Ahh acne. We meet again, my nemesis! But this time, I’ve cracked the code, and I’m ready to share it with the world. In this next segment of Why Gut Health Matters, I’m going to address the link between gut health and skin disorders. My personal skin issue has always been acne, but that’s not the only one affected by poor gut health. There’s also rosacea, eczema, psoriasis, and many, many more. While those last two have an auto-immune component (which we briefly covered in this segment of the series), all can be traced back to gut health — or lack thereof — even if they diverge in physical expression.
Myopia in Specialized Medicine
Unfortunately, most dermatologists aren’t trained to ask their patients about their digestion or even consider the possibility of a link between gut health and skin disorders (a connection first scientifically documented in the early 18th century!). I know from personal experience that in my 20 years of battling acne, never once did any physician or aesthetician I saw for my skin troubles ask me about my digestion or my diet. Nor did any of them see a problem with prescribing me round after round of antibiotics along with a Diflucan prescription, knowing that yeast infections would result from the constant antibiotic assault. This was normal — a standard course of dermatological treatment.
Today, if you walked into a psychiatrist’s office presenting with anxiety, you likely wouldn’t mention your constant gas and bloating or your eczema — nor would your doctor ask. You wouldn’t mention your psoriasis or depression to your GI specialist either. But the fact is, most if not all patients with skin disorders also have digestive disorders and mental health challenges. Specialized medicine has cordoned off our bodies into separate parts, ignoring the very real and very documented relationship between certain conditions. Conventional medicine no longer sees us as a complete system, much to the detriment of the whole-person patient.
Bugs Bugs and More Bugs
As I’ve mentioned in all of the previous segments of this series (especially the one addressing the gut as gate keeper), the living bacteria in the gut are integral to our overall health, and that includes skin health. When we take round after round of antibiotics, we aren’t just killing the “bad” bacteria — we’re killing nearly all the bacteria, giving fungi like candida a chance to run rampant in the system. Candida overgrowth results in a whole host of symptoms I don’t have time to go into today, but check out this extensive list to find out if they apply to you. I’ll give you a hint: skin problems is on the list.
Not only is gut bacteria crucial to maintaining healthy skin, so is the bacteria living right on the surface of our bodies. Like those found in the gut, the bugs on our skin protect us from the outside world of potential invaders, and when we kill them all off, it’s open season for everything else in the environment. When skin disorders are treated with antibiotics, the problem might seem to temporarily subside, but at best, it’s a band-aid solution. The cumulative effects of antibiotic use is a net negative, with gut dysbiosis as a common consequence.
Where They Don’t Belong: SIBO and Leaky Gut
SIBO (Small Intestine Bacterial Overgrowth) occurs when the bugs that belong in our large intestine start migrating up into our small intestine. It can also result when bugs from our food don’t get neutralized by the hydrochloric acid (HCl) in our stomachs — inadequate HCl is a major factor in SIBO.
While a very small number of bacteria naturally (and healthily) live in the small intestine, it’s supposed to be a nearly sterile environment. These microscopic interlopers can cause some major problems, one of which is gas. Lots of gas. Most patients with SIBO feel bloated and gassy after meals, especially meals rich in carbohydrates, because those bugs that don’t belong are breaking down their dinner before it gets where it’s supposed to be going. Other symptoms of SIBO include diarrhea, constipation, malabsorption of nutrients, and fatigue. Want to know another type of patient that often has SIBO? Patients with rosacea.
You might be asking what causes low stomach acid. A major cause of low stomach acid will be the topic of the last segment in this series: STRESS.
Let’s connect the dots:
Stress => Low Stomach Acid => SIBO => Rosacea
I’ll delve more deeply into how stress affects the gut next week, but this note from a recent paper should paint the picture for you nicely:
“Experimental studies show that psychological stress stagnates normal small intestinal transit time, encourages overgrowth of bacteria, and compromises the intestinal barrier.” (source)
… which leads me to …
Leaky Gut, which we’ve discussed extensively throughout this series. Leaky gut (aka intestinal permeability) is both the chicken and the egg when it comes to systemic inflammation in the body. A leaky gut allows partially digested food particles into the system, setting off an inflammatory immune response, and the resulting inflammation causes further leaky gut — a destructive cycle that can lead to autoimmune disease if gone unmitigated. (And as I mentioned at the top of the page, psoriasis and eczema are increasingly being seen and treated as autoimmune disease.) As we talked about in the segment on gut health and mood disorders, a leaky gut => a leaky brain => depression. But what I didn’t mention in that segment was this:
Stress => Leaky gut => ACNE
As many as 40% of acne patients also complain of constipation (or other digestive distress). A growing body of research is showing that acne patients have a larger variety of “bad” bacteria in their stool, a greater sensitivity to “bad bugs” (like e. coli) and a higher level of systemic inflammation resulting from leaky gut. If you’ve been following along with this series, you know we’ve come full circle to Your Gut as Your Gate Keeper. Fix the leaks, fix the skin.
Low-temperature electron micrograph of a cluster of E. coli bacteria, magnified 10,000 times.
Photo by Eric Erbe, digital colorization by Christopher Pooley, both of USDA, ARS, EMU.
Image released by the Agricultural Research Service, ID K11077-1
How to fix a leaky gut? How to clear up SIBO? It turns out, the answer is the same: reduce systemic inflammation by healing the gut wall and increasing the good guys. Stokes and Pillsbury, the pioneering researchers who discovered the gut-brain-skin connection in the early 1900’s, suggested probiotics and cod liver oil to do just that.
Sorry, did you read that whole sentence? IN THE EARLY 1900’S RESEARCHERS WERE RECOMMENDING PROBIOTICS AND COD LIVER OIL FOR SKIN DISORDERS. I’m not one for all caps, but I felt that deserved the emphasis. Imagine me yelling when you read that. WHY don’t conventional medical doctors use this and the subsequent studies supporting this work to inform how they treat their patients?
Probiotics help restore the proper balance of bacteria in the gut, thereby booting out the bad guys that create inflammation and toxins that harm the gut wall.
Cod liver oil is not only rich in Omega 3’s with potent anti-inflammatory and healing properties, it’s also rich in vitamin A, an important nutrient for healthy skin (which you know if you ever took Accutane for your acne).
Enteric-coated peppermint oil, an herbal remedy scientifically proven to relieve symptoms of IBS, is also being explored with promising findings for mitigating SIBO.
And while the research from Stokes and Pillsbury doesn’t cover this last ancient gut-healing solution, I’m going to cite my own anecdotal evidence and add bone broth to the list of tools to heal your gut. Rich in minerals, collagen (aka gelatin), and cartilage, bone broth is the ultimate gut- and skin-healing superfood. You’ve probably seen cosmetics products that boast collagen as a topical ingredient to reduce fine lines and wrinkles and create healthier looking skin. When ingested in the form of bone broth, collagen does a lot more than that.
- It promotes a healthy level of stomach acid
- It aids in digestion of problematic foods like dairy, legumes, meats, and grains
- It coats the lining of the gut to reduce permeability, reduce inflammation, and fill the leaks
- It supports a healthy immune system, including white blood cell production
- It provides amino acids — the building blocks of muscle in our bodies
- It promotes the absorption of minerals, including those already present in the broth, for skeletal support and bone health (source)
My personal success story with bone broth has reached more readers than anything else I’ve posted in a year of writing this blog. I can’t tell you how many people I’ve talked to about bone broth, encouraging them to try it and celebrating with them when they’ve seen results. In combination with a diet rich in probiotic foods and eliminating the trigger foods that create inflammation (for me that was mainly gluten), bone broth changed my life. I’ve recently experimented with adding this fermented cod liver oil and this enteric-coated peppermint oil into my diet out of curiosity (affiliate link). (I like to use myself as a guinea pig from time to time.)
“My worst” didn’t just mean my skin. I was more depressed and heavier than I’d ever been before or since.
Next week is the last segment of this series on Why Gut Health Matters, where I’ll not only wrap up this discussion but also challenge you to get started in healing your own gut. The end of this series doesn’t have to mean the end of the discussion for you — I’m happy to answer any questions you might have on the topic — just send me a note and we can keep the ball rolling to get your gut health where it needs to be.
FTC DISCLOSURE: This post contains affiliate links, which means I may receive monetary compensation for my endorsement, recommendation, testimonial and/or link to any products or services from this blog. I only link to products that I USE and LOVE. All opinions are my own.
Sources for this segment of the series include a 6-credit continuing education seminar presented by Merrily Kuhn, RN, CCRN (r), PhD, ND, PhD and the Institute of Brain Potential (bibliography and references can be viewed here), and information from the following articles, journals, and experts:
Stokes JH, Pillsbury DH (1930) The effect on the skin of emotional and nervous states: theoretical and practical consideration of a gastrointestinal mechanism. Arch Dermatol Syphilol 1930, 22:962-93
Ketron LW, King JH: Gastrointestinal findings in acne vulgaris. JAMA 1916, 60:671-75