Exploring the Gut Skin Axis Connection

The annals of human history are full of interesting and exciting forays into the human body. Brave men and women like Andreas Vesalius risked breaking the law of the times to dissect human cadavers and draw detailed illustrations of human anatomy, lessening our dependence on animal anatomy. In the 500+ years since Vesalius, we have steadily deepened our knowledge of the intricacies of our body systems, coming up with associations and relationships that could not have been thought of before. For instance, are you aware of the fact that your gut and skin are connected in a reciprocal axis, and that what happens in your intestines can affect the health and appearance of your skin and vice versa?

Oh yes! This is not bad science fiction. A 2008 study 1 published on PubMed shows that small intestine bacterial overgrowth (SIBO) a condition in which bacteria that should not be in the small intestine find their way there and colonize it is ten times more likely to be present in people with acne rosacea than in health controls. Acne is a skin condition. The study also showed that if SIBO was corrected in these individuals, their acne showed significant improvement. A 2004 study 2 published in the Journal of Pediatric Gastroenterology showed that Celiac disease has skin manifestations for example dermatitis herpetiformis. This cutaneous condition occurs in 25% of all celiac. It is also interesting to note that in Celiac disease, patients are more likely to present with oral mucosal lesions, alopecia and vitiligo. All these are skin conditions, showing that there is a gut-skin axis in our bodies.

How are the gut and skin connected?

There are several ways in which the gut and skin are connected, such that events in one system lead to other events in the second system. This is a biological example of Einstein’s ‘Spooky action from a distance’ explanation of Quantum physics. For example, an increase in intestinal permeability (leaky gut) will lead to bacteria and other foreign material finding their way into the body, causing local and systemic inflammation. This inflammation will then cause skin manifestations that may lead to disease. A study 3 on Fibrin micro clot formation in patients with acne showed that introduction of E.Coli, a bacterium found predominantly in the gut led to development of a more severe form of acne, further highlighting the connection between the gut and the skin.

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So what does this mean in the end? 

Having established that there is a gut-skin connection means that if you want healthier skin, then taking care of your gastrointestinal system is an effective method of preventing skin disease. For instance, you will have to avoid substances that may be harmful to your gut. Such substances include excessive consumption of alcohol, NSAIDs such as aspirin that remove the mucosal barrier of the stomach and thus lead to corrosion of the gastric wall, leading to a leaky gut and systemic inflammation with cutaneous manifestations. Indulging in good foods that are beneficial to your gut like coconut oil, bone broth and fermented vegetables with a healthy helping of probiotics will improve your gut health, and you can bet that these benefits will be felt on your skin.

What else can I do?

It is also necessary to find out the actual condition of your body’s intestinal system. This means getting comprehensive lab tests done on your stool. This will check whether you have good bacteria levels and also help in ruling out (or ruling in) any bacterial, yeast or parasitic infections that may be plaguing you. An immunological blood test will assess whether you have a leaky gut or not and if so what can be done about it. Getting tested for SIBO is another course of action that will allow you and your doctor to chart a course of action that will take you back to good gut health and consequently good skin health.

Eating the right foods and getting the required nutrients for good skin health is also important. Certain vitamins, minerals and other compounds that are essential for healthy, glowing skin will help in eradicating acne, dry skin, wrinkles and sun damage. Essential nutrients and vitamins include:

  • Vitamin A- suppresses androgen formation and inhibits sebaceous gland activity. Lack of Vitamin A causes the skin to harden and become scaly
  • Zinc- helps in the proper structure of proteins and cell membranes as well as improving wound healing and protecting the skin from UV radiation
  • Vitamin C- improves skin health and promotes faster healing
  • MSM- methylsulfonylmethane, an organic form of sulfur that can be found in fruits and vegetables is responsible for promoting collagen formation and also detoxifies the skin.

Being conscious of the gut skin connection is the key to healthy skin.

Reference Links:

  1. Small intestinal bacterial overgrowth in rosacea: clinical effectiveness of its eradication
  2. Paroli A 1 et al
  3. Gastroenterol Hepatol. 2008 Jul; 6(7):759-64. Doi:10.1016/j.cgh.2008.02.054. Epub May 5
  4. J Pediatr Gastroenterol Nutr. 2004 Jun; 39 Suppl 3:S734-5.
  5. The Gut Skin axis
  6. Saarialho-Kere U (1)
  7. Fibrin micro clot formation in patients with acne
  8. Juhlin L, Michaelsson G.
  9. Acta Derm Venereol. 1983; 63(6):538-40

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