Can An Unhealthy Gut Cause Skin Problems?

Can An Unhealthy Gut Cause Skin Problems?

Welcome to my blog post ‘Can An Unhealthy Gut Cause Skin Problems??’.

You may also be interested in the section of my blog dedicated to gut health, click here, in particular:

Can An Unhealthy Gut Cause Skin Problems?

Acne is a highly prevalent inflammatory skin condition.

It affects up to 90% of teenagers (1).

It is increasingly believed that the interaction between skin microbes and host immunity plays an important role in this disease, with perturbed microbial composition and activity found in acne patients. Cutibacterium acnes  is commonly found in sebum-rich areas and its over-proliferation has long been thought to contribute to the disease.

Acne also has close connections with the gastrointestinal tract, and many argue that the gut microbiota could be involved in the pathogenic process of acne. The emotions of stress (e.g., depression and anxiety), for instance, have been hypothesized to aggravate acne by altering the gut microbiota and increasing intestinal permeability, potentially contributing to skin inflammation. Over the years, an expanding body of research has highlighted the presence of a gut–brain–skin axis that connects gut microbes, oral probiotics, and diet.

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Although oral probiotics/prebiotics have been used in the past to prevent and treat bowel disease, evidence suggests that by adjusting the composition of the microbial community, probiotics induce immune reactions that expand beyond the gut to act on the skin Oral probiotics have been reported to enhance insulin sensitivity in animal models and regulate skin inflammation by interacting with gut-associated lymphoid tissue.

Certain strains of Lactobacillus encourage the production of IL-10 (an anti-inflammatory molecule) and promote T-regulatory cell function, which suggests that probiotics help balance the immune system.

Bifidobacterium coagulans (B. coagulans) also has immune-regulatory properties that can affect skin health.

Clinical trials have assessed the effect of probiotics on acne. Let’s highlight the findings of some:

  • Kang et al. reported that 8 weeks of topical Enterococcus faecalis treatment resulted in a 50% reduction in inflammatory acne compared with placebo. A 5% extract of Lactobacillus plantarum also reduced acne severity (i.e., acne size, count, and associated erythema).
  • In an Italian study, the group that received oral probiotics (250 mg of freeze-dried Bifidobacterium bifidum and L. acidophilus) as a supplement to acne treatment showed greater resolution of acne compared with the non-supplemented group. In addition, patients with probiotics supplementation showed greater tolerance of and compliance with oral antibiotics.
  • A recent clinical trial also indicated that probiotics decrease the side effects (i.e., vaginal candidiasis) associated with systemic antibiotics (i.e., minocycline) while providing synergistic benefits for inflammatory acne.

Taken together, the findings suggest that the microbiota plays an important role in acne pathogenesis and can be modulated for clinical improvement, but efforts should be made to identify the exact mechanisms and therapeutic effects of oral/topical probiotics in acne

There are also topical probiotics available.

Recent scientific evidence on topical probiotics and their effects on skin diseases has been reviewed (4)  and it is thought that they could also have the same benefit as oral probiotics in promoting positive bacterial balance to treat acne and other skin conditions.


  • Poor gut health can contribute to acne via leaky gut and the gut-brain axis.
  • Probiotics may well be helpful in improving acne.


  1. Potential Role of the Microbiome in Acne: A Comprehensive Review: click here.
  2. Acne vulgaris, probiotics and the gut-brain-skin axis: from anecdote to translational medicine: click here.
  3. The Skin and Gut Microbiome and Its Role in Common Dermatologic Conditions: click here.
  4. Topical Probiotics in Dermatological Therapy and Skincare: A Concise Review: click here.
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