The Link Between Gut Health, the Gut Microbiome, and Eczema
If you hear the word “eczema” — your brain probably immediately goes to “itchy, red, uncomfortable rash-type-thing.”
Your brain would be very accurate 🧠
But, would you also think of “gut health” when you think about eczema?! 👀
If you would not have before, hopefully you will moving forward as our gut health and microbiome have a HUGE influence on our skin health, including inflammatory skin conditions such as eczema (or atopic dermatitis).
Before we dive into the connection between our gut and eczema, let’s first explore eczema itsself a bit further:
Our skin is a physical and chemical barrier that protects us against our environment: allergens, toxins, pollutants, microbes, etc.
The integrity of our skin barrier is super, super important!
Eczema — often referred to as atopic dermatitis — is a skin condition associated with our immune system and systemic inflammation, where our skin barrier becomes dysfunctional.
There are a number of different subtypes of eczema/atopic dermatitis — some of which you might be familiar with or have heard before:
atopic dermatitis
seborrheic dermatitis
scalp dermatitis
nummular eczema
nickel sensitivity
With eczema — the skin barrier becomes compromised (or ”leaky”) — where loss of moisture and inflammation leads to irritation, and itchiness, which further damages the integrity of the skin barrier when we scratch at it. Scratching can also increase the potential for bacterial translocation which can cause further issues, like staph infections!
There are a bunch of different things that can cause eczema, randing from things like: essential fatty acid deficiency, genetic predispositions, allergens, topical irritants, stress and dysregulation in the nervous system, and burdened detox pathways, environmental factors..
.. and the gut and gut microbiome 😅
Let’s dive into it shall we?
How Gut Health and the Microbiome can Contribute to Eczema
There are several ways that your gut health may contribute to the both the development, and severity of eczema:
dysbiosis (an imbalance in the in the gut microbiome) or a GI infection of some sort
intestinal permeability (AKA ‘leaky gut’)
malabsorption
food sensitivities & intolerances (note: see intestinal permeability here 👀)
Let’s explore these:
Gut Dysbiosis and Eczema
There are trillions of bacteria and other microorganisms that live on and within us. In our gut specifically, there is a ecosystem of bacteria, archaea, viruses, fungi, etc that call our bodies home. Certain species and microbe types within our gut microbiome provide us with a ton of health benefits — ranging from things like modulation of the immune system, nutritent production, protection against pathogens and “bad bugs,” metabolic function, and more.
As the microbiome (and microbes) relate to eczema specifically:
Infections like H.Pylori, Candida, certain protozoa (single-cell parasitic organisms), as well as overgrowth of certain bacteria (like Staphylococcus aureus & Streptococcus spp.) may all play roles in the development and severity of eczema.
The main connection here is this:
Dysbiosis in the gut > Systemic Inflammation > Dermatological Issues like Eczema
Certain imbalances and infections in the gut and gut microbiome (like the ones mentioned above) can contribute to both localized and systemic inflammation, which is a major driver in inflammatory skin conditions like eczema.
Below we’ll look at some testing options to dive deeper into the inner happenings of your gut & gut microbiome. Stool tests and organic acid tests can give us more insight into which microbes specifically may be present, which majorly helps to inform the process moving forward to restore digestive health.
This is something I help my clients with inside of my 1:1 program the Gut Restore Method.
Intestinal Permeability (AKA “Leaky Gut”) and Eczema
Believe it or not, our gut lining is a measly ONE CELL thick. One cell! Separating everything that’s floating around in our guts from the delicate internal system of our body.
Similar to our skin — our gut lining is both a physical and chemical barrier protecting our body from exposure to external elements (toxins, pollutants, pathogens, antigens, etc.).
As the name suggests, intestinal permeability or “leaky gut” is there is where our single-cell-thick gut lining becomes “leaky.” Something has compromised the integrity of this lining. There are a variety of things can offend the gut lining: stress, antibiotics, medications like NSAIDs, infections in the gut (like Candida and parasites), food antigens, etc., being some of the major culprits.
When our gut lining becomes permeable, it’s open season for whatever is floating around in our intestines to make its way through into our bloodstream.
It’s at this point — where stuff floating around in the intestinal tract is able to make its way THROUGH our gut barrier, and into our bodies — where the immune system becomes impacted, goes into full-on protection mode, and systemic inflammation becomes a thing.
Similar to above (dybiosis and intestinal permeability often go hand-in-hand, anyway):
systemic inflammation = big driver for inflammatory skin conditions like eczema.
Nutrient Malabsorption and Eczema
Continuing to build on the last few points above, malabsorption (or poor absorption of nutrients), can play a big role in the severity of atopic dermatitis and the healing process.
Our small intestine is where we absorb the majority of our nutrients. We need a healthy, in-integrity gut lining to do so effectively. If inflammation and leaky gut is present, it will impact our body’s ability to absorb nutrients that are important for keeping our skin barrier healthy.
In addition to this — we need to be producing and secreting enough bile (which is a whole other thing; you can read up on this here!), to absorb fat-soluble vitamins. Bile is a substance created by the liver, and stored, concentrated and secreted by our gallbladder. It has a bunch of functions, some of which are breaking down dietary fats we consume, and playing a key role in our fat-soluble nutrients A, D, E, and K.
Vitamins A and E in particular are important for skin health, as potent antioxidants. Essential fatty acids are also incredibly important for the health of our skin barrier. Vitamin C and zinc are likewise important skin-healthy nutrients.
If we aren’t able to properly absorb and utilize these nutrients, it can influence both the severity of atopic dermatitis (and other skin issues!!), AND our ability to heal from it.
Food Sensitivities, Intolerances, and Eczema
I feel like a broken record here — but again 😅 — another deeper impact that dysbiosis, gut infections, and leaky gut can have on us is the development of food sensitivities and intolerances… which can also drive/contribute to the severity of eczema!
Remember how I mentioned above that when we have leaky gut, stuffs floating around in our intestine has free to slip on through our gut barrier and into general circulation? This is a major driver of food sensitivities.
Proteins and constituents from our foods that aren’t fully broken down (to then be properly absorbed through our gut barrier), can make their way through the gut barrier when there is permeability, leading to an immune response against them.
Basically, our immune system is clocking these food particles as “foreign invaders” 🚨 mounting a response against them (causing inflammation and other symptoms associated with food sensitivities). Which is a good thing!
However, our immune system is responding this way because these food particles/proteins/constituents are in the wrong place. They haven’t been properly broken down and absorbed — in which case, our system would not react in the same way, thus we wouldn’t experience food sensitivities in the same way.
Food intolerances, on the other hand, can stem from a few things (not always, but it’s common!):
dysbiosis in the gut (like SIBO), can cause food “intolerances” (such as in the case of SIBO and intolerances to foods high in FODMAPs)
a compromised gut barrier in the small intestine can impact our body’s ability to produce enzymes like lactase, which helps us to break down lactose in dairy products (ie. lactose intolerance)
Addressing these things would help with the food sensitivities, and thus inflammation associated with them.
Overall — food sensitivities and intolerances, with the immune’s system role in navigating them, can contribute to low-grade systemic inflammation.
Annnnnd like above and above and above 🤠: systemic inflammation = big driver for inflammatory skin conditions like eczema.
Haven’t yet Considered your Gut as a Root Cause Player in your Eczema? Here are Some Things to get Started with:
In case you’re reading this and had NO idea that your gut might be playing a role in your eczema (or other inflammatory skin condition!), here are a few things you can get started with right away to love on your gut health and skin:
Focus on anti-inflammatory nutrition.
Eat lots of colourful foods, in as much variety as possible. Stick to whole foods as much as possible. Minimize your intake of ultra-processed foods, highly refined carbohydrates, and alcohol. Enjoy anti-inflammatory herbs (both in your food, and as teas/infusions!), like turmeric, ginger, chamomile, rosemary, etc.
Prioritize gut-healing nutrients like glycine and proline
(found in gelatinous cuts of meat, bone broth, and supplemental gelatin)
Consume polyphenols
Think lots of COLOUR in foods: red, purple, black, blue, green foods) and resistant starches (cooked and cooled potatoes and rice, green plaintain) to feed species in the gut microbiome that keep the gut lining and mucosal barrier nice and healthy.
Be mindful of environment
Avoid extreme heat when possible (ie. reduce how often you’re doing hot yoga, saunas, and turn down the temp on your showers), consider investing in a humidifier for your space, inquire into your personal care products, detergent, etc., to see where there may be opportunity to swap to gentler products.
Keep hydrated!
Aim for at least half your bodyweight in ounces of filtered water daily; ideally with added minerals (like trace minerals, or a pinch of good quality salt)
Get your healthy fats in!
Essential fatty acids are critical for cellular and skin health. Ensure you’re getting lots of healthy fatty acids in by consuming small fish, seafood, walnuts, olives, avocados and coconut (and their respective oils), etc.
Patterns in the Gut Microbiome that may play a role in Eczema:
As I mentioned above — certain microbes in the gut have been correlated with eczema and other inflammatory skin conditions. Things like helicobacter pylori, candida, certain protozoa, and bacterial strains like staphylococcus aureus.
Functional labs (stool tests, organic acids tests, etc.) can be run to get a better idea of what we’re dealing with from a microbial perspective.
Here are some examples of a few panels from the GI MAP stool test, in a client of mine presenting with eczema. Note that H.Pylori is high, and both staph and strep are quite overgrown! Pseudomonas (shown elevated here), is a quite inflammatory species that may also be playing a role in this client’s case:
GI MAP panel showing elevated levels of staph aureus, strep, and pseudomonas.
GI MAP panel showing elevated levels of H.Pylori.
Here is a sample panel from an OAT (Organic Acids Test), showing positive markers for yeast and fungal overgrowth.
Looking for Support? Getting Help with Your Eczema: An Internal/External Approach
If you’re looking for 1:1 help with your eczema and gut health — there are a few ways I can help support you and your skin-healing journey!
GUT X SKIN RESCUE BUNDLE: In collaboration with Christine Preston from Skin Discovery Spa, this is the perfect way to dip your toes in 1:1 support with a collaborative skin team to help you from an internal and external perspective. This bundle gets you an initial session with both Christine and I to build out a robust skin-healing plan for you. You can learn more about the Gut x Skin Rescue Bundle here.
GUT RESTORE METHOD: If you’re looking for go-all-in deep-dive support that includes a personalized gut healing plan and access to things like the functional labs I mentioned above, the Gut Restore Method might be a great fit for you. This is my flagship, high-touch 5 month 1:1 program where we’ll take an investigative, root-cause approach to get to the bottom of your symptoms. You can learn more about the Gut Restore Method here.
