Skin conditions as a clue to internal health

Milk thistle can help improve skin clarity photo: wikipedia

Skin is our largest organ and serves as an important alert system for internal imbalances in digestion, hormones, immune function, and inflammatory processes. Standard treatment is often geared toward quieting these valuable symptoms with medications such as topical ointments and long-term antibiotics. Using a holistic perspective, we have an opportunity to use the external and superficial environment as a clue for a patient’s internal health.

Common skin conditions in primary care practices affecting patients of all ages include eczema, acne, and rosacea.


Eczema is a chronic inflammatory condition triggered by a combination of genetic and environmental factors. Though steroidal creams alleviate the expression of itchy red skin, the underlying cause remains unsolved. The eczema is surely uncomfortable, but in children, the risk of developing asthma and allergic rhinitis is higher than in children unaffected by eczema. These conditions together can severely affect a patient’s daily living activities. By addressing the underlying causes early, these children have an opportunity to mature into healthy adults.

In treating eczema, the assessment complexity changes based on the patient’s age. In infants, toddlers, and young children, I have found success simply by focusing on food sensitivities and gut microbiology as inflammatory triggers. Common food allergens include dairy, gluten, corn, soy, nuts, and eggs. I typically do a blood spot food sensitivity panel to guide the four-week elimination challenge. Identifying and eliminating food allergens can alleviate the inflammation causing the eczema.

Depending on the number of the patient’s food sensitivities, I will implement a gut repair with herbs like slippery elm, marshmallow root, and aloe vera. Research supports the ability of these herbs to gently coat the gut, reduce inflammation, and heal the tissue.

With an estimated 100 trillion bacterial organisms in the body, these bugs seem to have a lot of influence when it comes to our health. Researchers are placing a lot of attention on understanding the microbiome of the gut and its role in obesity, diabetes, mood disorders, immune disorders, hormone disorders, and much more.

Therefore, in addition to identifying food sensitivities, gut microflora should also be addressed to improve the immune system and potentially reduce food intolerances. Preventatively, studies have shown children have had a lower incidence of food allergies and eczema when an expectant mother supplemented with the probiotic strain, Lactobacillus Rhamnosis HN001. This strain of probiotic is also effective in infants for prevention of eczema and sinus infections.

In older children and adults, I run comprehensive digestive stool analyses and/or a lactulose breath test to evaluate inflammation triggered by dysbiosis, or microbial imbalance, from bacteria, yeast, or parasites. The laboratory completes sensitivity testing on organisms identified to aid in choosing an appropriate treatment, which could be either herbal or pharmaceutical.


Despite differences in clinical manifestations, acne and rosacea are two linked chronic inflammatory conditions sharing the same triggers. Typically, patients address these conditions because of their aesthetic appearance, but from a naturopathic perspective, this is an opportunity to support preventative wellness. For example, patients affected by rosacea have a higher likelihood of developing cardiovascular disease with elevations in total cholesterol, bad cholesterol, and inflammatory markers.

The facial pattern for acne can be used to help determine what systems require attention. Patients with acne around their mouth and during cyclic changes will likely require more hormonal support. Those affected by acne across the forehead often do best with digestive support. Acne on a patient’s cheeks sheds light on respiratory support.

People with bacterial overgrowth of the small intestines have a higher incidence of being affected by rosacea. Similarly, as with eczema, I assess food sensitivities and gut bacteria populations as inflammatory triggers.

For acne affected by hormone imbalance, herbal support has been shown to be extremely effective in clinical practice. After testing hormone levels, herbs can be tailored to the patient’s needs.

From a naturopathic perspective, an underlying cause of acne and rosacea is the liver’s inability to clear toxins from the body. The adjunctive use of liver-supporting herbs like burdock, nettles, dandelion, and milk thistle enhances detoxification and can improve skin clarity.

For both acne and rosacea, it is important to address them internally and externally. Oftentimes, patients try to scrub off their condition with harsh and drying products. Working with a skilled esthetician is helpful in determining the proper skincare regimen.

Skin conditions are often indicative of an imbalance to the internal environment and oftentimes, these external conditions are the driving motivation for a person to seek treatment. Though you may simply seek to improve the external appearance of the affliction, this is an opportunity to read bodily cues, which can prevent more serious conditions in the future.

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Thalia Farshchian is a naturopathic doctor at Discover Health. Her background includes both conventional and alternative modalities, and her practice is primarily focused on weight management, hormone imbalances, and gastrointestinal conditions. E-mail: [email protected]