Skin Deep

Our skin is the body's largest organ, and its most visible one. It protects us, breathes, sweats, makes vitamin D and helps keep out germs. It is also a window. Long before we feel unwell, the skin often shows what is happening deep inside: in the gut, the hormones, the blood sugar and the nervous system. Beautiful skin isn't only about what we put on it. It is a reflection of how we live.

The gut-skin connection

Almost a century ago, in 1930, two American dermatologists, John Stokes and Donald Pillsbury, suggested that worry and stress could upset the gut, and that an unhappy gut could in turn inflame the skin.¹ Their idea was largely forgotten for decades. Today, research is proving them right.

The gut and the skin are in constant communication through the immune system, hormones and the nervous system, a link known as the gut-skin axis.² When the gut lining is weakened and the balance of gut microbes is disturbed, inflammation can spread through the body and show up in the skin. Acne, eczema, rosacea and psoriasis have all been linked with changes in the gut.

Rosacea is a striking example. In an Italian study, people with rosacea were far more likely than others to have an overgrowth of bacteria in the small intestine, known as SIBO. When the overgrowth was treated, the rosacea cleared or greatly improved in most of them, and the improvement lasted for months.³ (For more on the gut, read The Master Regulator.)

The skin often shows what is happening deep inside.

What else shows in the skin

• Blood sugar. In a trial with young men with acne, a low-glycaemic diet, which keeps blood sugar steady, reduced spots more than a standard diet.⁴ Over time, high blood sugar also sticks to collagen, the protein that keeps skin firm, in a process called glycation, making it stiff and prone to wrinkles.⁵ (See Balancing the Sugar Seesaw.)
• Dairy. A review of studies involving almost 80,000 young people found that those who drank more milk were more likely to have acne.⁶ Not everyone is affected, but it can be worth exploring. (See The Dairy Question.)
• Inflammation. Many skin conditions are, at heart, inflammatory. Calming the "quiet fire" inside often calms the skin too. (See The Quiet Fire.)
• Hormones. Spots along the jaw and chin often follow the menstrual cycle or point to hormone imbalances such as PCOS. In menopause, falling oestrogen leaves skin thinner and drier. (See The Hormone Web.)
• Stress. Stress weakens the skin's protective barrier and slows its repair.⁷ It's no coincidence that eczema, psoriasis and acne so often flare during difficult times. (See The Cortisol Clock.)
• Sleep. "Beauty sleep" is real. People who slept poorly showed more signs of skin ageing, and their skin recovered less well from sun exposure and damage.⁸ (See The Art of Sleep.)
• Chemical load. Many skincare and household products contain fragrances and preservatives that can irritate sensitive skin. (See Lightening the Load.)

Clues your skin may be giving you

Some changes in the skin, hair and nails can be early signs of a need for more nutrients, or of a health problem that should be checked:

• Very dry, rough skin may point to a need for more healthy fats, or sometimes an underactive thyroid.
• Cracks at the corners of the mouth can be linked with low B vitamins or iron.
• Pale skin and tiredness may be a sign of anaemia.
• Slow-healing cuts can be linked with low zinc, or with raised blood sugar.
• Dark, velvety patches in the folds of the neck or armpits can be a sign of insulin resistance.
• Itching all over without a rash can sometimes be linked with low iron, or the liver, kidneys or thyroid.

These are clues, not a diagnosis. If you notice any of them, especially if they're new or don't go away, a qualified practitioner, such as at Rootwise, can help you find the cause, such as a nutrient shortfall, and will encourage you to see your GP if tests or medical care are needed.

Feeding your skin

• Eat a rainbow. The colourful pigments in fruit and vegetables, called carotenoids, build up in the skin. In one study, people who ate more fruit and vegetables for just six weeks developed a warmer, golden skin tone that others rated as healthier and more attractive.⁹ A study of older adults in several countries found that those who ate more vegetables, beans and olive oil had fewer wrinkles.¹⁰
• Get your vitamin C. The skin needs vitamin C to build collagen.¹¹ Peppers, kiwis, citrus fruits, berries, broccoli and rosehips are rich sources.
• Choose healthy fats. Oily fish, walnuts, flaxseed, avocado and olive oil help keep skin supple and calm.
• Eat zinc-rich foods, such as pumpkin seeds, chickpeas, lentils, nuts and shellfish, for healing.
• Feed your gut with fibre and fermented foods.
• Drink water throughout the day, and herbal teas.
• Cut back on sugar and highly processed foods.

Your lymphatic system: the body's quiet cleaner

Alongside the blood vessels runs a second network: the lymphatic system. It collects the fluid that seeps out of the blood vessels into the tissues, filters it through hundreds of lymph nodes, where immune cells check for germs, and returns it to the blood. It carries away waste products and helps the immune system do its work. The skin itself is laced with tiny lymph vessels.

Unlike the blood, which is pumped by the heart, lymph has no pump of its own. It relies on the squeeze of our muscles as we move, the rhythm of our breathing, and gentle pressure on the skin. When we sit still for long periods, lymph flows more slowly, and fluid can collect, leaving us feeling puffy and heavy, especially in the legs and around the eyes.

Supporting lymph flow

• Move. Walking is one of the best ways to keep lymph moving. Calf muscles act as a pump for the legs.
• Breathe deeply. The rise and fall of the diaphragm with deep belly breathing helps pump lymph through the chest, where the largest lymph vessels drain. (See The Healing Breath.)
• Rebound. Gentle bouncing on a mini trampoline is popular for lymph flow. The research is limited, but it's fun and good exercise. (See Born to Move.)
• Put your legs up. Lying with your legs up a wall for ten minutes lets gravity help fluid drain from the legs.
• Drink plenty of water, so lymph can flow freely.
• Alternate warm and cool water at the end of a shower, which many people find refreshing.

Lymphatic drainage massage

Manual lymphatic drainage (MLD) is a very gentle, rhythmic massage, developed in the 1930s by the Danish therapists Emil and Estrid Vodder. Using light, skin-stretching strokes, it encourages lymph to move toward working lymph nodes. It is an established part of treatment for lymphoedema, swelling caused by a damaged lymphatic system, for example after cancer treatment, where it is used alongside compression bandages, exercise and skin care.¹²

Many people also enjoy MLD for puffiness, fluid retention, recovery after cosmetic surgery, and simply for its deeply relaxing effect. For these uses the evidence is limited, but it is gentle and very soothing. Look for a therapist trained in a recognised method, such as Vodder, and see a specialist lymphoedema service for lymphoedema.

You can also try a simple version at home. Using flat, relaxed hands and very light pressure, just enough to gently stretch the skin, make slow strokes toward the nearest lymph nodes: from the face down the neck toward the collarbones, and up the arms toward the armpits. Always start by gently stroking above the collarbones to "clear the way".

Skin brushing

Dry skin brushing is a traditional ritual found in many cultures, from Scandinavia to Japan, Turkey and Russia. Using a firm, natural-bristle brush on dry skin, it is said to exfoliate, invigorate the circulation and support the flow of lymph.

The honest picture is that skin brushing hasn't been well studied. It certainly exfoliates, sweeping away dead skin cells to leave skin feeling soft and smooth, and many people find it energising and a lovely way to start the day. Claims that it removes toxins or cures cellulite aren't supported by evidence. But as a gentle daily ritual that brings you into your body, it has much to recommend it.

Herbs for the skin

• Burdock root and red clover are traditional "blood cleansers" used for skin conditions such as acne and eczema.
• Nettle, mineral-rich and calming for allergic skin.
• Calendula (marigold), soothing and healing on the skin. In one French trial, calendula cream protected the skin of women having radiotherapy for breast cancer better than a standard cream.¹³
• Chamomile, gentle and calming, as a tea or a cool compress.
• Cleavers, the sticky "goosegrass" of hedgerows, a traditional herb for the lymphatic system.

The best herbs for your skin depend on your constitution and the cause of the problem, so it's best to seek a practitioner's guidance rather than self-prescribe. (See The Architecture of Balance and When Plants Meet Pills.)

Gentle, natural skincare

• Use fewer products. A gentle cleanser, a simple moisturiser and sun protection are enough for most people.
• Choose fragrance-free products, especially for sensitive skin, eczema or rosacea.
• Don't over-wash. Hot water and harsh soaps strip the skin's natural oils and protective barrier.
• Protect from the sun, while still enjoying sensible daylight. (See Living by the Sun.)
• Try kitchen remedies: an oat bath for itchy skin, a thin layer of raw honey as a soothing mask, and a little olive or sunflower oil to moisturise. (See Closing the Divide.)

At Rootwise, we always look beneath the surface. When skin problems won't settle, the answer is often found in the gut, the diet, the hormones or the stresses of daily life. Healing from within brings a radiance no cream can match.