Can Gut Problems Cause Skin Issues? Understanding the Gut-Skin Connection
The short answer: Yes, your gut and your skin are closely connected. When digestion is off, whether from IBS, inflammatory bowel disease (IBD) or chronic constipation, it can raise inflammation in the body and affect how well your body clears waste and hormones. Over time, this can show up on your skin as eczema, acne, rosacea, psoriasis or other rashes. If your skin isn't responding to creams alone, your gut is worth a closer look.
What is the gut-skin connection?
The gut-skin connection (researchers call it the gut-skin axis) is the two-way relationship between your digestive system and your skin.
These two organs have a lot in common. Both are barriers between your body and the outside world. Both are home to trillions of bacteria. And both are deeply tied to your immune system.
When something goes wrong in the gut, the effects don't stay in the gut. Imbalanced gut bacteria and increased intestinal permeability are increasingly recognized as contributing factors in skin conditions like acne, psoriasis and eczema.
How does your gut affect your skin?
There are three main ways your gut influences your skin.
Your gut lining acts as a gatekeeper
Your gut lining decides what gets into your bloodstream. A healthy lining lets nutrients through and keeps out undigested food particles, bacteria and waste.
When the lining becomes irritated, it can get "leaky." In medicine, this is called increased intestinal permeability. Molecules that should stay in the gut can pass through, and your immune system responds with inflammation. That inflammation can show up on the skin.
Your gut bacteria shape inflammation
The bacteria living in your gut help train and calm your immune system. When that balance is disrupted (called dysbiosis), the body can become more inflamed overall, and the skin is often one of the first places it shows.
Your gut clears waste and hormones
Your liver packages up used hormones and waste and sends them into the gut to be eliminated through stool. When digestion is slow or the gut bacteria are out of balance, some of those hormones can be reabsorbed instead of cleared. This is one reason hormonal acne and gut health are often linked.
Which gut issues can cause skin problems?
Many common gut issues can disrupt the gut-skin connection, including irritable bowel syndrome (IBS), inflammatory bowel disease (IBD) such as Crohn's disease and ulcerative colitis, and chronic constipation. Whether the gut is irritated, inflamed or simply moving too slowly, the result can be the same: more inflammation in the body, an imbalanced microbiome, and a harder time clearing waste and hormones.
And the skin often reflects it. People with gut issues are more likely to experience eczema, acne, rosacea, psoriasis, hives and other rashes. In one study, more than half of adults with eczema also met the criteria for IBS, compared with about a quarter of people without eczema. With IBD, the skin is one of the most common places affected outside the gut, with conditions like psoriasis, tender red bumps on the shins, and painful skin sores. And a study of over 13,000 teenagers found that those with acne were more likely to have digestive symptoms like constipation, bad breath and reflux.
In my practice, I often see women who've been treating their skin and their digestion as two separate problems, when they're really two sides of the same story.
How do I know if my skin problem is coming from my gut?
Your skin issue may have a gut connection if:
Your eczema, acne or rosacea doesn't respond well to creams, or comes back as soon as you stop
You have regular bloating, gas, constipation or loose stools
Your skin flares after certain foods or stressful periods
You've taken several rounds of antibiotics
You've been diagnosed with a digestive condition like IBS, IBD or celiac disease
Your breakouts follow your cycle and you also struggle with constipation
How can I heal my gut to improve my skin?
Keep your skin care, and add the inside work
Gut support doesn't replace your skin treatments or prescriptions. It works alongside them. Keep doing what's helping on the outside while you look at what's happening inside.
Track your patterns
For two weeks, write down what you eat, how your digestion feels, your bowel movements, and how your skin looks. Add stress, sleep and your cycle if you can. Patterns often appear that you wouldn't notice day to day.
Support your gut basics
Fiber: feeds your good gut bacteria and keeps things moving
Fermented foods: like plain yogurt, kefir, sauerkraut or kimchi
Water: especially if you're increasing fiber
Regular movement: helps your gut move too
Stress care: your gut and skin are both sensitive to stress
Get a proper gut assessment
If your skin and gut symptoms have been hanging around for a while, guessing can only take you so far. A gut assessment looks at your full history, your symptoms, and, when helpful, testing such as stool analysis or breath testing for bacterial overgrowth. The goal is to find out what's driving the inflammation, so treatment can be targeted to you.
How long does it take for gut health to improve skin?
Your skin takes about a month to renew itself, and longer as we get older. When you start working on your gut, it usually takes a couple of months to see the difference in your skin. Small improvements at 6 to 8 weeks are a good sign you're on the right track.
Frequently asked questions
Can gut problems cause eczema?
Gut health is one of several factors that can contribute to eczema. Gut bacteria imbalance and increased intestinal permeability are linked with eczema, and gut issues like IBS appear more often in people with eczema. Working on gut health can be an important part of an eczema care plan, especially when topical treatments aren't enough.
Is leaky gut a real thing?
Yes. In medicine it's called increased intestinal permeability, and it's been studied in conditions like eczema, psoriasis, rosacea and IBD. "Leaky gut" is the everyday term for it.
Can constipation cause acne?
Constipation is linked to acne, particularly moderate to severe acne. Slow digestion can increase inflammation and affect how your body clears hormones, both of which play a role in breakouts.
Should I stop my skin creams if I'm working on my gut?
No. Gut support works alongside your skin care and prescriptions, not instead of them.
Who can help with the gut-skin connection?
If you've been dealing with stubborn eczema, acne or rashes, along with digestive symptoms that never quite settle, you don't have to keep treating them as separate problems. As a naturopathic doctor based in Leslieville, Toronto, I work with women across Ontario, in person and virtually, to look at the gut and the skin together.
If this sounds like you, a naturopathic doctor can see the holistic picture and connect the dots for you.
About the author
Dr. Negin Sayar, ND, is a naturopathic doctor in Leslieville, Toronto, with a focus on gut health, hormones and metabolic health. She trained as a medical doctor in Iran, and is a member of The Menopause Society. Dr. Sayar is regulated by the College of Naturopaths of Ontario and offers virtual care across Ontario.
This article is for educational purposes and is not a substitute for individual medical advice.