Skin Conditions
Explore practical information about eczema, acne, rosacea and psoriasis, including what each condition is, its common symptoms and triggers, and how the immune system, skin barrier and microbiome may be involved. The guides also examine the developing evidence around the gut–skin axis and inflammatory skin health.
Each section provides a quick answer, fuller explanation, useful statistics, related questions and relevant research. Persistent, painful or worsening symptoms should be assessed by a healthcare professional, particularly when there are signs of infection, extensive inflammation, scarring or possible joint involvement.
Eczema
Eczema is a chronic inflammatory skin condition that causes dry, itchy, irritated skin. The most common form, atopic eczema, involves a combination of skin-barrier weakness, immune-system activity, genetics and environmental triggers. The gut and skin microbiomes are also being investigated as part of this wider ecosystem.
Supporting your gut may be one part of caring for eczema-prone skin, but eczema usually needs an inside-and-out approach that also protects the skin barrier and follows appropriate medical treatment.
What is eczema?
Eczema is an umbrella term for conditions that make the skin inflamed, dry and itchy.
The form most people mean when they say eczema is atopic eczema, or atopic dermatitis.
It can appear anywhere on your body and can range from small patches of dry skin to widespread inflammation.
A weakened skin barrier means your skin has more difficulty holding onto moisture and protecting itself from irritants and allergens. At the same time, immune activity within the skin can become over-reactive, producing inflammation and itching.
Why does eczema itch so much?
Itching is one of the defining features of atopic eczema.
Inflammatory signals activate sensory nerves within your skin, creating the urge to scratch.
Scratching may briefly feel satisfying, but it can damage the barrier further.
That creates the familiar:
itch → scratch → barrier damage → more inflammation → more itch
cycle.
This is why controlling itch and protecting the barrier are both important parts of eczema management.
What can trigger eczema?
Triggers vary considerably between people.
They may include:
- soaps and detergents;
- fragrances;
- heat and sweating;
- cold, dry weather;
- particular fabrics;
- allergens;
- infections;
- stress;
- and changes in skin dryness.
Eczema is also associated with other atopic conditions such as asthma, hay fever and food allergy, particularly in children.
Where does the microbiome fit?
Your skin is itself an ecosystem.
Microorganisms living on healthy skin interact with your skin barrier and immune system.
Research has found characteristic changes in the skin microbiome during atopic dermatitis, while differences in the gut microbiome have also been observed. Scientists are therefore exploring a wider gut–skin axis involving microbial metabolites, immune regulation and barrier function.
But this relationship is complex.
Changes in microbes may contribute to inflammation, inflammation may change the microbial environment, or both may happen together.
Think of eczema-prone skin as a vulnerable garden fence
Your skin barrier is like the fence surrounding a garden.
When the fence is strong, it helps keep moisture inside while limiting unwanted visitors.
When gaps appear, moisture escapes and irritants can enter more easily.
Supporting eczema therefore means caring for the fence as well as the wider ecosystem behind it.
- Around 30% of people who develop atopic eczema may first experience symptoms during adulthood.
- 1 chronic itch–scratch cycle can repeatedly damage the skin barrier and prolong inflammation.
- 2 microbial ecosystems — your gut and skin microbiomes — are being investigated in atopic dermatitis research.
- 3 major influences on atopic eczema are genetics, immune dysregulation and environmental factors.
- 2 barriers — the intestinal and skin barriers — feature in modern gut–skin-axis research.
- 4 common atopic problems often discussed together are eczema, asthma, hay fever and food allergy.
- All ages can be affected, although atopic eczema most commonly begins during childhood.
- Why Does Eczema Make Your Skin So Itchy? Inflammatory signals activate sensory nerves while scratching further damages the skin barrier.
- Are Eczema and Allergies Connected?
Atopic eczema commonly occurs alongside allergic conditions including asthma, hay fever and food allergy.
Read More →
- Can Your Gut Microbiome Influence Eczema? Researchers are investigating how gut microbes, immune regulation and microbial metabolites may interact with atopic dermatitis.
- Why Is Moisturising Important for Eczema-Prone Skin? Moisturising helps support a barrier that struggles to retain water effectively.
- Can Probiotics Support Eczema? Some probiotic interventions have been investigated in atopic dermatitis, but benefits appear to depend on the specific strains and population studied.
Atopic dermatitis is increasingly understood as an interaction between skin-barrier dysfunction, immune dysregulation, genetics, environmental factors and microbial ecology.
Researchers have observed alterations in both skin and gut microbial communities in people with atopic dermatitis, but this does not mean that gut dysbiosis alone causes eczema.
Microbial metabolites and gut-mediated immune regulation are now particular areas of interest.
Featured Research
The Good Skin Solution: Natural Healing for Eczema, Psoriasis, Rosacea and Acne
Author: Shann Nix Jones
Publisher: Hay House UK
Publication date: 7 February 2017
Eczema is central to the story behind The Good Skin Solution.
Shann’s experience with her son’s eczema led her to think about skin as part of a wider ecosystem involving the gut, diet, microbes and external skin care. (Meet Shann)
Key Ideas
- Look beyond the visible patch of skin.
- Support the gut microbial ecosystem.
- Feed microbes with diverse plant fibres.
- Respect the skin barrier.
- Combine internal support with gentle external care.
- Never assume one intervention will work for everyone.
“Does eczema start in the gut?”
Not in any simple or universal sense.
The gut microbiome may influence immune and inflammatory pathways, but eczema also has strong genetic, barrier and environmental components.
“Should I treat the inside or the outside?”
Think inside and outside together.
Support good nutrition and your gut ecosystem internally while keeping the skin moisturised and following any appropriate eczema treatment externally.
“Should I avoid lots of foods?”
Not without a good reason.
Food allergy can coexist with eczema, particularly in children, but unnecessary elimination diets can make nutrition harder. Suspected food allergy should be discussed with an appropriate healthcare professional.
Support the internal ecosystem
Probiotic Goat’s Milk Kefir can be included as a fermented food within a varied diet.
Feed resident gut microbes
Complete Prebiotic provides fermentable fibres intended to support the gut microbial ecosystem.
Support dry, sensitive skin
Chuckling Goat’s gentler Kefir Lotion and sensitive-skin products provide moisturising topical support.
These products should be positioned as supportive nutrition and skin care — not treatments or cures for eczema.
Acne
Acne is a chronic inflammatory skin condition in which hair follicles and oil glands become blocked and inflamed. It most commonly affects the face, chest and back.
Hormones, sebum production, follicular blockage, inflammation and the local skin microbiome are major contributors.
Research is also exploring whether the gut microbiome, diet and metabolic signalling influence acne through the gut–skin axis.
What actually causes acne?
Acne develops within something called the pilosebaceous unit — your hair follicle and its associated oil gland.
Several things can happen together:
1. Your oil glands produce sebum.
2. Skin cells accumulate within the follicle.
3. The follicle becomes blocked.
4. Microbes within that environment interact with your immune system.
5. Inflammation produces redness, swelling, papules, pustules or deeper lesions.
Acne can therefore include both non-inflammatory comedones such as blackheads and whiteheads and inflammatory lesions such as spots, nodules and cysts.
Why do hormones matter?
Hormones — particularly androgens — influence sebaceous glands and oil production.
This helps explain why acne is especially common during puberty and why some adults notice changes around their menstrual cycle or other hormonal transitions.
Chuckling Goat explores this relationship in 6 ways to reduce your hormonal acne.
Does bacteria cause acne?
The answer is more nuanced than “bad bacteria cause spots.”
Cutibacterium acnes commonly lives on healthy skin.
Researchers now focus partly on the strain, environment and interaction with the immune system, rather than simply whether the organism is present.
In other words, acne is another ecosystem problem rather than a simple infection.
Where does your gut enter the picture?
Researchers are exploring interactions between:
- the gut microbiome;
- diet;
- insulin and IGF-1 signalling;
- hormones;
- inflammation;
- stress;
- the skin microbiome;
- and sebum production.
That makes the gut a possible contributor, not the single root cause of acne.
Think of a blocked garden drain
Imagine rainwater flowing through a garden drainage system.
If oil, debris and inflammation all converge around one drain, it becomes blocked.
Simply changing the soil elsewhere in the garden may help the wider environment, but the blocked drain still needs attention.
Acne works similarly: supporting your gut can complement proper skin and medical care, rather than replacing it.
- ~80% of people aged 11–30 experience acne at some point.
- ~9% of people worldwide are estimated to be affected by acne.
- 3 main areas commonly affected are the face, chest and back.
- 2 major lesion groups are non-inflammatory and inflammatory acne lesions.
- 4 interconnected influences include sebum, follicular blockage, microbes and inflammation.
- 2 microbiomes — gut and skin — are increasingly studied together in acne research.
- 1 chronic condition can affect both physical skin health and psychological wellbeing, which NICE specifically recognises in acne management.
- Why Do Hormones Cause Acne? Hormones can increase sebum production and influence inflammation.
- Can What You Eat Influence Acne? Dietary patterns may interact with metabolic signalling and your gut ecosystem.
- Why Do Adults Still Get Acne? Hormonal shifts, genetics, skin biology and lifestyle can allow acne to continue well beyond adolescence.
- Does Stress Affect Breakouts? Stress can influence hormonal, inflammatory and gut–brain pathways that may aggravate acne in some people.
- What Role Does the Skin Microbiome Play in Acne? Acne appears to involve interactions between C. acnes, the follicular environment and host immunity rather than simply the presence of one bacterium.
Acne is firmly established as a chronic inflammatory condition of the pilosebaceous unit.
Gut–skin research adds an emerging layer.
Scientists are investigating relationships among gut microorganisms, diet, hormones, IGF-1, sebum, stress and the skin microbiome, but this field is not yet strong enough to replace established acne treatments.
Featured Research
The Good Skin Solution: Natural Healing for Eczema, Psoriasis, Rosacea and Acne
Author: Shann Nix Jones
Publisher: Hay House UK
Publication date: 7 February 2017
Acne is one of the four conditions specifically covered by The Good Skin Solution.
Shann encourages readers to look beyond the visible spot and consider what is happening across the wider ecosystem — including digestion, food, hormones, microbial health and external skin care.
Key Ideas
- Acne is more complex than “dirty skin.”
- Your skin microbiome should be treated as an ecosystem.
- Diet and gut health may influence wider inflammatory pathways.
- Hormones remain important drivers.
- Gentle skin care matters.
- Gut support should complement appropriate acne treatment.
“Is acne caused by poor gut health?”
No single cause explains acne.
Gut health may influence some of the pathways involved, but hormones, sebum, follicular blockage, genetics, inflammation and skin microbes are all relevant.
“Should I scrub my skin to get rid of bacteria?”
No.
Over-cleansing and harsh scrubbing can irritate the skin barrier.
The aim is not to sterilise the ecosystem.
“What if my acne is painful or leaving scars?”
Seek appropriate medical advice.
NICE acne guidance specifically aims to reduce lesions while preventing recurrence and scarring.
Internal ecosystem support
Probiotic Goat’s Milk Kefir can be included as part of a fermented-food diet.
Feed the garden
Complete Prebiotic provides fermentable fibres for the gut microbiome.
External support
A gentle Kefir Lotion suitable for breakout-prone skin can form part of a simple topical routine.
Products should not replace proven acne treatment, particularly where acne is moderate, severe, painful or causing scars.
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Rosacea
Rosacea is a long-term inflammatory skin condition that mainly affects the face, causing symptoms such as flushing, persistent redness, burning, visible blood vessels and sometimes spots or eye symptoms.
Its exact cause is complex, involving immune, vascular, neurological, barrier and microbial factors.
Research is also exploring whether the gut microbiome contributes through the gut–skin axis, but gut support should be considered complementary rather than a cure.
What does rosacea look and feel like?
Rosacea varies widely between people.
Common features include:
- flushing;
- persistent facial redness;
- warmth or burning;
- stinging;
- visible small blood vessels;
- papules and pustules;
- eye irritation;
- and, in some people, thickening of the skin.
The NHS notes that rosacea mainly affects the face and that symptoms may be harder to see on darker skin tones.
Why does rosacea flare?
Rosacea-prone skin appears unusually sensitive to particular internal and environmental signals.
Triggers differ between people but can include:
- heat;
- sunlight;
- hot drinks;
- spicy food;
- alcohol;
- exercise;
- emotional stress;
- temperature changes;
- and irritating skincare.
This is why identifying your own pattern is usually more helpful than relying on a universal trigger list.
What is happening underneath the redness?
Rosacea is not simply an excess of blood near the skin.
Researchers are examining abnormal communication among:
blood vessels + sensory nerves + immune pathways + skin barrier + microorganisms
These systems can amplify one another.
A trigger may stimulate sensory nerves, blood vessels dilate, inflammatory signalling increases, and sensitive skin can become even more reactive.
What about microbes?
The skin microbiome is one area of active rosacea research.
Meanwhile, emerging gut microbiome studies are investigating whether intestinal microbes and their metabolites correlate with systemic inflammation and rosacea.
A 2026 study involving 300 women examined gut microbial patterns alongside metabolic and immune markers in rosacea.
This is interesting — but it does not yet establish a simple “fix your gut, fix rosacea” treatment model.
Think of rosacea as an over-sensitive garden irrigation system
Imagine that a garden’s irrigation pipes react dramatically to tiny changes in temperature and pressure.
The soil matters.
The plants matter.
But the sensitive irrigation system also needs attention.
That is a useful way to think about rosacea:
support the ecosystem, while also managing the specific vascular and inflammatory behaviour of rosacea-prone skin.
- ~5.46% of adults globally were estimated to have rosacea in a large systematic review.
- More than 5% worldwide is the prevalence estimate used in more recent rosacea treatment literature.
- 1.65 people per 1,000 per year were reported as being diagnosed with rosacea in UK incidence data cited by the Health Research Authority.
- 300 women participated in a recent study examining the gut microbiome and systemic inflammation in rosacea.
- 152 studies involving 20,944 people were included in one major systematic review of rosacea interventions.
- 4 interacting systems — vascular, neural, immune and microbial — help explain modern rosacea biology.
- 2 locations matter in microbiome research: the microbial ecosystem on your skin and the one within your gut.
- Why Does Rosacea Cause Flushing? Blood vessels and sensory nerves can become unusually reactive to heat, stress and other triggers
- Can Food Trigger Rosacea? Particular foods and drinks can trigger flushing in susceptible people, but triggers vary greatly between individuals.
- Could Histamine Affect Rosacea Flushing? Histamine can widen blood vessels and contribute to flushing in some contexts; GHE’s skin and histamine content explores this wider pathway.
- Does the Skin Microbiome Matter in Rosacea? Scientists are investigating how skin microorganisms interact with local immune responses and sensitive rosacea-prone skin.
- Could Gut Health Influence Rosacea? Emerging studies are examining gut microbial composition, metabolites and systemic inflammation in people with rosacea.
Rosacea is a chronic inflammatory disorder with multiple interacting mechanisms, not simply cosmetic redness.
Researchers are studying vascular abnormalities, innate immunity, sensory nerves, barrier dysfunction and microorganisms.
The gut–skin axis is a newer component of this picture.
Recent research has detected relationships between gut microbial patterns and metabolic or inflammatory markers in rosacea, but the field is still developing.
Featured Research
The Good Skin Solution: Natural Healing for Eczema, Psoriasis, Rosacea and Acne
Author: Shann Nix Jones
Publisher: Hay House UK
Rosacea is one of the four conditions featured directly in The Good Skin Solution.
Shann’s approach encourages readers to combine gentle external skin care with attention to the wider gut, diet and microbial ecosystem.
Key Ideas
- Rosacea-prone skin often needs gentleness.
- Look for your individual triggers.
- Don’t assume redness is only a surface issue.
- Support nutrition and microbial health internally.
- Respect the external skin barrier.
- Use appropriate medical treatment where needed.
“Is rosacea caused by gut dysbiosis?”
Current research does not establish gut dysbiosis as the universal cause of rosacea.
The gut microbiome is one promising area of investigation within a condition that also involves nerves, blood vessels, immunity and the skin barrier.
“Should I avoid every possible trigger?”
No.
A long list of restrictions can become unmanageable.
Track your own reactions and identify the triggers that genuinely matter to you.
“Should rosacea be treated like acne?”
Not automatically.
Although papules and pustules can look acne-like, rosacea and acne are different conditions and may require different treatment approaches.
Internal support
Probiotic Goat’s Milk Kefir can form part of a fermented-food and microbiome-supportive diet.
Feed your gut ecosystem
Complete Prebiotic provides fibres that gut microbes can ferment.
External support
For sensitive, redness-prone skin, choose the gentlest suitable Kefir Lotion or balm rather than aggressive exfoliating products.
Persistent facial redness, eye symptoms, painful skin or worsening rosacea should be assessed appropriately; products should be positioned as supportive skin care rather than rosacea treatments.
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Psoriasis
Psoriasis is a chronic immune-mediated inflammatory condition that causes skin cells to accumulate much faster than normal, producing well-defined areas of thickened, scaly and often itchy skin.
It is not contagious, and it is more than just a surface skin problem: psoriasis involves systemic immune activity and can be associated with conditions such as psoriatic arthritis. (Psoriasis Association)
The gut microbiome is an active area of psoriasis research, particularly because gut microbes interact so closely with immune and inflammatory signalling.
What is psoriasis?
Psoriasis happens when immune activity disrupts the normal process through which your skin renews itself.
New skin cells are produced much faster than usual and accumulate at the surface.
This creates characteristic areas of:
- thickened skin;
- scaling;
- redness or colour change;
- inflammation;
- itching;
- soreness;
- or cracking.
The appearance varies according to psoriasis type, body location and skin tone.
Is psoriasis autoimmune?
Psoriasis is generally considered an immune-mediated inflammatory disease.
Rather than responding appropriately to a threat, parts of the immune system become persistently activated and generate inflammatory signalling.
This accelerates processes within the skin.
Psoriasis isn’t only about your skin
One particularly important association is psoriatic arthritis, an inflammatory arthritis affecting joints and tendons.
The Psoriasis Association notes that around one in five people with psoriasis also have psoriatic arthritis, although estimates vary across sources and studies.
Psoriasis is also associated with several wider health conditions, making appropriate healthcare particularly important.
What triggers psoriasis?
Common triggers can include:
- stress;
- skin injury;
- some infections;
- particular medicines;
- smoking;
- excess alcohol;
- and other individual factors.
Not everyone responds to the same triggers.
What role could the gut microbiome play?
This is a particularly active field of gut–skin research.
Scientists have reported differences in gut microbial communities between people with psoriasis and healthy controls.
Possible mechanisms include:
immune regulation: gut microbes communicate extensively with immune cells;
intestinal barrier function: disruption may alter exposure to microbial products;
microbial metabolites: compounds including short-chain fatty acids can influence immune regulation;
systemic inflammation: signals originating in one part of the body can affect distant tissues.
But gut dysbiosis is not “the root cause”
This distinction is important.
Psoriasis has a strong genetic and immune component.
Gut changes may contribute to the inflammatory environment, result from psoriasis or associated lifestyle factors, or interact with disease in several directions.
The science therefore supports “gut microbiome involvement is plausible and under investigation”, rather than “psoriasis is caused by your gut.”
Think of psoriasis as an immune garden growing too quickly
Imagine a garden in which growth signals become stuck in the “on” position.
New growth appears before the old growth can clear.
Changing the soil might influence the ecosystem, but the signalling system controlling growth still needs proper attention.
That is why gut support and lifestyle can complement — but should not replace — evidence-based psoriasis care.
- 2–3% of the UK population is estimated to live with psoriasis. (Psoriasis Association)
- Up to 1.8 million people in the UK may therefore be affected by psoriasis.
- Around 1 in 5 people with psoriasis also have psoriatic arthritis according to current Psoriasis Association information.
- Up to 1 in 3 has been reported in some psoriatic-arthritis information sources, illustrating variation between estimates.
- 30 microbiome studies covering 749,275 participants were included in a recent review of psoriasis, psoriatic arthritis and gut microbes.
- 2015–2025 was the decade of publications evaluated in that recent microbiome review.
- 2 connected inflammatory conditions — psoriasis and psoriatic arthritis — can affect both skin and joints.
- Why Do Skin Cells Build Up in Psoriasis? — Immune signalling accelerates skin-cell turnover, causing cells to accumulate at the surface.
- Is Psoriasis an Autoimmune Condition? Psoriasis involves inappropriate immune activation and systemic inflammatory signalling.
- What Is Psoriatic Arthritis? Psoriatic arthritis is an inflammatory joint and tendon condition associated with psoriasis.
- Can Stress Trigger Psoriasis? Stress is commonly reported as a trigger and can interact with immune and inflammatory pathways.
- Could Gut Health Influence Psoriasis? Gut microbiome alterations have been observed in psoriasis, and researchers are investigating their relationship with immunity and inflammation.
There is growing evidence that the gut microbiome differs in people with psoriasis, although studies do not yet identify one universal psoriasis microbiome.
Current research is particularly interested in:
- microbial diversity;
- inflammatory signalling;
- gut permeability;
- short-chain fatty acids;
- immune regulation;
- and whether microbiome-directed treatments can improve clinical outcomes.
A 2025 systematic review and meta-analysis has now specifically examined randomized controlled trials of gut-microbiota-targeted therapies in psoriasis, reflecting how far this field has progressed from observational research.
However, microbiome interventions should still be viewed as emerging adjunctive approaches, not replacements for established psoriasis treatment.
Featured Research
- Psoriasis and gut microbes: research advances from mechanism to clinical application
- Characterization of the Gut Microbiota in Patients with Psoriasis
- Efficacy and safety of gut microbiota-targeted therapy in patients with psoriasis
- Exploring the Gut Microbiome’s Association in Psoriasis and Psoriatic Arthritis
The Good Skin Solution: Natural Healing for Eczema, Psoriasis, Rosacea and Acne
Author: Shann Nix Jones
Publisher: Hay House UK
Publication date: 7 February 2017
Psoriasis is one of the four central conditions covered in The Good Skin Solution.
The book encourages a wider view of inflammatory skin health — combining attention to gut microbes, diet, immune health and external skin care.
Key Ideas
- Psoriasis is more than a cosmetic skin issue.
- The immune system is central.
- The gut microbiome is connected to immune signalling.
- Prebiotic fibre helps feed gut microorganisms.
- Skin care should remain gentle and supportive.
- Internal support should complement appropriate clinical treatment.
“Is psoriasis caused by poor gut health?”
That’s too strong a conclusion.
Research clearly shows interest in the gut microbiome and psoriasis, but psoriasis is a complex immune-mediated disease with important genetic and environmental influences.
“Can changing my diet cure psoriasis?”
There is no single diet proven to cure psoriasis.
A balanced, fibre-rich diet can support overall health and the microbiome, but prescribed psoriasis treatment should not be stopped in favour of diet alone.
“Why should I tell my doctor if my joints hurt?”
Because psoriasis can be associated with psoriatic arthritis.
New or persistent joint pain, stiffness or swelling warrants medical assessment.
Support gut microbial diversity
Probiotic Goat’s Milk Kefir can form part of a varied fermented-food diet.
Feed your microorganisms
Complete Prebiotic provides fermentable dietary fibres for the gut microbiome.
Support dry, scaly skin externally
A suitable Kefir Lotion or balm can provide moisturising support to dry skin.
These should be positioned clearly as supportive nutritional and topical care, not treatments for psoriasis.
Anyone with significant psoriasis, extensive plaques, nail changes or possible joint symptoms should receive appropriate medical assessment and treatment.
