Dr. Anne Gürtler works on the Dermatological Clinic of the Ludwig Maximilian University of Munich and is a member of the German and European Society for Nutritional Medicine. Since specializing in nutritional medicine, she has been researching the connection between nutrition and inflammatory skin diseases. We asked her a few interesting questions about the skin microbiome, as well as questions about the connection between the gut and the skin.
Our skin is the largest organ in the human body and is home to more than 10 billion bacterial cells, between 10² and 10⁶ per square centimeter of skin depending on the region. After the gut, human skin contains the second highest number and variety 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 has an immune system that helps fight off infections. One way it does this is through the symbiosis of bacteria. The connection between our gut and skin microbiome is so close that the skin can be called the "mirror of the gut" - it essentially shows how "healthy" we are on the inside.
We also asked Dr. Anne Gürtler which skin diseases can be caused by a disturbed skin microbiome, what should be taken into account in skin care and which foods are particularly beneficial for the skin.
Can you name 3 signs for the most common symptoms/signs that the skin microbiome is no longer in balance?
There is no clear indication here. Rather, a disturbed skin microbiome can influence many skin diseases, which then manifest themselves in different ways.
"Our skin is populated by countless microorganisms, most of which live in peaceful coexistence. The totality of bacteria, viruses, fungi and mites is called the microbiome."
In some skin diseases, this balance can be disturbed, causing inflammation and eczema to flare up. For example, in acne, there are more Cutibaterium acnes , in rosacea there are more Demodex mites , and in neurodermatitis there are Staphyloccus aureus compared to people with healthy skin.
What can be done about it?
A targeted therapy can be initiated, for example, through external treatment with prescription creams. For this, a dermatologist should be consulted. In addition, the daily lifestyle can be decisive. When it comes to skin care, "more is better" does not always apply. Every day, I experience that when skin impurities are present, a cleaning and care routine that is too complex is often carried out. Returning to three products can help the skin to regenerate and find its balance again:
1. Gentle cleansing in the morning and evening (no rough peelings to avoid micro-injuries to the skin),
2. Skin care (fragrance-free care after washing your face),
3. Sun protection (in the morning). Skin care should be tailored to the individual skin type. Consultation with a dermatologist and/or medical cosmetician is also recommended.
What I find particularly fascinating is the connection between skin and nutrition. According to the latest findings, the skin and intestines seem to be more closely connected than was assumed a few years ago. In addition to a disturbed skin microbiome, some people with skin diseases also have an altered composition of the intestinal microbiome, with some species present in increased numbers and others in reduced numbers compared to people with healthy skin. Our daily diet is considered to be an important factor influencing the intestinal microbiome. Clinical studies are currently investigating whether dietary influences on the intestinal microbiome can have positive effects on the skin.
Clinical studies are currently investigating whether dietary influences on the intestinal microbiome can have positive effects on the skin. What can already be said is that a varied diet characterized by seasonal, unprocessed, plant-based staple foods appears to be beneficial to (skin) health. Probiotics and prebiotics are particularly interesting.
Probiotics : living microorganisms that provide health benefits to the body. These include, for example, so-called lactic acid bacteria and bifidobacteria. These can be created by fermenting food (sauerkraut, miso, kimchi, kombucha). They can also be taken as supplements. Previous studies with acne patients showed, for example, that taking probiotics over several weeks can improve the skin's appearance and that corresponding markers in the blood and tissue can change positively. 1
Prebiotics : Food 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.
Tell us your go-to skin food recipe!
Especially during the week, I try to use what I have in the fridge/pantry. I like to combine different food groups in a hearty bowl. The miso tahini dressing rounds everything off.
Ingredients:
- Complex carbohydrates, cooked
(e.g. green spelt/brown rice/millet/bulgur/potatoes/couscous/whole grain pasta)
- Seasonal vegetables, raw or roasted in the oven
(currently in autumn e.g.: pumpkin/Brussels sprouts/carrots/beetroot/aubergine)
- Seasonal fruit
(currently in autumn e.g.: apple/pear/grapes/dates/figs)
- High-quality protein
(e.g. tofu/tempeh/legumes (e.g. chickpeas))
- High-quality fats
(e.g. avocado/nuts)
- toppings
(e.g. cress/hemp seeds/roasted onions)
- Dressing: 70g tahini, 2 tbsp light miso paste, 1 tsp fresh chopped ginger, 1 tsp roasted sesame oil, 1 tsp maple syrup, 1 tsp soy sauce, 2-3 tbsp water
Preparation:
Puree all dressing ingredients with a hand mixer until you have a creamy sauce. Place the individual components of the bowl next to each other and drizzle with the sauce.
Sources:
- Fabbrocini, G. , et al. Supplementation with Lactobacillus rhamnosus SP1 normalizes skin expression of genes involved in insulin signaling and improves adult acne. Benef Microbes 7 , 625-630 (2016).
