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The Gut-Skin Axis May Be the Key to Healthy, Glowing Skin

Top MDs reveal how the health of your gut affects the health of your skin

Whether we’re talking about brain fog, weight loss or the immune system, lately it seems it all comes down to the millions of tiny microbes in our gut. But when acne starts forming or patches of psoriasis pop up, our gut isn’t always the first thing we examine. But maybe it should be! Turns out, our skin and gut microbiomes are connected. There’s a communication network between the two organs called the gut-skin axis, where the health of one influences the health of the other. Keep reading to learn how imbalances in the gut may manifest in your skin, plus the easy way to nourish your microbes for clear, glowing skin.

What is the gut-skin axis?

“The gut-skin axis refers to the relationship between the trillions of organisms that live in the gut – referred to as the gut microbiota – and the skin,” explains Yale and Columbia-trained gastroenterologist Robynne Chutkan, MD, host of The Gutbliss Podcast and author of The Microbiome Solution. These microbes do everything from break food down for digestion to power up our immune system. The cells lining our gut are also supported by these healthy bacteria, which are also responsible for keeping inflammatory toxins out of the bloodstream. And when it comes to healthy skin, it “relies on the nutrients extracted from your digestive tract,” says Dr. Chutkan.

However, when we load up on ultra processed foods or take antibiotics to fight off an infection, the balance of our gut is thrown off. This “creates a domino effect in the gut that can then affect the rest of the body and even the skin,” says board-certified dermatologist Whitney Bowe, MD, founder and CEO of Dr. Whitney Bowe Beauty. Diversity in gut bacteria naturally declines with age. And factors like stress and lack of sleep can also throw off the balance of bacteria. (Learn more about gut health and menopause.) “Your digestive tract is like the soil, and your skin is like a plant growing in that soil,” explains Dr. Chutkan. “If the soil isn’t healthy, the plant won’t thrive and bloom properly.”

How the gut-skin axis manifests in our skin

When our gut isn’t in tip-top shape, toxins can slip through the gut lining (a condition called leaky gut). This stimulates the immune system, explains Dr. Bowe. “Inflammatory molecules that should not enter our bloodstream are able to penetrate, triggering inflammation throughout the body, which can indirectly impact our skin health.” The result? Flare ups in skin conditions like…


Though factors like hormones, stress, bacteria and genetics all influence the likelihood we develop acne, gut health also plays a role. Says Dr. Chutkan, “Studies have found that more than half of all acne sufferers have an imbalanced gut microbiome.” One study linked acne breakouts to lower levels of beneficial bacteria like Lactobacillus and higher levels of pro-inflammatory bacteria that may lead to acne. What’s more, diets that harm the gut, like those high in sugar, also cause a higher prevalence of acne.


Emerging research posits that there could be a link between eczema and the gut. A review of studies revealed that folks with the skin condition often had lower levels of beneficial Bifidobacterium strains and more strains that weaken the immune system. So when toxins slip through the gut lining, the immune system flares up, leading to eczema.


This autoimmune condition flares up when the immune system mistakenly attacks the skin, causing scaly patches of dry skin. “One theory of how conditions like psoriasis develop is via an increase in intestinal permeability, which allows toxins in the gut to travel through the gut lining into the bloodstream and accumulate in the skin,” explains Dr. Chutkan. In people with the condition, researchers from UC Davis found less bacterial diversity in the gut. They also had overgrowth of bad bacteria and higher rates of leaky gut, which may drive more frequent immune flare ups.


A variety of gut issues – including H. pylori infection, inflammatory bowel disease and small intestinal bacterial overgrowth (SIBO) – are associated with rosacea. In fact, “SIBO is 10 times more prevalent in people with acne rosacea than in healthy controls,” says Dr. Chutkan. The skin condition manifests as redness, pimples and changes in skin texture. Like many other skin conditions, rosacea is caused by inflammation. So when our gut health isn’t in tip-top shape and inflammatory toxins slip through, we’re more likely to develop the rash-like skin condition.

Learn more: Say Goodbye to Redness, Bumps & Irritation — Dermatologists Reveal How to Get Rid of Rosacea

How to heal your skin with a healthy gut

1. Take a probiotic supplement

The first step to a healthier gut is making sure there are beneficial bacteria there in the first place. The easiest way to do so? Take a daily probiotic supplement, which has been linked to lower rates of psoriasis, acne and rosacea. In fact, one study found probiotics to be more effective than azithromycin, a common antibiotic treatment for acne.

Strains like Bifidobacterium longum and Lactobacillus rhamnosus have inflammation-soothing and skin-healing benefits. You’ll find these common strains in many probiotic supplements at drugstores. Dr. Chutkan also says strains like Bifidobacterium bifidum, Lactobacillus acidophilus and Streptococcus salivarius have been associated with beneficial skin effects. Or consider a skin-specific probiotic, like Skinesa ($59 for a one-month supply). In one study, it helped 92% of study subjects achieve clearer skin in 12 weeks.

2. Eat more fermented foods

fermented food great for gut skin axis - top view of glass bowls against grunge wood: cucumber pickles, coconut milk yogurt, kimchi, sauerkraut, red beets, apple cider vinegar

Supplements aren’t the only way to replenish the healthy bacteria in your gut. And Dr. Chutkan says doing so with foods may be a better way to go. Foods with live microbes, like yogurt, kimchi, sauerkraut and miso, undergo a fermentation process that loads them up with healthful bacteria. So when you eat them, they feed the healthy bacteria in your gut and change the composition of your gut bacteria for the better, she explains. (Kombucha also brims with healthy probiotics.)

3. Eat more plants

“A special class of phytonutrients called polyphenols has been shown to help rebalance our gut microbiome,” says Dr. Bowe. Foods with these plant compounds are typically rich in gut-healthy fiber and nutrients that raise levels of good bacteria. To get a healthy dose, try eating 30 different plant foods each week. It’s a strategy that scientists from the American Gut Project found to be highly effective at boosting gut bacteria when compared to eating fewer plant foods. (And it can help you lose weight!)

What’s more, as our good gut bugs eat the polyphenols, they produce postbiotics. These compounds have an antioxidant effect that can improve skin appearance. Dr. Bowe notes they’re also essential for reducing inflammation that harms our skin. Her suggestion: Enjoy polyphenol-rich foods like blueberries, grapes, almonds, red wine and dark chocolate. Or consider a polyphenol-rich supplement like her Bowe Growe Water-Enhancing Skin Elixir. Dr. Chutkan is also a fan of fiber-rich beans and leafy greens.

4. Avoid inflammatory foods

Sugar, processed grains and dairy can all increase inflammation and are irritating to the gut and skin, says Dr. Chutkan. And while many doctors will use antibiotics to treat skin conditions like acne and rosacea, she says her patients have had more success clearing their skin by eliminating the foods from their diet, “without the side effect of eventually making the condition worse by destroying essential bacteria.” Indeed, multiple studies show that cutting back on these foods and enjoying more whole foods like vegetables and fish improves eczema, acne and more. “Societies that eat a more indigenous diet with little or no processed or sugary foods have very few digestive problems – and virtually no acne!” says Dr. Chutkan. (Cutting back on sugar isn’t easy, but these tips on how to avoid refined sugar can help!)

Dr. Bowe also suggests avoiding dairy, “due to the milk proteins whey and casein which have been linked to inflammation.” Her one caveat: Fermented dairy like yogurt and kefir, which brim with healthful probiotic bacteria. Just watch out for added sugars!

5. Stay hydrated

glasses and pitcher of water with lemon to heal the gut-skin axis

Hydration is key for keeping all of the systems in our body functioning at their peak, including the gut. Researchers say that even the source of our water can have an impact on the microbiome. And according to Dr. Chutkan, it’s essential for healthy skin, as well. Her recommendation: Stick with plain water, and enjoy about half your body weight in ounces of water daily (i.e. 75 ounces for a 150 lbs. person).

This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.

For more on gut health, check out these stories:

The Gut-Brain Connection Explains Why Stress Hurts Your Stomach

Top MDs Reveal the 10 Best Foods to Eat For Gut Health

The Secret Weapon for Menopause? Your Gut Health Might Surprise You — And Help You Feel Your Best

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