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Gut Health and Its Impact on the Skin


The gut-brain-skin axis is more important to overall health than previously understood, and prebiotics and probiotics play a large role in the benefits.

Renata Block, MMS, PA-C

Renata Block, MMS, PA-C

Literature and marketing about the body’s microbiome and gut health have become popular topics among our health-conscious patients. As a result, the discussion of prebiotics and probiotics and their significant role in maintaining gut health has gained popularity within the last few years. Though the research is still in its infancy, it continues to point toward the gut-brain-skin connection even more. Additional data suggests how much of what we eat or the supplements we take can impact our skin health—which leads us to explore the world of prebiotics and probiotics, how they affect gut health to help us absorb all of these nutrients, thus opening the door to the gut-skin axis and how it can ultimately affect our skin regarding inflammatory response skin diseases such as eczema, psoriasis, vitiligo, and acne.

Why is the Microbiome Important?

Many microorganisms colonize the human gastrointestinal tract, including bacteria, archaea, viruses, fungi, and protozoa. The activity and composition of these microorganisms (collectively known as the gut microbiota, microbiome, or intestinal microflora) can affect human health and disease.1

The balance of the microbiome on the skin and in our gut is an essential front line of defense, protecting us from unwanted germs. A good equilibrium helps break down food, releasing energy and vitamins to keep the body healthy. Since the body must coexist with the microbiome, it plays a crucial role in keeping our skin healthy. However, the body is exposed to daily external factors that can disrupt the homogeneous environment for optimal health. For example, a disruption in the harmonious environment by processed foods, antibiotics, stress, infection, disease, cancer, exogenous organisms, and many other factors can drastically change the composition and activity of the gut microbiota.2

The microbiome’s balance and effect on the skin were initially introduced in 2016 by Arcket al. Recent research and literature review point to a solid relationship between the gut-brain-skin axis and the gut microbiome balance vital to maintaining health and optimal immunity.3 In the end, we are discovering the importance of having a balanced gut microbiome and any imbalance leading to an increased risk of inflammatory responses that can exacerbate acne, psoriasis, atopic dermatitis, urticaria, and even the worsening of vitiligo. In addition, a chronic unhealthy mix of microorganisms can lead to a leaky gut syndrome, weakening the intestinal wall, which is already linked to asthma and eczema.4

How Can We Feed Our Gut Microbiome?

The American diet has changed drastically since the introduction of processed foods. Adding a prebiotic and a probiotic can assist in creating a homogenous environment of microorganisms in the gut. Breaking down the benefits of each leads to understanding why taking both is much more beneficial than either.

1. Prebiotics

The fermentation process in the gut is an important step and prebiotics act as a primary carbon source of this metabolic process and the growth of beneficial bacteria such as Bifidobacteria and Lactobacilli. Overall, the health benefits of prebiotic dietary fibers can affect gut barrier permeability, decrease pathogenic bacteria populations and allergy risks, increase calcium absorption, and improve immune system defense.2

Examples include non-digestible specialized plant fibers such as spirulina, fructans, galactooligosaccharides, pectin, resistant starch, and rhamnose. They naturally exist in different dietary food products, including asparagus, sugar beet, garlic, chicory, onion, Jerusalem artichoke, wheat, honey, banana, barley, tomato, rye, soybean, human's and cow's milk, peas, beans, etc., and recently, seaweeds and microalgae.5

Research has found that the oral administration of microalgae can modulate the gut microbiota, activate the immune system in the gut, and have powerful anti-inflammatory benefits.6 Generally, prebiotics play an essential role in human health and are found to be safe.

2. Probiotics

Live beneficial bacteria make up the definition of probiotics and are known to improve digestive health. The primary purpose is to "replace" the good bacteria in the gut that a variety of factors, such as oral antibiotics, stress, and inflammation, can deplete.

Familiar probiotic foods include yogurt, kefir, sauerkraut, kombucha, pickles, sourdough bread, and miso. However, many more exist and are now widespread in supplement form, which may confuse the consumer because certain strains of these supplements may do more harm than good. Knowing what strain is best for the condition is essential and must be shown to be effective in clinical trials. The most commonly found are Lactobacillus and Bifidobacterium, but specific strains for treating certain conditions, such as acne, include a type of Lactobacillus known as Rhamnosus SP1. Other strains that comprise the seven core genera of microbial organisms include Saccharomyces, Streptococcus, Enterococcus, Escherichia, and Bacillus.1

Probiotics can be helpful as they are known to help digest food and fight off pathogens. In addition, clinical trials have shown probiotics to be beneficial in preventing allergies in children and atopic dermatitis.

Probiotics differ from prebiotics because they contain live organisms and may need special storage. But, overall, they are found to be relatively safe.

Final Microbiome Thoughts

rh2010/Adobe Stock
rh2010/Adobe Stock

Many patients are more conscious about their diet, which supports their gut and digestive health, and as clinicians, we are at the front line of this discussion regarding skin health. Research shows that a healthy balance of gut microbiota is required for optimal skin health, creating metabolic and immune homeostasis. More research points to how compositional gut microbiota changes have been linked with exacerbating inflammatory skin diseases such as eczema, psoriasis, and more. Daily prebiotics and probiotics help keep a homogenous microorganism environment for optimal skin health.


  1. Probiotics fact sheet for health professionals. National Institutes of Health: Office of Dietary Supplements. Updated June 2, 2022. Accessed April 10, 2023. https://ods.od.nih.gov/factsheets/Probiotics-HealthProfessional/
  2. Carlson JL, Erickson JM, Lloyd BB, Slavin JL. Health effects and sources of prebiotic dietary fiber. Curr Dev Nutr. 2018 Jan 29;2(3):nzy005. doi: 10.10923/cdn/nzy005.
  3. Widhiati S, Purnomosari D, Wibawa T, Soebono H. The role of gut microbiome in inflammatory skin disorders: A systematic review. Dermatol Reports. 2021 Dec 28;14(1):9188. doi: 10.4081/dr.2022.9188.
  4. Fermented foods can add depth to your diet. Harvard Health Publishing: Harvard Medical School. Published April 19, 2021. Accessed April 10, 2023. https://www.health.harvard.edu/staying-healthy/fermented-foods-can-add-depth-to-your-diet
  5. Davani-Davari D, Negahdaripour M, Karimzadeh I, Seifan M, Mohkam M, Masoumi SJ, Berenjian A, Ghasemi Y. Prebiotics: definition, types, sources, mechanisms, and clinical applications. Foods. 2019 Mar 9;8(3):92. doi: 10.3390/foods8030092.
  6. NeyrinckAM, Taminiau B, Walgrave H, Daube G, Cani PD, Bindels LB, DelzenneNM. Spirulina protects against hepatic inflammation in aging: an effect related to the modulation of the gut microbiota? Nutrients. 2017 Jun 20;9(6):633. doi: 10.3390/nu9060633.
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