Beauty 

The Emerging Link Between Gut Health and Acne

January 15, 2021 6 min read

Woman with mild acne looking into the camera

The body is a complex network with millions of interconnected processes occurring on a daily basis. Behind these ongoing pathways lies your gut, in charge of breaking down the foods you eat, absorbing nutrients, and supporting bodily functions such as energy production, hormonal balance, and mental health. 

If your gut microbiome is imbalanced, skin issues like acne might be your first hint that something is amiss. This article will explain the link between gut health and acne, proposing several lifestyle and dietary changes to consider if you're yearning for a fix. 

Understanding your skin and its functions

Your skin is your immune system's first line of defense. It's the largest organ, with three layers spanning around 20 square feet: the outer epidermis where acne rears its head, the structural dermis, and the protective subcutaneous fat. 

Each of these layers has a purpose of its own, but together, they constitute a barrier between the external environment and the body's essential organs. 

What is acne, exactly?

Pores cover your skin at the outer, epidermal layer. When these pores get blocked by oil, bacteria, dead skin, or dirt, you develop pimples. When these pimples occur repeatedly, it's called acne. 

Acne is the most common skin condition in the United States. While it's not life-threatening, it could lead to physical pain and emotional distress. Facial acne, in particular, can affect self-esteem and possibly lead to scarring. 

Acne can form anywhere on your body, but it's most common on the face, back, neck, chest, and shoulders. There are four types of acne:

  • Papules: Small, red bumps that appear when hair follicles are inflamed or infected
  • Pustules: Small, red pimples that have pus at their tip
  • Nodules: Solid, tender lumps under the skin
  • Cysts: Large, painful lumps under the skin that contain pus

What causes acne?

Each pore of your skin leads to a follicle made up of one hair and a sebaceous gland. When a gland secretes oil, it travels up the hair through the pore into the skin. This helps keep your skin lubricated and soft. However, when the glands secrete too much oil, dead skin and bacteria accumulate in the pores and acne results.

Acne stems from any number of triggers, including hormonal changes, birth control pills, corticosteroids, genetics, and sugar-laden diets. Puberty is the most vulnerable time to develop acne as it's linked to hormonal changes that affect oil production.

Once you've identified the root of your acne triggers, it's much easier to forge ahead in treating it.

The link between gut health and acne

More than 70 years ago, two dermatologists proposed a link between acne, mental health, and gastrointestinal mechanisms. Their hypothesis—aptly referred to as the gut-brain-skin axis—centered around how a person's emotional state can affect their intestinal microflora, increasing intestinal permeability and contributing to inflammation. 

Since then, modern research has validated that theory. A more recent review published in Gut Pathogens supports the ability of gut microbes and probiotics to influence systemic inflammation, oxidative stress, glycemic control, mood, and, you guessed it: acne.

In another review from the Journal of Clinical Medicineresearchers point to mounting evidence linking skin health to gut health. They postulate this connection may originate in the brain, with a substantial influence stemming from stress. Both animal and human studies have demonstrated that stress negatively impacts gut microflora, resulting in systemic inflammation. 

While more research is needed to determine the causal impacts of gut dysbiosis on skin conditions like acne, current research suggests a promising link. 

Acne cream on a woman's hand

Can probiotics help with acne?

Growing evidence sheds light on the potential relationship between probiotics and acne. Studies have demonstrated the capacity for certain probiotic strains to inhibit the activity of C. acnes, the primary bacteria responsible for acne. In doing so, the probiotics help restore the healthy bacterial balance of the skin's microbiome. 

When topically applied, probiotics have also proven useful for improving the skin barrier and producing ceramides. This can help soothe irritation from existing acne treatments, and some ceramides have even been shown to display antimicrobial activity against C. acnes

In one clinical trial, dermatologists at Kangnam St. Mary's Hospital in Korea found that eight weeks of topical treatment with E. faecalis reduced inflammatory acne lesions 50% compared to placebo. 

Another clinical study demonstrated the effectiveness of a 5% L. plantarum solution to improve the skin barrier and reduce redness caused by acne. Researchers attributed these effects to the antimicrobial peptides produced by the topical probiotic solution. 

As is the case with gut health and acne, more research is needed to determine the precise mechanisms and impacts of probiotics in acne. Once identified, probiotics may make an appearance in more than just the supplements aisle.

How can you manage acne?

For a condition expected to affect 85% of people at some point in their lives, acne sure is one pesky condition. While many patients talk to their physicians directly to try medications, others prefer more natural methods to avoid the side effects accompanying some conventional treatments. 

One of the best places to start is with your diet.

How your diet affects your skin

If you struggle with acne, you're probably familiar with the post-indulgence bumps that show up after you've treated yourself to an abundance of sugar, dairy, or fats.

There's no denying that what you eat can trigger acne. Some foods can spike blood sugar levels, leading to the production of insulin. When insulin accumulates at higher than normal levels in the blood, oil glands begin producing more oils, which puts you at risk of acne. 

Foods notorious for triggering these glucose peaks include white pasta, white rice, white bread, and sugar. These are the foods we consider high-glycemic, or refined, carbohydrates. They're primarily composed of simple sugars, which convert to sugar in the body almost instantly. 

Chocolate can also contribute to acne, according to a study published by the Journal of Clinical and Aesthetic Dermatology. The study examined 14 men between the ages of 18 and 35 who were given 100% cocoa capsules, gelatin capsules, or a combination of the two. Results indicated that acne-prone men saw an increased likelihood of acne development when consuming chocolate compared to the placebo group. 

Many studies have investigated the direct link between diet and acne. A study in the Journal of Clinical, Cosmetic, and Investigational Dermatology reviewed the impacts of a Western diet on acne formation. Researchers found that a diet rich in high-glycemic carbohydrates, dairy products, saturated fats, and trans fats could increase hormone and oil production, contributing to acne. This dietary pattern was also associated with higher inflammation in the body, further increasing the risk of developing acne. 

While reducing the intake of specific food groups can lower your acne risk, introducing others into your diet can promote its healing. 

Low-glycemic food choices are high in complex carbohydrates that can improve the health of your skin. Examples of complex carbohydrates include whole grains, legumes, and whole fruits and vegetables. Consuming foods rich in zinc, vitamin A, vitamin E, and antioxidants can also lower inflammation in your body, preventing acne. 

Zinc

Several studies have explored the link between zinc intake and acne outbreaks. According to one study published in the BioMed Research International Journal, low zinc levels were linked to severe cases of acne. 

Their conclusion suggested that a daily intake of 40 mg of zinc could help treat acne, even in severe outbreaks. Dietary sources of zinc include pumpkin seeds, cashews, beef, turkey, quinoa, lentils, and seafood. It can also be added as a supplement to the diet.

Vitamins E and A

A study in the Journal of Cutaneous and Ocular Toxicology linked severe acne cases to low vitamin A and E levels. This finding led researchers to suggest that boosting your diet with these two vitamins could help prevent acne outbreaks. 

You can get vitamin E from sunflower seeds, almonds, peanuts, and several cooking oils. Vitamin A, on the other hand, is found in spinach, carrots, pumpkins, and fish.

Antioxidants and Omega-3 Fatty acids

Numerous studies have supported the link between antioxidants, omega-3 fatty acids, and acne. The relationship is found to be inversely proportional—the higher your intake of these two nutrients, the lower your risk of having acne. 

A study published by the Journal of Lipids in Health and Disease showed that subjects given antioxidant supplements saw significantly reduced rates of acne outbreaks. 

Woman looking at acne in the mirror during her skincare routine

Lifestyle factors to consider

Several science-backed self-care practices exist to prevent acne from appearing or aggravating. Some of these simple precautionary measures include:

  • Using a mild cleanser once or twice daily to remove excess oil and dirt
  • Making sure your hair is clean and keeping it away from your face
  • Using water-based makeup that won't clog your pores (i.e., non-comedogenic)
  • Avoid hats and headbands if you're prone to forehead acne
  • Avoid touching your face whenever possible
  • Avoid squeezing pimples as it can spread bacteria and excess oil
  • Removing makeup before going to bed
  • Avoiding tight-fitting clothing, especially if you're sweating
  • Managing stress
  • Eating a nutritious diet

In conclusion

Acne is a common skin condition that affects people worldwide. Studies have shown a direct link between gut health and acne outbreaks, with more research on the horizon. 

Maintaining a healthy diet, with supplementation where necessary, can minimize pimple flares. This includes eating low-glycemic foods such as complex carbohydrates and omega-3 fatty acids, vitamins A and E, probiotics, and zinc. On the other hand, it's wise to avoid refined carbohydrates, dairy products, saturated fats, and trans fats. 

Regulating your microflora is of fundamental importance since your skin, similar to your gut, contains both good and bad bacteria. Replacing harmful bacteria with good bacteria can help restore skin balance, preventing acne and helping you achieve your best skin yet.

Up next: How to Get Your Best Skin From the Inside Out