I’ve had so many skin issues since my 20’s. I had perfect skin in high school when everyone else had acne. Then in medical school something drastically changed. I was already into yoga and eating healthy—or so I thought—and yet I developed cystic acne on my cheeks that wouldn’t go away.
I tried it all. The pill. Spironolactone. Retin A. Even cortisone injections directly into my zits. I had scars forming and thought my skin problems would would never go away.
Then I turned to functional medicine and did a 30-day elimination of gluten and dairy. After about two weeks my skin started clearing. I also started drinking more water and taking magnesium supplements to make sure my digestion was working properly. Four weeks in my acne was gone. No pills, no creams, no injections.
Where had my skin issues come from? Probably leaky gut (a.k.a. intestinal permeability) caused by high stress around a breakup and starting school. I might not have been allergic to those foods growing up, but I had become so.
If your skin is rough, dry, itchy, flaky, or breaking out, it may be your gut. So how can you heal your skin through your gut? Here is my 7-step approach—the same approach we use with our members at Parsley Health.
Food is medicine and food allergies and sensitivities are often the root cause of skin problems. At Parsley we prescribe specific elimination diets that remove common trigger foods like gluten, dairy, sugar, and nightshade vegetables. This elimination phase can take six or more weeks to start seeing a difference, so sticking with it is critical. Then we work with you to slowly add back in these foods to determine what may be triggering your skin issues.
Going beyond the basic testing that a typical primary care doctor or even dermatologist will do to assess the drivers of skin inflammation can be critical. There are a few tests I recommend if you’re suffering from skin problems.
- SIBO testing: Small intestinal bacterial overgrowth—bacteria from the large intestine that gets trapped in the small intestine—can be a driver of rosacea, flushing, and even eczema and acne. One study showed that treating SIBO resolved rosacea in 85% of cases. A breath test prescribed by a doctor can assess if this is a problem for you.
- Microbiome assessment for fungal overgrowth: This looks at different forms of yeast and imbalances in bacteria that studies show can drive conditions like acne and eczema.
- Intestinal permeability: Leaky gut, a condition in which the tight junctions in your intestinal lining break apart, can cause harmful substances to enter your bloodstream, leading to inflammation that can cause and aggravate skin conditions like rosacea and eczema.
- Hormone testing: Imbalances in hormones like cortisol, testosterone, DHEA-S, and estrogen are often ignored, but they could be a major contributor to skin conditions. Overproduction of testosterone, for instance, can trigger oil production on the skin which leads to acne.
- Metabolism and blood sugar: Fasting insulin and HgBA1C are useful tests for assessing if poor metabolic management is driving your skin problems.
- Food allergies and sensitivities: Allergies and sensitivities are not the same thing, so looking for both can often reveal triggers. In fact, people with celiac disease, or an intolerance to gluten, are three times more likely to have eczema.
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Sometimes professional grade supplements are a core part of healing the gut. At Parsley Health, we have a unique gut healing protocol that includes probiotics, digestive enzymes, and herbal antimicrobials that help rebalance the gut. Research has found that probiotics in conjunction with antibiotics improved acne treatment while a combination of prebiotics and probiotics can prevent and treat eczema.
Sometimes medications can help combat conditions like acne alongside diet and supplements. I sometimes use antifungals to reduce yeast overgrowth and antibiotics to treat SIBO if my patients have long-standing, hard to treat GI imbalances.
Sweating is one of our primary detoxification mechanisms. Exercise also stimulates movement in the GI tract, aiding in digestion. If you’re not getting in activity or you’re constipated, it you could be contributing to your skin problems.
6. Mental health and relaxation
Chronic stress can lead to elevated cortisol and catecholamines (things like norepinephrine) from the adrenal glands, which can exacerbate and trigger skin conditions like psoriasis, acne, and eczema. I recommend a daily meditation practice to every patient, like this one from Parsley Health’s 5 Day Reset.
Making big changes to diet and lifestyle can be difficult to implement on your own, so having the help of a health coach or doctor is key. I see so many patients at Parsley Health who have been through it all, seeing different types of practitioners and doctors who offered a quick fix that didn’t work. Truly healing the skin through the gut takes time. When it comes to sticking to any plan, people who have a support system and expert guidance do better.
I wish I had already trained in the functional approach to health when I was in med school. It would have saved me time and so much frustration and devastation about my skin issues to skip the thousands of dollars I spent on dermatologists, facials, creams, pills and makeup trying to fix the problem from the outside, when the solution was on the inside.
Our bodies are an interconnected ecosystem. I recommend finding a provider who can look at the whole picture if you’re dealing with skin issues like I did.