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The skin-gut connection: How intestinal bacteria and skin health are connected

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Like the gut, skin microbiomes regulate barrier function and monitor inflammation and are interlinked through a common gut-skin axis. Any imbalance in the gut microbiome naturally has an impact on the skin, and causes many skin diseases.

Skin accounts for 15% of body weight. An average individual has 300 million skin cells, while the skin microbes count is around one billion. These microbes play a dominant role in skin health and are the cause of many skin diseases such as acne, eczema, psoriasis, etc. 

Dr Kiran Godse

Explaining the role of the gut and skin microbiomes in maintaining skin health, Dr Kiran Godse, dermatologist and cosmetologist at Hiranandani Hospital, Vashi, Mumbai, states, “The gut and skin are both one of the largest epithelial surfaces in the body, and they inhabit a number of yeasts, bacteria and other micro-organisms that form their microbiome. These microbiomes regulate barrier function and monitor inflammation and are interlinked through a common gut-skin axis. Hence, any imbalance or dysbiosis in the gut microbiome naturally has an impact on the skin.”

These microbes are quite different from the ones living in a human’s gut. While the gut microbiome receives very little or no oxygen, the skin microbiome is exposed to plenty of oxygen-rich air. 

Sushant Kumar

Adding to it, Sushant Kumar, founder and CEO, Genefitletics, says, “Skin has been the most neglected part of our body. We have been focused on taking care of skin from outside through various skin treatments, radiation therapies, creams, ointments, lotions and even over the counter probiotics and antibiotics. It turns out that skin health starts from within. Like the gut, our skin’s microbiomes interact with our skin cells and even create a barrier to protect against pathogens and external environments. The most fascinating part is these gut microbes interact with skin microbes and have a larger role to play in skin health.”

Voomika Mukherjee

Emphasising it further, Voomika Mukherjee, dietitian and health coach, says, “The gut and skin microbiomes have a direct connection which we generally call as “gut-skin axis” which helps one’s immune system and fights against the harmful pathogens and hence maintains the skin homeostasis and decreases the inflammation. But one needs to balance the good bacteria over bad bacteria, the ratio that we as nutritionists suggest is 80 as good bacteria and 20 or below as bad bacteria.”  

one needs to balance the good bacteria over bad bacteria.

However, Kumar begs to differ on the classification of the good and bad bacteria. Instead, he says, “There is nothing called good microbes and bad microbes. It all depends upon the functions they perform. For instance, one organism or bacteria in the gut, which is producing nutrients in the body of an individual may be releasing toxins in the body of another one, and that’s what makes them good or bad.”

The imbalance has a direct bearing on skin health. It gives rise to a lot of inflammatory factors that affect the skin’s moisture retention, barrier function and immune function to ward off harmful pathogens. “All these factors can give rise to or aggravate skin conditions like eczema, rosacea, acne, hidradenitis suppurativa, atopic dermatitis, dandruff (or seborrhoeic dermatitis), psoriasis, etc,” adds Dr Godse. 

Leaky Gut is quite common nowadays. The consumption of frozen, processed food items, lots of refined and unhealthy junk foods/meals are to be blamed. These food items are easy to cook, good to eat, but certainly not at all healthy for the microbes. “It gradually starts affecting and hence destroying the villi present in the small intestine. Due to this, toxins leak out from the intestine into the bloodstream and hence starts with inflammation in the body and affects our skin health causing many skin issues,” says Mukherjee.  

For the uninitiated, the gut microbe assessment helps sequence microbial genes and analyse every biochemical activity taking place inside the body to give an accurate picture of the unique health of an individual. It helps provide personalised nutrition and lifestyle recommendations for preventing and reversing chronic diseases.

Almost 400 million Indians suffer from various skin issues ranging from acne, eczema to skin cancer.

“Almost 400 million Indians suffer from various skin issues ranging from acne, eczema to skin cancer. Most of the skin disorders stem from the leaky gut which is the root cause of almost all chronic conditions. So, it’s not just the skin health that needs healing, but the gut microbiome diversity of an individual so that he can get rid of other problems such as digestive issues or metabolic issues, which he might be facing along with the skin problems.” says Kumar.  

If an individual is suffering from skin problems, be it rashes or unexplained acne that pop up from nowhere, the first thing to do is apply medication on the skin surface. Rarely do people go skin deep to probe the root cause of skin inflammation and other skin-related conditions. The importance of gut microbiomes in maintaining good skin health is fast catching up in the medical fraternity. As Dr Godse highlights that he is mindful of the gut microbiome before prescribing any medication. “Most antibiotics can damage these good bacteria (microbiome) too along with bad bacteria, leading to altered immune function,” he adds. 

“Most antibiotics can damage these good bacteria (microbiome) too along with bad bacteria, leading to altered immune function.”
Dr Kiran Godse

Highlighting the importance of a gut microbe examination, Kumar explains, “Up the Gut solution enables an individual to get access to relevant insights into how foods consumed impacts his skin health, how to improve the diversity of the gut, balance the gut microbiome and what foods are beneficial and harmful for skin health.” Kumar further suggests a skin microbe analysis to know the cause better.  

The dermatologists too realise the importance of a balanced diet. The gut microbe examination helps the nutritionist chalk out a proper diet plan, and the dermatologists seek the patient’s cooperation in following this advisory, in toto. “We advise them to avoid processed foods, alcohol, and self-treatment with antibiotics. Including prebiotics such as curd or a high fibre food in the diet helps maintain a healthy gut microbiome, and eventually healthy skin,” states Dr Godse. 

Skin health also depends on the products that are applied to it. “One should be wise while using skincare products that include many irritants that can alter the skin’s microbiome. Including bland products with a minimal ingredient list is advised. Over-washing, over-exfoliation, using harsh cleansers, and long hot showers should also be avoided since it affects the skin’s microbiome,” advises Dr Godse.

The general diet should include:

  • More probiotics such as sugar-free Yakult probiotic, low-fat curd, buttermilk
  • Fermented foods such as idli, sauerkraut, kimchi, miso, yoghurt, kefir, sourdough
  • Prebiotic fibrous foods such as oatmeal, bran, banana
  • Hydration as water needs to be balanced simultaneously with the fibre, else one will feel bloated


Disclaimer: Medical Science is an ever evolving field. We strive to keep this page updated. In case you notice any discrepancy in the content, please inform us at [email protected]. You can futher read our Correction Policy here. Never disregard professional medical advice or delay seeking medical treatment because of something you have read on or accessed through this website or it's social media channels. Read our Full Disclaimer Here for further information.

Disclaimer: Medical Science is an ever evolving field. We strive to keep this page updated. In case you notice any discrepancy in the content, please inform us at [email protected]. You can further read our Correction Policy here. Never disregard professional medical advice or delay seeking medical treatment because of something you have read on or accessed through this website or it's social media channels. Read our Full Disclaimer Here for further information.

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Disclaimer: Medical Science is an ever evolving field. We strive to keep this page updated. In case you notice any discrepancy in the content, please inform us at [email protected]. You can futher read our Correction Policy here. Never disregard professional medical advice or delay seeking medical treatment because of something you have read on or accessed through this website or it's social media channels. Read our Full Disclaimer Here for further information.