Gut Health and Acne: Things To Know and What To Do

Too often, acne returns even after you use different medications or topical solutions. When this happens, it's time to look beneath the surface—specifically at the connection between the gut and your skin. Poor gut health can contribute to acne, and focusing on improving the gut microbiome can lead to clear skin. Here's everything you need to now to treat acne by fousing on gut health.

Treating Acne

Acne (acne vulgaris) is often treated on the surface. We use creams and lotions and other topical solutions—the options seem endless. Sometimes, these tedious and messy treatments help. Other times, they don’t seem to make a difference, resulting in an exhausting and frustrating cycle of trying more medications in hopes that something will stick. But research is growing to show that your gut microbiome may play a much bigger role in supporting healthy skin.

Skin treatments are often prescribed to manage symptoms—not necessarily to treat the root cause of the issue, says Katie McHugh, RD, a former health coach at Parsley Health. This isn’t really a good long-term solution. In fact, it can get you into a cycle of treatments that never really solves the problem.

“The issue is that the skin has a natural microbiome of its own and when we use topical antibiotics, we get rid of good bacteria, too,” McHugh says. Some topical treatments can end up creating a dependency of sorts, meaning that when you stop using them, the skin reacts and flares again. So, your skin microbiome is struggling.

If you’ve been attempting to find the right treatment for your skin, it’s time to take a deeper look at your body and health. Specifically, your gut. Yes, there is a skin-gut connection. Tending to your gut health may help solve your problems—or at least be a really effective complement to your current treatment plan.

Here’s what you need to know about the connection between skin issues and gut health and how to get clear skin from the inside, out.

What is the gut-skin connection?

Your gut and your skin may seem completely unrelated, but research suggests they are directly connected, with gastrointestinal disorders often manifesting as skin concerns (in the skin microbiome) and the gut microbiome playing a role in inflammatory skin conditions.

“It is apparent that there is a link between the gut microbiome and dermatological disease but the exact mechanism of action is not well understood,” McHugh says. “Current evidence suggests that it is likely due to a combination of both neurologic and immunologic responses to environmental shifts. This results in chronic systemic inflammation that impacts the skin.”

In fact, it can contribute to everything from eczema to psoriasis to acne . One explanation may be because the gut is the location for a lot of the immune system and gut microbes can impact the immune system, McHugh adds. For example, a 2020 study published in the journal Pathogens found a significant association between changes in the gut microbiome and psoriasis.

Evidence also suggests that certain foods are connected to acne development, with studies pinpointing specific metabolic pathways that may be responsible for changing the gut microbiome and leading to breakouts. The skin-gut connection even goes so far as both systems sharing some functionality, explains McHugh. The inner lining of the gut and outer surface of skin are both covered in what are called epithelial cells. And both the gut and the skin have their own unique microbiome.

While the skin acts as a line of defense against the external environment and keeps invaders from getting into the body, the gut is a defense system against anything you may ingest, deciding what gets absorbed and what doesn’t. “Both have high cellular turnover to inhibit unwanted bugs from binding to skin and the gut,” McHugh says. So, a balanced skin microbiome is key.

Can a healthier gut microbiome resolve your skin issues?

Yes, how to get clear skin may start with the gut. McHugh says she’s seen a difference in people’s skin when their treatment is focused on improving their gut skin axis. “We think of the skin as a reflection of what’s going on inside your body,” she says. Sometimes, clearer skin is an unplanned side effect of treating the gut to improve conditions like SIBO and other gastrointestinal problems. “We often focus on treating the gut, and gas and bloating is gone, and then people notice they have really clear skin even though it wasn’t something they were trying to treat. But they feel like their skin is more radiant now that their gut is functioning well,” McHugh says.

Of course, better gut health may not always be the only answer to skin problems. Skin conditions like acne and eczema can have a few different root causes, McHugh says. This is why Parsley Health’s clinicians and health coaches work with members to get to the bottom of it. “Acne, for example, can be hormonal. There can also be a stress component—same thing with eczema and rosacea,” McHugh explains. Stress plays a large role in skin health, and research also has found a connection between the gut and stress-related conditions, like anxiety, depression, and irritable bowel syndrome. So, it’s all interconnected, (which includes the skin-gut connection) even if we haven’t yet pinpointed how to easily solve it all for optimal health.

How to get clear skin, starting with your gut

There are some things that you can do to promote good gut health and in the process, help improve your skin. McHugh suggests:

• Remove inflammatory foods from your diet and focus on eating real, whole foods. “Highly processed and high-sugar foods can be inflammatory and impair the integrity of gut lining,” she says.
• Eat more probiotics and prebiotics. Probiotic foods—like kimchi, sauerkraut, and kombucha—contain bacteria that are good for your gut. Prebiotic foods—onions, oatmeal, asparagus, radishes—contain fiber that helps feed the gut bacteria. Both can help keep your gut going strong. If you can, it’s best to try and get these from whole food sources, but your provider may recommend an extra supplement depending on your diet and what certain test results reveal about the current state of your gut.
• Prioritize sleep. “Cells in the gut have a circadian rhythm and disruption in the circadian rhythm has been linked to GI issues,” McHugh says. Waking up often throughout the night, jet lag, and alcohol can alter your sleep and therefore, the rhythm of the gut microbes. Focus on practicing good sleep hygiene by staying off screens right before bedtime, setting a consistent bedtime and wake time, and trying to get a full 8 hours of sleep each night.
• Practice stress management. “Your gut is home to millions of neurons and the connection between the gut and brain is well understood,” McHugh says. “Stress is sometimes the root cause of skin issues, and it can certainly disrupt the microbiome, causing inflammation that can manifest on the skin as acne, rosacea, psoriasis, and more.”

Just know that it can take some time and commitment before you notice changes: “Some studies report improvement in as soon as 10 weeks with nutritional changes,” McHugh says. “I see it happening anywhere from 2-6 months.” Like all good things, improvements won’t happen overnight. But if you stick with these gut-healthy habits long-term, you’ll likely see some changes in your skin microbiome, and thus, complexion. (And you’ll just feel better overall anyway, so you’ve got nothing to lose.)

Other Ways to Naturally Treat Acne

Alongside dietary changes, there are also lifestyle choices and habits that can help clear up acne and/or support gut health. Four of the most successful include:

• Manage stress through relaxation techniques and stress-relief practices
• Get regular exercise to reduce inflammation and support healthy digestion
• Ensure adequate sleep for cell regeneration and toxin elimination
• Consider probiotic supplements to support a healthy gut microbiome

Takeaway

Yes, there are a lot of factors at play, but improving gut health can help manage acne, especially when used in tandem with other natural treatment strategies. If all else fails, it may be a good idea to work with a provider trained in holistic medicine who can help you get to the root cause of your skin issues and work towards your clear-skin goals.