The gut-skin axis refers to the interactions between the gut and skin microbiome, and it contributes to the pathophysiology of inflammatory facial skin diseases such as acne and rosacea. A possible connection between the gut and the skin was first suggested in 1930 by two dermatologist, John H. Stokes and Donald M. Pillsbury.
The microbiome is defined as the total of all microorganisms and their genes in an individual, with the largest portion represented by bacteria. This dynamic system is individually unique and it can adapt to changing environments within a few hours. Aside from cultural heritage, birth, environmental factors, sleep and physical activity, diet is believed to have the greatest influence on the gut’s microbiome diversity.
A varied, plant-focused diet with a high content of dietary fiber is key for a diverse and balanced gut microbiome. A dysbiotic microbiome may have a significant impact on the immune system and thus on the development of skin diseases. If the gut microbiome or gut barrier is compromised, harmful metabolites can enter the blood-circulation, alter the skin microbiome, and compromise the integrity of the skin barrier.
Acne patients seem to have an imbalanced microbiome compared to healthy individuals. They may not only present with a disrupted skin microbiome with an overpopulation of the bacteria Cutibacterium acnes, but may also suffer from a disturbed intestinal flora with an overpopulation of other species of bacteria. In this context, future studies are needed to define the potential of an oral probiotic supplementation in the treatment of certain skin disorders. Until then, nutritional recommendations to increase the protective microorganisms in the gut and to alleviate skin symptoms include pulses, seeds, nuts, roots, vegetables, and fruit.
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