The Brain–Gut–Skin Axis in Inflammatory and Disfiguring Skin Diseases: Mechanistic Insights, Clinical Correlations, and Therapeutic Strategies
February 2026
in “
Frontiers in Immunology
”
brain–gut–skin axis acne atopic dermatitis psoriasis rosacea vitiligo alopecia areata neuroendocrine stress gut microbial imbalances chronic inflammation microbial metabolites cytokines neuropeptides HPA axis microbiome-directed interventions psychoneuroimmunological approaches traditional herbal medicine BGSA herbal medicine
TLDR Skin diseases like acne and psoriasis are linked to stress, gut health, and inflammation, with new treatments focusing on gut and mind-body approaches.
The brain–gut–skin axis (BGSA) is increasingly recognized as a key factor in the development of inflammatory and disfiguring skin diseases such as acne, atopic dermatitis, psoriasis, rosacea, vitiligo, and alopecia areata. These conditions are now understood as systemic disorders linked to neuroendocrine stress, gut microbial imbalances, and chronic inflammation. Mechanistic studies highlight the role of microbial metabolites, cytokines, neuropeptides, and HPA axis signaling in interorgan communication. Emerging therapeutic strategies focus on microbiome-directed interventions and psychoneuroimmunological approaches, with integrative therapies like traditional herbal medicine showing promise but lacking robust clinical validation. The review calls for future research to employ longitudinal multi-omics analyses and standardized clinical trials to better understand causal pathways and improve patient-centered management.
