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  • Writer's pictureAku Energija

"Gut-skin” axis: understanding psoriasis from the gut and how TCM can help

In the last decade, the gut-skin-brain axis has emerged as a research field offering more and more evidence on the way foods and intestinal microbiota can affect the development of intestinal/skin diseases[1], and neurological-psychiatric-psychological disorders[2]. [Read more: The gut-brain connection and its importance]

Psoriasis is a chronic, inflammatory, difficult to cure autoimmune disease with high recurrence rate. According to WHO, because of the main symptom of damaged skin, itching is unbearable, and accompanied by erythema, papules, scales and other clinical characteristics, seriously threatening the physical and mental health of patients. In addition to the negative effects of quality of life, psoriasis is associated with a number of complications, including psoriasis arthritis, depression and anxiety, lymphoma, obesity and metabolic syndrome, which will increase the risk of early death.

The concept of the “gut-skin axis” links alterations in the gut microbiota with the inflammatory response in the skin. The development of psoriasis is associated with alterations in the function and composition of the gut microbiota. The progression of psoriasis often follows gastrointestinal inflammation, such as in IBD. Gut microbiota alterations is an important factor of the pathological mechanism of psoriasis.  However, the specific mechanism of this interaction is still unclear.

The integrity and dynamic characteristics of the intestinal micro-ecology are consistent with the holistic view and perpetual motion view in traditional Chinese medicine (TCM). Some theories such as "The lung and the large intestine are interior-exteriorly related", "Lung relating to skin theory" and "Gut-brain-skin axis theory", and some researches on TCM maintaining the balance of intestinal microecology, provide a basis for exploring the TCM mechanism of diagnosis and treatment of psoriasis from the perspective of intestinal microecology.[3]

Understanding of psoriasis from the perspective of “gut-skin” axis in Traditional Chinese Medicine

Traditional Chinese Medicine believes that human beings are an organic and unified whole. The viscera do not exist independently, but are connected through meridians and collaterals to form the external and internal relationship between the viscera and the viscera. Both physiologically and pathologically, they are interconnected and influence each other. 

Psoriasis, although manifested as superficial skin erythema and scales, is closely related to the dysfunction of the viscera. It has long been recorded in the Inner Canon of the Yellow Emperor that those who have all kinds of inner organs must show them to the outside, and the external expression must also be based on the internal dysfunction of the viscera. 

The skin and the large intestine are related to two different organs, which seems to “be totally unrelated”. Among them, skin dominates the whole body, defending against the invasion of  external evil. The large intestine is the conduction organ and the main excretion organ of the human body. Under the guidance of the “holistic view” of Traditional Chinese Medicine, the theory of “lung governs the skin/fur” believes that the lungs spread the essence of Qi on the skin, so that the skin can be firm and strong. If the lung Qi is insufficient or the lung Qi is blocked, it will be abnormal.

At the same time, Traditional Chinese Medicine believes in an “interior-exterior relationship between the lung and large intestine”, which means that the lung and the large intestine are interrelated in meridians and influence each other in physiology and pathology. If one of the lesions can cause the other side dysfunction, the diseases of the lung and intestines will affect each other, transmit and involve each other.

Treatment of psoriasis with TCM

According to TCM theory, skin is closely related to viscera, meridians, Qi and blood, body fluid, especially lung, with the lung governing diffusion, governing the fur, governing Sujiang, governing regulation of water passages. If the lung Qi is normal, the Qi, blood and body fluid can spread all over the body, the defensive Qi is abundant, and the external evil cannot invade. Based on the idea of “skin is closely related to the intestinal tract, so it is also closely related to the intestinal microecology”, some scholars believe that the therapeutic principles and methods of “regulating the spleen and stomach” and “calming the nerves” adopted by Traditional Chinese Medicine in the treatment of psoriasis are likely to play a therapeutic role by regulating the intestinal flora.[4]

TCM advantages in the treatment of psoriasis

Compared with modern medicine, TCM has unique advantages in the treatment of psoriasis, including the uniqueness of syndrome classification, abundance and flexibility of treatment ideas. By following the principles of differentiation of syndromes, a combination of internal and external treatment methods based on an understanding of the etiology and pathology were used. [Read more: TCM vs Western Medicine]

It tailors treatment to the different stages of skin lesions and individual patient constitution, directly alleviating patient symptoms, promoting the regression of skin rashes, and exhibiting a characteristic of “quick and effective treatment.” In TCM, this differentiation of patterns and treatment makes it possible to manage psoriasis in a special way.

At AKU ENERGIJA, we offer a range of therapies including acupuncture, herbal medicine and dietary advice that can help address such skin issues as eczema and psoriasis effectively, tailored to different patient constitutions. To determine your specific constitution and the appropriate treatment method, please make an appointment, and we will schedule a consultation for you.


  1. Mahmud RM, Akter S, Khanam Tamanna S, Mazumder L, Esti I Z, Banerjee S, et al.. Impact of gut microbiome on skin health: gut-skin axis observed through the lenses of therapeutics and skin diseases. Gut Microbes. (2022) 14:e2096995. 10.1080/19490976.2022.2096995

  2. Schiopu CG, Stefanescu C, Bolos A, Diaconescu S, Gilca-Blanariu GE, Stefanescu G. Functional gastrointestinal disorders with psychiatric symptoms: involvement of the microbiome–gut–brain axis in the pathophysiology and case management. Microorganisms. (2022) 10:2199. 10.3390/microorganisms10112199


  4. “Gut-skin”axis: understanding psoriasis from the gut. doi: 10.1691/ph.2021.1694


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