The Bio-Fermentary / 01A: The Fundamentals of Gut Health / 01B: The Link Between Gut Health and Skin Health

The Link Between Gut Health
and Skin Health


When you look in the mirror, what do you see? Clear, radiant skin? Or an inflamed, red and irritated complexion?

The answer to this simple question can provide you with a deep insight into what’s going on beyond the surface. Where there is gut inflammation, there is often also skin inflammation linked to dysbiosis – an imbalance in your microbiome. And it is this imbalance which, more often than not, shows up on our skin and is a visual illustration of the gut-skin axis at work.

The skin is a great barometer of what is going on inside the body. If your skin is irritated, inflamed or congested, chances are high that there may be an imbalance in your gut.
– Carla Oates, The Beauty Chef Gut Guide

The skin is a great barometer of what is going on inside the body. If your skin is irritated, inflamed or congested, chances are high that there may be an imbalance in your gut.
– Carla Oates, The Beauty Chef Gut Guide

Just like the gut-brain axis – whereby our gut and brain are in constant communication via the vagus nerve – our gut and skin also enjoy a consistent dialogue via what is known as the gut-skin axis72. This pathway allows the gut and skin to communicate via the microbiome – so it makes sense that if our gut is out of balance or inflamed in any way, our skin is one of the first places to show symptoms.


The simplest way to understand exactly how our gut health affects our skin is to use the analogy of our gut as a garden. If the soil in the garden isn’t healthy, balanced and thriving with a good array of nutrients and bacteria, then the plants that grow within its soil will struggle to blossom. For glowing, healthy skin, we must first turn our attention to our gut.

While a significant number of skin conditions are either caused by – or linked to – gut health issues, diagnosing this link can be a complex task. This is because the symptoms we experience when faced with skin health issues are often similar in nature to those we experience when our gut is out of balance. If, for example, we consume something that triggers inflammation in the gut – such as gluten or dairy – we may experience a skin manifestation such as a rash or hives73
. This link may seem obvious, but it requires that we pay careful attention to our bodies and the substances that trigger a reaction.

Similarly, if we suffer from leaky gut or intestinal permeability, we may be unable to fully absorb and utilise the key nutrients, minerals and vitamins that are essential for glowing, healthy skin. Furthermore, if our gut is considered to be ‘leaky’, endotoxins which would ordinarily be processed and expelled may escape into our bloodstream, placing extra pressure on our liver, thereby causing our skin to pick up the slack and assist in the elimination of toxins. Leaky gut also causes inflammation in the body, which is implicated in most skin issues, from acne to eczema and psoriasis74.

To heal our skin, it’s therefore important to heal and nourish our gut garden first.


Did you know that people with rosacea and acne are at least ten times more likely to have gut issues? And that 34% of people with IBS show skin manifestations? Gut inflammation is also linked to premature ageing of the skin, also known as ‘inflammaging.’
– Carla Oates

While there are a myriad of skin conditions linked to gut health issues, here are a few of the most common.


Unfortunately, acne can be an incredibly complex skin condition to treat, as its underlying causes can be either hormonal, digestive – or both.

Hormonal acne may be the result of fluctuations in hormone levels or sensitivity to a certain hormone, such as testosterone. In fact, excess testosterone is a common contributor to acne, as it stimulates the sebaceous glands in the skin, resulting in excess oil production and clogged pores75
. Our stress hormone, cortisol, can also wreak havoc on our complexion by triggering inflammation in our gut, which then manifests on the skin.

Digestive acne is closely implicated with gut disorders such as leaky gut and SIBO. SIBO is ten times as prevalent in people with acne76
, and leaky gut syndrome may also contribute to local skin inflammation, which is seen in people with acne. This cycle can be self-perpetuating, as an imbalance of bacteria or leaky gut can cause inflammation and malabsorption issues, meaning the skin isn’t getting all of the essential nutrients it needs.


As one of the most complex skin conditions to diagnose and understand, eczema – or atopic dermatitis – can be triggered by seemingly anything. However, for many, food allergies and intolerances, as well as leaky gut, play a major part77 . To help keep symptoms at bay, it’s essential to avoid trigger substances – which may include gluten, dairy, corn or soy – and foster a diverse and balanced microbiome, as microbial diversity is linked to a more robust immune system and reduced skin inflammation78 .

“Put simply, fermentation is a process where bacteria and/or yeasts are used to break down sugars and starches in foods.”
– Carla Oates, The Beauty Chef Gut Guide


Similar to acne, those with SIBO are 13 times more likely to have rosacea79 – the redness or flushing that most commonly affects the cheeks and nose. Microbial diversity again plays a role in keeping symptoms at bay, so nurture your belly by enjoying a wide range of fibrous plant-foods and steer clear of potential triggers, like caffeine, alcohol and spicy foods, which are known to exacerbate rosacea80 .


Like eczema, this dry, flaky skin condition is thought to share a link with a leaky gut81 . When endotoxins and other compounds leak through the gut wall, the body stages an attack, which causes an inflammatory response in the body, and subsequently, leads to skin manifestations. Stress and emotional upset can exacerbate psoriasis, so be sure to incorporate meditation, breathwork and similar strategies into your everyday life to keep symptoms under control.

Keratosis Pilaris (KP)

Sometimes referred to by sufferers as ‘chicken skin’ – KP typically appears on the backs of the arms and thighs. The cause is also mysterious, but research shows that our gut health may be a contributing factor with KP linked to malabsorption issues and/or nutrient deficiencies. Provitamin A, which can be found in GLOW SUPERCHARGED, plays a key role in smooth, healthy skin and a deficiency in this key vitamin may contribute to KP82 . Essential fatty acids are also important in terms of fighting skin inflammation, so up your intake of fatty fish such as sardines and mackerel, as well as avocado, nuts and seeds, as well as our very own OMEGA ELIXIR™.

Ageing skin

As we age, collagen – the protein in our skin that keeps it looking firm and plump – naturally declines. But what we may not realise is that our gut changes too, as our ability to produce anti-inflammatory short-chain fatty acids also declines. These age-related modulations in our microbiome can trigger low-grade chronic inflammation which, as we’ve explored, can be the underlying cause of many skin and gut health issues. Low-grade inflammation that occurs with age – also known as ‘inflammaging’ – can contribute to premature ageing of the skin and body as well as dysbiosis in the gut and weakened intestinal barrier function.

While the ageing process is unavoidable, research suggests that by promoting a healthy gut and encouraging microbial diversity, we may help to slow down the effects of ‘inflammaging’ and and ameliorate some of its symptoms.83

27 Antvorskov, Julie C et al. “Dietary Gluten Alters the Balance of pro-Inflammatory and Anti-Inflammatory Cytokines in T Cells of BALB/c Mice.” Immunology 138.1 (2013): 23–33. PMC. Web. 3 Sept. 2018

28He, Mei, et al. “Effects of Cow's Milk Beta-Casein Variants on Symptoms of Milk Intolerance in Chinese Adults: a Multicentre, Randomised Controlled Study.” Nutrition Journal, BioMed Central, 25 Oct. 2017

29Hutkins RW, Krumbeck JA, Bindels LB, et al. Prebiotics: why definitions matter. Curr Opin Biotechnol. 2016;37:1–7. doi:10.1016/j.copbio.2015.09.001

30Gibson GR, Roberfroid MB. Dietary modulation of the human colonic microbiota: introducing the concept of prebiotics. J Nutr. 1995;125:1401–1412

31Slavin J. Fiber and prebiotics: mechanisms and health benefits. Nutrients. 2013;5(4):1417–1435. Published 2013 Apr 22. doi:10.3390/nu5041417

32 Tzounis, X, et al. “Prebiotic Evaluation of Cocoa-Derived Flavanols in Healthy Humans by Using a Randomized, Controlled, Double-Blind, Crossover Intervention Study.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, Jan. 2011,

33Shi, Lye Huey, et al. “Beneficial Properties of Probiotics.” Tropical Life Sciences Research, Penerbit Universiti Sains Malaysia, Aug. 2016

34Rodiño-Janeiro BK, Vicario M, Alonso-Cotoner C, Pascua-García R, Santos J. A Review of Microbiota and Irritable Bowel Syndrome: Future in Therapies. Adv Ther. 2018;35(3):289–310. doi:10.1007/s12325-018-0673-5

35Didari T, Mozaffari S, Nikfar S, Abdollahi M. Effectiveness of probiotics in irritable bowel syndrome: Updated systematic review with meta-analysis. World J Gastroenterol. 2015;21(10):3072–3084. doi:10.3748/wjg.v21.i10.3072

36Moayyedi P, Ford AC, Talley NJ, et al The efficacy of probiotics in the treatment of irritable bowel syndrome: a systematic review Gut 2010;59:325-332

37Kim, J. Y., Kwon, J. H., Ahn, S. H., Lee, S. I., Han, Y. S., Choi, Y. O., et al. (2010). Effect of probiotic mix (Bifidobacterium bifidum, Bifidobacterium lactis, Lactobacillus acidophilus) in the primary prevention of eczema: a double-blind, randomized, placebo-controlled trial. Pediatr. Allergy Immunol. 21, e386–93. doi: 10.1111/j.1399-3038.2009.00958.x

38Drago L, De Vecchi E, Toscano M, Vassena C, Altomare G, Pigatto P. Treatment of atopic dermatitis eczema with a high concentration of Lactobacillus salivarius LS01 associated with an innovative gelling complex: a pilot study on adults. J Clin Gastroenterol. 2014;48 Suppl 1:S47-S51

39 Gao L et al A Novel Postbiotic From Lactobacillus rhamnosus GG With a Beneficial Effect on Intestinal Barrier Function Front. Microbiol., 14 March 2019 |

40Gao L et al A Novel Postbiotic From Lactobacillus rhamnosus GG With a Beneficial Effect on Intestinal Barrier Function Front. Microbiol., 14 March 2019 |

41Tsilingiri K, Rescigno M. Postbiotics: what else? Benef Microbes. 2013 Mar1;4(1):101-7. doi: 10.3920/BM2012.0046. Review. PubMed PMID: 23271068.

42Gao, et al. “A Novel Postbiotic From Lactobacillus Rhamnosus GG With a Beneficial Effect on Intestinal Barrier Function.” Frontiers, Frontiers, 25 Feb. 2019,

43“Health Benefits of Fermented Foods: Microbiota and Beyond.” Current Opinion in Biotechnology, Elsevier Current Trends, 18 Dec. 2016,

44Victoria Bell, Jorge Ferrão, Lígia Pimentel, Manuela Pintado, and Tito Fernandes, One Health. Fermented Foods, and Gut Microbiota. Foods. 2018 Dec; 7(12): 195. doi: 10.3390/foods7120195

45Holscher, Hannah D. “Dietary Fiber and Prebiotics and the Gastrointestinal Microbiota.” Gut Microbes, Taylor & Francis

46Sun et al. Microbiota-derived short-chain fatty acids promote Th1 cell IL-10 production to maintain intestinal homeostasis Nature Communications 9, Article number: 3555 (2018)

47 Li M, van Esch BCAM, Henricks PAJ, Folkerts G, Garssen J. The Anti-inflammatory Effects of Short Chain Fatty Acids on Lipopolysaccharide- or Tumor Necrosis Factor α-Stimulated Endothelial Cells via Activation of GPR41/43 and Inhibition of HDACs. Front Pharmacol. 2018;9:533. Published 2018 May 23. doi:10.3389/fphar.2018.00533

48Gonçalves P, Araújo JR, Di Santo JP. A Cross-Talk Between Microbiota-Derived Short-Chain Fatty Acids and the Host Mucosal Immune System Regulates Intestinal Homeostasis and Inflammatory Bowel Disease. Inflamm Bowel Dis. 2018 Feb 15;24(3):558-572. doi: 10.1093/ibd/izx029.



51Birt, Diane F, et al. “Resistant Starch: Promise for Improving Human Health.” Advances in Nutrition (Bethesda, Md.), American Society for Nutrition, 6 Nov. 2013

52Gareau, Melanie G., et al. “Pathophysiological Mechanisms of Stress-Induced Intestina Damage.” Http://, 31 May 2008,

53Segerstrom SC, Miller GE. Psychological stress and the human immune system: a meta-analytic study of 30 years of inquiry. Psychol Bull. 2004;130(4):601–630. doi:10.1037/0033-2909.130.4.601

54Morey JN, Boggero IA, Scott AB, Segerstrom SC. Current Directions in Stress and Human Immune Function. Curr Opin Psychol. 2015;5:13–17. doi:10.1016/j.copsyc.2015.03.007

55Chen Y, Lyga J. Brain-Skin Connection: Stress, Inflammation and Skin Aging. Inflammation & Allergy Drug targets. 2014; 13(3):177-190 doi:10.2174/1871528113666140522104422

56Yoon, Mi Young, and Sang Sun Yoon. “Disruption of the Gut Ecosystem by Antibiotics.” Yonsei Medical Journal, Yonsei University College of Medicine, 1 Jan. 2018