The connection between gut health and skin health is a topic that’s drawn much attention in recent years, alongside a growing body of research connecting inflammatory skin conditions with the balance of our gut microbiome.

Recent research has zeroed in on the “gut-skin axis” — a bidirectional communication system between the gastrointestinal tract and the skin — revealing how imbalances in the gut microbiome can trigger or exacerbate one of the most prevalent skin conditions in the world today, eczema.

Eczema affects a shocking 20 percent of children and 10 percent of adults worldwide, and these numbers have been climbing over recent decades. 

In young children, eczema often manifests as atopic eczema (or atopic dermatitis), characterised by dry, itchy, inflamed skin. It is part of the “atopic triad,” which also includes asthma and hay fever, meaning it often occurs in individuals who have a genetic tendency to develop allergic conditions.

The role of gut health in eczema

Environmental factors and genetic predispositions can be key factors in the development of eczema, but gut health is also a major player, says nutritionist and gut health specialist Evie Whitehead. 

Nutritional Therapist Evie Whitehead

“There is evidence to suggest that babies, children and adults that suffer with atopic dermatitis may have differences in their gut microbiome, and this can occur due to a number of variables including the way you were born, antibiotics, pre-natal and post-natal diet, and home environment, which can impact the early colonisation of gut microbes. 

“For example, one study showed that children brought up on a farm surrounded by animals, dirt and nature had significantly less allergies, skin conditions and autoimmune diseases when they grew up compared to babies from more sterile or city dwelling homes.”

The gut-skin connection: A delicate balance 

Imagine your gut as a bustling city, home to trillions of microorganisms that form the microbiome. This community plays a pivotal role in digestion, immune function, and even our mental health. When this delicate balance is disrupted (a condition known as dysbiosis) by things like poor diet, stress, or antibiotics, our skin can be one of the first places to show signs of trouble.

Addressing any imbalance in our gut health is a key strategy in tackling eczema and maintaining healthy skin, while fostering a diverse gut microbiome.

Approximately 223 million people are living with atopic dermatitis, of which around 43 million are aged 1 to 4.

Our gut microbiome thrives on diversity. The more varied our gut bacteria, the better equipped our body is to fend off inflammation and maintain overall health. Unfortunately, modern diets — high in processed foods and low in fibre — along with environmental stressors, can deplete this diversity, leading to microbial imbalance.

EXPLORE OUR UPCOMING PROGRAMME: The Future of Dermatology: Spotlight on Skin

The Future of Dermatology: Spotlight on Skin

“The gut microbiome responds really favourably to a diet rich in a variety of plant-based food”, explains Evie. She recommends including a wide variety of fruit, vegetables, wholegrains, beans, lentils and pulses to encourage the growth and balance of beneficial species of bacteria. 

Variety ensures that a wide range of this beneficial bacteria can flourish, each with its unique dietary preference. 

“Aim for plenty of colour and flavour from herbs and spices. Look to include probiotic foods such as live yoghurt or a daily dose of kefir. If you aren’t used to kefir or have never tried it, it is a really easy way to introduce friendly bacteria into your gut microbiome. 

Kefir is a fermented drink that’s packed with probiotics, containing up to 61 different strains of beneficial bacteria and yeast — far more than yoghurt.

“There are plenty of naturally fermented foods that can help support your gut-skin health these include; sauerkraut, kimchi, kefir, live yoghurt, tempeh, kombucha, olives.”

“Start with one serving per day and increase slowly and see how it makes you feel,” she suggests. “Take note of any dry or scaly skin patches to see if these improve. Remember that consistency is key to see if these changes will benefit you and your skin.”

“To find out if your gut microbiome is less healthy than it should be, there is testing available through stool tests,” says Evie.

“These can provide answers to your own unique gut microbiome balance and diversity. However, private functional tests do come at a cost, so it may be worth trying a new approach through food, and making some small changes to your diet.”

Fermented foods for gut health

Fermented foods have seen a surge in popularity recently due to their ability to provide us with beneficial enzymes, B vitamins, and omega-3 fatty acids. These create healthy amounts of short chain fatty acids which directly feed our gut cells.

“The most common fermented foods that naturally contain probiotics, or have probiotics added to them, include: yoghurt, kefir, kombucha, sauerkraut, pickles, miso, tempeh, kimchi, sourdough bread and some cheeses,” says Evie. 

The role of fibre

Increasing fibre intake is also crucial, as it feeds the healthy bacteria that in turn produce protective substances like short-chain fatty acids, which combat inflammation.

Most adults are only eating an average of about 20g of fibre a day, while research suggests we should be consuming 30-40g of fibrous foods daily to promote sufficient ingestion of prebiotics.

Which foods should eczema patients avoid?

A study by Nosrati et al. surveyed 169 patients with atopic dermatitis in relation to dietary modifications and clinical outcomes. Of those who experimented with dietary elimination, the biggest improvements in eczema were linked to the exclusion of white flour products, gluten, and nightshades. 

For those who added food items into their diets, the best improvements in skin were noted with the incorporation of vegetables, organic foods, and fish oil. 

Addressing the root cause of our skin woes

While gut health is not a cure-all, it’s a powerful tool in managing eczema. Founders of the gut stuff and authors of three books, Lisa and Alana Macfarlane, have made it their mission to guide and educate as many people as they can on the importance of balancing the gut to address a range of health issues, from IBS to psoriasis.

‘the gut stuff: The new gut-health and cookbook to understand your body and transform your gut‘.

“At ‘the gut stuff’, we’ve seen an increase in people messaging us about how their skin conditions could be linked to their gut,” Lisa tells ITN Business. “I think this is generally down to people being more educated and having a more holistic view of their health.”

Research shows that people struggling with skin conditions such as rosacea and psoriasis may find that making adjustments to their diet can alleviate the severity of their symptoms.

“Data shows that small intestinal bacterial overgrowth (SIBO) is associated with rosacea, and treating the SIBO can help to improve the skin condition,” says Lisa. “Additionally, those who suffer with inflammatory bowel disease (IBD) are at a higher risk of developing inflammatory skin conditions, like psoriasis and atopic dermatitis (eczema). Celiac disease has also been associated with psoriasis, atopic dermatitis, and rosacea.”

The Future of Dermatology 

Skin conditions affect around 60% of people in the UK at some point in their lives, with symptoms ranging from mild to life threatening. From common skin conditions such as acne, eczema or psoriasis, through to rarer ones such as chronic spontaneous urticaria (CSU), awareness, understanding and new treatments starts with the science.

ITN Business and the British Skin Foundation (BSF) have partnered to take an up-close and unfiltered look at the developments in dermatology for a news-style programme, ‘The Future of Dermatology: Spotlight on Skin’. In the programme we will explore the stories showcasing the research, the developments and the breakthroughs that can bring about life changing results, physically and psychologically, for people living with skin disease.​

 

References and useful resources: