Eczema is one of the most common inflammatory skin conditions, affecting both children and adults worldwide. While it appears on the skin, growing research suggests that factors inside the body — including the gut microbiome — may influence inflammation and immune responses linked to eczema.

Understanding the connection between the gut and the skin, often called the gut–skin axis, is helping researchers explore how supporting gut health may play a role in overall skin wellbeing.

Founder Insight

Hanna Sillitoe first became interested in the connection between gut health and skin while recovering from severe psoriasis in her thirties. During this time she began exploring emerging research on the gut microbiome and its influence on inflammation and skin conditions.

This experience sparked a long-standing interest in the role of the microbiome in skin health and inspired the development of Hanna Sillitoe’s gut-focused approach to wellbeing.

What Is Eczema?

Eczema, also known as atopic dermatitis, is a chronic inflammatory skin condition that causes dryness, itching and irritation. It often appears as red, inflamed patches of skin that may crack, flake or become sensitive.

The condition is closely linked to the immune system. In people with eczema, the immune system can react more strongly to environmental triggers such as allergens, irritants or microbes. This heightened immune response can lead to inflammation in the skin.

Eczema is also associated with a weakened skin barrier, meaning the outer protective layer of the skin does not function as effectively as it should. When the skin barrier is compromised, moisture escapes more easily and irritants can penetrate the skin, triggering inflammation.

Although eczema is commonly treated with topical creams, researchers increasingly recognise that internal factors — including immune activity and the microbiome — may also play a role in the condition.

The Gut Connection

The Gut–Skin Axis

The gut–skin axis describes the biological communication network between the gut microbiome, the immune system and the skin.

The gut microbiome is made up of trillions of microorganisms living in the digestive tract. These microbes play an important role in many processes throughout the body, including digestion, immune regulation and inflammation.

Because eczema is closely linked to immune activity, researchers have become increasingly interested in how the gut microbiome may influence inflammatory skin conditions.

Gut bacteria and immune signalling

Beneficial gut bacteria interact closely with immune cells located in the lining of the digestive tract. These interactions help regulate immune responses and maintain balance within the immune system.

When the microbiome becomes imbalanced — a state sometimes referred to as dysbiosis — immune signalling may become disrupted, potentially contributing to inflammatory responses that affect the skin.

The intestinal barrier

The gut lining acts as a protective barrier between the digestive system and the bloodstream. When this barrier is compromised, substances from the gut may pass into circulation and trigger immune reactions.

Some researchers believe that changes in the intestinal barrier may contribute to systemic inflammation linked to inflammatory skin conditions.

Systemic inflammation

Although eczema appears on the skin, it is increasingly understood as a condition involving systemic immune activity. Because the microbiome helps regulate inflammatory pathways, changes in gut bacteria may influence inflammatory responses throughout the body.

Microbiome diversity

A healthy microbiome typically contains a wide variety of beneficial bacterial species. Studies suggest that reduced microbial diversity may be associated with several inflammatory conditions, leading scientists to explore how microbiome balance may influence skin health.

What Research Shows

Research on Eczema and the Microbiome

Interest in the gut–skin axis has grown significantly in recent years, with researchers exploring how the gut microbiome may influence inflammatory skin conditions such as eczema.

Several studies have identified patterns linking eczema with differences in the gut microbiome.

Key findings include:

• Altered microbiome diversity – Some studies have found that people with eczema may have differences in gut microbiome composition compared with individuals without the condition.

• Changes in beneficial bacteria – Research suggests that certain beneficial bacterial species may be reduced in individuals with atopic dermatitis.

• Links to immune system development – Early-life microbiome development appears to influence how the immune system responds to allergens and environmental triggers, which may affect eczema risk.

• Gut inflammation and immune signalling – Because the microbiome helps regulate immune responses, imbalances in gut bacteria may contribute to inflammatory pathways associated with eczema.

Although research into the microbiome and eczema is still evolving, these findings highlight growing interest in how gut health may influence inflammatory skin conditions.

Sources

• Lee SY et al. The role of the gut microbiome in atopic dermatitis. Journal of Allergy and Clinical Immunology, 2018.

• Salem I et al. The gut microbiome as a major regulator of the gut–skin axis. Frontiers in Microbiology, 2018.

• West CE et al. Gut microbiota and atopic dermatitis. Current Opinion in Allergy and Clinical Immunology, 2015.

• Bunyavanich S et al. Early-life gut microbiome composition and atopic dermatitis. Journal of Allergy and Clinical Immunology, 2016.

Supporting the Microbiome

While research continues to develop, many scientists agree that maintaining a healthy and diverse gut microbiome is an important part of overall wellbeing.

Several everyday habits may help support a balanced microbiome.

Eat a diverse range of plant foods

A varied diet rich in vegetables, fruits, legumes, nuts and whole grains provides fibre and nutrients that nourish beneficial gut bacteria.

Increase fibre intake

Fibre acts as fuel for gut microbes. When bacteria ferment fibre, they produce compounds known as short-chain fatty acids, which may support gut barrier function and immune balance.

Include fermented foods

Fermented foods such as sauerkraut, kimchi, kefir and yoghurt naturally contain beneficial microorganisms that may help support microbiome diversity.

Support healthy lifestyle habits

Sleep, stress levels and physical activity can all influence the microbiome. Regular movement, restorative sleep and stress management may help support overall gut health.

Consider probiotic support

Some people choose to support their microbiome with probiotics — live microorganisms designed to help maintain a balanced gut environment.

Common Questions About Eczema and Gut Health

Can gut health affect eczema?

Emerging research suggests the gut microbiome may influence immune activity and inflammation associated with eczema. Scientists continue to explore how the gut–skin axis may play a role in inflammatory skin conditions.

Do probiotics help eczema?

Some studies have explored whether probiotics may help support microbiome balance and immune regulation. While results vary, researchers continue to investigate the role probiotics may play in supporting skin health.

What foods support gut health?

Foods rich in fibre and plant diversity may help support beneficial gut bacteria. Fermented foods can also provide naturally occurring microorganisms that contribute to microbiome diversity.

Conclusion

Eczema is a complex inflammatory condition influenced by many factors, including genetics, immune responses and environmental triggers. While there is no single explanation for why eczema develops, growing research into the gut–skin axis suggests that gut health may play an important role in supporting overall skin wellbeing.

By focusing on habits that support a healthy and diverse microbiome — including diet, lifestyle factors and microbiome support — many people aim to create a more balanced internal environment that may help regulate inflammation.

Understanding the connection between the gut and the skin highlights an important shift in how we think about skin health. Rather than focusing only on the surface of the skin, researchers increasingly recognise the importance of supporting the body from within.

Some people also choose to support their microbiome with probiotics — live cultures designed to help maintain a healthy balance of gut bacteria. Learn more about our Multi-Strain Biotic and how it supports gut health.