Copyright Essence
When we think of the health or appearance of our skin, our stomach’s microbiome may not be the first place we look to for improvement. But if you experience chronic skin conditions, you may want to. Chronic health conditions whether skin, digestive, or hormone-related can be exhausting to navigate, and it can take years to find a routine that feels manageable. If you are fatigued by countless doctor appointments, lab tests, countless over-the-counter remedies, and internet deep dives, you are not alone. Some patients may opt for medical interventions while others research holistic life changes, but neither alone may provide the remedies we seek out. No bodily system works in a silo, meaning they are connected. Oftentimes, struggles with one system can exacerbate struggles with another. For example, a common symptom of gut issues is inflammation, which in turn is a common trigger for skin flare ups. When our systems are working in harmony, they can yield better results both internally and externally, which is where a dual approach comes in. When we say ‘chronic skin conditions,’ we can be referring to sensitivities or autoimmune diseases including atopic dermatitis (eczema), psoriasis, chronic or cystic acne, seborrheic dermatitis, rosacea, or vitiligo to name a few. All of which are conditions dermatologist Dr. Zoe Indigo treats in her practice. “Additionally, I often care for patients with lichen planus, hidradenitis suppurativa (painful nodules and scarring in the underarms or groin), chronic urticaria (hives), melasma (stubborn facial hyperpigmentation), and alopecia areata, which causes patchy hair loss,” she tells ESSENCE. Understanding both the medical and emotional toll that living with these chronic conditions can have, Dr. Indigo prioritizes personalized, holistic treatment plans for long-term management. What causes flare ups? Dr. Indigo highlights that each condition comes with different triggers, though there are some that remain consistent. A large driver across the board? Stress. “The skin and mind are deeply connected, and emotional stress can fuel inflammation in almost every chronic condition,” she says. Additional antagonists can include shifts in environmental factors, hormones or immune systems, allergens and skin irritants, and diet. As far as diet is concerned: “dairy, high-glycemic foods (sugar and refined carbs), alcohol, and processed foods are common triggers for acne, rosacea, and eczema, while psoriasis and hidradenitis suppurativa may worsen with alcohol, red meat, or inflammatory foods. Conversely, diets rich in antioxidants, omega-3 fatty acids, fiber, lean proteins, and fresh fruits and vegetables can support healthier skin and fewer flares.” How are gut and skin health linked? “Gut health and skin health are deeply interconnected through what we call the gut–skin axis, and the immune system is the bridge between the two,” Dr. Indigo outlines. The term “gut health” speaks to “to the balance and diversity of the microorganisms (bacteria, fungi, and viruses) that live in the digestive tract, as well as how well the intestinal lining functions as a barrier.” Both of these factors aid in regulating the immune system, and when not functioning properly, can lead to irritation that affects the skin—it is the body’s largest organ, after all. These microorganisms also aid in digestion and metabolism, making diet a large factor in this process. When dietary triggers are introduced, they can provoke an overactive immune system and weakened intestinal lining which then exacerbates skin issues due to inflammation or excess toxins and bacteria. Dr. Indigo reminds us, “Prioritizing gut health isn’t just about digestion, it’s about creating a stable foundation for the immune system to function properly. The skin is also an immune organ, and the gut acts as both an immune regulator and an inflammation ‘control center’.” While a focus on gut health will not replace medical interventions and dermatological treatments, it can aid in creating the healthiest environment for skin to thrive. Remedies For A Balanced Approach Tailoring both pharmaceutical and holistic treatments to a patient’s individual needs is ideal for long-term maintenance. In terms of medical interventions, that can mean using prescription topical creams such as steroids, non-steroidal anti-inflammatory agents, retinoids, antifungal shampoos, oral antibiotics, biologic therapies, or light-based treatments. For holistic remedies, Dr. Indigo encourages stress management, proper sleep and sun protection, sensitive skincare, and dietary changes that cut back on irritants while incorporating more anti-inflammatory ingredients. She also may recommend supplements depending on the condition. For example, vitamin D and iron deficiencies are quite common, and treating them can address regulating the immune system and inflammation, and wound healing or hair loss, respectively. “Omega-3 fatty acids, from fish oil or plant-based sources, are particularly important for calming inflammation, supporting skin barrier health, and even complementing stronger treatments like isotretinoin (Accutane). I also highlight the role of zinc, which is critical for wound healing, acne control, and immune regulation. For stress-related skin flares, adaptogens like ashwagandha can be a helpful holistic tool to lower cortisol and reduce inflammatory triggers. In addition, probiotics or probiotic-rich foods can help rebalance the gut microbiome.” Overall, it’s all about the synergy of these remedies working together. Where To Begin A slow, intentional approach when incorporating multiple remedies is the best course of action, so as to not overwhelm yourself or your system. Dr. Indigo breaks a multi-level approach down in five central steps: “The first step is always dietary awareness, begin by reducing foods that are known to fuel inflammation and disrupt the gut. At the same time, start adding in more whole, nutrient-dense foods that feed the beneficial bacteria in your gut and help strengthen the gut lining. Starting with a vitamin D supplement is another simple and impactful first step, as it is essential for immune regulation and plays a role in strengthening the skin barrier. Additional supplements can be tailored depending on a patient’s needs. Next, I recommend layering in probiotic and prebiotic support. That can be through probiotic-rich foods like kefir, sauerkraut, or kombucha, or with a high-quality probiotic supplement, paired with prebiotic foods like garlic, onions, and bananas to feed the healthy microbes. Simple hydration and mindful eating—chewing slowly, eating at regular times—also support healthy digestion. Lifestyle practices matter just as much. Stress management is critical; I often suggest mindfulness, yoga, or journaling as accessible practices. Consistent sleep and movement also play powerful roles in balancing both gut and skin health. Finally, I tell patients to integrate these changes alongside their prescribed treatment, not in place of it. The goal is to create a strong foundation where the gut is calm, the immune system is balanced, and the skin responds better to medical therapy. Starting with small, daily habits, like swapping one processed snack for a fiber-rich fruit or committing to five minutes of meditation, makes it more sustainable and easier to build over time.”
