Why Gut Health Matters: Your Skin

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.

gut health and skin disorders

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. 

gut health and skin disorders

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

Fix it! 

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.)

gut health and skin disorders

“My worst” didn’t just mean my skin. I was more depressed and heavier than I’d ever been before or since.

What’s Next?

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 

http://www.consultantnutritionist.com/General-Health-Nutrition/Traditional-Bone-Broth-in-Modern-Health-and-Disease.html

http://chriskresser.com/naturally-get-rid-of-acne-by-fixing-your-gut

http://www.biomedcentral.com/content/pdf/1757-4749-3-1.pdf

http://wageningenacademic.metapress.com/content/0u3x16807123w358/#.VNq_SrB4qXw

http://healthandstyle.com/health/gut-may-causing-bad-skin/

http://docsdrive.com/pdfs/ansinet/jms/0000/57615-57615.pdf

http://www.altmedrev.com/publications/7/5/410.pdf

http://journals.lww.com/jcge/Abstract/2014/11001/Skin_Microbiome_and_Skin_Disease__The_Example_of.23.aspx

http://www.thecandidadiet.com/candidasymptoms.htm

Why Gut Health Matters: Your Gate Keeper

In researching and writing this series, I recognize the challenge I face in cleanly separating the interrelated subtopics I laid out last week. So I’m taking one step back to explain the role of the gut as “Gate Keeper” before jumping into the rest. Giving you this visual aid will help you understand the interconnectivity of everything that happens inside our digestive tract with respect to our health, and it will also impress upon you the importance of keeping the gut lining intact.

Because gut health is the cornerstone of overall wellbeing and vitality, what happens in the gut can beget a cascade of symptoms and ailments throughout the body and mind. All the subtopics I laid out for you last week overlap with each other because the source for all of them is arguably the same: leaky gut and the resulting inflammation. So to start, let me explain what those mean and why they matter.

When What’s Outside Comes Inside

The digestive tract (along with our skin) is our main interface with our environment. It acts as a vital barrier to unwelcome invaders and breaks food down into absorbable nutrients that pass through the gut walls and into the blood stream. It’s essential that what we introduce from the outside world that travels inside the gut does not pass through the gut lining until it’s been properly broken down. This is why I call the gut lining your body’s “Gate Keeper.”

gut permeability leaky gut

free image sourced through Creative Commons

When the Gate Isn’t Locked

The barrier function of the gut is one of the most critical aspects of our health. The gate should remain locked and impenetrable until the food inside has been adequately broken down into parts that the rest of our body recognizes as friendly. When that lock is broken, partially digested food particles can enter the blood stream and set off a cascade of negative physiological reactions; the first of which is inflammation. 

Inflammation is a healthy, normal part of our immune response. When we have a fever, that’s our immune system ramping up the heat to kill off a foreign invader (a cold or flu). When we eat something that wasn’t cooked properly, we expel it rapidly and experience burning pains in the abdomen — that’s our body keeping us safe from a food-born pathogen. When we scrape our ankle, the area around the cut becomes red, inflamed, as the white blood cells come to clean up the mess and bring in the platelets to scab over the opening. This type of inflammation is part of our Adaptive Immune System — it targets specific invaders and wipes them out, and when it’s working properly it keeps us healthy and alive. Indeed, inflammation is meant to protect us, but when it’s chronic — when our immune system is always turned on and we’re constantly fighting, inflammation can cause serious health problems.

How Chronic Inflammation becomes Chronic Disease

The food particles allowed into the blood stream as a result of an inflamed, leaky gut are made up of partially broken down proteins (short amino acid sequences).

What else is made up of short sequences of amino acids? Pathogens (bacteria, viruses, fungi). These microorganisms actually share some characteristics with partially digested food particles.
So what happens? Our immune system attacks the food — food sensitivities and allergies in the making. Because our immune system creates antibodies that will view this food as a threat going forward, we will now become inflamed when we eat it. 

gut permeability leaky gut

This unicorn is frolicking freely because she just pooped a rainbow with the help of her magical microbes. (free image sourced from imgarcade.com through Creative Commons)

What else is made up of these amino acids? For one, the cells in our own bodies. What about our myelin sheath (the protective coating around the axons of our nerves)? Our joints? Our skin? What if our immune system is so overactive and chronically inflamed that, not only does it start to see the cells of our own bodies as invaders, but the safety levers we have in place to block this auto-immunity are too hot and fatigued to notice? What if our Adaptive Immune System begins to see us as harmful to ourselves?? 

Answer: Autoimmune diseases like Crohn’s, MS, Rheumatoid Arthritis, Psoriasis, and  Lupus. Find me a person with an autoimmune disease without digestive issues, and I will find you a live unicorn with a rainbow mane.

Having a leaky gut will most definitely create chronic inflammation, and chronic inflammation begets chronic disease.

What Causes a Leaky Gut?

We don’t know the extent to which genetics are involved in creating a greater susceptibility for a leaky gut, but we do know that environmental factors play a huge role, and that the effects are reversible if you catch it and address it early. We also know that children who were born of a C-section and not breast-fed are more vulnerable than those born of vaginal birth and breast-fed (source). The list below represents the most significant reasons your gut can become inflamed:

1. Gut dysbiosis — an overgrowth of bad bacteria and/or fungus in the gut.

There will always be a percentage of “bad” bacteria in the gut, but they are (or should be) kept in check by the probiotic population — the beneficial bacteria that aid in nutrient breakdown and absorption, mood regulation, and immune response. Taking antibiotics kills both the good and the bad bacteria in the gut, and it can take up to 8 weeks to recolonize after a course. It can take just as long to recover from a food-born illness. If you’ve ever experienced a yeast infection after a round of antibiotics it’s because the good bacteria that were keeping the candida at bay were all killed off by your prescription. You can restore your probiotic colony by eating a diet rich in fermented food and low in sugar, choosing organic, and exercising regularly. And of course these are important to do on a regular basis. We’ll dive more deeply into probiotics in the coming weeks. 

gut permeability leaky gut

image source: Gaspirtz through Creative Commons

2. Food Sensitivity or Allergies

Our body begins to see certain foods as pathogens and creates cytokines (antibodies) to protect us from them, setting off an inflammatory response every time they enter the body. This particular one is a bit confusing, because it’s a chicken/egg problem. Did the leaky gut come before the allergy or did the allergy cause the leaky gut? It’s a commonly identified pattern that patients with one food sensitivity will develop others down the line if measures aren’t taken to throw water on the fire. What causes the initial sensitivity could be genetics or an exposure early in life that excited the immune system before it was strong enough to recognize friend from foe. Children who are born of C-section and not breast-fed are more likely to have both food and environmental sensitivities/allergies than those born through the vaginal canal and fed breast milk. We’ll go more in-depth about why that is and how to take steps for better outcomes later in this series.

3. Stress

Were you waiting for this to come up? Stress, whether it’s emotional or physical, causes leaky gut. I’m going to dedicate a whole post to this one, but suffice it to say that the physiological stress response itself weakens our immune system, promotes inflammation, and creates a hostile environment for beneficial bugs in the gut, which brings us back to the first thing on this list.

What does Chronic Inflammation Look Like?

What should we look for to indicate that we might be struggling with a gut problem that has led to chronic inflammation? How can we prevent it from sending us into full-blown auto-immune disease? I had some readers ask questions about bloat and puffiness, distended belly after eating certain foods, foggy-headedness, and general weight gain. I also had a few people ask me about eczema and acne, chronic yeast infections, middle body weight, and IBS. Yes, these are all signs of chronic inflammation and leaky gut.

gut permeability leaky gut

free image from Pixababy through creative commons

But something no one asked about was mood. If you have been diagnosed with a mood disorder like anxiety, depression, bipolar, or OCD, you are experiencing a symptom of leaky gut and chronic inflammation. Find me a person with anxiety and no digestive problems, and I’ll find you a fire-breathing dragon with tiny purple wings at your local pet store. In a future post, I will show you why a leaky gut = a leaky brain, but for now I’ll share that 80% of total serotonin in the body is located in enterochromaffin cells in the gut lining, which means that if we don’t have gut integrity, we are likely short on serotonin. 

What’s Next?

Wondering what you can do about some of these symptoms right now? Check out my kombucha recipe to get started adding fermented foods into your diet, and stay tuned for Friday’s post to learn how to make another probiotic-rich food. I’ll also explain a little bit more about why that matters. In the meantime, I’d love to know what you’d like to learn about next in this series. I’m deciding between stress and mood — the two are obviously intimately linked. Let me know your thoughts and questions below, and I’ll get the final touches on the next installment of Why Gut Health Matters.


Sources for this segment of this 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 journals and experts:

http://www.ncbi.nlm.nih.gov/pubmed/15911167

http://www.nature.com/nrn/journal/v13/n10/abs/nrn3346.html

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3228987/

http://www.sciencedirect.com/science/article/pii/S0016508509003461

http://physiologyonline.physiology.org/content/13/4/189

http://bjp.rcpsych.org/content/180/2/99.full

Dr. Tom O’Brian: http://thedr.com/ 

Dr. Mark Hyman: http://drhyman.com/

Chris Kresser: http://chriskresser.com/

Dr. Sara Gottfried: http://www.saragottfriedmd.com/

Jordan and Steve from the SCD Lifestyle: http://scdlifestyle.com/

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