Chronic skin conditions are complex and affected by many different factors. There is growing evidence that gives light to how the skin and gut microbioime are connected. A variety of microbes including bacteria, viruses, fungi, and protozoa live on and within the human digestive tract and collectively make up the gut microbiome. It plays a role in essential host activities including host immunity, host health and disease, nutrition and digestion. Along with this, there is evidence that the microbiome can influence other organ systems, and it has a particularly complex connection to the skin.

With this concept, a healthy diverse gut microbiome contributes to host health. An imbalanced or dysbiotic microbiome contributes to host disease and may be associated with skin disorders. A well balanced microbiome lives in harmony, in what we call a symbiotic relationship with one organism not affecting the other. Commensal (good) bacteria are responsible for 70% of our immune system reactions and 90% of our serotonin production. They help modulate the systemic immunity, reduce inflammation and thus impact skin wellness.

Under certain conditions, commensal bacteria can overgrow and pathogenic (bad) bacteria can thrive. The creates dysbiosis in the gut, which in turn can adversely affect the host. In the presence of increased gut permeability AKA leaky gut, the tight junctions in the intestines become more permeable and therefore allow large particles of food, bacteria, and toxins into the bloodstream. These particles and organisms which do not belong in the bloodstream are seen by the immune system as foreign invaders and will make antibodies against them. This triggers chronic inflammation and can possibly lead to autoimmune conditions such as psoriasis. Bacteria produce metabolites and they may enter the bloodstream, build up in the skin and impair the skin’s ability to function properly.

Factors that impact the gut microbiome include antibiotics, stress, and diet. Antibiotics can kill off commensal bacteria, allowing the overgrowth of pathogenic bacteria and

Stress decreases the release of gastric acid, changes gut motility, and creates a less favorable environment for beneficial bacteria. Psychological stress has been shown to decrease mucin production and decrease gut mucosal immune cell production. Mucin provides a protective layer in the intestines providing a defense against pathogenic bacteria and stomach acids. With an increase of stress hormone production, there is lowered overall immune defense against pathogenic bacteria allowing overgrowth.

Our microbiome is shaped by our diet choices. All bacteria needs beneficial slow digesting fibers (prebiotics) to feed them. A healthy diet with a variety of fruits and
vegetables will influence the growth of commensal bacteria. An unhealthy diet will reduce the growth of commensal bacteria that can lead to dysbiosis. The S.A.D. (Standard American Diet) is highly processed with excess sugar, refined carbohydrates, saturated and trans fats, low in fiber and over all nutrients. Therefore, it is imperative to have a healthy diet to treat chronic skin conditions.

The relationship between the skin and the gut is complex. However, research supports correlations between gut and skin health making it imperative to address problems within the gut when treating skin conditions. Addressing underlying gut dysfunction can not only improve skin health, but your overall health.