If you’ve ever wondered why skin creams only go so far—or why your eczema, acne, or psoriasis keeps flaring up—you’re not alone. We’ve helped hundreds of clients conquer their chronic skin conditions. Now, science is finally catching up with what many holistic practitioners have long observed—there is a gut-skin connection! The health of your skin is a reflection of your gut health.
A wonderful example of this is Brendan’s story.
When he first came to us in 2024, his hands and elbows were raw, cracked and bleeding from years of relentless psoriasis. He’d tried every ointment and steroid under the sun, but nothing lasted. What finally changed things wasn’t another cream—but a radical reset of his gut—and in 6 months his psoriasis was 80% gone.
And there are many more like him, living either entirely flare free, or still working their way to clear skin.
Helping people heal their inflammatory skin conditions is actually one of Amanda’s specialities.
She has helped so many people heal their acne, eczema, psoriasis, dermatitis, rosacea, urticaria and even just dry itchy skin – by looking at their gut microbiome, creating a personalised holistic plan and working together to shift into gut friendly lifestyle patterns.
This is the hidden story behind so many chronic skin issues.
Whether it’s breakouts, rashes, or persistent dryness, your skin is constantly in conversation with the trillions of microbes and immune messengers inside your gut. And when this gut-skin conversation breaks down, the result isn’t just a rash—it’s a sign that something deeper needs attention.
In this article, we’ll unpack the real science behind the gut-skin axis, show you what conventional advice often misses, and explain how personalising your approach—sometimes in ways that feel counterintuitive—can unlock real, lasting skin healing.
The Gut-Skin Axis: What Science Now Reveals
It’s easy to think of skin problems as just “surface issues,” but the real story runs far deeper—right down to the complex world of your gut microbiome.
In the last decade, researchers have mapped a powerful two-way communication network between your digestive tract and your skin, often called the gut-skin axis.
Here’s what’s going on under the surface:
1. Your Gut Lining is Your Internal Skin
Just as your skin acts as a barrier to keep the outside world at bay, your gut lining is a boundary between your inner world and everything you swallow. When this barrier breaks down (a process called “leaky gut” in functional medicine, or increased intestinal permeability in research), toxins, bacteria, and undigested food particles can slip into the bloodstream.
Your immune system sees these as threats—and the fallout often shows up in your skin as inflammation, rashes, breakouts, or chronic conditions like psoriasis and eczema.
2. The Microbiome is Your Skin’s Hidden Partner
Inside your gut, trillions of microbes are working behind the scenes—producing vitamins, regulating immune signals, and even creating anti-inflammatory compounds called short-chain fatty acids (SCFAs).
When your gut microbiome is balance and thriving, these beneficial bacteria help calm skin inflammation and reinforce your skin’s barrier. But when the gut ecosystem becomes imbalanced (a state known as dysbiosis), it can send a steady stream of inflammatory messengers to the skin.
3. The Immune Conversation
Nearly 70% of your immune system is located along the gut wall. When your gut microbes are out of balance, your immune system can go into overdrive—triggering skin flares or even autoimmunity. Certain immune signals, like interleukin-17 (IL-17) or tumour necrosis factor-alpha (TNF-α), are now directly linked to both gut and skin inflammation in research.
This means that gut healing isn’t just about what you eat, but also about how your immune system is trained by your microbes.
4. The Feedback Loop – Stress, Sleep, and Skin
The gut-skin conversation doesn’t happen in a vacuum. Stress, sleep deprivation, even what you put on your skin can change your gut flora—and your gut, in turn, influences how you respond to stress. This feedback loop is why chronic skin conditions so often flare after periods of emotional or physical stress, poor sleep, or even dietary slip-ups.
The bottom line?
If you want lasting skin health, you need to look beyond the surface and address the gut-skin connection with root causes inside the gut. Topical treatments can provide some relief (but not always), but for real change, the solution is an inside job.
Common Skin Conditions with Microbiome Links
Everyday, we see clear patterns between gut dysfunction and specific skin issues. Whether it’s a high pathogen, LPS dominant profile, or high histamine and low beneficial species, we’ve seen it all.
Many of the skin concerns below are now seen as autoimmune conditions, which also have microbiome links, here’s what often appears when the gut-skin axis is out of balance:
Psoriasis that resists standard treatment:
Many people with chronic plaque psoriasis have a long history of gut troubles—diarrhoea, bloating, or irritable bowel symptoms—that predate or flare alongside their skin outbreaks.
Research consistently links psoriasis with increased intestinal permeability and distinctive shifts in the gut microbiome, including lower levels of anti-inflammatory bacteria like Faecalibacterium prausnitzii and Akkermansia muciniphila.
Eczema and Atopic Dermatitis:
These often go hand-in-hand with food intolerances, unexplained digestive symptoms, or early-life antibiotic use. Gut dysbiosis can drive overactive immune responses, leading to the chronic itch-scratch cycle.
Studies show that children and adults with eczema frequently have less microbial diversity, lower important probiotic species like Bifidobacterium and higher levels of certain gut-derived inflammatory mediators.
Acne and Rosacea:
Persistent, cystic acne that doesn’t improve with topical regimens can be a red flag for underlying gut imbalances—especially small intestinal bacterial overgrowth (SIBO), high-sugar diets, or sensitivity to dairy and gluten.
Streptococcus is frequently high in chronic acne clients, while Rosacea is linked with gut bacteria present in SIBO patterns.
Unexplained Rashes, Hives, or Urticaria:
Chronic hives or recurrent rashes may signal a histamine intolerance or a “leaky gut” allowing food proteins to trigger immune reactions.
We often see these symptoms in people with a long antibiotic history, unresolved gut infections, or high levels of hydrogen sulphide–producing bacteria.
“Sensitive Skin” and Chronic Dryness:
For some, skin isn’t visibly inflamed but is reactive, sensitive to products, or chronically dry- and extremely itchy.
This can also be an external sign of impaired gut lining integrity, low short-chain fatty acids, or even malabsorption of key skin nutrients due to gut inflammation.
What do these patterns have in common?
The skin is rarely the first system affected, but it’s often the loudest messenger.The real roots—microbiome imbalances, immune dysregulation, increased intestinal permeability—often simmer quietly for years before skin symptoms appear.
Case Study: Brendan’s Psoriasis, Gut, and the Power of a Microbial Reset
Brendan (who we talked about earlier) was 53 when he first came to see us, worn down by years of relentless skin and gut symptoms.
As a roof plumber running his own business, he was used to pushing through discomfort.
But his psoriasis had become unmanageable—painful plaques on his hands, elbows, and knees cracked and bled with the slightest movement. Some nights, showering was unbearable; most days, the fatigue was like walking through wet concrete.
His doctors had tried every standard treatment; steroid creams, light therapy, even immune-modulating drugs.
The skin would clear for a while, only to flare up again, each time worse than before.
But what Brendan didn’t realise was how intertwined his symptoms really were. Alongside the skin pain, he lived with daily gut chaos—six to eight bouts of urgent diarrhoea, constant bloating, a thick feeling in his throat after meals, restless legs at night, and a persistent “foggy” brain that left him struggling to focus by mid-afternoon.
He was so used to powering through, he’d almost forgotten what it felt like to feel well.
Brendan’s case was a classic example of the gut-skin axis in crisis:
- Comprehensive stool testing revealed pronounced dysbiosis: low Faecalibacterium (an anti-inflammatory keystone species), high Proteobacteria (often linked to gut inflammation), and signs of increased intestinal permeability.
- Markers of systemic inflammation were elevated. His diet, while seemingly “healthy” (although he did need to reduce his daily alcohol intake) was high in processed wheat and low in fermentable fibre.
- His history included childhood antibiotics, a decade of stress and broken sleep, and years of relying on topical steroid creams.
Instead of chasing the next cream, Brendan embarked on a protocol focused on rebuilding his gut barrier, restoring microbial balance, and calming systemic inflammation. This included a gentle, low-reactivity gut repair diet; targeted prebiotics and postbiotics; stress management techniques; and careful, stepwise reintroduction of foods and probiotics. For the first time, the approach was “inside-out.”
The results?
Within three months, Brendan’s gut symptoms—once daily hurdles—became rare. His skin plaques softened, bled less, and for the first time in years, healing outpaced the flares. He described his thinking as “clearer than it’s been in a decade.” And even without retesting his microbiome, we saw dramatic improvement in his energy, he no longer suffered from afternoon crashes and returned to training in the gym.
Where he was previously flat, anxious and withdrawn he started to feel more physically confident, stable and was even sleeping better.
Brendan’s story isn’t unusual.
It’s a testament to the power of personalisation and the importance of treating the root, not just the rash.
The gut-skin connection is real, profound, and—when you know where to look—full of hope for those who feel stuck.
Gut Health and Psoriasis
Psoriasis is an inflammatory skin disorder that causes a rapid buildup of skin cells on your skin’s surface. Psoriasis affects up to 11% of people in developed countries.
Just like eczema, psoriasis is caused by an overactive immune system, linked with gut dysbiosis. It causes an imbalance in your immune system which leads to widespread inflammation that extends to your skin.
What is the evidence for this?
Patients who have
Further evidence for the role of gut dysbiosis in the development of psoriasis is demonstrated by the fact that IBD patients and psoriasis patients have similar patterns of gut dysbiosis.
They have less beneficial bacteria Bifidobacterium, Lactobacillius and Faecalibacterium
How does having enough good bacteria prevent psoriasis? F.prausnitzi, for example, plays a role in fighting inflammation via butyrate (anti-inflammatory SCFA) production.
Why Topical-Only Approaches Fail
It’s natural to reach for creams, ointments, or medicated washes when your skin is flaring.
In fact, for many of us, topical treatments are the first (and sometimes only) advice we’re given. And while these can bring short-term relief, they rarely deliver lasting change—especially for chronic or recurring conditions.
Why?
Because skin issues driven by gut dysfunction are fundamentally immune and metabolic in nature, not just surface problems. Topical treatments may suppress inflammation or soothe symptoms on the outside, but they can’t address the cascade of signals, triggers, and imbalances happening inside your body.
Here’s what the science (and our clinic experience) shows:
- Immunity Starts in the Gut: Over 70% of your immune system is concentrated along your gut lining, constantly training itself by interacting with gut microbes and dietary compounds. When this ecosystem is disrupted, immune cells are more likely to overreact—not just in the gut, but in distant organs like the skin.
- Metabolites Matter: Beneficial gut bacteria produce short-chain fatty acids (like butyrate), tryptophan metabolites, and other anti-inflammatory molecules that help regulate skin barrier function and keep inflammation in check. When your gut isn’t making enough of these, skin integrity suffers—no cream can substitute for these missing signals.
- Chronic Inflammation Is Systemic: Topical steroids and immunosuppressants may dampen inflammation in one spot, but the drivers—such as microbial imbalances, food intolerances, and leaky gut—remain unchecked. The result? Flare-ups return, often with greater intensity or in new places.
That’s why the best skin healing results come when you work from the inside out.
Addressing the root causes—gut ecology, barrier integrity, immune balance—sets the stage for genuine, lasting improvements in skin health.
What to do ….
Since gut dysbiosis is at the core of most of these skin issues, you will want to look at the causes and treatments for gut dysbiosis.
Potential causes of gut dysbiosis include:
- Over use of antibiotics and antibacterial supplements
- Too much sugar, processed foods and food additives
- Exposure to harmful chemicals and toxins from foods, i.e., pesticides
- Too much alcohol
- Oral health concerns
- High stress lifestyles
- Infections – parasite, bacterial, viral
Why Personalised Gut Testing Changes Everything
You may be wondering, “How do I know if my gut is at the root of my skin issues?”
This is where the new science of microbiome and gut function testing can transform your approach.
Unlike generic protocols, personalised testing lets us:
- Pinpoint imbalances in specific gut bacteria linked to skin inflammation (e.g., low Akkermansia or high Proteobacteria).
- Measure markers of leaky gut, inflammation, and digestive enzyme function.
- Identify hidden infections, parasites, or yeast overgrowths that may be fuelling immune reactions.
- Map your individual microbial anti-inflammatory capacity and inflammatory responses.
Our process combines advanced stool testing, targeted symptom assessment, and a deep-dive into your health history.
This data-driven approach uncovers patterns you might never see by trial and error, and helps us design a healing plan that fits your biology—not just a textbook.
What Real Healing Looks Like: An Individual Roadmap
True gut-skin healing is never one-size-fits-all. Here’s what a successful roadmap often includes:
1. Gut Barrier Repair:
Gentle, low-reactivity nutrition to support healing of the intestinal lining—sometimes using functional foods and supplements like bone broth, zinc, glutamine, or marshmallow root—always check with your practitioner before considering supplements.
2. Microbiome Rebalancing:
Targeted prebiotics, postbiotics, and, when lacking, specific probiotic strains (e.g., Saccharomyces boulardii, Lactobacillus rhamnosus GG), introduced gradually and monitored for individual response.
3. Immune Modulation:
Identifying and removing hidden food triggers, managing stress, and supporting immune regulation using both nutritional and lifestyle strategies.
4. Lifestyle and Environment:
Addressing sleep, stress, movement, and even topical routines—since what you put on your skin can also influence the gut via the skin-gut-immune axis.
5. Continuous Reassessment:
Healing isn’t linear. Retesting and realigning the plan based on progress and changing needs is key—what works at the start may need updating as your gut and skin recover.
Want to know where your own gut-skin axis stands?
We invite you to take our free Gut Health Assessment or book a discovery call with our team. Your journey to lasting skin health truly starts from within.
I hope you now understand how your gut is connected to your skin. If you are looking for an easy to follow
If you are wanting to get to the root cause of your skin complaints, you may also want to consider gut microbiome testing. You can learn more here…
I hope that you have enjoyed reading this article. Let us know if you have any questions in the comments below 🙂