Acne and Gut Health: Why This Connection Could Help You Clear Your Skin

Did you know that acne is the most common skin disease in the Western world? 

Between 79-95% of adolescents are affected by acne.1 That doesn’t include the masses who continue to struggle with acne throughout adulthood (or maybe even for the first time!).

While acne is a very complex health concern with thousands of potential factors, one thing has become clear. Over the last few decades, tons of research and focused studies have shown a definite link between acne and gut health.

At Primally Pure, we’re dedicated to bringing you the most updated and relevant information on holistic health topics. And there’s plenty of evidence (+ correlations) on this topic. Mounds of research suggest gut health – which impacts full-body health – is involved in the development (or healing!) of acne. 

It’s safe to say: this conversation around acne and gut health could drastically change the health (and appearance) of your skin. 

The Foundational Link: Gut Health + Systemic Health

As a holistic, non-toxic skincare company, we firmly believe your body’s systems are interconnected. Think of gut health as the first to fall in a natural domino effect.

→ Since most of your immune system is housed within your gut, gut health is of utmost importance. 

A healthy gut supports immune health

→ A strong immune system supports systemic (full body) health. 

And as we always say, skin health depends on full-body health – it’s all connected!

A healthy, robust gut should contain a vast microbiome with diverse colonies of:

  • Bacteria
  • Viruses
  • Fungi
  • Protozoa

Why is a diverse microbiome key to gut health? Truthfully, the inner workings of our complex bodies are somewhat of a mystery. Humans are still trying to understand the exact mechanism of the gut + the gut microbiome. 

However, research (and loads of anecdotal evidence) continue to show those with a more diverse microbiome are healthier in the long and short term! This is because your gut microbiome:2

  • Helps your body efficiently remove toxins 
  • Communicates with your brain + supports mental health (known as the gut-brain axis)
  • Absorbs + uses critical vitamins3 
  • Shapes your immune system (for better or for worse)
  • Protects against pathogens 
  • Breaks down metabolites
  • Helps maintain a healthy barrier (to keep toxins from entering your bloodstream)
  • Communicates with your skin (known as the gut-skin axis)4

But your immune system can’t function optimally without a healthy variety of microbes. These altered immune responses (aka a compromised immune system) promote the development of diseases. Including skin diseases.5 

Your immune system plays an enormous role in homeostasis, balance, and full-body health. It helps you function daily without constantly falling ill due to germs and bacteria. 

So, it makes sense that poor gut health could trickle down, eventually resulting in acne, breakouts, and other inflammatory skin conditions. Your gut microbiome plays a vital role in regulating your immune system by communicating with tissues and organs.4 

Here’s what we know: if something is intrinsically off, imbalanced, or triggered within your body, you will often experience a ripple effect. Acne and gut health are connected – your skin is trying to tell you something!

The Connection Between Acne and Gut Health (Gut-Skin Axis)

While it’s not *quite* this simple, at its root, skin health is synonymous with full-body health. Systemic health supports skin health. 

Often, when we address internal imbalances, external signs resolve naturally. This is one of the foundational principles of the gut-skin axis. We often see this in acne and gut health. 

The skin is your body’s largest organ and a detox pathway. It’s the first line of defense against harmful bacteria, fungi, and pathogens (which we know contribute to acne at the very least). But you might be surprised to learn how your skin overlaps – and even mirrors – the roles of your gut. 

Your skin and gut both:

  • Contain their own unique + densely populated microbiome5
  • Have a high cellular turnover rate5
  • Protect you from disease by maintaining homeostasis4

This explains the gut-skin axis, their relationship, and why poor gut health could reflect as poor skin health. It provides a logical connection between skin conditions like acne and gut health since we know they communicate and overlap in their roles.

How a Compromised Gut Can Lead to Skin Conditions

Even though your skin has its own microbiome, studies show it’s still affected by the health of your gut microbiome. A diverse gut microbiome is essential for gut-skin homeostasis. Disrupting gut integrity – or an imbalance of microbes – has “a significant impact on the overall homeostasis of skin.”3 


The state of your gut microbiome impacts both gut and skin tissues.3 And unfortunately, your gut is very sensitive. It requires a delicate balance. Even minor changes in the microbiome “community” can trigger immune-related responses. These immune responses lend themselves to the development of skin “diseases” like:6 

  • Acne
  • Dermatitis
  • Alopecia
  • Rosacea

…and many more. 

Similar to your gut lining, without homeostasis and proper diversity, your skin barrier becomes weak, making you far more prone to pathogens and imbalances. These imbalances and foreign invaders set you up for inflammation, often appearing as acne. 

The bottom line: Homeostasis in your gut supports homeostasis in your skin. In other words, acne and gut health are intricately linked. ;)

Gut-Skin Axis: More Proof

While this concept has been around for quite some time, the gut-skin axis concept has recently gained broader support. Studies prove intestinal bacteria from a weak intestinal barrier (aka leaky gut) can “travel” into your bloodstream and accumulate in your skin.4 

We know acne is an inflammatory response of the skin. Which poses the question: Is it possible that intestinal bacteria accumulated in the skin contribute to inflammation + acne?

The gut-skin axis is also supported by data showing those with skin conditions have an altered microbiome in both their skin and gut.5

Plus, the link between inflammatory skin conditions (like acne) and gut health is common in traditional medical literature. Dysbiosis (imbalance in the gut microbiome) often goes hand-in-hand with a variety of common inflammatory skin conditions like:3,7

  • Atopic dermatitis
  • Psoriasis 
  • Rosacea 

One study even went as far as sampling + comparing the gut diversity of participants with acne. They found that many of the patients with acne had a distinctly similar microbiome, with certain strains higher and others lower than the healthy range.5WOW! 

If we work backward, the connection becomes clear. Many gastrointestinal disorders create – or are associated with – manifestations in your skin. For example, some GI issues are discovered from an obvious skin condition pointing to a deeper seated issue in the GI tract.8 We see this happen with illnesses like:

  • Lupus → butterfly rash 
  • Small Intestinal Bacterial Overgrowth (SIBO) → rosacea9
  • GI Symptoms like gas + constipation → psoriasis10 

On the flip side, a balanced gut microbiome is associated with healthy skin, showing that acne and gut health are definitely connected. But while this is all interesting to consider, it may still leave you wondering: How does the gut become impaired in the first place? 

There are lots of factors, depending on your lifestyle, genetics, and more. But some of the most obvious things we know that can impact your gut includes:

Avoiding these triggers + supporting your body through holistic health practices and a whole-food diet can help bolster a more resilient gut microbiome. While supporting your gut health takes time and intention, here’s the good news: it also encourages healthy skin.

So, how can you support acne and gut health all at once? Glad you asked. ;) 

9 Ways to Support Acne and Gut Health

Your gut is constantly exposed to a wide variety of microbes – internally through food and externally through your environment (household products, personal care products, and the air quality where you live).

Because of this cumulative exposure, it’s essential to be intentional about the good bacteria you’re exposed to. Counteracting potential harmful exposures with good bacteria helps maintain homeostasis, supporting conditions like acne and gut health.

A gut approach (aiming to heal acne and gut health simultaneously) is much safer. It comes with fewer side effects than traditional acne treatments like tretinoin, steroids, birth control, Accutane, or harsh topicals. Plus, it’s a two-for-one. ;)

There are plenty of ways to tangibly support acne and gut health.

  • Stress management + hormone/adrenal balance Stress wreaks havoc on your gut. The more you can find ways to personally help you deal with stress, the better shape your gut will be in. As Dr. Will Cole talks about in length in our expert series interview, the gut-mind connection is strong. Chronic stress or trauma (and the inflammation that goes with it) can easily lead to hormonal imbalances contributing to acne. 

  • *Tip: Check out our founder’s 5 easy tips to balance hormones.

  • Try to avoid antibiotics – While there are situations where antibiotics are necessary (like our founder’s experience with an infected cut!), generally try to avoid antibiotics and seek alternative options. Antibiotics wipe out all the microbes in your body – good and bad, leaving you susceptible to various issues. 

  • Colon Hydrotherapy (Colonics) – These gut-cleansing treatments can help reduce inflammation and clear out old toxins and waste from your gut, giving your body a fresh start. It also intensely hydrates your colon, which many see reflected in the skin. Many report improved skin conditions after colon hydrotherapy sessions.

  • *Tip: Starting with red light therapy, a sauna session, or dry brushing will increase your results.

  • HydrationBeing well-hydrated assists digestion, which helps move waste out of your body properly. Hydration also keeps skin supple and healthy. Healthier skin means a stronger barrier and fewer bacteria/pathogens exposures. 

  • *Tip: Add gel water to your diet to hydrate even better.

  • Healing + soothing topicals – Prioritize ingredients like tallow and other animal-based ingredients that protect your skin microbiome and are easily absorbed + used by your body. When cleansing, opt for gentle, non-stripping cleansers that leave necessary bacteria in place. 

  • *Tip: If you’re a postpartum momma, you can even use breast milk directly on your skin. It’s full of rich probiotics and can help support a balanced skin microbiome.

  • Gut-healthy foods – Support diverse microbial communities and healthy intestinal lining to better absorb nutrients with foods like bone broth, animal-based protein, skin superfoods, and raw dairy (full of probiotics and bioavailable nutrients not found in conventional dairy). 

  • Opt for ethically sourced foods – Whenever you can, opt for organic or regeneratively grown food. These foods have much higher nutrient content and are less likely to be contaminated with toxins like glyphosate.

  • Limit sugar intake – A low-sugar lifestyle is best since it contributes to inflammation and feeds bad bacteria. Especially avoid refined sugars. One study showed a low-glycemic-load diet helped improve acne – showing a clear link between diet and acne, as well as acne and gut health. ;)12

  • Probiotics – Quite a few studies and research have pointed to the possibility of probiotics being an appropriate/effective treatment for acne – both topical and oral.13 The right strains of probiotics could make a huge difference for both acne and gut health.

  • Understanding this intricate and hard-wired connection between acne and gut health (and full-body health) helps us see how prioritizing gut health could be a major factor in healing acne naturally.

    Acne and Gut Health: Heal Naturally

    While healing your gut can have a profoundly positive impact on your skin, there are always other potential factors at play. Healing acne (especially chronic acne) can be a very complex subject with thousands of unique factors impacting each person. 

    While each individual has their own circumstances, focusing on gut health is a great place to start for anyone. It will inevitably support your health on a systemic level. Supporting acne and gut health simultaneously is a win-win for you – and your skin!

    Maybe, for you, healing acne naturally has more to do with the internal cause of acne. Maybe it’s the missing link.


    P.S. If you want to hear an inspiring real-life story of someone who healed their acne from the inside out, check out Grace’s story.


    1. MDPI The Role of the Gut Microbiome and Microbial Dysbiosis in Common Skin Diseases 
    2. National Library of Medicine | Introduction to the Human Gut Microbiota
    3. National Library of Medicine | Impact of Gut Microbiome on Skin Health: Gut-Skin Axis Observed Through the Lenses of Therapeutics and Skin Diseases
    4. National Library of Medicine | The Gut Microbiome as a Major Regulator of the Gut-Skin Axis 
    5. National Library of Medicine | Gut-Skin Axis: Current Knowledge of the Interrelationship Between Microbial Dysbiosis and Skin Conditions
    6. National Library of Medicine | The Gut Microbiome Alterations in Allergic and Inflammatory Skin Diseases - An Update
    7. National Library of Medicine | The Gut Microbiome: Human Health and Inflammatory Skin Diseases
    8. National Library of Medicine | Cutaneous Manifestation of Gastrointestinal Disease
    9. National Library of Medicine | Small Intestinal Bacterial Overgrowth in Rosacea: Clinical Effectiveness of Its Eradication
    10. Frontiers In Nutrition | Involvement of Gut Microbiota in the Development of Psoriasis Vulgaris
    11. National Library of Medicine | Does Glyphosate Affect the Human Microbiota?
    12. National Library of Medicine | A Low-Glycemic-Load Diet Improves Symptoms in Acne Vulgaris Patients: A Randomized Controlled Trial 
    13. National Library of Medicine | Probiotic Bacteria Induce a ‘Glow of Health’


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    If you’ve struggled to keep acne under control, it could be a sign of an underlying imbalance in your body. Acne and gut health are intricately linked. | Primally Pure Skincare

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