Many people think of skin issues as something that starts and ends with the skin. While topical treatments can be helpful sometimes even essential what’s happening inside the body is often just as important. In recent years, both scientific research and clinical experience have pointed to a strong link between gut health and skin health, known as the gut-skin connection.
Whether you’re dealing with acne, eczema, psoriasis, or rosacea, addressing your digestive health can be a key part of long-term healing. This is an area where naturopathic care excels: looking beyond the surface to explore root causes and whole-body connections.
What is the Gut-Skin Axis?
The gut-skin axis refers to the dynamic relationship between your digestive health and your skin. Your gastrointestinal (GI) tract is home to trillions of microorganisms, collectively known as the gut microbiome, that influence immunity, inflammation, nutrient absorption, and even hormone balance. When the microbiome is disrupted (a state called dysbiosis), it can trigger systemic inflammation that often shows up on the skin.
Common gut imbalances that may impact the skin:
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Leaky gut (intestinal permeability)
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Candida or fungal overgrowth
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Imbalanced gut flora (low good bacteria, overgrowth of bad)
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Chronic constipation or diarrhea
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Food intolerances or sensitivities
Skin Conditions Linked to Gut Health
Acne
Hormonal imbalances, poor detoxification, and systemic inflammation from the gut can contribute to breakouts. Studies have shown that people with acne often have reduced microbial diversity and higher levels of inflammatory markers.
Eczema & Atopic Dermatitis
Gut inflammation can increase histamine levels and immune dysregulation, exacerbating eczema. Children born via C-section can miss early microbial exposures are often at a higher risk of developing eczema.
Psoriasis
This autoimmune skin condition is closely linked to gut permeability and imbalanced gut flora. Many patients find relief with anti-inflammatory diets and targeted probiotic therapy.
Rosacea
Often tied to small intestinal bacterial overgrowth (SIBO), rosacea symptoms can improve dramatically when gut dysbiosis is addressed.
1. Identify and Remove Triggers
One of the first steps in supporting gut health is identifying potential dietary triggers that may be contributing to inflammation, gut permeability, or microbial imbalance.
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Gluten is a common culprit, particularly for individuals with eczema. Studies have shown a correlation between gluten sensitivity and atopic dermatitis, particularly in patients with celiac disease or non-celiac gluten sensitivity. Eliminating gluten may reduce eczema flares in sensitive individuals.
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Dairy, particularly conventional cow’s milk, has been linked to acne in several studies. Skim milk appears to be the most problematic, possibly due to its hormone content and processing.
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Sugar and refined carbohydrates can promote dysbiosis and increase systemic inflammation. They also spike insulin, which is associated with increased sebum production and acne development.
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Alcohol and excessive caffeine may disrupt the gut lining, increase gut permeability (“leaky gut”), and deplete key skin-supporting nutrients like zinc and B vitamins.
2. Repair the Gut Lining
When the gut lining becomes permeable, toxins, bacteria, and undigested food particles can enter the bloodstream and trigger systemic inflammation. This can manifest on the skin as rashes, breakouts, or chronic redness.
Key nutrients and herbs that support intestinal repair include:
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L-glutamine: An amino acid that serves as a primary fuel source for intestinal cells. Research shows it helps reduce intestinal permeability.
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Zinc carnosine: This compound has been shown to enhance gut mucosal integrity and support tissue repair.
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Slippery elm and marshmallow root: These demulcent herbs coat the intestinal lining and reduce irritation, providing symptomatic relief for gut discomfort.
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Aloe vera (inner leaf): Has anti-inflammatory properties and may promote healing of the intestinal mucosa.
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Bone broth: Rich in collagen, glycine, and glutamine—key nutrients for gut and skin healing.
Pro tip: These nutrients are often most effective when combined into a gut repair protocol tailored to your needs.
3. Omega-3 Fatty Acids (EPA & DHA)
Omega-3s are essential for maintaining skin barrier integrity and reducing systemic inflammation. Low levels are associated with dry, irritated skin and inflammatory skin conditions.
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EPA (eicosapentaenoic acid) has been shown to reduce inflammatory cytokines and sebum production, making it especially useful in acne and psoriasis.
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DHA (docosahexaenoic acid) helps maintain membrane fluidity in skin cells, which supports hydration and elasticity.
4. Vitamin D
Vitamin D plays a key role in immune modulation and skin barrier function. Deficiency is commonly found in individuals with eczema, psoriasis, and acne.
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It can help reduce T-cell-mediated inflammation in conditions like eczema and psoriasis.
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Also supports the integrity of the gut lining, providing dual benefits.
5. Repopulate with Good Bacteria
A balanced microbiome helps regulate immune function, reduce inflammation, and support healthy skin barrier function.
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Lactobacillus rhamnosus GG: Enhances skin barrier, reduces inflammation
- Use for: Eczema, atopic dermatitis
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Lactobacillus paracasei ST11: Reduces inflammation and skin sensitivity
- Use for: Rosacea, redness
- Bifidobacterium longum: Reduces inflammatory cytokines
- Use for: Acne, general skin inflammation
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Lactobacillus reuteri DSM 17938: Modulates immune response and improves skin appearance
- Use for: Acne, eczema
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Fermented foods like sauerkraut, kimchi, kefir, and miso contain live cultures that support microbial diversity. If underlying cause for gut issue is SIBO which is bacterial overgrowth in the small intestine, even beneficial bacteria can worsen symptoms if introduced too early. Some studies and clinical experience suggest probiotics can worsen bloating and gas in certain SIBO patients, especially early on.
6. Rebalance Digestion
Impaired digestion whether from low stomach acid, poor enzyme output, or sluggish bile flow can lead to malabsorption of key nutrients like zinc, vitamin A, omega-3s, and B vitamins, all of which are essential for healthy skin.
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Digestive bitters (e.g., gentian, dandelion root, artichoke) stimulate natural digestive secretions when taken 10–15 minutes before meals.
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Digestive enzymes can support those with compromised digestion (common in stress or aging) and improve nutrient absorption.
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Support liver detox pathways with foods like beets, cruciferous vegetables, and herbs like milk thistle or burdock root. The liver helps clear toxins and excess hormones that can otherwise contribute to acne or eczema.
7. Reduce Stress
The gut and brain are deeply connected via the gut-brain axis. Chronic stress alters gut motility, increases intestinal permeability, and disrupts the microbiome all of which can exacerbate skin issues.
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Stress raises cortisol, a hormone that can thin the skin, increase oil production, and delay wound healing.
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It also increases inflammatory cytokines, worsening conditions like acne, eczema, and psoriasis.
Evidence-based strategies for reducing stress include:
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Mindfulness and meditation: Studies show regular mindfulness practices lower inflammatory markers and improve skin conditions.
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Breathwork and vagal nerve stimulation: Practices like diaphragmatic breathing or humming can activate the parasympathetic nervous system and improve gut motility.
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Gentle movement: Yoga, walking, and tai chi reduce stress hormones and improve circulation to the skin.