Skin issues from Blastocystis infection? It sounds like a stretch but the connection between the gut and the skin has been found and is currently being explored (heavily!) in the scientific community. This article will focus on the connection between the Gut and the Skin and will outline some research that points to Blastocystis hominis as being one possible culprit for skin rashes including urticaria, rashes and lesions.
Blastocystis is a common gut infection worldwide. Anecdotally it seems to have quite a high rate of incidence here in Byron Bay and in Australia generally.
For a primer on the subject – Blastocystis hominis – A Protozoan Gut Parasite
Disease States and Blastocystis
For years the pathogenicity of Blastocystis hominis was debated in the scientific literature. In the last 10 years more and more research has come out validating the potential parasitic nature of the protozoan infection
“Clinical features of illness that have been attributed to Blastocystis spp. are nonspecific and include nausea, anorexia, abdominal pain, bloating, flatulence, and acute or chronic diarrhea. Of these features, the most commonly recorded symptoms among patients are abdominal pain and diarrhea. Symptoms can be variable, ranging from mild diarrheal illness and chronic diarrhea to acute gastroenteritis” (2)
It is still very much up in the air. Is this particular bug a problem like Giradia and Entamoeba histolytica? Is it more like the popular and sometimes troublesome (but not always) Helicobacter pylori? Finally it could simply be a scapegoat. A bug that we blame all our digestive problems on when really the issue is SIBO or food intolerances like gluten, lactose or fructose.
We haven’t quite worked that question out so it is worth keeping an open mind and exploring all options before deciding that Blastocystis is the root cause.
Ok. Let’s get into the real reason you are here. Is there a connection between your skin rash and your positive stool test showing you have Blastocystis?
Skin Issues From Blastocystis Infection
It shouldn’t come as a surprise that there is a connection between the gut and the skin. The connection is a hot topic in the research community at the moment and some interesting correlations are being made between the Gut-Skin Axis.
In one study 11% of people infected with Blastocystis hominis experienced skin issues. Interesting to note the majority of those with both Blastocystis and skin where female (3).
Another case of skin issues from Blastocystis infection described a patient with a Blastocystis hominis infection and chronic urticaria (hives). They found that treating the parasite cleared the skin condition in a matter of weeks (4).
In a third paper three separate case studies of patients with skin issues from Blastocystis infection all presented with skin rashes. All three were eventually screened for parasite infections and all three were found to have Blastocystis hominis. After treatment all three cases of skin rashes resolved (5).
Pretty compelling stuff.
One interesting study looked at the prevalence of Blastocystis infections among patients with active chronic or acute urticaria. Out of 54 patients with urticaria (skin rashes/hives) 61.1% where positive for Blastocystis when screened using PCR DNA based technology. Out of those positive for Blastocystis 21 displayed symptoms of infection and 12 were actually asymptomatic (except for the skin disorder). The study included a control group with no skin disorders and found only 8% infected with Blastocystis. Effective treatment (antibiotics in this case) resulted in the elimination of Blastocystis and 100% cure for the hives.
Gut Skin Connection – Beyond Blastocystis
The study referenced above suggested screening patients presenting with hives that didn’t respond to the standard treament for Blastocystis hominis.
The gut skin connection goes beyond Blastocystis.
Research has found correlations between
- Inflammatory Bowel Disease and skin ulcers, reddening and psoriasis
- Coeliac disease and dermatitis and psoriasis
- Rosacea and SIBO + Helicobacter pylori along with skin papules and pustules
The gut-skin axis has been well established in the literature. The work being done now is to iron out the details of how the connection is actually being made between the gut ecosystem and the skin. While this is valuable research I think that we can extrapolate from some of the findings currently being published and look to the gut microbiome for anyone suffering from skin disorders.
Other things to be on the lookout for would include
- SIBO (small intestinal bacterial overgrowth)
- Parasitic infections
- Bacterial dysbiosis
- Beneficial bacterial insufficiency
- Inflammatory Bowel Disease
References and Resources
- Blastocystis hominis – A Protozoan Gut Parasite
- New Insights on Classification, Identification, and Clinical Relevance of Blastocystis spp.
- Do not forget the stool examination!—cutaneous and gastrointestinal manifestations of Blastocystis sp. infection
- Chronic urticaria due to Blastocystis hominis
- Cutaneous Lesions in Blastocystis hominis Infection
- Association of Blastocystis hominis genetic subtypes with urticaria
- The gut-skin axis in health and disease: A paradigm with therapeutic implications.