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The Gut–Skin Axis: How Gut Health Influences Hair, Skin, and Nails

Our bodies communicate with us constantly. Sometimes the earliest signs that something is off do not begin on the surface, but deep inside the body, in the gut.

Increasingly, science is revealing how closely connected our internal systems are to what we see on the outside. In particular, the relationship between the gut, the gut microbiome, and the brain is proving to be central to overall health. This connection is not a passing wellness trend. It is grounded in well established biological pathways that influence inflammation, nutrient absorption, immune regulation, and tissue repair.

The Gut–Brain–Skin Axis: A Biological Communication Network

For decades, researchers have studied the gut–brain axis, the bidirectional communication between the gastrointestinal tract and the central nervous system. A growing body of evidence now shows that gut microbes play an active role in neuronal signalling, immune modulation, and hormone regulation. These pathways influence stress responses, mood, metabolic function, and systemic inflammation.

In research conducted by my colleagues and myself, we explored how specific gut microbes interact with the gut nervous system. Our work focused on Bacteroides thetaiotaomicron, a bacterial species known to support metabolic health and healthy body weight (Liu et al., Nature Medicine, 2017). We found that this microbe directly influences the gut nervous system, demonstrating that gut bacteria can shape gut function, including mechanisms involved in hunger regulation (Aktar et al., Gut Microbes, 2020).

Why does this matter for hair, skin, and nails? Because the gut is central to nutrient absorption and immune balance. When gut health is compromised, downstream effects are often visible throughout the body.

Gut Health, Inflammation, and Nutrient Availability

The gut plays a critical role in absorbing nutrients required for tissue growth and repair. These include essential vitamins, minerals, and fatty acids that support healthy hair, strong nails, and resilient skin. Disruptions to the gut microbiome, particularly reductions in beneficial bacterial strains, can promote inflammation within the gut and beyond. This inflammatory signalling has been linked to both gastrointestinal and skin inflammation (Jimenez-Sanchez et al., Gut Microbes, 2025).

Nutrients such as omega 3 fatty acids, iron, zinc, and vitamins are essential for keratin production and follicle function. Diets that are restrictive or low in nutrient density, combined with impaired gut absorption, can contribute to brittle nails, thinning hair, and reduced hair strength (DiBaise and Tarleton, Nutrition in Clinical Practice, 2019).  These effects are often not caused by a single factor, but by the combined impact of diet quality and gut health.

Beyond Digestion: The Gut’s Role in External Health

Although digestion is the gut’s most recognised function, its influence extends much further.

The gut is responsible for absorbing nutrients required for hair and nail growth, including biotin, zinc, iron, and vitamins A, C, and E. When absorption is impaired, tissues cannot regenerate efficiently (Mahmud et al., Gut Microbes, 2022).

The gut also plays a key role in regulating inflammation. Chronic gut inflammation can contribute to systemic inflammatory responses that manifest as acne, eczema, psoriasis, rosacea, or scalp conditions (Gao et al., Nutrients, 2023).

In addition, approximately 70 percent of the immune system resides in the gut. When immune signalling becomes dysregulated, inflammatory skin and hair disorders may follow (Mahmud et al., Gut Microbes, 2022).

Together, these processes are often referred to as the gut–skin axis. Importantly, they also extend to hair follicles and nails. Emerging research suggests that changes in the gut microbiome are associated with various forms of alopecia, and that interventions targeting gut health may influence hair growth dynamics (Carrington et al., Journal of Clinical and Aesthetic Dermatology, 2023).

What the Research Says About Nails, Hair, and Skin

A growing body of research supports the concept that external appearance reflects internal gut health.

Systematic reviews indicate that nutraceuticals such as probiotics and prebiotics, which modulate the gut microbiome, are associated with improvements in inflammatory skin conditions including acne and eczema (Zhao et al. Int. J. Mol. Med, 2025).

Clinical and preclinical studies also suggest that altering the gut microbiota may reduce inflammation linked to skin disorders and support biological pathways involved in hair follicle strength and function (Ashkanani et al. Microorganisms, 2026).

While dermatology and microbiome research is still mapping how specific bacterial changes affect tissue health, current evidence consistently supports the idea that a healthy gut environment contributes to healthier skin, hair, and nails.

In other words, the gut does not simply process food. It helps generate biochemical signals that influence the entire body, including the tissues we see every day.

ELCELLA and an Inside Out Approach to Wellness

At ELCELLA, many people share experiences of improved sleep, mood, and changes in how their skin and hair look and feel. These observations align with emerging scientific understanding of the links between gut health, immune balance, and external appearance.

Although large scale clinical trials directly connecting gut focused interventions with hair, skin, and nail outcomes are still developing, early scientific insights combined with real world observations are encouraging. As research continues to evolve, expanding the evidence base remains central to how we think about gut health and whole body wellbeing.

A Final Thought

The body is not a collection of isolated systems. It is a dynamic network in constant communication. The gut signals to the brain, the immune system responds, and the skin, hair, and nails often reflect what is happening beneath the surface.

Supporting gut health is not about chasing trends. It is about nurturing the biological foundation that supports the whole body, inside and out.

 

 

Recipts:

Aktar, R., Parkar, N., Stentz, R., Baumard, L., Parker, A., Goldson, A., Brion, A., Carding, S., Blackshaw, A., & Peiris, M. (2020). Human resident gut microbe Bacteroides thetaiotaomicron regulates colonic neuronal innervation and neurogenic function. Gut microbes, 11(6), 1745–1757. 

Ashkanani, A., Ashkanani, G., Yousef, M., Rob, M., Al-Marri, M., Naseem, N., Laws, S., & Chaari, A. (2026). Microbiome and Skin Health: A Systematic Review of Nutraceutical Interventions, Disease Severity, Inflammation, and Gut Microbiota. Microorganisms, 14(1), 63. 

Zhao, Y., Yu, C., Zhang, J., Yao, Q., Zhu, X., & Zhou, X. (2025). The gut‑skin axis: Emerging insights in understanding and treating skin diseases through gut microbiome modulation (Review). International journal of molecular medicine, 56(6), 210. 

Mahmud, M. R., Akter, S., Tamanna, S. K., Mazumder, L., Esti, I. Z., Banerjee, S., Akter, S., Hasan, M. R., Acharjee, M., Hossain, M. S., & Pirttilä, A. M. (2022). Impact of gut microbiome on skin health: gut-skin axis observed through the lenses of therapeutics and skin diseases. Gut microbes, 14(1), 2096995. 

Carrington, A. E., Maloh, J., Nong, Y., Agbai, O. N., Bodemer, A. A., & Sivamani, R. K. (2023). The Gut and Skin Microbiome in Alopecia: Associations and Interventions. The Journal of clinical and aesthetic dermatology, 16(10), 59–64.