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How Gut Health Affects the Skin

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Skin health starts inside your body. Learn how organ and gut health and your diet directly impact what appears on the surface and how to address skin health struggles.

Jennifer Fugo, M.S., LDN, CNS

Clinical Nutritionist, American Nutrition Association, Nutritional Aesthetics Alliance, LearnSkin

Can you share a little bit about your personal journey with gut and skin problems and how you identified the root cause and found a solution that works for you?

I was diagnosed with a form of atopic dermatitis called dyshidrotic eczema that impacted the palms of my hands back in 2014. At the time, I really didn’t have the knowledge that I know now about root causes, so I honestly threw so many things at my skin problem desperately trying to find something that would work — both from a supplement perspective as well as occasionally using topical steroids when my symptoms got really bad.

It took about 12 months for me to see any real progress, but eventually, my hands did clear up. If I were to look back at what I think was going on under the surface, I’d definitely suspect nutrient deficiencies, gut microbiome imbalances, liver detoxification challenges, and stressors (I was in grad school at the time). 

What inspired you to help others turn their health around and heal their skin?

At this point in time, I feel like patients struggling with skin concerns like eczema, psoriasis, rosacea, chronic hives, and dandruff should have more options because the time you miss out on is something that you can’t get back. People are often stuck thinking that medications or elimination diets are their only options. That’s not true.

There’s a great deal of research now that helps shed light on different hidden factors. That’s why I launched the Healthy Skin Show podcast to illuminate this research and clinical tips that could really change the trajectory of someone’s skin condition and quality of life. We have a huge following worldwide that includes not only patients, but also medical professionals who are excited to learn what else they can do or consider to help their patients.

Skin is a very important part of the body. Can you talk about why it’s important to take ownership of skin struggles and address underlying causes?

Skin is important, but it’s also the lowest priority organ. And that’s a really important concept to understand because skin issues are often the result of imbalances and challenges in other organ systems. So to ONLY blame the skin is incredibly short-sighted, and it explains why medication may be helpful for short-term symptom relief but not ideal long-term — especially given some of the potential side effects associated with them.

Wherever you are on your skin rash journey is where you’re meant to be, so if you don’t want to dig deeper into your case beyond a medication, that’s fine since it’s your body. However, I’m of the mindset that you and I are stewards of this one body that we have, and to ignore or block symptoms of underlying imbalances and disease may not be the best choice in the long run. What’s going on in your skin may very well be a reflection of deeper issues, and I personally believe that we should look deeper and ask why this is happening.

What first steps would you recommend someone take if they are struggling with a skin condition and tried endless over-the-counter and prescription medications with no relief?

The first step is to consider that there’s something else going on internally that’s driving the inflammation. We mistakenly assume that inflammation of the skin starts in the skin, but that’s not true. Inflammation can be generated elsewhere (even your GI tract) and show up on your skin. Even itching can be a sign of gut microbiome imbalances that are sent to your brain via the vagus nerve and then transmitted to the skin.

Reconsidering what you think you know about what’s driving your skin problems and beginning to do research is step one (and there is a lot of information on the Healthy Skin Show for you to dig through). I’d also recommend cleaning up your diet if it is loaded with processed foods as best as you can. Lastly, I commonly suggest supporting Phase 2 liver detoxification pathways, which often get overwhelmed in chronic skin cases that I work with in my clinical practice, with supplements such as the amino acid glycine and vitamin B6. 

Do you have any quick tips for someone who is intimidated by the thought of food elimination or finding recipes with new restrictions?

First of all, I understand your apprehension. In fact, there’s new research coming out that elimination diets can have unintended side effects such as triggering IgE allergies (to the foods that were unnecessarily eliminated) as well as creating a negative association with food (even without a history of eating disorders). I don’t generally recommend elimination diets to clients because they aren’t very sustainable, so I would recommend that if you’re interested in going down this route, speak with a nutritionist first to see if this is really warranted — especially if you have a history of disordered eating habits, food fear, or eating disorders.

If you want to test out a few eliminations on your own, try going egg-free, dairy-free, or gluten-free for two to three weeks to see if you notice any difference not only in your skin, but also in your body. When it comes to much more restrictive eliminations or combining multiple types of elimination diets, that’s where getting the help of a professional is helpful especially to avoid causing nutrient deficiencies and gut microbiome imbalances.

What foods would you recommend incorporating into everyday diets for healthier skin?

Naturally, your exact diet will vary based on your health and allergies, but generally I recommend foods that can support lowering inflammation. My go-to foods would include wild-caught cold-water fish (such as salmon, cod, or trout), pasture-raised chicken or other meat, ghee, oats, dark leafy greens, berries, and raw walnuts. Plus plenty of minerals and water since I don’t think most people get enough of these.

I’d also be careful how you cook meat in general. It’s important to avoid charring meats and other foods to reduce their advanced glycation end product content which can also cause acceleration of aging.

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