Derm Dispatch: The Gut-Skin Axis Moves From Fringe to Front Lines

Jessica DeLuise, PA-C, MHS, CCMS, didn't plan on becoming an Emmy Award–winning media personality. She planned on becoming a physician assistant—a decision rooted in her own teenage experience navigating polycystic ovary syndrome, primary amenorrhea, reflux with ulcers, and syncopal episodes. What she found through that patient journey was a clinician who made her feel heard, and she's been chasing that standard ever since.

Her path into culinary medicine grew from a similar place. Working in internal medicine, DeLuise noticed how directly nutrition affected her discharge patients—and how little support many of them had to act on dietary guidance once they left. She started selling health-focused snack bites at a local farmers market, doing food-as-medicine demonstrations that drew crowds. A presentation to a Girl Scout troop turned into media pitches, then television segments, and eventually a role as an on-air expert for QVC and a food and wellness contributor for Scripps News. She found out that she had won an Emmy in the middle of a telemedicine shift during the COVID-19 pandemic, after receiving what she initially assumed was a spam message.

The clinical substance of the conversation centers on something Renata Block, MMS, PA-C, sees regularly in dermatology practice: patients with hidradenitis suppurativa who spend months cycling through urgent care for incision and drainage without ever being referred appropriately. DeLuise knows that pattern from the other side. She describes building informal referral networks in her community—direct lines between urgent care and subspecialists — so patients can be triaged faster and treatment started earlier. "Once you get ahold of people, boy, your patient care is just up a degree, for sure," she says, acknowledging that tracking down the right contact isn't always easy. She extends the same logic beyond dermatology: A patient presenting with acanthosis nigricans in urgent care is a chance to prompt lipid or glucose screening. "While I'm not spending an inordinate amount of time, because it's not really my role," she says, "at least I can give them a little bit of guidance, recognize those signs and symptoms, and give them a path forward."

On supplementation, both clinicians land in the same place: Ask why. Patients taking a stack of supplements often have a specific symptom driving the decision, and that symptom is the real clinical lead. DeLuise notes that the question has surfaced undiagnosed iron-deficiency anemia and other underlying pathology that would otherwise have been missed. She's also clear about the limitations—supplement labeling is unreliable, additives are unknown, and quality varies enormously. "We don't know what the additives are, where they're coming from, if exactly what the label says is in that supplement is actually in the supplement," she says. Having a curated list of vetted recommendations ready for patients is a practical solution she uses in her own practice.

The conversation closes on the gut-skin axis, with Block raising emerging evidence linking specific probiotic strains to improvements in atopic dermatitis (AD), as well as prenatal pre- and probiotic use to reduce AD risk in offspring. DeLuise breaks down the distinction simply: "Probiotics are those live organisms, and prebiotics are, essentially, the food for the probiotics." She points to β-glucan from oats as a practical, low-cost prebiotic option—"inexpensive, ubiquitous, easy-to-use" and available at any grocery store. Her broader nutritional philosophy for busy patients: stock a good freezer, don't fear frozen produce, and embrace "naked meal prep"—batch-cooking plain proteins, grains, and vegetables that can be seasoned differently throughout the week, reducing friction without demanding perfection.