Gut-Brain-Skin Axis and Eczema: The Connection Between Gut Health, Mood and Skin

Gut-brain-skin axis and eczema research explores how the digestive system, emotional wellbeing and skin may communicate with one another. Although these areas of the body may seem separate, they are connected through the nervous system, immune system, hormones and the gut microbiome.

Understanding the gut-brain-skin axis and eczema does not mean that poor gut health causes eczema or that dietary changes can cure the condition. However, supporting digestive health, emotional wellbeing and skin health together may contribute to overall wellbeing and complement an established eczema management plan.

What is the gut-brain-skin axis?

The gut-brain-skin axis describes the two-way communication between the digestive system, brain, immune system and skin.

Your digestive system contains trillions of microorganisms, including bacteria, viruses and fungi. Together, these microorganisms are known as the gut microbiome. They help break down food, produce certain substances used by the body and interact with the immune system.

Researchers continue to study the relationship between the gut-brain-skin axis and eczema, including how the microbiome may influence immune regulation, inflammation and skin barrier function.

How may gut health and eczema be connected?

Eczema is a chronic inflammatory skin condition involving the skin barrier, immune system, genetics and environmental factors. Gut health is only one possible part of this much larger picture.

An imbalance or disruption in the gut microbiome is sometimes called gut dysbiosis. Changes to diet, infections, antibiotics, stress and certain health conditions may affect the balance of microorganisms in the gut. Researchers are exploring whether these changes can influence immune responses and inflammation elsewhere in the body, including the skin.

Studies have found differences between the gut microbiomes of some people with atopic dermatitis and those without the condition. However, it is not yet clear whether these differences contribute to eczema, result from the condition, or are influenced by other factors such as age, diet, medicines and environment.

For this reason, gut health should be viewed as one possible element of overall wellbeing rather than a single explanation for eczema flare-ups.

The connection between eczema, stress and mood

The gut and brain communicate through nervous, immune, hormonal and metabolic pathways. This relationship is known as the gut-brain axis. Stress can influence digestive symptoms and the gut microbiome, while signals from the digestive system may also affect stress responses and emotional wellbeing.

For people with eczema, this relationship may be especially important because the condition itself can place a significant emotional burden on everyday life. Persistent itching, disrupted sleep, visible skin changes and the demands of ongoing treatment can contribute to frustration, stress, anxiety and low mood.

Research consistently shows an association between atopic dermatitis and increased psychological distress. This relationship can work in both directions. Stress may aggravate itching and flare-ups for some people, while worsening eczema can create additional stress and emotional strain.

This does not mean stress causes eczema. Instead, it may act as an aggravating factor within the wider eczema cycle.

Practical ways to support your gut, mood and skin

There is no single food, supplement or lifestyle change that will work for everyone. Small, sustainable habits are usually more helpful than restrictive diets or expensive products making broad “gut healing” claims.

1. Eat a varied, fibre-rich diet

Dietary fibre helps support regular bowel function and provides fuel for beneficial gut bacteria.

Where tolerated, try to include a variety of:

• Vegetables and fruit

• Wholegrain breads, cereals, rice and pasta

• Beans, lentils and other legumes

• Nuts and seeds

Eating a wide variety of plant-based wholefoods is generally recommended for supporting gut microbial diversity and overall health. Introduce additional fibre gradually if you are not accustomed to eating much of it, as a sudden increase may cause bloating or discomfort.

2. Be realistic about fermented foods and probiotics

Some fermented foods, such as yoghurt and kefir containing live cultures, can form part of a balanced diet. However, not every fermented product contains live microorganisms by the time it is eaten, and the effects can vary between foods and individuals.

Probiotic supplements are also strain-specific, meaning that one probiotic may have a different effect from another. Current evidence does not support probiotic supplements as a proven treatment for eczema. People with an existing health condition or weakened

immune system should speak with a healthcare professional before taking them.

3. Avoid unnecessary restrictive diets

There is no universal “eczema diet”, and food does not cause eczema in most people. Removing several foods without professional guidance may lead to nutritional deficiencies, particularly in babies and children.

If you suspect that a food is causing an immediate allergic reaction or repeatedly worsening symptoms, speak with your GP, dermatologist, allergist or an Accredited Practising Dietitian. They can help determine whether allergy testing, supervised food challenges or dietary changes are appropriate.

Do not remove major foods such as dairy, wheat, egg or nuts solely to improve gut health or eczema unless advised by a qualified healthcare professional.

4. Find manageable ways to reduce stress

Stress cannot always be avoided, but small moments of recovery can help support emotional wellbeing.

This may include:

• Gentle physical activity

• Breathing exercises or mindfulness

• Spending time outdoors

• Listening to music

• Talking with someone you trust

• Making time for an enjoyable activity

These approaches are not substitutes for eczema treatment or professional mental health support. They may, however, help reduce the impact of stress and make the eczema cycle feel more manageable.

5. Prioritise sleep

Itching and sleep disruption commonly affect people with eczema, and poor sleep can make it harder to cope with stress.

Maintaining a consistent bedtime routine, keeping the bedroom comfortably cool, wearing soft and breathable clothing, and applying prescribed treatments and moisturiser before bed may help. Speak with your healthcare professional if itching regularly prevents you from sleeping.

6. Continue your usual eczema treatment

Supporting gut health should complement, rather than replace, evidence-based eczema care.

Continue to use moisturisers, prescribed medicines and other treatments as directed by your healthcare professional. Keeping eczema-prone skin moisturised helps support the skin barrier and can reduce dryness and discomfort.

When should you seek professional advice?

Speak with a GP or another qualified healthcare professional if you experience:

• Persistent abdominal pain, diarrhoea, constipation or bloating

• Unexplained weight loss or blood in your bowel movements

• Eczema that is worsening or not responding to your current treatment

• Suspected food allergy symptoms

• Ongoing anxiety, low mood or difficulty coping

• Sleep disruption that is affecting daily life

A GP may recommend further assessment or refer you to a dermatologist, gastroenterologist, allergist, psychologist or Accredited Practising Dietitian, depending on your symptoms.

A balanced approach to gut health, mood and eczema

Research into the gut-brain-skin axis is helping us better understand how different parts of the body communicate. Although there is still much to learn, taking care of your diet, stress levels, sleep and skin can support your overall wellbeing.

The goal is not to follow a perfect diet or “fix” your microbiome. It is to make realistic, nourishing choices while continuing the eczema care recommended by your healthcare professional.

At the Eczema Association of New Zealand, we understand that eczema can affect much more than the skin. We are here to support you with trusted information, practical guidance and a caring community. Explore our resources or contact our team for support with living well with eczema.

Frequently asked questions

Can poor gut health cause eczema?

There is no evidence that poor gut health is the sole cause of eczema. Eczema is influenced by genetics, the immune system, the skin barrier and environmental factors. Researchers have identified associations between the gut microbiome and atopic dermatitis, but the relationship is not yet fully understood.

Can probiotics treat eczema?

Probiotics are not currently considered a proven treatment for eczema. Different products contain different microorganisms and doses, and research findings have been inconsistent. Speak with your healthcare professional before using a probiotic supplement, particularly for a child or someone with a health condition.

Can stress make eczema worse?

Stress does not cause eczema, but it can aggravate itching and flare-ups for some people. Eczema symptoms can also increase stress, creating a difficult cycle between skin discomfort and emotional wellbeing.

Disclaimer: This information is general in nature and is not intended to replace medical, nutritional or mental health advice. Speak with a qualified healthcare professional for guidance based on your individual circumstances.