Wondering why your skin seems to freak out even when you’re doing all the right things? You know, the good skincare routine, drinking plenty of water, cutting back on sugar—but those pesky breakouts keep coming back? Well, it might be your gut. Or more specifically, the IBS diagnosis could be giving you clues into how to clear your acne for good.

What is IBS?

Let’s start with the basics. IBS (Irritable Bowel Syndrome) is kind of this umbrella term for a bunch of gut issues that aren’t linked to anything super serious like Crohn’s disease or ulcerative colitis. If you’ve been dealing with bloating, stomach cramps, and weird bowel habits (like, one day you can’t go, and the next day you can’t stop going), your doctor might have tossed around the term IBS.

Usually, before you get that label, they’ll run some tests—like checking your calprotectin levels (which helps rule out serious inflammation), and maybe checking for infections. If all those tests come back normal and you’re still feeling like your stomach’s doing somersaults, then congrats (sort of), you’ve got IBS.

But even if those tests are “normal,” that doesn’t mean everything is actually fine in your gut. I’m sure your gut feeling is that there’s something not quite right, too. There could still be a lot going on behind the scenes that’s not only messing with your digestion but also showing up on your skin. Your gut and your skin are more connected than you might think.

The Different Types of IBS

There are a few different types of IBS, so you might fall into one of these categories:

• IBS-C (Constipation-predominant): You might find it difficult to regularly go to the toilet, you’re probably going less than three times per week to pass a stool.
• IBS-D (Diarrhea-predominant): The opposite problem—you’re making way too many trips to the bathroom and they tend to be loose.
• IBS-M (Mixed): A lovely combo of both constipation and diarrhoea. Fun times, right?

Each type comes with its own set of challenges, but they can all wreak havoc on your skin in different ways.

How can IBS affect acne?

Okay, so here’s where it gets interesting. You might think, “If my doctor says everything’s normal, how can my gut still be causing problems?” Well, research shows that people with skin conditions like acne are more likely to have gut issues—even if those standard tests don’t pick anything up.

In fact, studies have found that IBS is more common in people with acne than in those with clear skin. So, while you might be trying all the topical treatments and slathering on all the creams, the real issue could be brewing in your gut.

What Triggers IBS (and Maybe Your Acne)?

Let’s talk about what might be causing your IBS symptoms in the first place—because if we can figure that out, we might also get to the bottom of your skin issues.

• Antibiotics – If you’ve struggled with acne for a while, chances are you’ve been on antibiotics at some point. While they can help clear up your skin temporarily, they can also throw your gut bacteria way out of whack, which can trigger some gut symptoms.
• Medications – Certain meds can mess with your gut motility (how fast, or slow, things move through your system) or irritate your gut lining.
• Infections or Food Poisoning – Have you ever had a bad case of food poisoning in the past? Sometimes that can trigger long-term gut issues like IBS.
• Stress – Yep, stress isn’t just bad for your mental health—it can mess with your gut, too. And when your gut’s unhappy, your skin might be too.

If we go back to those different types of IBS, they’ll affect your skin and overall health in different ways, too.

How Different Types of IBS Affect Your Skin

1. IBS-C (Constipation)

When things aren’t moving through your gut as fast as they should, your stool hangs out in your intestines longer than it’s supposed to. This is a problem because your stool is actually part of your body’s detoxification process. When you’re constipated, toxins and excess hormones—like oestrogen—aren’t being cleared out efficiently. Instead, they can get reabsorbed into your bloodstream, and guess where they might show up? Yep, your skin. This is one of the ways IBS is linked to hormonal acne, by affecting how well oestrogen is being detoxed by the body.

1. IBS-D (Diarrhoea)

On the flip side, if you’ve got IBS-D, things are moving way too quickly through your gut. This can affect how well your body absorbs nutrients from your food. You might be eating all the right things, but if your body doesn’t have time to soak up those nutrients, it can lead to deficiencies—like zinc, vitamin A, and omega-3s—all of which are super important for healthy skin. Plus, frequent diarrhoea can leave you dehydrated, which can make your skin look dry, irritated, and more prone to breakouts. If you have had diarrhoea for longer than two weeks, please get that checked with your GP!

The Three Main Gut Issues Behind IBS (and Acne)

I like to categorise gut health into these three main areas. It can make it a lot easier to see where you need to focus to help not just your gut, but your skin, too.

Digestion Problems

If you’re not breaking down your food properly, it can cause all kinds of gut issues. One way to check this is by looking at markers like pancreatic elastase—an enzyme your pancreas makes to help digest food. Low levels of this enzyme can mean your body isn’t absorbing nutrients properly, which can lead to deficiencies. And guess what? Nutrient deficiencies can show up in your skin. Zinc, vitamin A, omega-3, iron and B vitamins can all affect how our skin behaves, looks and feels.

Microbiome Imbalances

Your gut is home to trillions of bacteria—some good, some not-so-good. If you’ve got low levels of good bacteria, it can trigger gut issues and mess with your immune system, which might make your acne more inflamed.

On the flip side, you could have an overgrowth of bacteria (like SIBO—Small Intestinal Bacterial Overgrowth) or yeast infections. These overgrowths can trigger the immune system in your gut, which often shows up on your skin. The tricky part? These aren’t serious infections, so they’re not usually tested for by your regular doctor. That’s where private testing comes in—I love using the GI Map or Genova GI Effects in my clinic to get a full picture of what’s going on.

Gut Lining and Inflammation

Your gut lining is like a barrier that keeps the bad stuff out and lets the good stuff in. But if that lining gets damaged (sometimes called “leaky gut”), it can cause inflammation that affects your whole body—including your skin.

Imagine if you have really dry, cracked, and inflamed eczema on your hand. It starts to react to things that normally wouldn’t be an issue. Like, say, going for a swim in the sea—suddenly, the saltwater causes a burning, stinging sensation. The water isn’t the real problem; it’s the damaged skin that’s become overly sensitive.

When your gut lining is damaged, it’s kind of the same thing. Foods that wouldn’t normally cause issues start to trigger reactions because they’re slipping through into places they shouldn’t be, leading to an immune response and, you guessed it, skin flare-ups.

We can check for this by looking at markers like sIgA (secretory Immunoglobulin A), EPX (Eosinophil Protein X), and calprotectin. Another key player here is butyrate—a short-chain fatty acid (SCFA) that helps keep your gut lining healthy and reduces inflammation. Your gut bacteria make butyrate when they ferment fibre from your diet, so eating the right foods can make a big difference. Again, this is something we can check via a stool test.

Food Intolerances – Should I cut out foods to help my IBS & Acne?

Now, you might be thinking, “Should I just cut out all the foods that seem to trigger my IBS?” And yeah, food intolerances can definitely play a role. But here’s the thing: restrictive diets aren’t a long-term solution.

You’ve probably heard of the Low FODMAP diet, right? It’s super popular for managing IBS symptoms, and it can be really helpful—but only in the short term. The goal isn’t to stay on a super restrictive diet forever. Instead, by doing a comprehensive stool test and addressing the imbalances in your gut, you can usually start reintroducing most foods back into your diet.

Think about it like healing cracked, inflamed skin. Once your skin barrier is repaired, you can dip your hand in the sea without it stinging. The same goes for your gut—when you repair the gut lining, you become less reactive to foods. But a quick heads-up: this isn’t the case for true food allergies, which are a whole different story. This approach works best for certain intolerances (and done with a qualified health practitioner).

In fact, I’ve had clients who were convinced they’d never be able to eat certain foods again—but after we worked on healing their gut, they were able to enjoy those foods without any issues. Check out this review from one of my clients who said, “I’ve reintroduced foods I never thought I’d be able to eat again!”

So, What Can You Do to Help Your IBS and Acne?

Alright, let’s get to the good stuff—what you can actually do to feel better.

Get a Comprehensive Stool Test

This is the first step in figuring out what’s really going on in your gut. It can help identify imbalances in your bacteria, signs of inflammation, digestive issues, and more.

Identify and Address Imbalances

Once you know what’s out of whack, you can start addressing it—whether that means adding more fibre to feed your good bacteria, taking specific supplements, or addressing any bacterial overgrowths.

Reintroduce Foods Gradually

As your gut heals, you’ll likely be able to reintroduce foods that used to trigger your symptoms. This is a huge win not just for your gut, but for your overall quality of life.

Focus on Stress Management

Don’t underestimate the power of stress when it comes to both your gut and your skin. Practices like yoga, meditation, spending more time out in nature or even just deep breathing can make a huge difference. And if you don’t like any of those things suggested, just spend more time doing things you enjoy.

Can IBS make acne worse?

So, does IBS make acne worse? The answer is a big, resounding maybe! While IBS itself isn’t a direct cause of acne, the underlying gut issues that come with it can definitely contribute to skin problems. The good news? By understanding the gut-skin connection and taking steps to heal your gut, you can start seeing improvements in both your digestion and your complexion.

Remember, you don’t have to tackle this alone. If you’re feeling overwhelmed, working with a nutritionist (like me!) can help you navigate the process and get to the root of what’s going on.