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Writer's pictureDr. Erum Ilyas

The layers of skin

The skin is our largest organ. It forms a barrier to our body while also interacting with the environment around us. Within the layers of the skin, we have immune cells circulating serving as surveillance to protect our body from outside allergens and insults. Read more...
 

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skin issues

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How does skin protect our body?



The skin is our largest organ. It forms a barrier to our body while also interacting with the environment around us. Within the layers of the skin, we have immune cells circulating serving as surveillance to protect our body from outside allergens and insults.


What are the layers of skin?


The basic layers of the skin are 3: the epidermis, the dermis, and the adipose or fat layer. Think of the epidermis as the layer of skin you see directly. More specifically this layer is composed of 5 layers of cells progressing from the basal layer to the stratum corneum. These cells are called keratinocytes and form a barrier to the environment.

Keratinocytes have many functions. They are responsible for producing vitamin D for the body and converting it into its active form. They also produce a protein called keratin. If you have ever had a whitehead or blackhead or cyst and squeezed it and found cheesy white stuff that came out - that is keratin. It can have a bit of an odor if bacteria are present. This keratin actually plays a role in forming an effective barrier from the environment and preventing pathogens from getting through the skin.

The next layer is the dermis. This is where we find blood vessels that nourish the skin and play a role in thermoregulation. It is also where collagen and hyaluronic acid is found. This is the support that provides a structure for the skin. We find many structures in the dermis. The dermis is where we find hair follicles, sweat, glands, sebaceous glands, blood vessels, nerves, and lymphatic vessels. If you nick yourself and bleed, then you have gone past the epidermis into the dermis since there are no blood vessels in the epidermis itself. This can give a good sense of just how thin the epidermis can be while the dermis can be much thicker. Below the dermis is the fat or adipose tissue. This layer is not just about insulation. It plays a role in wound healing and possible hormonal links as well.

What are the functions of skin?

Langerhans cells are found in the epidermis and are thought to be a type of immune cell that may function somewhat like a watchman. It is looking for outside pathogens and informs the immune system in case a reaction needs to be mounted. Merkel cells are found at the base of the epidermis and have a close connection to the nervous system. They are thought to play a role in sensation to sense touch. Fibroblasts are found in the dermis and are responsible for producing connective tissue and assisting in healing after injury to the skin. Capillaries are found through the dermis to provide blood flow and nourish the skin. Lymphatic vessels are also found that remove waste and excess fluid. When our cheeks look flush with redness, this is because the capillaries have vasodilated and give an overall red appearance to the skin. Each of these cells has the ability to misbehave and form different types of skin cancer as well. Merkel cells in particular can form an aggressive type of skin cancer called Merkel Cell Carcinoma.

Why can't the body function without the protection of the skin?


Perhaps the first challenge faced by our body in performing routine functions in the absence of skin would be a loss of thermoregulation. This thermoregulation maintains a relatively stable body temperature responsible for ideal functioning of each organ. Variations in body temperature impact blood flow and lymphatic drainage that impact the vitality of our organs.


What are common skin issues?


The main challenges that face the skin can be broken down into :

  • Inflammatory

  • Infectious

  • Hyperplastic (tumors and growths)

  • Reactive

How is best to treat common skin issues?

Accurate assessment and diagnosis by a Board Certified Dermatologist can provide a path to treatment.


Can skin issues be treated without visiting a doctor?

Likely, most skin issues faced by people are initially managed personally or through cultural practices. That being said, even amongst non-Dermatologists in the medical community there is often little baseline understanding of the skin based on fact and science that establishing yourself with a local Board Certified Dermatologist makes sense to avoid misdiagnosis and mismanagement.



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