The Gut-Skin Axis: Can Your Gut Health Affect Your Skin?
Have you ever noticed that your skin seems to flare up when your digestion is unsettled, you’re under stress, or your diet has changed? Perhaps you’ve experienced acne after periods of eating differently, eczema that worsens during stressful times, or rosacea alongside digestive discomfort.
Could your gut be influencing your skin?
If you’re struggling with persistent skin concerns alongside digestive symptoms, Nutritional Therapy can help explore potential contributing factors through a personalised assessment of your diet, lifestyle, digestive health and nutritional status. Together, we can develop an evidence-informed plan tailored to your individual needs, supporting both gut and skin health.
While skin conditions are often treated with topical creams and medications, research increasingly suggests that what is happening inside the body—particularly within the digestive system—may also influence the health of our skin.
This doesn’t mean that every skin condition starts in the gut, or that improving gut health will magically clear every skin concern. Skin conditions are complex and influenced by genetics, hormones, immune function, lifestyle and environmental factors. However, growing evidence supports the existence of what is known as the gut-skin axis—a fascinating connection between the digestive system, the gut microbiome, the immune system and the skin.
The skin is often described as a window into our internal health. While not every skin condition originates in the gut, our digestive health, immune system and nutritional status can all influence how our skin looks, feels and functions.
As a Registered Nutritional Therapist, I take a whole-person approach rather than looking at symptoms in isolation. By considering digestive health alongside nutrition, lifestyle and medical history, we can begin to understand whether underlying factors may be contributing to skin concerns and how best to support the body as a whole.
What is the gut-skin axis?
The gut-skin axis describes the constant communication between the digestive system and the skin. This communication occurs through several pathways, including the immune system, the nervous system, hormones, the gut microbiome and the compounds produced by our gut bacteria.
The gut microbiome is made up of trillions of bacteria, fungi and other microorganisms that live within our digestive tract. Far from simply helping us digest food, these microorganisms play an essential role in maintaining overall health.
A healthy gut microbiome helps to:
- Support immune function
- Maintain the integrity of the intestinal lining
- Produce beneficial short-chain fatty acids
- Assist with nutrient absorption
- Regulate inflammation throughout the body
- Protect against harmful microorganisms
When the balance of the gut microbiome is disrupted—a state known as dysbiosis—these important functions may also be affected. Researchers believe this may contribute to inflammation, altered immune responses and changes that may influence skin health in some individuals.
Although research into the gut-skin axis is still evolving, it has become an increasingly important area of investigation within both gastroenterology and dermatology.
How can the gut influence the skin?
Immune regulation
Approximately 70% of the body’s immune cells are associated with the gut-associated lymphoid tissue (GALT). The gut microbiome helps regulate immune activity, teaching the immune system to respond appropriately to bacteria, viruses and other environmental challenges.
When the gut microbiome becomes imbalanced, inflammatory signals may increase. This systemic inflammation is thought to contribute to several inflammatory skin conditions in susceptible individuals.
The intestinal barrier
The lining of the digestive tract acts as a carefully regulated barrier, allowing nutrients to pass into the bloodstream while helping prevent bacteria and unwanted substances from entering circulation.
Some research suggests that increased intestinal permeability may allow bacterial components, such as lipopolysaccharides (LPS), to cross into the bloodstream. This may contribute to low-grade systemic inflammation in certain individuals, although this remains an active area of research and should not be considered the cause of all skin disease.
Nutrient absorption
Healthy skin depends on an adequate supply of nutrients.
Digestive problems that affect digestion or absorption may reduce the availability of nutrients involved in maintaining healthy skin, including:
- Zinc
- Vitamin A
- Vitamin D
- Iron
- Essential fatty acids
- Protein
- B vitamins
These nutrients all contribute to skin repair, collagen production, wound healing, immune function and maintaining a healthy skin barrier.
Beneficial bacterial metabolites
Our gut bacteria ferment dietary fibre to produce compounds known as short-chain fatty acids, including butyrate. These substances help nourish the cells lining the colon, regulate inflammation and support immune function.
Although research is ongoing, these beneficial compounds may also influence skin health through their effects on the immune system and inflammatory pathways.
What does the research tell us?
While evidence continues to develop, some skin conditions have stronger links to gut health than others.
Acne
Acne has one of the most extensively researched gut-skin connections.
Studies have identified differences in the gut microbiome of some people with acne compared with those without the condition. Diet also appears to influence acne through its effects on blood sugar regulation, insulin and insulin-like growth factor-1 (IGF-1), which can stimulate oil production and inflammation within the skin.
Higher glycaemic diets have been associated with worsening acne in some individuals.
Dairy, particularly skimmed milk, has also been associated with increased acne severity in some studies, although not everyone appears to be affected. Researchers believe this may relate to the effects of dairy on insulin, IGF-1 signalling and inflammatory pathways rather than dairy itself being harmful. This highlights why personalised nutrition is so important—foods that contribute to symptoms in one person may have no effect in another.
There is also emerging evidence that certain probiotic strains may provide additional support alongside conventional acne treatment, although further research is needed to identify which strains are most effective.
Atopic eczema (Atopic dermatitis)
The relationship between gut health and eczema is one of the strongest areas of gut-skin research.
Reduced gut microbial diversity, particularly during early life, has been associated with an increased risk of developing eczema. The gut microbiome plays an important role in educating the immune system and supporting immune tolerance, which may help explain this connection.
Although studies investigating probiotics have shown mixed results, certain strains appear beneficial for some individuals, particularly infants and children. As research continues, scientists hope to better understand which interventions are most effective and for whom.
Psoriasis
Psoriasis is now recognised as a systemic inflammatory condition rather than simply a skin disease.
Research has identified alterations in the gut microbiome and reduced microbial diversity in some people with psoriasis. There is also a recognised association between psoriasis and inflammatory bowel disease, highlighting the close relationship between gut health, immune regulation and chronic inflammation.
Nutrition may also play a supportive role in reducing the body’s overall inflammatory burden. Maintaining a varied, nutrient-rich diet, supporting gut health and achieving or maintaining a healthy body weight may complement appropriate medical treatment.
Some people with psoriasis also have coeliac disease or positive coeliac antibodies. Research suggests these individuals may benefit from a gluten-free diet when undertaken with appropriate medical assessment and nutritional guidance. However, there is currently insufficient evidence to recommend that everyone with psoriasis should avoid gluten. Instead, dietary advice should always be individualised and based on appropriate assessment rather than unnecessary dietary restriction.
Rosacea
Rosacea has become another area of growing interest within gut-skin research.
Several studies have found a higher prevalence of small intestinal bacterial overgrowth (SIBO) in people with rosacea. In some individuals with confirmed SIBO, treating the underlying condition has been associated with improvements in rosacea symptoms.
Rosacea has also been linked with coeliac disease and inflammatory bowel disease, further highlighting the close relationship between digestive health and skin health. However, these associations do not mean that one condition directly causes another, and further research is still needed to understand the mechanisms involved.
Does everyone with a skin condition have gut problems?
The simple answer is no.
Skin conditions are complex and can be influenced by many different factors, including:
- Genetics
- Hormones
- Stress
- Sleep
- Environmental factors
- Skincare products
- Nutrition
- Immune function
- Underlying medical conditions
While gut health may contribute to skin health in some people, it is unlikely to be the sole cause. Equally, someone may experience digestive symptoms without developing skin problems.
Rather than searching for a single cause, it is often more helpful to consider the body as an interconnected system. Understanding the wider picture can help identify factors that may be contributing to symptoms and guide a more personalised approach to supporting health.
Can certain foods affect skin inflammation?
Nutrition is one of the most discussed topics when it comes to skin health, yet it is also one of the most misunderstood.
Social media often promotes the idea that everyone with acne, eczema or psoriasis should avoid dairy or gluten. While this may be appropriate for some individuals, the current evidence does not support removing these foods routinely.
Research suggests that higher glycaemic diets may contribute to acne in some people, and dairy—particularly skimmed milk—has also been associated with increased acne severity in some studies. However, this relationship is complex and not everyone experiences the same response.
For psoriasis, the strongest evidence relates to people with coeliac disease or positive coeliac antibodies. In these individuals, following a gluten-free diet under professional guidance may improve both digestive and skin symptoms. For people without coeliac disease or evidence of gluten sensitivity, there is currently insufficient evidence to recommend avoiding gluten.
Some individuals also report improvements in skin symptoms after reducing dairy or other foods, but these responses appear to be highly individual. This reinforces the importance of personalised nutrition rather than assuming the same dietary approach will benefit everyone.
Rather than unnecessarily restricting foods, it is often more beneficial to focus on building a varied, nutrient-rich diet that supports the gut microbiome and overall health. Where a food is suspected to contribute to symptoms, working with a Registered Nutritional Therapist can help identify genuine triggers while ensuring the diet remains balanced and nutritionally adequate.
Supporting both gut and skin health
While there is no single diet that guarantees healthy skin, several habits are consistently associated with better gut and overall health.
These include:
- Eating a wide variety of colourful vegetables and fruit to provide fibre and plant compounds that nourish the gut microbiome.
- Including wholegrains and other fibre-rich foods where appropriate.
- Choosing good-quality sources of protein to support tissue repair and immune function.
- Including healthy fats, particularly omega-3 fatty acids from oily fish, flaxseed, chia seeds and walnuts.
- Staying well hydrated.
- Managing stress, as chronic stress can influence both the gut microbiome and inflammatory pathways.
- Prioritising good-quality sleep.
- Taking part in regular physical activity.
For some individuals, personalised nutritional support or functional testing may help identify factors contributing to ongoing digestive symptoms, nutritional imbalances or persistent skin concerns.
A naturopathic perspective
Naturopathic Nutritional Therapy views the body as an interconnected system rather than a collection of separate organs.
When someone presents with persistent skin concerns, it can be valuable to consider digestive health alongside other aspects of wellbeing, including nutrition, stress, sleep, lifestyle and medical history.
This approach does not replace medical diagnosis or treatment. Instead, it complements conventional care by exploring whether underlying nutritional or lifestyle factors may also be contributing to symptoms.
No two people are the same, which is why personalised assessment is so important. What works well for one person may not be appropriate for another, and unnecessary dietary restriction can sometimes do more harm than good.
By taking the time to understand the whole person rather than focusing solely on the skin, we can develop practical, sustainable strategies that support both digestive health and overall wellbeing.
Final thoughts
The relationship between the gut and the skin is one of the most exciting areas of current nutrition and microbiome research.
While we cannot say that all skin conditions originate in the gut, there is increasing evidence that digestive health, the gut microbiome, immune regulation and nutritional status all play important roles in maintaining healthy skin.
Looking after your gut isn’t simply about improving digestion. It may also help support immune function, reduce inflammation and contribute to healthier skin as part of a holistic approach to wellbeing.
If you’re experiencing ongoing digestive symptoms alongside persistent skin concerns, addressing both may provide valuable insight into your health. A personalised approach that considers your diet, lifestyle, medical history and individual needs is often far more effective than following generic advice or unnecessarily eliminating foods.
References
Aghasi M, Golzarand M, Shab-Bidar S, et al. Dairy Intake and Acne Vulgaris: A Systematic Review and Meta-analysis of Observational Studies. Clinical Nutrition. 2019.
Bowe WP, Logan AC. Acne vulgaris, probiotics and the gut-brain-skin axis. Gut Pathogens. 2011;3:1.
De Pessemier B, Grine L, Debaere M, et al. Gut-Skin Axis: Current Knowledge of the Interrelationship between Microbial Dysbiosis and Skin Conditions. Microorganisms. 2021;9(2):353.
Ford AR, Siegel M, Bagel J, et al. Diet and Psoriasis: Part 2. Celiac Disease and Role of a Gluten-Free Diet. Journal of the American Academy of Dermatology. 2018.
Mahmud MR, Akter S, Tamanna SK, et al. Impact of the Gut Microbiome on Skin Health: Gut-Skin Axis Observed Through the Lenses of Therapeutics and Skin Diseases. Microorganisms. 2022;10(5):931.
O’Neill CA, Monteleone G, McLaughlin JT, Paus R. The Gut-Skin Axis in Health and Disease: A Paradigm with Therapeutic Implications. BioEssays. 2016;38(11):1167–1176.
Salem I, Ramser A, Isham N, Ghannoum MA. The Gut Microbiome as a Major Regulator of the Gut-Skin Axis. Frontiers in Microbiology. 2018;9:1459.
Szántó M, Póliska S, Dajnoki Z, et al. The Gut-Skin Axis in Inflammatory Skin Diseases. International Journal of Molecular Sciences. 2024;25.
Thomsen SF. Atopic Dermatitis: Natural History, Diagnosis and Treatment. ISRN Allergy. 2014.
Topics covered in this article
- What is the gut-skin axis?
- How the gut microbiome influences skin health
- The role of the immune system in the gut-skin connection
- Intestinal barrier function and inflammation
- Nutrient absorption and healthy skin
- Short-chain fatty acids and the microbiome
- Acne and gut health
- Eczema and the gut microbiome
- Psoriasis, inflammation and gluten
- Rosacea and digestive health
- Can dairy affect your skin?
- Personalised nutrition versus unnecessary elimination diets
- Supporting gut and skin health through diet and lifestyle
- A naturopathic approach to skin health
- When to seek personalised nutritional support
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What is Nutritional Therapy?
Nutritional Therapy is a holistic approach to health and wellbeing that focuses on using food and nutrition to support the body's natural healing processes.
I provide personalised nutrition plans tailored to individual needs.
Whether you're looking to improve digestion, boost energy levels, manage weight, improve your nutrition intake, or address specific health concerns. Nutritional Therapy can offer valuable insights and support on your journey to optimal health.
My Nutritional Therapy diploma is held with the School of Health, and I am a registered Nutritional Therapist with the Federation of Nutritional Therapy Practitioners.
What is the difference between a; dietitian, nutritionist and nutritional therapist.
Dietitian's - Dietitian's provide practical guidance to sick individuals to help them make appropriate, healthy choices for a specific medical conditions. They often work as part of a clinical team, including for example doctors, nurses, physiotherapists etc. They take a direct approach to the illness being presented to them, not the body as a whole.
Nutritionists - Registered nutritionists are qualified to provide information and nutrition advice about food and eating habits. They may take a similar approach to a Nutritional Therapist. Nutritionists normally operate out of private practices. Dieticians will normally operate out of the NHS.
In general, nutritionists provide evidence-based information and guidance about the impacts of food and nutrition on the health and wellbeing of humans
Nutritional Therapists - Nutritional therapists practice complementary medicine, taking a holistic approach to the symptoms that are presenting in the body, They provide recommendations for diet and lifestyle to reduce or prevent health issues and illnesses. They work on the belief that the body has underlying nutritional and biochemical imbalances that lead to poor health, including mental health problems.
