Recently I have been inundated by questions about our gut health and skin health, especially acne. The two main questions are around "Your skin is your biggest detox organ," or "Bad bugs from your gut get pushed out through the skin and cause acne."
I am so happy that people are curious and I am so proud that you question things that you watched, heard or read on social media when they sound not quite right.
So, let’s break it down.
The Gut-Skin Connection: What Science Says
1. Gut Inflammation = Systemic Inflammation
When your gut is inflamed, be it from processed foods, chronic stress, infections, or an overgrowth of harmful bacteria (the so-called “bad bugs”), it can trigger a domino effect that leads to a condition called systemic inflammation.
Essentially, your whole body becomes inflammed and put you in a fight or flight mode. This often shows up on your skin as acne, eczema, or rosacea.
2. Microbiome Imbalance Fuels Acne
An imbalanced gut microbiome (dysbiosis) disrupts:
Sebum production
Hormonal regulation
Immune responses
All of which contribute to acne flare-ups. The gut and skin communicate constantly via what we call the gut-skin axis.
3. Immune System Crosstalk
If you are a frequent reader or listener of Ask Dr Vincent, you know that over 70% of your immune system lives in the gut. When your microbiome is out of balance, your immune system becomes reactive.
That can mean more inflammation, more flare-ups, and more breakouts BUT not because the bugs are "escaping" but because your whole body is on edge.
So why do you need to look after your gut to care for your skin?
Let’s be clear. “Bad gut bugs” don’t literally crawl or leak out through your skin. That’s not how the body works.
Acne isn’t caused by microbes physically exiting the gut.
Gut bacteria do not get excreted through your pores.
There’s no direct detox route from gut to skin.
Your gut talks to your skin through:
Immune signalling
Hormonal pathways
Metabolic byproducts (like toxins and short-chain fatty acids)
So when your gut is inflamed or imbalanced, your skin listens and reacts.
That’s why improving gut health with an anti-inflammatory diet, fibre, probiotics, and plenty of hydration often leads to clearer, healthier skin.
And, while your skin is your largest organ by surface area, but when it comes to detoxification, our liver and kidneys are the ones doing the heavy lifting
Our liver filters blood, neutralises toxins, breaks down alcohol and medication, and transforms harmful compounds into water-soluble forms so they can be safely excreted.
Our kidneys remove waste products through urine, handling the byproducts of digestion, cellular activity, and toxins filtered by the liver.
Our skin can excrete a tiny amount of waste like urea, ammonia, and salts through sweat, but it’s minimal and not a major detox pathway. Sweating won’t remove bacteria, heavy metals, drugs, or other large toxins in any meaningful way.
Don’t get me wrong, your skin is important, but it’s not doing the deep clean. That’s your liver and kidneys' job.
TDLR
Gut inflammation and microbiome imbalances absolutely affect your skin, but not by “pushing bugs out.”
Your liver and kidneys are the real detox powerhouses.
Your skin reflects your internal state — it's not your rubbish chute.
Take care of your gut, support your detox organs, and your skin will thank you.
Thank you to everyone who tuned into my live video! Join me for my next live video in the app.
