How gut bacteria affects skin health
Yes, gut health is linked to skin health
The gut microbiome is the collection of all of the bacteria and other microbes found in the gut (mouth, stomach, and intestines).
As science continues to advance, we are starting to learn more and more how pivotal the microbiome is and that our health may be reliant upon the microbiome! This is amazing since we are TRULY understanding how skin health is a reflection of inner health!
As a licensed naturopathic doctor, I aim to address my patient’s skin concerns holistically and integrative-ly.
As a holistic medicine expert, I understand that skin health is a manifestation of inner imbalance, and that identifying and treating the inner causes & triggers can provide meaningful and sustainable solutions for patients.
And as an integrative medicine expert, I am trained in both natural & pharmaceutical/conventional options, and understand when to best for both depending on patient preference, patient barriers, and more.
In the blog post, we are going to dive into what science has to say about gut bacteria and several skin issues, specifically with acne, eczema, and rosacea. And then, we are going to dive into what naturopathic doctor may offer to address skin conditions from a holistic and integrative point-of-view.
DISCLAIMER: This post does not constitute as medical advice; this post is not meant to diagnose, prevent, treat, or cure any medical conditions or disease; and this post is meant for educational purposes only. Always speak to your doctor before starting anything new.
Acne & the gut microbiome
Whenever someone sees me for constant acne, it makes me curious to know how their gut health is.
Science tells us that gut bacteria may play a role in acne. There is scientific evidence that shows that people with acne have very different gut bacteria profiles compared to people without acne, and scientists specifically say that people with acne have gut dysbiosis. Dysbiosis means that there is a recognizable imbalance in bacteria populations!
Additionally, scientists have found that irritable bowel syndrome (IBS) is linked to acne. And, IBS is a condition where people can experience gas, bloat, abdominal discomfort, and changes to bowel movements. And interestingly enough, science says that gut bacteria changes are linked to IBS too!
So, should people with acne just start a probiotic? Well, don’t go and start supplementing on your own! I’ll explain more why probiotics may not be helpful for some of these gut changes soon.
Eczema & the gut microbiome
I have been to help many patients achieve healthier & clearer skin by addressing their gut health. And, there is some interesting science that speaks about the gut microbiome and eczema.
When compared to people without eczema, science shows that people with eczema have depletions or absence of gut bacteria responsible for the production of short-chain fatty acids (SCFA).
SCFAs are basically gut bacteria byproducts that are made when bacteria digest fiber from our diet, and they are necessary to help drive down inflammation in the gut.
More recently, a study published this year in 2022 revealed that lower levels of butyric acid, a type of SCFA, has been linked to eczema & food sensitivity. Interestingly enough, eczema is becoming known as a condition where people have higher immune-mediated allergy responses that affect skin health.
And, another study recently published this year in 2022 concluded that gut-derived SCFAs “improve epidermal barrier integrity, ultimately limiting early allergen sensitization and disease development".
And to speak more about allergy responses in people with eczema, there’s interesting science indicating that food allergies may play a role in eczema. And when looking deeper into the science, literature suggests that gut bacteria changes may increase someone’s risk for experiencing food sensitivities.
Given what science has found, it could be suggested that a balanced gut bacteria is necessary for healthy production of SCFAs, which have been implicated in both eczema, skin health, and food sensitivities.
Isn’t that all so cool?
Rosacea & the gut microbiome
Rosacea is described as a chronic, inflammatory facial skin condition where people can experience episodic or constant redness and skin texture changes on the nose, chin, cheeks, and forehead.
Much like with acne and eczema, science also shows that gut health is linked to rosacea! Science shows that GERD, Celiac disease, Crohn’s disease, Ulcerative colitis, Small intestinal bacterial overgrowth, and IBS are more prevalent in people with rosacea. Additionally, science shows that a bacteria naturally found in the stomach may be involved in rosacea.
Helicobacter pylori (H. pylori) is naturally found in the stomach, and when it overgrows in the stomach, it can lead to gastritis and stomach ulcers.
When looking at H. pylori and rosacea, science says that H. pylori infection is commonly seen in people with rosacea! And, science shows an improvement in rosacea symptoms after successfully treated H. pylori infection.
Much like what its name suggests, small intestinal bacteria overgrowth (SIBO) is when there is overgrowth of bacteria in the small intestine. SIBO can look a lot like IBS, and there are several causes of SIBO. However, when looking at SIBO and rosacea, science says that patients with rosacea were 13 times more likely to have SIBO compared to controls. And, science also says that successful treatment of SIBO led to improvement of rosacea symptoms! Isn't that so cool?
So, how does one find out if they have H. pylori of SIBO? I’m going to talk all about how it’s tested for below. I’m also going to chat about how a licensed naturopathic doctor may address H. pylori and SIBO.
Naturopathic medicine is unique since we aim to identify & address root causes and triggers of symptoms, rather than just treating them symptoms alone.
Naturopathic medicine & IBS
As mentioned earlier, IBS is linked to acne and rosacea. So, how does a licensed naturopathic doctor approach IBS?
When someone experiences gas, bloat, abdominal pain, and changes to bowel movements, it’s all about getting the right diagnosis first.
IBS is considered a diagnosis of exclusion, which means that other conditions that look like IBS need to be ruled out first with labs and other work-up before IBS can be made as a diagnosis.
Conditions that look like IBS (and need to be ruled out) are:
Celiac disease
Colorectal cancer
Diverticulosis/Diverticulitis
Drug use
Gastrointestinal infections
Hyperthyroidism/Hypothyroidism
Inflammatory bowel disease - Crohn Disease and Ulcerative Colitis
Lactose intolerance
After IBS is diagnosed, the next step is to identify and address underlying causes and triggers of IBS symptoms. As mentioned earlier, gut bacteria changes have been shown to trigger IBS symptoms. To identify what is going on with gut bacteria in my patients, I recommend that they complete a stool analysis.
The stool analysis that we do in the office is Diagnostic Solutions’ GI-Map, which uses PCR technology to amplify and concretely identify gut bacteria imbalances in the gut. If gut bacteria imbalance is confirmed, there are several natural options that I may recommend to my patients to help bring their gut bacteria populations back into balance.
Natural options that I may address to my patients can involve: Therapeutic nutrition, lifestyle medicine, herbal medicine, and more.
And since everybody’s underlying causes and triggers are unique to them, all treatment plans are personalized to that specific patient to help them achieve optimal gut health AND also achieve healthier and clearer skin.
Naturopathic medicine & SIBO
As mentioned earlier, SIBO has been linked to rosacea. SIBO is why people shouldn’t start probiotics from the get-go. Science tells us that when people with SIBO take probiotics, it can worsen some of their symptoms!
So, how is SIBO tested for?
The gold-standard testing option for SIBO is called the lactulose breath test (LBT). This test measures different gases at different times to diagnose SIBO. After SIBO is confirmed from the LBT, there are several natural, conventional, and integrative options that can be recommended.
When looking at conventional/pharmaceutical options, science shows that there are several antibiotics that can eradicate bacterial overgrowth in the small intestine. When looking at natural options, there are dietary options and herbal options that have been shown to help with gut bacteria balance.
The most well-known diet recommended by providers to address gut bacteria imbalance is called the Low-FODMAP Diet. FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols, which are sugars that bacteria eat to produce gases that trigger gas, bloat, abdominal pain, and other symptoms of gut bacteria imbalance.
However, the Low-FODMAP diet can be very limiting, can be low in nutrient status, and can affect quality of life. So, it is not meant to be used as long-term therapy
Other dietary options that I’ve seen providers recommend to address symptoms of gut bacteria imbalance include the specific carbohydrate diet (SCD), the gut-and-psychology syndrome (GAPS) diet, and the elemental diet.
When looking at herbal medicine, there was a study that compared different herbal preparations to an antibiotic commonly used for SIBO. This study found that 2 sets of herbal preparations were as effective as antibiotics! However, length of treatment differed between pharmaceuticals and herbal treatment in this study, with herbal treatment needing to be 2 weeks longer than pharmaceutical treatment.
While these antibiotic, dietary, and herbal options may address gut bacteria imbalance that cause SIBO, they don't address the root cause of SIBO - as addressing causes may mitigate recurrence of SIBO.
When looking at what science has to say about SIBO root causes, there are several risk factors that have been shown to be related to SIBO:
Heartburn medication, specifically proton-pump inhibitors
Things that affect gut movement, such as opiate medications, diabetes, and more
Chronic pancreatitis
Structural abnormalities and connective issue disease
And more!
Naturopathic medicine & H. pylori
As mentioned earlier, science shows that H. pylori infection is linked to rosacea. When addressing H. pylori naturopathically, that also means addressing it with integrative medicine.
Before H. pylori treatment is started, we first need to confirm if someone does have H. pylori. And, that can be done several ways.
First, there is a breath test option that checks for gases. Second, there is a stool test option that checks for the bacteria.
The second option is what I commonly do with my patients, and I use the test mentioned before in this post - the GI-Map.
Once H. pylori is confirmed, it can then be addressed with different options.
From an integrative standpoint, conventional options to address H. pylori include antibiotics to kill the bacteria and an acid-blocker to reduce burning sensations. And, guidelines from the American College of Gasterenterology recommend such treatment for 14 days.
When looking at natural options, I have seen that a combination of herbal preparations to balance bacteria and herbal preparations to address burning sensations have been effective in my patients. However, I have seen that these herbal options need more time to take into effect compared to conventional options.
What if you want to address your skin holistically?
The answer is simple: Work with a licensed naturopathic provider. As mentioned earlier, licensed naturopathic providers are experts in holistic and integrative medicine.
As integrative medicine experts, we are trained in both natural and conventional options. So, you will be able to capture a vast array of treatment options to help you achieve your skin goals when you work with a licensed naturoapthic doctor.
If you want to see me, I see patients in-person and virtually. The only caveat is that since I am only licensed in the state of California, I can only see patients who are physically in the state of California (especially for telehealth patients).
If you are outside the state a California, a great resource to find a licensed naturoapthic doctor in your state is the Institute for Natural Medicine’s directory: https://naturemed.org/find-an-nd/.
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