What is the impact of diet on skin and hair health?

What is the relationship between gut axis and skin health?
The Skin and the gut play an important role in the smooth functioning of our immune and neuro endocrine systems. The two organs also share a unique relationship that is related to purpose and function. This relationship is often called the ‘Skin-Gut Axis’ in the scientific community.

To help understand how the gut’s health helps determine the skin & hair’s health, I engaged in a Twitter chat with renowned Dietitian and Diabetes educator from Mumbai, Ms. Ujjwala Baxi. We discussed how dietary alterations can help address concerns like acne and PCOS & the skin and hair manifestations of common ailments.

Here are the excerpts from our conversation.

Here is the first question, @ujjwalabaxi: Most of the time we advise hormonal acne or acne in PCOS patients on a low carbohydrate diet. What do we actually mean by it? #SkinGutAxis

— Dr. Divya Sharma (@divya_sharmaMD) April 13, 2021

A: Low-carb diets work only if done right! Before switching on to low-carb diets, we need to first weed off the unnecessary sugars, processed foods & excess hormone-based dairy foods. Doing these will help cut down the unwanted simple carbs from the diet.

The error that one usually makes is instead of starting slow, they immediately cut down rice, rotis as primary actions from their diet leaving insufficient food on the plate. This leads to a constant feeling of hunger & dissatisfaction thereby increasing intake of snacks which in turn aggravates acne.

One can start with a low carbohydrate diet by focussing on complex carbohydrates from grains like brown rice, broken wheat, millets & whole milled flours. Do add to the vital B complex, vitamins & minerals which add to satiety, prevent cravings & balance the disrupted hormonal issues.

One can further consume good fats from avocado, olives, Vitamin E from nuts like almonds & walnuts and oilseeds, Vitamin A from orange coloured fruits & veggies like papaya, carrots, tomatoes along with Magnesium, Zinc, Selenium that are essential for the hormonal pathways & metabolism.

Q2) I often see excessive #hair shedding in patients who have had a keto diet. Do you think #ketodiet has an adverse effect? @ujjwalabaxi #SkinGutAxis

— Dr. Divya Sharma (@divya_sharmaMD) April 13, 2021

A2) Yes, I do agree as I have seen new clients coming to me post keto diets with hair loss & sleep issues. Keto diet-induced hair loss is known as Telogen effluvium. It involves loss of as much as 30-50% of hair about three months after the precipitating event, in this case, the initiation of a ketogenic diet. However, this hair loss is temporary and new hair grows post 2 - 3 months of execution of the keto diet.

The hair loss is caused due to an immediate shift to a new diet. For somebody who was consuming all sorts of foods without any restrictions & suddenly plans to go “cold turkey” on carbs and proteins & concentrate more on fats - s/he is going to create a state of shock to his body due to energy deprivation. And in a deprived state, our body’s priority to nourish our scalp and hair roots are the least.

Another concern with keto diet is people tend to go heavy on grilled proteins like grilled chicken, fish, paneer, etc. Ingestion of such charred foods creates gut inflammation and forces our stomach to produce more acid in response to it. This leads to acidity issues which reflects on the skin in the form of acne and weakens our scalp.
 

Q3) What are your dietary recommendations for patients suffering from #psoriasis and #metabolic syndrome? @ujjwalabaxi #SkinGutAxis

— Dr. Divya Sharma (@divya_sharmaMD) April 13, 2021

A3) Psoriasis is an inflammatory condition. There is limited research on food that helps the ailment but some people who have psoriasis can manage it better if they eat more inflammation-fighting foods. These include antioxidant-rich herbs & spices like thyme, sage, cumin, and ginger. One can also opt for heart-healthy sources of fat, like olive oil, seeds, and nuts.

Patients suffering from Psoriasis must avoid sugar, dairy, red meat, mutton, spicy, oily foods, alcohol and sugar-laden treats. One must also avoid processed meats, prepackaged food products, canned fruits and vegetables and any processed foods high in sugar, salt, and fat. Lastly, nightshade vegetables like tomatoes, potatoes, eggplants & peppers should also be kept away from the diet as they have been reported as common triggers for psoriasis. The solanine component of these vegetables is known to affect digestion and cause inflammation.

Q4) My #vegan & #vegetarian patients ask me how to include more protein in their #diet especially the ones suffering from #hairloss. Please elaborate on how to include a high #protein diet for #hairfall. @ujjwalabaxi #SkinGutAxis

— Dr. Divya Sharma (@divya_sharmaMD) April 13, 2021

A4) Protein-rich diets include adequate amounts of plant proteins, rice protein, legumes, pulses, nuts, oilseeds, whole grains, some amounts of dairy (if vegetarian - probiotic rich yogurt) & soya products like tofu, soya based nutrela, nut milks, edamame, sattu. One needs to ensure that proteins need to be supported with some amount of complex carbs in the diet.

Q5) #Omega 3 fatty acids are found to be beneficial for #eczema & overall health of the #Skin. What would be your opinion on the best sources of high omega 3 fatty acids? @ujjwalabaxi #SkinGutAxis

— Dr. Divya Sharma (@divya_sharmaMD) April 13, 2021

A5) Omega 3 fatty acids coming from fatty fish like sardines, salmon, mackerel are known to reduce inflammation and these are EPA and DHA. Plant sources such as flaxseeds, chia seeds, walnuts are surely a good way to fight inflammation in the body and nourish the skin and hair.

What are the common #skin concerns caused due to #diabetes? #dermtwitter@divya_sharmaMD #SkinGutAxis

— Ujjwala Baxi (@ujjwalabaxi) April 13, 2021

A6) Common skin concerns in diabetes patients are acanthosis nigricans, skin tags, pigmentation, dermopathy, diabetic foot infection, hair thinning, Seborrheic dermatitis and infections that are both bacterial and fungal in nature.


 

Does #diet play an important role in treating #skin & hair disorders for #dermatologists? @divya_sharmaMD #SkinGutAxis #dermtwitter

— Ujjwala Baxi (@ujjwalabaxi) April 13, 2021

A7) Diet definitely plays a crucial role in preventing & treating skin concerns like pigmentation, acanthosis nigricans, skin tags, dermopathy as Glycated Collagen and hyperglycemia indirectly stimulates melanocytes and also predisposes to infections.
I have seen a tremendous response to diet and weight loss in many other skin related concerns also.



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