Neurodermatitis, also known as atopic dermatitis, is one of the most common chronic inflammatory skin diseases worldwide. It affects both children and adults and is characterized by dry skin, severe itching, and recurring eczema. For many sufferers, the search for causes and effective treatment options is a lengthy and often frustrating process.
Traditionally, factors such as genetics, the environment, allergies, and the immune system have been discussed as the main causes of atopic dermatitis. However, in recent years, science has focused on another, increasingly relevant area: the gut. Research shows that gut health and the composition of the intestinal flora may have a direct influence on skin health—and thus also on the development and progression of atopic dermatitis.
In this article, we explore how closely the gut and skin are connected, what research has discovered so far, and what practical measures can be taken by those affected. Finally, we answer the most frequently asked questions about atopic dermatitis and gut health.
The role of the intestine in our body
The intestine is no longer just an organ for digesting food. It is a highly complex system that performs numerous functions. Around 70 to 80 percent of all immune cells are located in the intestinal mucosa. These cells monitor and regulate which substances are allowed to enter the body and which must be repelled.
Central to the function of the gut is the microbiome —the community of trillions of microorganisms that live there. These microbes aid digestion, support the immune system, and produce substances that influence inflammation in the body. A balanced microbiome ensures that the body responds well to pathogens while preventing overreaction—which can be crucial in autoimmune and allergic diseases such as atopic dermatitis.
A disruption of the microbiome can be caused by various factors: antibiotics, an unhealthy diet, chronic stress, infections, or environmental influences. When the balance of the intestinal flora is disturbed, the protective barrier of the intestinal mucosa can be weakened. As a result, pro-inflammatory substances can more easily enter the bloodstream and trigger systemic inflammation, which also manifests in the skin.
The gut-skin axis: How the gut and skin are connected
The so-called gut-skin axis describes the direct connection between gut health and skin. Studies show that changes in the gut microbiome can influence the immune response and thus worsen skin conditions such as atopic dermatitis.
People with atopic dermatitis often have an altered composition of their intestinal flora . Certain beneficial bacteria are lacking, while others predominate. This imbalance can weaken the intestinal barrier function. Substances that should normally remain in the intestines enter the bloodstream and trigger inflammatory reactions.
In addition to the intestinal flora , allergies and food intolerances also play a role. Many atopic dermatitis patients are sensitive to certain foods such as dairy products, wheat, or eggs. Scientists suspect that an impaired intestinal flora promotes these reactions because the immune system reacts hypersensitively to certain proteins.
In addition, the gut influences the production of molecules such as short-chain fatty acids , which have anti-inflammatory effects and can strengthen the skin barrier. If this production is disrupted, the skin loses its protection and becomes more susceptible to irritation.
You can learn more about the gut-skin axis in our special article .
What research has shown so far
Research into the connection between the gut and atopic dermatitis is still at a relatively early stage, but initial results are promising:
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Studies in children: Some studies show that infants who received probiotics early in life had a lower risk of developing atopic dermatitis. Probiotics are live microorganisms that can positively influence the balance of intestinal flora.
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High-fiber diet: A diet rich in vegetables, fruits, and whole grains appears to promote the production of anti-inflammatory short-chain fatty acids. These substances strengthen the intestinal barrier and reduce systemic inflammation.
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Probiotics and prebiotics: Probiotics provide symptom relief for many patients. Prebiotics, which serve as food for the good gut bacteria, can also have a positive impact on the microbiome.
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Connection with allergies: Children with disturbed intestinal flora are more likely to develop allergies, which in turn can worsen atopic dermatitis.
Despite these findings, research is not yet advanced enough to recommend probiotics or specific diets as a universal therapeutic approach. The effect appears to vary greatly from individual to individual, and not every patient benefits equally.
Practical approaches for those affected
Even though there is no one-size-fits-all solution, those affected can do a lot themselves to support their intestines and skin.
A balanced diet plays a key role. High-fiber foods such as vegetables, legumes, fruit, and whole grain products promote a healthy gut flora. Fermented foods such as yogurt, kefir, sauerkraut, or kimchi provide beneficial lactic acid bacteria. At the same time, consumption of highly processed foods and sugar should be reduced, as these can have an inflammatory effect.
Stress negatively impacts both the gut and the skin. Relaxation exercises, yoga, or meditation can help calm the nervous system and positively influence the gut-skin axis.
Another approach is the targeted intake of probiotics. These can specifically strengthen the microbiome , but are best tried under medical supervision, as not every strain has the same effect on every patient.
Skin care also remains central: Regular moisturizing, gentle cleansers, and avoiding irritating substances help stabilize the skin barrier.
Lifestyle and environmental factors
In addition to diet and intestinal health, environmental factors also play an important role. Climatic conditions and allergens such as pollen, dust mites, or pet dander can worsen symptoms. Smoking, air pollution, and chemical additives in cosmetic products also have an impact.
Regular exercise promotes gut health and overall well-being. Exercise can reduce inflammation, relieve stress, and modulate the immune system.
Sleep is another crucial factor. Chronic sleep deprivation increases the production of pro-inflammatory molecules and can weaken the skin barrier.
Conclusion
The connections between atopic dermatitis and gut health are complex but increasingly well-researched. The gut-skin axis demonstrates that a healthy microbiome, an intact intestinal barrier, and a balanced lifestyle can have a significant impact on skin health.
For those affected, this means: In addition to skin care and medication, it's worth focusing on the gut. A healthy diet, stress management, exercise, and the support of probiotics can help alleviate the symptoms of atopic dermatitis and improve quality of life.
FAQ – Frequently Asked Questions
Can poor gut health cause atopic dermatitis?
Poor gut health can contribute to the development and progression of atopic dermatitis, as inflammation and a compromised intestinal barrier affect the immune system. However, the gut is not the sole cause—genetics, environment, and immune reactions also play a major role.
Which foods are recommended for atopic dermatitis?
High-fiber foods such as vegetables, fruits, legumes, and whole grains promote a healthy microbiome. Fermented foods such as yogurt or sauerkraut provide beneficial bacteria. Sugar, highly processed foods, and additives should be reduced.
Do probiotics help with atopic dermatitis?
Probiotics can relieve symptoms in patients, but the effect varies from person to person. It's best to take probiotics that have also been clinically tested for use in atopic dermatitis.
What role does stress play in atopic dermatitis?
Stress can negatively impact the gut-skin axis, increasing inflammation and weakening the skin barrier. Relaxation techniques such as yoga, meditation, or breathing exercises can be helpful.
Is there a cure for atopic dermatitis?
There is currently no complete cure. However, symptoms can be significantly improved through a combination of skin care, lifestyle measures, diet, and, if necessary, medication.
