SIBO and Acne: How Gut Bacteria Dictate Skin Conditions

Acne is a serious pain…in the gut. The reflection we see in the mirror is a reflection of what’s going on in our microbiome. Recently, scientists have begun to uncover the truth behind acne, and it’s more in-depth than just using the right facial cleanser. Research suggests there is a correlation between SIBO and acne [1].

What is this gastro disease, and how does it affect your skin? Let’s take a close look at the SIBO and acne connection and how to prevent other skin conditions through the gut-skin-axis.

The Problem with Acne Skin Care

It can often seem like there are a million different topical products to help cure this skin condition. Often these products don’t work. At most, they don’t work well. In fact, some may feel like they’re working in reverse.

sibo and acne
Might wanna
slow down with that

Many cosmetic companies use ethanol as an astringent to kill the bacteria that are causing acne.

This process was all the rage in the 90s when Stridex pads were a thing. However, many teens with sensitive skin noticed very quickly that these products would dry out their skin.

We now know that excessive use of these products can cause more harm to the skin than good, including drying the skin out.

One analysis stated,

“Topically applied ethanol acts as a skin penetration enhancer and may facilitate the transdermal absorption of xenobiotics (e.g. carcinogenic contaminants in cosmetic formulations). Ethanol use is associated with skin irritation or contact dermatitis, especially in humans with an aldehyde dehydrogenase (ALDH) deficiency [2].”

J Occup Med Toxicol

The truth about what causes acne lies in our gut. One specific gut condition, in particular, has been linked to the development of acne.

Small intestinal bacterial overgrowth, or SIBO for short, has been associated with the condition acne vulgaris in recent years. This finding is revolutionizing the way we view and even treat skin conditions.

What is SIBO? 

SIBO is essentially the overgrowth of bacteria in the small intestine that should be lower down in the large intestine [3]. That means toxins aren’t leaving the system. Instead, they’re coming back in…and then some.

Symptoms from SIBO can range from mild to severe. In more extreme cases, SIBO can lead to malabsorption. Most comonly, people experience an array of debilitating gastrointestinal symptoms.

Common GI problems associated with SIBO include:

There are many factors at play when it comes to developing SIBO. For the most part, this isn’t an overnight occurrence.

Some of the most common causes of SIBO include:

blowing nose
Always sick? Is it your gut?

Bacteria that overgrow can cause wreak all types of havoc on the gut biome, depending on the species that are present. These stomach bacteria can cause leaky gut, triggering inflammation. Inflammation is where the SIBO and acne connection begins.

SIBO and Acne

Low stomach acid (Hypochlorhydria) and constipation have been associated with acne for a long time. Now research shows that these two GI problems are closely related to the development of SIBO too.

Malabsorption of Food and Skincare

Are you getting all the benefits?

Stomach bacteria responsible for SIBO can cause malabsorption of foods. These greedy fiends are eating up all the nutrients that our probiotic bacteria need to flourish.

Research indicates that this malabsorption has been linked to the development of acne.

One study noted the causes of acne, stating,

“Zinc, folic acid, selenium, chromium and omega-3 fatty acids are all examples of nutrients which have been shown to influence depression, anger and/or anxiety. These same nutrients, along with systemic oxidative stress and an altered intestinal microflora have been implicated in acne vulgaris [5].”

Med Hypotheses.

So, missing out on crucial nutrients influences not only the gut-skin relationship but also the gut-brain-axis. These findings only lend more credence to the importance of maintaining your gut health.

Malabsorption and Inflammation

Malabsorption of nutrients also creates oxidative stress on the gut biome. Inevitably, the immune system jumps to the response, sparking inflammation.

As we discussed, one of the many symptoms of inflammation is skin issues. That theory is strengthened by the recent evidence pointing to the strong correlation between SIBO and acne.

SIBO and Toxins

SIBO can also cause toxins to build-up in the intestine. These toxins have been shown to cause leaky gut.

leaky gut check list
Go through the Leaky Gut Checklist

Leaky gut perpetuates systemic inflammation, ultimately contributing to acne.

An analysis looking at the gut biome and acne noted,

“Disruption in the intestinal barrier contributes to this feedback loop by allowing the penetration of poorly digested food, microbes, and toxins into the circulation to reach target tissue, including the skin, where they trigger Th2 immune responses resulting in further tissue damage [6].”

Front Microbiol.

As several studies keep pointing out, SIBO triggers inflammation, which results in leaky gut and acne. Therefore, the SIBO and acne relationship seems like a never-ending cycle. That is, unless you fight fire with fire.

SIBO and Acne…and Probiotics Supplements

Probiotics are well known to improve the overall health of the microbiome, but do they have a place in acne treatment? Well, research seems to indicate so. Long before probiotics were even called “probiotics,” two scientists named Stokes and Pillsbury used a fermented milk beverage with cod liver oil to help treat acne [7]!

Probiotics and Inflammation

Recently, there have been a handful of studies showing that probiotics can improve acne symptoms. Namely, studies are looking at how probiotics regulate immune responses.

One analysis found,

“Several strains of Lactobacillus also demonstrate anti-inflammatory properties. The addition of Lactobacillus paracasei NCC2461 has been shown to inhibit neutrogenic inflammation in a skin model, and the addition of L. paracasei NCC2461 to lymphocyte culture has been shown to strongly inhibit the proliferative activity of CD-4 + T-cells in a dose-dependent manner and to induce the anti-inflammatory cytokines IL-10 and TGF-beta [8].”

Int J Womens Dermatol.

Furthermore, probiotics have been shown to decrease inflammation and oxidative stress [9]. As we discussed earlier, these innate responses are two main contributors to acne. All of these factors suggest that probiotics supplements may be an effective way to support your skincare routine.

Prebiotics and Acne

Not only may probiotics help SIBO and acne, but the foods they consume might as well. One study noted that prebiotics play a role in fighting systemic inflammation [10]. As we noted earlier, systemic inflammation may result in leaky gut, which can trigger acne flareups.

gut health diet
Probiotics: Glow Inside and Out

Prebiotics are essential for healthy bacteria to colonize the gut biome. They are also rich in nutrients that are pivotal for optimal wellness.

That’s why we help you craft a prebiotic-rich diet in the Thryve Inside Gut Health Program.

At Thryve, we offer a personalized probiotic supplement based on your microbiome. By creating a probiotic supplement specifically for you, we can help you achieve your health goals quickly and effectively. Acne is a pain. Luckily, there are tools to help.

Thryve Probiotics Gut Health


[1] Bowe, W. P., & Logan, A. C. (2011). Acne vulgaris, probiotics and the gut-brain-skin axis – back to the future?. Gut pathogens3(1), 1. doi:10.1186/1757-4749-3-1

[2] Lachenmeier D. W. (2008). Safety evaluation of topical applications of ethanol on the skin and inside the oral cavity. Journal of occupational medicine and toxicology (London, England)3, 26. doi:10.1186/1745-6673-3-26

[3] Dukowicz, A. C., Lacy, B. E., & Levine, G. M. (2007). Small intestinal bacterial overgrowth: a comprehensive review. Gastroenterology & hepatology3(2), 112–122.

[4] Reddymasu, Savio C, et al. “Small Intestinal Bacterial Overgrowth in Irritable Bowel Syndrome: Are There Any Predictors?” BMC Gastroenterology, BioMed Central, 22 Feb. 2010,

[5] Katzman, Martin, and Alan C Logan. “Acne Vulgaris: Nutritional Factors May Be Influencing Psychological Sequelae.” Medical Hypotheses, U.S. National Library of Medicine, 2007,

[6] Salem, I., Ramser, A., Isham, N., & Ghannoum, M. A. (2018). The Gut Microbiome as a Major Regulator of the Gut-Skin Axis. Frontiers in microbiology9, 1459. doi:10.3389/fmicb.2018.01459

[7] Ereaux L. P. (1938). FACTS, FADS AND FANCIES IN THE TREATMENT OF ACNE VULGARIS. Canadian Medical Association journal39(3), 257–261.

[8] Kober, M. M., & Bowe, W. P. (2015). The effect of probiotics on immune regulation, acne, and photoaging. International journal of women’s dermatology1(2), 85–89. doi:10.1016/j.ijwd.2015.02.001

[9] Mikelsaar, Marika, and Mihkel Zimer. “Lactobacillus Fermentum ME-3 – an Antimicrobial and Antioxidative Probiotic.” Microbial Ecology in Health and Disease Volume 21, 2009 – Issue 1, 14 Oct. 2008,

[10] Schiffrin, E J, et al. “Systemic Inflammatory Markers in Older Persons: the Effect of Oral Nutritional Supplementation with Prebiotics.” The Journal of Nutrition, Health & Aging, U.S. National Library of Medicine, 2007,