What the Skin Reveals About Internal Health

Chronic skin complaints—rashes, dryness, acne, pigmentation, premature aging—often originate far below the surface. In a recent webinar, Dr. Thierry Hertoghe—an expert in healthy aging and longevity through hormone and nutritional therapies—and Dr. John Gaviria, a Colombian dermatologist, shared case-based insights. They discussed how hormonal patterns, microbial imbalances, and mitochondrial dysfunction often manifest through the skin.

“The skin doesn’t lie. It reflects what’s happening inside the body—hormonally, microbially, and emotionally.”

—Dr. Thierry Hertoghe

The skin is a diagnostic tool, not just a cosmetic factor, revealing subtle imbalances in endocrine, immune, and metabolic function long before symptoms appear elsewhere. Through real case studies and decades of experience, the webinar illustrated how restoring the skin starts by correcting what’s underneath, and we're going to break it down for you here.

Here's what you'll find in this article:

• Hormones and the Skin: Key Diagnostic Clues
• The Gut-Skin Axis: Microbial Disruption and Skin Expression
• A Functional Medicine Framework for Skin Health
• Case-Based Applications: Visual Clues That Point to Deeper Causes
• Support Clinical Decisions with Specialty Testing

Hormones and the Skin: Key Diagnostic Clues

Common skin presentations offer meaningful insight into hormone status. Recognizable patterns can point to which pathways may be disrupted:

“When the skin is dry, thin, or inflamed, we think: thyroid, cortisol, estrogen, growth hormone.”

—Dr. Thierry Hertoghe

The Gut-Skin Axis: Microbial Disruption and Skin Expression

Early life disruptions—like cesarean births, limited breastfeeding, and repeated antibiotic use—can have long-lasting effects on the gut microbiome. Over time, these factors compromise the gut-immune connection, leading to low-grade systemic inflammation, poor estrogen metabolism, and reduced absorption of key nutrients. Where do these internal imbalances often show up first? The skin.

“Microbiota is the immune system’s main teacher. If it's poorly trained, the whole body—including the skin—suffers.”

—Dr. John Gaviria

Many patients with chronic skin issues also report digestive symptoms like bloating or gas shortly after meals. Others experience inflammatory skin conditions such as rosacea or eczema, or more subtle signs like thinning hair and lateral eyebrow loss. Some notice their skin aging faster than expected or describe persistent fatigue and brain fog accompanying dermatologic complaints. These aren’t isolated issues—they’re signs of deeper dysfunctions that link back to the gut.

This is where targeted microbiome testing can offer added clinical insight. Assessing markers related to gut integrity, microbial balance, and inflammatory activity can help practitioners uncover connections between gastrointestinal health and skin conditions. When integrated thoughtfully with other specialty diagnostics, these evaluations support a more personalized, root-cause treatment strategy.

A Functional Medicine Framework for Skin Health

1. Rebuild the Gut

• Daily intake of large salads (not small side portions)
• No evening proteins → improves thyroid conversion
• Eliminate processed foods, alcohol, and excess sugars
• Probiotics: Lactobacillus, Bacteroides, Saccharomyces boulardii
  
  

2. Manage Oxidative Stress

• Antioxidants: Curcumin, alpha-lipoic acid
• Minerals: Zinc, selenium, magnesium
• Omega-6 support: Borage or evening primrose oil
• Consider SOD or glutathione precursors
  
  

3. Balance Endocrine Function

• Evaluate and support thyroid (T3, T4, rT3)
• Cortisol profiling (diurnal curve via saliva or urine)
• Consider low-dose GH or IGF-1 support when clinically appropriate
• Support estrogen metabolism with microbiome-focused strategies
• Rehydrate systemically: vasopressin, desmopressin, electrolyte balance

Case-Based Applications: Visual Clues That Point to Deeper Causes

Real-world patient cases detailed by Dr. Hertoghe show how skin findings can signal internal imbalances. The simplified examples below highlight how visible symptoms often reflected disruptions in hormonal, microbial, or metabolic function, supporting more targeted clinical investigation

Support Clinical Decisions with Specialty Testing

Specialty panels provide clarity when symptoms present in nonspecific or overlapping ways. Access Medical Labs offers diagnostic tools that help practitioners move beyond symptomatic treatment and toward root-cause protocols tailored to each patient’s biochemical individuality, such as:

• Hormone Panels (saliva, serum, urine)
• Comprehensive Metabolic Panels