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The gut‑skin axis: Emerging insights in understanding and treating skin diseases through gut microbiome modulation (Review)

  • Authors:
    • Yuantong Zhao
    • Chenchen Yu
    • Jingyu Zhang
    • Qinghua Yao
    • Xiao Zhu
    • Xiaorong Zhou
  • View Affiliations / Copyright

    Affiliations: Department of Immunology, School of Medicine, Nantong University, Nantong, Jiangsu 226001, P.R. China, Department of Dermatology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, Hubei 430071, P.R. China, School of Ocean and Tropical Medicine, The Second Affiliated Hospital of Guangdong Medical University, Guangdong Medical University, Zhanjiang, Guangdong 524003, P.R. China, Department of Immunology, School of Medicine, Nantong University, Nantong, Jiangsu 226001, P.R. China
    Copyright: © Zhao et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 210
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    Published online on: September 29, 2025
       https://doi.org/10.3892/ijmm.2025.5651
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Abstract

 Emerging evidence indicates a significant association between the composition and functionality of the gut microbiome and various skin disorders, including psoriasis, atopic dermatitis, acne and several dermatological conditions. The gut‑skin axis theory describes a complex bidirectional communication network between the gut and the skin, providing mechanistic insights into the pathogenesis of certain cutaneous diseases. Specifically, the gut microbiome influences skin health through the regulation of systemic immunity, inflammatory responses and metabolic pathways. Advances in high‑throughput sequencing and bioinformatics technologies have substantially enhanced the understanding of the role of the gut microbiome in skin pathology. Clinical and preclinical studies have demonstrated that restoring gut microbial homeostasis via interventions such as faecal microbiota transplantation, probiotics and prebiotics can ameliorate symptoms of skin diseases. Furthermore, personalized microbiome‑based therapies, next‑generation probiotics and dietary modifications hold promise for refining gut‑skin interactions and advancing precision medicine in dermatology. Therapeutic strategies targeting the gut‑skin axis offer novel avenues for innovative dermatological treatments, with future breakthroughs potentially involving microbial community engineering, postbiotics and artificial intelligence in microbiome‑related diagnostics. This narrative review summarizes recent advances in gut‑skin axis research, explores its potential in the prevention and management of selected dermatoses and discusses future trends and scientific developments in the field.
View Figures

Figure 1

Basic components of the gut-skin axis
(gut microbiota, skin microbiota) and the possible impact of gut
microbiota on human health. (A) Members of the gut microbiota
(mainly bacteria). Gut microbial communities maintain homeostasis
through competitive exclusion, metabolic cross-feeding, and niche
competition. (B) Factors that may affect gut microbiota
composition, including diet, antibiotics, host genetics, age and
environmental exposures. (C) Schematic representation of the skin
microbiome. The skin surface exhibits an acidic pH, high salinity,
low moisture and aerobic conditions, while the follicle-sebaceous
unit is relatively anaerobic and lipid-rich. Commensal microbiota
support skin barrier integrity through colonization resistance and
immune modulation. (D) The gut-organ axis system, where the gut
microbiota communicates bidirectionally with other organs (e.g.,
brain, kidney, liver, skin) via metabolites and microbial
components through endocrine, neural and immune pathways.

Figure 2

Implications of the gut
microbial-skin axis, i.e., the bi-directional interaction between
the gut and skin, and certain applications. (A) Next-generation
sequencing enables taxonomic profiling, while multi-omics
integration (metagenomics, metabolomics) facilitates functional
annotation of microbial pathways. (B) Gut dysbiosis alters systemic
levels of microbial metabolites (e.g., tryptophan derivatives),
triggering skin inflammation. Conversely, cutaneous inflamma- tion
impairs intestinal barrier function, shifting the gut microbial
composition. (C) The process of FMT, including donor screening,
fecal slurry preparation and recipient delivery. Application in
dermatology targets microbial reconstitution in conditions like AD.
(D) Microbiota-derived metabolites may influence histological
characteristics of early melanoma and clinical manifestations of
advanced melanoma through direct or indirect immunomodulatory
effects. AD, atopic dermatitis; FMT, fecal microbiota
transplantation; TMAO, trimethylamine N-oxide.
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Spandidos Publications style
Zhao Y, Yu C, Zhang J, Yao Q, Zhu X and Zhou X: The gut‑skin axis: Emerging insights in understanding and treating skin diseases through gut microbiome modulation (Review). Int J Mol Med 56: 210, 2025.
APA
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, 210. https://doi.org/10.3892/ijmm.2025.5651
MLA
Zhao, Y., Yu, C., Zhang, J., Yao, Q., Zhu, X., Zhou, X."The gut‑skin axis: Emerging insights in understanding and treating skin diseases through gut microbiome modulation (Review)". International Journal of Molecular Medicine 56.6 (2025): 210.
Chicago
Zhao, Y., Yu, C., Zhang, J., Yao, Q., Zhu, X., Zhou, X."The gut‑skin axis: Emerging insights in understanding and treating skin diseases through gut microbiome modulation (Review)". International Journal of Molecular Medicine 56, no. 6 (2025): 210. https://doi.org/10.3892/ijmm.2025.5651
Copy and paste a formatted citation
x
Spandidos Publications style
Zhao Y, Yu C, Zhang J, Yao Q, Zhu X and Zhou X: The gut‑skin axis: Emerging insights in understanding and treating skin diseases through gut microbiome modulation (Review). Int J Mol Med 56: 210, 2025.
APA
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, 210. https://doi.org/10.3892/ijmm.2025.5651
MLA
Zhao, Y., Yu, C., Zhang, J., Yao, Q., Zhu, X., Zhou, X."The gut‑skin axis: Emerging insights in understanding and treating skin diseases through gut microbiome modulation (Review)". International Journal of Molecular Medicine 56.6 (2025): 210.
Chicago
Zhao, Y., Yu, C., Zhang, J., Yao, Q., Zhu, X., Zhou, X."The gut‑skin axis: Emerging insights in understanding and treating skin diseases through gut microbiome modulation (Review)". International Journal of Molecular Medicine 56, no. 6 (2025): 210. https://doi.org/10.3892/ijmm.2025.5651
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