Basics of skin care - Clinical Tree

The importance of the skin

The skin is the body’s largest organ, which maintains not only our homeostasis but also a physiologic environment for us to inhabit. Moreover, the skin has an important aesthetic function, as it reveals information about health, age, and environmental exposures. The skin has captivated people since the beginning of time: skin has been described in the canon of western literature as dewy, luminous, and beautiful. Similarly, when the skin is weathered, wrinkled, creased, or worn, patients may feel almost trapped in their own bodies.

Skin care can be a challenging topic in minimally invasive aesthetic plastic surgery, as it traverses the boundary between cosmetics and a medicalized approach to the dermis. Product marketing is not necessarily related to product efficacy, and consumer confusion is high. An academic approach to skin care requires focus on ingredients that have demonstrated clinical efficacy, and gradual incorporation of products, according to unique patient characteristics.

Topics related to skin and complexion have an increasing importance as people are celebrating the unique variance in their skin tones, colors, and textures. Understanding skin from a 21st-century perspective demands respectfully considering patients of all demographic backgrounds and skin colors. Approaches that may work well for one patient population may not work well for another, and the nuances of treating the skin of people of color cannot be underestimated.

The function of the skin

The skin serves many functions crucial to the body’s normal operation, including barrier defense, ultraviolet (UV) protection, thermoregulation, and sensation.

Barrier defense

The skin offers the body’s first line of defense. As part of the innate immune system, it protects the body from external pathogens through mechanical and chemical mechanisms, including a waterproof barrier established by epithelial cells linked through tight junctions, secretion of lipids, and antimicrobial peptides. The healthy skin also houses a range of commensal bacteria that keep pathogenic bacteria from overpopulating.

UV protection

UV light from the environment is known to cause DNA damage, which relates to photoaging and carcinogenesis. The skin protects the body against UV damage through melanin, a peptide pigment that absorbs UV rays and neutralizes free radicals. Melanin is produced by melanocytes in the epidermis, “packaged” into melanosomes, and distributed to adjacent keratinocytes. The type of melanin and its organization in melanosomes contribute to the various skin colors in humans. ^,

Thermoregulation and sensation

The human body can retain a stable body temperature in various environments because of the thermoregulation function of the skin, which is controlled by the autonomic (involuntary) nervous system. In hot temperatures, the body cools down by sweating, dissipating heat to the environment through evaporation of water on the skin. In cold climate, the hair on the skin stands up to form “goosebumps,” a process called piloerection that prevents warm air from escaping.

The dermis of the skin contains a wide range of sensory receptors and free nerve endings, which allows us to feel pain, temperature, touch, pressure, stretch, and many other types of sensations.

In addition to physiologic functions, the appearance of the skin, such as its color, elasticity, and texture, also reveals one’s ethnicity, age, and general health status. This function of the skin has inspired the development of modern skin care, ranging from topical skin care products to in-office procedures to improve the skin quality.

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