Gut health and its effect on skin

Get clients to consider their gut health and you may just get to the root of their skin issues, discovers Georgia Seago

Until recently gut health, microbiome and probiotics weren’t terms commonly overheard in salons and spas. But this year the wellness industry will encourage us to put our insides under the microscope to look for answers to just about any health concern, and it seems the gut holds a lot of potential when it comes to figuring out the root of common, stubborn skin problems.

“Consumers are now approaching beauty with health in mind, realising that products alone cannot support the skin holistically and certainly cannot address the root cause of certain skin conditions such as acne and eczema,” says nutritionist Mel Turkerman, founder of distribution company Dermanutri. “They are looking for a more holistic approach to supporting their skin’s needs.”

At the root of this new approach is the idea that an unhealthy gut is the cause of a lot of health complaints affecting people in the modern world. “In essence, most of us have some level of unhealthy gut and this is a big cause of so many ailments. But people are getting tired of being prescribed a medication every time something goes wrong,” says Pamela Marshall, clinical aesthetician and managing director of Mortar + Milk salon in Fulham, London.

She believes the wellness industry’s focus on gut health is a sign consumers are realising that controlling our health with drugs isn’t the only way, and instead, “the best possible way is to eat healthily and learn about which foods affect your skin by paying attention to cause and effect.”

Something else health-conscious consumers are likely to start tuning into is the notion of the gut as our “second brain”, capable of telling us things we haven’t previously been able to understand about health problems and how the human body works. “We’re starting to realise we should be more aware of what’s going on in the gut. It’s telling us all sorts of things about obesity, for example, where we don’t yet truly understand why some people can slim down on a diet and some can’t. It’s a fascinating subject,” says Yvonne Wake, a nutritionist and part of Aromatherapy Associates’ panel of wellness experts.

The answers apparently lie in the balance of good and bad bacteria in the gut flora, a complex community of microorganisms that live in the digestive tract, and the hundreds of millions of neurons in the stomach’s lining that communicate with the brain and play an important role in the immune system. “If we’re not getting enough good bacteria to fight off the bad the microbial load becomes imbalanced and creates inflammation in the body,” explains Wake.

Many of the usual suspects are to blame for compromising gut flora: sugar, heavy carbs, caffeine, alcohol and processed foods. High stress levels and a lack of sleep can also throw the body off whack by affecting the microbial load thanks to altered levels of the stress hormone cortisol, weakening the body’s anti-inflammatory response. “This explains why if you are stressed your stomach can be quite upset,” adds Wake.

Dermatologists John Stokes and Donald Pillsbury first established the relationship between gut flora and healthy skin more than 70 years ago after they began to notice gut flora was altered in people with severe acne. “We forget that the skin is our largest functioning organ and it says a lot about our health,” says Wake, adding: “Skin conditions like acne, eczema and dermatitis are actually symptoms of something else that’s going on in the body, like a warning light.”

If the gut flora remains compromised for a period of time it is possible to develop leaky gut syndrome, where the intestines become permeable and allow partially digested food to escape into the bloodstream. “This leads to inflammation, which manifests on the skin.

It’s the body that creates skin problems,” says Wake. This cycle of systematic inflammation builds up toxicity in the body and can stop the digestive system eliminating effectively, sending those toxins straight to the skin.

“If I see someone who has continuous breakouts on their forehead area and ask how often they eliminated their bowels, almost inevitably it wouldn’t be daily,” says Marshall. Lorraine Perretta, a nutritional therapist and brand manager for Advanced Nutrition Programme, agrees that regular bowel movements are directly linked to problem skin. “When people don’t have good elimination you can see it on their skin in acne, but if someone is constipated the skin will look toxic – it’ll look sallow and even the eyes will lose their sparkle.”

She considers ‘regular’ movements as going once for every meal eaten, but says a healthy minimum is once a day. “Never go a day without going,” she stresses. While it might not be a typical treatment room conversation, asking clients how often they go could help you find out much more about the causes of their skin issues and how to treat them.

For salons and spas looking to boost their nutrition offer with a tangible way to introduce clients to supplements, taking on a nutrition brand that offers a high-quality probiotic could be a good idea. “Good bacteria breaks down food, supports the immune system and consumes bad bacteria, while ‘bad’ bacteria secretes toxins and promotes disease,” explains Wake. “The balance of good and bad is what keeps our gut, and therefore our skin and emotional and physical health, in balance.” Probiotic supplements contain strains of active good bacteria to support and increase the healthy bacteria already in the gut, with the aim of preventing further inflammation for a positive effect on the skin.

Perretta says: “A probiotic helps out the good bacteria by supporting what it’s already doing. New research suggests the greater the diversity of the strains in a 2017supplement the better, as some of the bacteria will die on its way through the digestive system, so the higher the number of cultures in the supplement the more that will survive.” Marshall is a strong believer in the power of probiotics to deal with skin concerns by tackling inflammation. She says: “If you can reduce inflammation you can help tackle clients’ skin issues internally while still healing externally. In order to heal the skin, we must look at treating clients by getting to the core of the issue in conjunction with treatment and appropriate skincare.”

The general consensus among nutritionists and healthcare professionals is that the supermarket yoghurt drinks billed as containing good bacteria have a sugar content that outweighs the probiotic goodness. Instead, Marshall says: “I always suggest a probiotic that has 30-50 billion live and active cultures from 10–15 different strains for the first month, and then clients can jump down to about 15–20 million cultures after that.” In her opinion, “Everyone needs a month of critical care and then it’s all about maintenance.”

However, not everyone is in agreement about who should take probiotics. Wake thinks it’s best for clients to get a diagnosis of a gut problem first. “You don’t need probiotics if you don’t have anything wrong with your gut,” she says. “You don’t want to overpower your gut flora balance, which is the whole point to this, keeping the balance right.” But she adds, “90% of the time, if you’re having bad skin problems continuously, you need to look at your diet and [addressing that] will do the job for you.”

When it comes to putting all this into practice in the salon, it helps to figure out a simple, relatable way of explaining the relationship between gut health and the skin to clients beforehand. Start by telling them they’re unlikely to know if their skin concerns are down to poor gut health because most of us just live with issues like acne and eczema and accept them as surface issues. However, Wake thinks it’s worth suggesting going down the gut route if a client suffers from acne and has tried everything to cure it without success.

“You need to see what’s going on in the gut. Advise clients to see an expert and get their poo tested to see how much yeast and good and bad bacteria it contains,” she suggests. “Then they could see a nutritionist and try changing their diet to eliminate the foods that cause inflammation and produce bad bacteria.” Wake does this with her own clients to determine the dietary causes of their skin problems. “For 90% of my clients who do this, their skin improves within five days,” she says.

Therapists shouldn’t be apprehensive when it comes to talking to clients about probiotic supplements. The subject may seem like more of a healthcare topic, but is an essential one for any skincare professional who wants to promote themselves as knowing everything there is to know about treating skin. “Tell clients that their digestion affects their skin, and while you’re not here to deal with their digestion, you’re here as a therapist to deal with skin,” advises Perretta.

“The easiest way to get clients thinking about their gut is by explaining it as directly connected to their skin, so they need to be aware if they have anything on their skin that looks toxic and if they’re not eliminating regularly.”

But as always, every client is different, and Turkerman says it’s important to find out if the client “has recently been on a course of antibiotics, has any digestive disturbances, or has highly sensitive or reactive skin.” If any of these is a factor then she too would recommend they try eliminating or reducing their sugar intake first. “Sugar feeds the bad bacteria, which challenge the probiotics in our gut,” she explains. After eliminating or reducing sugar, she’d then put clients on a probiotic supplement combined with a prebiotic (which contain a special type of non-digestible fibre that acts as fuel for the probiotics to reach the gut and get to work) to give added support for optimising the gut flora. “More advanced protocols may be necessary if the client has a more complex case history and isn’t responding to the treatment,” she says. For this, help clients seek out a Nutrition Society-registered nutritionist or other relevant healthcare professional.

For more on gut-friendly foods and professional products, see the March issue of Professional Beauty.