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The Role of Gut Microbiota in Dermatologic Conditions

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Emerging research suggests that disturbances in the composition of the gut microbiota can contribute to the development or exacerbation of dermatologic conditions.

Medically reviewed by

Dr. Dhepe Snehal Madhav

Published At May 7, 2024
Reviewed AtMay 7, 2024

Introduction

The human microbiota includes microorganisms that live in and on the bodies, like bacteria, fungi, and viruses. The gut is home to the largest microbes in the human body and has many immune cells. The cells lining the gut pass on important information to these immune cells. A balanced gut microbiome is necessary for good health and immune function. Recently, scientists have discovered a connection between the gut microbiome and the skin, known as the gut-skin axis. This connection suggests that problems in the gut can affect the skin.

What Is the Gut-Skin Axis?

The gut-skin axis connects the gut microbiome to the skin's health. This relationship works both ways and involves inflammation and the immune system. When the balance of microbes in the gut is off, it can contribute to inflammatory skin conditions such as eczema, rosacea, and psoriasis. By understanding how the gut microbiome influences skin health, scientists hope to develop new treatments.

Diet, lifestyle, and genetic makeup all play roles in keeping the gut microbiome in balance. This balance is important for regulating intestinal health, metabolism, and the immune system. When the balance of microbes in the gut is disrupted, it is known as gut dysbiosis.

What Role Does the Gut Microbiota Play in Dermatologic Conditions?

The gut microbiome affects the skin and related conditions in the following manner.

  • Regulates Inflammation - The gut microbiome plays a main role in regulating inflammation, which is necessary for dermatologic conditions like eczema, psoriasis, and acne. When there is an imbalance in the gut bacteria, it can trigger inflammation and worsen skin conditions.

  • Modulates Immune System - The gut-associated lymphoid tissue contains a large number of the body's immune cells, and the gut microbiome helps train and regulate the immune system. Gut bacteria balance disruption can lead to immune system irregularities, potentially affecting the development and severity of skin conditions.

  • Helps in Nutrient Absorption - The gut microbiome also aids in the digestion and absorption of important nutrients for skin health, such as vitamins A, D, E, and K, as well as essential fatty acids. If there are deficiencies in these nutrients, it can contribute to various dermatologic issues.

  • Brain-Gut Connection - The gut microbiome sends signals to the brain via the gut-brain axis, leading to an effect on stress responses and neuroendocrine signaling. Stress worsens many skin conditions, and the gut microbiome can help modulate stress responses.

  • Skin Barrier Function - Recent research suggests that the gut microbiome may influence the integrity and function of the skin barrier. If the gut microbiota is disrupted, it can affect the barrier of the skin and lead to a high risk of various skin conditions.

What Is the Impact of Gut Microbiome in Different Skin Conditions?

  • Gut Microbiome in Acne - Decades of research suggest a link between gut health and acne. People with acne tend to have a different mix of gut bacteria, with fewer Firmicutes and more Bacteroides. Some studies explore using probiotics to treat acne, with mixed results due to differences in products and study designs. While the gut microbiome is just one part of many factors, it likely interacts with the immune system to influence skin health.

  • Gut Microbiome in Atopic Dermatitis - Research suggests a connection between gut bacterial imbalance and atopic dermatitis (AD). AD patients often have more harmful bacteria like Faecalibacterium prausnitzii in their gut and lower levels of beneficial bacteria like Akkermansia and Bifidobacterium. These imbalances can lead to inflammation. Probiotics, especially those containing Lactobacillus and Bifidobacterium, show promise in treating AD, particularly in preventing it in infants. Probiotics help by balancing the immune system and reducing allergic responses.

  • Gut Microbiome in Psoriasis - Psoriasis patients have a higher risk of developing intestinal immune disorders like inflammatory bowel disease, ulcerative colitis, and celiac disease. The exact reasons are unclear, but disruptions in gut integrity and increased levels of certain proteins have been observed in psoriasis patients. Studies on the gut microbiome of psoriasis patients have shown differences compared to healthy individuals, including changes in the abundance of certain bacteria. Treatment with medications like secukinumab, which targets IL-17, can also affect the gut microbiome.

  • Gut Microbiome and Rosacea - Researchers have suggested a connection between gut microbial imbalance and rosacea, as rosacea patients often have a higher risk of gastrointestinal disorders. Helicobacter pylori infection and small intestinal bacterial overgrowth (SIBO) are particularly linked to the disease. Treating SIBO has been shown to reduce skin lesions in rosacea patients. Recent research in Korea and elsewhere has identified differences in the composition of gut bacteria in rosacea patients compared to healthy individuals. These differences include higher levels of Acidaminococcus and Megasphaera and lower levels of Peptococcaceae and Methanobrevibacter. The gut microbiome may be an important target for therapy in rosacea.

  • Gut Microbiome and Alopecia Areata - There is a suggested link between gut dysbiosis and alopecia areata, a condition where the immune system attacks hair follicles. Alopecia-related genes may affect gut colonization with microorganisms that trigger a specific immune response, leading to hair loss.

What Are the Therapeutic Implications of Gut Microbiota in Skin Conditions?

Different skin conditions can be managed and treated effectively by focusing on the gut microbiome through therapeutic interventions.

Some of the therapeutic implications are

  • Probiotics and Prebiotics - Probiotics and prebiotics can help restore harmony to the gut, which may lessen inflammation and improve skin health.

  • Dietary Changes - Certain diet changes can have a positive effect on gut microbiome and skin health. Consuming foods high in unhealthy fats, processed components, and sugar can disrupt the gut microbiome and make skin conditions worse.

  • Fecal Microbiota Transplantation (FMT) - FMT involves moving stool matter from a donor who is healthy into the gut of someone who needs it to restore a healthy gut microbiome. While FMT is mainly used to treat gastrointestinal conditions, it has shown promise in improving certain skin conditions by restoring the balance of gut bacteria and regulating immune responses.

  • Topical Microbiome-based Therapies - Ongoing research is being conducted on topical probiotics and other beneficial bacteria to treat skin conditions. These therapies bring back the bacterial balance and improve the protective barrier of the skin.

  • Psychobiotics - Psychobiotics are probiotics or prebiotics that target the connection between the gut and the brain to improve mental health. Since stress can worsen many skin conditions, and the gut microbiome affects how one responds to stress, psychobiotics may indirectly benefit skin health by reducing stress levels.

Conclusion

The complex relationship between gut microbiota and dermatologic conditions highlights the significance of using a comprehensive approach to skincare. Promoting a balanced gut environment via dietary choices, lifestyle adjustments, and specific interventions can improve skin health internally. As advancements in research progress, a more profound comprehension of the gut-skin connection could lead to tailored and efficient therapies for various dermatologic issues.

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Dr. Dhepe Snehal Madhav
Dr. Dhepe Snehal Madhav

Venereology

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skin caregut microbiota
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