Gut Health and Acne: Understanding the Connection & Ways to Heal

Acne starts around puberty as hormone changes occur and impacts over half of teens.

Having whiteheads and other forms of pimples can negatively impact self-image and confidence, especially in severe cases.

Acne can continue into adulthood, with adult acne occurring more commonly in women (12%) than men (3%).

In the past, acne was primarily related to increased androgen hormone levels and their effect on the skin and oil production.

But now we know there are many interacting factors like genetics, hormones, oil production, skin types, and gut bacteria that cause acne. 

Additionally, research has shown increased insulin and insulin-like growth factor I(IGF-1) levels are also associated with acne, which can be positively influenced by diet choices. 

Zooming out and looking at the whole picture of health can improve acne. 

Diet and lifestyle changes while partnering with a dermatologist and dietitian can fast-track your acne improvement and overall health.

Keep reading to learn more about the link between nutrition, gut health, and acne. 

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Gut Health and Acne: What’s the Connection?

The microbiome in your digestive tract may improve overall digestion, immune function, and even heart health.

Now, researchers have found a link between poor gut health and skin conditions, including acne.  

Understanding the Gut-Skin Connection

In recent years, research has focused on altered gut bacteria levels and its contribution to system-wide inflammation. 

Studies have demonstrated that gut inflammation affects the whole body, including imbalanced skin regulation, which manifests as acne or other inflammatory skin conditions.

The first large study on the gut-skin connection from 2001 found that half of patients with acne also had gut dysbiosis (imbalance of gut bacteria). 

A 2022 narrative review, including 14 human studies, reports unfavorable changes in gut bacteria in people with acne or acne improvement with the addition of beneficial gut bacteria. 

Gut dysbiosis can lead to a skin imbalance.

Other factors beyond diet cause acne, but gut bacteria is important to address. 

The Role of Inflammation

Acne is a chronic inflammatory skin disease.

Pro-inflammatory markers can trigger acne progression, and inflammatory diet choices can aggravate acne and increase inflammation in the body. 

Down-regulating (or reducing inflammation) in the body can help improve acne and inflammatory skin conditions. 

Research indicates that omega-6 fats (inflammatory fats) aggravate acne, psoriasis, and atopic dermatitis severity.

Omega-3 fats (anti-inflammatory) can reduce inflammation and IGF-1 levels, improving acne. 

Impact of a Leaky Gut

Gut dysbiosis can lead to a leaky gut (intestinal permeability) and whole-body inflammation. 

The intestinal lining is made of cells tightly joined together.

There are passageways that allow nutrients to pass (or permeate) from the digestive system to the bloodstream.

This intestinal barrier can become more permeable, allowing more substances to  “leak” through. 

Unfavorable bacteria or toxins could pass through the intestinal wall and stimulate an inflammatory response, which may worsen existing acne by altering skin homeostasis.

Factors including diet, stress, or medications can alter the normal intestinal cell wall, increasing intestinal permeability. 

Common Skin Conditions Linked to Gut Health

A few skin conditions have been linked to gut health, such as acne, psoriasis, and eczema. 

Acne

The 2022 narrative review mentioned above discussed the higher prevalence of gut dysbiosis in people with acne.

When gut health was restored to a favorable balance, acne improved. 

Studies have shown that when antibiotics are used to treat acne, there is a reduction of gut bacteria strains associated with acne, along with the reduction of bacteria on the skin.

Psoriasis

In individuals with psoriasis and bowel disease, the severity of psoriasis correlated with the severity of their bowel disease.

Dietary and lifestyle factors are regulators of gut health, and poor gut health is related to worsened psoriasis. 

Eczema

Eczema often starts in children causing an itchy skin condition and is related to food and environmental allergies. 

The gut is populated with different types of bacteria starting from birth.

Type of birth, formula, breast milk, and environment are just a few factors that influence gut bacteria types. 

Research shows that children with a greater diversity of gut bacteria have a decreased risk of eczema.

Eczema severity improves in children and adults with improved gut bacteria caused by diet changes and the addition of probiotics. 

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Potential Treatments for Gut Health and Acne

There are several strategies you can try to improve your gut health, like making dietary and lifestyle changes or possibly starting a probiotic.

‍Your dietitian can review the best options and help you make changes. 

Further understand your digestive health by taking the gut health quiz!

Diet and Lifestyle Changes

A diet rich in fruits, vegetables, whole grains, beans, lean protein like chicken or turkey, and omega-3 fats like nuts, fish, and flaxseed boosts vitamin and mineral intake, fuels beneficial gut bacteria, and maintains optimal glucose and insulin levels.

Overeating carbohydrates like sugar or sugary drinks, white pasta, bread, and rice eaten without protein or fiber foods can increase blood sugar and insulin levels.

‍Increased insulin levels have been correlated to worsened acne. 

Probiotic and Prebiotic Supplements

The authors of the 2022 narrative review found that the combined effect of antibiotics and oral probiotics yielded acne improvement by reducing unfavorable bacteria and facilitating beneficial gut bacteria in 45 patients with acne treated for twelve weeks. 

Additionally, four studies reviewed revealed that oral probiotics helped improve acne significantly. 

In three recent studies, topical probiotic lotions decreased skin lesions, redness, and inflammation.

More clinical research trials are currently in progress regarding the efficacy and types of probiotics to improve acne. 

Other skin conditions (psoriasis and eczema) improve by adding probiotics that help diversify gut bacteria. 

Anti-Inflammatory Foods 

Inflammatory markers are elevated during acne flare-ups.

Foods known to be anti-inflammatory include fruits, vegetables, and omega-3 fats.

However, there are limited studies on specific foods that reduce acne severity. 

A 2020 systematic review found that foods high in carbohydrates and lower in fiber, dairy, fat, and chocolate promote the formation of acne lesions, while the intake of fruits and vegetables was protective.

Research supports diets high in omega-3 fats instead of omega-6 fats to reduce and prevent inflammation in skin conditions, including acne. 

Stress Management

Stress negatively impacts your body's ability to repair and heal.

Stress can increase the inflammatory response.

It may take some experimentation to reduce your stress levels.

Many people find that activities like listening to music, journaling, exercising, and deep breathing reduce stress.

Consultation with a Dermatologist and Registered Dietitian

Working with a dermatologist and registered dietitian can ensure you cover all the factors that impact acne severity and improvement. 

A dermatologist can provide insight into medications, your specific acne and skin type, and any possible testing.

A dietitian can help you plan an acne-friendly diet and ensure you are fueling your body to feel and perform its best. 

Preventing Future Breakouts

Maintaining an anti-inflammatory lifestyle and diet can help prevent breakouts in conjunction with treatment recommended by a dermatologist. 

A dermatologist and dietitian can also help find appropriate probiotic supplements or topical creams suited to your needs. 

Fueling the body and maintaining a state of down-regulating inflammation will help reduce the severity or frequency of breakouts. 

An anti-inflammatory diet provides a variety of vitamins, minerals, and fiber that help to restore and maintain gut health.

The more you can control possible contributors to acne, the more you can pinpoint your acne triggers. 

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Takeaway

Acne often begins around puberty but can continue into adulthood.

Diet and lifestyle can exacerbate the severity and frequency of outbreaks.

Try some of these tips and seek care from a dermatologist and dietitian for a holistic approach. Start with an anti-inflammatory diet. 

How a Dietitian Can Help

If you’re struggling with acne and need help with diet and lifestyle changes, consider working with a gut health registered dietitian. 

Book an appointment with a Nourish dietitian today.