You know the old saying, the eyes are the windows to the soul. Maybe that’s true. But what researchers know for sure is that the skin is the window to what’s going on inside the body.

And when people deal with skin problems like acne, psoriasis, eczema by immediately resorting to over-the-counter creams and lotions, or the pharmaceuticals potions dermatologists routinely prescribe, sufferers often wind up just masking the problem, treating symptoms whose causes are more than skin-deep. And sometimes, even making matters worse. So, what to do instead? How about a more enlightened approach that connects the dots? Here’s where to start:

Skin health – or the opposite — starts on the inside.

Instead of high-tailing it to the drug store for relief, with my patients I often recommend looking into the skin-gut connection first, instead of pharma options. What’s going on inside the gut, especially with the trillions of the bacteria that live there, often directly affects the skin. When the gut microbiome is out of synch with the  rest of the body – a case of too few microbial strains or an overabundance of unfriendly strains – it often makes itself know in the form of common skin rashes, irritations and/or eruptions.

Your gut and skin are allies.

That the skin and the gut share this connection (and interconnection) shouldn’t come as much of a surprise. Both defend the body against foreign invaders, the skin from harmful bacteria and other toxins in the air and the soil, and the gut from any microbial bad news that enters the GI system along with the food we eat, preventing it from getting into the bloodstream. Both the skin and the gut depend on the friendly bacteria, working in tandem with our human cells, to keep these defenses in good working order.

Your gut and skin talk to each other – a lot.

Even if we don’t always know the exact conversation between gut and skin, we do know they’re talking to each other. Studies which have looked at people with psoriasis have found that they also have a disordered or altered gut microbiome. It’s a similar story with acne. Studies show an overpopulation of unfriendly bacteria on the skin of acne-sufferers, similar to what we see in the guts of people with common problems like IBS. There is the strong suggestion that gut “dysbiosis” contributes to skin “dysbiosis,” which is also a strong indicator that getting your gut in order should be put high on the healing to-do list.

Messed up microbiomes make skin struggle.

For some skin struggles, topical (and possibly toxic) creams may temporarily tame some symptoms, but they don’t deal with root causes, and one of the biggies is an unbalanced gut microbiome. Though there are a number of ways the delicate bacterial balance in your gut can shift to an unwell state, two big ones – which I can all but guarantee your dermatologist won’t check for (but should!) – are SIBO, or small intestinal bacterial overgrowth and SIFO, or small intestinal fungal overgrowth. To help you and your practitioner determine if SIBO or its fungal cousin SIFO may be wreaking havoc, check out my pointers on how to know if either are undermining your gut health and messing with your skin’s health.

Inflammation is one of their common enemies.

Inflammation is likely the most common link between skin and gut. As generations of teenagers have discovered, a fatty, greasy high-carb diet is a sure way to pump up the over-production of skin oil, or sebum, which can lead to acne. Research suggests that part of the problem is that a low-fiber, high-carb diet starves the good gut bacteria which contributes to toxins escaping into the bloodstream (“leaky gut”), triggering inflammation throughout the body, including the skin.

Stress is also a major gut and skin health wrecker.

Stress, another source of systemic inflammation, is another place where gut and skin meet. Again, teenagers, and for that matter, the rest of us, have learned that periods of higher-than-usual anxiety, especially when combined with low or poor sleep, often leads to skin break-outs. At the level of the gut, researchers have found that this kind of mega-stress can actually throw off the production of neurochemicals inside the gut which help calm the body, likely further stressing the skin.  

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In addition to run-of-the-mill (but serious) stress, doctors in the mental health field have known for years that patients experiencing serious emotional issues often also have gut and skin problems. On the happier side of the coin, I and my integrative health colleagues appreciate that when we work with our patients on diet and stress to address their gut problems, over time, that healing process tends to result in upgraded skin health, as in skin that’s plumper, smoother, and with a healthier glow. Granted, it’s not a snap-your-fingers instant complexion fix – but over a period of weeks and months, the improvements are hard to miss.

Get your skin and gut in order – so they can shine.

If you’re ready to start turning the ship around, here are a few steps to start taking now, for big benefits in due time. Try them at your own pace, adding one step at a time, or several at once if that’s easier for you to manage:

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1) Eat Smart: Cut back on sugar and high-carb foods and you’ll likely see the difference in a healthier complexion, for some people in just a matter of days. Add lots of fiber rich veggies, and keep the starchy ones to a minimum. Also steer clear of of lousy-for-the-gut, cheap, industrial oils in processed foods. If you do consume them, don’t be surprised by a dermis rife with skin irritations and/or extra-oily skin prone that’s to break-outs.

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2) Two-week elimination diet: What you eat can have a huge impact on how your skin looks. What’s making it misbehave? One of the most common is food sensitivities, with the most common food irritants being dairy and gluten. If you’ve spent a life loading up on either or both, try going cold turkey for two weeks and see if you one of these common food-skin triggers may be causing a lot of the trouble.

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3) Anti-inflammatory allies: Foods high in omega 3 fatty acids have an system-wide anti-inflammatory effects. Hard to beat small, fatty fish like sardines and anchovies for an anti-inflammatory boost. Think calm, healthy gut, equals calm, healthy skin. If you’re way into sugar, start taking steps to kick it – it’s a major inflamer.

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4) Prebiotics and probiotics: High-fiber foods like onions, asparagus and radishes are prebiotic, that is, they feed the friendly bacteria that tamp down inflammation. A cruciferous veggie like broccoli does that and more, helping to detoxify environmental toxins in the liver that can negatively affect skin health. Probiotic foods like sauerkraut, kimchi and kombucha help maintain a healthy gut microbiome balance.

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5) Drink up: Yep, good old-fashioned water. One study found, the more you drink, the healthier your skin was likely to be, so get your  6 – 8, 8 oz glasses every day.

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6) De-Stress: Yoga and meditation, any form you like, are excellent ways to take the edge of those over-active stress hormones that can stress out your skin. Deep, high-quality sleep, at least seven hours night, is a must. And moving your body, be it a brisk walk or something more vigorous, packs a beneficial one-two punch. Not only does the physical activity have a calming effect on the nervous system but the sweating that goes along with it stimulates the excretions of toxins from the skin.

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7) Do some SIBO sleuthing: Most of the time, conventional medical professionals are happy to ignore the gut. You, however, should not. If your gut is out of balance, or ‘leaky’, focus on healing and sealing your gut to guide it out of dysbiosis and back into balance. If you and practitioner determine that it’s actually SIBO (or SIFO) causing the trouble, then anti-microbials first is the way to go, as prebiotics and probiotics can worsen symptoms at first – making proper diagnosis especially important.