The relationship between gut health and skin health, often referred to as the gut-skin axis, has recently gained attention.
The gut microbiome, a community of trillions of microorganisms, plays an important role in maintaining overall health. A balanced gut microbiome supports immune function, regulates inflammation, and aids nutrient absorption – essential for healthy skin. Dysbiosis, or an imbalance in gut bacteria, has been linked to skin conditions including acne, eczema, rosacea, and psoriasis. (1)
Coeliac and other autoimmune conditions
Coeliac disease, an autoimmune disorder triggered by gluten consumption, has an association with skin problems, including dermatitis herpetiformis. DH is a chronic skin condition characterised by intensely itchy, blistering rashes that often appear on the elbows, knees, buttocks, and scalp. It results from deposition of IgA antibodies in the skin, due to an immune response against gluten.
Patients with DH often have underlying intestinal damage, even if they do not exhibit typical gastrointestinal symptoms. This demonstrates the systemic nature of gluten-related immune responses and underscores the importance of dietary management in alleviating gut and skin manifestations. (2)
Hormonal imbalance
The gut also plays a critical role in hormone health – influencing hormone production, regulation, and balance, supporting the endocrine system and modulating metabolic and immune functions through the gut-brain axis. Certain gut bacteria assist in the synthesis and regulation of hormones like serotonin, cortisol, and oestrogen.
Additionally, the gut helps metabolise and excrete excess hormones, preventing imbalances. Dysbiosis, or an imbalance in gut bacteria, can disrupt hormone signalling, leading to conditions such as insulin resistance, thyroid dysfunction, and oestrogen dominance. (3)
Hormones influence skin health, regulating oil production, hydration, and cell turnover. Imbalances in oestrogen, testosterone, and cortisol hormones can lead to acne, dryness, or premature ageing. Oestrogen promotes collagen and elasticity, while testosterone affects sebum levels. Managing hormonal health is crucial for maintaining healthy skin.
Gut permeability
Gluten can influence gut permeability, often referred to as “leaky gut,” especially in individuals with coeliac disease or non-coeliac gluten sensitivity (NCGS). Gluten contains a protein gliadin, which triggers the release of zonulin, which regulates the tight junctions in the intestinal lining. Increased zonulin levels can cause these junctions to loosen, allowing toxins, bacteria, and undigested food particles to enter the bloodstream. (4)
This heightened permeability is linked to systemic inflammation and autoimmune responses.
Inflammation and the gut-skin axis
When the gut lining is damaged, as seen in conditions like leaky gut syndrome, inflammatory molecules and toxins can enter the bloodstream. Studies have shown elevated levels of inflammatory markers in individuals with acne and psoriasis, indicating that these conditions may be linked to underlying gut issues. (5)
Nutrient deficiencies and skin function
Gluten intolerance can also impact the skin through nutrient deficiencies resulting from malabsorption. In coeliac disease damage to the small intestine can impair the absorption of vital nutrients like zinc, vitamin D, and essential fatty acids, crucial for maintaining healthy skin. Zinc deficiency can trigger rashes and delay wound healing, while a lack of vitamin D can impair the skin’s barrier function and immune response. (6)
Conclusion
The link between gluten intolerance and skin problems underscores the importance of recognising gluten as a potential trigger for dermatological conditions. For individuals with persistent skin issues, especially those resistant to conventional treatments, exploring the role of gluten intolerance may be beneficial.
A gluten-free diet remains the cornerstone of treatment for coeliac disease and dermatitis herpetiformis, while its role in managing other gluten-related skin issues continues to be an area of active research.
Understanding this connection not only offers insights into the systemic effects of gluten but also highlights the importance of personalised dietary interventions in managing skin health.
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Written by Zoe Hill, Nutritional Chef, Health Content Creator and Yoga Instructor
References
1. https://pmc.ncbi.nlm.nih.gov/articles/PMC7916842/
#:~:text=The%20dysbiotic%20state%20is%20characterized,microbio
me%2C%20reduced%20human%20and%20microbial
2. https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1155288/full
3. https://bsd.biomedcentral.com/articles/10.1186/s13293-023004902#:~:text=Evidence%20for%20interaction%20between%20gut,via%20the%20enterohepatic%20circulation%20(Fig.
4. https://pmc.ncbi.nlm.nih.gov/articles/PMC2653457/#:~:text=Gliadin%20induces%20an%20MyD88%2Ddependent,the%2
0pathogenesis%20of%20celiac%20disease
5. https://www.mdpi.com/2076-2607/11/10/2586
6. https://pmc.ncbi.nlm.nih.gov/articles/PMC8721081/