Singla N, Singla K, Attauabi M, Aggarwal D. Gut-skin axis: Emerging insights for gastroenterologists-a narrative review. World J Gastrointest Pathophysiol 2025; 16(3): 108952 [PMID: 41024986 DOI: 10.4291/wjgp.v16.i3.108952]
Corresponding Author of This Article
Mohamed Attauabi, Department of Gastroenterology and Hepatology, Copenhagen University Hospital-Herlev and Gentofte, Borgmester Ib Juuls Vej 1, DK-2730 Herlev, Denmark. mohamed.attauabi.01@regionh.dk
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Neeraj Singla, Medical Gastroenterology, Fortis Hospitals, Ludhiana 141123, Punjab, India
Khayati Singla, Department of Dermatology and Aesthetic sciences, Fortis Hospitals, Ludhiana 141123, Punjab, India
Mohamed Attauabi, Department of Gastroenterology and Hepatology, Copenhagen University Hospital-Herlev and Gentofte, Borgmester Ib Juuls Vej 1, DK-2730 Herlev, Denmark
Dhruv Aggarwal, Medical Student, Dayanand Medical College and Hospital, Ludhiana 141001, Punjab, India
Co-first authors: Neeraj Singla and Khayati Singla.
Author contributions: Singla N, Singla K, Attauabi M contributed to conceptualization, writing original draft, and revision; Aggarwal D contributed to methodology, assisted in the conceptualization, and contributed to the images and references; all authors read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mohamed Attauabi, Department of Gastroenterology and Hepatology, Copenhagen University Hospital-Herlev and Gentofte, Borgmester Ib Juuls Vej 1, DK-2730 Herlev, Denmark. mohamed.attauabi.01@regionh.dk
Received: April 28, 2025 Revised: June 5, 2025 Accepted: August 25, 2025 Published online: September 22, 2025 Processing time: 145 Days and 2.9 Hours
Abstract
The gut-skin axis (GSA) embodies a complex, bidirectional interaction between the gastrointestinal (GI) system and skin, driven by immune modulation, systemic inflammation, and gut microbiota dynamics. Disruptions in gut homeostasis, including dysbiosis and increased intestinal permeability, are increasingly recognized as contributing factors to dermatological conditions such as acne, psoriasis, and atopic dermatitis. For gastroenterologists, appreciating this interplay is essential, as diseases and their treatments frequently present with cutaneous manifestations, offering diagnostic and therapeutic insights. This review explores the underlying mechanisms of the GSA, focusing on the microbiome and its metabolites as key regulators of inflammation and immunity. It underscores the clinical importance of microbiome-targeted therapies, such as probiotics, prebiotics, and dietary modifications, in addressing both GI and dermatological disorders. Furthermore, the review examines the influence of GI conditions, including inflammatory bowel disease and celiac disease on skin health. This article seeks to equip gastroenterologists with practical insights for identifying, diagnosing, and managing skin conditions associated with GI health. The article also highlights the current limitations in knowledge regarding the GSA. The GSA represents a promising avenue for therapeutic advancements, encouraging interdisciplinary collaboration between gastroenterology and dermatology to optimize patient care.
Core Tip: The gut-skin axis reflects a robust bidirectional connection between the gut and skin, driven by immune and metabolic pathways. Intestinal dysbiosis is a key driver of systemic inflammation, impacting both the gut and skin. Dietary influences, atopy, and microbial modulation play critical roles in this interplay. Skin disorders like atopic dermatitis (AD), hidradenitis suppurativa, psoriasis have association with gastrointestinal (GI) diseases. They might also serve as an early marker of underlying GI pathology. Microbiome-targeted therapies like probiotics and fecal microbiota transplantation offer promising avenues in the management of skin disorders like psoriasis, AD and acne rosacea rooted in gut dysregulation.
