I’m preparing for my talk at the upcoming Wise Traditions Conference in Santa Clara, CA on November 10th. I’ll speaking on the “gut-brain-skin axis”, a fascinating topic that I’ve been exploring for some time. I hope some of you will be able to come to the conference, but I thought I’d share a little slice of my research here for those of you who can’t. (If you don’t make the conference and want to watch my entire presentation, I believe the Weston A. Price Foundation sells DVDs of the talks after the fact.)
I’ve discussed the gut-brain axis several times on my radio show, and I’ve at least mentioned the triangular connection between the gut, brain and skin. In this post I’d like to go a little deeper on the gut-skin connection.
And as a clinician who works with people on these conditions, I’d go as far as to say this:
If you want to heal your skin, you have to heal your gut.
Associations between Gut Disorders and Skin Conditions
Epidemiological evidence shows a clear association between gut problems and skin disorders. A recent report indicated that small intestine bacterial overgrowth (SIBO), a condition involving inappropriate growth of bacteria in the small intestine, is 10 times more prevalent in people with acne rosacea than in healthy controls, and that correction of SIBO in these individuals led to marked clinical improvement. (1) 14% of patients with ulcerative colitis and 24% of patients with Crohn’s disease have skin manifestations. (Interestingly enough, a study just came out showing that a drug normally used to treat psoriasis is also effective for Crohn’s disease.) Celiac disease also has cutaneous manifestations, such as dermatitis herpetiformis, which occurs in 1/4 of celiac sufferers. Celiacs also have increased frequency of oral mucosal lesions, alopecia and vitiligo. (2)
How Altered Gut Function Impacts the Skin
In a study way back in 1916, acne patients were more likely to show enhanced reactivity to bacterial strains isolated from stool. 66 percent of the 57 patients with acne in the study showed positive reactivity to stool-isolated bacteria compared to none of the control patients without active skin disease. 1 In a more recent study involving 80 patients, those with acne had higher levels of and reactivity to lipopolysaccharide (LPS) endotoxins in the blood. None of the matched healthy controls reacted to the e. coli LPS, while 65% of the acne patients had a positive reaction. Both of these studies suggest that increased intestinal permeability is an issue for a significant number of acne patients. (4)
Speaking of permeable barriers: most of you have heard of leaky gut by now, but what about “leaky skin”? The main function of the skin is to act as a physical, chemical and antimicrobial defense system. Studies have shown that both stress and gut inflammation can impair the integrity and protective function of the epidermal barrier. This in turn leads to a decrease in antimicrobial peptides produced in the skin, and an increase in the severity of infection and inflammation in the skin. (5)
The gut flora also influences the skin. Substance P is a neuropeptide produced in the gut, brain and skin that plays a major role in skin conditions. An altered gut microbiome promotes the release of substance P in both the gut and the skin, and probiotics can attenuate this response. (6) The gut microbiota influences lipids and tissue fatty acid profiles, and may influence sebum production as well as the fatty acid composition of the sebum. (7) This may explain why a Russian study found that 54% of acne patients have significant alterations to the gut flora (8), and a Chinese study involving patients with seborrheic dermatitis also noted disruptions in the normal gut flora. 2
Like what you’re reading? Get my free newsletter, recipes, eBooks, product recommendations, and more!
Probiotics Improve Skin Conditions
The first formal case report series on the value of using lactobacilli to treat skin conditions was published in 1961 by a physician named Robert Siver. He followed 300 patients who were given a commercially available probiotic and found that 80 percent of those with acne had some clinical improvement. 3 In a more recent Italian study involving 40 patients, Lactobacillus acidophilus and Bifidobacterium bifidum in addition to standard care led to better clinical outcomes than standard care alone. (9) And another recent study of 56 patients with acne showed that the consumption of a Lactobacillus fermented dairy beverage improved clinical aspects of acne over a 12-week period. (10)
The beneficial effect of probioitics on skin may explain why pasteurized, unfermented dairy is associated with acne, but fermented dairy is not. I haven’t seen any studies on raw dairy and skin conditions, but my guess is that it wouldn’t be associated either. Orally consumed probiotics reduce systemic markers of inflammation and oxidative stress, both of which are elevated locally in those with acne. (11) Oral probiotics can also regulate the release of pro-inflammatory cytokines within the skin. (12) The fermentation of dairy reduces levels of insulin-like growth factor 1 (IGF-1) by more than four-fold. (13) This is significant because studies show that acne is driven by IGF-1, and IGF-1 can be absorbed across colonic tissue. (14) This would be particularly problematic when increased intestinal permeability is present, which as I mentioned above is often the case in people with acne.
Better supplementation. Fewer supplements.
Close the nutrient gap to feel and perform your best.
A daily stack of supplements designed to meet your most critical needs.
- Strickler A, Kolmer JA, Schamberg JF: Complement fixation in acne vulgaris. J Cutaneous Dis 1916, 34:166-78. ↩
- Zhang H, Yu L, Yi M, Li K: Quantitative studies on normal flora of seborrhoeic dermatitis. Chin J Dermatol 1999, 32:399-400. ↩
- Siver RH: Lactobacillus for the control of acne. J Med Soc New Jersey 1961, 59:52-53. ↩
I started having weird autoimmune symptoms like dry eyes, dry mouth, fatigue, bowel issues in 2011. After spending months at different doctors and receiving no diagnosis, I started to get a little rash on my scalp. I was diagnosed with a form of scarring alopecia called Lichen Planopilaris. I started a gluten free diet to support my skin toward the end of 2011. I felt a little better but I still had other issues and didn’t feel healthy. Finally in July of this year I was diagnosed with Celiac disease. I think my undiagnosed Celiac kick started my Alopecia. Unfortunately it may be a battle for life. A gluten free diet didn’t make my gut feel much better and I was suffering from mal-absorbtion so I started a Paleo diet in August and my stomach is much better. I think I have less systemic inflammation but I still pray for a healthy scalp free of this painful and itchy rash that I have had for nearly a year. I have been under a good dermatologists care but this condition tends to be chronic. I have been in touch with other LPP patients who get some relief from paleo. I have only had a little relief to my skin.
Emma, you might try doing the elimination diet called the GAPS Intro for a month or two and see if that helps. It can be very effective at healing leaky gut, which may be an underlying cause for your scalp issues. I know another Celiac who is experiencing significant healing this way. Good luck to you!
Hi Chris,
Healing my gut has definitely improved my acne, but I would like to have your insight on this.
Is it possible that being hypothyroid can impair gut function leading to SIBO and other bacterial overgrowths? This would also likely lead to vitamin/mineral deficiencies further exasperating the problem, correct? I believe that I may be deficient in B12 and K2 but I don’t want to supplement without further testing.
I ask this because I will soon be visiting a naturopath and hopefully have some testing done for my thyroid and for SIBO, hopefully an organic acids test as recommended by you. Is there anything I should specifically mention or any specific tests I should have done?
Thanks,
Limak
Has anyone had success treating psoriasis? A close family member has it and it seems that sometimes diet is not enough. Would love to hear anyone’s experience.
Looking forward to your Wise Traditions Conference talk!
Hi Lisa, I have a client who suffers from a bad case of psoriasis. Although it hasn’t cleared completely, the inflammation has gone down ten-fold with diet alone. The foods that seem to make his condition worse are: red wine, all dairy, gluten, sugar, eggs, toxic seed oils (soybean, canola, etc), dark chocolate, nuts, flour and beer. I’m his personal trainer and when he has had a bad eating week, I can see it written all over his body. Lately, I asked him to eliminate dark chocolate because cocoa is way too high in omega 6 and therefore worsens his inflammation, not to mention the sugar which, even in small quantities does its damage, and he has seen dramatic results. don’t underestimate the power of a clean diet. A diet of meat, bone broth, fish, vegetables and some fruit may seem boring to your family member, but having smooth skin overrides the ‘boringness.’ I tell my client that it’s never boring to be healthy. He’s also lost all his belly fat eating this way, a nice bonus. Also, I’ve encouraged him to buy Green Pastures high vitamin cod liver oil butter/blend to see if that helps even further. Good luck!
Thanks Des, there should be more trainers around like you!
I’m definitely not “underestimating the power of a clean diet” but I have still not heard a testimonial of someone completely clearing psoriasis on diet alone.
Thanks for the tips, it sounds similar to something I would advise (paleo type diet with an autoimmune protocol) but testimonials are useful when encouraging people to give up so many foods.
Des is soooo right, eating clean, especially the bone marrow and broth soups are great healing foods, make sure it’s pastured livestock for the good omega balance and nutrients in the fats!! Also remember when giving up foods you love, they are really just cravings and when they go away you then start to control your foods and therefore your life too…
You’re very welcome and thank you for your kind words. It’s an ongoing battle, but when this individual gets it right, it shows.
It’s Chris’s site that got me into looking outside the box. Excercise is important, but nothing has the potential to heal like proper food (and the right attitude).
Once you eliminate all these foods, as daunting as it sounds, something miraculous happens; you stop craving them! I have little reason to eat this way, yet I do because I see the benefits. Plus, I feel free from the burden of all prccessed foods. I eat the same sort of foods every day, and I feel great. My skin is clear (I had flare ups before) and I just feel human again.
Good luck!
Absolutely true. My story is too long to post here as a comment (plan to blog about it soon) but the bottom line is this: A severe flare-up of a skin condition exacerbated by stress left me with a painful, stinging, burning, swollen and scaly inflamed epidermis, and I didn’t want to go back to the standard treatment regimen of drugs, particularly the antibiotics. I wanted to fix the cause, not the effect. Knowing I had an overactive immune system (connected, of course, to gut issues), I decided to work on that—and the quickest way I could figure was via a raw-milk-only diet to reestablish friendly gut flora, etc. One month on that and it was like I had new skin. Major caveat here: This was clean, healthy raw milk (and raw fermented milk products). All the skincare recommendations for “no dairy” should be “no PASTEURIZED dairy.” Major difference. The clean raw milk heals—the pasteurized dirty milk harms.
Your story is very interesting and encouraging. Thanks for sharing.
Like I often say, raw milk is nature’s original probiotic food.
Oh, YES I’ve noticed a connection…I got sick with bacterial (yeast & ? ) overgrowth in 2007 and something from a bad chicken in 2008 and have spent 4 years healing…and everything I was sensitive or allergic to came right out in my face, different times and spots for different things…like a map!
Everyone thought I was nuts when I said it was my gut and sensitivities/allergies. SO glad to read this!!
Celiac Disease Is Influenced by Season of Birth
One hypothesis is that the season in which a person is born may influence the development of this digestive disorder. Some researchers suspect that babies born in spring and summer are more susceptible to the disease, which is triggered by the gluten in wheat, barley and rye.
http://well.blogs.nytimes.com/2012/10/29/really-celiac-disease-is-influenced-by-season-of-birth/
Chris,
Healing the gut over the past 5 years has been key in healing my body from a horrific skin condition and immune system breakdown! The road has been long but I am grateful for all the healing that has taken place. Here is my story:
In the fall of 2008, I broke out into these horrendous skin rashes all over my legs. They were painful, hot and terribly itchy. I saw multiple dermatologists and doctors, applied various creams and took various medications…all to no avail. No one had a clue what this mystery rash was. Months went by and the rash spread to my arms, torso and neck. My energy levels dropped, my hair started falling out, I was gradually dropping weight and needless to say I became very scared and angry. I was still trying to work as a physical therapist and I was exhausted and miserable. I didn’t know what to do…I was desperate for answers and relief from the pain and itching. I would never have imagined that I would continue to experience these couple for the next few years!! The rashes were unbearable, but sadly it started getting worse.
In the late summer of 2009, I came down with an awful infection of my mouth, throat and tonsils. Doctors would give me an antibiotic and then the infection would return in 3 to 4 days after finishing it. The infections returned with a vengeance 4 times in a month and a half, leaving me mostly bed bound and having to go on short term disability at the age of 29!! The doctors didn’t know what to do. I was terrified! It is scary and does crazy things to your mind when you don’t know what is wrong with you. Here I was…a formally vibrant, fun-loving, high-level athlete stripped of everything I took for granted. My body was gaunt, sickly and plagued with rashes. I dropped to a size 1 pair of pants and I could barely walk down the street, let alone play a 90 minute soccer match. I lost my fun-loving personality to fear, anxiety and anger. I was a mess! I soon realized that conventional medicine had nothing to offer me…no relief from my pain and no plausible explanation for my symptoms. Thus, began my determined and desperate efforts to regain my health. By the grace of God, I came across an article about natural solutions to drug-resistance infections and started taking wild Mediterranean oregano oil. I thought, “What the heck! It couldn’t hurt, right?” The infection went away after about a week and for the first time in almost a year I got a little relief from the burning and itching of my skin. Halleluyah!
I began pouring over books and doing tons of research about nutrition, health and healing. For the first time I started thinking about what I was putting into my body and how it might affect me. I had an innate sense that my body was toxic and it was imperative that everything that came into and on my body needed to be clean and of the highest quality. The more I learned, the more astonished and dismayed I was at the toxins (chemicals, pesticides, hormones, etc) that are present in our food and environment. I came across the Paleo diet and the Weston A. Price foundation and I really started to understand the importance of food in healing and overall health. I was fascinated to learn about the vibrant health of our ancestors that were eating their traditional diets and how far we have strayed as a society from eating REAL FOOD! No wonder we are so sick! No wonder I was so sick! I grew up eating sugar, fast food and lots of refined carbohydrates. My cooking included mac and cheese from the box and cereal for dinner. I always thought about food this way…I could eat whatever I wanted because I was thin and a good athlete. I never once thought about how the quality of food affected me or could potentially affect me long term.
I always understood the importance of movement and exercise, however realized I needed to slow down. I was an athlete and I was used to pushing my body to the limits my whole life. I didn’t understand the value of rest and relaxation. Over-exercise without adequate rest will eventually break down your body. I began walking and doing yoga, versus the hard-core workouts I was accustomed to. I learned of the value of sleep and slept as much and as often as my body would let me. I began seeing holistic doctors and various alternative practitioners. I went through a battery of tests and found out I had multiple food allergies, parasites, fungal infections, heavy metal toxicity, etc. The list goes on. Basically, my immune system was severely compromised.
I finally turned a corner when I learned of this term called “leaky gut” that was likely contributing to a lot of my symptoms. It made sense considering that your gut is 70-80% of your immune system. I needed to heal my gut!! I took steps to begin the process of healing my gut (and I am still in the process) with diet, rest and supplementation. For the first time in a couple years I started to get relief from the rashes and they slowly began to go away….and bit by bit symptoms started to improve and I started to regain my health. My diet consists of a Paleo diet, minus nightshades and chicken eggs. I eat plenty of healthy fats, bone broths and fermented foods. 5 years later I have no more rashes and I was able to celebrate this year on beaches of Costa Rica…bare legs and bikini!! My journey has inspired me to help others and now have a blog with my husband called: http://www.paleosecret.com.
Chris…Thanks for all your research and work getting the word out about healing the gut and healing the body naturally!!! You are my “go to” guy for sound nutrition information and research. Healing my gut saved my life and my skin!!
Sincerely,
Brenda Walding, DPT, FDN
Wow! Your story sounds so much similar to mine. So sorry you went so long undiagnosed. I still haven’t been diagnosed either but had come across an article for leaky gut and since I had problems with my stomach over the years and taking anti acids I thought what the heck I will try taking some of my anti acids and then some probiotics and within three days what a difference. Like night and day. I really can tell a difference now by what I eat. The more I stay away from carbs he better. I believe it is leaky gut with candida. Thank you for sharing your story. God Bless
Hi Chris, something is going on with me but I have no idea what. I have always had great skin, spotty when a teenager re very oily but as I have got older it means my facial skin looks good, fewer lines and wrinkles so a youthful appearance that belies my age. I also have never suffered from eczema etc.
I started an evolving Paleo diet approx 18months ago, changing as I have learnt more.
First thing I did was to remove all grains/sugar and oils other than olive oil use on salads and using organic virgin coconut oil for cooking and fat from organic grass fed meat.
Within a few months I developed a very itchy tiny postule rash which turns scaly on the fingers of my right hand which developed less so on my left hand fingers and down on to my hands a little.
It seemed to me to be like a description of Dermatitis Herpeitformis and yet I didn’t have when eating grains. As if flaring up because of lack of gluten proteins – bemused?
I have had rheumatoid arthritis for 17yrs but have always refused medication preferring to use diet,
I wondered if it may be dairy that is the cause of the rash which to be honest I had very little of in previous years but had started eating yogurt for probiotics. I stopped eating thinking it may be the cause but the rash never properly went away even after 9months of no dairy. (lingers on one finger of my right hand) I decided after a while to try raw organic goats milk yogurt and the rash flared and spread immediately after one serving (I could be blaming it wrongly) As a week later the rash is stll active.
My mum is Coeliac but I have recently been tested and here in the UK they state that I test negative for DQ2 and DQ8. Even so I will still not be eating grains, but wonder if the rash could be caused by even the A2 raw goat yogurt and once eaten can cause an immune response that lasts for a long time, re my hand never quite healing. My rheumatoid symptoms also are worse when I have the intense rash. Oh also I have been taking colostrum for approx 6months hoping to gain health benefits, I understood that this was safe even if there may be a problem with dairy (I do not know that I have a problem with dairy which I did consume occasionally and as I have said never had a skin issue before starting Paleo) Can skin issues start when the body is suddenly deprived of gluten proteins – almost as if the Herpes virus is fighting for survival – that is what is going through my head. Have you ever heard of this before?
I would reall appreciate your thoughts.
It sounds like dyshydrotic eczema. I have this.
I’d recommend trying an auto-immune paleo diet and see if it helps. Dairy can be a problem for eczema for me
Going paleo, doing cleanses (ReNew Life’s different topics), cutting out GMO foods, eating organic/range raised, only using soap where the sun don’t shine, most recently adding lots of plain raw goat yogurt and milk has greatly improved my skin. The ecxema above my lips has just recently disappeared. Granted, it was greatly inflamed for several months, but that was due to the body eliminating it. For my horses when I put them on herbs they say to expect healing to take place at the rate of one month for every year of the disorder. Everyone that has posted how trying something and it didn’t work in 1, 2 or 6 months, you need to keep at it until the toxins are dealt with by the body.
Best Wishes and follow your Intuition!
I have a friend with psoriasis on her forehead. She ‘knows it comes from within’ (her words), but she doesn’t seem to want to address it. I think she is scared to change her routine of scrubbing the dickens out of her face every day, because she knows that works and gets her through her workday without a flare up. I mentioned trying a probiotic as a start and she was like no no no way. Would you have any advice for her on how to proceed? I don’t want to push the issue with her, but I can it is controlling her daily functioning. She is also addicted to the tanning salon, I get the feeling she feels it hides how her skin looks.
My rosacea didn’t really flare up until after I began a paleo diet last year. Since then I’ve been diagnosed with SIBO and I can absolutely say my skin clears up somewhat after being on antibiotics (I’ve been on two rounds so far.) The problem is after I’m done with the antibiotics about 2 weeks later my gut symptoms and breakouts return. Unfortunately being on a SCD diet hasn’t made much of a difference for me, and taking probiotics only worsens my skin if they include any bacteria from dairy. It is great that so many people report a diet change as being a large help but in my case it hasn’t.
I do believe in the gut-skin connection, but it isn’t always easy to figure out and apparently not always easy to heal the gut barrier. But I am going to keep trying!
I’ve been to a dermatologist as well and she has me putting a bunch of creams on my face, and of course that hasn’t done much of anything.
Hi Chris
My twin toddlers and I react to dairy by getting eczema. For me, eating dairy and then using dish soap seems to bring out eczema on my hands. Dish soap alone does not cause a problem. In the past I gave my boys raw milk from an Amish farm, hoping that this would help but it did not make a difference. I now give them dairy less frequently and they are able to tolerate it better. They can tolerate more dairy in the summer than the winter it seems before eczema appears. They are both gluten-free at home (I am gluten-free in order to avoid migraines – but celiac negative).
Not sure if this is helping or not but I usually start their meals with the meat portion, then give vegetables and then a starch at the end. I do this for several reasons, mainly to make sure that they don’t fill-up on carbs and ruin their appetite, but also feel that instinctively, this is how we would have eaten before the availablitly of so many grains. Does eating meat increase stomach acid right away and therefore kill off bacteria that might set-up camp in the small intestine?
Hi Everyone!
I am a firm believer in probiotics! My mother is 64 and she has concerned me for a while with her over use of antibiotics. She seemed to always have a cold of some sort. I finally convinced her to start using a probiotic called PB8, and not only has she not been sick she also has more energy, and her SKIN has a glow that I have not seen in a long time! I also have a 9yr old son with eczema that has shown improvment with a kids probiotic!
I have psoriasis and know that I have a leaky gut, so I’d bet if I could find a way to heal it I’d see improvement. I recently started eating mostly paleo. I plan on starting a sugar detox on 11/1 so hopefully if I add a probiotic too I’d see improvement. Do you have any probriotic brand recommendations?
Hey Chris,
this study: “And another recent study of 56 patients with acne showed that the consumption of a Lactobacillus fermented dairy beverage improved clinical aspects of acne over a 12-week period. (10)”
http://www.ncbi.nlm.nih.gov/sites/entrez/20692602
is about “Lactoferrin”-enriched products. Lactoferrin can be found in significant amounts in colostrum. Do you prefer colostrum to treat acne vulgaris?
I’ve noticed big improvement to my skin since going paleo. Butter is advertised as good fat but I noticed some pimples as soon as I introduced butter in my diet. Does Anyone have the same experience with butter?
I’ve noticed big improvement to my skin since starting paleo,
I am very dairy intolerant. Is it okay to drink kefir? or will it cause more problems?
Recently tried some homemade kefir from a local raw milk farm and it did not make me feel very good.
Hi Chris, I regret I won’t be able to come to the talk in November which upsets me deeply. My work schedule simply does not permit. Will you be giving a talk next year and if so, do you know what the talk will be about?
I have been on GAPS diet for almost four month. I believe the condition of my seborrheic dermatitis has improved. I still have ocasional flare ups, which could be related to die-off, environmental conditions like sun and wind, or, perhaps, something else. To heal the skin on my face, I treat it with diluted apple cider vinegar. I don’t use any soap on my face and it’s much better this way.