Acne, Anxiety and Sour Milk: Back to the Future

Below is the abstract of an open access article in the journal Gut Pathology. The paper draws attention to a seventy-year-old hypothesis relating gut flora, mental states and skin disorders. The widespread availability of commercially prepared kefir allows anyone with a skin condition or an anxiety disorder to test this hypothesis. Kefir is milk soured to the consistency of drinkable yoghurt by a dozen or more strains of lacto-fermenting organisms, chiefly species of the genus Lactobacillus. The fermentation converts milk sugar, lactose, to lactic acid. In addition, the live bacterial culture continues, in the acidic environment of the stomache, to convert any other sugars that may be present to lactic acid (plus perhaps a little alcohol) thereby increasing the acidification of the stomache contents. This in turn affects the environment in the further reaches of the gut, thereby controlling the species composition of the gut microflora, the metabolism of which, affects what passes the gut wall into the blood stream and lymphatic system.

Thus, for example, Lactobacillus rhamnosus, usually to be found in commercially prepared Kefir, produces substantial quantities of the mammalian neuroinhibitor, gamma amino butyric acid, or GABA, with reportedly significant psychoactive effects. That chemicals produced by gut microorganisms have a sedative effect is not entirely surprising since emotion is a matter nor only of the head but of the heart, which term should be understood to include the gut where, as acknowledged in common speech, emotion is registered.

Anecdotal reports suggest that Kefir can be effective in the treatment of dermatitis, food allergies and some chronic gut-related disabilities including colitis and Krohn's disease. The cost of experiment by those so afflicted is slight, and the downside seemingly small, since the transformation of the gut flora achieved through the use of probiotics such as kefir seems to depend on continued consumption and is thus easily terminated if no benefit is experienced.

Gut Pathog. 2011; 3: 1
Acne vulgaris, probiotics and the gut-brain-skin axis - back to the future?

Whitney P Bowe and Alan C Logan

Over 70 years have passed since dermatologists John H. Stokes and Donald M. Pillsbury first proposed a gastrointestinal mechanism for the overlap between depression, anxiety and skin conditions such as acne. Stokes and Pillsbury hypothesized that emotional states might alter the normal intestinal microflora, increase intestinal permeability and contribute to systemic inflammation. Among the remedies advocated by Stokes and Pillsbury were Lactobacillus acidophilus cultures. Many aspects of this gut-brain-skin unifying theory have recently been validated. The ability of the gut microbiota and oral probiotics to influence systemic inflammation, oxidative stress, glycemic control, tissue lipid content and even mood itself, may have important implications in acne. The intestinal microflora may also provide a twist to the developing diet and acne research. Here we provide a historical perspective to the contemporary investigations and clinical implications of the gut-brain-skin connection in acne.

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CanSpeccy: Guts and Gaba, Bugs and Brains, Allergies and Anxiety