Got acne that just won’t clear up for good, no matter how many topical medicines you apply, and how many facials and laser treatments you sit through? Well, your skin issues may not just be skin-deep: they may be caused by gut issues.

“An unhealthy gut can result in unhealthy skin. Acne may be a sign of weakened immunity, which can happen when harmful bacteria from the gut goes into the bloodstream,” says Dr Melvin Look, Director of PanAsia Surgery at Mount Elizabeth Hospital and a consultant surgeon in gastrointestinal, laparoscopic and obesity surgery.

“Changes in our gut microbiota may also trigger the release of neurotransmitters that lead to an overproduction of excess sebum in our skin. The harmful skin bacteria feeds on the sebum and clogs up pores.”

But just what is the connection between acne and gut issues? And more importantly, how can you ascertain if your acne is caused by gut issues?

“Our intestines are part of the gut-brain-skin axis. You can tell that there’s a disturbance in this axis is when your acne breakouts are related to episodes of altered mental states such as stress, depression and anxiety, together with digestive symptoms such as abdominal bloating, discomfort, loose stools or constipation.”

In fact, the link between skin issues and gut issues may be more common than you think.

“There are a few skin conditions that have a direct link to underlying gut disorders such as pyoderma gangrenosum and inflammatory bowel disease. Your dermatologist may refer you to see a gastroenterologist if they suspect you’re suffering from these conditions,” says Dr Reuben Wong, a gastroenterologist at Gleneagles Hospital.

But that doesn’t mean you can be rid of acne just by eliminating your gut issues—Dr Wong reckons that we are still a way off from controlling our skin health directly through our gut.

However, there are simple things you can do to manage acne.

“Eat less oily and fatty foods—studies have linked them to acne. Keep your gut bacteria healthy by eating well—the microflora in the gut sends signals that affect skin health. And give probiotics a go—early trials with certain probiotics have shown that they can help with acne,” he says.

And not that we mean to nag, but whether or not you have acne, it’s always a good idea to upkeep your gut health.

“Even if you don’t have a problem with acne, maintaining good gut health will help keep your skin youthful and glowy. Supplements such as zinc, folate, selenium, chromium and omega-3 fatty acids can also help if your dietary intake is inadequate,” adds Dr Look.