What Having Gut Issues & Eczema Taught Me About The Gut-Skin Connection

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September 25, 2022 — 11:02 AM

For my entire life, I have regularly struggled with two health issues: gut discomfort and eczema. I've long been prone to intense bloating and constipation, and flaking skin and itchiness has left my hands bleeding on many occasions. It's been an unpleasant combination, to say the least.

As a health editor, I know that my finicky gut could actually share a connection with my downright painful eczema. But I wanted to get a better picture of how close the gut-skin connection really was, so I reached out to two M.D.s to get to the bottom of it.

The term eczema refers to the skin condition atopic dermatitis (AD), which impacts the barrier of the skin. It's relatively common, with an estimated 1 in 10 individuals (about 31.6 million people) in the U.S. dealing with it.

“With atopic dermatitis, there is a skin barrier defect, and the skin loses water easily, becoming itchy and inflamed,” explains board-certified dermatologist Andrea Suarez, M.D., FAAD. For me, this means that no matter how much I moisturize, my skin always remains just as dry as before.

There are several kinds of eczema—each with its own unique triggers, symptoms, and appearance. They include but are not limited to: atopic dermatitis, contact dermatitis (irritation from poison ivy, for example), neurodermatitis (intensely itchy), and dyshidrotic eczema (which causes blisters).

Flares of this painful skin condition can occur because of stress, a change in environment, illness, irritants, and a range of other triggers you can’t control. At this point in time, there is no cure for atopic dermatitis. But there are plenty of ways to manage it and find relief; some of which start in the gut.

This happens because a common response to suboptimal gut health is inflammation, and “exczema is an inflammatory process,” Trubow says. "So any time there is inflammation in the body/bloodstream, eczema can develop."

As such, “research suggests that people with eczema may have lower gut bacterial diversity, lower levels of beneficial gut bacteria, and higher amounts of harmful gut bacteria,” notes Suarez.

And this connection is becoming solidly established thanks to robust research. For over a decade now, the library of studies on the gut-skin axis has been growing. For example, a 2021 review of the research on the gut-skin axis shows that an imbalance in the gut microbiome might have ties to other skin conditions such as rosacea, psoriasis, and acne vulgaris. "Additionally, observations such as the prevention of AD through probiotics and the increased prevalence of intestinal comorbidities in chronic skin diseases suggest that skin diseases can be linked to the gastrointestinal system," the review concludes.

Here's the good news: Given this intimate connection, showing our gut microbiome some love can also pay off for our skin. And due to the overwhelming research on the gut-skin axis, most skin care professionals encourage folks to address gut health as part of a broader holistic skin care routine.

While it won't completely cure your belly (or skin) woes, eating a gut-friendly diet is a great place to start. “Fiber-rich whole foods, such as fruits and vegetables, legumes, and whole grains, are thought to support a healthy gut microbiome,” notes Suarez. For a comprehensive guide to a gut-healthy diet, head here.

As for foods to consider avoiding? Trubow puts dairy, sugar, and processed foods at the top of the list. “Exposure to molds in the environment or foods can also impact skin health,” she adds, so consistently monitoring your home (and pantry staples) for mold is also a smart idea.

You can also check in with a healthcare professional and/or a board-certified dermatologist for more personalized ways to keep both your gut health and skin health in check.