The Gut–Skin Connection: Rosacea, Eczema & Psoriasis

Skin conditions such as rosacea, eczema, and psoriasis are often managed at the surface with creams or medications. But emerging research highlights a deeper link — many of these inflammatory conditions are tied to gut health.

By understanding this connection, we can begin to address the root causes rather than focusing only on symptoms.

Why Gut Health Matters for Skin

The gut influences skin health through nutrient absorption (vitamins A, D, E), metabolism, and immune regulation. When the gut lining is compromised or the microbiome is imbalanced, inflammatory signals can travel through the body — often showing up on the skin.

Rosacea

Rosacea is frequently associated with gut imbalances such as dysbiosis or small intestinal bacterial overgrowth (SIBO). Research shows:

• Patients with rosacea are more likely to have SIBO compared to controls¹.

• Treating SIBO has led to near-complete regression of rosacea symptoms, maintained for months¹.

• Managing gut inflammation and infections such as Helicobacter pylori may reduce flare-ups².

Eczema

Eczema is strongly connected to the gut microbiome and intestinal permeability. Key findings include:

• Changes in gut bacteria can occur before eczema appears³.

• In one study, 40% of eczema patients following a gut-focused elimination diet experienced significant improvement⁴.

When gut bacteria are imbalanced, the immune system becomes overactive — increasing inflammation and triggering flare-ups.

Psoriasis

Psoriasis is linked with chronic inflammation and other health issues such as arthritis, obesity, and metabolic dysfunction. Gut health plays a role through:

• Higher prevalence of inflammatory bowel disease among psoriasis patients⁵.

• Endotoxins “leaking” from the gut into the bloodstream (systemic endotoxemia), which may worsen psoriasis severity⁶.

Supporting Gut Health for Skin

Functional medicine approaches focus on restoring gut balance to improve skin conditions. Common strategies include:

• Dietary support – elimination diets to identify food triggers.

• Restore balance – using prebiotics and probiotics to nourish the microbiome.

• Lifestyle – prioritising sleep, managing stress, exercising, and spending time in sunlight.

• Nutrient support – ensuring adequate intake of collagen, vitamin C, and hyaluronic acid to support skin integrity

The Bottom Line

Not every skin condition is caused by gut dysfunction, but research shows a strong connection. For many people, addressing gut health has reduced symptoms of rosacea, eczema, and psoriasis — improving skin and overall wellbeing.

As Hippocrates said: “All disease begins in the gut.”

References

1. Parodi A, et al. Clin Gastroenterol Hepatol. 2008;6(7):759–764.

2. Gravina AG, et al. World J Gastroenterol. 2015;21(42):12348–12356.

3. Zheng H, et al. J Allergy Clin Immunol. 2016;138(2):632–634.

4. Bath-Hextall FJ, et al. Cochrane Database Syst Rev. 2008;(1):CD004347.

5. Eppinga H, et al. J Crohns Colitis. 2017;11(9):1162–1170.

6. Sikora M, et al. Arch Dermatol Res. 2018;310(8):691–697.

Disclaimer

This article is for educational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. Always consult a qualified healthcare professional before making changes to your diet, lifestyle, or treatment plan.