of H.pylori infection in those with rosacea when compared to controls and irradication of the bacteria led to a significant improvement in skin symptoms [2].

It is well established that the microbiome can regulate the immune response through multiple interactions with the immune system. In the case of atopic dermatitis, it is believed that lack of microbiome diversity during the early stages of life can affect the maturation of innate and adaptive immunity leading to chronic inflammation. Research has shown infants with atopic dermatitis to have low quantities of bifidobacterium and bacteroides [6, 10].

Although acne is caused by many factors, gut microbiome can play a key role in the progression and severity of the disease. The emotional stress that accompanies acne can impair the gut microbiome, most notably Lactobacillus and Bifidobacterium species. Psychological stress can cause intestinal microbes to produce neurotransmitters that can enter the bloodstream through the intestinal barrier, resulting in systemic inflammation [1, 7].

The skin microbiome

The skin microbiota, like the microbes present in the gut are able to interact with the immune system, helping to maintain skin homeostasis by inhibiting the growth of pathogenic bacteria found on the skin and decreasing inflammation. Dysregulation of the skin immune response can be seen in skin disorders such as psoriasis and atopic dermatitis [3, 8, 12].

The gut microbiome appears to have an influence on the skin microbiome. Short chain fatty acids (SCFAs) resulting from fiber fermentation in the gut can promote the growth of certain skin microbes, which influence immune defence and regulate skin inflammation [11].

Altering the gut microbiome to prevent and treat disease has been well established while the effect of skin microbiome on disease is still a developing and exciting area of research.

The role of prebiotics + probiotics in skin health

Diet is widely recognised as a key factor that mediates the function of the gastrointestinal microbiome. Dietary fiber goes through a process of bacterial fermentation in the GI tract, producing short chain fatty acids that promote a healthy colon. Studies have shown that a greater dietary fiber intake is associated with increased gut microbe diversity [5].

Consumption of probiotic foods are a great way to ensure you’re getting a wide diversity of the beneficial strains to promote skin health and help to maintain a healthy gut microbiome. Try to include a portion of the following foods daily:

Sauerkraut, kimchi, kefir, miso, tempeh, kombucha or even natural live yogurt

Consumption of prebiotic foods will also help to maintain a healthy balance gut microbiome. Prebiotics work in a similar way to fiber, acting as a source of fuel / food for the beneficial bacteria, allowing them to flourish in the gut and perform their health promoting functions. Although all prebiotics are fiber, not all fiber is prebiotic!

In summary

There is an undeniable relationship between the gut microbiome and the skin and although this is not a new area of research, it has become an important topic in dermatology and gastroenterology alike. It is evident that many environmental factors such as diet and psychological stress can influence the gut microbiome, which can directly or indirectly affect skin health. With the use of probiotics supplements and consumption of probiotic foods showing great promise in the management of skin disorders, they should be widely considered as a therapeutic approach to address these concerns.

Gut health, as part of any nutritional intervention is getting a lot of attention and skin health is no exception to this. Look after your gut microbiota and your skin will flourish.

This post originally appeared on The Secret Life of Skin September 23, 2019

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