Could Your Acne Be Caused By Gut Problems?



In recent years, gut health has become synonymous with helping maintain not only good digestion, but also enhancing immune health, mood support, weight management, and even skin health. We are beginning to see an overlap between diet and skin conditions such as acne, with alterations in intestinal microflora contributing to increased intestinal permeability and systemic inflammation. (1)

The interaction between the gut and skin has provided us with deeper insight into the connection between individual diets and their influence on acne.

What Is Acne?

Acne is a disease that affects the skin’s oil glands. (2) Pores connect the oil glands to the skin, and oil glands produce an oily substance called sebum. The pores then go on to connect the glands through a canal called a follicle—just like hair follicles on your head.

Inside each of these follicles, oils carry dead skin cells and other things like bacteria, dirt, and germs to the surface of the skin. When the follicle gets clogged, a pimple forms and grows.

Acne can form because bacteria, hair, skin cells, and even excess oil clumps together in the gland, which plugs up the pores and causes swelling. Other factors that can cause acne to flare or develop include hormone changes, certain medications, diet choices, food allergies, and emotional states such as stress, anxiety, and depression. All of these factors have the ability to alter the gut flora. (3)

You aren’t alone if you’ve experienced a breakout or two—or way more—as acne is the most common skin disease, with an estimated 80 percent of all people between the ages of 11 and 30 having acne outbreaks at some point. (4)

The Gut-Skin Connection


You might be wondering how gut problems can manifest in the skin, but if you really think about it, the skin is the body’s biggest organ, so any internal problems will often be exposed externally.

One of the skin’s main functions is to protect the body against pathogens, bacteria, chemicals, and microorganisms, but when the body is stressed and inflamed, the skin’s ability to protect us can become compromised.

A study that was conducted more than 70 years ago by dermatologists John Stokes and Donald Pillsbury discovered that emotions could not only alter gut flora, but also contribute to systemic inflammation which could exacerbate certain skin conditions such as acne. (5)

What the researchers found was that stress, and its many forms—whether it be real or perceived stress, hormonal imbalances, food intolerances, lack of sleep, poor food quality, excessive inflammation, environmental, or emotional—alters small intestinal transit time, encourages the overgrowth of bacteria, and compromises the intestinal barrier. (6)


SIBO, or small intestinal bacterial overgrowth, is defined as excessive bacteria in the small intestines, which can lead to chronic diarrhea, weight loss, malabsorption, and nutritional deficiencies.

Disturbances and any sort of imbalances found in the gut and GI tract can increase the likelihood of developing SIBO. (7) Once someone has developed SIBO, bacteria can overgrow and induce an inflammatory response in the intestinal mucosa, which over time can blunt the intestinal villi, which are little finger-like projections that are important for nutrient absorption. The bacteria can also thin the mucosa and impair gastric peristalsis, which is what helps move the food you eat through the digestive tract. (8)

If there is an overgrowth of bad bacteria in the gut, skin may not look great. The skin’s health depends largely on the health of the gut, and changes in the microbial flora can manifest in the skin. (9)

SIBO has been linked to numerous skin disorders, and one study found it to be 10 times more prevalent in those with acne rosacea versus healthy controls. (10)

Leaky Gut

Increased intestinal permeability, also known as leaky gut, can cause small undigested food particles to leak into the bloodstream, resulting in both systemic and local inflammation. This has been linked to various health problems, including skin issues. (11)

Gut inflammation can impair the integrity of the epidermal barrier (or the protective layer), which can lead to decreased production of antimicrobial peptides which are made in the skin; this can be problematic as it can increase the severity of skin inflammation. (12) Substances that can leak into our bodies include bacteria, fungus, undigested food particles, and toxins from bacterial metabolism.

Alterations in the gut microbiota can promote the release of something called Substance P in the gut and skin. Substance P is a neuropeptide that is made in the gut, brain, and skin, which has been found to play a leading role in skin conditions, such as acne. The gut influences fats and the fatty acid profile of tissues, which can change not only sebum production, but also the fatty acid composition of sebum. (13)

Your Skin Is Only as Healthy as Your Gut

Beauty from within: we have all heard that before. If you are looking to get clearer, brighter skin, then step away from the cosmetic counter for a minute and start focusing on what’s inside your gut.

The bugs that live inside of your GI tract have evolved over many years after being exposed to biological, chemical, and physical stressors. Your skin has learned to react to changes in these external and internal disruptors in order to protect you from harmful bacteria, but often at the skin’s expense. The following steps can help get your gut and skin health back on track.

3 Ways to Address Acne with Diet

There are three main ways to improve the diet when it comes to acne.

1. Remove Repeat Offenders


It should come as no surprise that some of the most problematic foods for our health have also been linked to gut and skin health issues, such as wheat, gluten, dairy, and sugar. Addressing underlying food intolerances, food allergies, and problematic foods in general should be step one on the path to healthy skin recovery.

Diets rich in sugar, processed carbs, refined food, rancid oils, and excessive omega-6 fatty acids have been linked to the creation of more pro-inflammatory mediators which have been associated with the development of inflammatory acne. (14)

Acne is linked to the consumption of dairy. The majority of the milk and dairy products consumed in the U.S. come from pregnant cows who have higher levels of estrogen. Most of the hormones present in milk, and especially the steroids, have been linked to digestive issues, increased sebum production, and increases in the ratio of saturated to monounsaturated fatty acids of skin surface triglycerides which lead to acne development. (15)

2. Show Your Liver Some Love

A congested liver is not a happy liver, not only for the sake of your hormones, but for your skin health as well. The largest internal organ is the liver, which contributes to over 500 different functions in the body.

The liver also plays a role in the metabolism of proteins, amino acids, fatty acids, and vitamins, all components of healthy skin. (16) One of the liver’s main functions is to detoxify harmful agents in the body as well as to produce bile, which is necessary for breaking down fats and helping with digestion. If the liver isn’t functioning properly it can cause toxins to build up in the body, which can later manifest as skin problems.

A healthy liver is necessary for metabolizing hormones, including estrogen-mimicking chemicals found in many cosmetic and body care products.

Eat more liver friendly foods, such as:

  • Beets
  • Fennel
  • Artichokes
  • Ginger
  • Apples
  • Dark leafy greens
  • Turmeric
  • Onions
  • Garlic
  • Cabbage
  • Broccoli

3. Eat More Healthy Fat

Organ meats, fatty fish, and full-fat grass-fed products are great, not only for skin health, but for gut health as well! Essential fatty acids (ALA, LA, and omegas 3, 6, and 9) and fat-soluble vitamins (A and E) are components of supple and healthy skin.

Essential fatty acids are essential in the synthesis of skin and connective tissues, as well as precursors of prostaglandins, or hormone-like compounds that affect inflammatory pathways. (17) Higher intake of linoleic acid, or LA, is associated with a lower likelihood of skin dryness and atrophy. (18)

Eat more healthy fats, including:

10 Recipes For Acne-Prone Skin

1. Chipotle Lime Salmon


Full of healthy fats and skin-supporting omega 3s, salmon is the perfect go to dish for satiety and supple skin!

2. Asian Ground Beef and Veggie Lettuce Wraps

Skip the take out and get your daily veggie requirement in without ever having to go out. Add in some Coconut aminos, ginger, onions, and garlic to make these Asian inspired lettuce wraps to get all the flavor and nutrition you’d need for a night in!

3. Jerky

A great on-the-go snack, free of gut-irritating nitrates and preservatives. Bring this homemade jerky with you to work, keep it at your desk, or have it handy for a quick pre-workout snack.

4. Beets and Berries Smoothie


Not only will your liver and skin love this smoothie, but your sweet tooth will be satisfied. This unique berry smoothie is packed with antioxidants, healthy fats, and gut-loving nutrients to support healthy skin and digestive health.

5. Chopped Liver

A great recipe for liver skeptics, this Paleo chopped liver is savory, tasty, and nourishing for the whole body. Packed with healthy protein and essential fats, this is the perfect snack to serve at your next get-together.

6. Sweet Potato Egg in a Hole

An innovative take on the classic toad in a hole, this recipe uses sweet potato noodles in place of toast. Packed with vitamins B, C, and A, this sweet and savory breakfast is full of high quality protein and essential fats to nourish your gut and skin cells.

7. Shrimp Paella

This low-carbohydrate, Paleo paella is a great one-pan dish that will satisfy your taste for travel and flavor. This grain-free version of the classic Spanish dish is perfect for your next backyard gathering, packed with exotic spices, protein, and nourishing veggies!

8. Tripe Stew


This nourishing broth is full of flavor, protein, and gut-healing nutrients, not to mention crisp bacon. Packed with vitamin B12, zinc, selenium, and choline, this hearty broth will impress not only your microbiome, but also your dinner guests!

9. Ginger, Carrot, and Sweet Potato Soup

This Paleo soup is not only sweet, creamy, and slightly spicy with an exotic flair, but also a great way to use up all of those extra sweet potatoes you have lying around. Serve it as a side dish, eat it for dinner on its own, or add pre-cooked ground poultry or shredded chicken for a skin soothing soup!

10. Lemon Curd

Get beautiful skin, heal your gut, and satisfy your sweet tooth all at the same time! With just six ingredients, you can enjoy this quick and easy recipe full of nourishing joint, gut, and skin-supporting amino acids morning, noon, or night.