How the gut-skin axis influences acne

What causes acne?

As with many other health conditions, we’re now beginning to understand that acne might be driven by inflammation.³ It was once thought that acne was simply the result of an overgrowth of bacteria in the skin, specifically Cutibacterium acnes (which used to be called Propionibacterium acnes). Acne was then, and remains to be, treated like an infection with antibiotics being one of the main treatments for this skin condition.⁴ However, this bacteria is not necessarily the enemy it is made out to be. It is actually an important part of the skin microbiota, and can make up as much as 90% of all microorganisms naturally found living on the skin in areas such as the face and back. In this capacity, it’s a beneficial microorganism that helps the skin maintain a low pH and competes against microorganisms which can cause serious skin infections such as Staphylococcus aureus. Unfortunately, given the right conditions, it can also be quite opportunistic and will continue to grow to a level that contributes to the formation of acne lesions and increases their severity.⁵

The presence of inflammation in the skin is thought to be the main factor which can tip the scales and allow this otherwise beneficial microorganism to worsen skin quality. Inflammation in the skin is believed to increase oil gland secretions, blocking hair follicles and creating an environment that C. acnes loves to grow in.³ As C. acnes begins to proliferate in this blocked oil-rich follicle, immune cells in the skin launch an inflammatory response aimed at keeping these bacteria under control. However, unfortunately the immune response worsens the problem by further increasing skin inflammation. Together, these processes turn blocked hair follicles into pimples and other more severe lesions, such as papules and pustules, associated with acne.³

What causes skin inflammation?

There can be many factors which increase inflammation and oil production in the hair follicles and kick-start this process, including high testosterone levels, insulin resistance, or high levels of stress hormones.⁶ The balance of microorganisms that live within the gut is also of importance, as they are able to influence skin inflammation and the microorganisms living on the skin through the gut-skin axis.⁵

The gut-skin axis and the gut microbiome

The health of the gut microbiota is thought to influence skin health and the development of acne through its effects on the immune system and the levels of inflammation it is programmed to create. A healthy gut microbiome can reduce inflammation produced by immune cells in the gut, with these effects transferred to the immune cells in the skin as they travel from site to site via circulation.⁵ This can reduce the level of inflammation produced by the skin, and help to reduce processes that support the growth of C. acnes such as excessive oil secretion. The gut microbiome also interacts with the skin microbiota through the production of nutrient-like substances which enter circulation and accumulate in the skin, some of which have antibacterial properties that can keep the levels of key microorganisms under control, including C. acnes.^5,7 Studies on the gut microbiome of people with acne have demonstrated low microbial diversity and unfavourable compositions, and these differences are thought to be contributing to inflammatory immune responses in the gut and the skin, worsening the symptoms of acne.⁵

As a healthy gut microbiome may help to prevent or reduce the symptoms of acne, supplementation with specific probiotic strains may help to improve the gut-skin axis and positively affect skin health.

Biome Acne™ Probiotic

Biome Acne™ Probiotic is a clinically-trialled probiotic that has been shown to reduce the symptoms of acne. It contains a combination of three specific probiotic strains, Lactobacillus salivarius LS03, Lactobacillus casei LC03, and Bifidobacterium breve BR03. Specific probiotic strains within Biome Acne™ Probiotic have been studied for their ability to improve the symptoms of acne, demonstrating beneficial interactions with the immune system to help reduce inflammation and production of antimicrobial substances which target C. acnes.¹ In a human clinical trial, the probiotic strains within Biome Acne™ Probiotic significantly improved the symptoms of acne, reduced skin redness, and improved the composition of the skin microbiome by reducing the population of C. acnes. Participants taking the probiotic experienced a 31% reduction in their acne symptoms after 4 weeks, with a 39% reduction in acne severity after 8 weeks.⁸

The gut microbiome and acne

Beneficial microorganisms in the gut, due to their ability to reduce inflammation created by the body’s immune cells and reduce the growth of acne-causing bacteria in the skin, can play a vital role in preventing and reducing the severity of acne. Supplementing with the clinically-trialled combination of probiotic strains found in Biome Acne™ Probiotic can help to improve the impact that the gut has on the skin, and ultimately help achieve clearer skin in those struggling with acne.