Your gut is a battlefield. Trillions of bacteria constantly struggle over dominance and territory. As incredible this may sound, there’s good reason to believe that the health of your skin is riding on this battle.
Research shows that acne patients frequently suffer from digestive and gut problems, and that fixing these issues also helps the skin. Often these problems go undetected as they don’t cause noticeable symptoms.
On this post I want to talk about the gut-skin axis and show why you should take this seriously. We’ll also look at some practical tips on dealing with the issue.
Gut dysbiosis and leaky gut
The digestive system is inhabited by two types of bacteria. The so-called good guys (probiotic bacteria) and the so-called bad guys. When the bacteria are in proper balance they are boon to your health, and help you in many ways – from digestion of food to production of vitamins and minerals.
But they can also turn harmful if the balance flips towards the harmful bacteria, a condition known as gut dysbiosis or small intestinal bacterial overgrowth (SIBO). The harmful bacteria interfere with digestion and produce toxins.
Normally the gut wall is a very effective barrier. It lets nutrients in, but keeps toxins and other harmful substances out of your body. SIBO can change this. The harmful bacteria produce substances that attack the gut wall and cause tiny, tiny cracks to appear. Through these cracks molecules can leak into your body, a condition known as leaky gut syndrome or intestinal permeability. Molecules that normally could not enter the body, such as:
- Bacterial toxins
- Incompletely digested food particles
- Candida and yeasts
- Bacteria and virus that live in the gut
The consequences include:
- Increased inflammation in the body (this is bad because acne patients already have more inflammation than people with clear skin).
- Extra burden on the liver.
- Can lead to development of food allergies as the immune system attacks incompletely digested food particles.
- Contributes to depression and other emotional problems. One study of 1641 patients with gastrointestinal problems showed a strong correlation between anxiety and depression and SIBO. Another study showed a significant decrease in depression and anxiety after 2 month supplementation with probiotics.
- May lead to nutrient deficiencies due to compromised digestion and absorption.
The vast majority of people with these gut issues have no noticeable symptoms. Or the symptoms are discounted just as normal rumblings from the digestive system. That’s why many people never think to link gut issues to their skin problems.
The acne-gut link
OK, so gut issues are not good, but what does it have to do with acne? There’s a good reason to believe gut problems contribute significantly to acne (or perhaps outright cause it). Consider the following:
- A Russian study found that 54% of the 114 acne patients studied had SIBO, and treating it led to faster clearing of the skin.
- A recent Korean study found that the consumption of a Lactobacillus-fermented dairy beverage improved clinical aspects of acne over 12 weeks. The group that consumed the fermented beverage had almost 40% less inflammatory lesions and 23% fewer pimples in total compared with the placebo group.
- A study of 113 acne rosacea patients showed that SIBO is almost 10 times more prevalent in people with rosacea compared to healthy controls (46% vs. 5%). Furthermore eradicating SIBO with antibiotic lead to complete clearing of rosacea in 71% of the patients and significant improvements in 22% of the patients. In other words the treatment helped 93% of rosacea patients.
- An older study showed that acne patients are more sensitive to bacteria from the stool than people with healthy skin. This indicates that the bacteria have leaked from the gut into the blood, thus sensitizing the immune system to them.
I could show you countless other studies also, but I think these are enough to make the point.
And if we compare acne patients to people with clear skin
- Acne is an inflammatory condition and gets worse as inflammation increases
- Studies show that acne patients have more inflammation as compared to people with clear skin
- Studies also show acne patients have lower levels of anti-inflammatory vitamins and nutrients
- Gut issues increase inflammation – and perhaps also acne?
- Studies show that treating gut issues clears or reduces acne
Unfortunately there’s not enough research to draw rock-solid conclusions. But we can say there’s very strong reason to suspect gut issues either contribute or cause acne.
What causes gut problems
Here are some common causes for gut issues:
- Antibiotic usage. Some antibiotics wipe out both the good and bad bacteria from the gut. As the harmful bacteria grow faster this leaves the door open for them to take over. This is why taking antibiotics to treat acne can spell a long-term disaster.
- Lack of sleep
- Low stomach acid. Incompletely digested food feeds the harmful bacteria.
- Diet. Diet high in processed foods and low in fruits and vegetables encourages growth of harmful bacteria.
- Eating foods you are sensitive. Eating foods you are sensitive to causes an inflammatory reaction in the gut. This causes further damage to the gut wall and aggravates the problem.
- Emotional issues. Studies constantly find that link between depression and leaky gut syndrome, but we can’t say for sure whether depression causes leaky gut or the other way around.
How to fix gut issues (and clear acne)
Here are a few effective treatments for gut issues.
- Restrict antibiotic usage to situations where they are absolutely necessary and ask your doctor for an antibiotic with minimal impact to gut flora.
- Probiotics. You can balance the gut flora with probiotic bacteria. You can do this by either eating fermented foods (such as homemade yogurt or kefir) or take a probiotic supplement.
- Healthy diet. Eat minimally processed foods. Fruits and vegetables are also important as the fiber in them feeds the probiotic bacteria.
- Stress management.
- Get enough sleep.
Summary and take home messages
Research has established a credible link between gut issues and skin problems (including acne). Furthermore, the same studies show that using probiotic bacteria to treat gut issues also helps the skin. For treating gut issues your best options are to avoid excessive antibiotic usage and supplement with probiotic bacteria. Taking care with your diet can also help.
So we can summarize that gut and skin problems go hand in hand. And that’s why any comprehensive acne treatment program should also address the gut problems.
- Acne vulgaris, probiotics and the gut-brain-skin axis – back to the future? (Full text PDF)
- Small intestinal bacterial overgrowth in rosacea: clinical effectiveness of its eradication.
- Impact of the impaired intestinal microflora on the course of acne vulgaris
- Dietary effect of lactoferrin-enriched fermented milk on skin surface lipid and clinical improvement of acne vulgaris