The Science of the Gut–Skin Axis: How Chiropractors & Integrative Practitioners Can Restore Skin Health

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Introduction

Modern scientific research indicates that skin health is closely linked to internal bodily processes, particularly in the digestive system. The gut–skin axis refers to the communication network between the gut microbiome, the immune system, and the skin. When gut microbial balance is disrupted (a state called dysbiosis), this can lead to inflammation, oxidative stress, and compromised skin barrier function. The result: acne, eczema, premature aging, psoriasis, and other skin issues.

For clinicians, especially those in chiropractic, functional, or integrative medicine, this is an opportunity. By understanding the mechanisms and utilizing evidence-based interventions—such as diet, supplements, stress management, chiropractic adjustments, and advanced diagnostics—practitioners can support both gut and skin health. Drawing upon clinical observations from dual-scope providers like Dr. Alexander Jimenez, this article surveys the science, mechanisms, and practical protocols for restoring skin via gut health.

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The Gut Microbiome & Skin: Mechanisms

What is the Gut–Skin Axis?

The gut–skin axis refers to the pathways that connect gut microbes, digestion, immune responses, metabolic products, and skin physiology. This includes:

• Immune signals: microbial byproducts (e.g., lipopolysaccharides, short-chain fatty acids) that modulate systemic immune responses;
• Metabolic/endocrine pathways: hormones and metabolites produced or modulated by gut bacteria;
• Barrier integrity: both gut lining and skin barrier depend on similar molecular players (e.g., tight junctions, antimicrobial peptides);
• Oxidative stress regulation: gut microbes help regulate oxidative stress; dysbiosis may increase reactive oxygen species.

How Dysbiosis Impacts Skin

1. Inflammation
   When harmful bacteria overgrow or the gut barrier is leaky, bacterial products can enter circulation and trigger immune activation. Elevated inflammatory cytokines can exacerbate acne, dermatitis, and psoriasis. (Olejniczak-Staruch et al., 2023; ScienceDirect, 2025)
2. Oxidative Stress
   Oxidative damage to skin proteins, lipids, and DNA accelerates aging and damages the skin barrier. Dysbiosis often correlates with increased free radical generation and reduced antioxidant defenses. (O’Neill et al., 2023)
3. Weakened Skin Barrier
   A strong skin barrier prevents pathogens, water loss, and allergens from entering. Disruption of the skin barrier allows irritants in and moisture out—leading to dryness, irritation, and sensitivity. Gut health (via microbial metabolites like short-chain fatty acids) influences skin barrier tightness and repair.
4. Manifestation of Skin Conditions
   • Acne: triggered by inflammation, hormonal imbalance, oxidative stress, and often worsened by overgrowth of certain bacteria.
   • Eczema / Atopic Dermatitis: lower microbial diversity, heightened immune reactivity, barrier dysfunction.
   • Psoriasis: chronic immune activation, oxidative stress, cytokine dysregulation.
   • Premature Aging: breakdown of collagen, reduced skin elasticity, pigmentation, and fine lines.

Numerous studies have shown that improving gut microbiota (through probiotics, prebiotics, and dietary changes) can reduce symptoms of atopic dermatitis and other inflammatory skin disorders. (Olejniczak-Staruch et al., 2023; Lopez et al., 2025)

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Evidence from Research

• Probiotics suppress inflammation and oxidative damage: Randomized trials and systematic reviews (e.g. O’Neill et al., 2023), show that probiotic supplementation reduces inflammatory markers and improves skin appearance.
• Dysbiosis in skin disease: Patients with acne, psoriasis, and eczema often have measurable differences in gut microbiome composition compared to healthy controls. (ScienceDirect, 2025; Olejniczak-Staruch et al., 2023)
• Nutrient deficiencies & antioxidants: Deficits in vitamin D, zinc, and omega-3 fatty acids correlate with worse skin and slower recovery; antioxidant supplementation shows beneficial effects. (IFN Academy, 2024)
• Clinical trials of prebiotics & fiber: High-fiber diets and prebiotic supplementation help shift the gut microbiota toward beneficial species, increasing short-chain fatty acid production, improving the skin barrier, and reducing inflammation. (IFN Academy, 2024; Nirvana Healthcare, 2024)

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Integrative & Chiropractic Approaches: Protocols & Clinical Correlation

For the Chiropractic Scientist audience—clinicians, researchers, evidence-seekers—what protocols and clinical observations support effective gut-skin restoration?

Diagnostics & Assessment

• Functional history taking: dietary history, gut symptoms (bloating, transit time), skin flare patterns, sleep, stress, and injury history.
• Laboratory markers:
  • Inflammatory markers (CRP, interleukins, TNF-?)
  • Oxidative stress markers (e.g., glutathione status, antioxidant enzymes)
  • Nutrient levels (vitamin D, zinc, omega-3 fatty acids)
  • Gut permeability or microbiome profiling (if available)
• Structural/Injury Assessment: Using neuromusculoskeletal imaging to identify injuries (sports, MVAs, work-related) that contribute to systemic stress, impaired mobility, and altered physiology. Dr. Jimenez, DC, APRN, FNP-BC, uses dual-scope imaging and assessments to find how injury contributes to inflammation and dysfunction.

Interventions & Treatment Plan

Based on current evidence and integrative/chiropractic practice observations:

Intervention Type	Key Action Points	Evidence / Clinical Rationale
Dietary Support	• Increase fiber (25-40 g/day) from whole foods, fruits, veggies, legumes. • Prebiotic foods (onions, garlic, leeks, bananas). • Probiotic foods / specific strains. • Reduce processed sugar, high GI carbs, and inflammatory fats.	Fiber supports gut microbiota diversity; prebiotics feed beneficial bacteria. Evidence shows that diet shifts can reduce skin inflammation and improve the skin barrier.
Supplementation	• Vitamin D supplementation to optimal levels • Zinc (especially for acne, wound healing) • Omega-3 fatty acids • Antioxidants (vitamin C, polyphenols) • Specific probiotic strains tested in trials (for skin disease)	Trials with probiotics have shown improvements in eczema, acne, and psoriasis when combined with a balanced diet; antioxidants also help reduce oxidative skin damage.
Stress Management & Lifestyle	• Mindfulness, meditation, breathing techniques • Proper sleep hygiene • Limiting environmental toxins (smoke, pollutants) • Regular movement/exercise adapted post-injury	Stress increases cortisol, disrupts gut barrier and microbiome; sleep is essential for repair; exercise improves immune regulation.
Chiropractic / Manual Therapies	• Spinal adjustments to reduce nerve interference and chronic stress • Soft tissue therapy/massage to alleviate tension • Acupuncture (if available) to modulate neural, immune responses • Rehabilitation and mobility work, especially after work/sports/MVA injuries	Addressing structural injuries reduces systemic inflammatory burden; better mobility supports better circulation, reduced stress; integrative modalities can complement dietary and microbiome interventions.
Monitoring & Iterative Care	• Re-testing inflammation/nutrient markers • Tracking skin condition over weeks/months (photos, etc.) • Adjusting interventions according to response (diet, supplements, therapies)	Skin turnover takes time, and the microbiome responds gradually; personalized plans are more effective than one-size-fits-all approaches.

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Clinical Observations: Dr. Alexander Jimenez

Dr. Jimenez, with his training as DC and APRN / FNP-BC, reports multiple clinical correlations relevant to the gut-skin axis in patients who also present with injuries or chronic pain:

• Patients after motor vehicle accidents often show elevated systemic inflammation, plus skin irritations or flare-ups (eczema, acne) thought to be related to stress, poor sleep, and dietary disruption during recovery.
• Work or sports injuries that impair mobility lead to reduced activity, which correlates with slowed gut transit, sometimes resulting in constipation or bloating. This condition appears to be linked with worsening skin barrier issues in practice.
• Nutrient deficiencies are common in this patient population—specifically, low vitamin D, low zinc, and inadequate omega-3 intake. Supplementation often improves not only pain and healing speed, but also skin clarity and barrier recovery.
• Use of neuromusculoskeletal imaging allows identification of hidden injuries (soft tissue damage, postural misalignments) that contribute to chronic stress responses and systemic inflammation; treating these via chiropractic adjustment, massage, and rehabilitation seems to reduce markers of inflammation and yield skin improvement over time.

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Protocol Example: Evidence-Based Integrated Care for Gut-Skin Repair

Here is a sample protocol, constructed with scientific support, for a patient suffering from acne or eczema along with a history of injury or chronic stress:

1. Baseline Measures
   • Labs: CRP, RBC, vitamin D, zinc, omega-3 index, possibly microbiome test if accessible; photographic documentation of skin; measure gut transit/bowel diary; sleep/stress questionnaire.
2. Dietary Plan
   • Increase fiber to 30+ grams per day from whole plant foods
   • Include prebiotic foods daily
   • Introduce fermented/probiotic foods or supplement with a strain with clinical evidence for skin disease (e.g., Lactobacillus rhamnosus, Bifidobacterium spp.)
3. Supplementation
   • Vitamin D to achieve sufficient serum 25-OH vitamin D levels (often 30-50 ng/mL)
   • Zinc (guided dosing, watch interactions)
   • Omega-3 fatty acids (EPA/DHA)
   • Antioxidant polyphenols (green tea, resveratrol, etc.)
4. Manual & Structural Therapies
   • Chiropractic adjustment schedule (depending on injury) to restore spinal alignment and reduce nerve irritation
   • Massage / soft tissue therapy to reduce muscle tension
   • Acupuncture, if available, to modulate inflammation and stress response
5. Lifestyle and Stress Modulation
   • Sleep: aim for 7-9 hours, establish a routine
   • Daily stress reduction: mindfulness, breathing practices, possibly yoga or tai chi
   • Physical activity appropriate for injury status: low impact at first, gradually increase
6. Monitoring & Adjustments
   • Recheck labs after 8-12 weeks (inflammatory markers, nutrients)
   • Assess skin changes (photos, patient report) every 4 weeks
   • Adjust supplement dosages and dietary components based on response
   • Adjust manual therapy/rehabilitation protocols depending on structural improvement

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Practical Implications for Chiropractic Scientist Readers

For chiropractors, chiropractic researchers, or clinician-scientists, these points are particularly relevant:

• The gut–skin axis provides a mechanism by which spinal injury, mobility loss, or dysfunction of the autonomic nervous system might indirectly contribute to skin disease. Understanding those systemic links enhances the scope of chiropractic influence beyond the musculoskeletal system alone.
• When designing studies or case reports, include measures of inflammation, oxidative stress, nutrient status, and possibly microbiome profiles. Also, consider including outcomes beyond pain or structural correction, such as skin health and patient quality of life.
• There is potential for integrative care trials combining chiropractic adjustments and dietary/microbiome interventions for skin disease. These could yield high-value data.
• Evidence suggests that combining structural (manual) modalities with functional medicine approaches (nutrition, gut health, stress) yields more robust and durable results than either alone.

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Challenges and Considerations

• Microbiome Testing Limitations: Tests vary in accuracy and cost, and sometimes, results are difficult to interpret clinically.
• Individual Variation: Genetic predisposition, environmental exposures, and prior skin treatments all affect response.
• Time Frame: Skin regeneration and microbiome shifts take weeks to months; patients must be counseled about realistic timelines.
• Safety: Supplements and probiotics must be of high quality; chiropractic adjustments and manual therapies must be tailored to the individual’s injury or health status; interdisciplinary collaboration may be necessary.

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Conclusion

The scientific literature increasingly supports the gut–skin axis as a key factor in skin health. Dysbiosis, inflammation, oxidative stress, and barrier disruption provide mechanistic links between gut health and skin conditions, such as acne, eczema, psoriasis, and aging. For chiropractic clinician-scientists and integrative practitioners, this opens the door to a broader therapeutic influence, combining manual therapies and structural correction with diet, supplements, stress management, and advanced diagnostics.

Clinicians like Dr. Alexander Jimenez demonstrate through dual-scope practice that treating injuries, optimizing internal health, and supporting gut microbiome balance can collectively produce improvements in skin health, along with reduced pain and enhanced recovery. Over time, integrative protocols for gut–skin restoration may become a standard part of chiropractic wellness care.

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References

• IFN Academy. (2024). The role of integrative and functional nutrition in skin health. Integrative and Functional Nutrition Blog.
• Nirvana Healthcare. (2024). Gut health and skin conditions connection. Nirvana Healthcare Group.
• O’Neill, C. A., Monteleone, G., McLaughlin, J. T., & Paus, R. (2023). The gut–skin axis in health and disease. Frontiers in Immunology, 14, 10385652. https://doi.org/10.3389/fimmu.2023.10385652
• Olejniczak-Staruch, I., Wójcik, A., & Narbutt, J. (2023). Gut microbiota and dermatology: Clinical insights into inflammation and dysbiosis. International Journal of Molecular Sciences, 24(12), 10329. https://doi.org/10.3390/ijms241210329
• ScienceDirect. (2025). Gut and skin dysbiosis in dermatological diseases. Current Research in Microbial Science, 6, 100110. https://doi.org/10.1016/j.crmicr.2025.100110
• Jimenez, A. (2025). Dr. Alexander Jimenez – Chiropractic and functional medicine insights. El Paso Injury Medical & Chiropractic Clinic.
• Jimenez, A. (2025). Dr. Alexander Jimenez – LinkedIn profile. LinkedIn.