Dr. Bryant Esquejo, ND • Holistic Acne & Eczema Healing

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Gut Microbiome & Skin Health

Intro

As a naturopathic provider, I see the gut as the crux of health and wellness. Science shows that gut health is connected to hormonal health and skin health (And we all know the connection between hormones and skin health). In this blog post, we are going to focus on how the gut microbiome (and postbiotics) has been connected to skin health. The gut microbiome is considered as all of the microbes in the gut. The gut is commonly used to refer to the whole digestive system - from mouth to anus; and microbes are used to describe bacteria, viruses, parasites, and all other microscopic organisms.

Topics we will cover in this blog post:

  • How the gut microbiome is connected to skin conditions

  • Postbiotics: What are they and how are they connected to skin health


Gut microbiome & skin conditions

Science shows that the gut microbiome has been connected to several different skin conditions.

Acne

First, the gut microbiome has been connected to acne. A 2017 study hypothesized that changes to the gut microbiome increases inflammatory markers that may lead to the development of acne, and a 2018 study showed that acne was associated with changes to the gut microbiome! And, scientists suggest that certain types of diets or eating certain types of foods may lead to acne by changing the gut microbiome population towards something that is more inflammatory! Additionally, science has just recently connected acne to irritable bowel syndrome (IBS), which is something that I have seen in practice for a while. And, one of my pillars for addressing acne is optimizing gut health (especially if someone is exhibiting symptoms of IBS)!

Psoriasis

Second, psoriasis has also been connected to changes in the gut microbiome. For those who do not know what psoriasis is, it is a chronic inflammatory skin condition with systemic symptoms, and it affects 2% of adults in the US! In regards to the gut-skin connection, science showed that people with psoriasis had lower bacteria diversity in the gut compared to people without psoriasis. Additionally, science shows that adding in certain types of bacteria strains from probiotics into the gut were shown to be of benefit in those with psoriasis and that the addition of these bacterial strains reduced inflammatory markers!

Rosacea

In addition to acne and psoriasis, rosacea has also been shown to be connected to changes in gut microbiome populations. In rosacea, we see that there is chronic inflammation of the skin, particularly in parts of the skin where there are a lot of oil glands. This inflammation leads to symptoms of redness and dryness. In regards to the gut-skin connection, science has shown that rosacea is associated with small intestinal bacterial overgrowth (SIBO) and H. pylori infection in the gut.

Eczema

Lastly, eczema has been connected with changes in the gut microbiome. Eczema is an inflammatory skin condition where people experience a very itchy rash that can be dry and flaky. And, science has shown that people with eczema have depletions or absence of gut bacteria responsible for the production of short-chain fatty acids compared to people without eczema. Short-chain fatty acids are a gut bacteria by-product, which is made after gut bacteria digest fiber from diet. And, short-chain fatty acids are necessary to help reduce inflammation in the gut.

In addition to addressing fiber in diet, looking at food allergens may be helpful as well. A condition called systemic contact dermatitis (SCD) has been shown to look very similar to eczema, but those with SCD also experience allergy symptoms (headache, malaise, runny nose, eye redness, and more) with a rash after consuming an allergen. So, I work to find if there are any dietary incompatibilities that could be playing a role in the development of eczema and eczema-like symptoms.


Postbiotics & skin

What are postbiotics?

Postbiotics are generally described as any byproduct from the microbiome, and these byproducts may exert beneficial effects. One postbiotic was already mentioned earlier - short-chain fatty acids. But, there are more! Beyond short-chain fatty acids, other postbiotics are:

  • Enzymes: The microbiome can make antioxidant enzymes, and animal models have shown that enzyme postbiotics can reduce inflammation in the gut

  • Cell-free supernatants: A supernatant is the surrounding liquid around microbes, and science shows that some supernatants contain biologically-active metabolites

  • Exopolysaccharides: The science is not clear about what this class of postbiotics do, but science has shown that it can modulate immune response.

  • Bacterial lysates: This type of postbiotic is obtained from chemical or mechanical degradation of bacteria, and science shows that it can modulate immune response and has been connected to potential changes in allergy responses.

  • Cell wall fragments: Science indicates that cell wall fragments from gut bacteria could increasing inflammation in the gut and be harmful

  • Other metabolites: The microbiome has also been shown to create Vitamin K and Vitamin B12, and play a role in amino acid metabolism.


Do postbiotics affect skin health?

Even though research is limited on postbiotics and skin health, the current published evidence is promising! Several studies have reported the effects of postbiotics and eczema, and there was a single study looking at the effects of topical postbiotics and acne!

In regards to eczema, a 2012 study showed that when bacterial lysates were given to children with parents who had eczema, it prevented the development of eczema in those children. Additionally, a study completed on human subjects in 2010 revealed that heat-killed Lactobacillus paracasei K71 led to lower need for topical pharmaceutical itch creams commonly prescribed for eczema. Also, a 2014 animal study showed that bacterial lysates from Lactobacillus plantarum modulated immune response and blocked pathways that contribute to the development of eczema! And more-recently, a 2021 study reviewing the literature on bacterial lysates and allergy response showed that bacterial lysates improved allergy responses, such as skin rashes and more.

In regards to acne, a study completed in 2020 showed that topical postbiotic was as effective as benzoyl peroxide (a commonly-used topical for acne) for mild-to-moderate acne. Researchers of this study indicated that topical postbiotic led to significant improvement of open comedones (black heads), closed comedones (white heads), and papules (acne); reduced severity of redness and how raised acne was; and reduced skin oiliness. Additionally, topical postbiotic was shown to have antimicrobial activity against acne-causing bacteria in the skin and inhibit enzymes playing a role in skin oil production.


Summary & Takeaways

When looking at skin health from a holistic perspective, that means looking at what is going on with skin health at the skin level in addition to addressing underlying factors affecting skin health. And, there are many factors that can plat a role in issues with skin health - and the gut is just one piece of it!

In this blog post you learned:

  • There is a connection between the gut microbiome and skin health

  • Postbiotics are defined as gut microbiome products that usually exert beneficial effect

  • Diet may be influencing the gut microbiome, leading to inflammation in the gut and down-stream skin manifestations

  • Probiotics may influence gut inflammation connected to skin issues

  • There are limited studies that show that postbiotics affect skin health, specifically with eczema and acne. But, the current evidence is promising and can pave the way for further research

Address chronic skin issues with a holistic approach

In regards to addressing skin health from a holistic perspective, it can mean:

  • Looking at someone’s diet (and how that is affecting gut health and downstream skin health)

  • Addressing someone’s skincare routine and identifying any possible skin-incompatible ingredients playing a role in skin issues

  • Investigating if and how hormones are playing a role in the development of acne or other skin issues

  • Seeing how stress response could be affecting gut health, hormonal health, and more leading to downstream skin issues

  • And more!

As a licensed naturopathic provider, I seek to holistically and integratively treat patients. With skin issues, I look for causes on the skin level and look for underlying causes affecting skin health, and I address those causes with integrative options for sustainable and long-lasting solutions. Click the button below to schedule an appointment with me.

Thanks so much for reading today! I hope you enjoyed this blog post and found it interesting & educational!


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DISCLAIMER: THESE STATEMENTS HAVE NOT BEEN EVALUATED BY THE FOOD AND DRUG ADMINISTRATION. DR. BRYANT ESQUEJO, ND HAS NO FINANCIAL TIES TO ANY SUPPLEMENT COMPANIES, PHARMACEUTICAL COMPANIES, OR TO ANY OF THE PRODUCTS MENTIONED IN THIS POST. THIS POST IS NOT MEANT TO TREAT, CURE, PREVENT, OR DIAGNOSE CONDITIONS OR DISEASES AND IS MEANT FOR EDUCATIONAL PURPOSES. AS ALWAYS, PLEASE CONSULT YOUR DOCTOR BEFORE TRYING ANY NEW TREATMENTS OR SUPPLEMENTS.