Dr. Anne Gürtler works at the Dermatological Clinic of the Ludwig Maximilian University in Munich and is a member of the German and European Society for Nutritional Medicine. Since specializing in nutrition medicine, she has been researching the connection between nutrition and inflammatory skin diseases. We asked her some exciting 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, depending on the region between 10² and 10⁶ per square centimeter of skin. After the gut, human skin contains the second highest number and variety of microorganisms. As the body's first line of defense, human skin provides a physical and chemical barrier against intrusion by foreign substances or microorganisms and provides an immune system to help fight infection. This happens, among other things, through the symbiosis of bacteria. The connection between our gut and skin microbiomes is so tight that the skin can be described as the "mirror of the gut" - it essentially shows how "healthy" we are on the inside.
We have Dr. Anne Gürtler also asked which skin diseases can cause 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 for the most common symptoms/signs that the skin microbiome is no longer in balance?
Dr. Gürtler: One cannot name a clear indication here. Rather, a disturbed skin microbiome can have an influence on many skin diseases, which then presents itself differently.Our skin is populated by countless microorganisms, most of which live peacefully together. The entirety of bacteria, viruses, fungi and mites is referred to as the microbiome.In some skin diseases, this balance can be disturbed, causing inflammation and eczema to flare up. For example, there are more Cutibaterium acnes in acne, more Demodex mites in rosacea and more Staphyloccus aureus in neurodermatitis compared to people with healthy skin.
What can you do about it?
Dr. Gürtler: A targeted therapy can be initiated, for example, by external treatment with prescription creams. A dermatologist should be consulted for this. In addition, the daily lifestyle can be decisive. When it comes to skin care, “a lot helps a lot” doesn’t always apply. Every day I experience that in the case of skin blemishes, too complex a cleaning and care routine is often carried out. A return to three products can help the skin to regenerate and find its balance:
- Mild cleansing in the morning and evening (no rough peelings to prevent micro-injuries to the skin),
- Skin care (scent-free care after washing the face),
- Light protection (in the morning). The skin care should be individually tailored to the skin type. A consultation with a dermatologist and/or medical cosmetics specialist is also recommended for this.
What fascinates me personally 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 a changed composition of the intestinal microbiome, in which some species are more numerous and others are fewer than in people with healthy skin. Our daily diet is considered an important factor influencing the intestinal microbiome. Clinical studies are currently investigating whether dietary influence on the intestinal microbiome can have positive effects on the skin.
What can already be said: a varied diet characterized by seasonal, unprocessed, plant-based staple foods seems to be (skin) health-promoting. Of particular interest are probiotics and prebiotics.
Probiotics: live microorganisms that provide health benefits to the body. These include, for example, so-called lactic acid bacteria and bifidobacteria. These can result from the fermentation of foods (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 complexion and the corresponding markers in the blood and tissue change positively.1
Prebiotics: Food components that the body cannot break down, but the consumption of which promotes the growth and activity of intestinal organisms. These include, for example, starch in potatoes and whole grains and pectin in fruit and vegetables.
Tell us your go-to skin food recipe!
Dr. Gürtler: Especially during the week, I try to use what's in the fridge/pantry. I like to combine different food groups in a hearty bowl. The miso tahini dressing rounds everything off.
- Complex carbohydrates, cooked
- Seasonal vegetables, raw or oven-roasted
- Seasonal fruit
- High quality protein
- High quality fats
- 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
Pure all the dressing ingredients with a hand mixer to a creamy sauce. Place the individual components of the bowl next to each other and drizzle with the sauce.
- Fabbrocini, G., et al. Supplementation with Lactobacillus rhamnosus SP1 normalizes skin expression of genes implicated in insulin signaling and improves adult acne.Benef Microbes 7, 625-630 (2016).