Dr. Anne Gürtler works on the Dermatology Clinic of the Ludwig-Maximilians-University Munich She is a member of the German and European Societies for Nutritional Medicine. Since specializing in nutritional medicine, she has been researching the connection between diet and inflammatory skin diseases. We asked her some interesting questions about the skin microbiome, as well as questions about the connection between the gut and skin.
Our skin is the largest organ in the human body and is home to more than 10 billion bacterial cells, ranging from 10² to 10⁶ per square centimeter, depending on the region. After the gut, human skin contains the second highest number and diversity of microorganisms. As the body's first line of defense, human skin forms a physical and chemical barrier against the penetration of foreign substances or microorganisms and possesses an immune system that helps ward off infections. This occurs, among other things, through the symbiosis of bacteria. The connection between our gut and skin microbiomes is so close that the skin can be described as a "mirror of the gut"—essentially reflecting how "healthy" we are internally.
We also asked Dr. Anne Gürtler which skin diseases can be associated with a disturbed skin microbiome, what should be considered in skin care, and which foods are particularly beneficial for the skin.
Can you name 3 signs of the most common symptoms/indications that the skin microbiome is out of balance?
Dr. Gürtler: There is no single, definitive sign. Rather, a disrupted skin microbiome can influence many skin diseases, manifesting itself in different ways. Our skin is colonized by countless microorganisms, most of which live in peaceful coexistence. The entirety of bacteria, viruses, fungi, and mites is referred to as the microbiome. In some skin conditions, this balance can be disrupted, leading to inflammation and flare-ups of eczema. For example, in acne, so-called [missing information - likely a specific condition or phenomenon] are frequently observed. Cutibacterium acnes, more about rosacea Demodex mites and in cases of atopic dermatitis Staphylococcus aureus compared to people with healthy skin.
What can be done about it?
Dr. Gürtler: Targeted therapy can be initiated, for example, through topical treatment with prescription creams. A dermatologist should be consulted for this. In addition, daily lifestyle can be crucial. When it comes to skincare, "more isn't always better." I see daily that people with blemishes often follow an overly elaborate cleansing and care routine. Focusing on three key products can help the skin regenerate and regain its balance:
- Gentle cleansing morning and evening (no harsh scrubs to prevent micro-injuries to the skin),
- Skin care (fragrance-free care following face washing),
- Sunscreen (in the morning). Skincare should be individually tailored to your skin type. Consultation with a dermatologist and/or medical cosmetician is recommended.
What I personally find particularly fascinating is the connection between skin and nutrition. According to the latest findings, the skin and intestines appear to be more closely linked than was assumed a few years ago.In some individuals with skin diseases, in addition to a disrupted skin microbiome, the composition of the gut microbiome is also altered, with some species being more prevalent and others less so compared to healthy individuals. Our daily diet is considered an important factor influencing the gut microbiome. Clinical studies are currently investigating whether dietary modification of the gut microbiome can have positive effects on the skin.
What we can already say is that a varied diet characterized by seasonal, unprocessed, plant-based staple foods appears to be beneficial for (skin) health. Probiotics and prebiotics are particularly interesting.
Probiotics: Probiotics are live microorganisms that provide health benefits to the body. These include, for example, lactic acid bacteria and bifidobacteria. They can be produced through the fermentation of foods (sauerkraut, miso, kimchi, kombucha). They can also be taken as supplements. Previous studies with acne patients, for instance, have shown that taking probiotics for several weeks can improve the skin's appearance and lead to positive changes in corresponding markers in the blood and tissue.1
Prebiotics: Dietary components that the body cannot break down, but whose consumption promotes the growth and activity of intestinal organisms. These include, for example, starch in potatoes and whole grains, and pectin in fruits and vegetables.
