– by Dr. Maureen Sweeney, Live Young Medical –
Skin is our largest organ, but did you know that it is much more than a 3.5-kilogram, 2.5-square-metre passive covering for our body?
There is a delicate interplay between our skin and our internal health. Its function as an organ is multi dimensional: it acts as a barrier to outside threats, providing physical protection against trauma and the environment and antimicrobial signals to ward off infectious invaders. It can heal itself when damaged where many organs cannot. Skin and its substructures, such as the sweat glands, hair follicles and small blood vessels, are indispensible in managing homeostasis (keeping our internal environment and temperature in just the right balance) and in the elimination of internal waste. Like our ears, nose and eyes it is a sensory organ sending vital touch, temperature and vibration communication to our brain. The skin is where the interface with sunlight allows biochemical interactions critical to health to take place, such as the metabolism of bilirubin in a jaundiced newborn and the first steps in Vitamin D production.
Medicine has traditionally divided skin disorders into those unique to the skin and those of internal illness that may manifest in the skin. In some conditions the divide is pretty clear, but in many instances this categorization is too simplistic. Eczema, acne and psoriasis are considered to be skin specific, however psoriasis can cause arthritis, stress aggravates eczema and hormones wreck havoc with acne. More recently we are appreciating that rosacea severity is linked to our intestinal health. An interesting example that demonstrates the interconnection between the skin and the inner body, specifically the nervous system and its sensory connection to the skin, is in the viral infections shingles and herpes simplex eruptions. These are both considered to be skin specific infections; the virus becomes dormant in the nervous system after the initial infection. Stress or another physical illness may then trigger the virus to become active again; it multiplies and travels to the skin surface along the sensory nerves, producing a painful blistering rash on the skin surface.
Conversely, diseases which are internal, such as lupus, may present with a typical rash and systemic viral and bacterial infections with measles and strep (GAS) can cause specific rashes that help diagnose the illnesses. Gluten intolerance may cause a blistering eruption and hives indicate we have been exposed to an allergen that has activated our immune system. Medical doctors and researchers were first alerted to the existence of HIV/AIDS by the sudden appearance of Kaposi sarcoma in young men, which until that point in the 1980s had been a very rare skin cancer.
Due to its exterior location, our skin has its own unique vulnerability to the effects of the external environment and it visibly shows the burden of toxins, lifestyle and exposure. Ultraviolet rays are the most important accelerant of skin aging and cause more serious consequences such as melanoma and other skin cancers. Many of the examples used in this article are instances where the severity of the condition can be impacted through dietary and lifestyle modifications. Others can be prevented through immunization or through implementing sound sexual and general health practises. Protecting yourself from harmful environmental factors, such as using sun protection or managing stress, are also areas where you can have an impact on your skin health.
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