Over five years ago, a physician friend of mine who was in the Integrative Medicine Fellowship with me called and said they were coming to Phoenix for a medical conference. They went on and on about how amazing this conference was going to be and how it was the future of medicine. I love learning new ways of thinking and expanding my medical knowledge so I couldn’t resist signing up! Especially if it was a cutting edge perspective that could potentially be the future of medicine. I was excited to hear what this was all about.


Functional Medicine: The Future of Medicine

The conference was the Institute for Functional Medicine (IFM): Applying Functional Medicine in Clinical Practice (AFMCP) 5-day course. And wow!! My friend was so right. Attending this conference was a complete game changer for me and I distinctly remember the moment when my mind was completely blown….

It was one of the first lectures of the first day and it was about the gut and the mechanism of how inflammatory foods contribute to the breakdown of the connections between the cells in the gut.
Here I am with some of my doc friends engaging a small group exercise at the IFM: AFMCP meeting in 2014. My first exposure to Functional Medicine. Yep, that’s me in the middle with the blonde hair. So happy to capture this amazing moment in my medical career.

Here I am with some of my doc friends engaging a small group exercise at the IFM: AFMCP meeting in 2014. My first exposure to Functional Medicine. Yep, that’s me in the middle with the blonde hair. So happy to capture this amazing moment in my medical career.

Leaky Gut

When this breakdown occurs, parts of food and other things that don’t normally pass between the cells get thru and out into the circulation. The immune system detects these and recognizes that they aren’t supposed to be there and starts an immune reaction. This whole process is commonly referred to as “leaky gut”.

As the lecture was unfolding, I was having a deja vu. I’ve sat in many, many, many lectures in my dermatology training about this very concept, but in a different context. It was like I was sitting in the same lectures I had in dermatology, but this one was referencing the cells of the gut lining rather than the skin cells.

Whoa! Mind BLOWN!


Leaky Skin

You see, there are several skin issues where the connection between the skin cells don’t work how they should and there is a separation between the skin cells.

This break in the skin barrier not only triggers the immune system to come repair this, but also skin allergens and irritants can penetrate the skin deeper than normal. The immune system picks up on all of this and sends out an immune reaction. I commonly refer to this as “leaky skin”.

Skin Diagram

It’s All Connected

I sat there thinking “OF COURSE!” Of course the behaviors of the cells of the skin and the immune system are the same as the behaviors of the cells of the gut lining and the immune system….and my mind began to wonder…could this concept can probably be expanded to ALL of the cell linings of other organ systems. Everything IS connected, right?

From then on, I couldn’t see the skin system as separate from any of the other organ systems no matter how hard I tried. I kinda had a “knowing” that was true before in a vague sense, but it had never had been scientifically right in front of me!

And if you think about this connection, it’s also anatomically true….


Gut-Skin Connection

The skin is our outer layer of our body and if you follow it along your body and onto your face and then to your lips and then inside your mouth. The mouth is considered the beginning of the gut system. The cells change from skin cells to mucous membrane cells on the lips and in the mouth and from then on you can just keep following this down the throat into the esophagus, stomach, small and large intestines, etc and then back out onto the skin. It’s like the gut is the inner skin!

Digestive system diagram

And this also got me thinking, if something leaks through the lining of the gut cells and into the circulation system, and the circulation system travels throughout the bod, including the skin.

So if you have inflammation in the gut that goes to the circulation system, and the circulation system extends into the skin, then it makes complete sense that you would see inflammation in the skin as well as the gut, etc.

And to go backwards, if there is a break in the skin barrier and an allergen or irritant enters circulation thru the skin’s circulation, is it possible that exposure to something on the skin can lead to some immune reactions in other areas inside of the body? Hmmm…now this is an interesting concept.

There actually is some data on this concept related to peanut allergy. Check out this article if you’d like to nerd out a little on this! Brough, Helen A. et al. (2015). Atopic dermatitis increases the effect of exposure to peanut antigen in dust on peanut sensitization and likely peanut allergy. Journal of Allergy and Clinical Immunology,135(1): 164 – 170.



More Connections

The gut and the skin are connected through circulation, but also the nervous system and hormone/endocrine system, immune system, etc. It seems odd to me now to think of these things as not connected or influencing each other to some degree.

Human body cross section


Gut-Skin Connection in Dermatology Research

Current scientific research agrees with this. Our dermatology research literature is exploding with these connections.

For example, here are just a handful of recent studies on the links between the skin and gut health.

  • Ely, P.H. (2018) Is psoriasis a bowel disease? Successful treatment with bile acids and bioflavonoids suggests it is,Clinics in Dermatology, 36(3): 376-89.
  • Salem, I., Ramser, A., Isham, N., & Ghannoum, M. A. (2018). The Gut Microbiome as a Major Regulator of the Gut-Skin Axis. Front Microbiol, 9, 1459.
  • Sikora, M. , Chrabąszcz, M. , Maciejewski, C. , Zaremba, M. , Waśkiel, A. , Olszewska, M. and Rudnicka, L. (2018), Intestinal barrier integrity in patients with plaque psoriasis. J Dermatol, 45: 1468-1470.

We are finding out more and more about the connections between the gut and the skin as well as other organ systems such as the nervous system/brain, the musculoskeletal system and arthritis.


Mind~Body~Spirit~Skin Care Approach

Exploring and understanding health and wellness from this perspective is why I pursued fellowship training in Integrative Medicine & Functional medicine and board-certification in Integrative medicine. It’s foundational to my approach to the skin from a Mind~Body~Spirit~Skin Care perspective and now you know why I can’t look at the skin by itself any more! It’s all connected.

Next week, we are going to dive deeper into the gut-skin connection and I will share with you a practical way to address the gut-skin connection and inflammation from the inside out using the “The 5 R Approach”.