Welcome back, DERM Community.
This week’s issue is brought to you by Decode.me
Last week, we explored functional and integrative dermatology: what it is, how to apply it responsibly, and why it matters in patient care. This week, we’re narrowing in on a cornerstone of that approach: the gut microbiome and functional testing.
Here’s the reality:
Your patients’ skin often tells a story about their internal health. And increasingly, the gut is a central character in that story.
Here's a detailed, evidence-informed look at telehealth from the infrastructure level to the clinic.
Why the Gut Matters in Dermatology
Patients ask:
“Why does my eczema flare after certain meals?”
“Could my acne be linked to my gut?”
“Is my diet making my psoriasis worse?”
These questions aren’t trivial.
Emerging evidence shows that the gut microbiome—the trillions of microorganisms in our intestines—plays a role in systemic inflammation, hormonal regulation, and even immune function. Dysbiosis, or imbalance in gut bacteria, can exacerbate chronic skin conditions.
Functional testing allows clinicians to move beyond guesswork and understand individual patterns in digestion, nutrient absorption, and microbial balance.
Functional Testing: What It Can Reveal
Functional tests are tools to assess:
Microbiome composition: Which bacterial species are thriving or lacking
Intestinal permeability (“leaky gut”): Which may contribute to systemic inflammation
Digestive efficiency: Enzyme activity, nutrient absorption, and food sensitivities
Inflammatory markers: CRP, cytokines, or metabolic byproducts affecting skin
When interpreted in context, these tests guide personalized dietary, lifestyle, and medical interventions, instead of one-size-fits-all advice.
Diet and Lifestyle: The Core of Gut-Skin Health
Testing is valuable, but diet remains the primary modulator of the microbiome. Evidence-based strategies include:
Fiber-rich foods: Vegetables, fruits, legumes, and whole grains feed beneficial bacteria
Fermented foods: Yogurt, kefir, kimchi, sauerkraut, miso, kombucha for microbial diversity
Balanced macronutrients: Adequate protein, healthy fats, and complex carbs support metabolic health
Anti-inflammatory foods: Omega-3s from fish, nuts, seeds, and colorful plant foods
Limit highly processed foods: Refined sugar, ultra-processed fats, and artificial additives can worsen dysbiosis
Lifestyle factors: Sleep, stress management, and physical activity influence microbial balance
Patients often need clear guidance: the goal is not perfection…it’s consistent, sustainable choices that support long-term gut and skin health.
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"All disease begins in the gut"
👋🏻 See you next Thursday, DERM community!
Functional testing and gut-focused care work best when clinical rigor meets practical, patient-centered guidance. Diet is medicine, but only when paired with structure, follow-up, and understanding. Patients want answers: they want to know why their skin behaves the way it does. This approach allows dermatologists to provide exactly that.
See you next Thursday, DERM Community!
— The Derm for Primary Care Team
