How gut health affects our skin

gut health skin

Research is now starting to show an emerging connection between gut health and our skin, according to Deputy Director of Research at The Skin Hospital in Sydney, Dr Philip Tong.

This is of particular interest to people living with acne, as research has already confirmed that foods high in processed sugar and some high glycemic index (high-GI) foods may have a role to play in triggering adult acne. 

Dr Tong, who’s also a practicing clinical and academic dermatologist in Sydney, explains this connection and discusses whether taking probiotics or changing your skincare products can help improve acne.

The ‘rainforest of bugs’ that live in and on us

Over the past 10 years, researchers have discovered a plethora of healthy microbes that live both on our skin and in our gut, Dr Tong says.

He says the gut-skin axis is much more complex than we can imagine. “The skin is coated by a ‘rainforest of healthy bugs’ that live on our skin as well as in the lining of our gut. 

“We now know that this microbial diversity helps to educate our immune system within the lining of our gut, as well as our skin.”

If that delicate balance is changed, that can result in skin problems such as acne, psoriasis, eczema and rosacea, he says.

Which foods affect our skin?

There are plenty of myths about how diet affects our skin, such as whether eating too much chocolate causes acne. 

It’s not the type of food that matters, but how much sugar and dairy it contains. Dr Tong says research has shown that a high intake of dairy and sugar can cause acne breakouts. 

“Foods with a higher glycemic index can also cause acne breakouts, so we advise people prone to acne to moderate these types of foods.” 

He says he’s also observed that people who tend to use a lot of protein supplements – before and after workouts – can also be prone to more back acne, particularly in men. 

“This may be due to the sugar or protein load associated with these supplements.”

Do probiotics help acne?

People with acne tend to have a distinct gut microbiome “signature”, Dr Tong says. 

“We suspect that this is caused by a disruption in the ‘harmony of healthy microbes’ that live on the skin – potentially caused by diet and sometimes other factors,” he said. 

So people are now asking if it’s possible to use products like probiotics to improve gut health and, in turn, our skin. And early-stage research suggests that may well be the case. 

Probiotics are living organisms that can help improve the microbiome, or return the microbiome to its normal state, Dr Tong says.

“This is a fascinating area of research, and there has been early evidence to suggest that probiotics may also improve skin health and conditions like acne.” 

Research is already underway to investigate whether applying probiotics and prebiotics directly to the skin can help improve acne. 

“This is still an emerging area of research, so we’ll have to wait and see, because the evidence isn’t quite there yet,” Dr Tong says.

Skincare products can change the microbiome

Dr Tong cautioned people with acne against scrubbing or washing their skin with harsh products, as this can also disrupt that delicate balance of microbes. Even using fragranced products can affect your skin, Dr Tong says. 

“They can all change the delicate balance of bacteria, fungi and viruses which live in perfect harmony on the skin.

“Any one of these factors can push it in one direction, and that can cause a number of skin conditions such as acne and rosacea that we now know are linked to changes in the microbiome.” 

Less is more when it comes to skincare, Dr Tong says.“Keep it simple. Use a simple cleanser and a fragrance-free moisturiser to improve skin health and reduce the risk of breakouts.”

Dr Tong often asks his patients to bring their skincare products to their consultation so he can check the ingredients that they’re using. 

“Even the combination of products can sometimes be a problem. By the end, I often find I’m helping them save a lot of money by streamlining their skincare routine too.”

Dr Tong is a dermatologist in private practice in Sydney and a visiting specialist at St Vincent’s Hospital. He’s also the Deputy Director of Research at The Skin Hospital and leads translational research at The Centenary Institute. He speaks widely on skin health and has a special interest in acne and acne scarring. 

Read more:

Getting skin breakouts from wearing a face mask? You could have ‘maskne’
How to deal with pimple breakouts as a teenager 
Lifestyle factors that may cause acne 
When to see a doctor about your acne


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The All About Acne team – the authors of this site – are a group of medically-trained skin experts from across Australia who have an interest in acne management. Our experienced team of leading dermatologists guarantees the information on this website is independent and based on the highest quality research available.

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