The great importance of an intact and healthy skin barrier is evident for some skin diseases, including acne, psoriasis, ichthyosis (fish scale disease) and atopic dermatitis (AD). But there is also a relationship between a leaky gut and skin diseases.
Slechte huidbarrière verhoogt doorlaatbaarheid van allergenen
Animal experiments showed a poor skin barrier function, a higher penetration of allergens through the skin, and where the immune system is sensitized, which can lead to eczema, among other things.
Simply ‘reinforcing’ the skin barrier with the right skin care cream can keep eczema under control for longer than if you didn’t. We’ve known that for quite some time. But what is still underexposed is the role of nutrition and the intestines.
The role of nutrition
Relatively little attention is paid to the influence of nutrition in the treatment of certain skin conditions. Fortunately, the number of studies on this is increasing.
The importance of your gut bacteria
A new way of looking is to look at the skin-gut axis. The influence of intestinal bacteria and the skin is receiving increasing attention. Gut bacteria react to your diet and an imbalance of good bacteria due to bad eating habits affects the immune system. This has consequences for your skin and intestines.
Disrupted intestinal epithelium leads to leakage
However, our epithelium(the tissue that covers the body surface, lines cavities and channels in the body, and forms glands)is not limited to the skin. The intestinal epithelium plays a role similar to that of the skin. Impairment of this barrier function leads to increased intestinal permeability, which is often referred to as a “leaky gut”.
Skin and heart disease, but also Parkinson’s in relation to a leaky gut
As with the skin barrier, a disruption of the intestinal barrier can occur, leading to increased intestinal permeability. Inflammation and imbalance of various gut microbiota (dysbiosis) are all associated with intestinal barrier disruption and have been linked to a number of diseases, including inflammatory bowel disease, celiac disease, fibromyalgia, heart disease, Parkinson’s disease, psoriasis, acne and atopic dermatitis.
Anti-inflammatory antigens leak out
Although not fully elucidated, it is thought that impaired gut barrier function allows the passage of antigens (substance that activates the immune system) from the gut, stimulating the immune system to produce an inflammatory response in people predisposed.
In addition to a barrier function, the intestine has a specialized task to absorb nutrients as well. The gut contains three main elements:
- intestinal bacteria with an outer mucus layer,
- a slime layer on the inside
- and an epithelial layer.
Digestion, hormone production, disease protection
The gut microbiome consists of a huge community of bacteria that play a crucial role in digestion, the production of hormones and vitamins B and K, inhibiting pathogenic cells, and helping to metabolize drugs.
How Drugs Need Bacteria (Or Not)
Research has shown that sulfasalazine, a drug used to treat inflammatory bowel disease (ulcerative colitis), needs gut bacteria to activate it. Conversely, an intestinal bacterium Eggerthella lenta can inactivate a heart medication digoxin. Enterocytes prevent intestinal contents from passing directly into the blood through tight intercellular connections, allowing only specific nutrients to pass while blocking others.
A secret health center: your GALT
Deep within the gut barrier is a network of immune cells organized into a specialized structure called gut-associated lymphoid tissue, or GALT. The GALT is an important organ that contains up to 70% of the body’s immune cells and plays an important role in our immunity.
How do you measure gut health?
While skin barrier function can be quantified with measures such as transepidermal water loss (TEWL), the intestinal barrier is often measured by oral administration of a sugar mix, usually lactulose, along with mannitol or rhamnose. The excretion of the sugars in the urine is examined.
When certain sugars pass through the intestinal wall
If there is significant intestinal barrier disruption, the larger molecules of lactulose can cross the barrier. While the smaller molecules (mannitol or rhamnose) are absorbed transcellularly, independent of the barrier function. The ratio lactulose/mannitol or rhamnose can be calculated and with a disturbed intestinal barrier the ratio increases because more lactulose crosses the barrier.
Bring back balance with probiotics
A 1986 study showed a lactulose/rhamnose ratio that was greater in children with atopic eczema compared to a control group. Treatment with probiotics significantly improved the ratio.
The usefulness of pre- and probiotics
Prebiotics (a collective name for indigestible carbohydrates and dietary fibres) provide relief from atopic eczema. Prebiotics are found in bread, fruit, vegetables, grain products and legumes.
Probiotics are also regarded as positive (good intestinal bacteria) in a Cochrane review in 2013. Four studies with 1428 children showed reduced atopic dermatitis after taking prebiotic supplements.
In a meta-analysis of 16 studies, it was shown how beneficial probiotics were for people with normal eczema complaints as for people with a very high risk of eczema complaints.
Search for the right dose
Specifically, a subgroup analysis showed that Lactobacillus and Lactobacillus with Bifidobacterium may also be protective against atopic dermatitis. However, the optimal dose, type of bacteria and duration of treatment with probiotics is still unclear.
What else can you do to improve a leaky gut? The gut moisturizer…
Just like a good moisturizer for your skin, is there a gut moisturizer? Possible gut moisturizers are gelatin tannate or xyloglycan. The exact effect is unclear, but it is thought that a protein layer is formed superficially in the intestinal wall, creating an intestinal barrier. There is not yet any research into the role of an intestinal moisturizer and the reduction of eczema.
Lopetuso LR, Scaldaferri F, Bruno G, Petito V, Franceschi F, Gasbarrini A. The therapeutic management of gut barrier leaking: the emerging role for mucosal barrier protectors. Eur Rev Med Pharmacol Sci. 2015;19(6):1068-76. Review·
Eutamene H, Beaufrand C, Harkat C, Theodorou V. The role of mucoprotectants in the management of gastrointestinal disorders. Expert Rev Gastroenterol Hepatol.2018 Jan;12(1):83-90
While you are here
Rosacea is a chronic skin condition that is associated with an increase and decrease in disease symptoms over many years. It is more common in fair-skinned people. These symptoms consist of redness in the face, skin inflammation, eye complaints and skin thickening of the nose (popularly known as the nose, forehead or chin). Once considered a condition limited to the skin and eyes, today rosacea goes deeper than the skin. There is strong evidence that rosacea is associated with non-skin related skin or systemic conditions.