How a Functional Medicine approach to Skin Conditions Can Help You Now

Skin conditions can be painful and can rob you of your self-confidence, here's how we can help...

Chronic skin conditions can be a major source of discomfort and frustration.

Skin conditions can cause embarrassment and social anxiety, as well as irritation and pain, and the can make everyday activities difficult.

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There are many different chronic skin conditions (as we’ll cover in more detail below), but some of the most common are eczema, psoriasis, and dermatitis.

These conditions can be very difficult to manage, but both conventional medicine, and a Functional Medicine approach to skin conditions, can help.

Table of Contents

What are chronic skin conditions?

Chronic skin conditions can vary in severity and duration.

With a Functional Medicine approach to skin conditions, the skin is often a symptom of other imbalances in other body systems.

By addressing these, the need for conventional medical treatment, such as antibiotics (oral or topical), steroid medications, biological medications or treatments such as Roaccutane, can be minimised or avoided completely.

Examples of chronic skin conditions include:

Most of us have experienced some kind of skin rash at some point in our lives, often temporary, and which then resolves.

However, in chronic skin problems, the condition is not only a physical concern, but can also have mental, emotional and social consequences.

We’ve seen first-hand with our clients, the devastating toll that chronic skin conditions can take on quality of life and mood, from not being able to sleep due to uncomfortable itchy skin, to depression caused by the psychological impact of a chronic visible symptom.

Chronic skin diseases are associated with some other common psychological problems such as:

Unfortunately, pharmaceutical treatments offered for chronic skin conditions usually do not provide long lasting benefits, and are not addressing the root causes of the skin condition (or are addressing it poorly).

Understanding signs & symptoms of skin conditions

Skin is the largest visible organ of the body and is one of a few organs that is responsible for detoxification.

The skin creates a permeable barrier that protects the body by keeping many harmful substances (toxins) out, while helping to remove waste products from the body, through sweat for example.

Some typical skin symptoms include:

How common are skin problems?

It is very difficult to estimate how many people suffer from skin conditions due to the lack of data in the general population.

For example, atopic dermatitis (eczema) is affecting 11-20% children and 5-10% adults (2); there are 1.1 million people suffering from psoriasis in UK, and that number can be even higher when including self-reported and under diagnosed cases (estimated to be around 1.8 million) (3).

It has also been estimated that one-third of the worlds population is affected by chronic skin diseases (4) 

Chronic skin conditions can affect the quality of life for people of all ages and races around the world.

The conventional medicine approach to skin conditions

The conventional medical approach is usually centred around reducing the severity of the  symptoms. Treatment may include;  

Unfortunately, some skin disorders do not respond to treatments, and some skin conditions are incurable.

However, in such cases, often people can have periods of time when the symptoms are much milder (followed by regular or more occasional flares).

Symptoms may reoccur in response to specific triggers such as:

Some incurable skin conditions can go into remission, providing longer term symptomatic relief.

What are the root causes of skin conditions?

In the Coho Health clinic, our practitioners explore the possible unique root causes of skin conditions.

Some common root causes to chronic skin conditions include:

The functional medicine approach to skin conditions

Functional medicine views skin conditions as an external symptom of underlying imbalances.

And so in the Functional Medicine approach to skin conditions, the practitioner works closely with the client, in order to identify these underlying imbalances, and then to implement a tailored protocol accordingly.

Identifying and addressing the underlying causes (such as those listed above), rather than just managing the symptoms of skin conditions, helps to improve symptoms and overall health in a sustainable manner.

Working this way, it becomes less likely that you experience a flare or reoccurrence of symptoms.

In the scientific research, and in our clinical experience, gastrointestinal imbalances are strongly associated with chronic skin conditions.

The microbiome is intricately associated with the immune system, and changes to the skin or gut microbiome alters immune function, which then promotes the development of skin conditions (5).

Many studies present the link between gut dysfunction and skin conditions, this association is commonly referred to as the ‘gut-skin axis’ (6, 7, 8).

Imbalances in the gut can manifest in the skin, via the effects of bacteria, yeast, immune cells such as antibodies (e.g. as seen in a food reaction), inflammatory signalling molecules such as cytokines, or histamine.

The intestinal barrier is a huge interface between what we take into our body (food, drinks, bacteria, yeast, parasites etc) and what we absorb into the blood. 

Disturbances in intestinal barrier function can go on to alter immune function and increase inflammation. 

The intestinal barrier should be robust, tightly controlling what is absorbed into the blood and what is not.

Unfortunately, very often the intestinal barrier is not as robust as it should be.

Many factors can alter intestinal barrier function, causing the intestinal barrier to be more permeable than it should be, a scenario referred to as ‘leaky gut’ (increased intestinal permeability).

Increased intestinal permeability drives immune dysfunction and systemic inflammation (9) – promoting the development of skin symptoms.

Functional Medicine approach to skin condition protocols

Each skin disorder has some common causal factors and unique pathophysiology (changes in normal function, that leads to signs and symptoms).

Understanding this for your specific skin condition is important, as well as identifying the unique triggers and contributing factors to your skin symptoms.

A Functional Medicine approach to skin conditions, tailored to your unique requirements, might include some of the below interventions (the below is not an exhaustive list):

Functional testing for skin conditions

We routinely apply Functional testing to help identify imbalances and factors that are driving a skin condition.

Some of the most common tests we use in our clinic to help those with chronic skin complaints are:

Gastrointestinal function and microbiome tests

Gastrointestinal function and microbiome tests assess markers such as; Helicobacter pylori, parasites, viruses, yeast and fungi (including candida), and markers concerning gut function – digestion, absorption, inflammation and gut immunity (10).

SIBO (Small Intestinal Bacterial Overgrowth) breath test

The SIBO (Small Intestinal Bacterial Overgrowth) breath test assesses for the presence of an overgrowth of bacteria in the small intestine (bacteria in the wrong place). 

There is a significant correlation between SIBO and skin conditions, particularly rosacea. 

For example, one study demonstrated that treating SIBO resolved rosacea symptoms in 85% cases (11, 12).

Food allergies, intolerances and coeliac disease

Tests for food allergies, intolerances and coeliac disease check if any foods are triggering immune responses and your symptoms. 

For example, a study has shown that those with gluten intolerance or coeliac disease are three times more likely to develop eczema (13).

Nutritional deficiencies

Nutritional deficiencies profile checks markers such as vitamin D status, fatty acid levels, vitamin B12 and folate). 

This helps us to understand levels of nutrients that play an important role in skin health. 

Essential fatty acids and vitamin D can modulate inflammatory responses in the skin (14, 15, 16), so ensuring optimal levels can be very helpful.

Fasting insulin and a HbA1c

Fasting insulin and a HbA1c testing helps us to understand if insulin resistance may be a driver of the skin symptoms (17).

Liver and kidney function

Liver and kidney function profiles assess the function of these organs, and can help us to understand if sub-optimal detoxification and elimination may be a contributing factor to skin problems.

Hormone tests

Hormone tests – such as cortisol, testosterone, DHEA-S and oestrogen, can be useful as hormone imbalances can contribute to skin conditions. 

For example, acne can be caused by high levels of testosterone, a hormone that plays an important role in the production of sebum (oil in the skin) (18). 

One example of this is acne in PCOS (Poly Cystic Ovary Syndrome), where high androgen hormones, such as testosterone and DHEA-S are commonly at play.

The wrap...

Skin conditions can have a deep impact on daily – not only in terms of constant irritation and pain, but also in terms of social anxiety, relationships, and self confidence.

Many of those things are part of the essence of enjoying a happy life!

At Coho Health, we absolutely live to achieve brilliant clinical outcomes together with our clients, and never more so than when we’re working to clear up a problematic skin condition.

Seeing the difference in our clients – and often the difference is literally life changing (not just in the skin itself but also in self-confidence) – means everything to us.

But, due to the range of underlying factors that can be involved, the Functional Medicine approach to skin conditions can require patience and commitment.

The good news is, that once we’ve treated the root cause or causes of the skin condition, it’s much less likely to come back.

And that means you get to keep your confidence and quality of like long term.

To your optimised, healthy future,

Aga & the Coho Health team

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