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The connection between gut health and skin conditions has drawn increased scientific interest, with research spotlighting the “gut-skin axis.” This complex relationship sheds light on why conditions like dermatitis may be worsened by imbalances in the gut, often linked to a condition known as leaky gut, or increased intestinal permeability. Understanding this connection can empower those with dermatitis to explore nutrition and lifestyle strategies that may relieve their symptoms. This article covers:
What is Leaky Gut?Leaky gut refers to a state where the lining of the small intestine becomes more permeable than it should be. In a healthy digestive system, the gut lining serves as a selective barrier, regulating what enters the bloodstream. However, when this barrier is compromised, larger particles—such as undigested food particles, toxins, and bacteria—can pass through, triggering an immune response. This constant immune activation can lead to chronic, low-grade inflammation, which has been associated with a variety of health issues, including autoimmune conditions and inflammatory skin diseases like dermatitis. How Does Leaky Gut Affect Skin Health? Leaky gut can contribute to skin inflammation and worsen dermatitis through several mechanisms: Systemic Inflammation: When particles that shouldn’t be in the bloodstream cross over, it activates the immune system. This chronic, low-grade inflammation can affect various parts of the body, including the skin. For those with dermatitis, this inflammatory response can increase skin irritation and itching. One mechanism by which leaky gut impacts dermatitis is through T-helper cells, a type of immune cell that becomes overactive in response to foreign particles. This overactivity can lead to increased skin inflammation, as Th cells promote the release of inflammatory compounds. Individuals with dermatitis often show a skewed Th cell response, and leaky gut may exacerbate this immune imbalance, leading to more intense or frequent skin flare-ups. Microbial Imbalance: The gut is home to a large population of bacteria that help regulate immune health. A leaky gut often goes hand in hand with a microbial imbalance, known as dysbiosis. Studies show that people with dermatitis, like eczema, often have different gut bacteria compositions than those without skin issues, suggesting a connection between gut imbalance and the severity of skin conditions. The gut microbiome, or the collection of trillions of bacteria living in the gut, plays a critical role in maintaining gut health and integrity. A balanced microbiome can help regulate immune responses and support a healthy gut barrier. However, in individuals with leaky gut, there is often an imbalance in gut bacteria, a condition known as dysbiosis. This imbalance may result from dietary choices, antibiotic use, or stress, and it can lead to increased gut permeability and a higher likelihood of immune dysregulation. Immune System Overactivity: With a more permeable gut, the immune system is exposed to foreign particles more often, leading to heightened immune responses. In atopic dermatitis, a common form of dermatitis, this overactive immune system plays a large role in flare-ups and worsening symptoms. For individuals with dermatitis, leaky gut can influence the skin by shifting the immune system into a more reactive state. This heightened immune response is particularly relevant in dermatitis, which involves an imbalance of immune activity that leads to skin inflammation, dryness, and irritation. When undigested food particles or pathogens pass through the leaky gut wall, they are flagged by the immune system as foreign invaders. The result is a chronic inflammatory reaction that can affect the skin, worsening dermatitis symptoms. Links Between Dysbiosis and Eczema Studies indicate that people with eczema, a common form of dermatitis, often have less diversity in their gut microbiome compared to those without skin issues. This reduced diversity may weaken the gut lining and increase inflammation. Some research even suggests that promoting a healthy gut microbiome through probiotics and prebiotics can help regulate immune responses and reduce the severity of eczema symptoms, particularly in young children. (1–3) The Gut-Liver-Skin Axis Recent studies propose that the liver also plays a role in this connection, as it detoxifies compounds that have entered the bloodstream from the gut. When leaky gut allows more toxins to enter the bloodstream, it can overload the liver, leading to increased inflammation that ultimately affects the skin. This is sometimes referred to as the “gut-liver-skin axis,” and it may further explain how gut health influences skin conditions like dermatitis. The Impact of Nutrient Deficiencies on Gut and Skin Health Nutrient deficiencies can worsen leaky gut by weakening the gut barrier, making the skin more susceptible to inflammation. Here’s a closer look at a few key nutrients that play an important role in maintaining a healthy gut and resilient skin:
5 Nutrition Tips to Support Gut Health and Manage Dermatitis Adding to the above nutrient highlights, here are five practical nutrition tips to further support gut health:
Additional Lifestyle Practices to Consider In addition to diet, managing stress, getting sufficient sleep, and limiting NSAID and antibiotic use can all help maintain gut integrity and reduce inflammation. Chronic stress, for instance, increases cortisol levels, which can weaken the gut barrier over time. Similarly, restorative sleep supports immune health and skin repair, making it an essential component of a gut-skin-friendly lifestyle. The connection between leaky gut and dermatitis reinforces the idea that good gut health is foundational to skin health. By focusing on gut-supportive nutrition, managing stress, and incorporating lifestyle changes, those with dermatitis may find relief from symptoms and improve skin resilience. Working with a Registered Nutritional Therapist can provide personalised guidance for integrating these practices and ensuring nutrient needs are met to support both gut and skin health References 1. Nekrasova AI, Kalashnikova IG, Bobrova MM, Korobeinikova A V., Bakoev SY, Ashniev GA, et al. Characteristics of the Gut Microbiota in Regard to Atopic Dermatitis and Food Allergies of Children. Biomedicines. 2024 Mar 1;12(3).
2. Bjerre RD, Holm JB, Palleja A, Sølberg J, Skov L, Johansen JD. Skin dysbiosis in the microbiome in atopic dermatitis is site-specific and involves bacteria, fungus and virus. BMC Microbiol. 2021 Dec 1;21(1). 3. Pachacama López AF, Tapia Portilla MF, Moreno-Piedrahíta Hernández F, Palacios-Álvarez S. Probiotics to Reduce the Severity of Atopic Dermatitis in Pediatric Patients: A Systematic Review and Meta-Analysis. Actas Dermosifiliogr. 2021 Nov 1;112(10):881–90.
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For those managing chronic skin conditions, the link between gut health and skin health has become an exciting area of study.
Most people know about probiotics (the beneficial gut bacteria) and prebiotics (the foods that nourish them), but the latest focus is on postbiotics, the valuable by-products produced when probiotics consume prebiotics. Unlike probiotics, these compounds don’t need to survive digestion to be effective, making them stable and ready to support both gut and skin health. From building a stronger skin barrier to reducing inflammation, postbiotics offer a new way to approach skin care from the inside out. But how exactly do they work, and how can you incorporate them into your daily routine? Here’s what you’ll find in this article:
By the end, you’ll see how focusing on postbiotics can be a powerful addition to your skincare approach, linking the latest science with practical solutions. What Are Postbiotics? Think of probiotics as the beneficial bacteria that live in your gut and prebiotics as the specific nutrients that feed them. Postbiotics are the beneficial compounds produced because of this interaction, which includes short-chain fatty acids (SCFAs), peptides, enzymes, and even fragments of bacterial cell walls. Unlike probiotics, which are live bacteria, postbiotics are stable and do not require live bacteria to survive digestion to provide health benefits. These finished products of microbial fermentation interact with the gut and immune system in unique ways. For example, SCFAs like butyrate, acetate, and propionate have been shown to support immune function and reduce inflammation, providing a promising new tool for managing both gut and skin health. (1) Postbiotics and Skin Barrier Function A particularly exciting aspect of postbiotics is their impact on the skin’s barrier function. The outermost layer of the skin, the stratum corneum, acts as a barrier, protecting against irritants, allergens, and pathogens. Recent research suggests that certain postbiotics can improve skin hydration and support the production of ceramides, lipid molecules that maintain the skin’s integrity and moisture levels. (2) By promoting hydration and strengthening the skin barrier, postbiotics may help to reduce the risk of common skin issues like dryness, sensitivity, and atopic dermatitis. SCFAs such as butyrate, produced by gut bacteria, have also been linked to the regulation of keratinocyte differentiation – the process where skin cells mature and migrate from the deeper layers of the skin to the surface, creating a strong, protective outer layer. This helps our skin defend against environmental stressors, pollutants, and dehydration. Additionally, studies have found that bacterial by-products like lipoteichoic acids from certain gut bacteria can positively influence the composition and function of the skin barrier, potentially reducing susceptibility to skin conditions such as eczema and dry skin. (1) Postbiotics and Immune Modulation The gut’s extensive network of neurons and immune cells has earned it the reputation of the body’s “second brain.” Postbiotics play a crucial role here, as they can modulate immune responses locally in the gut and systemically throughout the body (3). SCFAs such as acetate, propionate, and butyrate have been shown to possess anti-inflammatory properties, balancing immune activity and reducing chronic inflammation – a factor often linked to skin disorders such as psoriasis and atopic dermatitis. Moreover, postbiotics are known to support the production of regulatory T cells (Tregs), which help maintain immune tolerance and prevent overactive immune responses. This immune modulation may be particularly beneficial for individuals with inflammatory skin conditions, helping to reduce flare-ups and maintain healthier skin over time. Therapeutic Potential of Postbiotics in Skincare and Supplements Given their dual impact on the skin barrier and immune system, postbiotics are generating interest in both nutrition and dermatology. Topical applications of postbiotics are being explored as next-generation skincare ingredients, aiming to improve hydration, reduce inflammation, and balance the skin microbiome. Early studies on topical postbiotics show promising effects for managing conditions like acne, eczema, and rosacea. (4) In the realm of nutrition, postbiotic supplements may offer a more stable alternative to probiotics, as they don’t require live bacteria to be effective. This stability makes them resilient to the harsh conditions of the digestive system, providing a reliable way to improve gut health and, consequently, support skin health from the inside out. We can also support our postbiotic out put by giving our probiotics plenty of prebiotics, read on to find out how. How Postbiotics Can Help You Achieve Healthier Skin If you’re dealing with chronic skin issues, new research on postbiotics could open doors to better skin care from the inside out. Incorporating certain foods and products into your routine can help your body naturally produce postbiotics that support both gut and skin health. Foods rich in fermentable fibres, like oats, garlic, and onions, are great options—they encourage the production of short-chain fatty acids (SCFAs), a type of postbiotic known to benefit the skin barrier and reduce inflammation. I wrote an article specifically on SCFAs recently which you can access here Adding postbiotic supplements or topical skincare products with postbiotic ingredients may also help nourish and protect your skin. Together, these approaches offer a holistic way to strengthen your skin’s natural defences and balance your skin microbiome. As research continues, we’re likely to see even more personalised ways to harness postbiotics for specific skin needs. By understanding an individual’s unique microbiome, experts can tailor recommendations for foods, supplements, or skincare products that best support healthy skin and gut function. Looking Ahead: The Promise of Postbiotics for Gut and Skin Health With a growing understanding of postbiotics, these once-overlooked by-products of our gut bacteria are now seen as powerful compounds with far-reaching effects. From dietary changes to skincare and supplements, postbiotics offer a new way to support skin health that’s grounded in cutting-edge science. Whether you're looking to improve hydration, strengthen your skin barrier, or reduce irritation, postbiotics provide a promising path to healthier skin and a balanced gut. 5 Practical Tips for Getting Postbiotics Through Nutrition
These steps not only help increase postbiotics but also promote a healthier gut microbiome and, by extension, support skin health. References:
Atopic dermatitis (AD), commonly known as eczema, is a chronic inflammatory skin condition characterised by dry, itchy, and inflamed skin. Nutrition plays a crucial role in managing this condition, but when it comes to dietary choices, not all diets are created equal. The vegan diet, which excludes all animal products, has gained popularity for its ethical, environmental, and health benefits.
However, while a vegan diet can provide a wealth of nutrients, it may pose certain challenges for those trying to manage atopic dermatitis, especially if they need to follow a low FODMAP diet or avoid common triggers like tomato and soy. This article will explore the potential pitfalls of a vegan diet for those with eczema and provide insights on how to optimise a vegan diet whilst managing atopic dermatitis. Potential Nutrient Deficiencies One of the main concerns with a vegan diet is the potential for nutrient deficiencies. Key nutrients that are often lacking in a vegan diet include:
Challenges for Those Following a Low FODMAP Vegan Diet For individuals with atopic dermatitis who also need to follow a low FODMAP diet due to gut sensitivity or irritable bowel syndrome (IBS), managing a vegan diet can be even more challenging. The low FODMAP diet restricts certain types of fermentable carbohydrates that can cause gut distress, and many plant-based protein sources, such as beans, lentils, and certain vegetables, are high in FODMAPs. This restriction limits the variety of plant-based foods that can be consumed, potentially leading to inadequate protein, fibre, and micronutrient intake. In addition, a lack of plant-based foods diversity can negatively impact the gut microbiome, which is increasingly recognised as a key factor in managing atopic dermatitis. My Tip: Focus on low FODMAP plant-based proteins such as firm tofu (if soy is tolerated), tempeh, canned lentils (in limited quantities), quinoa, and small amounts of nuts and seeds. It may also be helpful to work with a Registered Nutritional Therapist to ensure adequate nutrition while following both a vegan and low FODMAP diet. Avoiding Common Triggers Like Tomato and Soy Tomato and soy are common triggers for some individuals with atopic dermatitis. Tomatoes are high in natural acids and certain compounds that can aggravate skin conditions in sensitive individuals. Soy, on the other hand, is a common allergen and can also be a high FODMAP food depending on the form consumed (e.g., soy milk from whole soybeans). For vegans who need to avoid both tomatoes and soy, their diet can become extremely restrictive. Soy is a staple protein source in many vegan diets, and avoiding it requires careful planning to ensure adequate protein intake. Similarly, tomatoes are commonly used in sauces and plant-based dishes, making it necessary to find suitable substitutes. My Tip: Opt for alternative protein sources like chickpeas (if tolerated), lentils, quinoa, hemp seeds, and pea protein. For cooking, use alternatives like coconut aminos instead of soy sauce and prepare tomato-free sauces using ingredients like roasted red peppers, carrots, or butternut squash. Coconut aminos can be found in some health food shops or on Amazon. Overreliance on Processed Vegan Foods The rise of veganism has led to an increase in the availability of vegan processed foods, which are often high in refined sugars, unhealthy fats, and additives. These processed foods can trigger or exacerbate inflammation, potentially worsening atopic dermatitis symptoms. Many processed vegan foods lack the necessary micronutrients that whole foods provide, leading to possible nutritional imbalances. My Tip: Focus on a whole-food, plant-based diet rich in fruits, vegetables (low FODMAP if necessary), nuts, seeds, legumes (low FODMAP alternatives), and whole grains. Minimise the consumption of processed vegan options to support better skin health. Imbalance in Omega-6 and Omega-3 Fatty Acids A vegan diet, especially if heavily reliant on vegetable oils like sunflower, safflower, and corn oil, may lead to an imbalance between omega-6 and omega-3 fatty acids. Omega-6 fatty acids, while essential, can promote inflammation when consumed in excess, particularly when not balanced with anti-inflammatory omega-3s. This imbalance can contribute to a flare in inflammatory skin conditions such as atopic dermatitis. My Tip: Incorporate more omega-3-rich plant foods, such as chia seeds, linseeds, hemp seeds, and algae-based supplements, to maintain a better balance of omega-6 to omega-3 fatty acids. Gut Health Considerations The health of the gut microbiome is increasingly recognised as a critical factor in managing atopic dermatitis. A vegan diet that lacks diversity can impact gut health negatively. Additionally, certain plant compounds, such as lectins and oxalates, can irritate the gut lining in sensitive individuals, potentially contributing to increased intestinal permeability ("leaky gut") and inflammation. My Tip: Ensure a diverse intake of plant-based foods, including various fibre sources like fruits, vegetables (adjusting for FODMAPs if needed), legumes, and fermented foods (e.g., sauerkraut, kimchi, and miso), to support a healthy and diverse gut microbiome. Personalised Nutrition: Not One Size Fits All While a vegan diet can offer many health benefits, it is not necessarily suitable for everyone, especially those managing a chronic condition like atopic dermatitis. Nutritional therapy should be tailored to individual needs, considering specific deficiencies, intolerances, and sensitivities. For some, including small amounts of high-quality animal-based foods or supplements may be necessary to achieve optimal nutrient balance and skin health. Tip: Work with a Registered Nutritional Therapist who specialises in skin health to create a personalised nutrition plan that addresses your unique needs and supports your skin condition. Conclusion A vegan diet can provide numerous health and planetary benefits, but it is essential to approach it with caution when managing atopic dermatitis, particularly if following a low FODMAP diet or avoiding common triggers like tomato and soy. Paying attention to nutrient intake, minimising processed foods, balancing fats, and supporting gut health are crucial steps in ensuring a vegan diet supports rather than hinders skin health. As always, personalised guidance from a qualified professional is key to navigating the complexities of nutrition and skin health effectively. By understanding these potential pitfalls, those with atopic dermatitis can make more informed dietary choices that help manage their condition more effectively. |
AuthorI’m Jessica Fonteneau, I’m the eczema specialist and I help people Escape from the Eczema trap. Archives
December 2024
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