September 14, 2026
Your Skin Is Talking!
What It Can Tell You About Your Health
What It Can Tell You About Your Health
We tend to think about skin from the outside in.
Acne? Buy a different cleanser.
Dry skin? Find a richer moisturiser.
Wrinkles? Reach for retinol.
Rosacea, eczema or psoriasis? Find something to calm the inflammation.
And, of course, topical treatments can be incredibly useful. Sometimes getting symptoms under control quickly is exactly what someone needs.
But there is another question that I think we should be asking more often:
Why is the skin behaving this way in the first place?
I recently listened to a fascinating discussion with integrative dermatologist Dr Mamina Turegano, and one idea ran through the entire conversation:
Skin problems are rarely just skin problems.
The skin is an organ. And like every other organ, it responds to what is happening throughout the body, our hormones, gut microbiome, immune system, metabolic health, stress levels, sleep, nutrition and environment.
That makes the skin rather interesting.
Sometimes, it may be one of the most visible windows we have into what is happening internally.
One of the first places to look when someone has persistent inflammatory skin problems is the gut.
We now understand that the trillions of microorganisms living within the gastrointestinal tract communicate extensively with the immune system. When that microbial ecosystem becomes disrupted, what we call dysbiosis, the consequences don't necessarily remain confined to the digestive tract.
Research increasingly links alterations in the gut microbiome with conditions including acne, eczema, psoriasis and rosacea.
And importantly, someone doesn't necessarily need dramatic digestive symptoms for the gut to be relevant.
Medication use, antibiotics, chronic stress, a low-fibre diet and highly processed foods can all influence the microbiome.
That doesn't mean every spot on your chin requires an expensive stool test.
It means that if a skin problem keeps returning, particularly alongside other symptoms, it may be worth widening the lens.
This was one of my favourite parts of the discussion.
For years, people with skin problems have often been encouraged to chase food intolerances.
Gluten goes.
Then dairy.
Then eggs.
Then nightshades.
Before long, someone can be eating an extremely restricted diet while becoming increasingly anxious about food.
But the relationship between food and skin is much more nuanced.
Sometimes changing the diet improves the skin not because one particular food was the villain, but because the dietary change altered the gut microbiome, reduced highly processed foods, improved blood glucose regulation or increased nutrient intake.
There is also a downside to excessive restriction: reducing dietary diversity may actually reduce microbial diversity.
A much more useful starting point for many people is to ask:
What can I add?
More vegetables. More berries. More legumes if tolerated. Nuts, seeds, herbs, spices and other colourful plant foods.
And importantly: more fibre.
The discussion highlighted a target of around 35g of fibre per day. Getting there through whole foods naturally encourages dietary diversity while bringing along polyphenols, vitamins, minerals and phytochemicals that support both microbial and overall health.
Rather than obsessing over the one food that might be causing your skin problem, it can sometimes be far more productive to ask whether you're feeding the microbes that help regulate inflammation.
Anyone who has developed a spot just before their period probably doesn't need convincing that hormones affect the skin.
But the relationship goes much further than acne.
Estrogen helps maintain skin hydration, supports collagen production and helps maintain the thickness of the epidermis.
This becomes particularly noticeable during perimenopause and menopause.
As estrogen declines, women may notice that their skin becomes:
This isn't simply cosmetic ageing. The biology of the skin itself is changing.
The discussion also highlighted why systemic estrogen replacement can improve skin hydration, collagen production and epidermal thickness in appropriate menopausal women.
That doesn't mean HRT should be prescribed as a skincare treatment. Hormone therapy is an individual medical decision with much broader considerations.
But it does explain why many women notice significant changes in their skin around menopause.
Testosterone is equally interesting.
We tend to associate androgens with oily skin and acne, and excess androgen activity can certainly contribute to both. It can also contribute to unwanted facial hair and scalp hair loss in susceptible women.
But too little isn't necessarily desirable either.
As testosterone declines, skin can become drier and thinner.
Once again, biology rarely comes down to "good hormone versus bad hormone".
Balance matters.
And so does how an individual metabolises those hormones.
Two women can have apparently similar hormone levels and completely different skin.
Why?
Because hormone levels are only part of the story.
Genetics influence sebaceous glands and oil production. But hormone metabolism, insulin sensitivity, stress, diet, the microbiome and environmental exposures can all modify how those genetic tendencies are expressed.
This is why looking at a single testosterone result doesn't always tell us everything we want to know.
Someone may have a relatively unremarkable testosterone level but produce more potent downstream androgen metabolites such as DHT.
It is one of the reasons I find hormone metabolism so much more interesting than simply asking whether a hormone is "high" or "low".
We've all heard someone say:
"I'm breaking out because I'm stressed."
There is genuine physiology behind that.
Stress increases cortisol and influences inflammatory signalling. In the discussion, Dr Turegano described how stress may also alter the composition of sebum, potentially making it more likely to contribute to clogged pores and breakouts.
But there is another important loop here.
Skin problems themselves create stress.
Persistent acne, hair loss, eczema or rosacea can have a profound effect on confidence and quality of life.
People may stop wanting to be photographed.
They avoid social situations.
They change what they wear.
They become hyper-aware of their appearance.
So the skin problem creates stress, and the stress may then further amplify inflammation.
This is why dismissing skin problems as "just cosmetic" misses how deeply they can affect someone's health and wellbeing.
This is another connection that often gets overlooked.
Insulin resistance and metabolic dysfunction can influence skin health, including acne.
High-sugar and high-glycaemic diets can drive insulin and related growth signalling pathways, which may influence oil production and inflammation.
So if an adult suddenly develops persistent acne, particularly alongside weight changes, irregular periods, increased facial hair or other signs of metabolic or hormonal dysfunction, it may be worth looking beyond skincare.
Sometimes the skin is giving us a metabolic clue.
This is an easy one to miss.
People often assume that because something is a vitamin or supplement, more must be better.
Not necessarily.
The discussion highlighted several supplements that can aggravate acne in susceptible people, including high-dose B12, biotin and whey protein. Testosterone supplementation can also contribute in some individuals.
So if your skin suddenly changes, ask:
What changed just before it happened?
New medication?
New supplements?
Protein powder?
Hormone therapy?
Diet?
Stress?
Sleep?
Looking at the timeline can sometimes provide more useful information than ordering another test.
One particularly interesting part of the conversation explored our everyday exposure to plastics and endocrine-disrupting chemicals.
We can't live in a bubble, and trying to remove every environmental chemical from our lives is neither realistic nor particularly good for our stress levels.
But we can reduce unnecessary exposure.
One obvious example is repeatedly putting very hot food or drinks into plastic.
Takeaway coffee cups may look like paper, but they generally require a plastic lining. Plastic lids are another source of contact with hot liquid and steam.
Similarly, reheating food in plastic containers is an easy habit to change.
The point isn't to become frightened of your environment.
It's to make sensible swaps where they're easy.
Use glass or ceramic for hot food.
Take a reusable coffee cup.
Don't microwave food in plastic.
Replace things gradually rather than trying to overhaul your entire life overnight.
As the discussion emphasised, this doesn't need to become an all-or-nothing exercise. Small reductions in exposure are far more realistic.
Late-night scrolling isn't only stealing sleep.
Light exposure at night can disrupt circadian signalling, which in turn influences hormones, metabolism, immune function and inflammation.
There is also some evidence discussed around visible blue light and pigmentation, particularly melasma. But for most people, I suspect the more important issue is what the phone is doing to sleep and circadian rhythm, rather than simply the light hitting the face.
Another reason to put the phone down before bed.
Your skin may thank you, and your brain certainly will.
Red light masks have exploded in popularity, and unlike many beauty trends, there is some interesting science behind photobiomodulation.
Red and near-infrared light can influence mitochondrial activity and inflammatory signalling, and may have a role as a complementary approach to skin health.
But "complementary" is the important word.
A red-light mask cannot compensate for poor sleep, uncontrolled metabolic dysfunction, smoking, nutrient deficiencies or excessive UV exposure.
The expensive gadget should never distract us from the fundamentals.
This is perhaps the most important point.
If you develop severe eczema, psoriasis, acne or another inflammatory skin condition, there is absolutely a place for conventional dermatology.
Nobody should be expected to suffer while spending six months investigating their microbiome.
Sometimes we need to calm the inflammation and investigate why it developed.
Those two approaches aren't mutually exclusive.
What I would love to see more of is this combination:
Treat what is happening on the skin while remaining curious about what may be driving it underneath.
Because sometimes the skin is the first place that imbalance becomes visible.
Instead of asking only:
"What should I put on my skin?"
consider asking:
How is my gut?
Have my hormones changed?
Am I sleeping properly?
What is my stress load?
How stable is my blood sugar?
Am I eating enough fibre and enough plant diversity?
Have I recently started a medication or supplement?
Am I getting enough protein and micronutrients?
What environmental exposures could I easily reduce?
And, of course:
Am I protecting my skin itself?
Good skincare still matters. Sunscreen matters. Appropriate topical treatments matter. Dermatology matters.
But healthy skin isn't manufactured entirely in the bathroom cabinet.
It is built from the inside and the outside.
And sometimes that breakout, dry patch, rash or sudden change isn't simply something to cover up.
It may be your body's most visible way of asking you to look a little deeper.
This article is for educational purposes and is not a substitute for individual medical or dermatological advice.