Mechanisms of gut-skin communication
Increased intestinal permeability (leaky gut) allows microbial antigens to enter the bloodstream, triggering systemic immune activation. This circulating inflammation reaches the skin via cutaneous immunology pathways, upregulating IL-1, IL-6, and TNF-α — all inflammatory drivers of acne. Additionally, gut bacteria produce short-chain fatty acids (SCFAs) including butyrate, which regulate systemic inflammation via histone deacetylase inhibition.