The SIBO Acne Connection: 5 SIBO Acne Facts (Most Dermatologists Won’t Tell You)

Written By


Expert Reviewed By

Dr. Lauryn Lax, OTD, MS

Dr. Lauryn, OTD, MS is a doctor of occupational therapy, clinical nutritionists and functional medicine expert with 25 years of clinical and personal experience in healing from complex chronic health issues and helping others do the same.

Have you heard of SIBO Acne or are you suffering from it? Small intestinal bacterial overgrowth (SIBO) and acne go hand in hand.

Unfortunately, the gut-skin connection often goes misdiagnosed for years (if not a lifetime) within the dermatology world..

Newsflash: 70% of your immune system is housed in your gut and influenced by your gut health—including your skin (your body’s largest immune organ)!

In other words, our skin health is a direct reflection of our gut health. if you have acne, chances are, SIBO or some other gut imbalance has something to do with it.

Read on to find out 5 SIBO Acne Facts (Most Dermatologists Won’t Tell You) then check out these 10 Holistic Acne Treatments to Do Now.

5 SIBO Acne Facts (Most Dermatologists Won’t Tell You) 

#1. SIBO is 10 Times More Predominant in People with Acne

Researchers compared adults with acne to “healthy controls” finding over 10x more rates of SIBO in those with acne. The SIBO positive patients were then treated for their overgrowth with traditional therapies and nearly 100% of them experienced remission of acne. #Gainz. 

#2. Certain Probiotics That “Clear Up” Acne Also Clear Up SIBO

Ever been told to take probiotics for better skin health and better gut health?

If you take the right strains, there may be something to this.

For example, separate studies suggest that the probiotic L. salivarius UCC118 may be affective for targeting acne and also SIBO.

One pre-clinical trial, just looking at the probiotic’s effect on 29 people with severe SIBO symptoms (diarrhea, bloating, foul stool, gas) found that after 90 days of taking L. salivarius UCC118, their gut health improved dramatically. This observation supports earlier research that points to remodeling and intestinal support of the gut microbiome.

Another study just looking at the affects of L. salivarius UCC118 on acne alone found significant “antagonistic” effects against acne activity.

Similarly, patients with SIBO who take certain probiotics (Saccharomyces boulardii, Bifidobacterium lactis, Lactobacillus acidophilus, and Lactobacillus plantarum) experienced 70% relief of symptoms; just like patients with acne who take these probiotics also experience acne remission.

Correlation? Or… is there a possibility that you’re actually “treating” and cleaning up your SIBO when the doc or Dr. Google suggests a probiotic for your SIBO acne? Hmmm…

#3. Antibiotics “Work” Against Acne (in the Short Term) Because They Clean Out Some Overgrowth

Speaking of “cleaning up your gut”…

Have you ever wondered why antibiotics are often prescribed (or over-prescribed) for acne?

Answer: SIBO may be at play.

Antibiotics are natural bacterial destroyers. Hence, if you have an overgrowth of bacteria in your upper gut (SIBO), taking an antibiotic can act like dropping a short term bomb on your gut bugs.

The problem is, the effects don’t always last long. Once the antibiotics cease, you are left with just a further disturbed gut (sort of like poking a wasp nest), allowing for more bacterial imbalances.

Even worse, have you ever why do many antibiotics just work in the short-term, only to have your acne return with vengeance in the long term?

If you have biofilm overgrowth (common in SIBO), you can become “resistant” to certain antibiotics, leading to MORE prescriptions or higher doses and longer durations of antibiotics as the doc tries to help you tackle your “stubborn acne.”

Biofilms act like plaques and are collectives of one or more types of bacteria that can grow on many different surfaces—including around SIBO bacteria itself. Biofilms act like “steel armor” for gut bacteria that make bacteria SUPER difficult to penetrate through.

#4. “Hormonal Acne” is Connected to Your Estrobolome

Many people blame their acne on hormone imbalances. “Hormonal acne” is exactly what it sounds like — acne influenced by shifts in your hormones.

The hormones that primarily trigger pimples and breakouts include estrogen, progesterone and cortisol.  For example, in women with PCOS, commonly characterized by skin breakouts, we know that higher testosterone and lower estrogens are at play.

Similarly for women on their period, we know that just before your period starts, estrogen and progesterone levels drop. This can trigger your sebaceous glands to secrete more sebum, an oily substance that lubricates your skin and can clog hair follicles, triggering inflammation and acne breakouts.

And we cannot fit cortisol (your stress hormone). When your body is under stress, as part of the stress response, cortisol levels rise to help your body handle the stressful experience. As a result, increased cortisol can also lead to increased oil production in our skin and prevent skin repair, ultimately promoting breakouts.

What causes cortisol to spike or estrogen and progesterone levels to really get out of balance in the first place?

A few common hormonal acne stressors include:

  • Sleep deprivation
  • Mold and alleged exposures
  • Eating foods you are intolerant to
  • Xenoestrogens (like synthetic estrogens in BPA-rich plastic water bottles, conventional chicken, and birth control pills)
  • Imbalances in the estrobolome (your gut!)

Repeat: Imbalances in your estrobolome  (your gut) act like the “domino effect” to cause imbalances in your hormones, imbalances in your skin and imbalances in your gut.

Your estrobolome is the collection of gut bacteria (housed in your gut) capable of metabolizing and balancing estrogens and other hormones. Hence, if your estrobolome is “off” from SIBO, then your estrogens, progesterone and cortisol follow suit.

Bacteria in the estrobolome produce beta-glucuronidase, an enzyme that turns estrogens into their active forms and send the appropriate amount of estrogen circulating throughout the body to do its thing.

When the gut is balanced and healthy, your estrobolome produces the “Goldilocks” (just right) amount of beta-glucuronidase to support estrogen balance.

However, if you have SIBO or gut dysbiosis, then beta-glucuronidase activity is altered, triggering either a decrease or excess of free estrogen, and consequently imbalances in your other hormones as well.

Hello hormonal acne—especially during that “time of the month” or in the face of stress! 

#5. Foods Like Pizza & Ice Cream Don’t “Cause” Acne (How Gut Bacteria Digest Them Do)

The concept of a gluten-free, lower sugar or dairy-free diet is not foreign in conventional dermatology. Often times when antibiotics and skin creams don’t seem to be working, a doctor may suggest food allergies or sugar intake may be connected.

That said, why do foods matter at all in our skin health?

Answer: We are what we digest.

Small intestinal bacterial overgrowth and food intolerances go hand in hand—primarily because when we have an overgrowth of bacteria in the upper gut (as opposed to the colon where the majority of bacteria should be), these little critters like to ferment foods before they make their way through the process of digestion. As a result, we end up with gas, bloating, constipation or diarrhea to many foods—particularly more allergenic and inflammatory foods like gluten, dairy and sweets.

In other words: It’s not necessarily the foods themselves that cause acne, but instead your gut bacteria and how they actually digest those foods (or prevent digestion)  in the first place.


The acne SIBO connection is real. If you have stubborn acne that won’t go away no matter what you try, it may be worth looking under the hood because health is an inside job.

Connect with a functional medicine practitioner today at our clinic to help you get to your root cause(s).

Also, check out my top 10 Holistic Acne Treatments to Do Now to begin supporting your gut-skin connection.

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