How To Ease Your Skin Issue By Starting With Your Gut
A few months ago, I saw a 24-year-old patient who struggled with acne. Since adolescence, she had tried "nearly everything" to get rid of this skin condition that destroyed her self-confidence. Countless visits to dermatologists, expensive skin care regimens, and several courses of antibiotics had created a few minor improvements, yet she still had acne.
You might wonder why this patient with acne would visit a medical doctor who specializes in gut health. But the reality is, everything connects with a healthy gut, including your skin. In my practice, I often see patients struggling with inflammatory skin disorders1 including acne vulgaris, atopic dermatitis, and psoriasis.
The gut-skin connection.
The gut-skin connection is more intricately connected than you might imagine. About 7 to 11% of people with inflammatory bowel disease (IBD), for instance, have psoriasis1. Gut inflammation eventually can become systemic inflammation. And that, along with oxidative stress, blood sugar imbalances, and other problems2, can all show up on your skin—especially if you are genetically predisposed to these conditions.
The types of patients I see are usually fed up with invasive procedures and expensive topical medications that temporarily cure the symptom but not the underlying problem. They don't want to keep taking pharmaceutical drugs, including antibiotics, to treat skin problems like acne, which disrupts the gut microbiome. Common culprits for these skin conditions are food sensitivities. For my patient with acne, a major problem was dairy. Her food journal revealed skim milk in her breakfast cereal and low-fat ice cream before bed.
Imagine their frustration when I tell patients like her that so-called healthy foods they eat are actually creating reactions that can show up as skin rashes (like eczema) and other skin disorders, including psoriasis and acne.
Understanding how gut health affects your skin goes way back. Interestingly, 80 years ago, researchers discovered that emotional states like depression and anxiety could alter gut microbiota2, increasing intestinal permeability (leaky gut) and contributing to inflammation in what is known as the gut-brain-skin axis. In one study, researchers looked at bacterial diversity among 43 patients with acne and 43 controls. They found those with acne had dysbiosis3, or gut imbalances.
Based on those and other studies, you might wonder why more dermatologists and other professionals aren't using gut-support nutrients and diet for healthy skin. And I wonder the same exact thing. One study found a probiotic supplement improved acne in 80% of the 300 participants1. Among their benefits, probiotics can help modulate immunity and inflammation, reducing acne in the process. Probiotics can also help people manage atopic dermatitis and show great promise for psoriasis1.*
For this patient with acne (as well as those with other skin conditions), I often customize a protocol based on their condition. But it always starts with the gut, and their condition almost always improves.
Have a skin issue? Here's how to take care of your gut.
In my practice, these seven gut-healing strategies create a solid foundation to eliminate acne, psoriasis, rashes, and other skin problems:
Nix food sensitivities.
The best way to find your particular sensitivities is to get tested. You can also do it at home with an elimination diet and journal. I ask patients to keep a journal to tease out their reactions since food sensitivities sometimes come in sneaky places. You'll want to cut out the top suspects, including gluten, soy, dairy, corn, and other foods that sabotage your gut and skin health. Consider dairy: If you think the benefits of a dairy-free diet apply only to the gut, think again. A dairy-free diet4 can give you healthy, vibrant, glowing skin. You might also be sensitive to spicy foods, as they are inflammatory to some. It's not as common, but if you can't get your skin conditions under control, consider looking there.
Cut out the sugar.
Nothing is more inflammatory than sugar. Studies show how it ages our cells, is linked to collagen loss, wreaks havoc in the gut, and contributes to acne. I've seen yeast at the root of many facial breakouts fed by a sugar habit because of the toxins secreted by yeast like Candida. Cutting out the sugar in these cases, plus herbal antifungals, clears up the skin, allowing it to glow healthily once again.
Add gut-nourishing foods.
Once we remove the bad ingredients that create gut and skin problems, we add in plenty of skin-supporting foods. A healthy diet includes skin-supporting vitamins and minerals but also nutrients that optimize gut health. My patient began eating more cultured and fermented foods like sauerkraut, which are rich in healthy gut flora or probiotics. She also consumed more prebiotic-rich foods like dandelion greens and Jerusalem artichoke. And we gradually increased her dietary fiber intake to 25 grams a day to further support those good gut bugs. Her acne disappeared, and as a nice "bonus," she lost 10 pounds over two months eating these gut-healing superfoods.
4. Build a healthy gut foundation with these supplements.*
The right probiotic supplement becomes a solid foundation for healthy skin.* I also like omega-3 fatty acids to manage inflammation5 that frequently accompanies skin conditions.* Depending on the patient's condition, I might also add supplements like deglycyrrhizinated licorice (DGL) and L-glutamine, an amino acid that plays multiple skin-benefiting roles in gut health, immune support, and more.*
5. Stay hydrated.
One of the healthiest things you can do for your gut and your skin6 is totally free: Drink more water. Keep a BPA-free canteen nearby and fill it throughout the day. Research has found that drinking the recommended amounts of water can actually increase dermal density of the skin6.
6. Manage stress.
Stress is a huge factor in how your gut behaves or misbehaves, and those repercussions show up on your skin. For many people, this adaptive response to the nearly constant stress life throws at them is activated for too long, without enough of its counterbalancing "relaxation" response. That takes its toll on your gut, skin, and overall health. One way to create this relaxation response is through a mindfulness practice like meditation. But the important thing to remember is to find something that works for you and do it regularly, like yoga, running, a stroll on the beach, or a hike in the forest.
Coconut Water Kefir
A healthy prebiotic- and probiotic-rich carbonated beverage great for helping to balance your gut ecosystem.
- 3 tablespoons water kefir grains*
- 4 cups pasteurized coconut water
- 1 cup fresh strawberries or blueberries (optional)
- ½ cup fresh lemon juice (optional)
*Water kefir grains can be found in natural-food stores or online at Amazon. With proper care, the culture can be used indefinitely to create probiotic-rich kefir. Your grains will not grow as quickly in coconut water as they will in a nice bath of nutrient-rich sugar. Refresh and reactivate the kefir grains in sugar water (¼ cup sugar in 4 cups water) for 24 to 48 hours between batches of Coconut Water Kefir. The sugar water will keep the grains healthy for the long term.
- Place the water kefir grains and the coconut water in a jar. Cover the jar loosely with a lid or cheesecloth and allow the kefir grains to culture the coconut water for ideally 24 to 36 (and no longer than 48) hours at room temperature.
- Once the culturing is complete (the mixture will have thickened), remove the kefir grains with a slotted spoon and store in a separate glass container filled with filtered water and a teaspoon of sugar to keep the kefir grains alive and active.
- You may drink the Coconut Water Kefir by itself, but for an added twist, puree the cultured coconut water with the berries and lemon juice in a blender to your desired consistency. The Coconut Water Kefir will last 1 to 3 weeks in the fridge; when blended with the berries and lemon juice, it will last for 2 to 3 days in the fridge. Serve cold.
The bottom line:
You don't need never-ending dermatologist visits and expensive creams to have great skin. Great skin starts right here, right now, with what you drink, eat, and supplement with. Eliminating skin conditions like acne, psoriasis, and atopic dermatitis begins within: with your gut. When you start with this foundation as the primary focus of healing, every area of your health improves, and you see it on the outside as well.
Vincent M. Pedre, M.D., medical director of Pedre Integrative Health and president of Dr. Pedre Wellness, is a board-certified internist in private practice in New York City since 2004. He completed his bachelor’s degree in Biology at Cornell University before attending the University of Miami School of Medicine and completed his residency in Internal Medicine at the Mount Sinai School of Medicine. He has appeared on the Martha Stewart Show and ABC and is the author of Happy Gut: The Cleansing Program to Help You Lose Weight, Gain Energy, and Eliminate Pain. Dr. Pedre is a clinical instructor in medicine at the Mount Sinai School of Medicine and is certified in yoga and medical acupuncture.