Gut Health and Acne: What to Know About the Skin Microbiome, Probiotics and What You Can Do
- Ellen Winnett
- Aug 12
- 8 min read
By Ellen Winnett, Clinical Nutritionist (BHSc) | Health Connection
If you’ve been struggling with acne, it might be time to look beyond the surface, towards your gut health.
Maybe you’ve seen “glow” powders and probiotic "pixie sticks" popping up in beauty aisles lately, promising radiant skin via your gut. While the marketing is covetably cute, the science runs deeper. As a Clinical Nutritionist (BHSc), I help clients uncover what’s really behind their persistent acne, and yes, it often starts in the gut.
The Gut-Skin Axis: What it is and why it matters for inflammation and the skin microbiome
The skin is our body's largest organ, but it's no solo act. Your skin in constant conversation with your inner world, especially your gut. The skin and gut are actually both composed of similar cell types that act as a kind of barrier to the outside world, and regulates what passes through. Many clients don’t realise just how deeply connected their gut and skin truly are, and that acne often reflects what's begun far beneath the surface.
The skin is part of a beautifully interconnected system, influenced by diet, stress, hormones, immune activity, detoxification, and, critically, the trillions of microbes living in your gut. This inner ecosystem, known as the gut microbiome, has far-reaching effects on skin health, and understanding this relationship can be a game-changer in managing acne effectively.
This connection is known as the gut-skin axis: a bi-directional communication pathway between your digestive system and your skin. It’s one of the most exciting (and empowering) areas in integrative skin health today.
Your inner world of gut microbes play a central role in regulating digestion, immune responses, inflammation, and nutrient absorption. A growing body of research shows how unfavourable changes in the gut bacteria balance (called dysbiosis) can contribute to inflammatory skin conditions like acne, eczema, and rosacea (a, b). A healthy microbiome can support clear, resilient skin by modulating systemic inflammation, influencing sebum production, supporting antioxidant status, and even strengthening barrier function. For example, a healthy gut microbiome produces nutrient-like substances that circulate to the skin where they have anti-bacterial properties agains C. acnes bacteria (a bacteria that can contribute to acne) (a,c).
But when dysbiosis occurs, it can disrupt the gut lining, leading to what’s commonly called “leaky gut.” This is when the intestinal barrier becomes more permeable than it should be, altering immune responses and allowing unwanted particles to slip into the bloodstream. These circulating bacterial byproducts, toxins and inflammatory compounds can influence distant sites, including the skin. This compromised chemical messaging between the gut, immune system and the skin can help explain why gut issues can show up as breakouts, reactive skin, sensitivity, or flare-ups of conditions like eczema by setting of skin inflammation from the inside-out (d, e).
Research suggests acne may begin as an inflammatory condition within the hair follicles and oil glands, with imbalances in the gut microbiome contributing to this process through systemic immune activation and increased inflammation (f).
Emerging research links gut dysbiosis with:
Chronic, cystic, or hormonal acne
Skin sensitivity and inflammation
Impaired detoxification pathways
Nutrient deficiencies (e.g. zinc, vitamin A, omega-3s)
If you’ve tried the topical treatments and nothing’s sticking, your gut might be calling for attention.
So, Can I Just Swallow a Probiotic Supplement?
From "inner beauty" powders to probiotic "pixie sticks", gut-focused skincare products and wellness formulas are everywhere, lining Mecca shelves alongside serums and flooding our favourite social media feeds. It all sounds very fun (and mighty convenient), but is this marketing or medicine? From RMS to The Beauty Chef, brands are banking on the gut-skin connection. Can you really sip your way to clearer skin? Unfortunately, cleaning up your gut (and supporting your skin) isn’t always as simple as swallowing a probiotic. Not yet, anyway.
Some studies have begun to back-up skin benefits of specific probiotic strains. For example, clinical trials have linked these strains to skin improvements and reduced acne symptoms:
Lactobacillus rhamnosus SP1: associated with improvements in adult acne severity.
Lactobacillus casei subsp. casei 327 (L. K-1): shown to support skin barrier integrity, reduce flakiness, and improve hydration.
Lactobacillus salivarius LS03: studied for its potential to reduce skin inflammation and modulate immune pathways in acne (f).
Still, we don’t yet have solid evidence to recommend a one-size-fits-all probiotic. Gut health is personal, and skin health is multifactorial, depending on much more than one or two strains.
That said, probiotics can be incredibly important and effective. They may help in the context of a broader clinical approach, especially when supported by personalised nutrition, prebiotics, stress management, and lifestyle changes that encourage a more diverse, resilient microbiome. I can certainly think of a few practitioner-favourite clinically-trialled probiotic formulas in our clinic that we can draw upon to help restore bacterial balance, modulate inflammation and improve the skin microbiome via the gut!
How Supporting Gut Health Supports Your Skin
Promoting gut health to improve acne isn’t about quick fixes. It involves reducing gut inflammation, supporting healthy digestion and detoxification pathways, and nourishing your microbiome with real, whole foods rich in prebiotics and probiotics.
Managing stress and getting good sleep are equally important, as both affect your gut and skin health through hormonal and immune pathways (g).
By addressing these factors, many clients notice clearer, calmer skin as a natural result of improved gut function and lowered systemic inflammation.
A Better Way to Support Clear Skin (From the Inside Out)
Gut imbalance doesn’t always come with obvious digestive symptoms. You might not have bloating or IBS, and still be experiencing microbiome dysfunction.
Clues can include:
Persistent acne (especially inflammatory or hormonal patterns)
Food sensitivities or skin reactions after eating
Fatigue, mood changes, or poor stress tolerance
History of antibiotics, restrictive dieting, or gut infections
Irregular bowel movements (constipation or loose stools)
Co-existing skin conditions like eczema or rosacea
In clinic, I often see acne resolve when we address underlying drivers like impaired digestion, leaky gut, stress, and blood sugar imbalances. Working with a personalised nutrition practitioner like myself gives you the gentle support to go alongside a practical, evidence-based clinical treatment plan.
Your Skin Is Talking... And Your Gut Might Be the Messenger
The exciting part? You can start healing from the inside out. Through functional testing and a personalised Clinical Nutrition plan, we can support both the gut and the skin - without relying solely on harsh medications or endless creams.
And while probiotics might not be the magic bullet, they can absolutely play a role as part of a well-considered strategy.
Your gut isn’t just about digestion. It’s the foundation of your overall health - and your skin’s appearance is often a reflection of what’s happening beneath the surface.
What You Can Expect in a Clinical Nutrition Consult
In a consultation with together, we go far beyond treating acne topically. I see the skin's surface as the tip of the iceberg. Together, we explore your whole health picture: digestion, eating habits, stress, sleep, energy, and lifestyle factors. This helps us understand what’s driving your skin concerns beneath the surface.
When appropriate, we also use gut microbiome testing to get an in-depth look at your individual gut bacteria balance, identifying imbalances unique to you that standard tests and treatments might miss. Pathology tests also allow me to analyse specific markers affecting skin health, like hormone panels or nutrient status. These personalised insights guide a tailored nutrition and lifestyle plan designed to calm inflammation, support gut barrier function, and rebalance your microbiome.
One client shared:
“From the very first session, Ellen took the time to really get to know me, my lifestyle, my concerns, and what I was hoping to improve. We focused on gut health, low energy, and persistent dry skin and acne. My energy levels have drastically improved and so have my gut issues. We now also have a clear plan in place for my skin and a much better understanding of what’s been causing the issues. Ellen has a really thoughtful, down-to-earth approach and I felt completely heard and supported throughout the process.”
Curious About Your Gut-Skin Connection?
Is It Time to Look Deeper?
If you’re dealing with ongoing acne and feel like you’ve tried everything without lasting success, consider zooming out. Your skin isn’t failing you - it’s just responding. When we listen to your skin and support your gut, we can help it respond in healthier, clearer ways. Let’s explore the root causes together - with a clear, evidence-informed roadmap that nourishes your skin from within.
If you’re ready to explore what might be holding your skin back and want a personalised, clinically informed approach, I’d love to work with you. Addressing the gut-skin connection offers a promising path towards clearer skin and improved wellbeing.
by Ellen Winnett Clinical Nutritionist (BHSc), Health Connection Clinic Founder
Ellen Winnett (she/her) is a university qualified Clinical Nutritionist and the founder of Health Connection, a nation-wide nutrition practice focused on gut, skin, and whole-person health. With a background in clinical nutrition and psychological science, Ellen helps people understand the root causes of their symptoms and restore balance through evidence-based, food-first strategies - supported by targeted prescriptions, lifestyle shifts, and advanced testing where needed.
References
Salem, I., Ramser, A., Isham, N., & Ghannoum, M.A. (2018). The Gut Microbiome as a Major Regulator of the Gut-Skin Axis. Frontiers in Microbiology, 9, 1459. https://doi.org/10.3389/fmicb.2018.01459
Bowe, W.P., & Logan, A.C. (2011). Acne vulgaris, probiotics and the gut-brain-skin axis—Back to the future? Gut Pathogens, 3(1), 1. https://doi.org/10.1186/1757-4749-3-1
Lee, Y.B., Byun, E.J., & Kim, H.S. (2019). Potential Role of the Microbiome in Acne: A Comprehensive Review. Journal of Clinical Medicine, 8(7), 987. https://doi.org/10.3390/jcm8070987
Di Landro, A., Cazzaniga, S., Parazzini, F., et al. (2019). The Role of the Microbiome in Acne Pathogenesis and Treatment: A Review of the Literature. Dermatology and Therapy, 9(2), 235–248. https://doi.org/10.1007/s13555-019-0298-5
Dréno, B., Araviiskaia, E., Berardesca, E., et al. (2020). Microbiome in Healthy Skin, Update for Dermatologists. Journal of the European Academy of Dermatology and Venereology, 34(2), 197–206. https://doi.org/10.1111/jdv.16074
Deidda, F., Amoruso, A., Nicola, S., et al. (2018). Lactobacillus salivarius LS03 and Bifidobacterium breve BR03 Modulate the Inflammatory Response in Human Macrophages: Implications for Acne. Beneficial Microbes, 9(4), 611–620. https://doi.org/10.3920/BM2017.0123
Farahnik, B., Park, K.K., Kroumpouzos, G., et al. (2017). Stress and the Skin: An Update on the Role of Stress in Skin Disease. Dermatology and Therapy (Heidelberg), 7(4), 1–8. https://doi.org/10.1007/s13555-017-0195-9
Isolauri, E., Salminen, S., & Ouwehand, A.C. (2004). Probiotics. Best Practice & Research Clinical Gastroenterology, 18(2), 299–313. https://doi.org/10.1016/j.bpg.2003.10.001
Jung, G.W., Tse, J.E., Guiha, I., & Rao, J. (2013). Prospective, Randomized, Open-label Trial Comparing the Efficacy of Lactobacillus rhamnosus SP1 and a Placebo in the Treatment of Acne Vulgaris. International Journal of Dermatology, 52(12), 1630–1631. https://doi.org/10.1111/ijd.12320
Ogawa, M., Saiki, A., Matsui, Y., et al. (2017). Oral Administration of Lactobacillus casei subsp. casei 327 Improves Skin Condition in Healthy Women: A Randomized, Double-blind, Placebo-controlled Trial. Beneficial Microbes, 8(5), 697–706. https://doi.org/10.3920/BM2016.0225
The New York Times. (2022, March). Keep Your Gut Healthy and Your Skin May Follow. https://www.nytimes.com/2022/03/08/well/gut-health-skin.html
Disclaimer
The views expressed in this article are intended solely for informational purposes. Even if and to the extent this article includes insights from practitioners, this article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment. Readers should not rely on the content for specific medical guidance. Always seek the advice of your healthcare professional for recommendations tailored to your individual circumstances.
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