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Acne and Gut Health: The Gut-Skin Connection

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The frustration of inflamed skin has become more prevalent in adult years. I attribute much of this to the fact that acne and gut health go hand in hand. Gut health could actually be the window to solving what the root cause of your acne is. 

Woman struggling with acne

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Acne, especially as an adult, is so frustrating. The frustration of inflamed skin has become more and more prevalent in adult years, long after the woeful days of puberty have come and gone. I attribute much of this to the fact that acne and gut health go hand in hand. Gut health could actually be the window to solving what the root cause of your acne is. 

Remember, acne has very little to do with hygiene and much more to do with imbalances in the body. Now, every case is different and it’s not always as simple as “heal your gut, heal your skin,” but your gut microbiome does play a very important role in skin health and shouldn’t be overlooked as an important contributing factor. 


I know all about the adult acne struggle because I experienced it firsthand for 18 years of my life. The unending aggravation of waking up each morning to a new crop of inflamed pustules. I would look in the mirror and become so frustrated that I was well past my teen years and still feeling like a middle schooler. And when I say I tried everything, I mean I tried EVERYTHING…

Oral antibiotics like doxycycline and minocycline, topical antibiotics like clindamycin, retinoids like tretinoin, AHAs like salicylic acid, and of course— the tried and true benzoyl peroxide. 

And then I got into the natural remedies… clay masks, apple cider vinegar, green tea as a toner. I even went as far as only washing my face with bottled water. 

And without fail, even after my bazillion step skincare routine, each morning I awoke to a new inflamed friend smack dab in the middle of my face. 

The piece I was missing all along was the fact that while products are effective to a point, they can only take you so far when you don’t address the inflammation within at the same time. It wasn’t until I took my gut health seriously and began taking steps to heal from the inside out and reverse my autoimmune symptoms that I began to see improvements in my skin. Our bodies are more connected than we even begin to understand. 


I know you’re well aware that acne generally equals blemishes on the skin. I’m not here to patronize! But do you truly know how acne forms and where those inflamed bumps actually come from? 

What is acne
Here’s a quick overview: 

All over your skin you have little pores that share a space with your hair follicles. Beneath the surface of those pores are your sebaceous glands, which produce sebum (AKA oil, kind of) to keep your skin moisturized. 

Acne occurs when your sebaceous glands create too much sebum (usually due to pesky hormones) and clog your pore. Because the pore is clogged, the sebum isn’t able to carry your dead skin cells away efficiently. The dead skin cells and sebum continue to clog up, creating a closed comedone, or in other words, non-inflammatory acne. 

The party really starts when bacteria enter the building, particularly Cutibacterium acnes (C. acnes), previously known as Propionibacterium acnes (P. acnes). This bacteria joins the dead skin cells and sebum, creating an inflammatory response— infection and swelling surrounding the pore. In other words… an inflamed pimple. 

So really what it comes down to is: 

  • Sebum production, which is controlled by hormones
  • Overgrowth of C. acnes bacteria
  • Buildup of dead skin cells
  • And your body’s inflammatory response

Most conventional acne treatments attempt to address one of the factors above. Antibiotics and benzoyl peroxide work to address the overgrowth of bacteria. Retinoids and AHAs work to speed up cell turnover and clear up the clog within the pore. 

But the important piece we’re missing is why is the body producing too much sebum to begin with? Why is the body overloaded with pathogenic C. acnes bacteria? Why is the body in a persistent inflammatory state? 

And most importantly— what can we do to identify the cause as to why these imbalances are occurring in the first place? 


A huge factor often overlooked with acne is the state of your gut. As I’m sure you know already, I’m a huge believer that the microbiome is at the center of our health. And this most definitely includes skin health! Acne and gut health are connected in more ways than you may realize. Did you know there’s such a thing as a skin microbiome?

Here’s some background on the microbiome:

Your microbiome hosts billions of microorganisms like bacteria in which some strains are beneficial and some pathogenic. The goal is to have a good balance of microorganisms where the healthy strains outweigh the not so healthy. 

Trouble arises when this balance is out of whack and bad bacteria make themselves a little too comfortable. When the ratio of good to bad microbes is off, your gut is in “dysbiosis.” 

Dysbiosis leads to leaky gut, which means the tight junctions along your gut lining loosen, the cells along this protective wall spread apart, and larger inflammatory molecules (like bacteria) can therefore “leak” into your bloodstream. Your gut lining is meant to stay sealed up tight so that only beneficial things (like nutrients) can filter through. 

acne and gut health
But how does that affect acne and skin health? 

As you can imagine, leaky gut causes a TON of inflammation. The bad bacteria that flow through your bloodstream produce inflammatory compounds, which triggers an immune response that leads to more inflammation throughout the body, including the skin. And as we know, the body being in an inflammatory state is a big contributor to acne. 

BUT not only does inflammation affect acne, but also the specific pathogenic bacteria that attack the sebaceous glands in your skin. 

The skin is your body’s largest organ (yes, organ!) and its first defense. Similarly to how your gut has a balance of bacteria and other microorganisms living within, so does your skin! We call this the “skin microbiome.” This delicate balance strengthens your skin’s barrier, but again like the gut, only if you have more good bacteria than bad. 

If you have leaky gut, we know that your body’s bad to good bacteria ratio is off kilter and the pathogenic bacteria travel through the gut lining and into other areas. Other areas like your skin microbiome. 

If you have an overgrowth of one particular bacterial strain, C. acnes, and it lives on your skin in high amounts, it triggers the frustrating and dreaded condition we all know so well— acne. 

So in short, the gut affects both inflammation AND bacteria balance— two major contributing factors known to trigger breakouts. Thus, acne and gut health go hand in hand. 

The Test I Recommend: Needless to say, gut infections and imbalances lead to inflammation in the skin and acne. This is why it’s so important to identify what infections and imbalances you may have. I recommend the GI Map Stool Test to do just that. It uses a sample of your stool to analyze the state of your GI tract by detecting your harmful versus healthy bacteria balance and identifying any harmful infections, pathogens, parasites, active viruses, and more. It does this by actually measuring the DNA of the microbes in your GI tract. 


Because gut health is imperative when it comes to acne, it’s important to take care of and replenish the good bacteria in your gut microbiome. One way to do this is by taking a quality probiotic supplement!

probiotics and acne

Probiotics are supplements that contain live bacteria that colonize in your gut microbiome.  A probiotic that is potent with diverse, beneficial bacteria strains that survive your digestive tract can benefit any function of your body that your microbiome affects. Therefore, probiotics have a big impact on the health of your skin. 

The probiotic I recommend most is Seed’s DS-01TM Daily Synbiotic. It’s actually a 2-in-1. It’s a 24 strain probiotic + prebiotic blend. This means it contains both live bacteria (probiotics) AND fuel that bacteria feed on (prebiotics). The bacteria in Seed’s Daily Synbiotic is scientifically proven to survive the journey through your GI tract AND the benefits of the specific strains used are evidence-based. 

You can also save 15% off your first month’s supply of Seed’s Daily Synbiotic by using code NIKKIYELTONRD at checkout! 


While getting to the root cause and healing your gut is one of the most essential things when healing acne, choosing the right skincare is also of utmost importance!

Commonly used cosmetic products, including makeup and skincare contain striking amounts of toxic metals, like lead, arsenic, and mercury. Too much of a toxic load leads to inflammation, which is not good for your skin, especially when struggling with acne. 

I highly suggest opting for gentle non-toxic skincare products as to be kind to your skin microbiome and lessen your toxic load. My favorite skincare brands that I personally use and love is Annmarie Skincare and Primally Pure. I use Annmarie Skincare for my everyday routine and Primally Pure for a little extra self care with masks and serums.


You may have been told in the past that food and acne are not correlated but in my opinion, that is just not true. It’s not simple enough to say that only certain foods cause acne— I’ll give them that. The food-acne connection is not black and white. However, this is because we are all very different from one another, our respective microbiomes are different, and therefore our food sensitivities and health triggers will be different as well. 

We DO know that food can create inflammation in the body. And, inflammation in the body can trigger acne. 

Foods to avoid in your diet 

There are two inflammatory food groups that contribute to acne— foods that aggravate the gut by triggering an immune response and foods that feed and promote the growth of bad bacteria. Let’s call them triggers and feeders. 

1. Trigger foods 

Because trigger foods cause an immune response, they produce inflammatory compounds that end up throughout the body, including the skin. The most common trigger foods when it comes to acne are gluten, cow’s dairy (particularly A1 dairy), and omega-6 fatty acids. 

If you do have these sensitivities, when you consume gluten, your immune system detects and reacts to undigested proteins in gluten— gliadin and glutenin. 

When you consume cow’s dairy products, your immune system reacts to the A1 casein as it’s very difficult to digest. Cow’s dairy also heightens your levels of insulin like growth factor-1 (IGF-1), which contributes to acne. 

And when you consume omega-6 fatty acids (commonly arachidonic acid and linoleic acid) in processed foods and seed oils, you are actually consuming a precursor to inflammatory lipid mediators. The goal is to have a lower ratio of omega-6 to omega-3 fatty acids.

2. Feeders 

Feeders are foods that actually serve as fuel for bad bacteria and fungi in your GI tract. They help to make your gut a perfect environment for these pathogenic microbes. The most common feeders are sugary foods (think sweets and soda) or foods that easily convert to sugar (think white pasta, white bread, and alcohol). It’s also best to avoid any overly-processed foods and oils.

When you eat a sugar filled diet, you are literally feeding the bad bacteria and yeast, thus making the microbes stronger and allowing them to thrive and spread to areas such as, you guessed it… your skin. 

While these are examples of the most common inflammation inducing foods, food triggers are unique to each person. This means that even certain “healthy” foods can be problematic if you have a specific sensitivity. This is why it’s best to identify what your unique triggers are with functional medicine testing.

The Test I Recommend:I use the LEAP 170 MRT Food Sensitivity Test with my clients so we can get to the bottom of their food triggers once and for all. The MRT is the best food sensitivity test on the market which identifies 170 food and chemical reactions that lead to Type 3 and 4 hyper-sensitivity pathway reactions. This can help you understand even the most mysterious food sensitivity related problems.

Foods to include in your diet 

The best foods to include in your diet when it comes to skin health are foods that feed the GOOD bacteria in your gut and strengthen your gut lining! We’re talking about healing, nourishing, nutrient-rich, and delicious foods. 

Here are some tips: 

  1. Include tons of fiber-rich foods in your meals because fiber moves through your GI tract undigested and feeds good bacteria only! Once your gut metabolizes the fiber, it releases short chain fatty acids, which are wonderfully anti-inflammatory. 
  1. Eat the rainbow! The more colorful your plate, the better. In each pigment, there are unique potent antioxidants and free radical fighting properties. For example the red pigment in tomatoes is lycopene and the orange pigment in carrots is beta-carotene. I also recommend adding superfood powders which are concentrated antioxidants such as Acerola cherry which has and can be added as a supplement or added right into a smoothie or juice. 
  1. Drink bone broth on the regular. Bone broth is liquid gold for the gut! It’s one of the best natural sources of collagen, gelatin, L-glutamine, glutathione, AND glycine. It’s a mouthful, I know.. but ALL of these are fantastic at healing and supporting the gut microbiome! 
tips to heal acne and the gut with food

And if you’re in need of some help coming up with gut-healing meal ideas and ingredients, I created an awesome Gut & Autoimmune Meal Plan Membership with specific meal plans, recipes, and resources to help you with what to eat!


Another aspect of your diet that contributes to acne is having sufficient nutrient levels. Having adequate nutrient levels ensures your body is able to function and respond to threats properly and efficiently. When you are nutrient deficient, your immune system is unable to fight off inflammation and pathogenic bacteria as effectively. 

These nutrients have been clinically studied and deficiencies have been found to have correlations with acne:


Zinc decreases oil production in the skin, which reduces the risk of bacterial overgrowth and clogged pores. It also keeps your skin’s cell walls stable and helps the cells to divide as they grow, which helps with cell turnover and skin healing. 

Good sources of zinc include: Shellfish, flaxseed, hempseed, pasture-raised beef

Vitamin A:

Both upper and lower layers of your skin need and utilize vitamin A. Vitamin A is a potent antioxidant that fights free radicals and helps to heal cell damage. It decreases inflammation and promotes new skin cell growth by speeding up cell turnover. It also helps the sebaceous glands in your hair follicles work properly. 

Good sources of vitamin A include: Leafy green vegetables, pasture-raised liver, carrots, sweet potatoes, squash

Vitamin C:

Vitamin C plays an important role in protecting and healing skin along with producing new skin cells. It helps to increase the production of collagen, which is a protein that’s responsible for the structure of your skin. It’s anti-inflammatory, reduces redness and swelling, and can accelerate the healing of acne and acne scars. 

Good sources of vitamin C include: Oranges, lemon, kiwi, broccoli, brussels sprouts, cabbage


Selenium helps to produce glutathione peroxidase, which is an enzyme that fights inflammation, including inflammation in acne. It also helps to protect antioxidants like vitamins A and E, which increases overall antioxidant levels.

Good sources of selenium include: Brazil nuts, fish like tuna, halibut and sardines, sunflower seeds


Glutathione regulates cell function and eliminates free radicals. If you don’t have enough glutathione, free radicals can multiply and cause oxidative stress. When you have enough glutathione, you’re better able to eliminate free radicals and replace damaged skin cells.

Good sources of glutathione include: Bone broth, spinach, avocado, asparagus, okra

acne and gut health

The Test I Recommend: I recommend working with a functional medicine practitioner to get your micronutrients tested annually. Micronutrient testing allows you to gain valuable insight into nutrient stores. This serves as the blueprint to correct and support important micronutrient levels. This is one of the many important tests I always run with my clients!


While acne and gut health are indisputably intertwined, there are of course other factors at play. Gut health is just one major player in the multi-faceted approach to healing acne. 

possible causes of acne

Other factors not to be ignored include: 

  • Genetics: While there isn’t a specific gene that causes acne, if your parents struggled with breakouts, you are more likely to experience them as well. 
  • Hormonal changes: Hormones are a major contributor to sebum production, which is one of the main factors that cause clogged sebaceous glands, leading to acne. 
  • Stress: Stress affects both hormones and inflammation, both major acne risk factors. 
  • Toxicity: When your body is overburdened with toxins such as environmental pollution and heavy metals, inflammation ensues.   
  • Insulin resistance: When you eat a high glycemic diet (too much sugar), it can trigger hyperinsulinemia, which is when your pancreas produces too much insulin to try to balance your blood sugar. This can trigger acne.
  • Liver congestion: The liver is one of the major pathways for natural detoxification. When your liver is overburdened with toxins, it creates chronic inflammation which leads to skin conditions such as acne.  

A guided reset can help eliminate possible food triggers, inflammation, and reduce your toxic load, which is a great head start to combat acne! 

A reset meal plan is designed to reset your microbiome and reboot your body by following a specific gut healthy and autoimmune friendly meal plan in combination with supporting phase 1 and phase 2 liver detoxification for optimal health.

It reduces the burden on the digestive system and the liver by taking digestive rest, enhances daily detoxification, allows the liver to function at an optimal level, and gives your body a break from working hard to eliminate unwanted chemicals, processed foods, caffeine, and sugars.

seasonal resets and acne

Check out my Gut & Autoimmune Reset & Reboot mini-course here!


If you’re struggling with acne, it’s likely a reflection of other imbalances going on within the body. Acne and gut health are most definitely connected and the food you eat plays a major role. 

It’s important to take a multi-strategy approach to acne, which is why I recommend working with not only a dermatologist, but also a functional medicine practitioner to come up with a game plan that looks at the big picture. It’s essential to look at gut infections, imbalances, deficiencies, and sensitivities. 
Know that it is possible to achieve glowing healthy skin! I would love nothing more than to be that practitioner for you. My signature program Microbiome Makeover was specifically created to heal your gut! It’s a hybrid 90 day coaching program which includes specific and in-depth labwork, detailed interpretations of your results, personalized coaching, and a step by step process. Let’s start your path to healing from the inside out! Apply here!

the gut skin connection

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"When it comes to balancing our body, healing the gut, reversing autoimmunity, and achieving optimal health—we are a lot like a car that won’t run right. In order to fix the problem once and for all instead of relying on jumper cables, we must get underneath the hood, run the diagnostics, and replace the battery so that it runs good as new."

-Nikki Yelton, RD

a note from nikki:

If you are ready to stop wasting precious time, get off the never-ending hamster wheel, and finally surrender trying to figure things out on your own—this is your moment. 

You don’t have to settle for just getting by and hoping tomorrow is a better day. We both know you are a woman who deserves better and are made for so. much. more.

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